Sample records for central pathology review

  1. Concordance between local, institutional, and central pathology review in glioblastoma: Implications for research and practice: A pilot study

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    Tejpal Gupta


    Full Text Available Background: There is significant inter-observer variation amongst the neuro-pathologists in the typing, subtyping, and grading of glial neoplasms for diagnosis. Centralized pathology review has been proposed to minimize this inter-observer variation and is now almost mandatory for accrual into multicentric trials. We sought to assess the concordance between neuro-pathologists on histopathological diagnosis of glioblastoma. Materials and Methods: Comparison of local, institutional, and central neuro-oncopathology reporting in a cohort of 34 patients with newly diagnosed supratentorial glioblastoma accrued consecutively at a tertiary-care institution on a prospective trial testing the addition of a new agent to standard chemo-radiation regimen. Results: Concordance was sub-optimal between local histological diagnosis and central review, fair between local diagnosis and institutional review, and good between institutional and central review, with respect to histological typing/subtyping. Twelve (39% of 31 patients with local histological diagnosis had identical tumor type, subtype and grade on central review. Overall agreement was modestly better (52% between local diagnosis and institutional review. In contrast, 28 (83% of 34 patients had completely concordant histopathologic diagnosis between institutional and central review. The inter-observer reliability test showed poor agreement between local and central review (kappa statistic=0.12, 95% confidence interval (CI: -0.03-0.32, P=0.043, but moderate agreement between institutional and central review (kappa statistic=0.51, 95%CI: 0.17-0.84, P=0.00003. Agreement between local diagnosis and institutional review was fair. Conclusions: There exists significant inter-observer variation regarding histopathological diagnosis of glioblastoma with significant implications for clinical research and practice. There is a need for more objective, quantitative, robust, and reproducible criteria for better

  2. Recommendations for pathology peer review. (United States)

    Morton, Daniel; Sellers, Rani S; Barale-Thomas, Erio; Bolon, Brad; George, Catherine; Hardisty, Jerry F; Irizarry, Armando; McKay, Jennifer S; Odin, Marielle; Teranishi, Munehiro


    Pathology peer review verifies and improves the accuracy and quality of pathology diagnoses and interpretations. Pathology peer review is recommended when important risk assessment or business decisions are based on nonclinical studies. For pathology peer review conducted before study completion, the peer-review pathologist reviews sufficient slides and pathology data to assist the study pathologist in refining pathology diagnoses and interpretations. Materials to be reviewed are selected by the peer-review pathologist. Consultations with additional experts or a formal (documented) pathology working group may be used to resolve discrepancies. The study pathologist is solely responsible for the content of the final pathology data and report, makes changes resulting from peer-review discussions, initiates the audit trail for microscopic observations after all changes resulting from peer-review have been made, and signs the final pathologist's report. The peer-review pathologist creates a signed peer-review memo describing the peer-review process and confirming that the study pathologist's report accurately and appropriately reflects the pathology data. The study pathologist also may sign a statement of consensus. It is not necessary to archive working notes created during the peer-review process.

  3. Central neurocytoma: a novel appraisal of a polymorphic pathology. Our experience and a review of the literature. (United States)

    Lenzi, Jacopo; Salvati, Maurizio; Raco, Antonino; Frati, Alessandro; Piccirilli, Manolo; Delfini, Roberto


    Central neurocytoma should be considered in the differential diagnosis of intraventricular tumours. The records of 20 patients operated on between 1975 and 2000 for central neurocytoma were retrospectively reviewed, and the histological gradings and clinical outcomes were compared. On the basis of our previous cases, in the latter five of this series, the following therapeutic protocol was adopted. In those cases in which total removal was achieved, no further treatment was given if the MIB-1 index was 4%, a course of conformational radiotherapy was delivered. In subtotally removed cases, radiosurgery with linac was also performed (median dose 20 Gy) as well as conformational radiotherapy whenever there was a recurrence of the lesion (median dose 45 Gy). In cases in which there was only partial cytoreduction, conformational radiotherapy was administered with the adjunct of polychemotherapy if the MIB-1 was >4%. Twenty patients were surgically treated: 11 men and nine women, with an average age of 26 years (range 17 years to 42 years).Total, subtotal and partial removals were achieved in, respectively, ten, three and seven cases. At average follow-up of 7 years, 16 patients had been cured, had significantly improved or were at least stable [Karnofsky performance status score (KPS)] >70 or more)]. On the other hand, four patients had worsened; of these, two had died and two had a KPS=50 and an unfavourable prognosis. The presence of histological atypia has proved to be a significantly negative risk factor for survival (P=0.02) while an MIB score >4% was significantly correlated with an unfavourable outcome (death or worsening of neurological status). The "atypical" neurocytoma seems to be a distinct entity, with a less favourable prognosis and a higher tendency to recur.

  4. Pathology of the Trachea and Central Bronchi. (United States)

    Shroff, Girish S; Ocazionez, Daniel; Vargas, Daniel; Carter, Brett W; Wu, Carol C; Nachiappan, Arun C; Gupta, Pushpender; Restrepo, Carlos S


    A wide variety of disorders can affect the trachea and central bronchi. Computed tomography is the imaging modality of choice in the evaluation of tracheobronchial disease. Tracheobronchial abnormalities are sometimes incidentally detected on routine imaging or when imaging is performed for another reason. Abnormalities of the tracheobronchial tree, however, can be easily missed because they can be subtle. Furthermore, because symptoms in patients with tracheobronchial disorders often overlap symptoms of lung disease, radiologists may focus their attention on the lungs and overlook the tracheobronchial tree. In this article, we review a wide range of tracheobronchial diseases with emphasis on their computed tomographic appearances.

  5. Domoic Acid Toxicologic Pathology: A Review

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    Olga M. Pulido


    Full Text Available Domoic acid was identified as the toxin responsible for an outbreak of human poisoning that occurred in Canada in 1987 following consumption of contaminated blue mussels [Mytilus edulis]. The poisoning was characterized by a constellation of clinical symptoms and signs. Among the most prominent features described was memory impairment which led to the name Amnesic Shellfish Poisoning [ASP]. Domoic acid is produced by certain marine organisms, such as the red alga Chondria armata and planktonic diatom of the genus Pseudo-nitzschia. Since 1987, monitoring programs have been successful in preventing other human incidents of ASP. However, there are documented cases of domoic acid intoxication in wild animals and outbreaks of coastal water contamination in many regions world-wide. Hence domoic acid continues to pose a global risk to the health and safety of humans and wildlife. Several mechanisms have been implicated as mediators for the effects of domoic acid. Of particular importance is the role played by glutamate receptors as mediators of excitatory neurotransmission and the demonstration of a wide distribution of these receptors outside the central nervous system, prompting the attention to other tissues as potential target sites. The aim of this document is to provide a comprehensive review of ASP, DOM induced pathology including ultrastructural changes associated to subchronic oral exposure, and discussion of key proposed mechanisms of cell/tissue injury involved in DOM induced brain pathology and considerations relevant to food safety and human health.

  6. A nationwide study of serous “borderline” ovarian tumors in Denmark 1978–2002: Centralized pathology review and overall survival compared with the general population (United States)

    Hannibal, Charlotte Gerd; Vang, Russell; Junge, Jette; Frederiksen, Kirsten; Kjaerbye-Thygesen, Anette; Andersen, Klaus Kaae; Tabor, Ann; Kurman, Robert J.; Kjaer, Susanne K.


    Objective To describe the study population and estimate overall survival of women with a serous “borderline” ovarian tumor (SBT) in Denmark over 25 years relative to the general population. Methods The Danish Pathology Data Bank and the Danish Cancer Registry were used to identify 1487 women diagnosed with SBTs from 1978 to 2002. The histologic slides were collected from Danish pathology departments and reviewed by expert pathologists and classified as SBT/atypical proliferative serous tumor (APST) or noninvasive low-grade serous carcinoma (LGSC). Associated implants were classified as noninvasive or invasive. Medical records were collected from hospital departments and reviewed. Data were analyzed using Kaplan–Meier and relative survival was estimated with follow-up through September 2, 2013. Results A cohort of 1042 women with a confirmed SBT diagnosis was identified. Women with stage I had an overall survival similar to the overall survival expected from the general population (p = 0.3), whereas women with advanced stage disease had a poorer one (p < 0.0001). This was evident both in women with non-invasive (p < 0.0001) and invasive implants (p < 0.0001). Only among women with advanced stage, overall survival of women with SBT/APST (p < 0.0001) and noninvasive LGSC (p < 0.0001) was poorer than expected from the general population. Conclusions To date this is the largest nationwide cohort of SBTs where all tumors have been verified by expert pathologists. Only in women with advanced stage SBT, overall survival is poorer than in the general population which applies both to women with noninvasive and invasive implants as well as to women with SBT/APST and noninvasive LGSC. PMID:24924123

  7. Directed peer review in surgical pathology. (United States)

    Smith, Maxwell L; Raab, Stephen S


    Second pathologist peer review is used in many surgical laboratory quality-assurance programs to detect error. Directed peer review is 1 method of second review and involves the selection of specific case types, such as cases from a particular site of anatomic origin. The benefits of using the directed peer review method are unique and directed peer review detects both errors in diagnostic accuracy and precision and this detection may be used to improve practice. We utilize the Lean quality improvement A3 method of problem solving to investigate these issues. The A3 method defines surgical pathology diagnostic error and describes the current state in surgical pathology, performs root cause analysis, hypothesizes an ideal state, and provides opportunities for improvement in error reduction. Published data indicate that directed peer review practices may be used to prevent active cognitive errors that lead to patient harm. Pathologists also may use directed peer review data to target latent factors that contribute to error and improve diagnostic precision.

  8. The spectrum of pathology in central core disease. (United States)

    Sewry, C A; Müller, C; Davis, M; Dwyer, J S M; Dove, J; Evans, G; Schröder, R; Fürst, D; Helliwell, T; Laing, N; Quinlivan, R C M


    Central core disease is a congenital myopathy with muscle weakness defined pathologically by the presence of extensive areas in muscle fibres that are devoid of oxidative enzyme activity. The gene responsible has been shown to be the ryanodine receptor 1 on chromosome 19q13 and mutations have now been identified in several patients. Some cases with the morphological defect remain molecularly undefined, particularly those studied before molecular studies were available. We have studied three families with congenital onset, each with a dominantly inherited mutation in a C-terminal exon of the ryanodine receptor 1. They illustrate the spectrum of pathology that can be observed in patients with the myopathic features of central core disease. We show that extensive fibrosis and fat may be present, type 1 fibre uniformity may occur in the absence of cores; cores may be central or peripheral, single or multiple; and that an appearance of multiple focal minicores might cause a diagnostic pathological dilemma. In addition, we show the value of immunocytochemistry in identifying cores, in particular the use of antibodies to desmin and gamma-filamin.

  9. Evolution of occlusal pathology. A literature review.

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    Camilo Guerrero


    Full Text Available Introduction: Many of the guidelines on occlusion and treatment alternatives in dentate and partially edentulous patients, are based on concepts raised in the beginning of dentistry. The diversity of the occlusion schools has become some of these concepts complex to understand and apply. This diversity makes difficult the compression of the occlusal physiology and its disorders, hindering the understanding of the occlusal pathology and its proper diagnosis and management. Objective: This is why we conducted a literature review about oclusal physiology and pathology, in order to gather information based on scientific evidence, which in order to clarify concepts and homogenize knowledge about physiological and morphological changesof thestomatognathic system, associated toocclusal alterations, allowing the future standardization of the occlusal diagnostic process at the Faculty of Dentistry of the National University of Colombia. Methodology: A search was conducted inMedLine, PubMed, Ovid, Ebsco, ScienceDirect and Hinari-Healthinternetwork using the Mesh terms: "Dental Occlusion" - "Stomatognathic System" - "masticatory System" - Temporomandibular Joint and the bibliographies of papers and review articles that had direct relationship to the topic; the publication deadline was not taken into account. In total, 79 articles, 10 texts and 7 websites were obtained. Conclusion: Occlusal pathology is an evolutionary process that might affect the form and/or function of any of the components of the stomatognathic system. Occlusal Harmony is a state in which each part of the system works in concert with the others to fulfill the functions of mastication, speech and swallowing; oral rehabilitation should be directed toward obtaining a harmonious occlusion.

  10. A Review of Select Centralized Pain Syndromes

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    David R. Spiegel


    Full Text Available Pain can be broadly divided into 3 classes, including nociceptive or inflammatory pain (protective, neuropathic (pathological, occurring after damage to the nervous system, or centralized (pathological, due to abnormal function but with no damage or inflammation to the nervous system. The latter has been posited to occur when descending analgesic pathways are attenuated and/or glutamatergic transmission is facilitated. Additionally, this “pain prone phenotype” can be associated with early life trauma and a suboptimal response to opiates. This article will review the relationships between centralized pain syndromes (ie, fibromyalgia, chronic low back pain, childhood sexual abuse, and opiate misuse. Finally, treatment implications, potentially effecting primary care physicians, will be discussed.

  11. The central domains of personality pathology in psychiatric patients. (United States)

    Mulder, Roger T; Newton-Howes, Giles; Crawford, Michael J; Tyrer, Peter J


    There is general agreement that the classification of personality disorders in DSM-IV is unsatisfactory. We systematically reviewed all studies that have analyzed patterns of personality disorder symptoms and signs in psychiatric patients; twenty-two papers were included in the final synthesis. There is reasonable consistency over the number and type of personality pathology traits reported despite differing samples, varying assessment methods, and different statistical manipulations. There are three or four high order traits; an externalizing factor incorporating borderline, narcissistic, histrionic, and antisocial traits (the latter is sometimes recorded as a separate trait); an internalizing factor incorporating avoidant and dependent traits; a schizoid factor; and often a compulsive factor. Using these domains of personality pathology would simplify classification, have higher clinical utility, and allow relatively easy translation of current research.

  12. Surgical pathology and the patient: a systematic review evaluating the primary audience of pathology reports. (United States)

    Mossanen, Matthew; True, Lawrence D; Wright, Jonathan L; Vakar-Lopez, Funda; Lavallee, Danielle; Gore, John L


    The pathology report is a critical document that helps guide the management of patients with cancer. More and more patients read their reports, intending to participate in decisions about their care. However, a substantial subset of patients may lack the ability to comprehend this often technical and complex document. We hypothesized that most literature on pathology reports discusses reports from the perspective of other physicians and not from the perspective of patients. An expert panel of physicians developed a list of search criteria, which we used to identify articles on PubMed, MEDLINE, Cochrane Reviews, and Google Scholar databases. Two reviewers independently evaluated all articles to identify for detailed review those that met search criteria. We identified the primary audience of the selected articles and the degree to which these articles addressed clarity of communication of pathology reports with patients. Of 801 articles identified in our search, 25 involved the formatting of pathology reports for clarity of communication. Recurrent themes in proposed improvements in reports included content standardization, variation in terminology, clarity of communication, and quality improvement. No articles discussed patients as their target audience. No study evaluated the health literacy level required of patients to comprehend pathology reports. In summary, there is a scarcity of patient-centered approaches to improve pathology reports. The literature on pathology reports does not include patients as a target audience. Limited resources are available to help patients comprehend their reports. Efforts to improve patient-centered communication are desirable to address this overlooked aspect of patient care.

  13. Imaging of Adult Ocular and Orbital Pathology - a Pictorial Review (United States)

    Grech, Reuben; Cornish, Kurt Spiteri; Galvin, Patrick Leo; Grech, Stephan; Looby, Seamus; O’Hare, Alan; Mizzi, Adrian; Thornton, John; Brennan, Paul


    Orbital pathology often presents a diagnostic challenge to the reporting radiologist. The aetiology is protean, and clinical input is therefore often necessary to narrow the differential diagnosis. With this manuscript, we provide a pictorial review of adult ocular and orbital pathology. PMID:24967016

  14. Evolution of occlusal pathology. A literature review.



    Introduction: Many of the guidelines on occlusion and treatment alternatives in dentate and partially edentulous patients, are based on concepts raised in the beginning of dentistry. The diversity of the occlusion schools has become some of these concepts complex to understand and apply. This diversity makes difficult the compression of the occlusal physiology and its disorders, hindering the understanding of the occlusal pathology and its proper diagnosis and management. Objective: This is w...

  15. Book Review - Telepractice in Speech-Language Pathology

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    Jean Blosser


    Full Text Available This article presents a review of the book: Telepractice in Speech-Language Pathology, authored by K. Todd Houston, PhD, CCC-SLP, LSLS Cert. AVT, and 20 contributing authors.   This is the first book entirely devoted to the delivery of speech-language pathology services at a distance. It provides practical information that includes: technical requirements, policy and regulatory issues, current applications in speech-language pathology, international perspectives on practice, and tele-supervision. Reviewer Dr. Jean Blosser highly recommends the work as a comprehensive resource on the topic of telepractice.  

  16. Pathologic features and clinical outcome of central neurocytoma:analysis of 15 cases

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    Yu Li; Xiu-Feng Ye; Guo Qian; Yu Yin; Qian-Guan Pan


    Objective:To get better recognition of central neurocytoma and diminish misdiagnosis.Methods:A retrospective review identified 15 cases of central neurocytoma.All cases of central neurocytoma were analyzed for their clinical symptoms,pathologic changes,immunohistochemical staining,prognosis and differential diagnosis.Clinical follow up was performed.Results:There were 8 males and 7 females aged 10-64 years (median 32.93 years).The most common presenting symptoms were those related to increased intracranial pressure (ICP),including headache (100%),papilledema (93%) and vomiting (80%).All tumors were located in the ventricular system.The tumors were composed of uniform cells with round nuclei and a fine chromatin pattern,and in some areas,small cells with perinuclear halo could be seen.In particular,the anuclear areas may have a fine fibrillary matrix (neuropil).Nuclear atypia and vascular proliferation appeared in two cases,respectively.Focal necrosis could be seen in one case.Immunohistochemical findings included expression of synaptophysin (15/15),neuron specific enolase (12/15) and glial fibrillary acidic protein (GFAP) (3/15).MIB-1 proliferation index ranged from 0.8-12.5%,and was more than 2% in 3 of 15 cases assessed.Follow-up information of 11 patients was available.Conclusions:Central neurocytoma has a favorable prognosis in general,but in some cases,the clinical course could be aggressive.Increase of GFAP positivity,proliferation index and vascular proliferation might suggest a more malignant process.

  17. Methanol intoxication: pathological changes of central nervous system (17 cases). (United States)

    Karayel, Ferah; Turan, Arzu A; Sav, Aydin; Pakis, Isil; Akyildiz, Elif U; Ersoy, Gokhan


    The nervous system has increased susceptibility for methanol intoxication. The aim of this study is to investigate various central nervous system lesions of methanol intoxication in 17 cases autopsied in the mortuary department of the Council of Forensic Medicine in Istanbul, Turkey. The reasons of methanol intoxication in the cases was likely the unwitting ingestion of methanol while drinking illegal alcohol. Survival times ranged from several hours to days. In 8 cases (47%), cerebral edema and in 9 cases (53%) at occipital, temporal and parietal cortex, basal ganglia and pons, petechial bleeding was observed. In addition to these findings, hemorrhagic necrosis were observed in thalamus, putamen, and globus pallidus in 5 cases (29.4%) and, in cerebral cortex in another 3 cases (17.6%). In 3 of the cases (17.6%) in which cerebral edema was found, herniation findings accompanied to the situation and in 2 cases (11.7%), pons bleeding was observed. Around the basal ganglia, in 2 of the cases with hemorrhagic necrosis, the situation ended with a ventricular compression. In 7 cases (41%), the associated findings of chronic ischemic changes in cortical neurons, lacunae formation, degeneration of granular cell layer of the cerebellum, and reactive gliosis were considered as the results of chronic alcoholism.

  18. Metabolic and infectious pathologies in Brazilian medical literature: a review

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    Mauricio Rocha-e-Silva


    Full Text Available OBJECTIVE: This review of original reports on metabolic and infectious diseases that were recently published in Brazilian journals is designed to inform the readership of CLINICS about their content. METHODS: I conducted a search in PubMed for original research articles (clinical or basic research recently published (2008-2009 by Brazilian medical and biological periodicals. Papers on metabolic pathologies were retrieved by searching for appropriate keywords such as metabolic syndrome and obesity. Papers on infectious disease were obtained by entering 15 different keywords for the most commonly occurring pathologies. Review articles, editorials, letters to the editor, and case reports were manually excluded. Selected titles were then categorized into appropriate sub-categories. RESULTS: This search produced a total of 123 articles, which filtered down to 72 articles after eliminating editorials, review articles, letters to the Editor and case reports. Reviewed periodicals were Arquivos Brasileiros de Cardiologia, Arquivos Brasileiros de Endocrinologia e Metabologia, Brazilian Journal of Biological and Medical Research, Brazilian Journal of Infectious Diseases, Jornal de Pediatria, Jornal de Pneumologia, Revista da Associação Médica Brasileira, Revista da Escola de Enfermagem da Universidade de São Paulo, and São Paulo Medical Journal. The articles were then briefly summarized.

  19. Central nervous system tumors: Radiologic pathologic correlation and diagnostic approach

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    Ishita Pant


    Full Text Available Objective: This study was conducted to formulate location-wise radiologic diagnostic algorithms and assess their concordance with the final histopathological diagnosis so as to evaluate their utility in a rural setting where only basic facilities are available. Materials and Methods: A retrospective analysis to assess the concordance of radiology (primarily MRI with final histopathology report was done. Based on the most common incidence of tumor location and basic radiology findings, diagnostic algorithms were prepared. Results: For supratentorial intraaxial parenchymal location concordance was seen in all high-grade astrocytomas, low- and high-grade oligodendrogliomas, metastatic tumors, primitive neuroectodermal tumors, high-grade ependymomas, neuronal and mixed neuro-glial tumors and tumors of hematopoietic system. Lowest concordance was seen in low-grade astrocytomas. In the supratentorial intraaxial ventricular location, agreement was observed in choroid plexus tumors, ependymomas, low-grade astrocytomas and meningiomas; in the supratentorial extraaxial location, except for the lack of concordance in the only case of metastatic tumor, concordance was observed in meningeal tumors, tumors of the sellar region, tumors of cranial and paraspinal nerves; the infratentorial intraaxial parenchymal location showed agreement in low- as well as high-grade astrocytomas, metastatic tumors, high-grade ependymoma, embryonal tumors and hematopoietic tumors; in the infratentorial intraaxial ventricular location, except for the lack of concordance in one case of low-grade astrocytoma and two cases of medulloblastomas, agreement was observed in low- and high-grade ependymoma; infratentorial extraaxial tumors showed complete agreement in all tumors of cranial and paraspinal nerves, meningiomas, and hematopoietic tumors. Conclusion: A location-based approach to central nervous system (CNS tumors is helpful in establishing an appropriate differential diagnosis.

  20. NCI Central Review Board Receives Accreditation (United States)

    The Association for the Accreditation of Human Research Protection Programs has awarded the NCI Central Institutional Review Board full accreditation. AAHRPP awards accreditation to organizations demonstrating the highest ethical standards in clinical res

  1. Central sensitization in chronic low back pain: A narrative review. (United States)

    Sanzarello, Ilaria; Merlini, Luciano; Rosa, Michele Attilio; Perrone, Mariada; Frugiuele, Jacopo; Borghi, Raffaele; Faldini, Cesare


    Low back pain is one of the four most common disorders in all regions, and the greatest contributor to disability worldwide, adding 10.7% of total years lost due to this health state. The etiology of chronic low back pain is, in most of the cases (up to 85%), unknown or nonspecific, while the specific causes (specific spinal pathology and neuropathic/radicular disorders) are uncommon. Central sensitization has been recently recognized as a potential pathophysiological mechanism underlying a group of chronic pain conditions, and may be a contributory factor for a sub-group of patients with chronic low back pain. The purposes of this narrative review are twofold. First, to describe central sensitization and its symptoms and signs in patients with chronic pain disorders in order to allow its recognition in patients with nonspecific low back pain. Second, to provide general treatment principles of chronic low back pain with particular emphasis on pharmacotherapy targeting central sensitization.

  2. Central nervous system lesions in adult T-cell leukaemia: MRI and pathology

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    Kitajima, M.; Korogi, Y.; Shigematsu, Y.; Liang, L.; Takahashi, M. [Department of Radiology, Kumamoto University School of Medicine, Honjo, Kumamoto (Japan); Matsuoka, M. [Second Division of Internal Medicine, Kumamoto University School of Medicine, Honjo, Kumamoto (Japan); Yamamoto, T. [Department of Pathology, Kumamoto University School of Medicine, Honjo, Kumamoto (Japan); Jhono, M. [Department of Dermatology, Kumamoto University School of Medicine, Honjo, Kumamoto (Japan); Eto, K. [The National Institute for Minamata Disease, Minamata (Japan)


    Adult T-cell leukaemia (ATL) is a T-cell lymphoid neoplasm caused by human T-cell leukaemia virus type I (HTLV-I). Radiological findings in central nervous system (CNS) involvement have not been well characterised. We reviewed the MRI of 18 patients with ATL who developed new neurological symptoms or signs, and pathology specimens from a 53-year-old woman who died of ATL. MRI findings were divided into three categories: definite, probable, and other abnormal. Definite and probable findings were defined as ATL-related. The characteristic findings were multiple parenchymal masses with or without contrast enhancement adjacent to cerebrospinal fluid (CSF) spaced and the deep grey matter of both cerebral hemispheres, plus leptomeningeal lesion. One patient had both cerebral and spinal cord lesions. Other abnormal findings in eight patients included one case of leukoencephalopathy caused by methotrexate. The histology findings consisted of clusters of tumour cells along perivascular spaces, and scattered infiltration of the parenchyma, with nests of tumour cells. Leptomeningeal infiltration by tumour spread into the parenchyma and secondary degeneration of the neuronal tracts was observed. MRI was useful for detecting CNS invasion by ATL and differentiating it from other abnormalities. The MRI findings seemed to correlate well with the histological changes. (orig.)

  3. Central registry in psychiatry: A structured review

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    Jyoti Prakash


    Full Text Available Background: Central registry in psychiatry is being practiced in few countries and has been found useful in research and clinical management. Role of central registry has also expanded over the years. Materials and Methods: All accessible internet database Medline, Scopus, Embase were accessed from 1990 till date. Available data were systematically reviewed in structured manner and analyzed. Results: Central registry was found useful in epidemiological analysis, association studies, outcome studies, comorbidity studies, forensic issue, effective of medication, qualitative analysis etc., Conclusion: Central registry proves to be effective tool in quantitative and qualitative understanding of psychiatry practice. Findings of studies from central registry can be useful in modifying best practice and evidence based treatment in psychiatry.

  4. Reviewing Two Types of Addiction - Pathological Gambling and Substance Use

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    Seyed Amir Jazaeri


    Full Text Available Gambling, including pathological gambling and problem gambling, has received increased attention from clinicians and researchers over the past three decades since gambling opportunities have expanded around the world. Gambling disorders affect 0.2-5.3% of adults worldwide, although measurement and prevalence varies according to the screening instruments and methods used, and availability and accessibility of gambling opportunities. Several distinct treatment approaches have been favorably evaluated, such as cognitive behavioral and brief treatment models and pharmacological interventions. Although promising, family therapy and support from Gamblers Anonymous are less well empirically supported. Gambling disorders are highly comorbid with other mental health and substance use disorders, and a further understanding is needed of both the causes and treatment implications of this disorder. This article reviews definition, causes and associated features with substance abuse, screening and diagnosis, and treatment approaches.

  5. Horseshoe kidney: a review of anatomy and pathology. (United States)

    Natsis, Konstantinos; Piagkou, Maria; Skotsimara, Antonia; Protogerou, Vassilis; Tsitouridis, Ioannis; Skandalakis, Panagiotis


    Horseshoe kidney (HSK) is the most common renal fusion, which is characterized by three anatomic anomalies: ectopia, malrotation and vascular changes. Patients with HSK are prone to a variety of complications, genitourinary and non-genitourinary. In this paper, the anatomy of HSK is delineated with a great emphasis on its blood supply. After reviewing the literature, the arterial supply patterns found by each author were categorized according to the classification system proposed by Graves. The majority of HSKs were found to be supplied by renal arteries derived from the abdominal aorta below the isthmus or by vessels originating from the common iliac arteries. In addition, the abnormalities associated with HSK are highlighted and classified in anatomical variations, congenital anomalies as well as in pathologic conditions related to HSK.

  6. [Ultrasound-guided central venous access in adults and children: Procedure and pathological findings]. (United States)

    Scheiermann, P; Seeger, F H; Breitkreutz, R


    Central venous line placement is a standard procedure in critical care and peri-operative medicine. This procedure can be associated with severe complications. In contrast to the landmark technique, ultrasound-guided punctures can significantly reduce the rate of complications. Patients with a high risk for difficult vascular access include critical care and emergency patients as well as patients on anticoagulation medication and dialysis. Placement of central venous catheters can be difficult in ventilated patients and if there has been prior surgery in the puncture area. In children and small infants central venous access can also be challenging due to the anatomical relationship in the head and neck region. Puncture techniques are explained briefly by means of ultrasound anatomy. Typical ultrasonographic images visualize pathological findings in order to identify dangers and complications in central venous catheterization.

  7. Oxidative Stress Is a Central Target for Physical Exercise Neuroprotection Against Pathological Brain Aging. (United States)

    García-Mesa, Yoelvis; Colie, Sandra; Corpas, Rubén; Cristòfol, Rosa; Comellas, Francesc; Nebreda, Angel R; Giménez-Llort, Lydia; Sanfeliu, Coral


    Physical exercise is suggested for preventing or delaying senescence and Alzheimer's disease (AD). We have examined its therapeutic value in the advanced stage of AD-like pathology in 3xTg-AD female mice through voluntary wheel running from 12 to 15 months of age. Mice submitted to exercise showed improved body fitness, immunorejuvenation, improvement of behavior and cognition, and reduced amyloid and tau pathology. Brain tissue analysis of aged 3xTg-AD mice showed high levels of oxidative damage. However, this damage was decreased by physical exercise through regulation of redox homeostasis. Network analyses showed that oxidative stress was a central event, which correlated with AD-like pathology and the AD-related behaviors of anxiety, apathy, and cognitive loss. This study corroborates the importance of redox mechanisms in the neuroprotective effect of physical exercise, and supports the theory of the crucial role of oxidative stress in the switch from normal brain aging to pathological aging and AD.

  8. Pathologic features of metastatic lymph nodes identified from prophylactic central neck dissection in patients with papillary thyroid carcinoma. (United States)

    Lee, Hyoung Shin; Park, Chanwoo; Kim, Sung Won; Noh, Woong Jae; Lim, Soo Jin; Chun, Bong Kwon; Kim, Beom Su; Hong, Jong Chul; Lee, Kang Dae


    The importance of pathologic features of metastatic lymph nodes (LNs), such as size, number, and extranodal extension, has been recently emphasized in patients with papillary thyroid carcinoma (PTC). We evaluated the characteristics of metastatic LNs identified after prophylactic central neck dissection (CND) in patients with PTC. We performed a retrospective review of 1,046 patients who underwent unilateral or bilateral thyroidectomy with ipsilateral prophylactic CND. We reviewed the characteristics of the metastatic LNs and analyzed their correlation to the clinicopathologic characteristics of the primary tumor. Cervical LN metastasis after prophylactic CND was identified in 280 out of 1046 patients (26.8 %). The size of metastatic foci (≥2 mm) was independently correlated with primary tumor size (≥1 cm) (p = 0.016, OR = 1.88). Primary tumor size (≥1 cm) was also correlated to the number of metastatic LNs (≥5) (p = 0.004, OR = 3.14) and extranodal extension (p = 0.021, OR = 2.41) in univariate analysis. The size of the primary tumor affects pathologic features of subclinical LN metastasis in patients with PTC. Patients with primary tumors ≥1 cm have an increased risk of larger LN metastases (≥2 mm), an increased number of LN metastases (≥5), and a higher incidence of ENE, which should be considered in decision for prophylactic CND.

  9. Skin wounds vitality markers in forensic pathology: An updated review. (United States)

    Casse, Jean-Matthieu; Martrille, Laurent; Vignaud, Jean-Michel; Gauchotte, Guillaume


    Wound age evaluation is one of the most challenging issues in forensic pathology. In the first minutes or hours, standard histological examination may not determine whether the wound was inflicted in the pre- or post-mortem period. While red blood cell infiltration is classically considered as a sign of vital reaction, several studies have shown that extravasation of blood cells may also occur after death and cannot be used as a reliable marker in the diagnosis of wound vitality. Numerous studies about wound vitality are available in the literature. They have evaluated markers involved in coagulation or inflammation, using various methods such as enzymology, molecular biology or immunohistochemistry. In this update, we first introduce some methodological principles. Then, we review the main studies available in the literature. Immunohistochemistry seems to be the most valuable method, given its easy application and the possibility to analyse the localization of the molecules of interest. Some markers are promising, such as CD15, TNFα, IL-6, IL-1β, TGFα or TGFβ1. Prior to their application in daily practice, these early results need to be confirmed with other studies, conducted by independent teams and integrating multiple controls. Most notably, the antibodies have to be tested in numerous post-mortem wounds. Indeed, a critical risk of overexpression in post-mortem wounds is present. Some promising markers have been later invalidated because of post-mortem false positivity. Finally, optimal sensitivity and specificity values could probably be reached by combining several markers, validated by large groups of pre- and post-mortem wounds.

  10. Cystosarcoma phyllodes: Pathological enigma: A retrospective review of 162 cases

    Directory of Open Access Journals (Sweden)

    R P Narayanakar


    Full Text Available Purpose: Phyllodes tumor (PT is a rare fibroepithelial neoplasm comprising <1% of all breast tumors. Clinical spectrum ranges from benign (B, borderline (BL, and locally recurrent to malignant (M and metastatic type. The aim of our study was to analyze the clinicopathological factors, compare treatment options, and evaluate outcome in patients with PT. Methods: We retrospectively reviewed 162 women with PT. The surgical intervention varied from simple excision (lumpectomy/wide local excision (WLE in benign cases to simple/modified radical or radical mastectomy (SM/MRM/RM in malignant and recurrent tumors. Results: Out of 162 patients, B, BL, and M were 95 (58.64%, 29 (18%, and 38 (23.45%, respectively. Mean age, duration of lump, and size were 38 ± 8 years, 28 ± 10 months, and 12 ± 5 cm, respectively. Recurrence rate with B, BL, and M was 15.78%, 41.37%, and 55.26%, respectively (P = 0.00001. As compared to WLE (22%, SM (23.8%, and MRM/RM (14.2%, recurrence was higher with lumpectomy (48.9% (P = 0.004. Positive correlation was found between recurrence rate with the size of tumor (P = 0.008 and also number of recurrence with holoprosencephaly (P = 0.047. There was no association between the number of recurrences and size of tumor (P = 0.63. Malignant PT was seen in 38 (24% and distant metastasis was seen in 7 (18%. Mean duration of follow-up was 42 months. Conclusion: WLE with negative margins should be the initial surgery for PT. The role of adjuvant radiotherapy and chemotherapy is uncertain. PT is pathological enigma. Till date, no factors can accurately predict the recurrence and outcome. PT is known for unpredictable behavior and high recurrence rates, hence long-term follow-up is advised.

  11. Management of intracranial pathology during pregnancy: Case example and review of management strategies

    Directory of Open Access Journals (Sweden)

    Vijay M Ravindra


    Conclusions:Pregnancy presents a challenge for any patient requiring neurosurgical intervention. We present an interesting case example with a rare central nervous system neoplasm and discuss the management of intracranial pathology in pregnant patients.

  12. Biocultural implications of oral pathology in an ancient Central California population. (United States)

    Griffin, Mark C


    Bioarchaeologists have long noted two unusual trends in the dentitions of prehistoric Native Californian populations: high rates of wear and low prevalence of caries. The Central California site of CA-CCO-548 offers a unique opportunity to examine the relationship between oral pathology and extreme dental wear in a large (n = 480), ancient (4,300–3,100 BP), and temporally well-defined population sample. This study specifically examines three interrelated processes of the oral cavity in this population: dental wear, dental caries, and periodontal disease. The results show high levels of dental wear (average of 6.1, Smith system), low frequencies of carious lesions (2.5%), low frequencies of periodontal disease (17.8%), and high frequencies of periapical abscesses (10.7%). The pathological processes examined here have complicated multifactorial etiologies. However, they all share the common primary etiological agents of facultative pathogenic bacteria proliferation in the oral biofilm. Integration of the current etiological explanations for infections of the oral cavity, information from the ethnographic record pertaining to subsistence and activity patterns in Native Californian populations, and statistical analysis of specific disease and wear patterns leads to a novel explanation for the observed pattern of oral pathology in this population sample. Specifically, the introduction of antibacterial compounds through dietary items and non-alimentary tooth use is suggested as the most likely explanation for the unusually low prevalence of dental caries and periodontal disease.

  13. Pathological and Clinical Correlation between Celiac Disease and Helicobacter Pylori Infection; a Review of Controversial Reports. (United States)

    Rostami-Nejad, Mohammad; Javad Ehsani-Ardakani, Mohammad; Assadzadeh, Hamid; Shahbazkhani, Bijan; Ierardi, Enzo; Losurdo, Giuseppe; Zojaji, Homayon; Alizadeh, Amirhoshang Mohammad; Naderi, Nosratollah; Sadeghi, Amir; Zali, Mohammad Reza


    There are overwhelming reports and descriptions about celiac associated disorders. Although there is a clear genetic association between celiac disease (CD) and some gastrointestinal disorders, there are controversial reports claiming an association between CD and Helicobacter pylori (H. pylori) infection. Different studies indicated the possible association between lymphocytic gastritis and both CD and H. pylori infection, although this evidence is not consistently accepted. Also it was shown that an increase in intraepithelial lymphocytes count is associated with both H. pylori infection and celiac disease. Therefore the following questions may raise: how far is this infection actually related to CD?, which are the underlying patho-mechanisms for these associations? what are the clinical implications? what is the management? and what would be the role of gluten free diet in treating these conditions? PubMed (PubMed Central), Ovid, ISI of web knowledge, and Google scholar were searched for full text articles published between 1985 and 2015. The associated keywords were used, and papers described particularly the impact of pathological and clinical correlation between CD and H. pylori infection were identified. In this review we tried to answer the above questions and discussed some of the recent developments in the pathological and clinical aspects of CD and H. pylori infection.

  14. Imaging of adult ocular and orbital pathology--a pictorial review. (United States)

    Grech, Reuben; Cornish, Kurt Spiteri; Galvin, Patrick Leo; Grech, Stephan; Looby, Seamus; O'Hare, Alan; Mizzi, Adrian; Thornton, John; Brennan, Paul


    Orbital pathology often presents a diagnostic challenge to the reporting radiologist. The aetiology is protean, and clinical input is therefore often necessary to narrow the differential diagnosis. With this manuscript, we provide a pictorial review of adult ocular and orbital pathology.

  15. Towards a consensus definition of pathological video-gaming: A systematic review of psychometric assessment tools

    NARCIS (Netherlands)

    King, Daniel L.; Haagsma, Maria C.; Delfabbro, Paul H.; Gradisar, Michael; Griffiths, Mark D.


    Pathological video-gaming, or its proposed DSM-V classification of “Internet Use Disorder”, is of increasing interest to scholars and practitioners in allied health disciplines. This systematic review was designed to evaluate the standards in pathological video-gaming instrumentation, according to C

  16. Novel Indications for Benzodiazepine Antagonist Flumazenil in GABA Mediated Pathological Conditions of the Central Nervous System. (United States)

    Hulse, Gary; Kelty, Erin; Hood, Sean; Norman, Amanda; Basso, Maria Rita; Reece, Albert Stuart


    This review paper discusses the central role of gamma-aminobutyric acid (GABA) in diverse physiological systems and functions and the therapeutic potential of the benzodiazepine antagonist flumazenil (Ro 15- 1788) for a wide range of disorders of the central nervous system (CNS). Our group and others have studied the potential of flumazenil as a treatment for benzodiazepine dependence. A small but growing body of research has indicated that flumazenil may also have clinical application in CNS disorders such as Parkinson's disease, idiopathic hypersomnia and amyotrophic lateral sclerosis. Despite this body of research the therapeutic potential of flumazenil remains poorly understood and largely unrealized. The purpose of this paper is not to provide an exhaustive review of all possible therapeutic applications for flumazenil but rather to stimulate research interest, and discussion of the exciting therapeutic potential of this drug for a range of chronic debilitating conditions.

  17. Why gamblers fail to win: a review of cognitive and neuroimaging findings in pathological gambling

    NARCIS (Netherlands)

    R.J. van Holst; W. van den Brink; D.J. Veltman; A.E. Goudriaan


    The purpose of this review is to gain more insight in the neuropathology of pathological gambling (PG) and problem gambling, and to discuss challenges in this research area. Results from the reviewed PG studies show that PG is more than just an impulse control disorder. PG seems to fit very well wit

  18. Pathologic and post-operative conditions of the plantar fascia: review of MR imaging appearances. (United States)

    Yu, J S


    Magnetic resonance (MR) imaging has emerged as an important noninvasive diagnostic imaging technique for assessment of foot pathology. This modality, owing to its multiplanar imaging capability and inherent superiority in contrast, has been shown to be more accurate and sensitive for detection of plantar fascia pathology than any other imaging method. One of the most important and recognizable causes of heel pain is plantar fasciitis. With the exception of plantar fasciitis, there has been little emphasis on imaging other conditions that affect this important structure. The objective of this review is to demonstrate, from a perspective of MR imaging, the many different pathologic conditions that affect the plantar fascia. Included in this review will be a discussion of normal anatomy as well as entities such as acute plantar fasciitis, chronic plantar fasciitis, traumatic rupture, normal post-surgical changes, pathologic post-fasciotomy conditions, infection, and fibromatosis.

  19. Pathologic and post-operative conditions of the plantar fascia: review of MR imaging appearances

    Energy Technology Data Exchange (ETDEWEB)

    Yu, J.S. [Ohio State Univ., Columbus (United States). Dept. of Radiology


    Magnetic resonance (MR) imaging has emerged as an important noninvasive diagnostic imaging technique for assessment of foot pathology. This modality, owing to its multiplanar imaging capability and inherent superiority in contrast, has been shown to be more accurate and sensitive for detection of plantar fascia pathology than any other imaging method. One of the most important and recognizable causes of heel pain is plantar fasciitis. With the exception of plantar fasciitis, there has been little emphasis on imaging other conditions that affect this important structure. The objective of this review is to demonstrate, from a perspective of MR imaging, the many different pathologic conditions that affect the plantar fascia. Included in this review will be a discussion of normal anatomy as well as entities such as acute plantar fasciitis, chronic plantar fasciitis, traumatic rupture, normal post-surgical changes, pathologic post-fasciotomy conditions, infection, and fibromatosis. (orig.)

  20. Pathologic Correlates of Primary Central Nervous System Lymphoma Defined in an Orthotopic Xenograft Model (United States)

    Kadoch, Cigall; Dinca, Eduard B.; Voicu, Ramona; Chen, Lingjing; Nguyen, Diana; Parikh, Seema; Karrim, Juliana; Shuman, Marc A.; Lowell, Clifford A.; Treseler, Patrick A.; James, C. David; Rubenstein, James L.


    Purpose The prospect for advances in the treatment of patients with primary central nervous system lymphoma (PCNSL) is likely dependent on the systematic evaluation of its pathobiology. Animal models of PCNSL are needed to facilitate the analysis of its molecular pathogenesis and for the efficient evaluation of novel therapeutics. Experimental Design We characterized the molecular pathology of CNS lymphoma tumors generated by the intracerebral implantation of Raji B lymphoma cells in athymic mice. Lymphoma cells were modified for bioluminescence imaging to facilitate monitoring of tumor growth and response to therapy. In parallel, we identified molecular features of lymphoma xenograft histopathology that are evident in human PCNSL specimens. Results Intracerebral Raji tumors were determined to faithfully reflect the molecular pathogenesis of PCNSL, including the predominant immunophenotypic state of differentiation of lymphoma cells and their reactive microenvironment. We show the expression of interleukin-4 by Raji and other B lymphoma cell lines in vitro and by Raji tumors in vivo and provide evidence for a role of this cytokine in the M2 polarization of lymphoma macrophages both in the murine model and in diagnostic specimens of human PCNSL. Conclusion Intracerebral implantation of Raji cells results in a reproducible and invasive xenograft model, which recapitulates the histopathology and molecular features of PCNSL, and is suitable for preclinical testing of novel agents. We also show for the first time the feasibility and accuracy of tumor bioluminescence in the monitoring of a highly infiltrative brain tumor. PMID:19276270

  1. Pathology of the appendix in children: an institutional experience and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Rabah, Raja [Wayne State University, Department of Pathology, Children' s Hospital of Michigan, Detroit, MI (United States)


    The appendix can be affected by a variety of congenital and acquired diseases, but acute appendicitis is the most common pathology found in the pediatric population. This is a retrospective review of all appendectomies performed during a 2-year period at a major children's hospital with a review of the literature regarding the most common pathologic findings. The pathology database was reviewed for appendectomy specimens, and patient medical records were evaluated to determine the age, gender, race and operative diagnosis. All slides were reviewed and the histologic findings were recorded. A total of 392 appendectomies were performed, including 68 incidental appendectomies and 324 performed for clinical suspicion of acute appendicitis. In 247 of the latter, acute appendicitis was confirmed histologically, and of the remainder 14 were interval appendectomies, 2 had findings suspicious for Crohn disease, 1 confirmed diverticulitis and 60 were histologically negative for appendicitis. Acute appendicitis is the most common pathologic cause of appendectomy, but various other pathologic entities are found in children. Examination of the appendix is warranted even when it appears normal on exploration. (orig.)

  2. Abdominal tuberculosis in Ahmadi, Kuwait: a clinico-pathological review. (United States)

    Abdul-Ghaffar, N U; Ramadan, T T; Marafie, A A


    For studying abdominal tuberculosis (TB) in Ahmadi, files off all patients admitted to our hospital with abdominal TB over 15 years (1981-1996) were reviewed. Nineteen patients are reported here. Young adults were predominant in our study. The non-Arab Asians were the most frequently affected group in relation to their population in Ahmadi, and Kuwaitis were the least frequently affected group. Abdominal pain, sweating, anorexia and fever were the most frequent presenting symptoms. Ascites and intestinal obstruction were the most frequent clinical presentations. Two patients presented with acute appendicitis and one patient had tuberculous pancreatitis. Abdominal lymph nodes, peritoneum, ileum and and caecum were the most frequently affected abdominal structures. We found laparoscopy very helpful in diagnosis of abdominal TB and we recommend it as the diagnostic method of choice. All our patients responded well to antituberculous chemotherapy. It should be kept in mind that abdominal TB still affects the indigenous and expatriate population of Kuwait.

  3. Upper gastrointestinal barium evaluation of duodenal pathology: A pictorial review

    Institute of Scientific and Technical Information of China (English)

    Pankaj; Gupta; Uma; Debi; Saroj; Kant; Sinha; Kaushal; Kishor


    Like other parts of the gastrointestinal tract(GIT), duodenum is subject to a variety of lesions both congenital and acquired. However, unlike other parts of the GIT viz. esophagus, rest of the small intestine and large intestine, barium evaluation of duodenal lesions is technically more challenging and hence not frequently reported. With significant advances in computed tomography technology, a thorough evaluation including intraluminal, mural and extramural is feasible in a single non-invasive examination. Notwithstanding, barium evaluation still remains the initial and sometimes the only imaging study in several parts of the world. Hence,a thorough acquaintance with the morphology of various duodenal lesions on upper gastrointestinal barium examination is essential in guiding further evaluation. We reviewed our experience with various common and uncommon barium findings in duodenal abnormalities.

  4. Interleukin-1 in the central nervous system: from physiology to pathology. (United States)

    Tringali, G; Dello Russo, C; Preziosi, P; Navarra, P


    A classification on the basis of time-course effect is proposed to describe the pleiotropic actions of interleukin-1 (IL-1) on the central nervous system (CNS); two main time-frames, minutes-to-days and days-to-years, are distinguished. The former includes the central aspects of acute-phase response with fever, altered food and water intake, sleepiness, sickness behaviour and neuroendocrine changes. Apart from stress response triggered by immune-inflammatory stimuli, the concept that IL-1 mediates other types of stress is also reviewed, showing that the cytokine may have a role in mediating hypothalamic responses to restrain stress and nociceptive stimuli. The days-to-years time-frame includes several CNS disorders accompanied by inappropriate and/or sustainedly elevated IL-beta production: ischaemia, Alzheimer's disease, HIV-related dementia and experimental allergic encephalomyelitis-multiple sclerosis. In all cases, IL-beta is not envisioned as an aetiological factor, but it contributes significantly to the maintenance of disease state. Current and perspective therapeutic approaches involving the modulation of IL-beta production and effects are briefly discussed.

  5. Review of Metaplastic Carcinoma of the Breast: Imaging Findings and Pathologic Features

    Directory of Open Access Journals (Sweden)

    Rebecca Leddy


    Full Text Available Metaplastic carcinoma (MPC, an uncommon but often aggressive breast cancer, can be challenging to differentiate from other types of breast cancer and even benign lesions based on the imaging appearance. It has a variable pathology classification system. These types of tumors are generally rapidly growing palpable masses. MPCs on imaging can present with imaging features similar to invasive ductal carcinoma and probably even benign lesions. The purpose of this article is to review MPC of the breast including the pathology subtypes, imaging features, and imaging pathology correlations. By understanding the clinical picture, pathology, and overlap in imaging characteristics of MPC with invasive ductal carcinoma and probably benign lesions can assist in diagnosing these difficult malignancies.

  6. International Clinical Guidelines for the Adoption of Digital Pathology: A Review of Technical Aspects. (United States)

    García-Rojo, Marcial


    Digital slides, also called whole-slide images, are being evaluated to replace conventional microscopy, and several guidelines have been published. This paper reviews technical specifications of digital pathology systems that have been included in the guidelines and position papers from the Canadian Association of Pathologists, the College of American Pathologists, the American Telemedicine Association, the Digital Pathology Association, the Food and Drug Administration, the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, the Society of Toxicologic Pathology, the European Commission, the Spanish Society of Anatomic Pathology, The Royal College of Pathologists and The Royal College of Pathologists of Australasia. In conclusion, most technical aspects are well covered by these guidelines, although they offer limited information regarding image quality and compression, and file formats.

  7. The Use of Multislice Spiral CT to Predict the Resectability of Central Lung Cancer: Correlation with Pathologic and Surgical Findings

    Institute of Scientific and Technical Information of China (English)

    Yang Liu; Yu'e Sun; Naikang Zhou; Qiming Xu


    OBJECTIVE To assess the accuracy of multi-slice spiral CT (MSCT) with imaging reconstruction in judging central pulmonary vascular involvement from central lung cancer, and to explore its ability to predict the resectability of lung cancer.METHODS MSCTs were conducted on 48 patients who were diagnosed preoperatively with central lung cancer. Images of pulmonary arteries and veins that might affect Iobectomy or pneumonectomy were reconstructed by means of imaging processing techniques. Then the relationship of the tumor to the vessels was assessed prospectively on both axial CT images and axial CT images plus reconstructed images(CT-RI) in comparison to subsequent pathologic and surgical findings.RESULTS MSCTs were obtained on all 48 patients whom 42 underwent thoracotomy, Iobectomy or pneumonectomy. Compared with the axial CT images,CT-RI was more accurate in judging the relationship of the central pulmonary vessels to the tumor based on subsequent pathologic 78 vessels studiedand surgical findings (186 vessels studied) (0.01 <P<0.05). The sensitivity and positive predictive value of unresectability of the vessels were all remarkably higher with CT-RI (P<0.01).CONCLUSION MSCT with imaging reconstruction can improve the recognition of neoplastic invasion of central pulmonary vessels. It can be used to predict preoperatively the resectability of central lung cancer and to plan surgery.

  8. Lessons learned from independent central review. (United States)

    Ford, R; Schwartz, L; Dancey, J; Dodd, L E; Eisenhauer, E A; Gwyther, S; Rubinstein, L; Sargent, D; Shankar, L; Therasse, P; Verweij, J


    Independent central review (ICR) is advocated by regulatory authorities as a means of independent verification of clinical trial end-points dependent on medical imaging, when the data from the trials may be submitted for licensing applications [Food and Drug Administration. United States food and drug administration guidance for industry: clinical trial endpoints for the approval of cancer drugs and biologics. Rockville, MD: US Department of Health and Human Services; 2007; Committee for Medicinal Products for Human Use. European Medicines Agency Committee for Medicinal Products for Human Use (CHMP) guideline on the evaluation of anticancer medicinal products in man. London, UK: European Medicines Agency; 2006; United States Food and Drug Administration Center for Drug Evaluation and Research. Approval package for application number NDA 21-492 (oxaliplatin). Rockville, MD: US Department of Health and Human Services; 2002; United States Food and Drug Administration Center for Drug Evaluation and Research. Approval package for application number NDA 21-923 (sorafenib tosylate). Rockville, MD: US Department of Health and Human Services; 2005; United States Food and Drug Administration Center for Drug Evaluation and Research. Approval package for application number NDA 22-065 (ixabepilone). Rockville, MD: US Department of Health and Human Services; 2007; United States Food and Drug Administration Center for Drug Evaluation and Research. Approval package for application number NDA 22-059 (lapatinib ditosylate). Rockville, MD: US Department of Health and Human Services; 2007; United States Food and Drug Administration Center for Biologics Evaluation and Research. Approval package for BLA numbers 97-0260 and BLA Number 97-0244 (rituximab). Rockville, MD: US Department of Health and Human Services; 1997; United States Food and Drug Administration. FDA clinical review of BLA 98-0369 (Herceptin((R)) trastuzumab (rhuMAb HER2)). FDA Center for Biologics Evaluation and Research

  9. Multi-detector computed tomography imaging of large airway pathology:A pictorial review

    Institute of Scientific and Technical Information of China (English)

    Tejeshwar Singh Jugpal; Anju Garg; Gulshan Rai Sethi; Mradul Kumar Daga; Jyoti Kumar


    The tracheobronchial tree is a musculo-cartilagenous framework which acts as a conduit to aerate the lungs and consequently the entire body. A large spectrum of pathological conditions can involve the trachea and bronchial airways. These may be congenital anomalies, infections, post-intubation airway injuries, foreign body aspiration or neoplasms involving the airway. Appropriate management of airway disease requires an early and accurate diagnosis. In this pictorial essay review, we will comprehensively describe the various airway pathologies and their imaging findings by multi-detector computed tomography.

  10. Review of Dilaceration of Maxillary Central Incisor: A Mutidisciplinary Challenge. (United States)

    Walia, Pawanjit Singh; Rohilla, Ajit Kumar; Choudhary, Shweta; Kaur, Ravneet


    Traumatic injuries to primary dentition may interfere with the development of permanent dentition. Among the many malformations, dilaceration is particularly important to the clinician. Management of dilacerated maxillary central incisor requires a multidisciplinary approach. The main purpose of this review is to present the etiological factors, the mechanism, clinical features, radiographic features and treatment of dilaceration of the maxillary central incisors. How to cite this article: Walia PS, Rohilla AK, Choudhary S, Kaur R. Review of Dilaceration of Maxillary Central Incisor: A Multidisciplinary Challenge. Int J Clin Pediatr Dent 2016;9(1):90-98.

  11. Central nervous system manifestations of neonatal lupus: a systematic review. (United States)

    Chen, C C; Lin, K-L; Chen, C-L; Wong, A May-Kuen; Huang, J-L


    Neonatal lupus is a rare and acquired autoimmune disease. Central nervous system abnormalities are potential manifestations in neonatal lupus. Through a systematic literature review, we analyzed the clinical features of previously reported neonatal lupus cases where central nervous system abnormalities had been identified. Most reported neonatal lupus patients with central nervous system involvement were neuroimaging-determined and asymptomatic. Only seven neonatal lupus cases were identified as having a symptomatic central nervous system abnormality which caused physical disability or required neurosurgery. A high percentage of these neurosymptomatic neonatal lupus patients had experienced a transient cutaneous skin rash and had no maternal history of autoimmune disease before pregnancy.

  12. The effects of implementing synoptic pathology reporting in cancer diagnosis: a systematic review. (United States)

    Sluijter, Caro E; van Lonkhuijzen, Luc R C W; van Slooten, Henk-Jan; Nagtegaal, Iris D; Overbeek, Lucy I H


    Pathology reporting is evolving from a traditional narrative report to a more structured synoptic report. Narrative reporting can cause misinterpretation due to lack of information and structure. In this systematic review, we evaluate the impact of synoptic reporting on completeness of pathology reports and quality of pathology evaluation for solid tumours. Pubmed, Embase and Cochrane databases were systematically searched to identify studies describing the effect of synoptic reporting implementation on completeness of reporting and quality of pathology evaluation of solid malignant tumours. Thirty-three studies met the inclusion criteria. All studies, except one, reported an increased overall completeness of pathology reports after introduction of synoptic reporting (SR). Most frequently studied cancers were breast (n = 9) and colorectal cancer (n = 16). For breast cancer, narrative reports adequately described 'tumour type' and 'nodal status'. Synoptic reporting resulted in improved description of 'resection margins', 'DCIS size', 'location' and 'presence of calcifications'. For colorectal cancer, narrative reports adequately reported 'tumour type', 'invasion depth', 'lymph node counts' and 'nodal status'. Synoptic reporting resulted in increased reporting of 'circumferential margin', 'resection margin', 'perineural invasion' and 'lymphovascular invasion'. In addition, increased numbers of reported lymph nodes were found in synoptic reports. Narrative reports of other cancer types described the traditional parameters adequately, whereas for 'resection margins' and '(lympho)vascular/perineural invasion', implementation of synoptic reporting was necessary. Synoptic reporting results in improved reporting of clinical relevant data. Demonstration of clinical impact of this improved method of pathology reporting is required for successful introduction and implementation in daily pathology practice.

  13. Long-Term Mangiferin Extract Treatment Improves Central Pathology and Cognitive Deficits in APP/PS1 Mice. (United States)

    Infante-Garcia, Carmen; Ramos-Rodriguez, Juan Jose; Delgado-Olmos, Irene; Gamero-Carrasco, Carlos; Fernandez-Ponce, Maria Teresa; Casas, Lourdes; Mantell, Casimiro; Garcia-Alloza, Monica


    Alzheimer's disease (AD) is the most common cause of dementia; however, available treatments have had limited success. Therefore AD patients are in tremendous need of new pharmacological approaches that may delay or slow the progression of the disease. In addition to the classical neuropathological features, immunological and inflammatory processes are also involved in AD pathogenesis. Naturally occurring compounds, such as Mangifera indica Linn (MGF) extracts have previously been shown to significantly reduce peripheral inflammatory processes. In order to explore the role of MGF in AD central pathology, we have orally treated APP/PS1 mice for 22 weeks. While MGF did not affect amyloid pathology, tau hyperphosphorylation was significantly reduced in the cortex and hippocampus. Also, inflammatory processes, measured by microglia and astrocyte burdens, were diminished in MGF-treated mice. Moreover, neuronal morphological alterations, such as abnormal neurite curvature and dystrophies, highly increased in APP/PS1 mice, were significantly ameliorated by long-term MGF treatment. Reduction of all these pathological features were accompanied by compelling improvements of episodic and spatial memory in APP/PS1 mice treated with MGF. Altogether our data suggest that MGF may provide a useful tool to target different aspects of AD pathology and could lead to more effective future therapeutic or preventive strategies.

  14. Toward a consensus definition of pathological video-gaming: a systematic review of psychometric assessment tools. (United States)

    King, Daniel L; Haagsma, Maria C; Delfabbro, Paul H; Gradisar, Michael; Griffiths, Mark D


    Pathological video-gaming, or its proposed DSM-V classification of "Internet Use Disorder", is of increasing interest to scholars and practitioners in allied health disciplines. This systematic review was designed to evaluate the standards in pathological video-gaming instrumentation, according to Cicchetti (1994) and Groth-Marnat's (2009) criteria and guidelines for sound psychometric assessment. A total of 63 quantitative studies, including eighteen instruments and representing 58,415 participants, were evaluated. Results indicated that reviewed instrumentation may be broadly characterized as inconsistent. Strengths of available measures include: (i) short length and ease of scoring, (ii) excellent internal consistency and convergent validity, and (iii) potentially adequate data for development of standardized norms for adolescent populations. However, key limitations included: (a) inconsistent coverage of core addiction indicators, (b) varying cut-off scores to indicate clinical status, (c) a lack of a temporal dimension, (d) untested or inconsistent dimensionality, and (e) inadequate data on predictive validity and inter-rater reliability. An emerging consensus suggests that pathological video-gaming is commonly defined by (1) withdrawal, (2) loss of control, and (3) conflict. It is concluded that a unified approach to assessment of pathological video-gaming is needed. A synthesis of extant research efforts by meta-analysis may be difficult in the context of several divergent approaches to assessment.

  15. The integration of pathology into the clinical years of undergraduate medical education: a survey and review of the literature. (United States)

    Magid, Margret S; Cambor, Carolyn L


    Pathology as a basic science discipline traditionally is a component of the preclinical medical school curriculum. While there have been regional and nationwide surveys reporting on the curricular organization and instructional formats of preclinical pathology instruction, the extent of required pathology integration into the clinical medical school curriculum, particularly as it relates to practical issues of patient management, has not been studied. A survey soliciting information about required pathology programs in the clinical years was distributed to the members of the Undergraduate Medical Educators Section of the Association of Pathology Chairs (APC). A literature search of such programs was also performed. Thirty-seven respondents representing 30 medical schools (21% of the 140 Liaison Committee on Medical Education-accredited medical schools in the APC) described a total of 16 required pathology programs in the clinical years. An additional 10 programs were identified in the literature. Advantages of required pathology activities in the clinical years include educating medical students in effective utilization of anatomic and clinical pathology for patient care and exposing them to the practice of pathology. Reported challenges have been competition for curricular time in the clinical years, attitudinal resistance by clerkship directors, failure to recognize pathology as a clinical discipline, and insufficient number of faculty in pathology departments. By survey sample and literature review, there has been relatively little progress in the integration of required pathology exposure into the clinical years. Development of practice-related pathology competencies may facilitate introduction of such curricular programs in the future.

  16. Comorbidity issues in the pharmacological treatment of pathological gambling: a critical review

    Directory of Open Access Journals (Sweden)

    Hollander Eric


    Full Text Available Abstract Background Pathological Gambling (PG is an impulse control disorder often comorbid with other psychopathology, particularly bipolar spectrum disorders, attention deficit/hyperactivity disorder, obsessive-compulsive disorder (OCD and substance abuse. This paper reviews the published literature on the pharmacological management of PG, highlighting how clinical and subclinical comorbid psychopathology influences the choice of pharmacological treatment. Methods Using Medline, the authors reviewed relevant articles published on this topic from1995 to 2005, focusing on the best-designed studies for inclusion. Results Much of the literature on PG-treatment presupposes different theories regarding this disorder. Data suggest the utility of differentiating the pharmacotherapy of pathological gamblers in light of their comorbid profile, specifically assessing for comorbid bipolar, ADHD, OCD, and substance abuse disorders. Conclusion Decisions about pharmacological treatment of PG should take into account current and previous comorbid disorders which influence treatment selection.

  17. Regulatory forum opinion piece: Clarification and simplification of the pathology peer review documentation process. (United States)

    Tomlinson, Michael J; Leininger, Joel R


    The transparency and documentation of the peer review process have been discussed recently. Our position is that transparency is best achieved when peer review is a collaborative process, in which both parties are open-minded but both also realize that the study pathologist retains complete control over the findings (raw data) and over the content of the pathology report. For these reasons, we believe that histopathology raw data should be defined as the observations made by the study pathologist (printed and/or electronic formats) rather than as the tissue slides recommended by the Organisation for Economic Co-operation and Development (OECD). Also, because the study pathologist retains control over the histopathology raw data, any notes or tabulations of findings by the study pathologist and peer review pathologist during the peer review are interim notes and should not be included as an appendix to the pathology report though they may be retained if desired, as currently recommended. Because the histopathology raw data have not been created until completion of the peer review, the performance of a peer review should be documented in the study report, as currently recommended, but that it not be a GLP-compliant process.

  18. Effects of physical exercise on central nervous system functions: a review of brain region specific adaptations. (United States)

    Morgan, Julie A; Corrigan, Frances; Baune, Bernhard T


    Pathologies of central nervous system (CNS) functions are involved in prevalent conditions such as Alzheimer's disease, depression, and Parkinson's disease. Notable pathologies include dysfunctions of circadian rhythm, central metabolism, cardiovascular function, central stress responses, and movement mediated by the basal ganglia. Although evidence suggests exercise may benefit these conditions, the neurobiological mechanisms of exercise in specific brain regions involved in these important CNS functions have yet to be clarified. Here we review murine evidence about the effects of exercise on discrete brain regions involved in important CNS functions. Exercise effects on circadian rhythm, central metabolism, cardiovascular function, stress responses in the brain stem and hypothalamic pituitary axis, and movement are examined. The databases Pubmed, Web of Science, and Embase were searched for articles investigating regional brain adaptations to exercise. Brain regions examined included the brain stem, hypothalamus, and basal ganglia. We found evidence of multiple regional adaptations to both forced and voluntary exercise. Exercise can induce molecular adaptations in neuronal function in many instances. Taken together, these findings suggest that the regional physiological adaptations that occur with exercise could constitute a promising field for elucidating molecular and cellular mechanisms of recovery in psychiatric and neurological health conditions.

  19. Review of approaches to the recording of background lesions in toxicologic pathology studies in rats. (United States)

    McInnes, E F; Scudamore, C L


    Pathological evaluation of lesions caused directly by xenobiotic treatment must always take into account the recognition of background (incidental) findings. Background lesions can be congenital or hereditary, histological variations, changes related to trauma or normal aging and physiologic or hormonal changes. This review focuses on the importance and correct approach to recording of background changes and includes discussion on sources of variability in background changes, the correct use of terminology, the concept of thresholds, historical control data, diagnostic drift, blind reading of slides, scoring and artifacts. The review is illustrated with background lesions in Sprague Dawley and Wistar rats.

  20. New insights into the pathology of Parkinson's disease: does the peripheral autonomic system become central? (United States)

    Probst, A; Bloch, A; Tolnay, M


    Recent studies in aged, neurologically unimpaired subjects have pointed to a specific induction site of the pathological process of Parkinson's disease (PD) in the region of the dorsal glossopharyngeus-vagus complex as well as in the anterior olfactory nucleus. From the lower brainstem, the disease process would then pursue an ascending course and involve more rostral brainstem areas, limbic structures, and eventually the cerebral cortex. One barrier to the acceptance of the caudal medullary structures as the induction site of PD pathology is that not all parts of the nervous system have been investigated for the presence of PD-associated lesions in cases of early asymptomatic PD. Using alpha-synuclein immunostaining, we investigated the brain, the sacral, and thoracic autonomic nuclei of the spinal cord as well as several components of the peripheral autonomic nervous system in a autopsy cohort of 98 neurologically unimpaired subjects aged 64 or more. Our data indicate that the autonomic nuclei of the spinal cord and the peripheral autonomic nervous system belong to the most constantly and earliest affected regions next to medullary structures and the olfactory nerves in neurologically unimpaired older individuals, thus providing a pathological basis for early premotor autonomic dysfunctions at a prodromal stage of PD.

  1. Review of the current state of whole slide imaging in pathology

    Directory of Open Access Journals (Sweden)

    Liron Pantanowitz


    Full Text Available Whole slide imaging (WSI, or "virtual" microscopy, involves the scanning (digitization of glass slides to produce "digital slides". WSI has been advocated for diagnostic, educational and research purposes. When used for remote frozen section diagnosis, WSI requires a thorough implementation period coupled with trained support personnel. Adoption of WSI for rendering pathologic diagnoses on a routine basis has been shown to be successful in only a few "niche" applications. Wider adoption will most likely require full integration with the laboratory information system, continuous automated scanning, high-bandwidth connectivity, massive storage capacity, and more intuitive user interfaces. Nevertheless, WSI has been reported to enhance specific pathology practices, such as scanning slides received in consultation or of legal cases, of slides to be used for patient care conferences, for quality assurance purposes, to retain records of slides to be sent out or destroyed by ancillary testing, and for performing digital image analysis. In addition to technical issues, regulatory and validation requirements related to WSI have yet to be adequately addressed. Although limited validation studies have been published using WSI there are currently no standard guidelines for validating WSI for diagnostic use in the clinical laboratory. This review addresses the current status of WSI in pathology related to regulation and validation, the provision of remote and routine pathologic diagnoses, educational uses, implementation issues, and the cost-benefit analysis of adopting WSI in routine clinical practice.

  2. Review of the current state of whole slide imaging in pathology. (United States)

    Pantanowitz, Liron; Valenstein, Paul N; Evans, Andrew J; Kaplan, Keith J; Pfeifer, John D; Wilbur, David C; Collins, Laura C; Colgan, Terence J


    Whole slide imaging (WSI), or "virtual" microscopy, involves the scanning (digitization) of glass slides to produce "digital slides". WSI has been advocated for diagnostic, educational and research purposes. When used for remote frozen section diagnosis, WSI requires a thorough implementation period coupled with trained support personnel. Adoption of WSI for rendering pathologic diagnoses on a routine basis has been shown to be successful in only a few "niche" applications. Wider adoption will most likely require full integration with the laboratory information system, continuous automated scanning, high-bandwidth connectivity, massive storage capacity, and more intuitive user interfaces. Nevertheless, WSI has been reported to enhance specific pathology practices, such as scanning slides received in consultation or of legal cases, of slides to be used for patient care conferences, for quality assurance purposes, to retain records of slides to be sent out or destroyed by ancillary testing, and for performing digital image analysis. In addition to technical issues, regulatory and validation requirements related to WSI have yet to be adequately addressed. Although limited validation studies have been published using WSI there are currently no standard guidelines for validating WSI for diagnostic use in the clinical laboratory. This review addresses the current status of WSI in pathology related to regulation and validation, the provision of remote and routine pathologic diagnoses, educational uses, implementation issues, and the cost-benefit analysis of adopting WSI in routine clinical practice.

  3. Utilizing Whole Slide Images for Pathology Peer Review and Working Groups. (United States)

    Malarkey, David E; Willson, Gabrielle A; Willson, Cynthia J; Adams, E Terence; Olson, Greg R; Witt, William M; Elmore, Susan A; Hardisty, Jerry F; Boyle, Michael C; Crabbs, Torrie A; Miller, Rodney A


    This article describes the results of comparisons of digitally scanned whole slide images (WSIs) and glass microscope slides for diagnosis of tissues under peer review by the National Toxicology Program. Findings in this article were developed as a result of the data collected from 6 pathology working groups (PWGs), 1 pathology peer review, and survey comments from over 25 participating pathologists. For each PWG, 6-14 pathologists examined 10-143 tissues per study from 6- and 9-month perinatal studies and 2-year carcinogenicity studies. Overall it was found that evaluation of WSIs is generally equivalent to using glass slides. Concordance of PWG consensus diagnoses based upon review of WSIs versus glass slides ranged from 74% to 100% (median 86%). The intra- and interobserver diagnostic variation did not appear to influence the conclusions of any study. Based upon user opinions collected from surveys, WSIs may be less optimal than glass slides for evaluation of subtle lesions, large complex lesions, small lesions in a large section of tissue, and foci of altered hepatocytes. These results indicate that, although there may be some limitations, the use of WSIs can effectively accomplish the objectives of a conventional glass slide review and definitely serves as a useful adjunct to the conduct of PWGs.

  4. 'Platonic jealousy': a conceptualization and review of the literature on non-romantic pathological jealousy. (United States)

    Hill, R; Davis, P


    Romantic jealousy has long been of interest to psychodynamically oriented clinicians. More recently empirical investigations have emerged into the causes and treatments of romantic jealousy. What has not kept pace with this interest is a wider research agenda into non-romantic forms of jealousy. While work has appeared in relation to specific groups or topics, such as sibling rivalry, no attempt has been made to draw together the material on non-romantic jealousy. In this paper the theoretical and empirical material on non-romantic jealousy is reviewed in order to answer two fundamental questions. Firstly, is non-romantic jealousy necessarily pathological? Secondly, to what extent is it helpful to subsume all forms of non-romantic jealousy under one term? It is suggested that while non-romantic jealousy is not always pathological, the term non-romantic jealousy may be a useful differentiating term, not least in highlighting an important area for future research.

  5. Centrally Delivered BACE1 Inhibitor Activates Microglia, and Reverses Amyloid Pathology and Cognitive Deficit in Aged Tg2576 Mice. (United States)

    Thakker, Deepak R; Sankaranarayanan, Sethu; Weatherspoon, Marcy R; Harrison, Jonathan; Pierdomenico, Maria; Heisel, Jennifer M; Thompson, Lorin A; Haskell, Roy; Grace, James E; Taylor, Sarah J; Albright, Charles F; Shafer, Lisa L


    Multiple small-molecule inhibitors of the β-secretase enzyme (BACE1) are under preclinical or clinical investigation for Alzheimer's disease (AD). Prior work has illustrated robust lowering of central amyloid β (Aβ) after acute administration of BACE1 inhibitors. However, very few studies have assessed the overall impact of chronically administered BACE1 inhibitors on brain amyloid burden, neuropathology, and behavioral function in aged preclinical models. We investigated the effects of a potent nonbrain-penetrant BACE1 inhibitor, delivered directly to the brain using intracerebroventricular infusion in an aged transgenic mouse model. Intracerebroventricular infusion of the BACE1 inhibitor (0.3-23.5 μg/d) for 8 weeks, initiated in 17-month-old Tg2576 mice, produced dose-dependent increases in brain inhibitor concentrations (0.2-13 μm). BACE1 inhibition significantly reversed the behavioral deficit in contextual fear conditioning, and reduced brain Aβ levels, plaque burden, and associated pathology (e.g., dystrophic neurites), with maximal effects attained with ∼1 μg/d dose. Strikingly, the BACE1 inhibitor also reversed amyloid pathology below baseline levels (amyloid burden at the start of treatment), without adversely affecting cerebral amyloid angiopathy, microhemorrhages, myelination, or neuromuscular function. Inhibitor-mediated decline in brain amyloid pathology was associated with an increase in microglial ramification. This is the first demonstration of chronically administered BACE1 inhibitor to activate microglia, reverse brain amyloid pathology, and elicit functional improvement in an aged transgenic mouse model. Thus, engagement of novel glial-mediated clearance mechanisms may drive disease-modifying therapeutic benefit with BACE1 inhibition in AD.

  6. Central exclusive production within the Durham model: a review

    CERN Document Server

    Harland-Lang, L A; Ryskin, M G; Stirling, W J


    We review recent results within the Durham model of central exclusive production. We discuss the theoretical aspects of this approach and consider the phenomenological implications in a variety of processes, comparing to existing collider data and addressing the possibilities for the future.

  7. POLD1: Central mediator of DNA replication and repair, and implication in cancer and other pathologies. (United States)

    Nicolas, Emmanuelle; Golemis, Erica A; Arora, Sanjeevani


    The evolutionarily conserved human polymerase delta (POLD1) gene encodes the large p125 subunit which provides the essential catalytic activities of polymerase δ (Polδ), mediated by 5'-3' DNA polymerase and 3'-5' exonuclease moieties. POLD1 associates with three smaller subunits (POLD2, POLD3, POLD4), which together with Replication Factor C and Proliferating Nuclear Cell Antigen constitute the polymerase holoenzyme. Polδ function is essential for replication, with a primary role as the replicase for the lagging strand. Polδ also has an important proofreading ability conferred by the exonuclease activity, which is critical for ensuring replicative fidelity, but also serves to repair DNA lesions arising as a result of exposure to mutagens. Polδ has been shown to be important for multiple forms of DNA repair, including nucleotide excision repair, double strand break repair, base excision repair, and mismatch repair. A growing number of studies in the past decade have linked germline and sporadic mutations in POLD1 and the other subunits of Polδ with human pathologies. Mutations in Polδ in mice and humans lead to genomic instability, mutator phenotype and tumorigenesis. The advent of genome sequencing techniques has identified damaging mutations in the proofreading domain of POLD1 as the underlying cause of some inherited cancers, and suggested that mutations in POLD1 may influence therapeutic management. In addition, mutations in POLD1 have been identified in the developmental disorders of mandibular hypoplasia, deafness, progeroid features and lipodystrophy and atypical Werner syndrome, while changes in expression or activity of POLD1 have been linked to senescence and aging. Intriguingly, some recent evidence suggests that POLD1 function may also be altered in diabetes. We provide an overview of critical Polδ activities in the context of these pathologic conditions.

  8. Statistical challenges for central monitoring in clinical trials: a review. (United States)

    Oba, Koji


    Recently, the complexity and costs of clinical trials have increased dramatically, especially in the area of new drug development. Risk-based monitoring (RBM) has been attracting attention as an efficient and effective trial monitoring approach, which can be applied irrespectively of the trial sponsor, i.e., academic institution or pharmaceutical company. In the RBM paradigm, it is expected that a statistical approach to central monitoring can help improve the effectiveness of on-site monitoring by prioritizing and guiding site visits according to central statistical data checks, as evidenced by examples of actual trial datasets. In this review, several statistical methods for central monitoring are presented. It is important to share knowledge about the role and performance capabilities of statistical methodology among clinical trial team members (i.e., sponsors, investigators, data managers, monitors, and biostatisticians) in order to adopt central statistical monitoring for assessing data quality in the actual clinical trial.

  9. Interactions of pannexin 1 with NMDA and P2X7 receptors in central nervous system pathologies: Possible role on chronic pain. (United States)

    Bravo, D; Maturana, C J; Pelissier, T; Hernández, A; Constandil, L


    Pannexin 1 (Panx1) is a glycoprotein that acts as a membrane channel in a wide variety of tissues in mammals. In the central nervous system (CNS) Panx1 is expressed in neurons, astrocytes and microglia, participating in the pathophysiology of some CNS diseases, such as epilepsy, anoxic depolarization after stroke and neuroinflammation. In these conditions Panx1 acts as an important modulator of the neuroinflammatory response, by secreting ATP, by interacting with the P2X7 receptor (P2X7R), and as an amplifier of NMDA receptor (NMDAR) currents, particularly in conditions of pathological neuronal hyperexcitability. Here, we briefly reviewed the current evidences that support the interaction of Panx1 with NMDAR and P2X7R in pathological contexts of the CNS, with special focus in recent data supporting that Panx1 is involved in chronic pain signaling by interacting with NMDAR in neurons and with P2X7R in glia. The participation of Panx1 in chronic pain constitutes a novel topic for research in the field of clinical neurosciences and a potential target for pharmacological interventions in chronic pain.

  10. Spinal epidural abscess presenting as intra-abdominal pathology: a case report and literature review. (United States)

    Bremer, Andrew A; Darouiche, Rabih O


    Spinal epidural abscess is a rare infectious disease. However, if left unrecognized and untreated, the clinical outcome of spinal epidural abscess can be devastating. Correctly diagnosing a spinal epidural abscess in a timely fashion is often difficult, particularly if the clinician does not actively consider the diagnosis. The most common presenting symptoms of spinal epidural abscess include backache, radicular pain, weakness, and sensory deficits. However, early in its course, spinal epidural abscess can also present with vague and nondescript manifestations. In this report, we describe a case of spinal epidural abscess presenting as abdominal pain, and review the literature describing other cases of spinal epidural abscess presenting as intra-abdominal pathology.

  11. Halitosis--a common medical and social problem. A review on pathology, diagnosis and treatment. (United States)

    Zalewska, A; Zatoński, M; Jabłonka-Strom, A; Paradowska, A; Kawala, B; Litwin, A


    Bad breath is a condition that has health and social implications. This paper provides a comprehensive review of the classification of halitosis, it's etiology, it's prevalence, diagnosis and treatment strategies for the condition. Halitosis is affecting about 25-30% of world's population. It includes categories of genuine halitosis, pseudo-halitosis and halitophobia. It is believed that in 80-90% of cases halitosis origins in the oral cavity and the most common causes are: gingival pathologies, caries and poor oral hygiene. Extraoral sources of halitosis are responsible for 10-20% of all cases and are caused by poor diet, alcohol abuse, tobacco smoking, certain drugs and diseases of other parts of digestive tract as well as some systemic conditions. Diagnostics of halitosis includes subjective methods (examiner's sense of smell) and objective methods (instrumental analysis). Simple, subjective examination is considered a "golden standard" in clinical practice. In case of pathological halitosis identifying the direct cause of halitosis is essential. After excluding, or after successful treatment, of all oral pathologies, in case of remaining fetor ex ore identification and treatment of halitosis often requires multidisciplinary approach. Many unknowns remain in causes and mechanisms of halitosis. It can significantly impair quality of life, social interactions, lead directly to depression,low self-esteem or other mood disorders, therefore it is important to properly identify, treat and continue research on halitosis.

  12. Improving the creation and reporting of structured findings during digital pathology review

    Directory of Open Access Journals (Sweden)

    Ida Cervin


    Full Text Available Background: Today, pathology reporting consists of many separate tasks, carried out by multiple people. Common tasks include dictation during case review, transcription, verification of the transcription, report distribution, and report the key findings to follow-up registries. Introduction of digital workstations makes it possible to remove some of these tasks and simplify others. This study describes the work presented at the Nordic Symposium on Digital Pathology 2015, in Linköping, Sweden. Methods: We explored the possibility to have a digital tool that simplifies image review by assisting note-taking, and with minimal extra effort, populates a structured report. Thus, our prototype sees reporting as an activity interleaved with image review rather than a separate final step. We created an interface to collect, sort, and display findings for the most common reporting needs, such as tumor size, grading, and scoring. Results: The interface was designed to reduce the need to retain partial findings in the head or on paper, while at the same time be structured enough to support automatic extraction of key findings for follow-up registry reporting. The final prototype was evaluated with two pathologists, diagnosing complicated partial mastectomy cases. The pathologists experienced that the prototype aided them during the review and that it created a better overall workflow. Conclusions: These results show that it is feasible to simplify the reporting tasks in a way that is not distracting, while at the same time being able to automatically extract the key findings. This simplification is possible due to the realization that the structured format needed for automatic extraction of data can be used to offload the pathologists′ working memory during the diagnostic review.

  13. Central nervous system tumors and related intracranial pathologies in radium dial workers

    Energy Technology Data Exchange (ETDEWEB)

    Stebbings, J.H.; Semkiw, W.


    Among the female radiation workers in the radium dial industry there is no overall excess of brain or central nervous system tumors. A significant excess did appear, however, in one of three major cohorts; the excess was not due to an excess of gliomas and cannot be ascribed with certainty to radium or external radiation. A significant proportional excess of tumors outside the brain was observed, and is consistent with irradiation of nervous system tissue from adjacent bone. Early deaths from brain abscess or mastoiditis, which are coded as diseases of the nervous system and sense organs, were observed. 12 refs., 11 tabs.

  14. 3xTg-AD Mice Exhibit an Activated Central Stress Axis during Early-Stage Pathology (United States)

    Hebda-Bauer, Elaine K.; Simmons, Tracy A.; Sugg, Andrew; Ural, Eren; Stewart, James A.; Beals, James L.; Wei, Qiang; Watson, Stanley J.; Akil, Huda


    Activation of the hypothalamic-pituitary-adrenal (HPA) axis occurs in response to the organism’s innate need for homeostasis. The glucocorticoids (GCs) that are released into the circulation upon acute activation of the HPA axis perform stress-adaptive functions and provide negative feedback to turn off the HPA axis, but can be detrimental when in excess. Long-term activation of the HPA axis (such as with chronic stress) enhances susceptibility to neuronal dysfunction and death, and increases vulnerability to Alzheimer’s disease (AD). However, little is known how components of the HPA axis, upstream of GCs, impact vulnerability to AD. This study examined basal gene expression of stress-related molecules in brains of 3xTg-AD mice during early-stage pathology. Basal glucocorticoid levels and mRNA expression of the glucocorticoid receptor (GR), mineralocorticoid receptor (MR), and corticotropic releasing hormone (CRH) in several stress- and emotionality-related brain regions were measured in 3–4-month-old 3xTg-AD mice. Despite normal glucocorticoid levels, young 3xTg-AD mice exhibit an activated central HPA axis, with altered mRNA levels of MR and GR in the hippocampus, GR and CRH in the paraventricular nucleus of the hypothalamus, GR and CRH in the central nucleus of the amygdala, and CRH in the bed nucleus of the stria terminalis. This HPA axis activation is present during early-stage neuropathology when 3xTg-AD mice show mild behavioral changes, suggesting an ongoing neuroendocrine regulation that precedes the onset of severe AD-like pathology and behavioral deficits. PMID:22976078

  15. High Trypanosoma cruzi infection prevalence associated with minimal cardiac pathology among wild carnivores in central Texas

    Directory of Open Access Journals (Sweden)

    Rachel Curtis-Robles


    Full Text Available Infection with the zoonotic vector-borne protozoal parasite Trypanosoma cruzi causes Chagas disease in humans and dogs throughout the Americas. Despite the recognized importance of various wildlife species for perpetuating Trypanosoma cruzi in nature, relatively little is known about the development of cardiac disease in infected wildlife. Using a cross-sectional study design, we collected cardiac tissue and blood from hunter-donated wildlife carcasses- including raccoon (Procyon lotor, coyote (Canis latrans, gray fox (Urocyon cinereoargenteus, and bobcat (Lynx rufus – from central Texas, a region with established populations of infected triatomine vectors and increasing diagnoses of Chagas disease in domestic dogs. Based on PCR analysis, we found that 2 bobcats (14.3%, 12 coyotes (14.3%, 8 foxes (13.8%, and 49 raccoons (70.0% were positive for T. cruzi in at least one sample (right ventricle, apex, and/or blood clot. Although a histologic survey of right ventricles showed that 21.1% of 19 PCR-positive hearts were characterized by mild lymphoplasmocytic infiltration, no other lesions and no amastigotes were observed in any histologic section. DNA sequencing of the TcSC5D gene revealed that raccoons were infected with T. cruzi strain TcIV, and a single racoon harbored a TcI/TcIV mixed infection. Relative to other wildlife species tested here, our data suggest that raccoons may be important reservoirs of TcIV in Texas and a source of infection for indigenous triatomine bugs. The overall high level of infection in this wildlife community likely reflects high levels of vector contact, including ingestion of bugs. Although the relationship between the sylvatic cycle of T. cruzi transmission and human disease risk in the United States has yet to be defined, our data suggest that hunters and wildlife professionals should take precautions to avoid direct contact with potentially infected wildlife tissues.

  16. Stenosis of central canal of spinal cord in man: incidence and pathological findings in 232 autopsy cases. (United States)

    Milhorat, T H; Kotzen, R M; Anzil, A P


    The central canal of the spinal cord is generally regarded as a vestigial structure that is obliterated after birth in 70% to 80% of the general population. This report describes the first detailed histological study of the human central canal in 232 subjects ranging in age from 6 weeks' gestation to 92 years. Whole spinal cords were harvested at autopsy and sectioned serially from the conus medullaris to the upper medulla. Histological findings and morphometric analysis of the cross-sectional luminal area were used to grade stenosis at seven levels of the canal. Varying grades of stenosis were present at one or more levels in none (0%) of 60 fetuses, one (3%) of 34 infants, three (18%) of 17 children, 21 (88%) of 24 adolescents and young adults, 67 (96%) of 70 middle-aged adults, and all 27 adults aged 65 years or older (100%). The stenotic process was most pronounced in the thoracic segments of the canal and involved more levels with higher grades of stenosis in older individuals. Histological findings consisted of disorganization of the ependymal epithelium, formation of ependymal rosettes or microcanals, proliferation of subependymal gliovascular buds, and intracanalicular gliosis. These features are consistent with a pathological lesion involving ependymal injury and scarring and are less compatible with an involutional or degenerative process. Stenosis of the central canal probably influences the anatomical features of syringomyelia and may account for variations in cavity formation such as the prevalence of holocord syrinxes in children, the formation of focal and paracentral syrinxes in adults, and the rare incidence of syrinx formation in many older individuals with acquired lesions known to produce syringomyelia.

  17. Insights on diagnosis of oral cavity pathologies by infrared spectroscopy: A review (United States)

    Giorgini, Elisabetta; Balercia, Paolo; Conti, Carla; Ferraris, Paolo; Sabbatini, Simona; Rubini, Corrado; Tosi, Giorgio


    Fourier-Transform Infrared microspectroscopy, a largely used spectroscopic technique in basic and industrial researches, offers the possibility to analyze the vibrational features of molecular groups within a variety of environments. In the bioclinical field, and, in particular, in the study of cells, tissues and biofluids, it could be considered a supporting objective technique able to characterize the biochemical processes involved in relevant pathologies, such as tumoral diseases, highlighting specific spectral markers associable with the principal biocomponents (proteins, lipids and carbohydrates). In this article, we review the applications of infrared spectroscopy to the study of tumoral diseases of oral cavity compartments with the aim to improve understanding of biological processes involved during the onset of these lesions and to afford to an early diagnosis. Spectral studies on mouth, salivary glands and oral cystic lesions, objectively discriminate normal from dysplastic and cancer states characterizing also the grading.

  18. Bisphosphonates and oral pathology II. Osteonecrosis of the jaws: review of the literature before 2005. (United States)

    Estefanía Fresco, Ruth; Ponte Fernández, Ruth; Aguirre Urizar, José Manuel


    Bisphosphonates are bone-turnover modulating drugs which are used in the management of a number of bone diseases ranging from osteoporosis to neoplasic pathology-associated osteolysis. In the last years a number of cases of osteonecrosis of the jaws associated with these drugs have been reported. In this review we analyze the cases published in the literature indexed from 2003 to December 2005. During this period 246 cases were reported, being more frequently associated with women in the sixth decade of life. More frequently associated bisphosphonates were the nitrogenated bisphosphonates (pamidronate, zolendronic acid) and the most common oral antecedent was a dental extraction. Nevertheless more than 25% of the cases were spontaneous. The most frequent site was the mandible and most of the cases presented clinical evidence of bone exposure and pain. Different treatments have been proposed with different antibiotic therapies with or without surgery, showing in general terms an uncertain prognosis with low healing rates.

  19. Water Related Health Problems in Central Asia—A Review

    Directory of Open Access Journals (Sweden)

    Zakir Bekturganov


    Full Text Available The present paper provides an extensive literature review on water related health issues in Central Asia. Even though the per capita amount of available freshwater is substantial in all Central Asian states the uneven distribution in time and space creates problems for water availability. Due to this, the Central Asian economies are developing under increasing water deficiency. The degradation of water supply systems and sewage treatment plants is often severe leading to potentially high water loss rates and inadequate accessibility to safe water supply. In this context, rural areas are the most affected. Low tariffs in combination with absent metering and low collection rates for water fees mean that operation and maintenance costs for basic services of water supply and sanitation are not covered. Unsafe water supply contains both microbiological and non-microbiological contaminants. Helminthiasis and intestinal protozoa infections are of considerable public health importance in Central Asia. Agricultural and industrial pollution is especially affecting downstream areas of Amu Darya and Syr Darya rivers. In large areas copper, zinc, and chromium concentrations in water exceed maximum permissible concentration. Thus, there is an urgent need to strengthen the environmental monitoring system. Small-scale water supply and sanitation systems need to be developed in line with more efficient public spending on these.

  20. Deception studies manipulating centrally acting performance modifiers: a review. (United States)

    Williams, Emily L; Jones, Hollie S; Sparks, Sandy; Marchant, David C; Micklewright, Dominic; McNaughton, Lars R


    Athletes anticipatorily set and continuously adjust pacing strategies before and during events to produce optimal performance. Self-regulation ensures maximal effort is exerted in correspondence with the end point of exercise, while preventing physiological changes that are detrimental and disruptive to homeostatic control. The integration of feedforward and feedback information, together with the proposed brain's performance modifiers is said to be fundamental to this anticipatory and continuous regulation of exercise. The manipulation of central, regulatory internal and external stimuli has been a key focus within deception research, attempting to influence the self-regulation of exercise and induce improvements in performance. Methods of manipulating performance modifiers such as unknown task end point, deceived duration or intensity feedback, self-belief, or previous experience create a challenge within research, as although they contextualize theoretical propositions, there are few ecological and practical approaches which integrate theory with practice. In addition, the different methods and measures demonstrated in manipulation studies have produced inconsistent results. This review examines and critically evaluates the current methods of how specific centrally controlled performance modifiers have been manipulated, within previous deception studies. From the 31 studies reviewed, 10 reported positive effects on performance, encouraging future investigations to explore the mechanisms responsible for influencing pacing and consequently how deceptive approaches can further facilitate performance. The review acts to discuss the use of expectation manipulation not only to examine which methods of deception are successful in facilitating performance but also to understand further the key components used in the regulation of exercise and performance.

  1. Clinical and Pathological Investigation on Turkey Diseases in North-central City of Jos, Nigeria, 2009-2014

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    Olatunde Babatunde Akanbi


    Full Text Available Information on turkey production and disease is rare in Nigeria, possibly because turkeys are seldom raised commercially. Also, turkeys require intensive husbandry and health care after hatching, which backyard poultry producers hardly provided especially, when raised in a disease endemic environment. In an attempt to document the diseases militating against turkey production in Nigeria, clinical and necropsy records were reviewed from veterinary practices in Jos and the Central Diagnostic Laboratory of the National Veterinary Research Institute (NVRI, Vom, Nigeria between 2009 - 2014. A total of 306 turkeys from backyard flocks were presented to the Veterinary clinics between 2009-2014 with various health complaints by backyard flock owners. Viral (Pox and Newcastle disease and parasitic (Helminthosis, Coccidiosis and Ectoparasitism diseases were mostly diagnosed. During the same period, 42 samples comprising 25 carcasses and 17 cloacal swabs were submitted for post mortem examination, virus isolation and microbiological test. Colisepticaemia, colibacillosis, pullorum disease, airsacculitis and infectious sinusitis are the main diseases diagnosed at post-mortem examination and microbiological test, while none of the samples were positive for influenza by virus isolation. It was observed that turkey rearing was small-scaled and kept as backyard poultry in North-central Nigeria. It can therefore be concluded from this study that turkeys raised in north-central city of Jos are affected by diseases ranging from viral to bacterial and parasitic, which can adversely affect productivity. This can therefore be improved upon by controlling the diseases mostly affecting turkeys.

  2. Pathological and Clinical Features and Management of Central Nervous System Hemangioblastomas in von Hippel-Lindau Disease

    Directory of Open Access Journals (Sweden)

    Hiroshi Kanno


    Full Text Available Central nervous system (CNS hemangioblastoma is the most common manifestation of von Hippel-Lindau (VHL disease. It is found in 70-80% of VHL patients. Hemangioblastoma is a rare form of benign vascular tumor of the CNS, accounting for 2.0% of CNS tumors. It can occur sporadically or as a familial syndrome. CNS hemangioblastomas are typically located in the posterior fossa and the spinal cord. VHL patients usually develop a CNS hemangioblastoma at an early age. Therefore, they require a special routine for diagnosis, treatment and follow-up. The surgical management of symptomatic tumors depends on many factors such as symptom, location, multiplicity, and progression of the tumor. The management of asymptomatic tumors in VHL patients is controversial since CNS hemangioblastomas grow with intermittent quiescent and rapid-growth phases. Preoperative embolization of large solid hemangioblastomas prevents perioperative hemorrhage but is not necessary in every case. Radiotherapy should be reserved for inoperable tumors. Because of complexities of VHL, a better understanding of the pathological and clinical features of hemangioblastoma in VHL is essential for its proper management.

  3. Pathology of Haemonchus contortus in New World camelids in the southeastern United States: a retrospective review. (United States)

    Edwards, Erin E; Garner, Bridget C; Williamson, Lisa H; Storey, Bob E; Sakamoto, Kaori


    Most small ruminant farms in tropical climates are plagued by Haemonchus contortus, a hematophagous, abomasal parasite. Heavy burdens of this parasite can cause anemia, hypoproteinemia, weight loss, and mortality in susceptible animals. Haemonchus contortus is becoming a major health concern in New World camelids as well, namely llamas (Llama glama) and alpacas (Vicugna pacos), yet little research has been conducted regarding its prevalence or pathology in these species. Herein, we present a retrospective review of llamas and alpacas that were admitted to The University of Georgia Veterinary Teaching Hospital and Athens Diagnostic Laboratory between the years 2002 and 2013. Antemortem fecal egg count (FEC) estimates performed on 30 alpacas were negatively correlated with hematocrit, hemoglobin, and red blood cell count. Total protein was not significantly correlated with FEC. On postmortem examination, 55 of 198 camelids, including 2 from the aforementioned antemortem review, were infected with H. contortus, with llamas (42.6%) having a significantly higher infection rate than alpacas (22.2%). In 15.7% of the total cases, the parasite was the major cause of death. Common gross lesions included peritoneal, thoracic, and pericardial effusions, visceral pallor, subcutaneous edema, and serous atrophy of fat. Histologic lesions included centrilobular hepatic necrosis, hepatic atrophy, lymphoplasmacytic inflammation of the mucosa of the third gastric compartment (C3), extramedullary hematopoiesis in both the liver and spleen, and the presence of nematodes in C3. Our study emphasizes the importance of H. contortus diagnosis and herd monitoring in New World camelids, particularly llamas.

  4. Clinical and pathological analysis of 116 cases of adult adrenal cortical adenoma and literature review

    Directory of Open Access Journals (Sweden)

    Jia AH


    Full Text Available Ai-Hua Jia,1 Hong-Quan Du,2 Min-Hua Fan,2 Yu-Hong Li,1 Jun-Long Xu,1 Gui-Fen Niu,2 Jie Bai,2 Guang-Zhen Zhang,2 Yu-Bo Ren1 1Department of Pathology, Liaocheng People’s Hospital, Liaocheng, People’s Republic of China; 2Department of Endocrinology, Liaocheng People’s Hospital, Liaocheng, People’s Republic of China Background: The aim of this study is to investigate origin, gross features, microscopic features, immunohistochemical properties, and differential diagnosis of adrenal cortical adenoma (ACA in patients ≥20 years old.Methods: The clinicopathological features of 116 cases of ACA and the immunohistochemical features of 50 cases of ACA were evaluated, and the relevant literature was reviewed.Results: In our cohort, 76.72% (89/116 of the cases were functional, and 27 cases had non-functional, benign adrenal adenomas. ACA presented as an island tumor with an envelope, and the mean tumor size was 3.6 cm (range 1–5 cm, with a mean tumor weight of 9.28 g (range 5–113 g. The shape of the tumor cells was consistent, and mitosis was rarely observed. Forty of the 46 patients with cortisol-secreting ACA had tumors containing granule cells. Primary aldosteronism was observed in 43 cases. Thirty-eight cases had endoscopically visible tumors, with clear cells and lipid-rich cytoplasm arranged in irregular patches or strips. Cortisol-producing ACAs were associated with atrophy of the non-tumorous cortex. Adrenocortical adenomas displayed positive immunohistochemical staining for MELAN-A, Syn (46 of 50 cases of ACA, NSE (44 of 50 cases of ACA, Vim (42 of 50 cases of ACA and Ki-67 <5% (24 of 50 cases of ACA; the remaining 26 cases were negative for Ki-67.Conclusion: Prediction of endocrine syndrome in functional ACA was possible based on its structure and morphologic features, which could prevent an unanticipated postoperative crisis. However, a clinical study is needed to validate these findings. Keywords: adrenal cortical adenoma

  5. Review of Amyotrophic Lateral Sclerosis, Parkinson's and Alzheimer's diseases helps further define pathology of the novel paradigm for Alzheimer's with heavy metals as primary disease cause. (United States)

    Cavaleri, Franco


    Pathologies of neurological diseases are increasingly recognized to have common structural and molecular events that can fit, sometimes loosely, into a central pathological theme. A better understanding of the genetic, proteomic and metabolic similarities between three common neurodegenerative diseases - Amyotrophic Lateral Sclerosis (ALS), Parkinson's disease (PD) and Alzheimer's disease (AD) - and how these similarities relate to their unique pathological features may shed more light on the underlying pathology of each. These are complex multigenic neuroinflammatory diseases caused by a combined action by multiple genetic mutations, lifestyle factors and environmental elements including a proposed contribution by transition metals. This comprehensive dynamic makes disease decoding and treatment difficult. One case of ALS, for example, can manifest from a very different pool of genetic mutations than another. In the case of ALS multiple genes in addition to SOD1 are implicated in the pathogenesis of both sporadic and familial variants of the disease. These genes play different roles in the processing and trafficking of signalling, metabolic and structural proteins. However, many of these genetic mutations or the cellular machinery they regulate can play a role in one form or another in PD and AD as well. In addition, the more recent understanding of how TREM-2 mutations factor into inflammatory response has shed new light on how chronic inflammatory activity can escalate to uncontrolled systemic levels in a variety of inflammatory diseases from neurodegenerative, auto-inflammatory and autoimmune diseases. TREM-2 mutations represent yet another complicating element in these multigenic disease pathologies. This review takes us one step back to discuss basic pathological features of these neurodegenerative diseases known to us for some time. However, the objective is to discuss the possibility of related or linked mechanisms that may exist through these basic disease

  6. [Pathology of the internal organs and central nervous system in acquired immunodeficiency syndrome (with special reference to opportunistic infections)]. (United States)

    Masini, T; Chinaglia, D; Riviera, L; Capricci, E; Gullotta, F; Spigolon, G; Bauer, A L


    Extracerebral and cerebral pathology in AIDS (with particular emphasis on the opportunistic infections). The Authors present the extracerebral pathology of 27 cases of AIDS observed at the Department of Pathology of Milan and the cerebral pathology of 80 cases of AIDS collected by three Institutes (Department of Pathology of Milan, Department of Pathology of Rimini and Department of Neuropathology of Münster) with particular emphasis on the pathology of the opportunistic infections. In the adults' group, the most frequent infections are the protozoan ones (T. gondii) followed with equal incidence by the viral and fungal diseases. In the pediatric group the viral diseases are the most frequently seen. Almost all of the adults show multiple infections in the same organ or in different organs. Diffuse lesions with heavy pathologic fields were observed also without tissue reaction. As to cerebral pathology AIDS' patients with opportunistic infections show focal symptoms, whereas the so called "subacute microglial encephalitis" generally appears as a demential syndrome. In cases with progressive multifocal leukoencephalopathy JC virus was always found and in one case also SV 40 - and BK virus. The diffuse demyelinization in some cases of HIV-Encephalopathy is aspecific. In HIV-positive newborns with cerebral signs, the lesions are characterized by oedema, spongiosis and microcalcifications of the basal ganglia; these are aspecific lesions which can be found in toxic and infectious encephalopathies.

  7. Cross-species approaches to pathological gambling: a review targeting sex differences, adolescent vulnerability and ecological validity of research tools. (United States)

    van den Bos, Ruud; Davies, William; Dellu-Hagedorn, Francoise; Goudriaan, Anna E; Granon, Sylvie; Homberg, Judith; Rivalan, Marion; Swendsen, Joel; Adriani, Walter


    Decision-making plays a pivotal role in daily life as impairments in processes underlying decision-making often lead to an inability to make profitable long-term decisions. As a case in point, pathological gamblers continue gambling despite the fact that this disrupts their personal, professional or financial life. The prevalence of pathological gambling will likely increase in the coming years due to expanding possibilities of on-line gambling through the Internet and increasing liberal attitudes towards gambling. It therefore represents a growing concern for society. Both human and animal studies rapidly advance our knowledge on brain-behaviour processes relevant for understanding normal and pathological gambling behaviour. Here, we review in humans and animals three features of pathological gambling which hitherto have received relatively little attention: (1) sex differences in (the development of) pathological gambling, (2) adolescence as a (putative) sensitive period for (developing) pathological gambling and (3) avenues for improving ecological validity of research tools. Based on these issues we also discuss how research in humans and animals may be brought in line to maximize translational research opportunities.

  8. Bacterial, Fungal, and Parasitic Infections of the Central Nervous System: Radiologic-Pathologic Correlation and Historical Perspectives. (United States)

    Shih, Robert Y; Koeller, Kelly K


    Despite remarkable progress in prevention and treatment, infectious diseases affecting the central nervous system remain an important source of morbidity and mortality, particularly in less-developed countries and in immunocompromised persons. Bacterial, fungal, and parasitic pathogens are derived from living organisms and affect the brain, spinal cord, or meninges. Infections due to these pathogens are associated with a variety of neuroimaging patterns that can be appreciated at magnetic resonance imaging in most cases. Bacterial infections, most often due to Streptococcus, Haemophilus, and Neisseria species, cause significant meningitis, whereas the less common cerebritis and subsequent abscess formation have well-documented progression, with increasingly prominent altered signal intensity and corresponding contrast enhancement. Atypical bacterial infections are characterized by the development of a granulomatous response, classically seen in tuberculosis, in which the tuberculoma is the most common parenchymal form of the disease; spirochetal and rickettsial diseases are less common. Fungal infections predominate in immunocompromised hosts and are caused by yeasts, molds, and dimorphic fungi. Cryptococcal meningitis is the most common fungal infection, whereas candidiasis is the most common nosocomial infection. Mucormycosis and aspergillosis are characterized by angioinvasiveness and are associated with high morbidity and mortality among immunocompromised patients. In terms of potential exposure in the worldwide population, parasitic infections, including neurocysticercosis, toxoplasmosis, echinococcosis, malaria, and schistosomiasis, are the greatest threat. Rare amebic infections are noteworthy for their extreme virulence and high mortality. The objective of this article is to highlight the characteristic neuroimaging manifestations of bacterial, fungal, and parasitic diseases, with emphasis on radiologic-pathologic correlation and historical perspectives.

  9. Substrate-protecting antiproteolytic agents for the prevention of pathological degradation of connective tissues. A review. (United States)

    Robert, A-M


    Connective tissues play an important role in the physiological functions of the organism. The integrity of the macromolecular components of these tissues, also called extracellular matrix, is necessary for their functional efficiency. A number of proteinases present in the organism, and the activity of which increases with age and with several pathologies, specifically degrade the components of the extracellular matrix. For a long time, tentatives for the protection of the matrix-components against degradation were made with low molecular weight inhibitors, not very efficient in vivo and not devoid of inconveniencies. We initiated a different approach for the preservation of the macromolecules of the extracellular matrix against proteolytic degradation with substances which exert an intense antiproteolytic activity not only in vitro, but also in vivo. The particularity of these substances is the fact that they do not act on the enzymes, but combine with the macromolecules. This is the type of combination of substances with the macromolecules of the matrix that prevents their degradation by the proteinases. Because of this affinity of such antiproteolytic agents not for the enzymes but for the substrates, we called them "substrate protectors" (Robert et al., 1979). The aim of the present review is to summarise the essential of our experiments which led to the description of substrate protectors.

  10. Cognitive distortions as a component and treatment focus of pathological gambling: a review. (United States)

    Fortune, Erica E; Goodie, Adam S


    The literature on the role of cognitive distortions in the understanding and treatment of pathological gambling (PG) is reviewed, with sections focusing on (a) conceptual underpinnings of cognitive distortions, (b) cognitive distortions related to PG, (c) PG therapies that target cognitive distortions, (d) methodological factors and outcome variations, and (e) conclusions and prescriptive recommendations. The conceptual background for distortions related to PG lies in the program of heuristics and biases (Kahneman & Tversky, 1974) as well as other errors identified in basic psychology. The literature has focused on distortions arising from the representativeness heuristic (gambler's fallacy, overconfidence, and trends in number picking), the availability heuristic (illusory correlation, other individuals' wins, and inherent memory bias), and other sources (the illusion of control and double switching). Some therapies have incorporated cognitive restructuring within broader cognitive-behavioral therapies, with success. Other therapies have focused more narrowly on correcting distorted beliefs, more often with limited success. It is concluded that the literature establishes the role of cognitive distortions in PG and suggests therapies with particularly good promise, but is in need of further enrichment.

  11. Physiotherapy treatments in musculoskeletal pathologies associated with haemophilia. A literature review. (United States)

    Guodemar-Pérez, Jesús; Ruiz-López, Montserrat; Rodríguez-López, Elena; García-Fernández, Pablo; Hervás-Pérez, Juan Pablo


    The aim of this study is to offer physiotherapists a synthesis of the main therapeutic tools available for the treatment of musculoskeletal pathologies in patients with haemophilia, according to the scientific literature. Although bleeds are recognised as no longer being a cause of death for people with haemophilia, the accompanying musculoskeletal injuries now represent the main problem associated with this disorder. There is a lack of clear guidelines to date regarding the physiotherapy treatment of these disorders. We performed a keyword searches of Pubmed, Scopus, Sciencedirect, Cochrane and PEDro databases. In total, 555 references were retrieved, of which only 55 fulfilled the inclusion criteria. Publications were grouped by the main symptoms caused by haemophilia and the physiotherapy treatments available. The literature reviewed shows that physiotherapists have a range of therapeutic tools at their disposal for the treatment of the main musculoskeletal disorders suffered by patients with haemophilia. Physiotherapy interventions act upon inflammation and pain, as well as favouring the reabsorption of haematomas, preventing muscle fibrosis and joint ankylosis and recovering the joint range from prior to the lesions. Also, these interventions help prevent muscle atrophy and provide patients with the optimal physical conditions for facing the small and repetitive injuries that, over time, can have a detrimental effect on their quality of life.

  12. Review of commonly used clinical pathology parameters for general gastrointestinal disease with emphasis on small animals. (United States)

    Steiner, Jörg M


    A wide variety of markers are available to assess the function and pathology of the gastrointestinal (GI) tract. This review describes some of these markers with special emphasis given to markers used in dogs and cats. Small intestinal disease can be confirmed and localized by the measurement of serum concentrations of folate and cobalamin. Fecal α1-proteinase inhibitor concentration can increase in individuals with excessive GI protein loss. A wide variety of inflammatory markers are available for a variety of species that can be used to assess the inflammatory activity of various types of inflammatory cells in the GI tract, although most of these markers assess neutrophilic inflammation, such as neutrophil elastase, calprotectin, or S100A12. N-methylhistamine can serve as a marker of mast cell infiltration. Markers for lymphocytic or eosinophilic inflammation are currently under investigation. Exocrine pancreatic function can be assessed by measurement of serum concentrations of pancreatic lipase immunoreactivity (PLI) and trypsin-like immunoreactivity (TLI). Serum PLI concentration is increased in individuals with pancreatitis and has been shown to be highly specific for exocrine pancreatic function and sensitive for pancreatitis. Serum TLI concentration is severely decreased in individuals with exocrine pancreatic insufficiency.

  13. Nausea and vomiting in pregnancy: a review of the pathology and compounding opportunities. (United States)

    Zur, Eyal


    Nausea and vomiting in pregnancy can have serious adverse effects on the quality of a woman's life, affecting her occupational, social, and domestic functioning, and her general well-being; therefore, it is very important to treat this condition appropriately and effectively. Evidence-based algorithms support the use of oral pyridoxine alone or combined with doxylamine as first-line treatment. Promethazine or dimenhydrinate, known as a second-line treatment, should be added to the first-line treatment or should be added only to pyridoxine according to different algorithms. In most of the world, there is a lack of approved medicines using this combination approach known as the first-line treatment. Therefore, compounding pharmacists should supply the demand by compounding 10-mg pyridoxine hydrochloride and 10-mg doxylamine succinate slow-release capsules. Since transdermal promethazine does not exist world wide, and, since this medicine has significant added values compared to the oral/rectal dosage forms, compounding pharmacists should offer physicians transdermal promethazine as a second-line therapy in nausea and vomiting in pregnancy. This review summarizes the nausea and vomiting in pregnancy problems and discusses the compounding opportunities that exist in this common and wide-spread pathology in order to improve a woman's quality of life.

  14. A review of definitions of the Himalayan Main Central Thrust (United States)

    Martin, Aaron J.


    Most workers regard the Main Central Thrust (MCT) as one of the key high strain zones in the Himalaya because it accommodated at least 90 km of shortening, because that shortening exhumed and buried hanging wall and footwall rocks, and due to geometric and kinematic connections between the Main Central Thrust and the structurally overlying South Tibet Detachment. Geologists currently employ three unrelated definitions of the MCT: metamorphic-rheological, age of motion-structural, or protolith boundary-structural. These disparate definitions generate map and cross-section MCT positions that vary by up to 5 km of structural distance. The lack of consensus and consequent shifting locations impede advances in our understanding of the tectonic development of the orogen. Here, I review pros and cons of the three MCT definitions in current use. None of these definitions is flawless. The metamorphic-rheological and age of motion-structural definitions routinely fail throughout the orogen, whereas the protolith boundary-structural definition may fail only in rare cases, all limited to sectors of the eastern Himalaya. Accordingly, a definition based on high strain zone geometry and kinematics combined with identification of a protolith boundary is the best working definition of the MCT.

  15. Behavioral Interventions in the Treatment of Pathological Gambling: A Review of Activity Scheduling and Desensitization (United States)

    Dowling, Nicki; Jackson, Alun C.; Thomas, Shane A.


    Cognitive and behavioral interventions have been cautiously recommended as "best practice" in the treatment of pathological gambling. Behavioral interventions, using a range of techniques, have been the most commonly evaluated approach to the psychological treatment of pathological gambling. The recent literature evaluating behavioral treatments…

  16. A critical review of the concept of pathological grief following pregnancy loss

    NARCIS (Netherlands)

    Janssen, H.J.E.M.; Cuisinier, M.C.J.; Hoogduin, K.A.L.


    It has often been suggested in the literature on pregnancy loss, that parents run a high risk of complicated or pathological grief as a result of the specific characteristics of such loss. What confuses the issue is that pathological grief has been defined in various ways. In the interest of improvi

  17. A review of Heinrich Obersteiner's 1888 textbook on the central nervous system by the neurologist Sigmund Freud. (United States)

    Hatzigiannakoglou, Paul D; Triarhou, Lazaros C


    In 1888, the Austrian neuroanatomist Heinrich Obersteiner, founder of Vienna's Neurological Institute, published his "Introduction to the Study of the Structure of the Central Nervous Organs in Health and Disease", a fundamental textbook in which he summarised the state-of-the-art knowledge available then on the normal and pathological anatomy of the human nervous system, incorporating many of his original research findings. The book became "the Bible for generations of budding neurologists" worldwide and was crucial for the eventual development of neurology as an independent medical discipline. In his early career as a neuroanatomist, Sigmund Freud wrote a review of Obersteiner's book for the Wiener Medizinische Wochenschrift. That review was not included in the "Standard Edition of the Complete Psychological Works". The present article provides an English translation of Freud's review and further discusses its historical context, especially regarding the influence of Theodor Meynert on his two illustrious students, Freud and Obersteiner.

  18. Pathologic and Protective Roles for Microglial Subsets and Bone Marrow- and Blood-Derived Myeloid Cells in Central Nervous System Inflammation

    DEFF Research Database (Denmark)

    Wlodarczyk, Agnieszka; Cédile, Oriane; Jensen, Kirstine Nolling;


    and also immunoregulation and regenerative processes. Better understanding and characterization of myeloid cell heterogeneity is essential for future development of treatments controlling inflammation and inducing neuroprotection and neuroregeneration in diseased CNS. Here, we describe and compare three......Inflammation is a series of processes designed for eventual clearance of pathogens and repair of damaged tissue. In the context of autoimmune recognition, inflammatory processes are usually considered to be pathological. This is also true for inflammatory responses in the central nervous system...

  19. Proliferative verrucous leukoplakia (PVL): a review of an elusive pathologic entity! (United States)

    Gillenwater, Ann M; Vigneswaran, Nadarajah; Fatani, Hanadi; Saintigny, Pierre; El-Naggar, Adel K


    Proliferative verrucous leukoplakia (PVL) is a rare less recognized form of oral leukoplakia. Patients with this condition represent a unique clinically and pathologically progressive characteristic from conventional leukoplakia. Because of the lack of defined pathologic lesions, identifying patients with the early diagnosis of PVL is challenging. This is largely due to the overlapping clinical and pathologic early features with conventional multifocal leukoplakia with dysplasia. The diagnosis can only be achieved through the keen clinical observation of the temporal progression in individual patients to verrucous and/or conventional squamous carcinoma. We present a brief view of the clinicopathologic and biological characteristics of PVL and discuss diagnosis, differential diagnosis, and management.

  20. Digital pathology

    CERN Document Server

    Sucaet, Yves


    Digital pathology has experienced exponential growth, in terms of its technology and applications, since its inception just over a decade ago. Though it has yet to be approved for primary diagnostics, its values as a teaching tool, facilitator of second opinions and quality assurance reviews and research are becoming, if not already, undeniable. It also offers the hope of providing pathology consultant and educational services to under-served areas, including regions of the world that could not possibly sustain this level of services otherwise. And this is just the beginning, as its adoption b

  1. Tubulointerstitial damage as the major pathological lesion in endemic chronic kidney disease among farmers in North Central Province of Sri Lanka. (United States)

    Nanayakkara, Shanika; Komiya, Toshiyuki; Ratnatunga, Neelakanthi; Senevirathna, S T M L D; Harada, Kouji H; Hitomi, Toshiaki; Gobe, Glenda; Muso, Eri; Abeysekera, Tilak; Koizumi, Akio


    Chronic kidney disease of uncertain etiology (CKDu) in North Central Province of Sri Lanka has become a key public health concern in the agricultural sector due to the dramatic rise in its prevalence and mortality among young farmers. Although cadmium has been suspected as a causative pathogen, there have been controversies. To date, the pathological characteristics of the disease have not been reported. Histopathological observations of 64 renal biopsies obtained at Anuradhapura General Hospital from October 2008 to July 2009 were scored according to Banff 97 Working Classification of Renal Allograft pathology. The correlations between the histological observations and clinical parameters were statistically analyzed. Interstitial fibrosis and tubular atrophy with or without nonspecific interstitial mononuclear cell infiltration was the dominant histopathological observation. Glomerular sclerosis, glomerular collapse, and features of vascular pathology such as fibrous intimal thickening and arteriolar hyalinosis were also common. Although hypertension was identified as one of the common clinical features among the cases, it did not influence the histopathological lesions in all the cases. This study concludes that tubulointerstitial damage is the major pathological lesion in CKDu. Exposure(s) to an environmental pathogen(s) should be systematically investigated to elucidate such tubulointerstitial damage in CKDu.

  2. [Peer review procedures in pathology - more than ten years of experience in the free state of Saxony]. (United States)

    Eberlein-Gonska, Maria; Baretton, Gustavo; Habeck, Jörg-Olaf


    The positive experiences regarding peer review practice go back to the 1990s and can be traced in the position paper of the German Medical Association concerning quality assurance in the field of pathology. This evolved into the initiative of pathologists in Saxony to implement the peer review practice within the remit of their State Medical Association. Since the 14(th) of May 1999 various institutes as well as medical group practices in pathology and cytology have joined forces to undertake voluntary inter-institutional quality control measures. The aim was to improve the process and especially the outcome quality by reviewing each other's quality (analysing samples) on the basis of defined criteria. A positive review outcome report, which will have to be unanimously agreed upon by all participants, will lead to a positive recommendation for a certificate issued by the Medical Association of Saxony. Between 1999 and 2011 a total of 56 peer review proceedings took place. The potentials for improvement concern the problem of "kitchen pathology" still being used in the context of macroscopic description, the quality of microscopic description including the use of correct nomenclature, the quality of tumour classification and immune histological investigations. Statements concerning the advantage of the peer review method in particular refer to the integration of resident pathologists. Due to the long period of implementation of the peer review system und the small number of proceedings, it is not possible to come to a clear conclusion about the improvement or deterioration of quality. During a period of more than 10 years three peer review proceedings were not successful. In this situation, it is appropriate to ask the question of how restrictive peer reviews should be. The three most important aspects for the pathologists in Saxony are: self-determination, learning from each other, and a commitment to quality improvement. So this method set an example of how a

  3. Imaging in Tumors of he Mandible: Case Series, Pathologic Correlation & Literature Review

    Directory of Open Access Journals (Sweden)

    N. Sedighi


    Full Text Available Most of the radiologists do not have opportunity to be exposing to the radiologic investigation of patients suspicious for mandibular neoplasms in Iran."nWe had the opportunity to study interesting cases of mandibular bone tumors with proved pathologic diagnosis. In the present study, we describe clinical history and physical examination of these patients, moreover, the results of radiologic and pathologic findings will be assessed. The results of the current study could be helpful to increase the knowledge of radiologists in challenging with these tumors. It also will provide useful information about their characteristics in imaging.

  4. New Cancer Prevention and Control Central Institutional Review Board Established | Division of Cancer Prevention (United States)

    The NCI Central Institutional Review Board (CIRB) Initiative announced the establishment of the Cancer Prevention and Control (CPC) CIRB January 14, extending the benefits of centralized review to investigators participating in clinical trials sponsored by the Division of Cancer Prevention (DCP). |

  5. Review of Breast Cancers That Can Mimic a Cystic Component: Ultrasonographic and Pathologic Correlations

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Yun Woo; Kwon, Kui Hyang; Choi, Deuk Lin; Lee, Dong Wha [Dept. of Radiology, (Korea, Republic of); Kim, Kyung Whan [Dept. of Radiology, Soonchunhyang Cheonan Hospital, Cheonan (Korea, Republic of); Yang, Seung Bo [Dept. of Radiology, Soonchunhyang Gumi Hospital, Gumi (Korea, Republic of)


    We illustrate the sonographic findings of malignant breast masses that can mimic a cystic component with pathologic correlations. The disease entities presented in this study include infiltrating ductal carcinoma, ductal carcinoma in situ (DCIS), papillary carcinoma, mucinous carcinoma, medullary carcinoma, metaplastic carcinoma, and a malignant phyllodes tumor. Malignant masses with a cystic component are often characterized by well-circumscribed round, oval, or lobular masses, thereby appearing benign on ultrasonography. On pathology, the cystic component of a malignant mass is identified by cystic degeneration, hemorrhage, necrosis, or ductal dilatation. If the mass is well-circumscribed with a cystic component, a biopsy should be considered in the analysis of the solid component within a mass.

  6. Asperger's syndrome with unusual cerebral pathology: Case report and literature review. (United States)

    Liu, Liqiong; Vo, Van; Ware, Marcus; Xiong, Zhenggang


    A case of Asperger's syndrome with unusual cerebral pathological changes is reported. A 22-year-old male had been having diagnostic Asperger's syndrome since the age of eight and had epilepsy during the past two years. Radiological studies revealed a focal intra-axial cortical and subcortical cerebral lesion with hyper-intensity and non-enhancing contrast in the left frontal lobe. Histological and immunohistochemical studies demonstrated that the lesion consisted of cortical laminar disorganization, neuronal dysmorphism and increased heterotopic neurons in sub-cortical white matter. To our knowledge, this is the first case of Asperger's syndrome with focal cerebral pathological abnormalities rather than mini-columnar changes and the gyrial malformation reported in the literature.

  7. Main pathologies associated with "Staphylococcus aureus" infections in rabbits: a review


    Haesebrouck, F.; Corpa, J.M.; Hermans, K.


    Staphylococcus aureus is a versatile opportunistic pathogen that causes a wide spectrum of pathologies. In rabbits, this bacterium infects dermal lesions causing suppurative dermatitis, and invades subcutaneous tissues, causing different well-known disease conditions such as mastitis, abscesses (subcutaneously or affecting internal organs) and pododermatitis. However, the lesions associated with S. aureus have rarely been described in detail in the literature. The aim of this paper is to upda...

  8. Plasmacytoid Transitional Cell Carcinoma of Bladder: A Clinico-pathological Study and Review of Literatures

    Institute of Scientific and Technical Information of China (English)

    FENG Xiaoli; ZHANG Hongtu; SUN Yuntian; LIU Xiuyun


    Objective: To study the pathologic features of plasmacytoid transitional cell carcinoma of the bladder, and to analyze the diagnostic features, criteria for differential diagnosis and the clinical significance of the tumor. Methods: Two cases of bladder plasmacytoid transitional cell carcinoma were studied. Routine paraffin sections with HE staining, Pap smear and immunohistochemistry by S-P method were observed under a light microscope. Pathological and clinical data were analyzed by comparison with early reported cases in literatures. Results: A characteristic feature of this tumor was of deep invasion in the lamina propria and/or muscularis propria, in addition to the component of carcinoma in situ in the mucosa, when tumors were diagnosed. The histological pattern and cytological features showed similarity to a plasmacytoid tumor. The tumor cells were strongly positive for AE1/AE3, CEA and CK18. The prognosis appeared to be worse than ordinary transitional cell carcinoma. Conclusion: The plasmacytoid transitional cell carcinoma of bladder is rare but has typical pathological, immunohistological and clinical features. Pathologists should be aware of this kind of primary tumor of bladder.

  9. Pathology Databanking and Biobanking in The Netherlands, a Central Role for PALGA, the Nationwide Histopathology and Cytopathology Data Network and Archive

    Directory of Open Access Journals (Sweden)

    M. Casparie


    Full Text Available Since 1991, a nationwide histopathology and cytopathology network and archive is in operation in The Netherlands under the name PALGA, encompassing all sixty-four pathology laboratories in The Netherlands. The overall system comprises decentralized systems at the participating laboratories, a central databank, and a dedicated communication and information exchange tool. Excerpts of all histopathology and cytopathology reports are generated automatically at the participating laboratories and transferred to the central databank. Both the decentralized systems and the central system perform checks on the quality and completeness of excerpts. Currently, about 42 million records on almost 10 million patients are stored in the central databank. Each excerpt contains patient identifiers, including demographic data and the so-called PALGA diagnosis. The latter is structured along five classification axes: topography, morphology, function, procedure, and diseases. All data transfer and communication occurs electronically with encryption of patient and laboratory identifiers. All excerpts are continuously available to all participating pathology laboratories, thus contributing to the quality of daily patient care. In addition, external parties may obtain permission to use data from the PALGA system, either on an ongoing basis or on the basis of a specific permission. Annually, 40 to 60 applications for permission to use PALGA data are submitted. Among external users are the Dutch cancer registry, population-based screening programs for cancer of the uterine cervix and breast cancer in The Netherlands, and individual investigators addressing a range of research questions. Many scientific papers and theses incorporating PALGA data have been published already. In conclusion, the PALGA system is a unique system that requires a minimal effort on the part of the participating laboratories, while providing them a powerful tool in their daily practices.

  10. The central masturbation fantasy in heterosexual males across the life cycle: masturbation fantasies across the normality-pathology spectrum. (United States)

    Colarusso, Calvin A


    Moses Laufer described the central masturbation fantasy as an essentially adolescent phenomenon that leads to the final sexual organization. In this paper the central masturbation fantasy, formulated during the preoedipal and oedipal years, consolidated in adolescence, and in a process of continuous evolution across the life cycle, is considered an essential concept for understanding sexuality in heterosexual males. Sex and aggression, as posited in Freud's dual theory of the drives, are core components of all masturbation fantasies, across the diagnostic spectrum, from the most normal/neurotic to the most criminally bizarre. Clinical examples illustrate both points. The tendency among clinicians, particularly clinical associates, to avoid analyzing all aspects of masturbation is discussed.

  11. Evidences of Polymorphism Associated with Circadian System and Risk of Pathologies: A Review of the Literature

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    F. J. Valenzuela


    Full Text Available The circadian system is a supraphysiological system that modulates different biological functions such as metabolism, sleep-wake, cellular proliferation, and body temperature. Different chronodisruptors have been identified, such as shift work, feeding time, long days, and stress. The environmental changes and our modern lifestyle can alter the circadian system and increase the risk of developing pathologies such as cancer, preeclampsia, diabetes, and mood disorder. This system is organized by transcriptional/tranductional feedback loops of clock genes Clock, Bmal1, Per1–3, and Cry1-2. How molecular components of the clock are able to influence the development of diseases and their risk relation with genetic components of polymorphism of clock genes is unknown. This research describes different genetic variations in the population and how these are associated with risk of cancer, metabolic diseases such as diabetes, obesity, and dyslipidemias, and also mood disorders such as depression, bipolar disease, excessive alcohol intake, and infertility. Finally, these findings will need to be implemented and evaluated at the level of genetic interaction and how the environment factors trigger the expression of these pathologies will be examined.

  12. Evidences of Polymorphism Associated with Circadian System and Risk of Pathologies: A Review of the Literature (United States)

    Valenzuela, F. J.; Vera, J.; Venegas, C.; Muñoz, S.; Oyarce, S.; Muñoz, K.; Lagunas, C.


    The circadian system is a supraphysiological system that modulates different biological functions such as metabolism, sleep-wake, cellular proliferation, and body temperature. Different chronodisruptors have been identified, such as shift work, feeding time, long days, and stress. The environmental changes and our modern lifestyle can alter the circadian system and increase the risk of developing pathologies such as cancer, preeclampsia, diabetes, and mood disorder. This system is organized by transcriptional/tranductional feedback loops of clock genes Clock, Bmal1, Per1–3, and Cry1-2. How molecular components of the clock are able to influence the development of diseases and their risk relation with genetic components of polymorphism of clock genes is unknown. This research describes different genetic variations in the population and how these are associated with risk of cancer, metabolic diseases such as diabetes, obesity, and dyslipidemias, and also mood disorders such as depression, bipolar disease, excessive alcohol intake, and infertility. Finally, these findings will need to be implemented and evaluated at the level of genetic interaction and how the environment factors trigger the expression of these pathologies will be examined. PMID:27313610

  13. Centralized Decentralization or Decentralized Centralization? A Review of Newer Norwegian Research on Schools and Their Communities (United States)

    Kvalsund, Rune


    In this paper, Norwegian research on the relationship between the school and the local community during the past 30 years is reviewed. The Norwegian context of schooling is briefly described, pointing out the rural-urban conflict. The review is organized into two phases: research in the expansive and contractive phases of the Norwegian welfare…

  14. MALDI TOF imaging mass spectrometry in clinical pathology: a valuable tool for cancer diagnostics (review). (United States)

    Kriegsmann, Jörg; Kriegsmann, Mark; Casadonte, Rita


    Matrix-assisted laser desorption/ionization (MALDI) time-of-flight (TOF) imaging mass spectrometry (IMS) is an evolving technique in cancer diagnostics and combines the advantages of mass spectrometry (proteomics), detection of numerous molecules, and spatial resolution in histological tissue sections and cytological preparations. This method allows the detection of proteins, peptides, lipids, carbohydrates or glycoconjugates and small molecules.Formalin-fixed paraffin-embedded tissue can also be investigated by IMS, thus, this method seems to be an ideal tool for cancer diagnostics and biomarker discovery. It may add information to the identification of tumor margins and tumor heterogeneity. The technique allows tumor typing, especially identification of the tumor of origin in metastatic tissue, as well as grading and may provide prognostic information. IMS is a valuable method for the identification of biomarkers and can complement histology, immunohistology and molecular pathology in various fields of histopathological diagnostics, especially with regard to identification and grading of tumors.

  15. Advantage of CT scan in muscular pathology. Personal cases and review of the literature

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    Laroche, M.; Rousseau, H.; Mazieres, B.; Bonafe, A.; Joffre, F.; Arlet, J.


    The advantage of CT scans in muscular pathology is studied. The scan, in addition to the diagnosis of tumors and muscular abscesses, permits to differentiate primary myopathies from neurogenic atrophies: in the course of myopathies, the muscle volume is preserved and they appear as a hypodensity; in neurogenic atrophies, the muscle volume is reduced with preserved density. The CT scan permits to determine the extension of these lesions. In the course of polymyositis, certain forms of rheumatid arthritis, the scan discloses a trabecular and 'worm-eaten' aspect of the muscles. This is also observed after long-term steroid therapy and other endocrine diseases (hyperthyroidism, osteomalacia) indicating an infra-clinical myopathy. In vertebral osteoporosis with fractures and patients with chronic lumbalgia, very ofter, an atrophy of the spinal muscle is observed. Finally, in the course of acquired kyphosis of the adult patient (camptocormia), the CT scan suggest an isolated myopathy, with late manifestations, of the paravertebral muscles.

  16. Intracranial lesions with high signal intensity on T1-weighted MR images – review of pathologies (United States)

    Zimny, Anna; Zińska, Lidia; Bladowska, Joanna; Neska-Matuszewska, Małgorzata; Sąsiadek, Marek


    Summary In the article we present pathological intracranial substances and lesions, which produce high signal intensity on T1-weighted MR images. Six groups of substances are discussed: 1. Gadolinium – based contrast agents, 2.hemoglobin degradation products (intra- and extra-cellular methemoglobin), 3. lipid-containing lesions (lipoma, dermoid cyst, implanted fatty materials, laminar cortical necrosis), 4. substances with high concentration of proteins (colloid cyst, craniopharyngioma, Rathke’s cleft cyst, ectopic posterior pituitary gland), 5. melanin (metastatic melanoma), 6. lesions containing mineral substances such as: calcium (calcifications, Fahr’s disease), copper (Wilson’s disease) and manganese (hepatic encephalopathy, manganese intoxication in intravenous drug abusers). Appropriate interpretation of signal intensity as well as analysis of location of lesions and clinical symptoms enables planning of further diagnostics and, in many cases, establishing the final diagnosis based on MR examination. PMID:24505222

  17. Solitary central osteoma of mandible in a geriatric patient: Report and review (United States)

    Bhujbal, Ravi B.; Nayak, Ajay G.


    Solitary central osteomas of jaw are extremely rare lesions with only few previously documented cases. This paper reports a case of large solitary central osteoma involving mandible symphysis- parasymphysis region in an elderly female patient. A brief review of similar cases reported in the literature is also provided in this paper. Key words:Osteomas, osteogenic,bone, tumor, jaw, mandible. PMID:27034765

  18. Reviewing the pathogenesis of antibody-mediated rejection and renal graft pathology after kidney transplantation. (United States)

    Morozumi, Kunio; Takeda, Asami; Otsuka, Yasuhiro; Horike, Keiji; Gotoh, Norihiko; Narumi, Shunji; Watarai, Yoshihiko; Kobayashi, Takaaki


    The clinicopathological context of rejection after kidney transplantation was well recognized. Banff conferences greatly contributed to elucidate the pathogenesis and to establish the pathologic criteria of rejection after kidney transplantation. The most important current problem of renal transplantation is de novo donor-specific antibody (DSA) production leading chronic rejection and graft loss. Microvascular inflammation is considered as a reliable pathological marker for antibody-mediated rejection (AMR) in the presence of DSA. Electron microscopic study allowed us to evaluate early changes in peritubular capillaries in T-lymphocyte mediated rejection and transition to antibody-mediated rejection. Severe endothelial injuries with edema and activated lymphocyte invaded into subendothelial space with early multi-layering of peritubular capillary basement membrane suggest T-lymphocyte mediated rejection induce an unbounded chain of antibody-mediated rejection. The risk factors of AMR after ABO-incompatible kidney transplantation are important issues. Anti-ABO blood type antibody titre of IgG excess 32-fold before transplant operation is the only predictable factor for acute AMR. Characteristics of chronic active antibody-mediated rejection (CAAMR) are one of the most important problems. Light microscopic findings and C4d stain of peritubular capillary and glomerular capillary are useful diagnostic criteria of CAAMR. Microvascular inflammation, double contour of glomerular capillary and thickening of peritubular capillary basement are good predictive factors of the presence of de novo DSA. C4d stain of linear glomerular capillary is a more sensitive marker for CAAMR than positive C4d of peritubular capillary. Early and sensitive diagnostic attempts of diagnosing CAAMR are pivotal to prevent chronic graft failure.

  19. Vagus nerve stimulation for epilepsy: A review of central mechanisms


    Krahl, Scott E.; Clark, Kevin B.


    In a previous paper, the anatomy and physiology of the vagus nerve was discussed in an attempt to explain which vagus nerve fibers and branches are affected by clinically relevant electrical stimulation. This companion paper presents some of vagus nerve stimulation's putative central nervous system mechanisms of action by summarizing known anatomical projections of vagal afferents and their effects on brain biogenic amine pathways and seizure expression.

  20. Pathological features of the central nervous system lesions with Epstein-Barr virus in patients with HIV/AIDS

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    Kozko V.N.


    Full Text Available Background. HIV infection/AIDS is a social disease and morbidity in some segments of the population is threatening. One of the target organs for HIV is the nervous system. The central nervous system lesion occurring in the form of meningoencephalitison the background of HIV infection is one of the leading death causes in patients with severe immunosuppression. Objective. Reveal the typicalmorphologic changes in the central nervous system during Epstein-Barr virus meningoencephalitis in patients with HIV/AIDS. Methods. Brain tissue and meningesof deceased patients with Epstein-Barr virus meningoencephalitis. Selected 6 deaths – three women and three men, aged 28 to 34 years. Following routine procedure histologic sections were produced, which were stained with hematoxylin and eosin staining, Nissl. Results. We showed signs of development of subacute encephalitis with the presence of giant areas of demyelination by morphological study of the combination of clinical cases of HIV and Epstein-Barr virus infection. In brain tissue we identified giant cells. In addition to this significant feature of the combination of HIV and Epstein-Barr virus infection can be considered productive development of vasculitis with thrombosis and ischemic brain lesions. During histological studies in HIV-infected patients were found: infiltration of the vessel wall by leukocytes, edema and proliferative changes in the intima. All this leads to a narrowing of the lumen and thrombosis with further possible infarct, vessel rupture and hemorrhage. Conclusion. It is established that in case of damage of the central nervous system with Epstein-Barr virus in HIV patients develops subacute giant cell encephalitis with the presence of demyelination areas, a bland astrogliosis, development of productive vasculitis with thrombosis, that complicated by ischemic lesions of the brain.

  1. Primary osseous tumors of the pediatric spinal column: review of pathology and surgical decision making. (United States)

    Ravindra, Vijay M; Eli, Ilyas M; Schmidt, Meic H; Brockmeyer, Douglas L


    Spinal column tumors are rare in children and young adults, accounting for only 1% of all spine and spinal cord tumors combined. They often present diagnostic and therapeutic challenges. In this article, the authors review the current management of primary osseous tumors of the pediatric spinal column and highlight diagnosis, management, and surgical decision making.

  2. Septal panniculitis: Clinico-pathological review of the literature and case presentation

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    Gabriela Martinez Braga


    Full Text Available The panniculitides comprise a large and heterogeneous group of diseases, with a high prevalence in the general population, in which the inflammatory process affects the subcutaneous tissue. We briefly review the classification, clinical and histology of the primary panniculitides and present a representative case.

  3. Clinical pathological impacts of microRNAs in papillary thyroid carcinoma: A crucial review. (United States)

    Chruścik, Anna; Lam, Alfred King-yin


    MicroRNAs (miRNA) deregulation is an important event in the pathogenesis of papillary thyroid carcinoma. The alternations of miRNAs could be measured at the cancer tissue or serum so that the clinical impacts of them in papillary thyroid carcinoma could be studied. Using the approach, miRNA deregulation was reported to be associated with pathological stages in papillary thyroid carcinoma as reflected by the differences in extent of extra-thyroidal invasion, size of the tumour as well as presence of lymph nodes metastases. The most common miRNAs involved in these processes are miRNA-146, miRNA-222 and miRNA-221. Also, miRNA-222 and miRNA-146b deregulation are commonly associated with cancer recurrence in patients with papillary thyroid carcinoma. Additionally, miRNA-146, miRNA-222, and miRNA-221 are the top-regulated miRNAs involved in the pathogenesis confirmed by deep-sequencing and have their function studied in vitro. Targeting these subsets of miRNAs may be useful in management of patients with papillary thyroid carcinoma.

  4. Age-associated physiological and pathological changes at the blood-brain barrier: A review. (United States)

    Erdő, Franciska; Denes, László; de Lange, Elizabeth


    The age-associated decline of the neurological and cognitive functions becomes more and more serious challenge for the developed countries with the increasing number of aged populations. The morphological and biochemical changes in the aging brain are the subjects of many extended research projects worldwide for a long time. However, the crucial role of the blood-brain barrier (BBB) impairment and disruption in the pathological processes in age-associated neurodegenerative disorders received special attention just for a few years. This article gives an overview on the major elements of the blood-brain barrier and its supporting mechanisms and also on their alterations during development, physiological aging process and age-associated neurodegenerative disorders (Alzheimer's disease, multiple sclerosis, Parkinson's disease, pharmacoresistant epilepsy). Besides the morphological alterations of the cellular elements (endothelial cells, astrocytes, pericytes, microglia, neuronal elements) of the BBB and neurovascular unit, the changes of the barrier at molecular level (tight junction proteins, adheres junction proteins, membrane transporters, basal lamina, extracellular matrix) are also summarized. The recognition of new players and initiators of the process of neurodegeneration at the level of the BBB may offer new avenues for novel therapeutic approaches for the treatment of numerous chronic neurodegenerative disorders currently without effective medication.

  5. Mini review of Central Exclusive Production at LHC

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    Brona, Grzegorz


    The LHC experiments provide an unprecedented coverage in pseudo-rapidity. This advantage and the high LHC luminosity allow for broad studies of central exclusive production (CEP) \\mbox{processes} such as exclusive production of $\\Upsilon$, di-leptons, di-photons and di-jets. With the proposed near beam detectors (FP420 and FP220) exclusive Higgs and SUSY states will be also \\mbox{accesible}. The \\mbox{discussion} is focused on the CMS programme, but both CMS and ATLAS have similar \\mbox{kinematical} coverage and may perform similar studies.

  6. Mini review of Central Exclusive Production at LHC

    CERN Document Server

    Brona, Grzegorz


    The LHC experiments provide an unprecedented coverage in pseudo-rapidity. This advantage and high LHC luminosity allow for broad studies of central exclusive production (CEP) processes such as exclusive production of ¡, di-leptons, di-photons and di-jets. Finally, with the proposed near beam detectors (FP420 and FP220) the exclusive Higgs and SUSY states will be also accesible. The discussion is focused on the CMS programme, as both CMS and ATLAS have similar kinematical coverage and may perform similar studies.

  7. A review of novel optical imaging strategies of the stroke pathology and stem cell therapy in stroke

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    Markus eAswendt


    Full Text Available Transplanted stem cells can induce and enhance functional recovery in experimental stroke. Invasive analysis has been extensively used to provide detailed cellular and molecular characterization of the stroke pathology and engrafted stem cells. But post mortem analysis is not appropriate to reveal the time scale of the dynamic interplay between the cell graft, the ischemic lesion and the endogenous repair mechanisms. This review describes non-invasive imaging techniques which have been developed to provide complementary in vivo information. Recent advances were made in analyzing simultaneously different aspects of the cell graft (e.g. number of cells, viability state and cell fate, the ischemic lesion (e.g. blood brain barrier consistency, hypoxic and necrotic areas and the neuronal and vascular network. We focus on optical methods, which permit simple animal preparation, repetitive experimental conditions, relatively medium-cost instrumentation and are performed under mild anesthesia, thus nearly under physiological conditions. A selection of recent examples of optical intrinsic imaging, fluorescence imaging (FLI and bioluminescence imaging (BLI to characterize the stroke pathology and engrafted stem cells are discussed. Special attention is paid to novel optimal reporter genes/probes for genetic labeling and tracking of stem cells and appropriate transgenic animal models. Requirements, advantages and limitations of these imaging platforms are critically discussed and placed into the context of other non-invasive techniques, e.g. magnetic resonance imaging (MRI and positron emission tomography (PET, which can be joined with optical imaging in multimodal approaches.

  8. Pío del Río Ortega: A Visionary in the Pathology of Central Nervous System Tumors

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    Santiago eRamon y Cajal


    Full Text Available The last 140 years have seen considerable advances in knowledge of central nervous system tumors. However, the main tumor types had already been described during the early years of the twentieth century. The studies of Dr. Pío del Río Hortega have been ones of the most exhaustive histology and cytology–based studies of nervous system tumors. Río Hortega’s work was performed using silver staining methods, which require a high level of practical skill and were therefore difficult to standardize. His technical aptitude and interest in nervous system tumors played a key role in the establishment of his classification, which was based on cell lineage and embryonic development. Río Hortega’s approach was controversial when he proposed it. Current classifications are based not only on cell type and embryonic lineage, as well as on clinical characteristics, anatomical site, and age.

  9. Editorial review: an update on central sensitivity syndromes and the issues of nosology and psychobiology. (United States)

    Yunus, Muhammad B


    Central sensitization (CS), simply defined as an amplified response of the central nervous system to peripheral input, is a concept of great importance in clinical medicine. It has helped to explain aspects of the pathophysiology of common diseases, e.g. fibromyalgia syndrome (FMS), irritable bowel syndrome, vulvodynia, headaches, chronic pelvic pain and other overlapping conditions (collectively called central sensitivity syndromes, or CSS). It also applies to pain of complex regional pain syndrome, osteoarthritis (OA), rheumatoid arthritis (RA) and post-operative pain. The pathology-pain gap in CSS is readily explained by CS. Many FMS and other CSS patients have peripheral pathology, e.g. nociceptive areas in the muscles, arthritis, small fiber neuropathy and inflammation. Pro-inflammatory cytokines are elevated in some patients. Identification of CS in patients with structural pathology, e.g. OA and RA, has helped to explain why not all patients benefit from nonsteroidal anti-inflammatory drugs or joint replacement surgery, and require therapy directed at CS. Glial cells are important in pain processing. Remarkable advances have been achieved in neuroimaging, including visualization of grey matter and white matter, not only during provoked pain but also pain at rest. Based on CS mechanisms, targeted individual therapy may now be possible. Appropriate nosology is important particularly for effective patient care. Dichotomy of neurochemical-structural ("functional") and structural ("organic") pathology should be abandoned; many patients have both. Psychobiology is also biology. Patient-blaming terms like somatization, somatizer and catastrophizing should be avoided. For therapy, both pharmacological and non- pharmacological approaches are important, including recognition of subgroups and person/patient-centered care.

  10. Implications of blast exposure for central auditory function: A review

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    Frederick J. Gallun, PhD


    Full Text Available Auditory system functions, from peripheral sensitivity to central processing capacities, are all at risk from a blast event. Accurate encoding of auditory patterns in time, frequency, and space are required for a clear understanding of speech and accurate localization of sound sources in environments with background noise, multiple sound sources, and/or reverberation. Further work is needed to refine the battery of clinical tests sensitive to the sorts of central auditory dysfunction observed in individuals with blast exposure. Treatment options include low-gain hearing aids, remote-microphone technology, and auditory-training regimens, but clinical evidence does not yet exist for recommending one or more of these options. As this population ages, the natural aging process and other potential brain injuries (such as stroke and blunt trauma may combine with blast-related brain changes to produce a population for which the current clinical diagnostic and treatment tools may prove inadequate. It is important to maintain an updated understanding of the scope of the issues present in this population and to continue to identify those solutions that can provide measurable improvements in the lives of Veterans who have been exposed to high-intensity blasts during the course of their military service.

  11. Diagnostic radiology of pet and wild birds: a review II. Indications of radiological examination and radiographs of pathological lesions. (United States)

    Beregi, A; Molnár, V; Felkai, F; Bíró, F; Szentgáli, Z


    The second part of the review dealing with the diagnostic radiology of pet and wild birds discusses the indications of radiological examination, the interpretation of radiographs taken of pathological lesions, and the differential diagnosis of such lesions. Radiology has paramount importance in the diagnosis of diseases affecting the skeletal, digestive, respiratory, urogenital and cardiovascular systems. Certain diseases (shortage of grits, ovarian cysts) cannot be recognized without radiography. Other conditions (e.g. Macaw Wasting Disease, renal tumours, egg retention) require this complementary diagnostic method for confirmation of a suspicion based upon the clinical signs. Radiographic examination is also indicated for follow-up of the surgical management of bone fractures and for facilitating the implantation of transponders aimed at individual identification of the birds.

  12. Pathological clavicular fracture as ifrst presentation of renal cell carcinoma:a case report and literature review

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    Yan Kong; Jin Wang; Huan Li; Peng Guo; Jian-Fa Xu; He-Lin Feng


    Renal cell carcinoma (RCC) accounts for approximately 3%of all cancer cases. RCCs usually metastasize to the lungs, bones, liver, or brain. Only<1%of patients with bone metastases manifested clavicular RCC metastases. hTus, clavicular metastasis as the initial presentation of RCC is extremely rare. We report a patient with RCC metastasis to the letf clavicle, which was ifrst presented with pain caused by a pathological fracture. Magnetic resonance image revealed a renal tumor, and technetium-99m–methylene diphosphonate bone scintigraphy showed multiple osseous metastases. The patient eventually underwent surgery to remove the lateral end of the letf clavicle and right kidney. Histopathology revealed renal tumor and clear cell carcinoma in the clavicle. Finally, we review 17 cases of clavicular metastases originating from different malignancies.

  13. Traumatic pseudolipoma causing facial asymmetry: An uncommon pathology and review of its pathogenesis

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    Kunal Sah


    Full Text Available We present an uncommon case of traumatic pseudolipoma in a 24-year-old female, causing facial asymmetry. Literature review suggests trauma as a possible etiology for its pathogenesis, which was present in this case. Microscopically, sometimes it is difficult to differentiate between normal adipose tissue and lipoma. Clinician must provide accurate clinical information in order to make a definitive diagnosis of traumatic pseudolipoma. Its pathogenesis has also been highlighted in this article.

  14. Challenges in the Diagnosis of Urothelial Carcinoma Variants: Can Emerging Molecular Data Complement Pathology Review? (United States)

    Solomon, James P; Lowenthal, Brett M; Kader, A Karim; Parsons, J Kellogg; Flaig, Thomas W; Siefker-Radtke, Arlene O; Dyrskjøt, Lars; Hansel, Donna E


    Urothelial carcinoma can exhibit a wide variety of histopathologic phenotypes or variant morphologies, classifications of which have recently been revised in the 2016 World Health Organization Classification of Tumours of the Urinary System and Male Genital Organs. Many of these variants not only present diagnostic challenges, but also have clinical implications that affect patient prognosis and treatment strategies. This review will discuss these variant morphologies and their relationship to current understanding of the underlying biology of urothelial carcinoma and molecular classification paradigms.

  15. Extracorporeal shock wave therapy for musculoskeletal pathology--a literature review. (United States)

    Saw, A


    For more than two decades extracorporeal shock wave lithotripsy has emerged as the standard therapy for calculi in the kidney and urinary tract, and biliary system. Application of extracorporeal shock waves in orthopaedics involves treatment of recalcitrant chronic pain of plantar fasciitis, tennis elbow and calcifying tendonitis of the shoulder. This review explores current evidence-based issues related to its potential use as a treatment option for some musculoskeletal conditions.

  16. Central Neurocytoma: A Review of Clinical Management and Histopathologic Features. (United States)

    Lee, Seung J; Bui, Timothy T; Chen, Cheng Hao Jacky; Lagman, Carlito; Chung, Lawrance K; Sidhu, Sabrin; Seo, David J; Yong, William H; Siegal, Todd L; Kim, Minsu; Yang, Isaac


    Central neurocytoma (CN) is a rare, benign brain tumor often located in the lateral ventricles. CN may cause obstructive hydrocephalus and manifest as signs of increased intracranial pressure. The goal of treatment for CN is a gross total resection (GTR), which often yields excellent prognosis with a very high rate of tumor control and survival. Adjuvant radiosurgery and radiotherapy may be considered to improve tumor control when GTR cannot be achieved. Chemotherapy is also not considered a primary treatment, but has been used as a salvage therapy. The radiological features of CN are indistinguishable from those of other brain tumors; therefore, many histological markers, such as synaptophysin, can be very useful for diagnosing CNs. Furthermore, the MIB-1 Labeling Index seems to be correlated with the prognosis of CN. We also discuss oncogenes associated with these elusive tumors. Further studies may improve our ability to accurately diagnose CNs and to design the optimal treatment regimens for patients with CNs.

  17. Fungal Infections of the Central Nervous System: A Pictorial Review

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    Jose Gavito-Higuera


    Full Text Available Fungal infections of the central nervous system (CNS pose a threat to especially immunocompromised patients and their development is primarily determined by the immune status of the host. With an increasing number of organ transplants, chemotherapy, and human immunodeficiency virus infections, the number of immunocompromised patients as susceptible hosts is growing and fungal infections of the CNS are more frequently encountered. They may result in meningitis, cerebritis, abscess formation, cryptococcoma, and meningeal vasculitis with rapid disease progression and often overlapping symptoms. Although radiological characteristics are often nonspecific, unique imaging patterns can be identified through computer tomography as a first imaging modality and further refined by magnetic resonance imaging. A rapid diagnosis and the institution of the appropriate therapy are crucial in helping prevent an often fatal outcome.

  18. Pathological gambling in women: a review Jogo patológico em mulheres: uma revisão

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    Silvia Saboia Martins


    Full Text Available Pathological gambling was only recently recognized as a psychiatric disorder (DSM-III, APA, 1980. Most studies of pathological gambling include only male subjects. Despite the paucity of information, it is likely that at least one-third of pathological gamblers are women. The objective of this article is to review clinical and epidemiological characteristics of female gamblers as compared to their male counterparts. MEDLINE and PsycINFO were searched for investigational studies and reviews of the past 10 years on clinical (sociodemographic, course and progression, psychiatric comorbidities, genetics, and personality and epidemiological aspects of female gamblers. Other relevant articles were also selected from reference lists. It is concluded that the current literature indicates some common characteristics in female and male gamblers, but it also indicates the possibility that each gender may carry etiopathogenic differences that when better understood should lead to improved treatment and prevention strategies.Ainda que jogos de azar e os problemas a eles relacionados sejam antigos para a humanidade, o Jogo Patológico, como alteração do comportamento humano, somente passou a ser reconhecido oficialmente como transtorno psiquiátrico a partir de sua inclusão na 3ª Edição do Manual Diagnóstico e Estatístico de Transtornos Mentais (APA,1980. A maioria dos estudos sobre jogadores patológicos tem como base uma população eminentemente masculina. Entretanto, estima-se que pelo menos um terço dos indivíduos que recebem este diagnóstico sejam mulheres. O objetivo deste estudo foi revisar características clínicas e epidemiológicas de jogadoras comparadas a jogadores. As bases de dados MEDLINE e PsycINFO foram consultadas a respeito de estudos sobre Jogo Patológico publicados nos últimos dez anos, com especial enfoque para características clínicas (dados sócio-demográficos, curso e evolução, comorbidade psiquiátrica, gen

  19. Pathology, physiologic parameters, tissue contaminants, and tissue thiamine in morbid and healthy central Florida adult American alligators (Alligator mississippiensis) (United States)

    Honeyfield, D.C.; Ross, J.P.; Carbonneau, D.A.; Terrell, S.P.; Woodward, A.R.; Schoeb, T.R.; Perceval, H.F.; Hinterkopf, J.P.


    An investigation of adult alligator (Alligator mississippiensis) mortalities in Lake Griffin, central Florida, was conducted from 1998-2004. Alligator mortality was highest in the months of April and May and annual death count peaked in 2000. Bacterial pathogens, heavy metals, and pesticides were not linked with the mortalities. Blood chemistry did not point to any clinical diagnosis, although differences between impaired and normal animals were noted. Captured alligators with signs of neurologic impairment displayed unresponsive and uncoordinated behavior. Three of 21 impaired Lake Griffin alligators were found to have neural lesions characteristic of thiamine deficiency in the telencephalon, particularly the dorsal ventricular ridge. In some cases, lesions were found in the thalamus, and parts of the midbrain. Liver and muscle tissue concentrations of thiamine (vitamin B"1) were lowest in impaired Lake Griffin alligators when compared to unimpaired alligators or to alligators from Lake Woodruff. The consumption of thiaminase-positive gizzard shad (Dorosoma cepedianum) is thought to have been the cause of the low tissue thiamine and resulting mortalities. ?? Wildlife Disease Association 2008.

  20. Correlation of Routine Histo-Pathology, Frozen Section and Squash Preparation in The Diagnosis of Space Occupying Lesions of Central Nervous System

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    Aritra Ash


    Full Text Available Intra-operative consultation is an important part of the management of patients with space occupying lesions (SOL of central nervous system. The correlation between intra-operative frozen section diagnosis with final histopathological diagnosis is an integral part of quality assurance in surgical pathology. Aim of study-1To study the correlation of routine histopathology, frozen section (FS and squash preparation in the diagnosis of SOL of central nervous system (CNS.2 To find out incidence of various types of lesions of CNS.3 To study sensitivity of frozen section, squash cytology and routine histopathology for diagnosis of SOLs of CNS. Materials and Methods-Total 100 cases of SOLs of CNS were studied retrospectively which were diagnosed and reported with frozen section followed by routine histopathology. The diagnoses on frozen sections and squash cytology were compared with the final diagnosis on paraffin sections to assess the concordance and discordance rates between both as well as to find out the incidence of various lesions of CNS. Results- In present study, the overall concordance rate was 88%, discordance rate was 12% in our institution. In cases where the FS and the routine histopathology diagnosis were discordant the final diagnosis was derived from the findings of routine histopathological examination. Astrocytoma (38% was the most common diagnosis with highest incidence rate in frozen section as well as routine histology in the present study.

  1. Atypical antipsychotics in the treatment of pathological aggression in children and adolescents: literature review and clinical recommendations

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    Eduardo Henrique Teixeira


    Full Text Available Objective: To review the literature about the use of atypical antipsychotics in the treatment of pathological aggression in children and adolescents. Method: The databases MEDLINE, SciELO, and LILACS were searched for publications in Portuguese or English from 1992 to August 2011 using the following keywords: mental disease, child, adolescent, treatment, atypical antipsychotic, aggressive behavior, aggression, and violent behavior. Results: Sixty-seven studies of good methodological quality and clinical interest and relevance were identified. Studies including children and adolescents were relatively limited, because few atypical antipsychotics have been approved by the Food and Drug Administration (FDA. All the medications included in this review (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole and clozapine have some effectiveness in treating aggression in children and adolescents, and choices should be based on clinical indications and side effects. Conclusions: There are few studies about the effectiveness and safety of atypical antipsychotics for the pediatric population, and further randomized controlled studies with larger groups of patients and more diagnostic categories, such as severe conduct disorder and oppositional defiant disorder, should be conducted to confirm the results reported up to date and to evaluate the impact of long-term use.


    Directory of Open Access Journals (Sweden)

    Rod Whiteley


    Full Text Available It is a commonly held perception amongst biomechanists, sports medicine practitioners, baseball coaches and players, that an individual baseball player's style of throwing or pitching influences their performance and susceptibility to injury. With the results of a series of focus groups with baseball managers and pitching coaches in mind, the available scientific literature was reviewed regarding the contribution of individual aspects of pitching and throwing mechanics to potential for injury and performance. After a discussion of the limitations of kinematic and kinetic analyses, the individual aspects of pitching mechanics are discussed under arbitrary headings: Foot position at stride foot contact; Elbow flexion; Arm rotation; Arm horizontal abduction; Arm abduction; Lead knee position; Pelvic orientation; Deceleration-phase related issues; Curveballs; and Teaching throwing mechanics. In general, popular opinion of baseball coaching staff was found to be largely in concordance with the scientific investigations of biomechanists with several notable exceptions. Some difficulties are identified with the practical implementation of analyzing throwing mechanics in the field by pitching coaches, and with some unquantified aspects of scientific analyses

  3. R&D implementation in a department of laboratory medicine and pathology: a systematic review based on pharmaceutical companies. (United States)

    Feulefack, Joseph; Sergi, Consolato


    A systematic literature review on pharmaceutical companies may be a tool for guiding some procedures of R&D implementation in a department of Laboratory Medicine and Pathology. The use of pharmaceutical companies for this specific analysis arises from less variability of standards than healthcare facilities. In this qualitative and quantitative analysis, we focused on three useful areas of implementation, including R&D productivity, commercialization strategies, and expenditures determinants of pharmaceutical companies. Studies and reports of online databases from 1965 to 2014 were reviewed according to specific search terms. Initially, 218 articles and reports were found and examined, but only 91 were considered appropriate and used for further analysis.  We identified some suggested implementation strategies relevant for marketing to enhance companies' own R&D strategies; such as reliability of companies on "sourcing-in" R&D facilities and "think-tank" events. Regardless of the study and of the country, cash flow and profitability always positively influenced R&D expenditure, while sales and firm size did not. We consider that handling R&D determinants should require caution. It seems critical that implementation of R&D systems is directly related with productivity, if it reflects dual embodiment of efficiency and effectiveness. Scrutinizing the determinants of R&D expenditures emphasizes significant factors that are worth to highlight when planning an R&D investment strategy. Although there is no receipt fitting every situation, we think that health care plan makers may find relevant data in this systematic review in creating an initial implementation framework.

  4. Culture of Rights and Functional Pathologies of Contemporary Legal Systems


    Sarlo, Oscar


    It's observed critically the present course of legal culture, especially around the so-called culture of rights. The legal culture is concerned with symbolic functions, which may exhibit pathologies. The symbolic functions of legal systems are briefly reviewed, which, in my opinion, are hampered or annulled by the development of some that consider pathological tendencies in contemporary legal systems, leading to a deepening dysfunctionality of law. In all this, law schools plays a central role.

  5. Review paper: a review of the pathology of abnormal placentae of somatic cell nuclear transfer clone pregnancies in cattle, sheep, and mice. (United States)

    Palmieri, C; Loi, P; Ptak, G; Della Salda, L


    Cloning of cattle, sheep, and mice by somatic cell nuclear transfer (SCNT) can result in apparently healthy offspring, but the probability of a successful and complete pregnancy is less than 5%. Failures of SCNT pregnancy are associated with placental abnormalities, such as placentomegaly, reduced vascularisation, hypoplasia of trophoblastic epithelium, and altered basement membrane. The pathogenesis of these changes is poorly understood, but current evidence implicates aberrant reprogramming of donor nuclei by the recipient oocyte cytoplast, resulting in epigenetic modifications of key regulatory genes essential for normal placental development. The purpose of this review is to provide an overview of the anatomic pathology of abnormal placentae of SCNT clones and to summarize current knowledge concerning underlying pathogenetic mechanisms.

  6. Computed tomography for the diagnosis of lumbar spinal pathology in adult patients with low back pain or sciatica : a diagnostic systematic review

    NARCIS (Netherlands)

    van Rijn, Rogier M.; Wassenaar, Merel; Verhagen, Arianne P.; Ostelo, Raymond W. J. G.; Ginai, Abida Z.; de Boer, Michiel R.; van Tulder, Maurits W.; Koes, Bart W.


    In low back pain if serious pathology is suspected diagnostic imaging could be performed. One of the imaging techniques available for this purpose is computed tomography (CT), however, insight in the diagnostic performance of CT is unclear. Diagnostic systematic review. Studies assessing the diagnos

  7. A brief review of some pathology research supported by the Georgia Commodity Commission for Pecans at the USDA-ARS, Byron (United States)

    With the changes currently taking place nationally in the pecan industry, and the production issues faced specifically by growers in Georgia and elsewhere in the southeastern region, the pathology research projects funded by the Georgia Commodity Commission for Pecans (CC) are reviewed. The results ...

  8. 75 FR 70268 - Submission for OMB Review; Comment Request; NIH NCI Central Institutional Review Board (CIRB... (United States)


    ... Federal Register on August 16, 2010 (75 FR 49938) and allowed 60-days for public comment. No public... (Attachment 2K). Participants Facilitated Review (FR) 1,450 1 10/60 (.17 hour) 242 Acceptance Form (Attachment... the reviewer is requested to serve as a reviewer for a study. CIRB helpdesk surveys...

  9. Isolated spinal neurosarcoidosis: An enigmatic intramedullary spinal cord pathology-case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Manish K Kasliwal


    Full Text Available Isolated spinal cord neurosarcoidosis (NS in the absence of systemic disease or intracranial involvement is exceptionally rare. Adjunctive laboratory tests though useful may not be reliable and the absence of any pathognomonic radiological features makes the diagnosis difficult. As spinal cord NS may be a presenting feature of systemic sarcoidosis which may be occult on routine workup, 18 F-fluorodeoxyglucose-positron emission tomography (FDG-PET may be of value in unraveling this systemic involvement avoiding biopsying the spinal cord. A case of truly isolated NS is described with review of literature on this enigmatic pathology. Long segment intramedullary signal changes with focal parenchymal along with dural/meningeal enhancement in the absence of significant cervical stenosis in a young patient of northern European or African-American decent is very suggestive of NS and although may be presumably treated with steroids; there should be a low threshold for spinal cord biopsy especially in the absence of response to steroids to confirm isolated spinal cord NS in a patient with clinical neurological deterioration.

  10. Pathology review of proliferative lesions of the exocrine pancreas in two chronic feeding studies in rats with ammonium perfluorooctanoate

    Directory of Open Access Journals (Sweden)

    Jessica M. Caverly Rae


    Full Text Available Two chronic dietary studies, conducted years apart, with ammonium perfluorooctanoate (APFO in Sprague Dawley rats have been previously reported. Although both included male 300 ppm dietary dose groups, only the later study, conducted in 1990–1992 by Biegel et al., reported an increase in proliferative lesions (hyperplasia and adenoma of the acinar pancreas. An assessment of the significance of the differences between both studies requires careful consideration of: the diagnostic criteria for proliferative acinar cell lesions of the rat pancreas (for example, the diagnosis of pancreatic acinar cell hyperplasia versus adenoma is based on the two-dimensional size of the lesion rather than distinct morphological differences; the basis for those criteria in light of their relevance to biological behavior; and the potential diagnostic variability between individual pathologists for difficult-to-classify lesions. A pathology peer review of male exocrine pancreatic tissues from the earlier study, conducted in 1981–1983 by Butenhoff et al., was undertaken. This review identified an increase in acinar cell hyperplasia but not adenoma or carcinoma in the earlier study. Both studies observed a proliferative response in the acinar pancreas which was more pronounced in the study by Biegel et al. Definitive reasons for the greater incidence of proliferative lesions in the later study were not identified, but some possible explanations are presented herein. The relevance of this finding to human risk assessment, in the face of differences in the biological behavior of human and rat pancreatic proliferative lesions and the proposed mechanism of formation of these lesions, are questionable.

  11. Book review: Vetter, H. 2005. Terralog. Turtles of the World. Vol. 3. Central and South America

    Directory of Open Access Journals (Sweden)


    Full Text Available Book review: Vetter, H. 2005. Terralog. Turtles of the World. Vol. 3. Central and South America/Schildkröten der Welt Band 3. Mittel- und Südamerika: 1-128, color pictures 606 + 9. Edition Chimaira, Frankfurt, Germany.ISBN 3-930612-82-8; 29.7 x 20.8 cm

  12. Phase 5 storage (Project W-112) Central Waste Complex operational readiness review, final report

    Energy Technology Data Exchange (ETDEWEB)

    Wight, R.H.


    This document is the final report for the RFSH conducted, Contractor Operational Readiness Review (ORR) for the Central Waste Complex (CWC) Project W-112 and Interim Safety Basis implementation. As appendices, all findings, observations, lines of inquiry and the implementation plan are included.

  13. Central Venous Catheter-Related Tachycardia in the Newborn: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Aya Amer


    Full Text Available Central venous access is an important aspect of neonatal intensive care management. Malpositioned central catheters have been reported to induce cardiac tachyarrhythmia in adult populations and there are case reports within the neonatal population. We present a case of a preterm neonate with a preexisting umbilical venous catheter (UVC, who then developed a supraventricular tachycardia (SVT. This was initially treated with intravenous adenosine with transient reversion. Catheter migration was subsequently detected, with the UVC tip located within the heart. Upon withdrawal of the UVC and a final dose of adenosine, the arrhythmia permanently resolved. Our literature review confirms that tachyarrhythmia is a rare but recognised neonatal complication of malpositioned central venous catheters. We recommend the immediate investigation of central catheter position when managing neonatal tachyarrhythmia, as catheter repositioning is an essential aspect of management.

  14. Central Venous Catheter-Related Tachycardia in the Newborn: Case Report and Literature Review (United States)

    Amer, Aya; Broadbent, Roland S.; Edmonds, Liza


    Central venous access is an important aspect of neonatal intensive care management. Malpositioned central catheters have been reported to induce cardiac tachyarrhythmia in adult populations and there are case reports within the neonatal population. We present a case of a preterm neonate with a preexisting umbilical venous catheter (UVC), who then developed a supraventricular tachycardia (SVT). This was initially treated with intravenous adenosine with transient reversion. Catheter migration was subsequently detected, with the UVC tip located within the heart. Upon withdrawal of the UVC and a final dose of adenosine, the arrhythmia permanently resolved. Our literature review confirms that tachyarrhythmia is a rare but recognised neonatal complication of malpositioned central venous catheters. We recommend the immediate investigation of central catheter position when managing neonatal tachyarrhythmia, as catheter repositioning is an essential aspect of management. PMID:28058050

  15. Neuronopathic Lysosomal Storage Diseases: Clinical and Pathologic Findings (United States)

    Prada, Carlos E.; Grabowski, Gregory A.


    Background: The lysosomal--autophagocytic system diseases (LASDs) affect multiple body systems including the central nervous system (CNS). The progressive CNS pathology has its onset at different ages, leading to neurodegeneration and early death. Methods: Literature review provided insight into the current clinical neurological findings,…

  16. Relationship between chronic pathologies of the supraspinatus tendon and the long head of the biceps tendon: systematic review


    Redondo-Alonso, Lucía; Chamorro-Moriana, Gema; Jiménez-Rejano, José Jesús; López-Tarrida, Patricio; Ridao-Fernández, Carmen


    Background Chronic supraspinatus tendinopathy is a common clinical problem that causes functional and labor disabilities in the population. It is the most frequent cause of shoulder pain. This pathology may be frequently associated to the affectation of the long head of biceps tendon (LHBT), the main stabilizer of the glenohumeral joint together with the supraspinatus. The main aim of this work is to study the prevalence of lesions in LHBT associated to the chronic pathology of the supraspina...

  17. Central Sensitization Syndrome and the Initial Evaluation of a Patient with Fibromyalgia: A Review

    Directory of Open Access Journals (Sweden)

    Kevin C. Fleming


    Full Text Available In both primary care and consultative practices, patients presenting with fibromyalgia (FM often have other medically unexplained somatic symptoms and are ultimately diagnosed as having central sensitization (CS. Central sensitization encompasses many disorders where the central nervous system amplifies sensory input across many organ systems and results in myriad symptoms. A pragmatic approach to evaluate FM and related symptoms, including a focused review of medical records, interviewing techniques, and observations, is offered here, giving valuable tools for identifying and addressing the most relevant symptoms. At the time of the clinical evaluation, early consideration of CS may improve the efficiency of the visit, reduce excessive testing, and help in discerning between typical and atypical cases so as to avoid an inaccurate diagnosis. Discussion of pain and neurophysiology and sensitization often proves helpful.

  18. Meteorological variability and infectious disease in Central Africa: a review of meteorological data quality. (United States)

    Heaney, Alexandra; Little, Eliza; Ng, Sophia; Shaman, Jeffrey


    Central African countries may bear high climate change-related infectious disease burdens because of preexisting high rates of disease, poor healthcare infrastructure, land use changes, and high environmental change vulnerabilities. However, making connections between climate and infectious diseases in this region is hampered by the paucity of high-quality meteorological data. This review analyzes the sources and quality of meteorological data used to study the interactions between weather and infectious diseases in Central African countries. Results show that 23% of studies used meteorological data that mismatched with the disease spatial scale of interest. Use of inappropriate weather data was most frequently identified in analyses using meteorological station data or gridded data products. These findings have implications for the interpretation of existing analyses and provide guidance for the use of climate data in future analyses of the connections between meteorology and infectious diseases in Central Africa.

  19. Amyloid-Beta Related Angiitis of the Central Nervous System: Case Report and Topic Review

    Directory of Open Access Journals (Sweden)

    Amre eNouh


    Full Text Available Amyloid-beta related angiitis (ABRA of the central nervous system (CNS is a rare disorder with overlapping features of primary angiits of the CNS (PACNS and cerebral amyloid angiopathy (CAA. We evaluated a 74-year-old man with intermittent left sided weakness and MRI findings of leptomeningeal enhancement, vasogenic edema and subcortical white matter disease proven to have ABRA. We discuss clinicopathological features and review the topic of ABRA.

  20. Efficacy of Epidural Injections in the Treatment of Lumbar Central Spinal Stenosis: A Systematic Review


    Manchikanti, Laxmaiah; Kaye, Alan David; Manchikanti, Kavita; Boswell, Mark; Pampati, Vidyasagar; Hirsch, Joshua


    Context: Lumbar central spinal stenosis is common and often results in chronic persistent pain and disability, which can lead to multiple interventions. After the failure of conservative treatment, either surgical or nonsurgical modalities such as epidural injections are contemplated in the management of lumbar spinal stenosis. Evidence Acquisition: Recent randomized trials, systematic reviews and guidelines have reached varying conclusions about the efficacy of epidural injections in the man...

  1. Does Acupuncture Alter Pain-related Functional Connectivity of the Central Nervous System? A Systematic Review. (United States)

    Villarreal Santiago, María; Tumilty, Steve; Mącznik, Aleksandra; Mani, Ramakrishnan


    Acupuncture has been studied for several decades to establish evidence-based clinical practice. This systematic review aims to evaluate evidence for the effectiveness of acupuncture in influencing the functional connectivity of the central nervous system in patients with musculoskeletal pain. A systematic search of the literature was conducted to identify studies in which the central response of acupuncture in patients with musculoskeletal pain was evaluated by neuroimaging techniques. Databases searched were AMED, CINAHL, Cochrane Library, EMBASE, MEDLINE, PEDro, Pubmed, SCOPUS, SPORTDiscuss, and Web of Science. Included studies were assessed by two independent reviewers for their methodological quality by using the Downs and Black questionnaire and for their levels of completeness and transparency in reporting acupuncture interventions by using Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) criteria. Seven studies met the inclusion criteria. Three studies were randomized controlled trials (RCTs) and four studies were nonrandomized controlled trials (NRCTs). The neuroimaging techniques used were functional magnetic resonance imaging (fMRI) and positron emission tomography (PET). Positive effects on the functional connectivity of the central nervous system more consistently occurred during long-term acupuncture treatment. The results were heterogeneous from a descriptive perspective; however, the key findings support acupuncture's ability to alter pain-related functional connectivity in the central nervous system in patients with musculoskeletal pain.

  2. Skin thickening as unique pathologic sign of an inflammatory breast cancer: a case report and review of the literature. (United States)

    Ballesio, L; D'Ambrosio, I; Ravazzolo, N; Angeletti, M; Di Pastena, F; Tardioli, S; Lodise, P; Marini, M


    We report the case of a 42-year-old woman with inflammatory cancer of the right breast treated with neoadjuvant chemotherapy, surgery, additional chemotherapy, and consolidative radiotherapy (RT), that has metastatized to the chest wall and presented a resumption of disease on the contralateral breast. Magnetic Resonance (MR), performed after the second phase's fourth round of additional chemotherapy, showed a modest reduction of scar metastases on the right and a contralateral anomalous skin thickening with high signal intensity in T2 weighted images (WI) with multiple mass-like enhancements located in a wide area of the central region at the union of higher quadrants. These findings were suggestive for resumption of contralateral disease; the biopsy confirmed an inflammatory breast cancer (IBC) infiltrating lobular type with high mitotic rate. A retrospective evaluation of the previous MR exam, performed 5 months before, was conducted: on the left side only a modest skin thickening was found as an early sign. A careful review of the literature has confirmed that skin thickening, increased density and clinical signs of inflammation are the most common findings in inflammatory cancer. We report the case of a patient affected by IBC whose unique early sign of resumption on the contralateral breast was skin thickening.

  3. Subjective endpoints in clinical trials: the case for blinded independent central review

    Directory of Open Access Journals (Sweden)

    Walovitch R


    Full Text Available Richard Walovitch,1 Bin Yao,2 Patrick Chokron,1 Helen Le,1 Glenn Bubley3 1WorldCare Clinical, LLC, Boston, MA, USA; 2Amgen, Inc, Thousand Oaks, CA, USA; 3Director of Genitourinary Medical Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA Abstract: Primary efficacy and safety endpoints in clinical trials are often subjective assessments made by site personnel. For international confirmatory trials conducted over broad geographic regions and different clinical practice settings, variability in these subjective assessments can be substantial. Centralized endpoint assessment committees (EACs offer a mechanism through which to reduce assessment bias and potentially increase assessment precision and accuracy, particularly in open-label trials. An overview of regulatory agencies' rationales for an EAC is reviewed. In addition, the two main types of EACs, the blinded independent central review, and the consensus panel are compared. Selection of endpoints for EAC evaluation and design of EAC process to maximize EAC value proposition are also discussed. Keywords: endpoint assessment committee, FDA, central review, BICR, adjudication, consensus panel

  4. Osler's pathology. (United States)

    Pai, S A


    Sir William Osler, one of the giants of clinical medicine, had his initial training as a pathologist. He was one of the physicians responsible for the impact that autopsies have had on medicine. He also contributed to the development of laboratory medicine. Osler made significant discoveries in anatomic pathology and hematology. His expertise was restricted not just to human pathology, but also to veterinary pathology. His mentors played a fundamental role in his achievements in academics.

  5. [Pathological jealousy]. (United States)

    Zacher, A


    Pathological jealousy can make life unbearable for all concerned. The proximity of this condition to obsessive-compulsive phenomena has given rise to the notion that it might respond to substances of proven value in the treatment of obsessive-compulsive disorders. This case history exemplifies the successful treatment of pathological jealousy with the selective serotonin reuptake inhibitor (SSRI) fluoxetine. The substance not only proved to be a successful antidepressant, but also effectively mitigated the anguish of the patient's pathological jealousy. On the basis of these findings, fluoxetine--as also other SSRIs--should always be considered as a possible effective pharmacological strategy for the treatment of pathological jealousy.

  6. Personality dimensions and disorders in pathological gambling

    DEFF Research Database (Denmark)

    Odlaug, Brian Lawrence; Schreiber, Liana R N; Grant, Jon E


    This review presents the most current research in personality dimensions and disorders with respect to pathological gambling.......This review presents the most current research in personality dimensions and disorders with respect to pathological gambling....

  7. Randomized controlled trials in central vascular access devices: A scoping review (United States)

    Keogh, Samantha; Rickard, Claire M.


    Background Randomized controlled trials evaluate the effectiveness of interventions for central venous access devices, however, high complication rates remain. Scoping reviews map the available evidence and demonstrate evidence deficiencies to focus ongoing research priorities. Method A scoping review (January 2006–December 2015) of randomized controlled trials evaluating the effectiveness of interventions to improve central venous access device outcomes; including peripherally inserted central catheters, non-tunneled, tunneled and totally implanted venous access catheters. MeSH terms were used to undertake a systematic search with data extracted by two independent researchers, using a standardized data extraction form. Results In total, 178 trials were included (78 non-tunneled [44%]; 40 peripherally inserted central catheters [22%]; 20 totally implanted [11%]; 12 tunneled [6%]; 6 non-specified [3%]; and 22 combined device trials [12%]). There were 119 trials (68%) involving adult participants only, with 18 (9%) pediatric and 20 (11%) neonatal trials. Insertion-related themes existed in 38% of trials (67 RCTs), 35 RCTs (20%) related to post-insertion patency, with fewer trials on infection prevention (15 RCTs, 8%), education (14RCTs, 8%), and dressing and securement (12 RCTs, 7%). There were 46 different study outcomes reported, with the most common being infection outcomes (161 outcomes; 37%), with divergent definitions used for catheter-related bloodstream and other infections. Conclusion More high quality randomized trials across central venous access device management are necessary, especially in dressing and securement and patency. These can be encouraged by having more studies with multidisciplinary team involvement and consumer engagement. Additionally, there were extensive gaps within population sub-groups, particularly in tunneled devices, and in pediatrics and neonates. Finally, outcome definitions need to be unified for results to be meaningful and

  8. Psychosocial wellbeing in the Central and Eastern European transition: an overview and systematic bibliographic review. (United States)

    Eiroá Orosa, Francisco José


    This paper presents the results of a systematic review of literature on the psychosocial wellbeing of populations in Central and Eastern Europe during the transition period subsequent to the fall of the SovietBloc. A revision of research addressing emotional wellbeing trends in this period and theoretical models was carried in order to verify their validity in the analysis of empirical studies. Hence, a systematic bibliographic review was conducted, aiming to find possible subjective mediators between social variables derived from change sand emotional wellbeing. The results of the review show that subjective mediators such as locus of control,perceived control, self-efficacy beliefs, perceived familial support, and the subjective evaluation of social change explain part of the relationship between macrosocial changes and emotional wellbeing. Results appear coherent with proposed multidimensional models of social change and mental health, although further research should be conducted to determine the specific weight of these phenomena in individual emotional wellbeing.

  9. The behavioral economics of substance use disorders: reinforcement pathologies and their repair. (United States)

    Bickel, Warren K; Johnson, Matthew W; Koffarnus, Mikhail N; MacKillop, James; Murphy, James G


    The field of behavioral economics has made important inroads into the understanding of substance use disorders through the concept of reinforcer pathology. Reinforcer pathology refers to the joint effects of (a) the persistently high valuation of a reinforcer, broadly defined to include tangible commodities and experiences, and/or (b) the excessive preference for the immediate acquisition or consumption of a commodity despite long-term negative outcomes. From this perspective, reinforcer pathology results from the recursive interactions of endogenous person-level variables and exogenous environment-level factors. The current review describes the basic principles of behavioral economics that are central to reinforcer pathology, the processes that engender reinforcer pathology, and the approaches and procedures that can repair reinforcement pathologies. The overall goal of this review is to present a new understanding of substance use disorders as viewed by recent advances in behavioral economics.

  10. Extracellular vesicles in physiology, pathology and therapy of the immune and central nervous system, with focus on extracellular vesicles derived from mesenchymal stem cells as therapeutic tools

    Directory of Open Access Journals (Sweden)

    Sylwia eKoniusz


    Full Text Available Extracellular vesicles (EVs are membrane-surrounded structures released by most cell types. They are characterized by a specific set of proteins, lipids and nucleic acids. EVs have been recognized as potent vehicles of intercellular communication to transmit biological signals between cells. In addition, pathophysiological roles of EVs in conditions like cancer, infectious diseases and neurodegenerative disorders are well established. In recent years focus has been shifted on therapeutic use of stem cell derived-EVs. Use of stem cell derived-EVs present distinct advantage over the whole stem cells as EVs do not replicate and after intravenous administration, they are less likely to trap inside the lungs. From the therapeutic perspective, the most promising cellular sources of EVs are mesenchymal stem cells (MSCs, which are easy to obtain and maintain. Therapeutic activity of MSCs has been shown in numerous animal models and the beneficial paracrine effect of MSCs may be mediated by EVs. The various components of MSC derived-EVs such as proteins, lipids and RNA might play a specific therapeutic role. In this review, we characterize the role of EVs in immune and central nervous system (CNS; present evidences for defective signalling of these vesicles in neurodegeneration and therapeutic role of EVs in CNS.

  11. Review article: Hydrological modeling in glacierized catchments of central Asia - status and challenges (United States)

    Chen, Yaning; Li, Weihong; Fang, Gonghuan; Li, Zhi


    Meltwater from glacierized catchments is one of the most important water supplies in central Asia. Therefore, the effects of climate change on glaciers and snow cover will have increasingly significant consequences for runoff. Hydrological modeling has become an indispensable research approach to water resources management in large glacierized river basins, but there is a lack of focus in the modeling of glacial discharge. This paper reviews the status of hydrological modeling in glacierized catchments of central Asia, discussing the limitations of the available models and extrapolating these to future challenges and directions. After reviewing recent efforts, we conclude that the main sources of uncertainty in assessing the regional hydrological impacts of climate change are the unreliable and incomplete data sets and the lack of understanding of the hydrological regimes of glacierized catchments of central Asia. Runoff trends indicate a complex response to changes in climate. For future variation of water resources, it is essential to quantify the responses of hydrologic processes to both climate change and shrinking glaciers in glacierized catchments, and scientific focus should be on reducing uncertainties linked to these processes.

  12. Systematic review and meta-analysis of the diagnostic accuracy of ductoscopy in patients with pathological nipple discharge

    NARCIS (Netherlands)

    Waaijer, L.; Simons, J. M.; Borel Rinkes, I. H M; Van Diest, P. J.; Verkooijen, H. M.; Witkamp, A. J.


    Background Invasive surgery remains the standard for diagnosis of pathological nipple discharge (PND). Only a minority of patients with nipple discharge and an unsuspicious finding on conventional breast imaging have cancer. Ductoscopy is a minimally invasive alternative for evaluation of PND. This

  13. A clinicopathologic analysis of primary central nervous system lymphomatoid granulomatosis: case report and literature review

    Directory of Open Access Journals (Sweden)

    FU Yong-juan


    Full Text Available Objective To investigate the clinical, neuroimaging and histopathological features of primary central nervous system lymphomatoid granulomatosis (LG. Methods The clinical manifestation, neuroimaging, histopathological and biological features of a patient with primary central nervous system LG were presented, and the related literatures were reviewed. Results A 57-year-old male presented with memory impairment, weak in orientation, calculation, apprehension and judgment for 3 months. Magnetic resonance imaging (MRI showed space-occupying lesions in bilateral frontal lobes, with T1WI isointensity and T2WI hyperintensity, and the enhancement was irregular. The lesion was slight expansive with yellow surface and gray-white section in color and soft texture and abundant blood supply. Microscopically, the lesion was characterized by angiocentric and angiodestructive lymphoproliferation, partly showed the structure of LG characterized by T cell predominant proliferation, macrophage infiltration, astrocyte activation, small vessel proliferation and hyalinization, and partly showed the structure of lymphoma characterized by diffuse atypical B cell proliferation, with IgK monoclonal production. Epstein-Barr virus (EBV was negative. Conclusion As a precursor disease of lymphoma, LG should be considered in the differential diagnosis of both diffuse and multifocal lesions of the central nervous system. The relavance between primary central nervous system LG and EBV infection should be further discussed.

  14. Central hyperexcitability as measured with nociceptive flexor reflex threshold in chronic musculoskeletal pain: a systematic review. (United States)

    Lim, Edwin Choon Wyn; Sterling, Michele; Stone, Andrew; Vicenzino, Bill


    Chronic musculoskeletal conditions are increasingly conceived as involving altered central nervous system processing, and impaired nociceptive flexor reflex (NFR) appears to reflect altered central nervous system processing. The primary objective was to synthesize the evidence for impaired NFR in these conditions. The secondary objective was to evaluate the NFR stimuli parameters employed by reviewed studies. Electronic databases: MEDLINE, CINAHL, Embase, PEDro, Google Scholar, and Cochrane library were searched from the mid-1960s to June 2010. Experimental reports were systematically reviewed and meta-analysis (where possible) was performed. NFR thresholds and parameters of NFR stimuli were extracted. Sixteen trials were identified, 11 of which were suitable for inclusion in the meta-analysis. Compared to healthy controls, standardized mean differences in NFR threshold were significantly lower in subjects with primary headache (-0.45; 95% confidence interval [CI] -0.77 to -0.13, P=0.005), fibromyalgia (-0.63; 95% CI -0.93 to -0.34, Ppain (-1.51; 95% CI -2.10 to -0.93, Pcentral hyperexcitability in people with chronic musculoskeletal pain. Our review also suggests that shorter inter-pulse duration tends to yield smaller variability in NFR threshold. However, further research investigating optimal stimulation parameters is still warranted.

  15. Application of Molecular Pathology in Endocrine Pathology. (United States)

    Linke, Ebru Serinsoz; Tezel, Gaye Güler


    Rapid growth in knowledge of cell and molecular biology led to the increased usage of molecular techniques in anatomical pathology. This is also due to the advances achieved in the techniques introduced in the last few years which are less laborious as compared to the techniques used at the beginning of the "molecular era". The initial assays were also very expensive and were not performed except for selected centers. Moreover, the clinicians were not sure how to make use of the accumulating molecular information. That situation has also changed and molecular techniques are being performed in a wide variety of medical settings which also has a reflection on the endocrine system pathology among other organ systems. This review will provide an update of genetic changes observed in different endocrine system pathologies and their diagnostic, therapeutic and prognostic values.

  16. Preliminary design review package for the solar heating and cooling central data processing system

    Energy Technology Data Exchange (ETDEWEB)


    This preliminary design review package, consisting of the Software Performance Specification, Hardware Performance Specification, and the Verification Plan for the Central Data Processing System (CDPS), was prepared by the IBM Corporation. The Central Data Processing System, located at IBM's FSD facility in Huntsville, Alabama, provides the resources required to assess the performance of solar heating and cooling systems at remote sites. These sites include residential, commercial, government, and educational types of buildings, and the solar heating and cooling systems can be hot water, space heating, cooling, and combinations of these. The instrumentation data associated with these systems will vary according to the application and must be collected, processed, and presented in a form which supports continuity of performance evaluation across all applications.

  17. Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review

    Directory of Open Access Journals (Sweden)

    Daniele Cristina Perin

    Full Text Available ABSTRACT Objective: to identify evidence-based care to prevent CLABSI among adult patients hospitalized in ICUs. Method: systematic review conducted in the following databases: PubMed, Scopus, Cinahl, Web of Science, Lilacs, Bdenf and Cochrane Studies addressing care and maintenance of central venous catheters, published from January 2011 to July 2014 were searched. The 34 studies identified were organized in an instrument and assessed by using the classification provided by the Joanna Briggs Institute. Results: the studies presented care bundles including elements such as hand hygiene and maximal barrier precautions; multidimensional programs and strategies such as impregnated catheters and bandages and the involvement of facilities in and commitment of staff to preventing infections. Conclusions: care bundles coupled with education and the commitment of both staff and institutions is a strategy that can contribute to decreased rates of central line-associated bloodstream infections among adult patients hospitalized in intensive care units.

  18. Diagnosis and management of traumatic cervical central spinal cord injury: A review

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein


    Full Text Available Background: The classical clinical presentation, neuroradiographic features, and conservative vs. surgical management of traumatic cervical central spinal cord (CSS injury remain controversial. Methods: CSS injuries, occurring in approximately 9.2% of all cord injuries, are usually attributed to significant hyperextension trauma combined with congenital/acquired cervical stenosis/spondylosis. Patients typically present with greater motor deficits in the upper vs. lower extremities accompanied by patchy sensory loss. T2-weighted magnetic resonance (MR scans usually show hyperintense T2 intramedullary signals reflecting acute edema along with ligamentous injury, while noncontrast computed tomography (CT studies typically show no attendant bony pathology (e.g. no fracture, dislocation. Results: CSS constitute only a small percentage of all traumatic spinal cord injuries. Aarabi et al. found CSS patients averaged 58.3 years of age, 83% were male and 52.4% involved accidents/falls in patients with narrowed spinal canals (average 5.6 mm; their average American Spinal Injury Association (ASIA motor score was 63.8, and most pathology was at the C3-C4 and C4-C5 levels (71%. Surgery was performed within 24 h (9 patients, 24-48 h (10 patients, or after 48 h (23 patients. In the Brodell et al. study of 16,134 patients with CSS, 39.7% had surgery. In the Gu et al. series, those with CSS and stenosis/ossification of the posterior longitudinal ligament (OPLL exhibited better outcomes following laminoplasty. Conclusions: Recognizing the unique features of CSS is critical, as the clinical, neuroradiological, and management strategies (e.g. conservative vs. surgical management: early vs. late differ from those utilized for other spinal cord trauma. Increased T2-weighted MR images best document CSS, while CT studies confirm the absence of fracture/dislocation.

  19. Social complexity and inequality in the Late Neolithic of the Central Balkans: reviewing the evidence

    Directory of Open Access Journals (Sweden)

    Marko Porčić


    Full Text Available The aim of this paper is to review and critically evaluate relevant archaeological evidence regarding recent claims about the social complexity of Late Neolithic societies in the Central Balkans. Theory suggests that the relevant evidence should be related to population size, economic intensification, ranking, and craft specialisation. It is concluded that, although there are indications that inequalities existed and also demographic potential for organisational complexity, there is no unambiguous evidence that institutionalised inequality in the form of complex polities such as chiefdoms or states ever developed.

  20. Calcified central venous catheter fibrin sheath: case report and review of the literature. (United States)

    Keehn, Aryeh; Rabinowitz, Dan; Williams, Steve K; Taragin, Benjamin H


    We present a 6-year-old girl with acute lymphoblastic leukemia who demonstrated on chest X-ray a radiopacity in the superior vena cava after removal of an implanted venous access device. This radiopacity was initially thought to be a retained catheter fragment. On review of previous imaging, we were able to document the temporal development of a calcified catheter cast as distinct from the catheter. This case represents a rare consequence of central venous catheterization in children. Knowledge of this finding as a possible complication may help avoid performance of unnecessary follow-up imaging or invasive procedures.

  1. Cannabinoids and centrak neuropathic pain. A review (Cannabinoidi e dolore neuropatico centrale. Una rassegna

    Directory of Open Access Journals (Sweden)

    Francesco Crestani


    Full Text Available Only recently, the medical community highlighted the pharmacological scientific bases of the effects of Cannabis. The most important active principle, Delta-9-tetrahydrocannabinol was identified in the second half of the last century, and receptors were subsequently identified and endogenous ligands, called endocannabinoids, were characterized. The effectiveness of the cannabinoids in the treatment of nausea and vomit due to anti-neoplastic chemotherapy and in the wasting-syndrome during AIDS is recognized. Moreover, the cannabinoids have shown analgesic properties, particularly interesting with regard to the central neuropathic pain. This article will review the current knowledge and will give practical guidance on how to proceed in prescribing cannabinoids.

  2. Oral pathology. (United States)

    Niemiec, Brook A


    Oral disease is exceedingly common in small animal patients. In addition, there is a very wide variety of pathologies that are encountered within the oral cavity. These conditions often cause significant pain and/or localized and systemic infection; however, the majority of these conditions have little to no obvious clinical signs. Therefore, diagnosis is not typically made until late in the disease course. Knowledge of these diseases will better equip the practitioner to effectively treat them. This article covers the more common forms of oral pathology in the dog and cat, excluding periodontal disease, which is covered in its own chapter. The various pathologies are presented in graphic form, and the etiology, clinical signs, recommended diagnostic tests, and treatment options are discussed. Pathologies that are covered include: persistent deciduous teeth, fractured teeth, intrinsically stained teeth, feline tooth resorption, caries, oral neoplasia, eosinophilic granuloma complex, lymphoplasmacytic gingivostomatitis, enamel hypoplasia, and "missing" teeth.

  3. A Study on Clinical and Pathologic Features in Lupus Nephritis with Mainly IgA Deposits and a Literature Review



    Objective. To study the clinical and pathologic features of systemic lupus erythematosus (SLE) that has atypical lupus nephritis (LN) with mainly IgA deposits. Methods. We searched the SLE patients who had nephritis with mainly IgA deposits in our hospital and selected the information including clinical manifestations, laboratory tests, treatments, and prognosis. Results. From January 2009 to June 2012, 5 patients were definitely diagnosed as SLE according to both 1982 and 2009 ACR classifica...

  4. Pathology databanking and biobanking in The Netherlands, a central role for PALGA, the nationwide histopathology and cytopathology data network and archive.

    NARCIS (Netherlands)

    Casparie, M.; Tiebosch, A.T.M.G.; Burger, G.; Blauwgeers, H.; Pol, A.; Krieken, J.H.J.M. van; Meijer, G.A.


    Since 1991, a nationwide histopathology and cytopathology network and archive is in operation in The Netherlands under the name PALGA, encompassing all sixty-four pathology laboratories in The Netherlands. The overall system comprises decentralized systems at the participating laboratories, a centra

  5. Candida infection of the central nervous system following neurosurgery: a 12-year review.

    LENUS (Irish Health Repository)

    O'Brien, Deirdre


    BACKGROUND: Candida infection of the central nervous system (CNS) following neurosurgery is relatively unusual but is associated with significant morbidity and mortality. We present our experience with this infection in adults and discuss clinical characteristics, treatment options, and outcome. METHODS: All episodes of Candida isolated from the central nervous system were identified by searching our laboratory database. Review of the cases was performed by means of a retrospective chart review. RESULTS: Eleven episodes of Candida CSF infection following neurosurgery were identified over a 12-year period. Candida albicans was the predominant species isolated (n = 8, 73%). All infections were associated with foreign intracranial material, nine with external ventricular drains (82%), one with a ventriculoperitoneal shunt, one with a lumbar drain, and one with Gliadel wafers (1,3-bis [2-chloroethyl]-1-nitrosurea). Fluconazole or liposomal amphotericin B were the most common anti-fungal agents used. The mortality rate identified in our series was 27%. CONCLUSIONS: Candida infection following neurosurgery remains a relatively rare occurrence but one that causes significant mortality. These are complex infections, the management of which benefits from a close liaison between the clinical microbiologist and neurosurgeon. Prompt initiation of antifungal agents and removal of infected devices offers the best hope of a cure.

  6. A review on alcohol: from the central action mechanism to chemical dependency

    Directory of Open Access Journals (Sweden)

    João Victor Vezali Costardi


    Full Text Available SummaryIntroduction:alcohol is a psychotropic depressant of the central nervous system (CNS that promotes simultaneous changes in several neuronal pathways, exerting a profound neurological impact that leads to various behavioral and biological alterations.Objectives:to describe the effects of alcohol on the CNS, identifying the signaling pathways that are modified and the biological effects resulting from its consumption.Methods:a literature review was conducted and articles published in different languages over the last 15 years were retrieved.Results:the studies reviewed describe the direct effect of alcohol on several neurotransmitter receptors (gamma-aminobutyric acid [GABA], glutamate, endocannabinoids AEA and 2-AG, among others, the indirect effect of alcohol on the limbic and opioid systems, and the effect on calcium and potassium channels and on proteins regulated by GABA in the hippocampus.Discussion and conclusion:the multiple actions of alcohol on the CNS result in a general effect of psychomotor depression, difficulties in information storage and logical reasoning and motor incoordination, in addition to stimulating the reward system, a fact that may explain the development of addiction. Knowledge on the neuronal signaling pathways that are altered by alcohol allows the identification of effectors which could reduce its central action, thus, offering new therapeutic perspectives for the rehabilitation of alcohol addicts.

  7. Peripherally inserted central venous catheter safety in burn care: a single-center retrospective cohort review. (United States)

    Austin, Ryan E; Shahrokhi, Shahriar; Bolourani, Siavash; Jeschke, Marc G


    The use of peripherally inserted central catheter (PICC) line for central venous access in thermally injured patients has increased in recent years despite a lack of evidence regarding safety in this patient population. A recent survey of invasive catheter practices among 44 burn centers in the United States found that 37% of burn units use PICC lines as part of their treatment protocol. The goal of this study was to compare PICC-associated complication rates with the existing literature in both the critical care and burn settings. The methodology involved is a single institution retrospective cohort review of patients who received a PICC line during admission to a regional burn unit between 2008 and 2013. Fifty-three patients were identified with a total of seventy-three PICC lines. The primary outcome measurement for this study was indication for PICC line discontinuation. The most common reason for PICC line discontinuation was that the line was no longer indicated (45.2%). Four cases of symptomatic upper extremity deep vein thrombosis (5.5%) and three cases of central line-associated bloodstream infection (4.3%, 2.72 infections per 1000 line days) were identified. PICC lines were in situ an average of 15 days (range 1 to 49 days). We suggest that PICC line-associated complication rates are similar to those published in the critical care literature. Though these rates are higher than those published in the burn literature, they are similar to central venous catheter-associated complication rates. While PICC lines can be a useful resource in the treatment of the thermally injured patient, they are associated with significant and potentially fatal risks.

  8. Pathological Gambling: Psychiatric Models (United States)

    Westphal, James R.


    Three psychiatric conceptual models: addictive, obsessive-compulsive spectrum and mood spectrum disorder have been proposed for pathological gambling. The objectives of this paper are to (1) evaluate the evidence base from the most recent reviews of each model, (2) update the evidence through 2007 and (3) summarize the status of the evidence for…

  9. Potential role of environmental contaminants in the pathology of beak deformities among Black-capped chickadees in South-central Alaska (United States)

    US Fish and Wildlife Service, Department of the Interior — More than 1,400 individual Black-capped Chickadees (Poecile atricapillus) with beak deformities were recorded in south-central Alaska between 1991 and 2005. Over 200...

  10. Continuing studies of mortality of alligators on central Florida lakes : Pathology and nutrition : Final report to St. Johns River Water Management District (United States)

    US Fish and Wildlife Service, Department of the Interior — Investigations into the continuing, unexplained mortality of alligators on Lake Griffin in central Florida were conducted. Lake Griffin was surveyed for dead...

  11. Determinants of pathologic mineralization. (United States)

    Kirsch, Thorsten


    Physiologic mineralization is necessary for the formation of skeletal tissues and for their appropriate functions during adulthood. Mineralization has to be controlled and restricted to specific regions. If the mineralization process occurs in regions that normally do not mineralize, there can be severe consequences (pathologic or ectopic mineralization). Recent findings have indicated that physiologic and pathologic mineralization events are initiated by matrix vesicles, membrane-enclosed particles released from the plasma membranes of mineralization-competent cells. The understanding of how these vesicles are released from the plasma membrane and initiate the mineralization process may provide novel therapeutic strategies to prevent pathologic mineralization. In addition, other regulators (activators and inhibitors) of physiologic mineralization have been identified and characterized, and there is evidence that the same factors also contribute to the regulation of pathologic mineralization. Finally, programmed cell death (apoptosis) may be a contributor to physiologic mineralization and if occurring after tissue injury may induce pathologic mineralization and mineralization-related differentiation events in the injured and surrounding areas. This review describes how the understanding of mechanisms and factors regulating physiologic mineralization can be used to develop new therapeutic strategies to prevent pathologic or ectopic mineralization events.

  12. Overlapping molecular pathological themes link Charcot-Marie-Tooth neuropathies and hereditary spastic paraplegias. (United States)

    Timmerman, Vincent; Clowes, Virginia E; Reid, Evan


    In this review we focus on Charcot-Marie-Tooth (CMT) neuropathies and hereditary spastic paraplegias (HSPs). Although these diseases differ in whether they primarily affect the peripheral or central nervous system, both are genetically determined, progressive, long axonopathies that affect motor and sensory pathways. This commonality suggests that there might be similarities in the molecular pathology underlying these conditions, and here we compare the molecular genetics and cellular pathology of the two groups.

  13. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens. (United States)

    Packer, Mark


    The purpose of this review is to summarize relevant data from publications appearing in the peer-reviewed scientific literature over the past decade since US Food and Drug Administration approval of the implantable collamer lens (ICL), and, in particular, to review studies relating to sizing methodology, safety, and effectiveness, as well as more recent studies reporting clinical outcomes of the V4c Visian ICL with KS Aquaport, VICMO. A literature search was conducted using two databases, and, to identify all articles published after 2005 related to the Visian ICL (STAAR Surgical, Inc.). Articles were examined for their relevance to sizing methodology, clinical safety, and effectiveness, and the references cited in each article were also searched for additional relevant publications. The literature review revealed that all currently reported methods of determining the best-fit size of the ICL achieve similarly satisfactory results in terms of vault, the safe distance between the crystalline lens and the ICL. Specifically, meta-analysis demonstrated that sulcus-to-sulcus and white-to-white measurement-based sizing methods do not result in clinically meaningful nor statistically significant differences in vault (two-sample two-sided t-test using pooled mean and standard deviations; t (2,594)=1.33; P=0.18). The reported rates of complications related to vault are very low, except in two case series where additional risk factors such as higher levels of myopia and older age impacted the incidence of cataract. On the basis of preclinical studies and initial clinical reports, with up to 5 years of follow-up, the new VICMO central port design holds promise for further reduction of complications. Given its safety record and the significant improvement in vision and quality of life that the ICL makes possible, the benefits of ICL implantation outweigh the risks.

  14. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens (United States)

    Packer, Mark


    The purpose of this review is to summarize relevant data from publications appearing in the peer-reviewed scientific literature over the past decade since US Food and Drug Administration approval of the implantable collamer lens (ICL), and, in particular, to review studies relating to sizing methodology, safety, and effectiveness, as well as more recent studies reporting clinical outcomes of the V4c Visian ICL with KS Aquaport, VICMO. A literature search was conducted using two databases, and, to identify all articles published after 2005 related to the Visian ICL (STAAR Surgical, Inc.). Articles were examined for their relevance to sizing methodology, clinical safety, and effectiveness, and the references cited in each article were also searched for additional relevant publications. The literature review revealed that all currently reported methods of determining the best-fit size of the ICL achieve similarly satisfactory results in terms of vault, the safe distance between the crystalline lens and the ICL. Specifically, meta-analysis demonstrated that sulcus-to-sulcus and white-to-white measurement-based sizing methods do not result in clinically meaningful nor statistically significant differences in vault (two-sample two-sided t-test using pooled mean and standard deviations; t (2,594)=1.33; P=0.18). The reported rates of complications related to vault are very low, except in two case series where additional risk factors such as higher levels of myopia and older age impacted the incidence of cataract. On the basis of preclinical studies and initial clinical reports, with up to 5 years of follow-up, the new VICMO central port design holds promise for further reduction of complications. Given its safety record and the significant improvement in vision and quality of life that the ICL makes possible, the benefits of ICL implantation outweigh the risks. PMID:27354760

  15. Understanding Central Mechanisms of Acupuncture Analgesia Using Dynamic Quantitative Sensory Testing: A Review

    Directory of Open Access Journals (Sweden)

    Jiang-Ti Kong


    Full Text Available We discuss the emerging translational tools for the study of acupuncture analgesia with a focus on psychophysical methods. The gap between animal mechanistic studies and human clinical trials of acupuncture analgesia calls for effective translational tools that bridge neurophysiological data with meaningful clinical outcomes. Temporal summation (TS and conditioned pain modulation (CPM are two promising tools yet to be widely utilized. These psychophysical measures capture the state of the ascending facilitation and the descending inhibition of nociceptive transmission, respectively. We review the basic concepts and current methodologies underlying these measures in clinical pain research, and illustrate their application to research on acupuncture analgesia. Finally, we highlight the strengths and limitations of these research methods and make recommendations on future directions. The appropriate addition of TS and CPM to our current research armamentarium will facilitate our efforts to elucidate the central analgesic mechanisms of acupuncture in clinical populations.

  16. Barrier function in the peripheral and central nervous system-a review. (United States)

    Reinhold, A K; Rittner, H L


    The peripheral (PNS) and central nervous system (CNS) are delicate structures, highly sensitive to homeostatic changes-and crucial for basic vital functions. Thus, a selection of barriers ensures the protection of the nervous system from noxious blood-borne or surrounding stimuli. In this chapter, anatomy and functioning of the blood-nerve (BNB), the blood-brain (BBB), and the blood-spinal cord barriers (BSCB) are presented and the key tight junction (TJ) proteins described: claudin-1, claudin-3, claudin-5, claudin-11, claudin-12, claudin-19, occludin, Zona occludens-1 (ZO-1), and tricellulin are by now identified as relevant for nerval barriers. Different diseases can lead to or be accompanied by neural barrier disruption, and impairment of these barriers worsens pathology. Peripheral nerve injury and inflammatory polyneuropathy cause an increased permeability of BNB as well as BSCB, while, e.g., diseases of the CNS such as amyotrophic lateral sclerosis, multiple sclerosis, spinal cord injury, or Alzheimer's disease can progress and worsen through barrier dysfunction. Moreover, the complex role and regulation of the BBB after ischemic stroke is described. On the other side, PNS and CNS barriers hamper the delivery of drugs in diseases when the barrier is intact, e.g., in certain neurodegenerative diseases or inflammatory pain. Understanding of the barrier - regulating processes has already lead to the discovery of new molecules as drug enhancers. In summary, the knowledge of all of these mechanisms might ultimately lead to the invention of drugs to control barrier function to help ameliorating or curing neurological diseases.

  17. Second-Generation central venous catheter in the prevention of bloodstream infection: a systematic review 1 (United States)

    Stocco, Janislei Gislei Dorociaki; Hoers, Hellen; Pott, Franciele Soares; Crozeta, Karla; Barbosa, Dulce Aparecida; Meier, Marineli Joaquim


    Abstract Objective: to evaluate the effectiveness and safety in the use of second-generation central venous catheters impregnated in clorhexidine and silver sulfadiazine when compared with other catheters, being them impregnated or not, in order to prevent the bloodstream infection prevention. Method: systematic review with meta-analysis. Databases searched: MEDLINE, EMBASE, CINAHL, LILACS/SciELO, Cochrane CENTRAL; search in Congress Proceedings and records from Clinical Trials. Results: 1.235 studies were identified, 97 were pre-selected and 4 were included. In catheter-related bloodstream infection, there was no statistical significance between second-generation impregnated catheter compared with the non-impregnated ones, absolute relative risk 1,5% confidence interval 95% (3%-1%), relative risk 0,68 (confidence interval 95%, 0,40-1,15) and number needed to treat 66. In the sensitivity analysis, there was less bloodstream infection in impregnated catheters (relative risk 0,50, confidence interval 95%, 0,26-0,96). Lower colonization, absolute relative risk 9,6% (confidence interval 95%, 10% to 4%), relative risk 0,51 (confidence interval 95% from 0,38-0,85) and number needed to treat 5. Conclusion: the use of second-generation catheters was effective in reducing the catheter colonization and infection when a sensitivity analysis is performed. Future clinical trials are suggested to evaluate sepsis rates, mortality and adverse effects. PMID:27508901

  18. Effect of Probiotics on Central Nervous System Functions in Animals and Humans: A Systematic Review (United States)

    Wang, Huiying; Lee, In-Seon; Braun, Christoph; Enck, Paul


    To systematically review the effects of probiotics on central nervous system function in animals and humans, to summarize effective interventions (species of probiotic, dose, duration), and to analyze the possibility of translating preclinical studies. Literature searches were conducted in Pubmed, Medline, Embase, and the Cochrane Library. Only randomized controlled trials were included. In total, 38 studies were included: 25 in animals and 15 in humans (2 studies were conducted in both). Most studies used Bifidobacterium (eg, B. longum, B. breve, and B. infantis) and Lactobacillus (eg, L. helveticus, and L. rhamnosus), with doses between 109 and 1010 colony-forming units for 2 weeks in animals and 4 weeks in humans. These probiotics showed efficacy in improving psychiatric disorder-related behaviors including anxiety, depression, autism spectrum disorder (ASD), obsessive-compulsive disorder, and memory abilities, including spatial and non-spatial memory. Because many of the basic science studies showed some efficacy of probiotics on central nervous system function, this background may guide and promote further preclinical and clinical studies. Translating animal studies to human studies has obvious limitations but also suggests possibilities. Here, we provide several suggestions for the translation of animal studies. More experimental designs with both behavioral and neuroimaging measures in healthy volunteers and patients are needed in the future. PMID:27413138

  19. Review of the genus Lesteva Latreille, 1797 of Central Asia (Coleoptera: Staphylinidae: Omaliinae: Anthophagini). (United States)

    Shavrin, Alexey V


    A taxonomic review of the genus Lesteva Latreille, 1797 of the Central Asia is presented. The type material of the following species was revised: L. bucharica Fauvel, 1900, L. fasciata Luze, 1903, L. nova Bernhauer, 1902, L. transcaspica Bernhauer, 1935 and L. turkestanica Luze, 1904. Lectotypes for L. bucharica and L. turkestanica, a lectotype and paralectotype for L. transcaspica are designated. One species is described as new: L. (s.str.) schuelkei sp. n. (Tajikistan, NW Pamir: Peter-I Mts. and Hissar Mts.). Three synonyms are proposed: L. (s.str.) fasciata=L. (s.str.) turkestanica, syn n.=L. (s.str.) transcaspica, syn. n., L. nova=L. (s.str.) aculeata Shavrin, 2010, syn. n. Three species are redescribed: L. (s.str.) bucharica, L. (s.str.) fasciata and L. (s.str.) nova. All species are illustrated and their distribution mapped. A key to species known from Central Asia, as well as new provincial records for L. (s.str.) barsevskisi Shavrin, 2010, L. (s.str.) bucharica and L. (s.str.) fasciata are provided.

  20. A review of pathologies associated with high T1W signal intensity in the basal ganglia on Magnetic Resonance Imaging


    Zaitout, Zahia; Romanowski, Charles; Karunasaagarar, Kavitasagary; Connolly, Daniel; Batty, Ruth


    Summary With several functions and a fundamental influence over cognition and motor functions, the basal ganglia are the cohesive centre of the brain. There are several conditions which affect the basal ganglia and these have various clinical and radiological manifestations. Nevertheless, on magnetic resonance imaging there is a limited differential diagnosis for those conditions presenting with T1 weighted spin echo hyperintensity within the central nervous system in general and the basal ga...

  1. Guidewire-Related Complications during Central Venous Catheter Placement: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Faisal A. Khasawneh


    Full Text Available Seldinger's technique is widely used to place central venous and arterial catheters and is generally considered safe. The technique does have multiple potential risks. Guidewire-related complications are rare but potentially serious. We describe a case of a lost guidewire during central venous catheter insertion followed by a review of the literature of this topic. Measures which can be taken to prevent such complications are explained in detail as well as recommended steps to remedy errors should they occur.

  2. Non-invasive neuromuscular electrical stimulation in patients with central nervous system lesions: an educational review. (United States)

    Schuhfried, Othmar; Crevenna, Richard; Fialka-Moser, Veronika; Paternostro-Sluga, Tatjana


    The aim of this educational review is to provide an overview of the clinical application of transcutaneous electrical stimulation of the extremities in patients with upper motor neurone lesions. In general two methods of electrical stimulation can be distinguished: (i) therapeutic electrical stimulation, and (ii) functional electrical stimulation. Therapeutic electrical stimulation improves neuromuscular functional condition by strengthening muscles, increasing motor control, reducing spasticity, decreasing pain and increasing range of motion. Transcutaneous electrical stimulation may be used for neuromuscular electrical stimulation inducing repetitive muscle contraction, electromyography-triggered neuromuscular electrical stimulation, position-triggered electrical stimulation and subsensory or sensory transcutaneous electric stimulation. Functional electrical stimulation provokes muscle contraction and thereby produces a functionally useful movement during stimulation. In patients with spinal cord injuries or stroke, electrical upper limb neuroprostheses are applied to enhance upper limb and hand function, and electrical lower limb neuroprostheses are applied for restoration of standing and walking. For example, a dropped foot stimulator is used to trigger ankle dorsiflexion to restore gait function. A review of the literature and clinical experience of the use of therapeutic electrical stimulation as well as of functional electrical stimulation in combination with botulinum toxin, exercise therapy and/or splinting are presented. Although the evidence is limited we conclude that neuromuscular electrical stimulation in patients with central nervous system lesions can be an effective modality to improve function, and that combination with other treatments has an additive therapeutic effect.

  3. Central retinal vein occlusion: A review of current Evidence-based treatment options

    Directory of Open Access Journals (Sweden)

    Amy Patel


    Full Text Available A central retinal vein occlusion (CRVO can induce an ischemic and hypoxic state with resulting sequelae of macular edema and neovascularization. Many treatment options have been studied. Our review aims to investigate the safety and efficacy of the multiple treatment options of CRVO. A PubMed and Cochrane literature search was performed. Well-controlled randomized clinical trials that demonstrated strong level 1 evidence-based on the rating scale developed by the British Centre for Evidence-Based Medicine were included. Seven clinical trials met inclusion criteria to be included in this review. These included studies that investigated the safety and efficacy of retinal photocoagulation (1 study, intravitreal steroid treatment (2 studies, and antivascular endothelial growth factor treatment (4 studies for the treatment of CRVO. In addition, studies evaluating surgical treatment options for CRVO were also included. Many treatment modalities have been demonstrated to be safe and efficacious in the treatment of CRVO. These treatment options offer therapeutic benefits for patients and clinically superior visual acuity and perhaps the quality of life after suffering from a CRVO.

  4. Central and Peripheral Fatigue During Resistance Exercise – A Critical Review

    Directory of Open Access Journals (Sweden)

    Zając Adam


    Full Text Available Resistance exercise is a popular form of conditioning for numerous sport disciplines, and recently different modes of strength training are being evaluated for health benefits. Resistance exercise differs significantly in nature, and several variables determine the direction and range of adaptive changes that occur in the muscular and skeletal system of the body. Some modes of resistance training can also be effective in stimulating the cardiovascular system. These variables include exercise selection (general, specific, single or multi joint, dynamic, explosive, type of resistance (free weights, variable resistance, isokinetics, order of exercise (upper and lower body or push and pull exercises, and most of all the training load which includes intensity expressed as % of 1RM, number of repetitions, number of sets and the rest interval between sets. Manipulating these variables allows for specific adaptive changes which may include gains in muscle mass, muscle strength or muscle endurance. It has been well established that during resistance exercise fatigue occurs, regardless of the volume and intensity of work applied. The peripheral mechanisms of fatigue have been studied and explained in more detail than those related to the CNS. This review is an attempt to bring together the latest knowledge regarding fatigue, both peripheral and central, during resistance exercise. The authors of this review concentrated on physiological and biochemical mechanisms underlying fatigue in exercises performed with maximal intensity, as well as those performed to exhaustion with numerous repetitions and submaximal load.

  5. [Effects of electromagnetic field from cellular phones on selected central nervous system functions: a literature review]. (United States)

    Bak, Marek; Zmyślony, Marek


    In the opinion of some experts, a growing emission of man-made electromagnetic fields (EMF), also known as electromagnetic is a source of continuously increasing health hazards to the general population. Due to their large number and very close proximity to the user's head, mobile phones deserve special attention. This work is intended to give a systematic review of objective studies, assessing the effects of mobile phone EMF on the functions of the central nervous system (CNS) structures. Our review shows that short exposures to mobile phone EMF, experienced by telephone users during receiving calls, do not affect the cochlear function. Effects of GSM mobile phone EMF on the conduction of neural impulses from the inner car neurons to the brainstem auditory centres have not been detected either. If Picton's principle, saying that P300 amplitude varies with the improbability of the targets and its latency varies with difficulty of discriminating the target stimulus from standard stimuli, is true, EMF changes the improbability of the targets without hindering their discrimination. Experiments with use of indirect methods do not enable unequivocal verification of EMF effects on the cognitive functions due to the CNS anatomical and functional complexity. Thus, it seems advisable to develop a model of EMF effects on the excitable brain structures at the cellular level.

  6. Sellar collision tumor involving metastatic lung cancer and pituitary adenoma: radiologic-pathologic correlation and review of the literature. (United States)

    Sogani, Julie; Yang, Wanhua; Lavi, Ehud; Zimmerman, Robert D; Gupta, Ajay


    Collision tumors of the sella turcica involving metastases to pituitary adenomas are rare. We report a case of a collision tumor involving metastatic lung cancer with an emphasis on the neuroimaging and histopathological studies. A review of the literature including the diagnostic and management implications as well as pathogenetic mechanisms is also discussed.

  7. A Study on Clinical and Pathologic Features in Lupus Nephritis with Mainly IgA Deposits and a Literature Review

    Directory of Open Access Journals (Sweden)

    Liu Hongyan


    Full Text Available Objective. To study the clinical and pathologic features of systemic lupus erythematosus (SLE that has atypical lupus nephritis (LN with mainly IgA deposits. Methods. We searched the SLE patients who had nephritis with mainly IgA deposits in our hospital and selected the information including clinical manifestations, laboratory tests, treatments, and prognosis. Results. From January 2009 to June 2012, 5 patients were definitely diagnosed as SLE according to both 1982 and 2009 ACR classification criteria. But renal biopsy showed that all cases had mainly IgA deposits and were free of IgG, C1q, and fibrinogen-related antigen deposits under immunofluorescent microscopy, which did not match with typical LN. There were 2 males and 3 females, aging from 31 to 64 years and with an average of years. The 5 cases had multiple-system involvements, mainly the renal system. Compared to primary IgAN, the atypical LN showed some differences: older than primary IgAN, more women than men, no previous infection history, lower incidence of serum IgA elevation, and ACL positive rate as high as 100%. Conclusion. Nephritis with mainly IgAN deposits, as an atypical LN, may be a special subtype of SLE.

  8. The pathology of lithium induced nephropathy: a case report and review, with emphasis on the demonstration of mast cells. (United States)

    B N, Kumarguru; M, Natarajan; Nagarajappa, A H


    Lithium is a psychotropic agent which is widely employed in the psychiatric practice throughout the world. The therapeutic index of lithium is low and an acute intoxication may appear, which may lead to death or a permanent disability. A frequent side effect of lithium is renal toxicity. The collecting tubules have been identified as the site of action of lithium, due to the down regulation of Acquaporin-2. The mast cells have been associated with a wide range of human renal diseases. They have been documented to be associated with interstitial fibrosis and an impaired renal function. We are reporting a case of a 42 year old male who was admitted with a history of an altered sensorium of short duration. He had bipolar disorder and was on lithium. Investigations revealed a severely compromised renal function. The patient's condition worsened and he expired. A necropsy was performed. The kidneys and the lungs were subjected to a histopathological examination. The kidneys showed a significant Chronic Tubulointerstitial Nephropathy [CTIN] and a considerable glomerular pathology. Toludine blue [1%] staining demonstrated mast cells in the interstitium and the connective tissue of the renal pelvis. This appears to be the first time that mast cells were demonstrated in a case of lithium induced nephropathy in humans. It may be hypothesized that mast cells may possibly play a role in lithium induced nephropathy as a concurrent mechanism.

  9. A afferent fibers are involved in the pathology of central changes in the spinal dorsal horn associated with myofascial trigger spots in rats. (United States)

    Meng, Fei; Ge, Hong-You; Wang, Yong-Hui; Yue, Shou-Wei


    A afferent fibers have been reported to participate in the development of the central sensitization induced by inflammation and injuries. Current evidence suggests that myofascial trigger points (MTrPs) induce central sensitization in the related spinal dorsal horn, and clinical studies indicate that A fibers are associated with pain behavior. Because most of these clinical studies applied behavioral indexes, objective evidence is needed. Additionally, MTrP-related neurons in dorsal root ganglia and the spinal ventral horn have been reported to be smaller than normal, and these neurons were considered to be related to A fibers. To confirm the role of A fibers in MTrP-related central changes in the spinal dorsal horn, we studied central sensitization as well as the size of neurons associated with myofascial trigger spots (MTrSs, equivalent to MTrPs in humans) in the biceps femoris muscle of rats and provided some objective morphological evidence. Cholera toxin B subunit-conjugated horseradish peroxidase was applied to label the MTrS-related neurons, and tetrodotoxin was used to block A fibers specifically. The results showed that in the spinal dorsal horn associated with MTrS, the expression of glutamate receptor (mGluR1α/mGluR5/NMDAR1) increased, while the mean size of MTrS-related neurons was smaller than normal. After blocking A fibers, these changes reversed to some extent. Therefore, we concluded that A fibers participated in the development and maintenance of the central sensitization induced by MTrPs and were related to the mean size of neurons associated with MTrPs in the spinal dorsal horn.

  10. The proof-of-concept of ASS234: Peripherally administered ASS234 enters the central nervous system and reduces pathology in a male mouse model of Alzheimer disease (United States)

    Serrano, Mari Paz; Herrero-Labrador, Raquel; Futch, Hunter S.; Serrano, Julia; Romero, Alejandro; Fernandez, Ana Patricia; Samadi, Abdelouahid; Unzeta, Mercedes; Marco-Contelles, Jose; Martínez-Murillo, Ricardo


    Background The heterogeneity of Alzheimer disease requires the development of multitarget drugs for treating the symptoms of the disease and its progression. Both cholinergic and monoamine oxidase dysfunctions are involved in the pathological process. Thus, we hypothesized that the development of therapies focused on these targets might be effective. We have developed and assessed a new product, coded ASS234, a multipotent acetyl and butyrylcholinesterase/monoamine oxidase A–B inhibitor with a potent inhibitory effect on amyloid-β aggregation as well as antioxidant and antiapoptotic properties. But there is a need to reliably correlate in vitro and in vivo drug release data. Methods We examined the effect of ASS234 on cognition in healthy adult C57BL/6J mice in a model of scopolamine-induced cognitive impairment that often accompanies normal and pathological aging. Also, in a characterized transgenic APPswe/PS1ΔE9 mouse model of Alzheimer disease, we examined the effects of short-term ASS234 treatment on plaque deposition and gliosis using immunohistochemistry. Toxicology of ASS234 was assessed using a quantitative high-throughput in vitro cytotoxicity screening assay following the MTT assay method in HepG2 liver cells. Results In vivo, ASS234 significantly decreased scopolamine-induced learning deficits in C57BL/6J mice. Also, reduction of amyloid plaque burden and gliosis in the cortex and hippocampus was assessed. In vitro, ASS234 exhibited lesser toxicity than donepezil and tacrine. Limitations The study was conducted in male mice only. Although the Alzheimer disease model does not recapitulate all features of the human disease, it exhibits progressive monoaminergic neurodegeneration. Conclusion ASS234 is a promising alternative drug of choice to treat the cognitive decline and neurodegeneration underlying Alzheimer disease. PMID:27636528

  11. Use of matrix metalloproteinase-9 (MMP-9 and its tissue inhibitor (TIMP-1 in the pathomorphological diagnosis of carotid pathology: literature review and own observations

    Directory of Open Access Journals (Sweden)

    Yu. I. Kuzyk


    Full Text Available Matrix metalloproteinases (MMPs are the degradative enzymes of the extracellular matrix. Currently, the role of MMP-2 and MMP-9 in the progression of atherosclerosis (AS is proved. The question of possible involvement of MMP-9 into elastin degradation in fibromuscular dysplasia (FMD and pathological tortuosity (PT remains open and insufficiently explored. The aim of the study – analysis of the current literature on the role of degradative enzymes in the development of carotid pathology and study of the expression of type I, III, IV collagens, MMP-9 and TIPM-1 in the wall of the carotid arteries in FMD, PT and AS. Materials and methods included literature review and own research. Immunohistochemical study of type I, III and IV collagens, TIMP-1 and MMP-9 was carried out on surgical material of patients with main carotid diseases: three observations with AS, two – with FMD, two – with PT. The level of expression was assessed by semiquantitative method. Results. Own observations showed that in FMD types I and III collagen content in the media and in the adventitia remains unchanged. MMP-9 expression level reached the highest level of intensity in atherosclerotic plaques, particularly in macrophages, constituting the main part of the atheromatous mass. Moderate intensity of expression is noted in FMD and PT. In PT expression prevailed in the lower third of the media on the border with adventitia, including the adventitia, in FMD – mainly in the media. The level of TIMP-1 is weakly positive in PT and FMD, negative in AS. Conclusions. These results demonstrate the possibility of using MMP-9 and TIMP-1 as a morphological marker determining pathological processes in carotid pathology. Data of immunohistochemical study of type I, II, IV collagens indicate moderate expression of collagen type I in FMD and PT, severe expression of collagen III in FMD, moderate in PT. Type IV collagen is highly expressed in atherosclerotic plaques. For AS high

  12. Acrolein—an α,ß-Unsaturated Aldehyde: A Review of Oral Cavity Exposure and Oral Pathology Effects


    Dror Aizenbud; Itay Aizenbud; Abraham Z. Reznick; Katia Avezov


    Acrolein is a highly reactive unsaturated aldehyde widely present in the environment, particularly as a product of tobacco smoke. Our previous studies indicated the adverse consequences of even short-term acrolein exposure and proposed a molecular mechanism of its potential harmful effect on oral cavity keratinocytic cells. In this paper we chose to review the broad spectrum of acrolein sources such as pollution, food, and smoking. Consequently, in this paper we consider a high level of oral ...

  13. Nontraditional applications in clinical pathology. (United States)

    Jordan, Holly L; Register, Thomas C; Tripathi, Niraj K; Bolliger, Anne Provencher; Everds, Nancy; Zelmanovic, David; Poitout, Florence; Bounous, Denise I; Wescott, Debra; Ramaiah, Shashi K


    Most published reviews of preclinical toxicological clinical pathology focus on the fundamental aspects of hematology, clinical chemistry, coagulation, and urinalysis in routine toxicology animal species, for example, rats, mice, dogs, and nonhuman primates. The objective of this continuing education course was to present and discuss contemporary examples of nonroutine applications of clinical pathology endpoints used in the drug development setting. Area experts discussed bone turnover markers of laboratory animal species, clinical pathology of pregnant and growing laboratory animals, clinical pathology of nonroutine laboratory animal species, and unique applications of the Siemens Advia(®) hematology analyzer. This article is a summary based on a presentation given at the 31st Annual Symposium of the Society of Toxicologic Pathology, during the Continuing Education Course titled "Nontraditional Applications of Clinical Pathology in Drug Discovery and Preclinical Toxicology."

  14. Meta-analysis and review: effectiveness, safety, and central port design of the intraocular collamer lens

    Directory of Open Access Journals (Sweden)

    Packer M


    Full Text Available Mark Packer Mark Packer MD Consulting, Inc., Boulder, CO, USA Abstract: The purpose of this review is to summarize relevant data from publications appearing in the peer-reviewed scientific literature over the past decade since US Food and Drug Administration approval of the implantable collamer lens (ICL, and, in particular, to review studies relating to sizing methodology, safety, and effectiveness, as well as more recent studies reporting clinical outcomes of the V4c Visian ICL with KS Aquaport, VICMO. A literature search was conducted using two databases, and, to identify all articles published after 2005 related to the Visian ICL (STAAR Surgical, Inc.. Articles were examined for their relevance to sizing methodology, clinical safety, and effectiveness, and the references cited in each article were also searched for additional relevant publications. The literature review revealed that all currently reported methods of determining the best-fit size of the ICL achieve similarly satisfactory results in terms of vault, the safe distance between the crystalline lens and the ICL. Specifically, meta-analysis demonstrated that sulcus-to-sulcus and white-to-white measurement-based sizing methods do not result in clinically meaningful nor statistically significant differences in vault (two-sample two-sided t-test using pooled mean and standard deviations; t (2,594=1.33; P=0.18. The reported rates of complications related to vault are very low, except in two case series where additional risk factors such as higher levels of myopia and older age impacted the incidence of cataract. On the basis of preclinical studies and initial clinical reports, with up to 5 years of follow-up, the new VICMO central port design holds promise for further reduction of complications. Given its safety record and the significant improvement in vision and quality of life that the ICL makes possible, the benefits of ICL implantation outweigh the risks

  15. Lysosomal Fusion Dysfunction as a Unifying Hypothesis for Alzheimer's Disease Pathology

    Directory of Open Access Journals (Sweden)

    Kristen E. Funk


    Full Text Available Alzheimer's disease is characterized pathologically by extracellular senile plaques, intracellular neurofibrillary tangles, and granulovacuolar degeneration. It has been debated whether these hallmark lesions are markers or mediators of disease progression, and numerous paradigms have been proposed to explain the appearance of each lesion individually. However, the unfaltering predictability of these lesions suggests a single pathological nidus central to disease onset and progression. One of the earliest pathologies observed in Alzheimer's disease is endocytic dysfunction. Here we review the recent literature of endocytic dysfunction with particular focus on disrupted lysosomal fusion and propose it as a unifying hypothesis for the three most-studied lesions of Alzheimer's disease.

  16. Contributions of Dr. Juan Rosai to the pathology of cutaneous vascular proliferations: A review of selected lesions. (United States)

    Wick, Mark R


    Vascular proliferations in the skin have been thoroughly studied over the past 35 years, and a great deal of knowledge has been accrued regarding their pathobiological features. Dr. Juan Rosai has been a consistent contributor to the literature on this topic throughout most of his career, and this article reviews selected cutaneous endothelial lesions that he helped to characterize. They include histiocytoid-epithelioid hemangioma, targetoid-hobnail hemangioma, acquired tufted hemangioma, glomeruloid hemangioma, spindle cell hemangioma, retiform hemangioendothelioma, and angiosarcoma. Two potential simulants of angiosarcoma-papillary intravascular endothelial hyperplasia and cutaneous rudimentary meningocele-meningothelial hamartoma-are also considered.

  17. Constitutional transitions in Central and Eastern Europe : [book reviews] / Philipp Kiiver

    Index Scriptorium Estoniae

    Kiiver, Philipp


    Arvustus: Sadurski, W. Rights before courts : a study of constitutional courts in postcommunist states of Central and Eastern Europe. Springer, 2005 ; Albi, A. EU enlargement and the constitutions of Central and Eastern Europe. Cambridge University Press, 2005

  18. Acrolein—an α,ß-Unsaturated Aldehyde: A Review of Oral Cavity Exposure and Oral Pathology Effects

    Directory of Open Access Journals (Sweden)

    Dror Aizenbud


    Full Text Available Acrolein is a highly reactive unsaturated aldehyde widely present in the environment, particularly as a product of tobacco smoke. Our previous studies indicated the adverse consequences of even short-term acrolein exposure and proposed a molecular mechanism of its potential harmful effect on oral cavity keratinocytic cells. In this paper we chose to review the broad spectrum of acrolein sources such as pollution, food, and smoking. Consequently, in this paper we consider a high level of oral exposure to acrolein through these sources and discuss the noxious effects it has on the oral cavity including on salivary quality and contents, oral resistance to oxidative stress, and stress mechanism activation in a variety of oral cells.

  19. Helicobacter pylori as a risk factor for central serous chorioretinopathy: Literature review

    Institute of Scientific and Technical Information of China (English)

    Aránzazu; Mateo-Montoya; Martine; Mauget-Fa?se


    Helicobacter pylori(H. pylori), a Gram-negative bacterium, is one of the most frequent causes of gastrointestinal infections worldwide. It has been associated as a pathogen for the human body with many systemic diseases, including different eye diseases. We will focus on a specific eye disease called idiopathic central serous chorioretinopathy(ICSCR). This disease is characterized by a serous detachment of the neurosensory retina in the macular region, which affects the vision to different degrees. Currently, the pathophysiology of ICSCR is not clear and there is no effective treatment. However, several potential risk factors have been elucidated. One of the factors that has more frequently been associated with ICSCR is stress. As H. pylori was identified as a possible etiological factor for occlusive arterial diseases in young people who were particularly stressed, it was thought that H. pylori might also be present in ICSCR. Therefore, some physicians started to test its presence in patents with ICSCR. If H. pylori happened to be associated with ICSCR, the treatment of gastrointestinal infection could also improve visual symptoms and help to remediate this eye disease. Although H. pylori is highly prevalent in the general population, a true cor-relation seems to exist. We present a review on the relationship between ICSCR and H. pylori.

  20. Welfare State Development in Central and Eastern Europe: A State of the Art Literature Review

    Directory of Open Access Journals (Sweden)

    Dragos Adascalitei


    Full Text Available The welfare states in Central and Eastern Europe (CEE have undergone massive changes since the beginning of the 1990s. This paper reviews the literature on welfare state development in CEE in light of the theories that have been used to study advanced capitalist democracies. Its purpose is to critically assess the extent to which different theories can explain changes in the welfare state during and after transition. It argues that until now two strands of literature have crystallised: institutionalism and actor-centred explanations. Institutionalists agree that welfare reforms are limited by the path dependence of the national welfare state structures though this framework is biased towards explaining stability. Recent literature seeks to overcome this bias by adding variables that traditionally belong to the actor-centred paradigm. This essay will argue that the gains from such an approach are exceeded by losses in the accuracy and parsimony of explanations. Further, in the actor-centred camp the welfare state is seen as a product of bargaining between various national and international actors. Yet the debate about who is responsible for the present welfare state arrangements is far from over. Unanswered questions revolve around the impact of political parties and ideologies on welfare reforms, the role of bureaucracies, the efficiency of international financial institutions in advocating retrenchment and the precise mechanisms through which all the above actors defend their interests.

  1. Laparoscopic complete mesocolic excision with central vascular ligation in right colon cancer:A comprehensive review

    Institute of Scientific and Technical Information of China (English)

    Luca Maria Siani; Gianluca Garulli


    Aim of the study is to comprehensively review the latest trends in laparoscopic complete mesocolic excision(CME) with central vascular ligation(CVL) for the multimodal management of right colon cancer. Historical and up-to-date anatomo-embryological concepts are analyzed in detail,focusing on the latest studies of the mesenteric organ,its dissection by mesofascial and retrofascial cleavage planes,and questioning the need for a new terminology in colonic resections. The rationale behind Laparoscopic CME with CVL is thoroughly investigated and explained. Attention is paid to the current surgical techniques and the quality of the surgical specimen,yielded through mesocolic,intramesocolic and muscularis propria plane of surgery. We evaluate the impact on long term oncologic outcome in terms of local recurrence,overall and disease-free survival,according to the plane of resection achieved. Conclusions are drawn on the basis of the available evidence,which suggests a pivotal role of laparoscopic CME with CVL in the multimodal management of right sided colonic cancer: performed in the right mesocolic plane of resection,laparoscopic CME with CVL demonstrates better oncologic results when compared to standard non-mesocolic planes of surgery,with all the advantages of laparoscopic techniques,both in faster recovery and better immunological response. The importance of minimally invasive mesoresectional surgery is thus stressed and highlighted as the new frontier for a modern laparoscopic total right mesocolectomy.

  2. Primary central nervous system lymphomas in 72 immunocompetent patients: pathologic findings and clinical correlations. Groupe Ouest Est d'étude des Leucénies et Autres Maladies du Sang (GOELAMS) (United States)

    Camilleri-Broët, S; Martin, A; Moreau, A; Angonin, R; Hénin, D; Gontier, M F; Rousselet, M C; Caulet-Maugendre, S; Cuillière, P; Lefrancq, T; Mokhtari, K; Morcos, M; Broët, P; Kujas, M; Hauw, J J; Desablens, B; Raphaël, M


    We reviewed 72 primary central nervous system lymphomas occurring in immunocompetent patients. The cases were reviewed for clinical data, histology, immunophenotype, bcl-2 and p53 expression, and Epstein-Barr virus association. Follow-up was available for 40 patients included in the Groupe Ouest Est d'étude des Leucénies et Autres Maladies du Sang (GOELAMS) lymphomes cérébraux primitifs (LCP 88) trial. Each diagnosis, requiring a consensus among at least 3 pathologists, was performed according to the recent Revised European-American Lymphoma classification and equivalents in the updated Kiel classification. Tumors were predominantly classified as diffuse large B-cell lymphomas. There were 3 T-cell lymphomas and 1 Hodgkin lymphoma. The proteins bcl-2 and p53 were expressed in 35% and 16% of the tested cases, respectively. Epstein-Barr virus was not found by in situ hybridization except in the case classfied as a cerebral localization of Hodgkin disease. No significant association was found between subtypes, bcl-2 or p53 expression, and patient survival. From the standpoint of their biologic characteristics, primary central nervous system lymphomas are very similar to systemic diffuse large B-cell lymphomas. In contrast to AIDS-related primary central nervous system lymphomas, primary central nervous system lymphomas are rarely associated with Epstein-Barr virus and in immunocompetent patients they express bcl-2 at a relatively low rate.

  3. [Long-term carriers of genomic structures of the influenza virus in the blood leukocytes of children with congenital pathology of central nervous system]. (United States)

    Bannikov, A I; Rodionova, V B; Grinbaum, E B; Biziukina, E G; Popova, T L; Karpova, L S; Sominina, A A; Kiselev, O I


    Children with central nervous abnormality were followed up for a long time (180 days). The clinical samples (nasal swabs, blood samples) were investigated for influenza virus antigens or RNA detection by virologic and molecular biological techniques. No viral isolate was found throughout the follow-up. The use of the polymerase chain reaction made it possible to reveal the long-term persistence (for 180 days) of NS- and genes of influenza A (H1N1) viruses in the leukocytes and of HA-gene in the nasal swabs. No NS-gene was found in the nasal swabs. The polymerase chain reaction appears to be more effective for the diagnosis of persistent influenza infection that the conventional techniques--immunofluorescence and enzyme-linked immunosorbent assay (ELISA).

  4. Zika virus - emergence, evolution, pathology, diagnosis, and control: current global scenario and future perspectives - a comprehensive review. (United States)

    Singh, Raj Kumar; Dhama, Kuldeep; Malik, Yashpal Singh; Ramakrishnan, Muthannan Andavar; Karthik, Kumaragurubaran; Tiwari, Ruchi; Saurabh, Sharad; Sachan, Swati; Joshi, Sunil Kumar


    This review converses the Zika virus which has attained global concern due to its rapid pandemic potential and impact on humans. Though Zika virus was first isolated in 1947, till the recent large-scale outbreak which occurred in Micronesia, in 2007, the virus was placed into the innocuous pathogen category. The World Health Organization on 1 February 2016 declared it as a 'Public Health Emergency of International Concern.' Of the note, American as well as Pacific Island strains/isolates is relatively closer to Asian lineage strains. The African and American strains share more than 87.5% and 95% homologies with Asian strains/isolates, respectively. Asian strains form independent clusters, except those isolated from China, suggesting relatively more diversity than African strains. Prevention and control are mainly aimed at the vector population (mosquitoes) with Aedes aegypti being the main species. Surveys in Africa and Asia indicated seropositivity in various animal species. However, so far its natural reservoir is unknown. There is an urgent need to understand why Zika virus has shifted from being a virus that caused mild illness to unforeseen birth defects as well as autoimmune-neurological problems. Unfortunately, an effective vaccine is not available yet. Availability of cryo-electron microscopy based on 3.8 Å resolution revealing mature Zika virus structure and the probable virus attachment site to host cell would provide critical insights into the development of antiviral treatments and vaccines.

  5. Paravertebral Well-Differentiated Liposarcoma with Low-Grade Osteosarcomatous Component: Case Report with 11-Year Follow-Up, Radiological, Pathological, and Genetic Data, and Literature Review

    Directory of Open Access Journals (Sweden)

    Nicolas Macagno


    Full Text Available Despite being one of the most frequent soft-tissue sarcomas, well-differentiated liposarcoma has never been reported near the spine. The authors present the case of a 67-year-old man with progressive history of back pain. Physical examination revealed a mass located within the right paravertebral muscles. MR and CT imaging showed a heavily ossified central mass surrounded by a peripheral fatty component. No connection with the underlying bone was detected on imagery and during surgery. After surgical resection, histopathological examination revealed a tumor harboring combined features of well-differentiated liposarcoma and low-grade osteosarcoma. Tumor cells displayed overexpression of MDM2, CDK4, and P16 by immunohistochemistry and CGH revealed amplification of 12q13-15 as the only genetic imbalance. MDM2 FISH analysis was performed but was inconclusive. The pathological, immunohistochemical, and genetic features, the differential diagnoses, and the therapeutic management of this unusual tumor are discussed. No complementary treatment was performed initially. Following first treatment, two recurrences occurred 6 and 9 years later, both displaying histological features similar to the first occurrence. Radiotherapy was started after the second recurrence. Follow-up shows no evidence of disease 11 years after initial diagnosis. This case was unusual due to the paravertebral location of the tumor and its divergent differentiation.


    Directory of Open Access Journals (Sweden)

    O. M. Rozhnova


    Full Text Available The objective of the research is a review of approaches to the evaluation of biocompatibility of medical devices on the basis of metals and alloys, and to find ways of overcoming the low engraftment of implanted structures. Implantation by artificial materials allows us to regain the use of human organs and tissues and to date has no rivals. The advantage of using metals and alloys for implanted structures is their high reliability in operation, long servicelife, and high functionality. The nature of the interaction between the human body and the implant has an impact on resource use and the durability of the structures. Manufacturers of scientific research into medical implants at the present stage are directed to obtain materials that will not adversely affect the human body, and to ensure the maximum survival rate when using them. At the same time, the data presented in the article suggests that attempts to make higher biocompatible material properties tend to reduce the development of new methods for the surface treatment and the chemical composition modulation implants. World literature demonstrates the lack of a systematic approach to the problem of increased sensitivity of patients to different metals and alloys (metal sensitization, resulting in the development of complications such as the development of aseptic inflammation and infectious complications of unstable structures, and loss of functionality. Consequently, there is a need to search for ways to improve the biocompatibility of materials used in medicine, based on an assessment of immune defense mechanisms, and the development of algorithms preoperative tactics. 

  7. PET/CT assessment in follicular lymphoma using standardized criteria: central review in the PRIMA study

    Energy Technology Data Exchange (ETDEWEB)

    Tychyj-Pinel, Christelle [Service de Medecine Nucleaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre-Benite (France); Ricard, Fabien [Service de Medecine Nucleaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre-Benite (France); Universite de Lyon, Faculte de Medecine, UCB Lyon 1, Lyon (France); Fulham, Michael [Royal Prince Alfred Hospital, Department of PET and Nuclear Medicine, Sydney (Australia); University of Sydney, Sydney Medical School, Sydney (Australia); Fournier, Marion [Centre Hospitalier Lyon Sud, The Lymphoma Academic Research Organisation (LYSARC), Pierre-Benite (France); Meignan, Michel [CHU Henri Mondor, Medicine Nucleaire, Creteil (France); Lamy, Thierry [Service d' Hematologie, CHU, Rennes (France); Vera, Pierre [Centre Henri Becquerel, Service de Medecine Nucleaire, Rouen (France); Rouen University, QuantIF (Litis EA4108), Rouen (France); Salles, Gilles [Universite de Lyon, Faculte de Medecine, UCB Lyon 1, Lyon (France); Service d' Hematologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre-Benite (France); Trotman, Judith [University of Sydney, Sydney Medical School, Sydney (Australia); Concord Hospital, Department of Haematology, Concord, NSW (Australia)


    We aimed to compare the standardized central review of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT scans performed after induction therapy for follicular lymphoma (FL) in the PRIMA study (Salles et al., Lancet 377:42-51, 2011; Trotman et al., J Clin Oncol 29:3194-3200, 2011) to scan review at local centres. PET/CT scans were independently evaluated by two nuclear medicine physicians using the 2007 International Harmonization Project (IHP) criteria (Cheson et al., J Clin Oncol 25:579-586, 2007; Juweid et al., J Clin Oncol 25:571-578, 2007; Shankar et al., J Nucl Med 47:1059-1066, 2006) and Deauville 5-point scale (5PS) criteria (Meignan et al., Leuk Lymphoma 50:1257-1260, 2009; Meignan et al., Leuk Lymphoma 51:2171-2180, 2010; Barrington et al., Eur J Nucl Med Mol Imaging 37:1824-1833, 2010). PET/CT status was compared with prospectively recorded patient outcomes. Central evaluation was performed on 119 scans. At diagnosis, 58 of 59 were recorded as positive, with a mean maximum standardized uptake value (SUV{sub max}) of 11.7 (range 4.6-35.6). There was no significant association between baseline SUV{sub max} and progression-free survival (PFS). Sixty post-induction scans were interpreted using both the IHP criteria and 5PS. Post-induction PET-positive status failed to predict progression when applying the IHP criteria [p = 0.14; hazard ratio (HR) 1.9; 95 % confidence interval (CI) 0.8-4.6] or 5PS with a cut-off ≥3 (p = 0.12; HR 2.0; 95 % CI 0.8-4.7). However, when applying the 5PS with a cut-off ≥4, there was a significantly inferior 42-month PFS in PET-positive patients of 25.0 % (95 % CI 3.7-55.8 %) versus 61.4 % (95 % CI 45.4-74.1 %) in PET-negative patients (p = 0.01; HR 3.1; 95 % CI 1.2-7.8). The positive predictive value (PPV) of post-induction PET with this liver cut-off was 75 %. The 42-month PFS for patients remaining PET-positive by local assessment was 31.1 % (95 % CI 10.2-55.0 %) vs 64.6 % (95 % CI 47.0-77.6 %) for PET

  8. A review of nanoparticle functionality and toxicity on the central nervous system. (United States)

    Yang, Z; Liu, Z W; Allaker, R P; Reip, P; Oxford, J; Ahmad, Z; Ren, G


    Although nanoparticles have tremendous potential for a host of applications, their adverse effects on living cells have raised serious concerns recently for their use in the healthcare and consumer sectors. As regards the central nervous system (CNS), research data on nanoparticle interaction with neurons has provided evidence of both negative and positive effects. Maximal application dosage of nanoparticles in materials to provide applications such as antibacterial and antiviral functions is approximately 0.1-1.0 wt%. This concentration can be converted into a liquid phase release rate (leaching rate) depending upon the host or base materials used. For example, nanoparticulate silver (Ag) or copper oxide (CuO)-filled epoxy resin demonstrates much reduced release of the metal ions (Ag(+) or Cu(2+)) into their surrounding environment unless they are mechanically removed or aggravated. Subsequent to leaching effects and entry into living systems, nanoparticles can also cross through many other barriers, such as skin and the blood-brain barrier (BBB), and may also reach bodily organs. In such cases, their concentration or dosage in body fluids is considered to be well below the maximum drug toxicity test limit (10(-5) g ml(-1)) as determined in artificial cerebrospinal solution. As this is a rapidly evolving area and the use of such materials will continue to mature, so will their exposure to members of society. Hence, neurologists have equal interests in nanoparticle effects (positive functionality and negative toxicity) on human neuronal cells within the CNS, where the current research in this field will be highlighted and reviewed.

  9. Does pre-surgical central modulation of pain influence outcome after total knee replacement? A systematic review. (United States)

    Baert, I A C; Lluch, E; Mulder, T; Nijs, J; Noten, S; Meeus, M


    The aim of this study is to systematically review whether the presence of altered central pain modulation pre-surgical influences outcome after total knee replacement (TKR) in patients with knee osteoarthritis (OA), and if so which indices of central pain modulation predict poor outcome after TKR. To identify relevant articles, PubMed and Web of Science were searched. The search strategy was a combination of key words related to "Knee Osteoarthritis and Total Knee Replacement", "Central Pain Modulation" and "Post-Surgical Outcome Measures". Articles fulfilling the inclusion criteria were screened for methodological quality and results were analyzed and summarized. Sixteen prospective cohort studies were included. Strong evidence is available that presence of catastrophic thinking and poor coping strategies predict more pain after TKR and that there is no association between fear of movement and post-surgical pain or function. Evidence on other psychosocial influences is limited or conflicting. Literature on the influence of other signs of altered central pain modulation on post-surgical outcome is scarce. It is plausible that pre-surgical signs of altered central pain modulation, such as joint pain at rest or widespread pain sensitization, predict more post-surgical pain. Surgeons should be attentive for patients with signs of altered central pain modulation before surgery as they might be at risk for unfavorable outcome. A broader therapeutic approach aiming to desensitize the central nervous system can be adapted in these patients. Further research is however needed to identify the influence of central pain modulation pre-surgical in predicting outcome after TKR.

  10. Computer Security for Commercial Nuclear Power Plants - Literature Review for Korea Hydro Nuclear Power Central Research Institute

    Energy Technology Data Exchange (ETDEWEB)

    Duran, Felicia Angelica [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Security Systems Analysis Dept.; Waymire, Russell L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Security Systems Analysis Dept.


    Sandia National Laboratories (SNL) is providing training and consultation activities on security planning and design for the Korea Hydro and Nuclear Power Central Research Institute (KHNPCRI). As part of this effort, SNL performed a literature review on computer security requirements, guidance and best practices that are applicable to an advanced nuclear power plant. This report documents the review of reports generated by SNL and other organizations [U.S. Nuclear Regulatory Commission, Nuclear Energy Institute, and International Atomic Energy Agency] related to protection of information technology resources, primarily digital controls and computer resources and their data networks. Copies of the key documents have also been provided to KHNP-CRI.

  11. The relationship of community biopsy-diagnosed cervical intraepithelial neoplasia grade 2 to the quality control pathology-reviewed diagnoses: an ALTS report. (United States)

    Castle, Philip E; Stoler, Mark H; Solomon, Diane; Schiffman, Mark


    We examined the predictors (cytologic interpretations, pathology review, human papillomavirus [HPV] testing results, and colposcopic impressions) of precancer among 545 women with clinical center biopsy diagnoses of cervical intraepithelial neoplasia (CIN) 2 in the ASCUS LSIL Triage Study. Among women with a CIN 2 biopsy result, there was an increasing likelihood that the loop electrosurgical excision procedure (LEEP) tissue sample was diagnosed as precancer (CIN 3) with an increasing number of clinical risk factors of cervical precancer (high-grade squamous intraepithelial lesion [HSIL] cytology, high-grade colposcopy, detection of HPV type 16; Ptrend biopsy and LEEP tissue samples, HPV-16 was positively associated (odds ratio [OR], 4.8; 95% confidence interval [CI], 2.6-8.8) with a CIN 3 diagnosis, whereas testing negative for HPV or positive for noncarcinogenic HPV types was negatively associated (OR, 0.32; 95% CI, 0.14-0.75) with a CIN 3 diagnosis. Although we found clear evidence that HPV-16 detection helped clarify whether a biopsy specimen diagnosed as CIN 2 represented HPV infection or cervical precancer, this relationship was not sufficiently robust to be clinically useful for reducing the overtreatment of women with HPV infection.

  12. Geo-ecological effects of Global Change in the Central Spanish Pyrenees: A review at different spatial and temporal scales


    García-Ruiz, José M.; López-Moreno, Juan I.; Lasanta, Teodoro; Vicente-Serrano, Sergio M.; González-Sampériz, Penélope; Valero-Garcés, Blas L.; Sanjuán, Yasmina; Beguería, Santiago; Nadal-Romero, Estela; Lana-Renault, Noemí; Gómez-Villar, Amelia


    We review the effects of climate variability and land use / land cover changes in the Central Spanish Pyrenees at different spatial and temporal scales. Paleoclimatic studies based upon multi-proxy analyses of lacustrine, glacial and speleothematic deposits, among others, have demonstrated the occurrence of intense climatic fluctuations not only during the Late Upper Pleistocene associated to deglaciation, but also during the Holocene, affecting plant cover distribution, runoff generation, fl...

  13. Pathology of the parathyroid glands in hyperparathyroidism. (United States)

    Baloch, Zubair W; LiVolsi, Virginia A


    This paper reviews the embryology, histology and pathology of the human parathyroid glands. It emphasizes those pathologic lesions which are found in the setting of clinical hyperparathyroidism. Also discussed are certain molecular features of hyperfunctioning parathyroid glands. The difficulties encountered in parathyroid FNA are reviewed and illustrated.

  14. Tuberculose meningo-encefalica na infância: estudo anatomo-patologico de 10 casos Tuberculosis of the central nervous system in the childhood: anatomo-pathological study of ten cases

    Directory of Open Access Journals (Sweden)

    Ligia M. Barbosa Coutinho


    Full Text Available Estudo anátomo-patológico de 10 casos de tuberculose do SNC em crianças, com idade inferior a 10 anos. São enfatizadas as alterações macro e microscópicas produzidas pela tuberculose nas meninges, parênquima nervoso e vasos. Os achados clínicos e patológicos são discutidos e correlacionados com a literatura. Os autores concluem que: 1 a lesão, em crianças com tuberculose do SNC, é geralmente uma meningoencefalite proliferativa; 2 o parênquima nervoso pode ser afetado por propagação contígua do processo tuberculoso ou por alterações circulatórias secundárias a lesões arteriais; 3 por causa da localização dos vasos endocranianos no espaço sub-aracnóideo, eles são geralmente lesados pelo processo inflamatório, que determina uma endarterite obliterante, a qual pode ser observada por angiografia carotídea.The anatomo-pathological study of ten cases of tuberculosis of the central nervous system (CNS in children under 10 years old is reported. The emphasis is given to the macroscopic and microscopic changes produced by the tuberculosis in the meninges, in the nervous parenchyma and in the vessels. The clinical and pathological findings are discussed and correlated with the literature. The authors concluded that: 1 the lesion in children with tuberculosis of the CNS is generally a proliferative meningoencephalitis; 2 the nervous parenchyma may be affected by the contiguous propagation of the tuberculous process or by the circulatory changes secondary to the arterial lesions; 3 because of the localization of the endocranial vessels in the sub-arachnoidal space they are generally injured by the inflammatory process, which can determine an obliterating endarteritis, which can be observed by a carotid angiography.

  15. Tumores pediátricos primários do sistema nervoso central: estudo anatomopatológico de 623 casos Primary paediatric tumours of the central nervous system: pathological study of 623 cases

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Bleggi Torres


    Full Text Available Tumores primários do sistema nervoso central (SNC representam a segunda mais freqüente forma de neoplasia em crianças abaixo dos 15 anos, entretanto são as principais neoplasias responsáveis pelo óbito. Os autores relatam a análise epidemiológica e histopatológica de 623 tumores primários do SNC que acometeram pacientes pediátricos no período de 1990 a 1996 na cidade de Curitiba- PR. Neste período foram analisadas 3318 biópsias de SNC. Do total, 623 eram provenientes de neoplasias acometendo pacientes pediátricos (18,7%. As idades dos pacientes variaram de S meses a 15 anos, sendo que 325 tumores ocorreram no sexo masculino e 298 no sexo feminino. Grande parte dos tumores localizava-se na fossa posterior. Dos 623 tumores, 277 eram de origem glial. As mais freqüentes foram: astrocitoma (27,9%, meduloblastoma (9,95%, craniofaringioma (5,93%, ependimoma (4,97% e glioblastoma (3,37%.Tumours of central nervous system (CNS represent the second most frequent malignancy in children under 15 years of age but are the commonest cause of death. The authors present the epidemiologic and histopathologic analysis of 623 primary tumours of CNS occurring during the period 1990 to 1996 in paediatric patients. In this period 3318 biopsies of CNS were analyzed. In this total were included 623 paediatric tumours (18.7%. The age of patients ranged from 5 months to 15 years, 325 tumours occurred in males and 298 in females. The majority affected the posterior fossa. The majority of paediatric neoplasias were of glial origin (n=277. The most frequent tumours were: astrocytoma (27.9%, medulloblastoma (9.95%, craniopharyngioma (5.93%, ependymoma (4.97% and glioblastoma (3.37%.

  16. Candida infection of the central nervous system following neurosurgery: a 12-year review.

    LENUS (Irish Health Repository)

    O'Brien, Deirdre


    Candida infection of the central nervous system (CNS) following neurosurgery is relatively unusual but is associated with significant morbidity and mortality. We present our experience with this infection in adults and discuss clinical characteristics, treatment options, and outcome.

  17. Occult inflammatory breast cancer: review of clinical, mammographic, US and pathologic signs; Carcinoma infiammatorio occulto della mammella: revisione di reperti mammografici, ecografici, clinici ed anatomo-patologici

    Energy Technology Data Exchange (ETDEWEB)

    Cumo, Francesca; Gaioni, Maria Berenice; Bonetti, Franco; Manfrin, Erminia; Remo, Andrea; Pattaro, Christian [Policlinico G.B. Rossi, Verona (Italy). Dipartimento di scienze morfologico biomediche; Policlinico G.B. Rossi, Verona (Italy). Sezione di radiologia, Sezione di anatomia patologica. Dipartimento di medicina e sanita' pubblica, Sezione di epidemiologia e statistica medica, igiene


    Purpose: To examine the clinical, radiologic and pathologic findings of occult inflammatory breast cancer (OIBC) in order to identify features useful for diagnosis. Materials and methods: We retrospectively reviewed the records of 19 women with OIBC observed at our Department between 1992 and 2001. We analysed the clinical history, mammographic, ultrasonographic, and pathologic findings and investigated overall survival (OS), prognostic variables and radio-pathologic correlations. Results: The most common mammographic findings were: diffusely density (52.63%), trabecular thickening (42.1%), mass (36.84%). The most common US findings were axillary lymphadenopathy (68,75%), skin thickening (43.75%) and mass (56.25%). At least one inflammatory sign was found in 14 women (74%) at mammography (subcutaneous thickening, trabecular thickening, diffuse increase of density) or at US (subcutaneous thickening, diffuse increase in echogenicity due to oedema, lymph vessel dilatation). Estrogen receptors (ER) were present in 63.2% and Progesterone receptors (PgR) in 36.8%. Significant prognostic variables were ER and Ki 67. Conclusions: The typical radiological pattern of clinical inflammatory breast carcinoma is less frequently present in OIBC; nevertheless the radiologist must pay attention because frequently OIBC presents just one radiological sign and this should be enough for a diagnostic suspicion. Moreover, the absence of clinical and radiological inflammatory signs does not exclude inflammatory breasts cancer because OIBC can manifest at imaging as a mass or isolated calcification. ER and PgR are positive in a high percentage of patients and confirm that OIBC has a better prognosis that clinical inflammatory breast cancer. [Italian] Scopo: Esaminare i reperti clinici, radiologici ed anatomo-patologici del carcinoma infiammatorio occulto della mammella (IBCO) al fine di identificare alcune caratteristiche utili alla diagnosi. Materiale e metodi: E' stato effettuato

  18. The role of the central nervous system in osteoarthritis pain and implications for rehabilitation. (United States)

    Murphy, Susan L; Phillips, Kristine; Williams, David A; Clauw, Daniel J


    It has been known for some time that central nervous system (CNS) pain amplification is present in some individuals with osteoarthritis; the implications of this involvement, however, are just starting to be realized. In the past year, several research reviews have focused on evidence supporting shared mechanisms across chronic pain conditions for how pain is generated and maintained in the CNS, irrespective of the underlying structural pathology. This review article focuses on current literature describing CNS amplification in osteoarthritis by discussing peripheral sensitization, central sensitization, and central augmentation, and the clinical manifestation of central augmentation referred to as centralized pain, and offers considerations for rehabilitation treatment and future directions for research.

  19. Pharmacological Treatments in Pathological Gambling

    DEFF Research Database (Denmark)

    Grant, Jon E; Odlaug, Brian Lawrence; Schreiber, Liana R N


    AIMS: Pathological gambling (PG) is a relatively common and often disabling psychiatric condition characterized by intrusive urges to engage in deleterious gambling behavior. Although common and financially devastating to individuals and families, there currently exist no formally approved...... pharmacotherapeutic interventions for this disorder. This review seeks to examine the history of medication treatments for PG. METHODS: A systematic review of the 18 double-blind, placebo-controlled pharmacotherapy studies conducted for the treatment of pathological gambling was conducted. Study outcome and the mean...

  20. Curriculum Guidelines for Pathology and Oral Pathology. (United States)

    Journal of Dental Education, 1985


    Guidelines for dental school pathology courses describe the interrelationships of general, systemic, and oral pathology; primary educational goals; prerequisites; a core curriculum outline and behavioral objectives for each type of pathology. Notes on sequencing, faculty, facilities, and occupational hazards are included. (MSE)

  1. The taxonomy, life cycle and pathology of Sarcoptes scabiei and Notoedres cati (Acarina, Sarcoptidae: A review in a Fennoscandian wildlife perspective

    Directory of Open Access Journals (Sweden)

    Morten Kraabøl


    Full Text Available Mites constitute an old cosmopolitan group, abundant in various terrestrial and aquatic habitats of considerable environmental variations. The majority of mites are free-living, whereas some have evolved parasitic relationships with a variety of animals either as endo- or ectoparasites. The ectoparasitic and skin burrowing Sarcoptes scabiei and Notoedres cati, cause sarcoptic and notoedric mange among a variety of mammalian species, including humans. In a non-adequate host these mites lead to pseudo-scabies which is often self-curable. The aim of this review is to provide an overview of recent knowledge on the taxonomy, life cycles and pathology of these two mites, which are of relevance to Fennoscandian wildlife, by considering knowledge on transmission vectors, host immunology, and some documented outbreaks. These mites affect the health and survival of mammals in four ways; 1 skin tissue damages, 2 loss of body fluids, 3 allergic reactions and 4 secondary bacterial infections. A short-term effect of outbreaks is usually high mortality, and long-term effects vary from extinction to biased population structure to no effect at all. Red foxes are generalist predators that are important end-hosts for mites that develop disease depending on their immunity status, and transmit mites to other hosts. Outbreaks of mange may possibly have ecological consequences on a wider scale. In an endangered species, like the arctic fox or Eurasian lynx, loss of only a few individuals can be critical. It might be wise for management authorities to develop emergency plans to minimize consequences of outbreaks of sarcoptic or notoedric mange in threatened species such as the arctic fox and the lynx.

  2. Mixed exocrine-neuroendocrine carcinoma of the nasal cavity: clinico-pathologic and molecular study of a case and review of the literature. (United States)

    La Rosa, Stefano; Furlan, Daniela; Franzi, Francesca; Battaglia, Paolo; Frattini, Milo; Zanellato, Elena; Marando, Alessandro; Sahnane, Nora; Turri-Zanoni, Mario; Castelnuovo, Paolo; Capella, Carlo


    Sinonasal intestinal-type adenocarcinomas (ITACs) are rare neoplasms histologically resembling intestinal adenocarcinomas. Although a neuroendocrine differentiation in ITACs has been described, true mixed exocrine-neuroendocrine carcinomas, neoplasms in which each component represents at least 30 % of the lesion, are extremely rare and their molecular alterations are largely unknown. We describe herein the clinico-pathologic features, the methylation profile, chromosomal gains and losses, and mutation analysis of KRAS, BRAF and p53 in a nasal mixed exocrine-neuroendocrine carcinoma resected in a 79-year-old man. The tumor was composed of an ITAC and a poorly differentiated neuroendocrine carcinoma. Both exocrine and neuroendocrine components were CK8, CK20, CDX2 and p53 positive, and CK7 and TTF1 negative. The neuroendocrine component also showed immunoreactivity for chromogranin A, synaptophysin, serotonin and glicentin. Gains and losses were found at following chromosome regions: 17p13 (TP53), 14q24 (MLH3), 19q13 (KLK3), 5q21 (APC), 7q21 (CDK6), 9q34 (DAPK1), 12p13 (TNFRSF 1A, CDKN1B), 13q12 (BRCA2), 17p13.3 (HIC1), 18q21 (BCL2), and 22q12 (TIMP3). Aberrant methylation was detected only in the neuroendocrine component and involved APC and DAPK1 genes. No mutation of KRAS (exons 2-4), BRAF (exon 15), and p53 (exons 4-10) was found in both components. The results suggest a monoclonal origin of the tumor from a pluripotent cell undergoing a biphenotypic differentiation and that the neuroendocrine differentiation may be from an exocrine to an endocrine pathway. We have also reviewed the literature on sinonasal mixed exocrine-neuroendocrine carcinomas to give to the reader a comprehensive overview of these very rare tumor types.

  3. Thyroid abnormality trend over time in northeastern regions of Kazakstan, adjacent to the Semipalatinsk nuclear test site. A case review of pathological findings for 7271 patients

    Energy Technology Data Exchange (ETDEWEB)

    Zhumadilov, Z. [Semipalatinsk State Medical Academy (Kazakstan); Gusev, B.I.; Takada, Jun; Hoshi, Masaharu; Kimura, Akiro; Hayakawa, Norihiko; Takeichi, Nobuo


    From 1949 through 1989 nuclear weapons testing carried out by the former Soviet Union at the Semipalatinsk Nuclear Test Site (SNTS) resulted in local fallout affecting the residents of Semipalatinsk, Ust-Kamenogorsk and Pavlodar regions of Kazakstan. To investigate the possible relationship between radiation exposure and thyroid gland abnormalities, we conducted a case review of pathological findings of 7271 urban and rural patients who underwent surgery from 1966-96. Of the 7271 patients, 761 (10.5%) were men, and 6510 (89.5%) were women. The age of the patients varied from 15 to 90 years. Overall, a diagnosis of adenomatous goiter (most frequently multinodular) was found in 1683 patients (63.4%) of Semipalatinsk region, in 2032 patients (68.6%) of Ust-Kamenogorsk region and in 1142 patients (69.0%) of Pavlodar region. In the period 1982-96, as compared before, there was a noticeable increase in the number of cases of Hashimoto's thyroiditis and thyroid cancer. Among histological forms of thyroid cancer, papillary (48.1%) and follicular (33.1%) predominated in the Semipalatinsk region. In later periods (1987-96), an increased frequency of abnormal cases occurred among patients less than 40 years of age, with the highest proportion among patients below 20 in Semipalatinsk and Ust-Kamenogorsk regions of Kazakstan. Given the positive findings of a significant cancer-period interaction, and a significant trend for the proportion of cancer to increase over time, we recommend more detailed and etiologic studies of thyroid disease among populations exposed to radiation fallout from the SNTS in comparison to non-exposed population. (author)

  4. 75 FR 49938 - Proposed Collection; Comment Request; NIH NCI Central Institutional Review Board (CIRB... (United States)


    ... Review (FR) 1450 1 10/60 (.17 hour)......... 247 Acceptance Form (Attachment 2L). Participants Study... requested to serve as a reviewer for a study. CIRB helpdesk surveys measure satisfaction of helpdesk users and is conducted occasionally or each time the person contacts the helpdesk. Frequency of...

  5. Blood-based biomarkers of microvascular pathology in Alzheimer's disease.

    LENUS (Irish Health Repository)

    Ewers, Michael


    Sporadic Alzheimer\\'s disease (AD) is a genetically complex and chronically progressive neurodegenerative disorder with molecular mechanisms and neuropathologies centering around the amyloidogenic pathway, hyperphosphorylation and aggregation of tau protein, and neurofibrillary degeneration. While cerebrovascular changes have not been traditionally considered to be a central part of AD pathology, a growing body of evidence demonstrates that they may, in fact, be a characteristic feature of the AD brain as well. In particular, microvascular abnormalities within the brain have been associated with pathological AD hallmarks and may precede neurodegeneration. In vivo assessment of microvascular pathology provides a promising approach to develop useful biological markers for early detection and pathological characterization of AD. This review focuses on established blood-based biological marker candidates of microvascular pathology in AD. These candidates include plasma concentration of vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) that are increased in AD. Measures of endothelial vasodilatory function including endothelin (ET-1), adrenomedullin (ADM), and atrial natriuretic peptide (ANP), as well as sphingolipids are significantly altered in mild AD or during the predementia stage of mild cognitive impairment (MCI), suggesting sensitivity of these biomarkers for early detection and diagnosis. In conclusion, the emerging clinical diagnostic evidence for the value of blood-based microvascular biomarkers in AD is promising, however, still requires validation in phase II and III diagnostic trials. Moreover, it is still unclear whether the described protein dysbalances are early or downstream pathological events and how the detected systemic microvascular alterations relate to cerebrovascular and neuronal pathologies in the AD brain.

  6. Licensing the future: report on BioMed Central's public consultation on open data in peer-reviewed journals. (United States)

    Hrynaszkiewicz, Iain; Busch, Stefan; Cockerill, Matthew J


    We report the outcomes of BioMed Central's public consultation on implementing open data-compliant licensing in peer-reviewed open access journals. Respondents (42) to the 2012 consultation were six to one in favor (29 in support; 5 against; 8 abstentions) of changing our authors' default open access copyright license agreement, to introduce the Creative Commons CC0 public domain waiver for data published in BioMed Central's journals. We summarize the different questions we received in response to the consultation and our responses to them - matters such as citation, plagiarism, patient privacy, and commercial use were raised. In light of the support for open data in our journals we outline our plans to implement, in September 2013, a combined Creative Commons Attribution license for published articles (papers) and Creative Commons CC0 waiver for published data.

  7. Antibiotic resistance among bacterial pathogens in Central Africa: a review of the published literature between 1955 and 2008. (United States)

    Vlieghe, E; Phoba, M F; Tamfun, J J Muyembe; Jacobs, J


    A systematic review of the published literature on bacterial resistance in Central Africa between 1955 and 2008 was performed. Eighty-three publications from seven countries were retrieved, the majority presenting data on enteric and other gram-negative pathogens. Despite methodological limitations in many studies, alarming resistance rates are noted in nearly all pathogens. Of special concern are multidrug resistance in Shigella and Salmonella spp. and the emergence of meticillin-resistant Staphylococcus aureus, high-level penicillin-resistant Streptococcus pneumoniae and extended-spectrum beta-lactamases among gram-negative pathogens. These findings make clear that the Central African region shares the worldwide trend of increasing antimicrobial resistance and is in urgent need of sound surveillance based on competent and affordable microbiology to provide clear data on antimicrobial resistance. These data could enable redaction of local treatment guidelines and fuel national and regional policies to contain antimicrobial resistance.

  8. Central and peripheral peptides regulating eating behaviour and energy homeostasis in anorexia nervosa and bulimia nervosa: a literature review. (United States)

    Tortorella, Alfonso; Brambilla, Francesca; Fabrazzo, Michele; Volpe, Umberto; Monteleone, Alessio Maria; Mastromo, Daniele; Monteleone, Palmiero


    A large body of literature suggests the occurrence of a dysregulation in both central and peripheral modulators of appetite in patients with anorexia nervosa (AN) and bulimia nervosa (BN), but at the moment, the state or trait-dependent nature of those changes is far from being clear. It has been proposed, although not definitively proved, that peptide alterations, even when secondary to malnutrition and/or to aberrant eating behaviours, might contribute to the genesis and the maintenance of some symptomatic aspects of AN and BN, thus affecting the course and the prognosis of these disorders. This review focuses on the most significant literature studies that explored the physiology of those central and peripheral peptides, which have prominent effects on eating behaviour, body weight and energy homeostasis in patients with AN and BN. The relevance of peptide dysfunctions for the pathophysiology of eating disorders is critically discussed.

  9. REVIEW ARTICLE: In vivo magnetic resonance imaging: insights into structure and function of the central nervous system (United States)

    Natt, Oliver; Frahm, Jens


    Spatially resolved nuclear magnetic resonance (NMR) techniques provide structural, metabolic and functional insights into the central nervous system and allow for repetitive in vivo studies of both humans and animals. Complementing its prominent role in diagnostic imaging, magnetic resonance imaging (MRI) has evolved into an indispensable research tool in system-oriented neurobiology where contributions to functional genomics and translational medicine bridge the gap from molecular biology to animal models and clinical applications. This review presents an overview on some of the most relevant advances in MRI. An introduction covering the basic principles is followed by a discussion of technological improvements in instrumentation and imaging sequences including recent developments in parallel acquisition techniques. Because MRI is noninvasive in contrast to most other imaging modalities, examples focus on in vivo studies of the central nervous system in a variety of species ranging from humans to mice and insects.

  10. 78 FR 52204 - Proposed Collection; 60-day Comment Request: NIH NCI Central Institutional Review Board (CIRB... (United States)


    ...), will publish periodic summaries of proposed projects to be submitted to the Office of Management and... Board (CIRB) provides a centralized approach to human subject protection and provides a cost efficient... constituted IRB and provides a comprehensive and efficient mechanism to meet regulatory...

  11. Video Views and Reviews: Neurulation and the Fashioning of the Vertebrate Central Nervous System (United States)

    Watters, Christopher


    The central nervous system (CNS) is the first adult organ system to appear during vertebrate development, and the process of its emergence is commonly called neurulation. Such biological "urgency" is perhaps not surprising given the structural and functional complexity of the CNS and the importance of neural function to adaptive behavior and…

  12. Chiari 1 malformation presenting as central sleep apnea during pregnancy: a case report, treatment considerations, and review of the literature

    Directory of Open Access Journals (Sweden)

    Erik K. St. Louis


    Full Text Available Purpose: Chiari malformation (CM type 1 frequently causes obstructive or central sleep-disordered breathing (SDB in both adults and children, although SDB is relatively rare as a presenting manifestation in the absence of other neurological symptoms. The definitive treatment of symptomatic CM is surgical decompression. We report a case that is, to our knowledge, a novel manifestation of central sleep apnea (CSA due to CM type 1 with severe exacerbation and initial clinical presentation during pregnancy.Methods: Case report from tertiary care comprehensive sleep medicine center with literature review of sleep-disordered breathing manifestations associated with CM type 1. PubMed search was conducted between January 1982 and October 2013. Results: We report a 25-year-old woman with severe central sleep apnea initially presenting during her first pregnancy that eventually proved to be caused by CM type 1. The patient was successfully treated preoperatively by adaptive servoventilation (ASV, with effective resolution of sleep-disordered breathing following surgical decompression, and without recurrence in a subsequent pregnancy.Our literature review found that 58% of CM patients with SDB had OSA alone, 28% had CSA alone, 8 (10% had mixed OSA/CSA, and 6 (8% had hypoventilation. Of CM patients presenting with SDB, 50% had OSA, 42% had CSA, 8% had mixed OSA/CSA, and 10.4% had hypoventilation. We speculate that CSA may develop in CM patients in whom brainstem compression results in excessive central chemoreflex sensitivity with consequent hypocapnic CSA.Conclusions: CM type 1 may present with a diversity of SDB manifestations, and timely recognition and surgical referral are necessary to prevent further neurological deficits. ASV therapy can effectively manage CSA caused by CM type 1, which may initially present during pregnancy.

  13. 视网膜母细胞瘤中枢神经系统转移的临床、病理及影像分析%Clinical,pathological and radiological features of retinoblastoma with central nervous system metastasis

    Institute of Scientific and Technical Information of China (English)

    胡慧敏; 李静; 易优; 王一卓; 黄东生; 史季桐; 李彬; 张伟令; 张谊; 周燕; 洪亮


    Objective To summarize the clinical,pathological and radiological features of retinoblastoma (RB)with central nervous system (CNS)metastasis.Methods Twenty -three patients were confirmed to have RB with CNS metastasis in Beijing Tongren Hospital from December 2005 to December 201 3,and their clinical data were retrospectively analyzed.Results (1 )The incidence of RB with CNS metastasis was 1 .83% (23 /1 260 cases),and the incidence of CNS metastasis was 7.64%(1 1 /1 44 cases)if RB with optic nerve involvement which was confirmed through pathology.At first visit 1 0 cases had a confirmed diagnosis of RB with CNS metastasis,while the other 1 3 cases had a diagnosis of RB in extraocular stages.(2)Eleven patients with RB in extraocular stages had the pathological evi-dence of optic nerve involvement which was pathologically confirmed,6 patients had optic nerve involvement with cho-roid involvement,2 patients had optic nerve involvement with nerve sheath involvement.(3)All the patients whose diagnosis of CNS metastasis had the radiological evidence of CNS metastases,and 1 case had autopsy and pathological evidence for extensive brain metastases.The main radiological feature of CNS metastasis was meninges metastasis.Thir-teen cases had the radiological features of meninges metastasis and 5 cases accompanied with spinal cord meninges me-tastasis.Then,the following radiological feature was that 7 cases had the mass of suprasellar pool.(4)Twelve cases with CNS metastasis showed the cerebrospinal fluid (CSF)RB cells positive,and the positive rate was 52.1 7%(1 2 /23 ca-ses).Conclusions (1 )The occurrence of RB with CNS metastasis is very low,but the risk of CNS metastasis in-creased in the patients with the pathological evidence of the optic nerve involvement.(2)The main site of CNS metasta-ses is meninges,followed by mass formation in the suprasellar pool.The main route for CNS metastases was along the optic nerve and /or nerve sheath directly invading and /or disseminating

  14. Neglected tropical diseases in Central America and Panama: review of their prevalence, populations at risk and impact on regional development. (United States)

    Hotez, Peter J; Woc-Colburn, Laila; Bottazzi, Maria Elena


    A review of the literature since 2009 reveals a staggering health and economic burden resulting from neglected tropical diseases in Panama and the six countries of Central America (referred to collectively here as 'Central America'). Particularly at risk are the 10.2million people in the region who live on less than $2 per day, mostly in Guatemala, Honduras, Nicaragua and El Salvador. Indigenous populations are especially vulnerable to neglected tropical diseases. Currently, more than 8million Central American children require mass drug treatments annually (or more frequently) for their intestinal helminth infections, while vector-borne diseases are widespread. Among the vector-borne parasitic infections, almost 40% of the population is at risk for malaria (mostly Plasmodium vivax infection), more than 800,000 people live with Chagas disease, and up to 39,000 people have cutaneous leishmaniasis. In contrast, an important recent success story is the elimination of onchocerciasis from Central America. Dengue is the leading arbovirus infection with 4-5million people affected annually and hantavirus is an important rodent-borne viral neglected tropical disease. The leading bacterial neglected tropical diseases include leptospirosis and trachoma, for which there are no disease burden estimates. Overall there is an extreme dearth of epidemiological data on neglected tropical diseases based on active surveillance as well as estimates of their economic impact. Limited information to date, however, suggests that neglected tropical diseases are a major hindrance to the region's economic development, in both the most impoverished Central American countries listed above, as well as for Panama and Costa Rica where a substantial (but largely hidden) minority of people live in extreme poverty.

  15. Review of Universal Salt Iodation in East Central and Southern Africa (ACSA)


    Commonwealth Regional Hearth Community Secretariat for East Central and Southern Africa, CRHCS/ECSA


    This paper presents a regional position on Universal Salt Iodation (USI) intervention in 14 countries ill the East, Central and Southern Africa( ECSA) region,namely;Botswana,Kenya,Malawi,Mauritius,Mozambique,Namibia,bells,South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe The is a follow-up to a resolution on the need to develop a regional position on USI intervention which was made at the Commonwealth Regional Health Community 25th Health Ministers Conference in Port Louis, Ma...

  16. A review of nanoparticle functionality and toxicity on the central nervous system


    Yang, Z.; Z. W. Liu; Allaker, R P; Reip, P.; Oxford, J; Ahmad, Z.; Ren, G.


    Although nanoparticles have tremendous potential for a host of applications, their adverse effects on living cells have raised serious concerns recently for their use in the healthcare and consumer sectors. As regards the central nervous system (CNS), research data on nanoparticle interaction with neurons has provided evidence of both negative and positive effects. Maximal application dosage of nanoparticles in materials to provide applications such as antibacterial and antiviral functions is...


    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska


    Full Text Available Introduction: Central giant cell granuloma (CGCG is a benign aggressive destructive osteolytic lesion of osteoclastic origin. The central giant cell granuloma is often found in the mandible, anterior to the first molars. It most commonly occurs in patients under the age of 30, with a clear female prevalencePurpose: To present a case of CGCG of the lower jaw in Department of Oral and maxillofacial surgery, University Hospital "St. Anna". Although en bloc resection provides the lowest recurrence rate, only a few single case reports describe the use of this technique followed by reconstruction with autogenous bone grafts.Material and methods: The medical history of a 28 years patient with a large central giant cell granuloma in the mandible. Biopsy specimen taken from the lesion showed CGCG followed by curettage with peripheral ostectomy with preservation of the continuity of the mandible.Result: At the 1-year clinical and radiological follow up there was no sign of recurrence. Conclusion: After complete healing of the graft, prosthetic rehabilitation with implants will be perfomed. This allows the best functional and aesthetic results.

  18. CLIPPERS: chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. Review of an increasingly recognized entity within the spectrum of inflammatory central nervous system disorders. (United States)

    Dudesek, A; Rimmele, F; Tesar, S; Kolbaske, S; Rommer, P S; Benecke, R; Zettl, U K


    Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a recently defined inflammatory central nervous system (CNS) disorder, prominently involving the brainstem and in particular the pons. The condition features a combination of clinical symptoms essentially referable to brainstem pathology and a characteristic magnetic resonance imaging (MRI) appearance with punctate and curvilinear gadolinium enhancement 'peppering' the pons. The radiological distribution is focused in the pons and adjacent rhombencephalic structures such as the cerebellar peduncles, cerebellum, medulla and the midbrain. While the lesion burden with a perivascular pattern is typically most dense in these pontine and peripontine regions, enhancing lesions may additionally extend into the spinal cord and supratentorial structures such as the thalamus, basal ganglia, capsula interna, corpus callosum and the cerebral white matter. Another core feature is clinical and radiological responsiveness to glucocorticosteroid (GCS)-based immunosuppression. As withdrawal of GCS treatment results commonly in disease exacerbation, long-term immunosuppressive therapy appears to be mandatory for sustained improvement. Diagnosis of CLIPPERS is challenging, and requires careful exclusion of alternative diagnoses. A specific serum or cerebrospinal fluid (CSF) biomarker for the disorder is currently not known. Pathogenesis of CLIPPERS remains poorly understood, and the nosological position of CLIPPERS has still to be established. Whether CLIPPERS represents an independent, actual new disorder or a syndrome that includes aetiologically heterogeneous diseases and/or their prestages remains a debated and not finally clarified issue. Clinicians and radiologists should be aware of this condition and its differential diagnoses, given that CLIPPERS constitutes a treatable condition and that patients may benefit from an early introduction of GCS ensued by long

  19. The Danish Pathology Register

    DEFF Research Database (Denmark)

    Bjerregaard, Beth; Larsen, Ole B


    The National Board of Health, Denmark in 1997 published guidelines for reporting of pathology data and the Danish Pathology Register (DPR) was established.......The National Board of Health, Denmark in 1997 published guidelines for reporting of pathology data and the Danish Pathology Register (DPR) was established....

  20. Gray matter pathology and multiple sclerosis. (United States)

    Wegner, Christiane; Stadelmann, Christine


    Gray matter demyelination is frequent and extensive in most patients with multiple sclerosis (MS) and has recently received much attention in neuropathologic and imaging studies. Gray matter lesions show distinct pathologic features that make their detection difficult with conventional imaging techniques. Thus, despite their high prevalence, their impact on clinical symptoms has not been defined well so far. This review focuses on recent information from pathologic and imaging studies and summarizes our current knowledge on cortical pathology derived from human and experimental studies.

  1. Risk factors and current recommendations for prevention of infections associated with central venous catheters: a literature review

    Directory of Open Access Journals (Sweden)

    Danielle de Mendonça Henrique


    Full Text Available Backgound and Objectives: Infections related to central venous catheter (CVC use constitute an important a problem. It is estimated that approximately 90% of bloodstream infections (BSI are caused by CVC use. This study aims at reviewing the risk factors and current recommendations for prevention of infections associated with central venous catheter use. Methods: A total of 12 articles published in the last 5 years and indexed in the databases of the Latin American and Caribbean Literature on Health Sciences (LILACS, Nursing Database (BDENF, International Literature on Health Sciences (Medline/Pubmed were selected, as well as publications related to the recommendations for BSI prevention, such as: Institute for Healthcare Improvement (IHI, Centers for Disease Control and Prevention (CDC and the National Health Surveillance Agency (ANVISA. Results: Two categories were identified: prevention and control measures and risk factors for BSI associated with central venous catheter use. Conclusions: Some recommendations that were well-defined over the years have been questioned by some authors and continuing training and education of the multidisciplinary team are the most important factors for the prevention of bloodstream infections associated with CVC use.

  2. Protection by Neuroglobin Expression in Brain Pathologies (United States)

    Baez, Eliana; Echeverria, Valentina; Cabezas, Ricardo; Ávila-Rodriguez, Marco; Garcia-Segura, Luis Miguel; Barreto, George E.


    Astrocytes play an important role in physiological, metabolic, and structural functions, and when impaired, they can be involved in various pathologies including Alzheimer, focal ischemic stroke, and traumatic brain injury. These disorders involve an imbalance in the blood flow and nutrients such as glucose and lactate, leading to biochemical and molecular changes that cause neuronal damage, which is followed by loss of cognitive and motor functions. Previous studies have shown that astrocytes are more resilient than neurons during brain insults as a consequence of their more effective antioxidant systems, transporters, and enzymes, which made them less susceptible to excitotoxicity. In addition, astrocytes synthesize and release different protective molecules for neurons, including neuroglobin, a member of the globin family of proteins. After brain injury, neuroglobin expression is induced in astrocytes. Since neuroglobin promotes neuronal survival, its increased expression in astrocytes after brain injury may represent an endogenous neuroprotective mechanism. Here, we review the role of neuroglobin in the central nervous system, its relationship with different pathologies, and the role of different factors that regulate its expression in astrocytes. PMID:27672379

  3. Protection by Neuroglobin Expression in Brain Pathologies. (United States)

    Baez, Eliana; Echeverria, Valentina; Cabezas, Ricardo; Ávila-Rodriguez, Marco; Garcia-Segura, Luis Miguel; Barreto, George E


    Astrocytes play an important role in physiological, metabolic, and structural functions, and when impaired, they can be involved in various pathologies including Alzheimer, focal ischemic stroke, and traumatic brain injury. These disorders involve an imbalance in the blood flow and nutrients such as glucose and lactate, leading to biochemical and molecular changes that cause neuronal damage, which is followed by loss of cognitive and motor functions. Previous studies have shown that astrocytes are more resilient than neurons during brain insults as a consequence of their more effective antioxidant systems, transporters, and enzymes, which made them less susceptible to excitotoxicity. In addition, astrocytes synthesize and release different protective molecules for neurons, including neuroglobin, a member of the globin family of proteins. After brain injury, neuroglobin expression is induced in astrocytes. Since neuroglobin promotes neuronal survival, its increased expression in astrocytes after brain injury may represent an endogenous neuroprotective mechanism. Here, we review the role of neuroglobin in the central nervous system, its relationship with different pathologies, and the role of different factors that regulate its expression in astrocytes.

  4. A systematic review on prevalence and risk factors associated with treatment- emergent central sleep apnea

    Directory of Open Access Journals (Sweden)

    Gaurav Nigam


    Conclusions: The aggregate point prevalence of TECSA is about 8% with the estimated range varying from 5% to 20% in patients with untreated OSA. The prevalence tends to be higher for split-night studies compared to full night titration studies. TECSA can occur at any CPAP setting although extremely high CPAP settings could increase the likelihood. Male gender, higher baseline apnea-hypopnea index, and central apnea index at the time of diagnostic study could be associated with the development of TECSA at a subsequent titration study.

  5. Reviewing the case of the atypical central-engine activity in GRB 110709B

    CERN Document Server

    Fraija, Nissim; Patricelli, Barbara


    The unusual GRB 110709B triggered Swift/BAT twice, with a time difference of $\\sim 11$ minutes. Its light curve presented three noticeable peaks but only two were originally identified. In this work, we describe each peak as due to a different central-engine phase: the first one is the millisecond-protomagnetar stage, the second one is the BH-formation collapse phase and the last one is the Collapsar scenario with a Blandford-Znajek engine. Additionally, we analyze and explain the afterglow phase evoking the standard fireball model. Our model can successfully describe the timescales, fluxes and spectral indices observed for GRB 110709B.

  6. Late Isolated Central Nervous System Relapse from Ovarian Serous Adenocarcinoma: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Tiago Biachi de Castria


    Full Text Available Central nervous system involvement by ovarian serous adenocarcinoma is rare. We report a case of a 60-year-old woman that developed brain metastasis as isolated site of relapse 4.5 years after a complete resection and adjuvant chemotherapy for a stage Ic disease. She proceeded to a craniotomy with resection of the lesion and, subsequently, to a whole brain radiotherapy. Nineteen months later, she developed carcinomatous meningitis as isolated site of recurrence. Patient was submitted to intrathecal chemotherapy with methotrexate; however, she died from progressive neurologic involvement disease few weeks later.

  7. Systematic review of antiretroviral-associated lipodystrophy: lipoatrophy, but not central fat gain, is an antiretroviral adverse drug reaction.

    Directory of Open Access Journals (Sweden)

    Reneé de Waal

    Full Text Available BACKGROUND: Lipoatrophy and/or central fat gain are observed frequently in patients on antiretroviral therapy (ART. Both are assumed to be antiretroviral adverse drug reactions. METHODS: We conducted a systematic review to determine whether fat loss or gain was more common in HIV-infected patients on ART than in uninfected controls; was associated with specific antiretrovirals; and would reverse after switching antiretrovirals. RESULTS: Twenty-seven studies met our inclusion criteria. One cohort study reported more lipoatrophy, less subcutaneous fat gain, but no difference in central fat gain in HIV-infected patients on ART than in controls. Randomised controlled trials (RCTs showed more limb fat loss (or less fat gain with the following regimens: stavudine (versus other nucleoside reverse transcriptase inhibitors (NRTIs; efavirenz (versus protease inhibitors (PIs; and NRTI-containing (versus NRTI-sparing. RCTs showed increased subcutaneous fat after switching to NRTI-sparing regimens or from stavudine/zidovudine to abacavir/tenofovir. There were no significant between-group differences in trunk and/or visceral fat gain in RCTs of various regimens, but results from efavirenz versus PI regimens were inconsistent. There was no significant between-group differences in central fat gain in RCTs switched to NRTI-sparing regimens, or from PI-containing regimens. CONCLUSIONS: There is clear evidence of a causal relationship between NRTIs (especially thymidine analogues and lipoatrophy, with concomitant PIs possibly having an ameliorating effect or efavirenz causing additive toxicity. By contrast, central fat gain appears to be a consequence of treating HIV infection, because it is not different from controls, is not linked to any antiretroviral class, and doesn't improve on switching.

  8. A Comparative Review Over the Pension Systems’ Performance in Central and Eastern European Countries

    Directory of Open Access Journals (Sweden)

    Luise Mladen


    Full Text Available Towards the late 90’s, together with overcoming the shock of transition, most countries in Central and Eastern Europe began a process of profound reform of the pension systems. The aim of these reforms was mainly ensuring the financial sustainability of the pension systems often without taking into account their primary goal: to provide adequate retirement incomes, to allow the elderly to maintain a decent living standard after retirement and to have economic independence. However, a successful pension system is not the one that involves little spending but the one achieving its primary goal while limiting the future pressures on public finances.The economic crisis has increased the vulnerability of the pension systems. The economic recessions or slow economic growth, budget deficits and debt burdens, low employment rates have led to rising the concern about the ability of pension systems to fulfill their purpose. In this context, most Central and Eastern European countries have recently been forced to take up new changes in pensions. In our study we accomplished a comparative analysis of the pension systems’ performance based on calculating a composite indicator that includesthree components: the indicator of adequacy, the financial sustainability indicator and the indicator of modernity. Each of these components is obtained by aggregating a selection of sub-indicators. The purpose of this analysis is to identify best practices for successful reform, but also to highlight potentialhazards or imbalances that might face various emerging countries.

  9. Review of centralized packaging systems for distribution of retail-ready meat. (United States)

    Jeyamkondan, S; Jayas, D S; Holley, R A


    There is growing interest in centralized preparation of retail-ready meat cuts for distribution to widely dispersed retail stores due to the convenience of having high-quality ready-to-go products that are consistently provided to consumers at lower cost. Various centralized packaging techniques are described. Of all packaging techniques, master packaging is the most economical and shows promise for commercial application. Nevertheless, the master-packaging technique must be integrated with strict temperature control in a narrow range just above freezing (- 1.5 +/- 0.5 degrees C), good processing hygiene, and maintenance of a completely anoxic atmosphere in the package headspace throughout the distribution period to maximize storage life. Packaging using the CAPTECH process reduces the residual O2 present in the headspace to 300 ppm. Oxygen scavengers must be incorporated in the package to absorb the residual O2 and preserve the metmyoglobin reducing activity of meat tissues. Integration of all these technologies can provide a storage life of retail-ready meat up to 10 weeks in the master package followed by 3 days of retail display life. This extension of storage life is sufficient for transporting meat to distant markets.

  10. Pathology in drug discovery and development. (United States)

    Jubb, Adrian M; Koeppen, Hartmut; Reis-Filho, Jorge S


    The rapid pace of drug discovery and drug development in oncology, immunology and ophthalmology brings new challenges; the efficient and effective development of new targeted drugs will require more detailed molecular classifications of histologically homogeneous diseases that show heterogeneous clinical outcomes. To this end, single companion diagnostics for specific drugs will be replaced by multiplex diagnostics for entire therapeutic areas, preserving tissue and enabling rapid molecular taxonomy. The field will move away from the development of new molecular entities as single agents, to which resistance is common. Instead, a detailed understanding of the pathological mechanisms of resistance, in patients and in preclinical models, will be key to the validation of scientifically rational and clinically effective drug combinations. To remain at the heart of disease diagnosis and appropriate management, pathologists must evolve into translational biologists and biomarker scientists. Herein, we provide examples of where this metamorphosis has already taken place, in lung cancer and melanoma, where the transformation has yet to begin, in the use of immunotherapies for ophthalmology and oncology, and where there is fertile soil for a revolution in treatment, in efforts to classify glioblastoma and personalize treatment. The challenges of disease heterogeneity, the regulatory environment and adequate tissue are ever present, but these too are being overcome in dedicated academic centres. In summary, the tools necessary to overcome the 'whens' and 'ifs' of the molecular revolution are in the hands of pathologists today; it is a matter of standardization, training and leadership to bring these into routine practice and translate science into patient benefit. This Annual Review Issue of the Journal of Pathology highlights the central role for pathology in modern drug discovery and development.

  11. Hitchhiker's guide to multi-dimensional plant pathology. (United States)

    Saunders, Diane G O


    Filamentous pathogens pose a substantial threat to global food security. One central question in plant pathology is how pathogens cause infection and manage to evade or suppress plant immunity to promote disease. With many technological advances over the past decade, including DNA sequencing technology, an array of new tools has become embedded within the toolbox of next-generation plant pathologists. By employing a multidisciplinary approach plant pathologists can fully leverage these technical advances to answer key questions in plant pathology, aimed at achieving global food security. This review discusses the impact of: cell biology and genetics on progressing our understanding of infection structure formation on the leaf surface; biochemical and molecular analysis to study how pathogens subdue plant immunity and manipulate plant processes through effectors; genomics and DNA sequencing technologies on all areas of plant pathology; and new forms of collaboration on accelerating exploitation of big data. As we embark on the next phase in plant pathology, the integration of systems biology promises to provide a holistic perspective of plant–pathogen interactions from big data and only once we fully appreciate these complexities can we design truly sustainable solutions to preserve our resources.

  12. Pathological differences between white and grey matter multiple sclerosis lesions. (United States)

    Prins, Marloes; Schul, Emma; Geurts, Jeroen; van der Valk, Paul; Drukarch, Benjamin; van Dam, Anne-Marie


    Multiple sclerosis (MS) is a debilitating disease characterized by demyelination of the central nervous system (CNS), resulting in widespread formation of white matter lesions (WMLs) and grey matter lesions (GMLs). WMLs are pathologically characterized by the presence of immune cells that infiltrate the CNS, whereas these immune cells are barely present in GMLs. This striking pathological difference between WMLs and GMLs raises questions about the underlying mechanism. It is known that infiltrating leukocytes contribute to the generation of WMLs; however, since GMLs show a paucity of infiltrating immune cells, their importance in GML formation remains to be determined. Here, we review pathological characteristics of WMLs and GMLs, and suggest some possible explanations for the observed pathological differences. In our view, cellular and molecular characteristics of WM and GM, and local differences within WMLs and GMLs (in particular, in glial cell populations and the molecules they express), determine the pathway to demyelination. Further understanding of GML pathogenesis, considered to contribute to chronic MS, may have a direct impact on the development of novel therapeutic targets to counteract this progressive neurological disorder.

  13. 病理性赌博的发生机制研究综述%A Review on the Mechanism of Pathological Gambling

    Institute of Scientific and Technical Information of China (English)

    叶绿; 马红宇; 史文文; 李娜; 王斌


    Pathological gambling refers to a gambling behavior conducted by the individuals who can't control the impulse and then addict to gamble,which adversely affects individuals,families and society.On the basis of referring to relevant literatures,it was found that the mechanism of pathological gambling may be attributed to the interaction of three factors,including biologic,psychological and social facets.Future research should pay attention to the building of the causal model of pathological gambling,and strengthening the study of pathological gambling intervention and prevention.%病理性赌博是指个体难以控制赌博冲动,使其持久地沉溺于赌博中,以致个人、家庭和社会受到不良影响的赌博行为.本研究在参阅病理性赌博和其它行为成瘾相关文献的基础上,对病理性赌博的发生机制进行探讨,指出其是生物、心理和社会因素共同作用的结果.未来研究应注重构建病理性赌博的成因模型、加强病理性赌博的干预和预防研究.

  14. Diagnostics of femoroacetabular impingement and labral pathology of the hip: a systematic review of the accuracy and validity of physical tests

    NARCIS (Netherlands)

    Tijssen, M.P.W.; Cingel, R. van; Willemsen, L.; Visser, E. de


    PURPOSE: Femoroacetabular impingement (FAI) and labral pathology have been recognized as causative factors for hip pain. The clinical diagnosis is now based on MRI-A (magnetic resonance imaging-arthrogram) because the physical diagnostic tests available are diverse and information on diagnostic accu

  15. Central mucoepidermoid carcinoma radiographically mimicking an odontogenic tumor: A case report and literature review (United States)

    da Silva, Leorik Pereira; Serpa, Marianna Sampaio; da Silva, Luiz Arthur Barbosa; Sobral, Ana Paula Veras


    Central mucoepidermoid carcinoma (CMC) of the jaw bones is a rare malignant salivary gland tumor of unknown pathogenesis, comprising about 4% of all mucoepidermoid carcinomas (MECs). Most cases are histologically classified as a low-grade tumor and radiographically appear as a well-defined unilocular or multilocular radiolucent lesion. Block resection or wide local excisions are the treatment of choice and patients usually show a good overall prognosis although a long-term follow-up is necessary. This report describes a case of a 28-year-old male with MEC in the posterior region of the mandible and discusses its clinical, radiographic and histopathological findings. Although rare, CMC may be considered a differential diagnosis in cases of proliferative and osteolytic lesions in the oral cavity even when its clinical and/or radiographic findings do not suggest malignancy. PMID:27721620

  16. Diagnostic Challenges of Low-Grade Central Osteosarcoma of Jaw: a Literature Review

    Directory of Open Access Journals (Sweden)

    Seyd Hosein Tabatabaei


    Full Text Available Low Grade Central Osteosarcoma (LGCO is a rare subtype of osteosarcoma that is less aggressive than conventional osteosarcoma. The importance of LGCO lies in the fact that regarding microscopic and radiographic features, it occasionally simulates some benign jaw lesions and would consequently be misdiagnosed in many patients. The present study was conducted to collect the information and descriptive analyses related to ten cases reported between 1987 and 2010, including a sample reported by the authors emphasizing on diagnostic errors and the prevailing misdiagnosis. The aforementioned reports were gathered in full-texts through Google and PubMed search engines. Conclusion: The results of this study showed that the pathologists should exactly evaluate the clinical, radiographic, and histopathologic features in order to observe the evidence of invasion.

  17. Central mucoepidermoid carcinoma radiographically mimicking an odontogenic tumor: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Leorik Pereira da Silva


    Full Text Available Central mucoepidermoid carcinoma (CMC of the jaw bones is a rare malignant salivary gland tumor of unknown pathogenesis, comprising about 4% of all mucoepidermoid carcinomas (MECs. Most cases are histologically classified as a low-grade tumor and radiographically appear as a well-defined unilocular or multilocular radiolucent lesion. Block resection or wide local excisions are the treatment of choice and patients usually show a good overall prognosis although a long-term follow-up is necessary. This report describes a case of a 28-year-old male with MEC in the posterior region of the mandible and discusses its clinical, radiographic and histopathological findings. Although rare, CMC may be considered a differential diagnosis in cases of proliferative and osteolytic lesions in the oral cavity even when its clinical and/or radiographic findings do not suggest malignancy.

  18. Central pancreatectomy for pancreatic schwannoma: A case report and literature review (United States)

    Xu, Shao-Yan; Sun, Ke; Owusu-Ansah, Kwabena Gyabaah; Xie, Hai-Yang; Zhou, Lin; Zheng, Shu-Sen; Wang, Wei-Lin


    Schwannomas are mesenchymal tumors originating from Schwann cells in peripheral nerve sheaths. Although the tumor can be located in any part of the human body, the most common locations are the head, neck, trunk and extremities. Pancreatic schwannomas are rare. To our knowledge, only 64 cases of pancreatic schwannoma have been reported in the English literature over the past 40 years. In this paper, we present a pancreatic schwannoma in a 59-year-old female. Ultrasound, computed tomography and magnetic resonance imaging revealed the tumor located in the pancreatic body; however, accurate diagnosis was hard to obtain preoperatively and a pancreatic cystadenoma was preliminarily considered. During laparotomy, the mass was found in the body of the pancreas. An enlarged gallbladder with multiple stones was also observed. We performed central pancreatectomy, end-to-side pancreaticojejunostomy and cholecystectomy. Notably, central pancreatectomy has been reported in only one case prior to this report. The gross specimen showed a mass with a thin capsule, 1.6 cm × 1.1 cm × 1.1 cm in size. Microscopic examination showed that the tumor was mainly composed of spindle-shaped cells with palisading arrangement and no atypia, which is consistent with a benign tumor. Both hypercellular and hypocellular areas were visible. Immunohistochemical staining revealed strongly positive results for protein S-100. Finally, the tumor was diagnosed as a schwannoma of the pancreatic body. Postoperatively, the patient recovered well and left the hospital 6 d later. During the 53-mo follow-up period, the patient remained well and free of complications. PMID:27729750

  19. Central genomic regulation of the expression of oestrous behaviour in dairy cows: a review. (United States)

    Woelders, H; van der Lende, T; Kommadath, A; te Pas, M F W; Smits, M A; Kaal, L M T E


    The expression of oestrous behaviour in Holstein Friesian dairy cows has progressively decreased over the past 50 years. Reduced oestrus expression is one of the factors contributing to the current suboptimal reproductive efficiency in dairy farming. Variation between and within cows in the expression of oestrous behaviour is associated with variation in peripheral blood oestradiol concentrations during oestrus. In addition, there is evidence for a priming role of progesterone for the full display of oestrous behaviour. A higher rate of metabolic clearance of ovarian steroids could be one of the factors leading to lower peripheral blood concentrations of oestradiol and progesterone in high-producing dairy cows. Oestradiol acts on the brain by genomic, non-genomic and growth factor-dependent mechanisms. A firm base of understanding of the ovarian steroid-driven central genomic regulation of female sexual behaviour has been obtained from studies on rodents. These studies have resulted in the definition of five modules of oestradiol-activated genes in the brain, referred to as the GAPPS modules. In a recent series of studies, gene expression in the anterior pituitary and four brain areas (amygdala, hippocampus, dorsal hypothalamus and ventral hypothalamus) in oestrous and luteal phase cows, respectively, has been measured, and the relation with oestrous behaviour of these cows was analysed. These studies identified a number of genes of which the expression was associated with the intensity of oestrous behaviour. These genes could be grouped according to the GAPPS modules, suggesting close similarity of the regulation of oestrous behaviour in cows and female sexual behaviour in rodents. A better understanding of the central genomic regulation of the expression of oestrous behaviour in dairy cows may in due time contribute to improved (genomic) selection strategies for appropriate oestrus expression in high-producing dairy cows.

  20. [Pathology of the vitreomacular interface]. (United States)

    Pop, Monica; Gheorghe, Alina


    Vitreous role in the pathophysiology of retinal diseases has increased importantly over the recent years. This was possible using Optical Coherence Tomography which reviewed the way the vitreoretinal interface should be looked at and defined and classified new pathologies such as Vitreoretinal Traction Syndrome. Vitreous is not an empty space but an important anatomical structure with role in ocular physiology. With age biochemical changes occur so that vitreous starts to liquefy. Once the vitreous is liquefied (sinchisis) it collapses and passes in the retrohialoid space (sineresis). In complete PVD besides sinchisis there is a weakness of the adherence between the posterior cortex and ILM with total detachment of posterior cortex. Abnormal adhesions are associated with incomplete PVD. The definition and understanting of vitreoretinal pathology is an active and continuous process, PVD being the trigger of a lot of retinal pathologies: epiretinal membrane, macular hole, tractional macular oedema, VMTS, myopic traction maculopathy, exacerbations of exudative ARMD.

  1. A review of ozone-induced effects on the forests of central Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, Maria de Lourdes de [Instituto de Recursos Naturales, Colegio de Postgraduados, Carretera Los Reyes-Texcoco, 56230 Montecillo, Edo. Mexico (Mexico)]. E-mail:; Hernandez-Tejeda, Tomas [Instituto Nacional de Investigaciones Forestales Agricolas y Pecuarias, Mexico, Col. Viveros de Coyoacan, 04110 Mexico, D.F. (Mexico)


    The first report on oxidant-induced plant damage in the Valley of Mexico was presented over 30 years ago. Ozone is known to occur in the Mexico City Metropolitan Area and elsewhere as the cause of chlorotic mottling on pine needles that are 2 years old or older as observed in 1976 on Pinus hartwegii and Pinus leiophylla. Visible evidences for the negative effects of ozone on the vegetation of central Mexico include foliar injury expressed as chlorotic mottling and premature defoliation on pines, a general decline of sacred fir, visible symptoms on native forest broadleaved species (e.g. Mexican black cherry). Recent investigations have also indicated that indirect effects are occurring such as limited root colonization by symbiotic fungi on ozone-damaged P. hartwegii trees and a negative influence of the pollutant on the natural regeneration of this species. The negative ozone-induced effects on the vegetation will most likely continue to increase. - Ozone induced symptoms, poor tree regeneration and limited root colonization by mycorrhiza fungi observed in the valley of Mexico.

  2. [Diffuse superficial siderosis of the central nervous system: four case reports and review of the literature]. (United States)

    Calvo, Marta; de Miguel, Cristina; Pinel, Ana; Ortega, José M; Aladro, Yolanda


    Introduccion. La siderosis superficial difusa del sistema nervioso central (SNC) es una rara condicion debida a depositos de hemosiderina en las capas subpiales del cerebro y la medula espinal. La fuente de sangrado cronico o recurrente en el espacio subaracnoideo se detecta solo en un 50% de los casos. Los sintomas mas caracteristicos son ataxia cerebelosa e hipoacusia neurosensorial. Las secuencias eco de gradiente potenciadas en T2 de resonancia magnetica constituyen el metodo diagnostico de eleccion. Casos clinicos. Presentamos cuatro pacientes con siderosis superficial difusa del SNC relacionada con angiopatia amiloide, anticoagulacion oral, schwannoma del VIII par craneal y sin fuente de sangrado conocida en un caso. Dos pacientes desarrollaron ataxia cerebelosa; tres de ellos, episodios recurrentes de alteracion focal neurologica; uno, demencia; y el cuarto es un hallazgo radiologico. No se objetivo progresion clinica durante el seguimiento (2-11 años) en tres de ellos. El paciente con angiopatia amiloide evoluciono a demencia. Conclusiones. Los episodios recurrentes de alteracion focal neurologica son los sintomas mas frecuentes en nuestros casos de siderosis superficial difusa del SNC. La evolucion natural de esta condicion no se conoce bien y puede constituir un hallazgo radiologico.

  3. Mini Review: circular RNAs as potential clinical biomarkers for disorders in the central nervous system

    Directory of Open Access Journals (Sweden)

    Dan eLu


    Full Text Available Circular RNAs (circRNAs are a type of noncoding RNAs (ncRNAs, produced in eukaryotic cells during post-transcriptional processes. They are more stable than linear RNAs, and possess spatio-temporal properties. CircRNAs do not distribute equally in the neuronal compartments in the brain, but largely enriched in the synapses. These ncRNA species can be used as potential clinical biomarkers in complex disorders of the central nervous system (CNS, which is supported by recent findings. For example, ciRS-7 was found to be a natural microRNAs sponge for miRNA-7 and regulate Parkinson’s disease (PD/ Alzheimer’s disease (AD-related genes; circPAIP2 is an intron-retaining circRNA which upregulates memory-related parental genes PAIP2 to affect memory development through PABP reactivation. The quantity of circRNAs carry important messages, either when they are inside the cells, or in circulation, or in exosomes released from synaptoneurosomes and endothelial. In addition, small molecules such as microRNAs and microvesicles can pass through the blood-brain barrier (BBB and get into blood. For clinical applications, the study population needs to be phenotypically well-defined. CircRNAs may be combined with other biomarkers and imaging tools to improve the diagnostic power.

  4. Omega-3 Fatty Acids and their Role in Central Nervous System - A Review. (United States)

    Wysoczański, Tomasz; Sokoła-Wysoczańska, Ewa; Pękala, Jolanta; Lochyński, Stanisław; Czyż, Katarzyna; Bodkowski, Robert; Herbinger, Grzegorz; Patkowska-Sokoła, Bożena; Librowski, Tadeusz


    Polyunsaturated fatty acids (PUFAs) are crucial for our health and wellbeing; therefore, they have been widely investigated for their roles in maintaining human health and in disease treatment. Most Western diets include significant amount of saturated and omega-6 fatty acids and insufficient quantity of omega-3; however, the balance between omega-6 and omega-3 PUFA, in particular, is essential for the formation of pro- and anti-inflammatory lipids to promote health and prevent disease. As our daily diet affects our health, this paper draws attention to unique representatives of the omega-3 fatty acid group: alpha-linolenic acid and its derivatives. Recently, this has been shown to be effective in treating and preventing various diseases. It has been confirmed that omega-3 PUFAs may act as therapeutic agents as well and their significant role against inflammatory diseases, such as cardiovascular and neurodegenerative diseases, has been described. Some of nutritional factors have been described as a significant modifiers, which can influence brain elasticity and thus, effect on central nervous system functioning. Therefore, appropriate dietary management appears to be a non-invasive and effective approach to counteract neurological and cognitive disorders.

  5. [Central nervous system in IgG4-related disease: case report and literature review]. (United States)

    Vanegas-Garcia, A L; Calle-Lopez, Y; Zapata, C H; Alvarez-Espinal, D M; Saavedra-Gonzalez, Y A; Arango-Viana, J C


    Introduccion. La enfermedad relacionada con IgG4 es una entidad clinica multisistemica recientemente descrita y que se presenta con diferentes manifestaciones clinicas. Los organos que estan afectados con mayor frecuencia son el pancreas, la via biliar y las glandulas salivales, y es menos frecuente la afeccion del sistema nervioso central. Caso clinico. Mujer de 33 años con alteraciones cognitivas, alucinaciones, cefalea, sindrome convulsivo, sinusitis maxilar con afeccion osea y evidencia de paquimeningitis y panhipopituitarismo, con biopsia meningea que confirmo una enfermedad relacionada con IgG4, tras haberse descartado causas secundarias. Se inicio tratamiento con glucocorticoides y azatioprina, sin recaidas despues de 12 meses de seguimiento. Conclusiones. Se debe considerar el diagnostico de enfermedad relacionada con IgG4 en casos de paquimeningitis hipertrofica e hipofisitis, incluso sin que se acompañen de otras manifestaciones sistemicas, siempre que se hayan descartado otras causas mas frecuentes. El tratamiento de eleccion son los glucocorticoides, y puede ser necesario añadir otro inmunosupresor como ahorrador de esteroides y para evitar las recaidas. Se necesitan estudios prospectivos para evaluar las diferentes manifestaciones clinicas y paraclinicas y establecer los resultados del tratamiento a largo plazo.

  6. Electrifying reviews of the central North Sea area; Elektrisifiseringsvurderinger for midtre Nordsjoe

    Energy Technology Data Exchange (ETDEWEB)

    Husdal, Geir


    We conducted a site evaluation of power from land to several fields in the central North Sea. The findings are included Dagny, Edvard Grieg, Draupne and Johan Sverdrup. In addition, an unidentified future field is included in the evaluation. Unclassified cost estimates have been prepared and measures cost is calculated for a main concept based on a set of assumptions and suppositions. To check the robustness of the results and to identify which parameters the results are most sensitive to, we conducted sensitivity analyzes in which key assumptions are changed. The study shows a cost of Nok 412 Nok / tonne reduction in Co2 emissions. This is slightly higher than the sum of the current Co2 tax and quota price, but lower than the Co2 cost proposed in the white paper. Sensitivity calculations show that the cost of measures is very sensitive to investment costs, future energy demand and the price difference between gas sold on the continent and electricity from the grid in Norway. (eb)

  7. Reviewing education and training for governance and active citizenship in Europe : a Central and Eastern European perspective : the implications of the research for Central and Eastern European policy design on active citizenship and governance

    NARCIS (Netherlands)

    Chioncel, Nicoleta; Jansen, Theo


    The RE-ETGACE Project, 'Reviewing Education and Training for Governance and Active Citizenship in Europe - A Central and Eastern European Perspective' is a complementary measure to the original ETGACE Project 'Education and Training for Governance and Active Citizenship in Europe'. The ETGAGE Projec

  8. Autoimmune central diabetes insipidus in a patient with ureaplasma urealyticum infection and review on new triggers of immune response. (United States)

    Murdaca, Giuseppe; Russo, Rodolfo; Spanò, Francesca; Ferone, Diego; Albertelli, Manuela; Schenone, Angelo; Contatore, Miriam; Guastalla, Andrea; De Bellis, Annamaria; Garibotto, Giacomo; Puppo, Francesco


    Diabetes insipidus is a disease in which large volumes of dilute urine (polyuria) are excreted due to vasopressin (AVP) deficiency [central diabetes insipidus (CDI)] or to AVP resistance (nephrogenic diabetes insipidus). In the majority of patients, the occurrence of CDI is related to the destruction or degeneration of neurons of the hypothalamic supraoptic and paraventricular nuclei. The most common and well recognized causes include local inflammatory or autoimmune diseases, vascular disorders, Langerhans cell histiocytosis (LCH), sarcoidosis, tumors such as germinoma/craniopharyngioma or metastases, traumatic brain injuries, intracranial surgery, and midline cerebral and cranial malformations. Here we have the opportunity to describe an unusual case of female patient who developed autoimmune CDI following ureaplasma urealyticum infection and to review the literature on this uncommon feature. Moreover, we also discussed the potential mechanisms by which ureaplasma urealyticum might favor the development of autoimmune CDI.

  9. Central venous catheterization -- an anatomical review of a clinical skill -- Part 1: subclavian vein via the infraclavicular approach. (United States)

    Boon, J M; van Schoor, A N; Abrahams, P H; Meiring, J H; Welch, T; Shanahan, D


    The safe and successful performance of a central venous catheterization (CVC) requires a specific knowledge of anatomy in addition to a working knowledge. Misunderstanding the anatomy may result in failure or complications. This review aims to aid understanding of the anatomical framework, pitfalls, and complications of CVC of the subclavian (SCV). CVC is common practice amongst surgeons, anesthesiologists, and emergency room physicians during the preparations for major surgical procedures such as open-heart surgery, as well as, for intensive care monitoring and rapid restoration of blood volume. Associated with this technique are certain anatomical pitfalls and complications that can be successfully avoided if one possesses a thorough knowledge of the contraindications, regional anatomy, and rationale of the technique.

  10. Herpes simplex encephalitis and subsequent cytomegalovirus encephalitis after chemoradiotherapy for central nervous system lymphoma: a case report and literature review. (United States)

    Suzuki, Hiroshi I; Hangaishi, Akira; Hosoya, Noriko; Watanabe, Takuro; Kanda, Yoshinobu; Motokura, Toru; Chiba, Shigeru; Kurokawa, Mineo


    Neurological complications during the treatment of hematological malignancies have a wide range of causes. Treatment-related leukoencephalopathy has been recognized as a major complication of combined chemotherapy and radiotherapy for central nervous system (CNS) lymphoma, and can complicate the diagnosis of CNS infection. Herein, we present a patient with diffuse large B-cell lymphoma who developed herpes simplex encephalitis (HSE) and subsequent cytomegalovirus encephalitis after chemoradiotherapy for CNS relapse. Although cerebrospinal fluid examination (CSF) showed no significant pleocytosis, brain magnetic resonance imaging and polymerase chain reaction analysis of the CSF were useful in the diagnosis. With a review of the literature on the association between HSE and radiotherapy for CNS malignancies, our case suggests that an awareness of viral encephalitis is important in the differential diagnosis of acute neurologic disturbance during chemoradiotherapy for CNS lymphoma.

  11. Obesity as the initial manifestation of central nervous system relapse of acute lymphoblastic leukemia: case report and literature review. (United States)

    Zhang, Li-Dan; Li, Yan-Hong; Ke, Zhi-Yong; Huang, Li-Bin; Luo, Xue-Qun


    A 6-year-old boy with acute lymphoblastic leukemia in remission experienced hyperphagia, obesity, and emotional disorders. Cytomorphologic examination of cerebral spinal fluid (CSF) and cranial MRI did not help in differentiating between central nervous system leukemia (CNSL) and other CNS diseases including tuberculosis in this boy. Flow cytometric CSF analysis on repeated lumber puncture detected lymphoblasts, while microscopic CSF examination did not definitively show relapse disease. The diagnosis of CNSL was thus made and confirmed by the response to leukemia treatment. Obesity can be the first manifestation of CNSL and the diagnosis can be challenging. A combination of CSF cytomorphology, CSF flow cytometry, and cranial MRI can be useful in the diagnosis of the disease. Two mechanisms of CNSL-related obesity are discussed based on the literature review.

  12. Risk Factors for Central Lymph Node Metastasis in CN0 Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Wei Sun

    Full Text Available Central lymph node metastasis (CLNM is common in papillary thyroid carcinoma (PTC. Prophylactic central lymph node dissection (PCLND for patients with clinically negative central compartment lymph nodes (CN0 remains controversial. The phrase "clinically negative" is used to indicate that patients exhibited no clinical evidence of CLNM by ultrasonography (US or computerized tomography (CT preoperatively. In this study, we analyze the risk factors for CLNM in CN0 patients.The PUBMED and SCIE databases were systematically searched for works published through January 31, 2015. All of the patients included in this study underwent thyroidectomy+PCLND. Revman 5.3 software was used to analyze the data.Twenty studies and 9084 patients were included in this meta-analysis. The following variables were associated with an increased risk of CLNM in CN0 patients: age 2 cm for PTC patients (OR = 2.98, 95% CI 2.08-4.28, p 0.5 cm for papillary thyroid microcarcinoma (PTMC patients (OR = 2.30, 95% CI = 1.71-3.09, p 1 cm exhibited a higher risk factor associated with CLNM than PTMC (tumor size < 1 cm (OR = 2.83, 95% CI = 2.15-3.72, p<0.00001. Bilateral tumors (OR = 1.21, 95% CI = 0.92-1.58, p = 0.17 and lymphocytic thyroiditis (OR = 0.88, 95% CI = 0.71-1.09, p = 0.25 had no association with CLNM in CN0 patients.Our systematic review identified several clinical features associated with CLNM in CN0 patients, including age, sex, multifocality, size, location, lymphovascular invasion, capsular invasion, and extrathyroidal extension. These factors should guide the application of PCLND in CN0 patients.

  13. Effectiveness of heparin versus 0.9% saline solution in maintaining the permeability of central venous catheters: a systematic review

    Directory of Open Access Journals (Sweden)

    Eduardo José Ferreira dos Santos


    Full Text Available Abstract OBJECTIVE Determining which is the most effective solution (heparin flush compared to 0.9% saline flush for reducing the risk of occlusions in central venous catheters (CVC in adults. METHOD The systematic review followed the principles proposed by the Cochrane Handbook; critical analysis, extraction and synthesis of data were performed by two independent researchers; statistical analysis was performed using the RevMan program 5.2.8. RESULTS Eight randomized controlled trials and one cohort study were included and the results of the meta-analysis showed no difference (RR=0.68, 95% CI=0.41-1.10; p=0.12. Analysis by subgroups showed that there was no difference in fully deployed CVC (RR=1.09, CI 95%=0.53-2.22;p=0.82; Multi-Lumen CVC showed beneficial effects in the heparin group (RR=0.53, CI 95%=0.29-0.95; p=0.03; in Double-Lumen CVC for hemodialysis (RR=1.18, CI 95%=0.08-17.82;p=0.90 and Peripherally inserted CVC (RR=0.14, CI 95%=0.01-2.60; p=0.19 also showed no difference. CONCLUSION Saline solution is sufficient for maintaining patency of the central venous catheter, preventing the risks associated with heparin administration.

  14. Volcano-Hydrothermal Systems of the Central and Northern Kuril Island Arc - a Review (United States)

    Kalacheva, E.; Taran, Y.; Voloshina, E.; Ptashinsky, L.


    More than 20 active volcanoes with historical eruptions are known on 17 islands composing the Central and Northern part of the Kurilian Arc. Six islands - Paramushir, Shiashkotan, Rasshua, Ushishir, Ketoy and Simushir - are characterized by hydrothermal activity, complementary to the fumarolic activity in their craters. There are several types of volcano-hydrothermal systems on the islands. At Paramushir, Shiashkotan and Ketoy the thermal manifestations are acidic to ultra-acidic water discharges associated with hydrothermal aquifers inside volcano edifices and formed as the result of the absorption of magmatic gases by ground waters. A closest known analogue of such activity is Satsuma-Iwojima volcano-island at the Ryukyu Arc. Another type of hydrothermal activity are wide spread coastal hot springs (Shiashkotan, Rasshua), situated as a rule within tide zones and formed by mixing of the heated seawater with cold groundwater or, in opposite, by mixing of the steam- or conductively heated groundwater with seawater. This type of thermal manifestation is similar to that reported for other volcanic islands of the world (Satsuma Iwojima, Monserrat, Ischia, Socorro). Ushishir volcano-hydrothermal system is formed by the absorption of magmatic gases by seawater. Only Ketoy Island hosts a permanent acidic crater lake. At Ebeko volcano (Paramushir) rapidly disappearing small acidic lakes (formed after phreatic eruptions) have been reported. The main hydrothermal manifestation of Simushir is the Zavaritsky caldera lake with numerous coastal thermal springs and weak steam vents. The last time measured temperatures of fumaroles at the islands are: >500ºC at Pallas Peak (Ketoy), 480ºC at Kuntamintar volcano (Shiashkotan), variable and fast changing temperatures from 120º C to 500ºC at Ebeko volcano (Paramushir), 150ºC in the Rasshua crater, and > 300ºC in the Chirpoy crater (Black Brothers islands). The magmatic and rock-forming solute output by the Kurilian volcano

  15. Congenital central hypoventilation syndrome associated with Hirschsprung's Disease: case report and literature review (United States)

    Sandoval, Renata Lazari; Zaconeta, Carlos Moreno; Margotto, Paulo Roberto; Cardoso, Maria Teresinha de Oliveira; França, Evely Mirella Santos; Medina, Cristina Touguinha Neves; Canó, Talyta Matos; de Faria, Aline Saliba


    Abstract Objective: To report the case of a newborn with recurrent episodes of apnea, diagnosed with Congenital Central hypoventilation syndrome (CCHS) associated with Hirschsprung's disease (HD), configuring Haddad syndrome. Case description: Third child born at full-term to a non-consanguineous couple through normal delivery without complications, with appropriate weight and length for gestational age. Soon after birth he started to show bradypnea, bradycardia and cyanosis, being submitted to tracheal intubation and started empiric antibiotic therapy for suspected early neonatal sepsis. During hospitalization in the NICU, he showed difficulty to undergo extubation due to episodes of desaturation during sleep and wakefulness. He had recurrent episodes of hypoglycemia, hyperglycemia, metabolic acidosis, abdominal distension, leukocytosis, increase in C-reactive protein levels, with negative blood cultures and suspected inborn error of metabolism. At 2 months of age he was diagnosed with long-segment Hirschsprung's disease and was submitted to segment resection and colostomy through Hartmann's procedure. A genetic research was performed by polymerase chain reaction for CCHS screening, which showed the mutated allele of PHOX2B gene, confirming the diagnosis. Comments: This is a rare genetic, autosomal dominant disease, caused by mutation in PHOX2B gene, located in chromosome band 4p12, which results in autonomic nervous system dysfunction. CCHS can also occur with Hirschsprung's disease and tumors derived from the neural crest. There is a correlation between phenotype and genotype, as well as high intrafamilial phenotypic variability. In the neonatal period it can simulate cases of sepsis and inborn errors of metabolism. PMID:26838603

  16. Neuropeptides and central control of sexual behaviour from the past to the present: a review. (United States)

    Argiolas, Antonio; Melis, Maria Rosaria


    Of the numerous neuropeptides identified in the central nervous system, only a few are involved in the control of sexual behaviour. Among these, the most studied are oxytocin, adrenocorticotropin, α-melanocyte stimulating hormone and opioid peptides. While opioid peptides inhibit sexual performance, the others facilitate sexual behaviour in most of the species studied so far (rats, mice, monkeys and humans). However, evidence for a sexual role of gonadotropin-releasing hormone, corticotropin releasing factor, neuropeptide Y, galanin and galanin-like peptide, cholecystokinin, substance P, vasoactive intestinal peptide, vasopressin, angiotensin II, hypocretins/orexins and VGF-derived peptides are also available. Corticotropin releasing factor, neuropeptide Y, cholecystokinin, vasopressin and angiotensin II inhibit, while substance P, vasoactive intestinal peptide, hypocretins/orexins and some VGF-derived peptide facilitate sexual behaviour. Neuropeptides influence sexual behaviour by acting mainly in the hypothalamic nuclei (i.e., lateral hypothalamus, paraventricular nucleus, ventromedial nucleus, arcuate nucleus), in the medial preoptic area and in the spinal cord. However, it is often unclear whether neuropeptides influence the anticipatory phase (sexual arousal and/or motivation) or the consummatory phase (performance) of sexual behaviour, except in a few cases (e.g., opioid peptides and oxytocin). Unfortunately, scarce information has been added in the last 15 years on the neural mechanisms by which neuropeptides influence sexual behaviour, most studied neuropeptides apart. This may be due to a decreased interest of researchers on neuropeptides and sexual behaviour or on sexual behaviour in general. Such a decrease may be related to the discovery of orally effective, locally acting type V phosphodiesterase inhibitors for the therapy of erectile dysfunction.

  17. Primary central nervous system lymphoma report of 32 cases and review of the literature. (United States)

    Dubuisson, Annie; Kaschten, Bruno; Lénelle, Jacques; Martin, Didier; Robe, Pierre; Fassotte, Marie-France; Rutten, Isabelle; Deprez, Manuel; Stevenaert, Achille


    We retrospectively analyzed 32 cases of primary central nervous system lymphoma (PCNSL). Five cases were diagnosed in the period 1987-1994, for 27 cases in the period 1995-2002. There were 17 men and 15 women whose median age was 69 years. Three patients were immunodeficient. The commonest symptoms were focal deficit (16 patients) and cognitive/behaviour disturbances (14 patients). Radiologically, a total of 47 contrast-enhancing lesions were observed in 32 patients; 18 patients had deep-seated lesions. All but two patients underwent histological diagnosis following craniotomy (11 patients) and/or stereotaxic biopsy (22 patients); diagnosis was obtained on CSF cytology in one patient with a third ventricle tumour. In the last patient, the diagnosis was based on the finding of marked tumour shrinkage under corticotherapy, despite two negative histological examinations. Treatment included surgical resection (10 patients), chemotherapy (25 patients) and/or radiotherapy (12 patients). According to the therapeutic recommendations of the GELA (Groupe d'Etude des Lymphomes de l'Adulte), 19 patients received at least two courses of high-dose methotrexate; intrathecal chemotherapy was used in 20 patients with methotrexate and/or cytosine arabinoside. Radiation therapy consisted of whole brain irradiation followed by a boost on tumour site. Nine patients received a combined treatment of chemotherapy and radiotherapy. Twelve patients showed rapid progression to death. At the time of last contact, 28/32 patients (88%) had died, all from PCNSL disease or from complications due to its treatment. The median survival time was 13.9 months. We conclude that PCNSL is an increasingly frequent tumour. The diagnosis is obtained by stereotactic biopsy in the majority of cases. The prognosis appears dismal despite an intensive multidisciplinary therapeutic approach.

  18. Delivering a pathology curriculum in an integrated medical course. (United States)

    Carr, Norman J; Olmos, Martin; Bushnell, John


    Modern integrated medical curricula usually do not include a separate pathology course. Consequently, there is a risk that important pathological principles may be omitted. We aimed to ensure that pathology is properly represented by developing a core pathology curriculum created in consultation with local pathologists. Appropriate information technology to track the delivery of this material within the integrated curriculum structure was developed using a learning content management system in which a metadata schema was constructed. This allows a sophisticated view of where and how pathology appears in the course and can also increase the visibility of the subject by demonstrating the central place of pathology in medicine. In conclusion, a core curriculum in pathology that can be tracked by information technology with sufficient power and flexibility is a solution to the potential loss of pathology from integrated medical courses. We believe the result is superior to a stand-alone pathology course.

  19. A review of 48 patients after bear attacks in Central India: Demographics, management and outcomes

    Directory of Open Access Journals (Sweden)

    Surendra B Patil


    Full Text Available Introduction: Bear attacks though relatively rare are frequent enough to be of concern for those who are in bear habitats. Our centre at Nagpur, being surrounded by dense forests from all the sides, treats a large number of victims. Aim: The aim was to document the injuries, management and the potential complications of bear attacks. Materials and Methods: We reviewed the records of 48 consecutive patients who were treated in our department from January 2006 to December 2013 for bear attacks. Outcome: The majority of patients were referred 24-48 h post-attack. All but two patients had involvement of either the face or scalp. Involvement of eyes, mandible, facial nerve, was common. Reconstruction included simple suture of lacerations to management of complex compound injuries with three-dimensional defects. Thirteen patients developed infection. Conclusion: Bear attack victims need a multidisciplinary approach. Early broad spectrum antibiotics, anti-rabies prophylaxis and irrigation and debridement of the wound are needed. We advise early referral to tertiary treatment centres.

  20. Phytol a Natural Diterpenoid with Pharmacological Applications on Central Nervous System: A Review. (United States)

    Pereira Costa, Jessica; da Silva Oliveira, Johanssy; Mario Rezende Junior, Luis; de Freitas, Rivelilson Mendes


    Phytol (3,7,11,15-tetramethylhexadec-2-en-1-ol), a diterpene member of long and ramified chain of unsaturated acyclic alcohols. The objective of study was to conduct a systematic review of this diterpene and its pharmaceutical applications in Nervous System diseases in humans and/or rodents. Periodicals bases, such as ScienceDirect and PubMed, were used, as well as technological basis of European Patent Office, World Intellectual Property Organization, United States Patent and Trademark Office, Derwent Innovations Index(®), Latin American Bank of Patents and data base of Instituto Nacional de Propriedade Industrial (INPI-National Institute of Industrial Property). The software EndNote-X5 was utilized as reference with the keywords: phytol, anxiolytic, antidepressant and anticonvulsant and their correlations in English, Spanish and Portuguese from January 2003 to June 2014. There are many publications on phytol in international literature. However, there is a reduced number of articles related to pharmacological activities proposed here. In reference to technological bases, patents present a wide range of pharmacological and commercial applications as cosmetics, hypolipodemic, anxiolytic and antidepressant. Therefore, it is necessary to explore phytol molecules, which present high pharmacological potential from scientific and technological points of view, in search of transference of technologies to generate economical and industrial growth.

  1. [Contact allergy to Anacardiaceae. A review and case reports of poison ivy allergy in central Europe]. (United States)

    Ippen, H


    In Europe, as opposed to North America, poison-ivy rash is hardly known. For this reason a detailed review of the allergenic members of the Anacardiaceae family is given, and the misleading nomenclature of "poison ivy", "poison oak", and some other species of this family are discussed. An up-to-date representation of the chemical structure of the allergenic substance group (denoted as "Urushiol") from this family is provided as well as botanical information regarding the plants themselves. Prevention of this dangerous sensitization and the therapy of this allergic reaction are discussed. The four cases presented are as follows: a young German woman who became sensitized to poison ivy or poison oak while in the USA and showed a cross reaction to other Rhus species (R. copallina, R. javanica (semialata), R. trichocarpa) as well as to Choerospondias axillaris var. japonica and to mangoes; a landscape gardener with an occupationally acquired allergy to Anacardium occidentale; and two control persons giving positive results to skin tests with Urushiol and Rhus trichocarpa respectively, to which the source of sensitization could not be clarified. Tests with three kinds of pistachio and two native-European Anacardiaceae (Rhus typhina and Cotinus coggygria) yielded negative results in each case. Prophylaxis to sensitization requires familiarity with the numerous Anacardiaceae and derivative products to which one could come in contact. These substances, summarized in a table, include mango, cashew and "sweet pepper".

  2. Canine and feline oral pathology


    Costa, S.; Pais, B.; Almeida, D.; Simões, J.; Mega, A. C.; Vala, Helena


    The aim of this work was to present a brief review of the main conditions affecting the oral cavity of dogs and cats. In recent years there has been increased attention with regard to veterinary dentistry, being several and frequent the pathologies located in the oral cavity of our pets. These diseases mainly affect the teeth and the mucous membranes of the oral cavity, and may, in chronic cases, also affect vital organs. This condition could have different causes, including hereditary, conge...

  3. Pancreatic ifstula after central pancreatectomy:case series and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Yan-Ming Zhou; Xiao-Feng Zhang; Lu-Peng Wu; Xu Su; Bin Li and Le-Hua Shi


    BACKGROUND: Postoperative pancreatic ifstula is one of the most common complications after pancreatectomy. This study aimed to assess the occurrence and severity of pancreatic ifstula after central pancreatectomy. METHODS: The  medical  records  of  13  patients  who  had undergone central pancreatectomy were retrospectively studied, together with a literature review of studies including at least ifve cases of central pancreatectomy. Pancreatic ifstula was deifned and graded according to the recommendations of the International Study Group on Pancreatic Fistula (ISGPF). RESULTS: No death was observed in the 13 patients. Pancreatic ifstula developed in 7 patients and was successfully treated non-operatively. None of these patients required re-operation. A total of 40 studies involving 867 patients who underwent central pancreatectomy were reviewed. The overall pancreatic ifstula rate of the patients was 33.4% (0-100%). Of 279 patients, 250 (89.6%) had grade A or B ifstulae of ISGPF and were treated non-operatively, and the remaining 29 (10.4%) had grade C ifstulae of ISGPF. In 194 patients, 15 (7.7%) were re-operated upon. Only one patient with grade C ifstula of ISGPF died from multiple organ failure after re-operation. CONCLUSION: Despite the relatively high occurrence, most pancreatic ifstulae after central pancreatectomy are recognized a grade A or B ifstula of ISGPF, which can be treated conservatively or by mini-invasive approaches.

  4. Neurostimulation for primary headache disorders: Part 2, review of central neurostimulators for primary headache, overall therapeutic efficacy, safety, cost, patient selection, and future research in headache neuromodulation. (United States)

    Jenkins, Brian; Tepper, Stewart J


    This article is the second of 2 articles reviewing neurostimulation for primary headaches. In Part 1, we described methods, pathophysiology and anatomy, and history of neuromodulation in the treatment of headache, as well as reviewing the literature on peripheral neuromodulation for primary headaches. Peripheral targets for stimulation include percutaneous nerves, transcranial holocephalic, occipital nerves, auriculotemporal nerves, supraorbital nerves, cervical epidural, and sphenopalatine ganglia. In Part 2, we describe available literature on central neuromodulation in primary headaches. Central stimulation targets include vagus nerve and deep brain structures. Part 2 also analyzes overall therapeutic efficacy, safety, cost, patient selection, and recommendations for further research of neurostimulation modalities based on available data.

  5. Pathological fear of cot death. (United States)

    Weightman, H; Dalal, B M; Brockington, I F


    Cot death (sudden infant death syndrome) is one of the most common causes of death in the first year of life. Four cases with a pathological fear of cot death are presented. All the patients were depressed and in 2 cases the fear of cot death had an obsessional quality. In all cases there were complications during pregnancy (miscarriage, threatened abortion, recurrent vomiting in last trimester). In 1 case, the patient knew 3 mothers who had suffered cot deaths; in another, the infant was gravely ill in the neonatal period. Pathological fear of cot death can be recognised by the presence of two central features - overvigilance and excessive nocturnal checking of the baby's breathing. Therapeutic interventions are discussed.

  6. Pathological Gambling in Parkinson's Disease

    DEFF Research Database (Denmark)

    Callesen, Mette Buhl; Linnet, Jakob; Thomsen, Kristine Rømer

    Pathological Gambling in Parkinson’s Disease Mette Buhl Callesen, Jakob Linnet, Kristine Rømer Thomsen, Albert Gjedde, Arne Møller PET Center, Aarhus University Hospital and Center of Functionally Integrative Neuroscience, Aarhus University.   The neurotransmitter dopamine is central to many...... aspects of human functioning, e.g., reward, learning, and addiction, including Pathological Gambling (PG), and its loss is key to Parkinson’s Disease (PD). PD is a neurodegenrative disorder caused by progressive loss of dopamine-producing cells in the midbrain [1]. One type of treatment of PD symptoms...... is medication that binds to dopamine receptors in the brain, i.e., dopamine agonists [1]. Unfortunately, for some PD patients a very serious side effect to this specific kind of treatment is developing PG. PG is an Impulse Control Disorder characterized by recurrent maladaptive behavior associated with personal...

  7. A suspicious breast lesion detected by dynamic contrast-enhanced MRI and pathologically confirmed as capillary hemangioma: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Lian He; Li, Qing Chang; Xu, Hong Tao; Wang, Xin; Wang, En Hua [The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang (China); Ma, Shuang [Dept. of Neurology, Sheng Jing Hospital of China Medical University, Shenyang (China)


    Breast capillary hemangioma is a type of benign vascular tumor which is rarely seen. Little is known about its presentation on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Here, we describe a case of suspicious breast lesion detected by DCE-MRI and pathologically confirmed as capillary hemangioma. Our case indicates that a small mass with a superficial location, clear boundary, and homogeneous enhancement on DCE-MRI indicates the possible diagnosis of hemangioma, whereby even the lesion presents a washout type curve.

  8. Jurassic and Cretaceous clays of the northern and central North Sea hydrocarbon reservoirs reviewed

    Energy Technology Data Exchange (ETDEWEB)

    Wilkinson, M.; Haszeldine, R.S.; Fallick, A.E.


    The principal clays of the northern and central North Sea are illite (sometimes with interlayered smectite) and kaolin. Chlorite is only locally important. Although it has been proposed that kaolin within North Sea sandstones is detrital in origin, the majority of workers have concluded that it is authigenic, largely the product of feldspar alteration. Kaolin is found within a wide range of sedimentary settings (and within shales) apparently defying the notion that kaolin is an indicator of meteoric water deposition. Within sandstones, the earliest authigenic kaolin has a vermiform morphology, the distribution of which is controlled by the availability of detrital mica to act as a nucleus, and the composition of the post-depositional porewaters. This vermiform kaolin formed in meteoric water, the presence of which is easily accounted for below sub-aerial exposure surfaces in non-marine formations, and below unconformities over marine units. In fully marine sands, and even marine shale units, kaolin still occurs. It has therefore been suggested that even these locations have been flushed with meteoric water. Early vermiform kaolin recrystallizes to a more blocky morphology as burial proceeds, at least in the Brent Group. Blocky kaolin has been reported as growing before, synchronously with, and after the formation of quartz overgrowths, though oxygen isotope studies support low-temperature growth, pre-quartz. Blocky kaolin may form during meteoric flushing associated with lower Cretaceous uplift and erosion, though it is found in fault blocks that are thought to have remained below sea level. Here, the kaolin may form in stagnant meteoric water, relics of the post-depositional porewater. It has also been proposed that the blocky kaolin grew in ascending basinal waters charged with carboxylic acids and CO{sub 2}, though this hypothesis is not supported by stable oxygen isotope data. Some of the blocky kaolin is dickite, the stable polymorph above 100{sup o}C. Fibrous

  9. Cerebellar Ataxia with Complete Clinical Recovery and Resolution of MRI Lesions Related to Central Pontine Myelinolysis: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Cristina Dolciotti


    Full Text Available There are several reports of central pontine myelinolysis (CPM in a setting of malnutrition, alcoholism, and chronic debilitating illness associated with electrolyte abnormalities, especially hyponatremia. The cause of myelinolysis is still under debate, and, although osmotic effects are thought to be responsible in most cases, alternative pathological factors should be considered [King et al.: Am J Med Sci 2010;339:561–567]. We report a case of CPM in a patient with recent chemotherapy for colon cancer without electrolyte unbalance and otherwise unexplained causes. Moreover, the present case is an example of the unusual clinical ataxic variant, followed by complete recovery without any specific treatment. The diagnosis was confirmed by MRI, which showed a characteristic hyperintense signal abnormality in the central part of the pons with an unaffected outer rim. One month later, we observed complete resolution of clinical and radiological symptoms.

  10. First-line treatment and outcome of elderly patients with primary central nervous system lymphoma (PCNSL)-a systematic review and individual patient data meta-analysis

    NARCIS (Netherlands)

    B. Kasenda (Benjamin); A.J.M. Ferreri (Andrés J.M.); E. Marturano; D. Forst; J.E.C. Bromberg (Jacolien); H. Ghesquieres; C. Ferlay; J-Y. Blay (Jean Yves); K. Hoang-Xuan (Khê); E.J. Pulczynski; A. Fosså; Y. Okoshi; S. Chiba; K. Fritsch (Kristina); A. Omuro; B.P. O'Neill; O. Bairey; S. Schandelmaier; V. Gloy; N. Bhatnagar; S. Haug; S. Rahner; T.T. Batchelor (Tracy); G. Illerhaus (Gerald); M. Brie


    textabstractBackground: To investigate prognosis and effects of first-line therapy in elderly primary central nervous system lymphoma (PCNSL) patients. Patients and methods: A systematic review of studies about first-line therapy in immunocompetent patients ≥60 years with PCNSL until 2014 and a meta

  11. Effect of a vascular access team on central line-associated bloodstream infections in infants admitted to a neonatal intensive care unit : a systematic review

    NARCIS (Netherlands)

    Legemaat, Monique M; Jongerden, IP; van Rens, Roland M F P T; Zielman, Marjanne; van den Hoogen, Agnes


    OBJECTIVE: To review the effect of a vascular access team on the incidence of central line-associated bloodstream infections in infants admitted to a neonatal intensive care unit. DATA SOURCES: MEDLINE, CINAHL, Embase, Web-of-Science and the Cochrane Library were searched until December 2013. STUDY

  12. Updated review of marine alien species and other ‘newcomers’ recorded from the Maltese Islands (Central Mediterranean

    Directory of Open Access Journals (Sweden)

    J. EVANS


    Full Text Available An updated review of marine alien species and other ‘newcomers’ recorded from the Maltese Islands is presented on account of new records and amendments to a previous review in 2007. Species were classified according to their establishment status (‘Questionable’, ‘Casual’, ‘Established’, ‘Invasive’ and origin (‘Alien’, ‘Range expansion’, ‘Cryptogenic’. A total of 31 species were added to the inventory, while 6 species have been removed, bringing the total number of species to 73. Of these, 66 are considered to be aliens (or putative aliens but with uncertain origin with the remaining 7 resulting from range expansion. Six records are considered to be questionable and hence unverified. For verified records, the dominant taxonomic groups are Mollusca (represented by 21 species and Actinopterygii (15 species, followed by Crustacea (8 species and Rhodophyta (7 species. Eight of these species (aliens: Caulerpa cylindracea, Lophocladia lallemandi, Womersleyella setacea, Brachidontes pharaonis, Percnon gibbesi, Fistularia commersonii, Siganus luridus; range extender: Sphoeroides pachygaster are considered to be invasive. The introduction pathway for 30 species is unknown. Amongst the alien species, ‘Shipping’ is the most common introduction pathway, followed by ‘Secondary dispersal’ from elsewhere in the Mediterranean Sea. An increasing trend in the number of alien marine species reported from the Maltese Islands is evident, with a peak of 22 species recorded during the last decade (2001–2010. A discussion on the rationale for including range-expanding species in national inventories of recent arrivals, and in the analysis of trends in records from the Maltese Islands, is included. In particular, the general warming trend of Mediterranean surface waters appears to be facilitating the westward spread of thermophilic alien species from the Eastern to the Central Mediterranean, and the eastward range expansion of

  13. Pathology in Greece. (United States)

    Sakellariou, S; Patsouris, E


    Pathology is the field of medicine that studies diseases. Ancient Greece hosted some of the earliest societies that laid the structural foundations of pathology. Initially, knowledge was based on observations but later on the key elements of pathology were established based on the dissection of animals and the autopsy of human cadavers. Christianized Greece under Ottoman rule (1453-1821) was not conducive to the development of pathology. After liberation, however, a series of events took place that paved the way for the establishment and further development of the specialty. The appointment in 1849 of two Professors of Pathology at the Medical School of Athens for didactical purposes proved to be the most important step in fostering the field of pathology in modern Greece. Presently in Greece there are seven university departments and 74 pathology laboratories in public hospitals, employing 415 specialized pathologists and 90 residents. The First Department of Pathology at the Medical School of Athens University is the oldest (1849) and largest in Greece, encompassing most pathology subspecialties.

  14. Mini Review: Anticholinergic Activity as a Behavioral Pathology of Lewy Body Disease and Proposal of the Concept of “Anticholinergic Spectrum Disorders” (United States)

    Tomioka, Hiroi; Hachisu, Mitsugu


    Given the relationship between anticholinergic activity (AA) and Alzheimer's disease (AD), we rereview our hypothesis of the endogenous appearance of AA in AD. Briefly, because acetylcholine (ACh) regulates not only cognitive function but also the inflammatory system, when ACh downregulation reaches a critical level, inflammation increases, triggering the appearance of cytokines with AA. Moreover, based on a case report of a patient with mild AD and slightly deteriorated ACh, we also speculate that AA can appear endogenously in Lewy body disease due to the dual action of the downregulation of ACh and hyperactivity of the hypothalamic-pituitary-adrenal axis. Based on these hypotheses, we consider AA to be a behavioral pathology of Lewy body disease. We also propose the concept of “anticholinergic spectrum disorders,” which encompass a variety of conditions, including AD, Lewy body disease, and delirium. Finally, we suggest the prescription of cholinesterase inhibitors to patients in this spectrum of disorders to abolish AA by upregulating ACh.

  15. Autopsy practice in forensic pathology - evidence-based or experience-based? a review of autopsies performed on victims of traumatic asphyxia in a mass disaster. (United States)

    Colville-Ebeling, Bonnie; Freeman, Michael; Banner, Jytte; Lynnerup, Niels


    Current autopsy practice in forensic pathology is to a large extent based on experience and individual customary practices as opposed to evidence and consensus based practices. As a result there is the potential for substantial variation in how knowledge is applied in each case. In the present case series, we describe the variation observed in autopsy reports by five different pathologists of eight victims who died simultaneously from traumatic asphyxia due to compression during a human stampede. We observed that there was no mention of the availability of medical charts in five of the reports, of potentially confounding resuscitation efforts in three reports, of cardinal signs in seven reports and of associated injuries to a various degree in all reports. Further, there was mention of supplemental histological examination in two reports and of pre-autopsy radiograph in six reports. We inferred that reliance on experience and individual customary practices led to disparities between the autopsy reports as well as omissions of important information such as cardinal signs, and conclude that such reliance increases the potential for error in autopsy practice. We suggest that pre-autopsy data-gathering and the use of check lists specific to certain injury causes are likely to result in less deviation from evidence-based practices in forensic pathology. Pre-autopsy data-gathering and check lists will help ensure a higher degree of standardization in autopsy reports thus enhancing the quality and accuracy of the report as a legal document as well as rendering it more useful for data-gathering efforts.

  16. A critical review of records of alien marine species from the Maltese Islands and surrounding waters (Central Mediterranean

    Directory of Open Access Journals (Sweden)



    Full Text Available An updated list of alien marine species recorded from the Maltese Islands and surrounding waters, compiled from scientific and ‘grey’ literature and from authenticated unpublished reports to the authors, is presented. The listed species are classified in one of four categories as regards establishment status: established, casual, invasive and questionable. Doubtful records are listed as ‘?’. A total of 48 species, including nine dubious ones, are included in the list. Of the accepted records, 64% are established, of which 15.4% are invasive, 18% are casual and 18% are questionable. The most represented groups are molluscs (14 species, fish (13 species and macrophytes (10 species. Six species are classified as invasive in Maltese waters: Lophocladia lallemandii, Womersleyella setacea, Caulerpa racemosa var. cylindracea, Percnon gibbesi, Fistularia commersonii and Sphoeroides pachygaster; impacts of some of these species on local ecosystems are discussed. Since the early 1900s, there has been an increasing trend in the number of alien marine species reported from the Maltese Islands. Transportation via shipping and in connection with aquaculture, as well as the range expansion of Lessepsian immigrants, appear to be the most common vectors for entry, accounting for 20%, 11% and 32% respectively of the alien species included in this review. The general warming trend of Mediterranean waters and increasing marine traffic may be facilitating the spread of warm-water Atlantic and Indo-Pacific species to the central Mediterranean, including the Maltese Islands.

  17. Intrathecal colistin for drug-resistant Acinetobacter baumannii central nervous system infection: a case series and systematic review. (United States)

    Khawcharoenporn, T; Apisarnthanarak, A; Mundy, L M


    Treatment limitations exist for drug-resistant Acinetobacter baumannii central nervous system (CNS) infection. We conducted a retrospective study and systematic literature review to identify patients with drug-resistant A. baumannii CNS infection who received primary or adjunct intrathecal or intraventricular (IT/IVT) colistin. In a case series of seven Thai patients and 17 patients identified in the literature, clinical and microbiological cure rates with IT/IVT colistin therapy were 83% and 92%, respectively. Three patients (13%) developed chemical ventriculitis and one (4%) experienced treatment-associated seizures. Death was associated with delayed IT/IVT colistin therapy compared to survival (mean time from diagnosis to IT/IVT colistin, 7 vs. 2 days; p 0.01). The only independent predictor of mortality was the severity of illness (APACHE II score > 19, adjusted odds ratio 49.5; 95% CI 1.7-1428.6; p 0.02). This case series suggests that administration of primary or adjunctive IT/IVT colistin therapy was effective for drug-resistant A. baumannii CNS infection.

  18. Correlation of compliance with central line associated blood stream infection guidelines and outcomes: a review of the evidence

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    Gerkin R


    Full Text Available Background Clinical practice guidelines are developed to assist in patient care but the evidence basis for many guidelines has been called into question. Methods We conducted a literature review using PubMed and analyzed the overall quality of evidence and made strength of recommendation behind 8 Institute of Health Care (IHI guidelines for prevention of central line associated blood stream infection (CLABSI. Quality of evidence was assessed by the American Thoracic Society (ATS levels of evidence (levels I through III. We also examined data from our intensive care units (ICUs for evidence of a correlation between guideline compliance and the development of VAP.Results None of the guidelines was graded at level I. Two of the guidelines were graded at level II and the remaining 6 at level III. Despite the lack of evidence, 2 of the guidelines (hand hygiene, sterile gloves were given a strong recommendation. Chlorhexidine and use of nonfemoral sites were given a moderate recommendation. In our ICUs compliance with the use of chlorhexidine correlated with a reduction in CLABSI (p<0.02 but the remainder did not.Conclusions The IHI CLABSI guidelines are based on level II or III evidence. Data from our ICUs supported the use of chlorhexidine in reducing CLABSI. Until more data from well-designed controlled clinical trials become available, physicians should remain cautious when using current IHI guidelines to direct patient care decisions or as an assessment of the quality of care.

  19. Imaging Findings of Complex Fibroadenoma of the Breast: Correlation with Pathologic Findings

    Energy Technology Data Exchange (ETDEWEB)

    You, Sun Kyoung; Choi, Bo Bae; Kim, Kyung Hee [Chungnam National University Hospital College of Medicine, Seoul (Korea, Republic of)


    The imaging findings of complex fibroadenoma have been rarely reported even though the risk of developing breast carcinoma in a patient with complex fibroadenoma is higher than that for a patient with simple fibroadenoma. We reviewed the imaging features and pathologic findings of complex fibroadenomas. Between April 2003 and April 2010, the mammographic and sonographic findings of five patients with complex fibroadenomas were retrospectively reviewed according to the Breast Imaging Reporting and Data System (BIRADS). The pathologic findings were retrospectively reviewed for all 5 patients. The mammography findings showed masses (3 cases) and asymmetry (1 case). On ultrasonography, complex echo patterns were noted in all the patients, and all the lesions were assigned to BI-RADS category 4, suspicious for abnormality. The complex echoic patterns showed two types: 1) a mixture of a heterogeneous hypoechoic central portion and a fuzzy hyperechoic peripheral area in 2 cases, 2) a mixture of tiny anechoic and hypoehoic lesions in 3 cases. Multiple cystic changes were noted in all the cases on the pathologic analysis. Complex fibroadenomas showed different ultrasonographic findings from simple fibroadenomas such as two types of complex echo patterns, even though the other findings were similar to those of simple fibroadenoma. Cystic changes were noted in all the cases on the pathologic analysis. Awareness of these imaging findings will help us to properly diagnose complex fibroadenoma

  20. Central nervous system antiretroviral efficacy in HIV infection: a qualitative and quantitative review and implications for future research

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    Cysique Lucette A


    Full Text Available Abstract Background There is conflicting information as to whether antiretroviral drugs with better central nervous system (CNS penetration (neuroHAART assist in improving neurocognitive function and suppressing cerebrospinal fluid (CSF HIV RNA. The current review aims to better synthesise existing literature by using an innovative two-phase review approach (qualitative and quantitative to overcome methodological differences between studies. Methods Sixteen studies, all observational, were identified using a standard citation search. They fulfilled the following inclusion criteria: conducted in the HAART era; sample size > 10; treatment effect involved more than one antiretroviral and none had a retrospective design. The qualitative phase of review of these studies consisted of (i a blind assessment rating studies on features such as sample size, statistical methods and definitions of neuroHAART, and (ii a non-blind assessment of the sensitivity of the neuropsychological methods to HIV-associated neurocognitive disorder (HAND. During quantitative evaluation we assessed the statistical power of studies, which achieved a high rating in the qualitative analysis. The objective of the power analysis was to determine the studies ability to assess their proposed research aims. Results After studies with at least three limitations were excluded in the qualitative phase, six studies remained. All six found a positive effect of neuroHAART on neurocognitive function or CSF HIV suppression. Of these six studies, only two had statistical power of at least 80%. Conclusions Studies assessed as using more rigorous methods found that neuroHAART was effective in improving neurocognitive function and decreasing CSF viral load, but only two of those studies were adequately statistically powered. Because all of these studies were observational, they represent a less compelling evidence base than randomised control trials for assessing treatment effect. Therefore

  1. Pathological narcissism and the obstruction of love. (United States)

    Kealy, David; Ogrodniczuk, John S


    Pathological narcissism is a form of maladaptive self-regulation that impedes the capacity to love. Although narcissism is often construed as excessive self-love, individuals with pathological narcissism are impaired in being able to love themselves as well as others. With the subject of impaired love in mind, we review selected conceptualizations from an enormous and diverse psychodynamic literature on narcissism. Major theoretical approaches illustrate a number of psychodynamics associated with narcissistic self-regulatory problems. This paper provides a concise overview of major conceptual themes regarding pathological narcissism and impaired capacity to love.

  2. Hip joint pathology

    DEFF Research Database (Denmark)

    Tijssen, M; van Cingel, R E H; de Visser, E


    The purpose of this retrospective cohort study was to (a) describe the clinical presentation of femoroacetabular impingement (FAI) and hip labral pathology; (b) describe the accuracy of patient history and physical tests for FAI and labral pathology as confirmed by hip arthroscopy. Patients (18-6...

  3. Trends in pathology graduate medical education. (United States)

    Alexander, C B


    Comprehensive data show trends in graduate medical education in pathology with regard to the numbers of accredited programs, persons certified from those programs, and demographics of the population of first year-trainees in pathology. Experience with US seniors and foreign-trained physicians in the PGY match process for pathology from 1991 through 2000 is presented, along with data on the types of medical schools generating pathology trainees for the PGY-1 year and the top medical schools of origin of US medical graduates who completed the program and became certified in pathology between 1995 and 1999. The impact of reimbursement of the credentialing year is also addressed through data collected from the PRODS Survey 2000, and those results are reviewed. Finally, turnover rates among pathology program directors of combined AP/CP programs and subspecialty programs since 1994 are presented. An analysis of these trends is provided, along with suggestions to improve both the perception of careers in pathology and the actual choice of a career in pathology.

  4. Practicing pathology in the era of big data and personalized medicine. (United States)

    Gu, Jiang; Taylor, Clive R


    The traditional task of the pathologist is to assist physicians in making the correct diagnosis of diseases at the earliest possible stage to effectuate the optimal treatment strategy for each individual patient. In this respect surgical pathology (the traditional tissue diagnosis) is but a tool. It is not, of itself, the purpose of pathology practice; and change is in the air. This January 2014 issue of Applied Immunohistochemistry and Molecular Morphology (AIMM) embraces that change by the incorporation of the agenda and content of the journal Diagnostic Molecular Morphology (DMP). Over a decade ago AIMM introduced and promoted the concept of "molecular morphology," and has sought to publish molecular studies that correlate with the morphologic features that continue to define cancer and many diseases. That intent is now reinforced and extended by the merger with DMP, as a logical and timely response to the growing impact of a wide range of genetic and molecular technologies that are beginning to reshape the way in which pathology is practiced. The use of molecular and genomic techniques already demonstrates clear value in the diagnosis of disease, with treatment tailored specifically to individual patients. Personalized medicine is the future, and personalized medicine demands personalized pathology. The need for integration of the flood of new molecular data, with surgical pathology, digital pathology, and the full range of pathology data in the electronic medical record has never been greater. This review describes the possible impact of these pressures upon the discipline of pathology, and examines possible outcomes. There is a sense of excitement and adventure. Active adaption and innovation are required. The new AIMM, incorporating DMP, seeks to position itself for a central role in this process.

  5. Presentation, pathology, and outcome of HIV associated renal disease in a specialist centre for HIV/AIDS



    OBJECTIVES: To describe the presentation, pathology, and outcome of biopsy proved renal disease in HIV infected patients at a central London HIV unit from 1992 to 1996. METHODS: Retrospective review of a computerised database and case notes to identify patients with renal disease confirmed by antemortem percutaneous renal biopsy or necropsy. RESULTS: 17 patients were identified, 13 had biopsy and four necropsy confirmed renal disease. Abnormalities included HIV associated nephropathy (H...

  6. 先天性肾发育不良临床及病理回顾%The Clinical and Pathological Review of Renal Dyaplasia

    Institute of Scientific and Technical Information of China (English)

    葛人铨; 李衷初; 刘国华; 张忠德; 葛莉; 叶唯靖; 陈方


    报告先天性单侧肾发育不良26例,多见于女孩,左侧好发.主要症状为滴尿及尿路感染,并可伴其他泌尿系畸形;静脉尿路造影患肾不显影,对侧肾代偿增大;B超为异位肾或未探及肾脏:病理表现为镜下见大量初生未成熟的扩张导管,未成熟的肾小球及肾小管排列异常;手术行患肾及输尿管切除,效果良好.%Twenty-six cases of renal dysplasia with main symptoms of incontinence and urinary tract imfection are reported.A large number of dysplastic kidneys were not visualized by B-mode ultrasonography and radionuclide imaging,and the orifice of ureter were not identified by cystoscopy.Under excretory urography the visualization of dysplastic kidneys was not apparent and the contralateral side appeared compensatory hypertrophy.The pathological features included disarrangement of primitive ducts and glomeroli with cartilage and calcification.All of them received nephrouretertomy.Because of the displacenent of the displastic kidneys,we think it is easy and convenient to operate through the McBurney's approach.

  7. Central venous catheter - flushing (United States)

    ... during cancer treatment Bone marrow transplant - discharge Central venous catheter - dressing change Peripherally inserted central catheter - flushing Sterile technique Surgical wound care - open Review Date 9/22/2016 Updated by: ...

  8. A primary primitive neuroectodermal tumor of the central nervous system in a 51-year-old woman: a case report and literature review. (United States)

    Ašmonienė, Virginija; Skiriutė, Daina; Gudinavičienė, Inga; Tamašauskas, Šarūnas; Skauminas, Kęstutis; Deltuva, Vytenis Pranas; Tamašauskas, Arimantas


    Primitive neuroectodermal tumors are a group of rare, aggressive, and highly malignant embryonal tumors of unknown etiology of the central and peripheral nervous systems. It is a term for a group of small round cell tumors thought to be derived from fetal neuroectodermal precursor cells. Primitive neuroectodermal tumor is usually described as a tumor of children younger than 15 years and is very rare in adults. The article presents a short literature review and a rare case of a primary primitive neuroectodermal tumor of the central nervous system diagnosed in a 51-year-old woman.

  9. Metastasis in central nervous system: Clinicopathological study with review of literature in a tertiary care center in South India

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    Rashmi Patnayak


    Full Text Available Background: Secondary central nervous system (CNS tumors are common in Western countries, but in Indian literature, scant data are available. With the advent of newer imaging techniques, the confirmatory histopathological diagnosis has become comparatively easier. Hereby, we have analyzed our data from a single tertiary care center in south India. Materials and Methods: In this retrospective study from January 2000 to December 2010, histopathologically diagnosed secondary CNS tumors were reviewed along with clinical, imaging, and relevant immunohistochemical findings. Meningeal, lymphoproliferative, and myeloproliferative tumors and autopsy data were not included in the study group. Results: There were 40 secondary CNS tumors. Male to female ratio was 2.3:1. Age range was wide (28-75 years. Majority of cases were seen in the fourth and fifth decade. Imaging-wise, (computed tomography and magnetic resonance imaging majority were single lesions ( n = 34, 85%. Most commonly, these single lesions were present in the cerebral hemisphere ( n = 20, 50% followed by cerebellum ( n = 10, 25%. Adenocarcinoma accounted for maximum number of cases ( n = 25, 62.5% with lungs being the most common primary. Conclusion: We have noted 25% metastatic adenocarcinomas in cerebellar location, which is higher when compared with available world literature. However, we also encountered a good number of cases (30% due to unknown primary. Though histopathological examination with use of immunohistochemical markers can reliably distinguish primary from secondary CNS tumors in addition to available clinical and imaging data, particularly in developing countries, still a better work-up with an array of immunohistochemical markers and newer imaging modalities is desirable.

  10. [Pathology- a new revival]. (United States)

    Barshack, Iris


    The field of pathology has undergone considerable change in recent years. The editor and editorial board of this journal are to be commended for their decision to devote a special issue to the field of pathology. Pathology deals with the characterization, investigation, and diagnosis of disease and disease processes and as such, has Long been considered one of the foundations of medicine. It is a rich and multi-faceted field which has retained its breadth of scope in the face of ever-increasing specialization and sub-specialization in medicine. In addition to its classic roles in autopsy, case description, and the diagnosis of pathoLogic processes, new and innovative spheres of activity are becoming integral to the field, especially in the realm of molecular pathology. Pathology is a Leading player in the new age of "personalized cancer therapy", where pathologists are responsible not only for diagnosing disease in the tissue, but also for conducting additional tests which may predict its response to specific drug therapies. In this context, moLecular pathology has become essential to the field both in the provision of cLinical service and research. To fully implement this trend, we are witness to the rise of tissue collection and tissue banking initiatives for both diagnostic and research purposes. A national tissue banking project in Israel has recently received considerable attention.

  11. A clinico-pathological study of orbito-ocular tumors at Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria: A 5-year review

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    Dominic Chinda


    Full Text Available Background: Orbito-ocular tumors are a common cause of morbidity and mortality in our environment. Patients often present late with unsightly fungating tumors resulting in difficult management and poor outcome. The aim of the study was to determine the clinical profile, diagnostic work-up, treatment and histo-pathological types of orbito-ocular tumors seen at Ahmadu Bello University Teaching Hospital, Shika-Zaria from June 2006 to June 2011. Materials and Methods: A retrospective analysis of all patients who presented to the eye clinic with orbito-ocular tumors during the study period was made. Information extracted incwudes patient demographics, clinical diagnoses, radiological and sonological reports, surgery performed, and histology reports as well as adjuvant chemotherapy and radiotherapy where indicated. Results: A total of 54 patients were managed during the study period. Those without histology reports were excluded from the study. Forty-nine patients were included for analysis. There were 29 male and 20 female patients giving a male to female ratio of 1.8:1. Their age range was 1.5-74 years with a mean of 22 years. Eighteen of the patients had retinoblastoma, eleven had squamous cell carcinoma, two had Kaposi′ sarcoma, and one case of nasopharyngeal carcinoma. There were 2 patients with pre-malignant conditions and 10 patients with benign lesions. Thirty-two of the patients had exenterations, sixteen had excisional biopsies, and one had enucleation. Seventy eight percent of the tumors were malignant. Conclusion: Most of the orbito-ocular tumors seen in this study were malignant. Delayed hospital presentation is a characteristic feature. Retinoblastoma and squamous cell carcinoma are the most common orbito-ocular tumors.

  12. Hamartomas, teratomas and teratocarcinosarcomas of the head and neck: Report of 3 new cases with clinico-pathologic correlation, cytogenetic analysis, and review of the literature

    Directory of Open Access Journals (Sweden)

    Lydiatt William M


    Full Text Available Abstract Background Germ-cell tumors (GCT are a histologically and biologically diverse group of neoplasms which primarily occur in the gonads but also develop at different extragonadal sites in the midline of the body. The head and neck region including the upper respiratory tract is a very rare location for such tumors in both children and adults, which can cause diagnostic and therapeutic difficulties. Methods We describe here two new cases of multilineage tumors including sinonasal teratocarcinosarcoma [SNTCS], and congenital oronasopharyngeal teratoma (epignathus and compare their features with those of a new case of a rare salivary gland anlage tumor [SGAT], an entity for which the pathogenesis is unclear (i.e. hamartoma versus neoplasm. We correlate their presenting clinico-pathological features and compare histologic and cytogenetic features in an attempt to elucidate their pathogenesis and biologic potentials. Results and discussion Cytogenetic analysis revealed chromosomal abnormalities only in the case of SNTCS that showed trisomy 12 and 1p deletion. Both cytogenetic abnormalities are characteristically present in malignant germ cell tumors providing for the first time evidence that this rare tumor type indeed might represent a variant of a germ cell neoplasm. The SGAT and epignathus carried no such cytogenetic abnormalities, in keeping with their limited and benign biologic potential. Conclusion The comparison of these three cases should serve to emphasize the diversity of multilineage tumors (hamartomas and GCT of the upper respiratory tract in regards to their biology, age of presentation and clinical outcomes. Malignant tumors of germ cell origins are more likely to affect adults with insidious symptom development, while benign tumors can nevertheless cause dramatic clinical symptoms which, under certain circumstances, can be fatal.

  13. [Gunshot wounds: forensic pathology]. (United States)

    Lorin de la Grandmaison, Geoffroy


    Gunshot wounds are among the most complex traumatic lesions encountered in forensic pathology. At the time of autopsy, careful scrutiny of the wounds is essential for correct interpretation of the lesions. Complementary pathological analysis has many interests: differentiation between entrance and exit wounds, estimation of firing distance, differentiation between vital and post mortem wounds and wounds dating. In case of multiple headshots, neuropathological examination can provide arguments for or against suicide. Sampling of gunshot wounds at autopsy must be systematic. Pathological data should be confronted respectively to autopsy and death scene investigation data and also ballistic studies. Forensic pathologist must be aware of the limits of optic microscopy.

  14. Primary melanocytic tumors of the central nervous system: A neuroradiological and clinicopathological study of five cases and brief review of literature

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    Sushila Jaiswal


    Full Text Available Primary melanocytic tumors of the central nervous system (CNS are uncommon lesions. These lesions arise from the melanocytes located within leptomeninges and include diffuse melanocytosis and meningeal melanomatosis (seen in neurocutaneous melanosis, melanocytoma, and malignant melanoma. To study, the clinical course, neuroradiological features, morphology and immunohistochemistry of primary melanocytic tumor of CNS. Demographic, clinical and surgico-pathologic findings of five patients with melanocytic tumors seen between 1996 and 2003 were studied. In this study, five cases of primary melanocytic tumors have been reported: four cases of malignant melanoma and one case of melanocytoma. Three of the 5 cases were intracranial and 2 were spinal. The mean age in the present study was 26 years. Presenting features varied according to the location. Primary melanocytic tumor of CNS are rare. Whenever possible, complete surgical excision is the best treatment.

  15. Insulin dysfunction and Tau pathology

    Directory of Open Access Journals (Sweden)

    Noura eEl Khoury


    Full Text Available The neuropathological hallmarks of Alzheimer's disease (AD include senile plaques of β-amyloid (Aβ peptides (a cleavage product of the Amyloid Precursor Protein, or APP and neurofibrillary tangles (NFT of hyperphosphorylated Tau protein assembled in paired helical filaments (PHF. NFT pathology is important since it correlates with the degree of cognitive impairment in AD.Only a small proportion of AD is due to genetic variants, whereas the large majority of cases (~99% is late onset and sporadic in origin. The cause of sporadic AD is likely to be multifactorial, with external factors interacting with biological or genetic susceptibilities to accelerate the manifestation of the disease.Insulin dysfunction, manifested by diabetes mellitus (DM might be such factor, as there is extensive data from epidemiological studies suggesting that DM is associated with an increased relative risk for AD. Type 1 diabetes (T1DM and type 2 diabetes (T2DM are known to affect multiple cognitive functions in patients. In this context, understanding the effects of diabetes on Tau pathogenesis is important since tau pathology show a strong relationship to dementia in AD, and to memory loss in normal aging and mild cognitive impairment.Here, we reviewed preclinical studies that link insulin dysfunction to Tau protein pathogenesis, one of the major pathological hallmarks of AD. We found more than 30 studies reporting on Tau phosphorylation in a mouse or rat model of insulin dysfunction. We also payed attention to potential sources of artifacts, such as hypothermia and anesthesia, that were demonstrated to results in Tau hyperphosphorylation and could major confounding experimental factors. We found that very few studies reported the temperature of the animals, and only a handful did not use anesthesia. Overall, most published studies showed that insulin dysfunction can promote Tau hyperphosphorylation and pathology, both directly and indirectly, through hypothermia.

  16. Review of recent studies from central and Eastern Europe associating respiratory health effects with high levels of exposure to "traditional" air pollutants.


    Jedrychowski, W


    The serious environmental problems caused by decades of Communist mismanagement of natural resources in countries of Central and Eastern Europe have been brought to light in recent years. All environmental media, including air, water, food, and soil have been burdened with toxic chemicals. Large segments of the population have been, and are now being exposed to air pollution levels exceeding guidelines established by western countries and by international health organizations. This review foc...

  17. The integripennis species group of Geocharidius Jeannel, 1963 (Carabidae, Bembidiini, Anillina) from Nuclear Central America: a taxonomic review with notes about biogeography and speciation


    Igor Sokolov; David Kavanaugh


    Abstract Our review recognizes 15 species of the integripennis species group of Geocharidius from Nuclear Central America, include three species previously described ( Geocharidius gimlii Erwin, Geocharidius integripennis (Bates) and Geocharidius zullinii Vigna Taglianti) and 12 described here as new. They are: Geocharidius andersoni sp. n. (type locality: Chiapas, Chiapas Highlands, Cerro Huitepec) and Geocharidius vignatagliantii sp. n. (type locality: Chiapas, Motozintla, Sierra Madre de C...

  18. Parasitic diseases of the central nervous system. (United States)

    Chacko, Geeta


    Parasitic infections, though endemic to certain regions, have over time appeared in places far removed from their original sites of occurrence facilitated probably by the increase in world travel and the increasing migration of people from their native lands to other, often distant, countries. The frequency of occurrence of some of these diseases has also changed based on a variety of factors, including the presence of intermediate hosts, geographic locations, and climate. One factor that has significantly altered the epidemiology of parasitic diseases within the central nervous system (CNS) is the HIV pandemic. In this review of the pathology of parasitic infections that affect the CNS, each parasite is discussed in the sequence of epidemiology, life cycle, pathogenesis, and pathology.

  19. Pathological narcissism and narcissistic personality disorder. (United States)

    Pincus, Aaron L; Lukowitsky, Mark R


    We review the literature on pathological narcissism and narcissistic personality disorder (NPD) and describe a significant criterion problem related to four inconsistencies in phenotypic descriptions and taxonomic models across clinical theory, research, and practice; psychiatric diagnosis; and social/personality psychology. This impedes scientific synthesis, weakens narcissism's nomological net, and contributes to a discrepancy between low prevalence rates of NPD and higher rates of practitioner-diagnosed pathological narcissism, along with an enormous clinical literature on narcissistic disturbances. Criterion issues must be resolved, including clarification of the nature of normal and pathological narcissism, incorporation of the two broad phenotypic themes of narcissistic grandiosity and narcissistic vulnerability into revised diagnostic criteria and assessment instruments, elimination of references to overt and covert narcissism that reify these modes of expression as distinct narcissistic types, and determination of the appropriate structure for pathological narcissism. Implications for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and the science of personality disorders are presented.

  20. Latin American forensic pathology: scope and needs

    Directory of Open Access Journals (Sweden)

    Gabriel M. Fonseca


    Full Text Available Pathology pertains to the study of a disease; from ancient times it has sought to explain the cause of death through postmortem examination. The advancement of science and technology has led to a greater definition of roles and has favored its development through different subspecialties among which we stands out forensic pathology. This discipline has its own characteristics, scope, case series, procedures and terminology. Likewise, although forensic pathology does not differ substantially from clinical pathology, significant differences can be found between the Anglo American approach and the Latin American approach. Beyond semantics of these alleged differences, the article reviews the concepts involved and discusses the scope and requirements needed to qualify experts, in the understanding that globalizing criteria should establish new paradigms and define the specific roles of the specialty.

  1. Clinico-pathologic, dermoscopic and ultrasound examination of a rare acral tumour involving the nail - case report and review of the literature. (United States)

    Grigore, Lavinia Elena; Baican, Corina Iulia; Botar-Jid, Carolina; Rogojan, Liliana; Letca, Alina Florentina; Ungureanu, Loredana; Cosgarea, Rodica


    There is a large spectrum of tumors presenting as nodular lesions that may affect the subungual space. We report the case of a 62-year-old woman presenting with a rapidly growing nodular lesion under the nail of the first left toe. Non-invasive examinations using dermoscopy, ultrasonography and elastography were performed for the preoperative assessment of the lesion. The biopsy of the lesion revealed superficial acral fibromyxoma, a benign tumor with predisposition for acral sites. The patient underwent radical surgery with wide resection margins. This is the first case report of a superficial acral fibromyxoma affecting the subungual region characterized by dermoscopic, ultrasonographic and elastographic features. We also performed a short review of the literature.

  2. The role and application of exfoliative cytology in the diagnosis of oral mucosa pathology - contemporary knowledge with review of the literature. (United States)

    Kazanowska, Krzysztofa; Hałoń, Agnieszka; Radwan-Oczko, Małgorzata


    On the basis of the current available literature, the authors have presented a short description of cytological examination and its application in the oral mucosa disease diagnostic process. Furthermore, the advantages and disadvantages of this method are described. The available diagnostic tools used for oral smears were reviewed as well as more and more often available methods which aim at making the diagnosis process more accurate and more favorable for patients. Oral cytology analysis may, in the near future, be a very useful examination for patients in terms of diagnostics and monitoring, not only during the treatment but also afterwards. The authors would like to demonstrate what a beneficial tool this cytological examination could be as a fast and cheap cancer prophylactic test. This opinion is based on the fact that this cytological method has significantly improved the detection of uterine cervical cancer during a gynecological examination since the introduction of the Papanicolau technique in the 40s.

  3. Central Neuropathic Pain Syndromes. (United States)

    Watson, James C; Sandroni, Paola


    Chronic pain is common in patients with neurologic complications of a central nervous system insult such as stroke. The pain is most commonly musculoskeletal or related to obligatory overuse of neurologically unaffected limbs. However, neuropathic pain can result directly from the central nervous system injury. Impaired sensory discrimination can make it challenging to differentiate central neuropathic pain from other pain types or spasticity. Central neuropathic pain may also begin months to years after the injury, further obscuring recognition of its association with a past neurologic injury. This review focuses on unique clinical features that help distinguish central neuropathic pain. The most common clinical central pain syndromes-central poststroke pain, multiple sclerosis-related pain, and spinal cord injury-related pain-are reviewed in detail. Recent progress in understanding of the pathogenesis of central neuropathic pain is reviewed, and pharmacological, surgical, and neuromodulatory treatments of this notoriously difficult to treat pain syndrome are discussed.

  4. Efficacy and safety of intravitreal therapy in macular edema due to branch and central retinal vein occlusion: a systematic review.

    Directory of Open Access Journals (Sweden)

    Amelie Pielen

    Full Text Available BACKGROUND: Intravitreal agents have replaced observation in macular edema in central (CRVO and grid laser photocoagulation in branch retinal vein occlusion (BRVO. We conducted a systematic review to evaluate efficacy and safety outcomes of intravitreal therapies for macular edema in CRVO and BRVO. METHODS AND FINDINGS: MEDLINE, Embase, and the Cochrane Library were systematically searched for RCTs with no limitations of language and year of publication. 11 RCTs investigating anti-VEGF agents (ranibizumab, bevacizumab, aflibercept and steroids (triamcinolone, dexamethasone implant with a minimum follow-up of 1 year were evaluated. EFFICACY CRVO: Greatest gain in visual acuity after 12 months was observed both under aflibercept 2 mg: +16.2 letters (8.5 injections, and under bevacizumab 1.25 mg: +16.1 letters (8 injections. Ranibizumab 0.5 mg improved vision by +13.9 letters (8.8 injections. Triamcinolone 1 mg and 4 mg stabilized visual acuity at a lower injection frequency (-1.2 letters, 2 injections. BRVO: Ranibizumab 0.5 mg resulted in a visual acuity gain of +18.3 letters (8.4 injections. The effect of dexamethasone implant was transient after 1.9 implants in both indications. SAFETY: Serious ocular adverse events were rare, e.g., endophthalmitis occurred in 0.0-0.9%. Major differences were found in an indirect comparison between steroids and anti-VEGF agents for cataract progression (19.8-35.0% vs. 0.9-7.0% and in required treatment of increased intraocular pressure (7.0-41.0% vs. none. No major differences were identified in systemic adverse events. CONCLUSIONS: Anti-VEGF agents result in a promising gain of visual acuity, but require a high injection frequency. Dexamethasone implant might be an alternative, but comparison is impaired as the effect is temporary and it has not yet been tested in PRN regimen. The ocular risk profile seems to be favorable for anti-VEGF agents in comparison to steroids. Because comparative data from head

  5. [Pathological peculiarities of chronic kidney disease in patient from sub-Saharan Africa. Review of data from the Democratic Republic of the Congo]. (United States)

    Pakasa, Nestor-M; Sumaïli, Ernest-K


    Chronic kidney disease (CKD) is a major global public health problem. But kidney involvement is more common and appears more severe in Africa than in developed countries. The likely causes of end stage renal disease (ESRD) or CKD stage 3 and above in developed countries are diabetes, hypertension and less frequently glomerular diseases. In contrast, in decreasing order in Africa are glomerulopathies, hypertension and diabetes. The reasons for this preponderance of glomerular diseases are not fully known but may be linked to the persistence or reemergence of tropical diseases. This study reviews the kidney involvements more associated with common tropical diseases including HIV/AIDS. The most common HIV/AIDS lesion is a specific focal and segmental glomerulosclerosis (FSGS) termed HIV-associated nephropathy (HIV-AN). Renal complications of tropical parasites are heterogenous. Various glomerulopathies like FSGS occur during various filariasis infections. Schistosoma mansoni is responsible for membranoproliferative glomerulonephritis and amyloidosis. Human African trypanosomiasis is associated with cryoglobulinemic membranoproliferative glomerulonephritis. The Plasmodium malariae is mainly responsible for membranoproliferative glomerulonephritis. Acute patterns (acute tubular necrosis or acute postinfectious glomerulonephritis) are observed during Plasmodium falciparum infection. Several other viral, bacterial or mycobacterial infections like leprosy and tuberculosis still prevalent in Africa can also affect the kidney. Sickle cell disease is responsible for a variety of renal injuries. In conclusion, kidney lesions linked to tropical diseases partly explain the peculiar pattern of CKD of the black race and play a significant role in the current outbreak of the CKD in Subsaharan Africa.

  6. Germline and somatic genetic predictors of pathological response in neoadjuvant settings of rectal and esophageal cancers: systematic review and meta-analysis. (United States)

    Salnikova, L E; Kolobkov, D S


    Oncologists have pointed out an urgent need for biomarkers that can be useful for clinical application to predict the susceptibility of patients to preoperative therapy. This review collects, evaluates and combines data on the influence of reported somatic and germline genetic variations on histological tumor regression in neoadjuvant settings of rectal and esophageal cancers. Five hundred and twenty-seven articles were identified, 204 retrieved and 61 studies included. Among 24 and 14 genetic markers reported for rectal and esophageal cancers, respectively, significant associations in meta-analyses were demonstrated for the following markers. In rectal cancer, major response was more frequent in carriers of the TYMS genotype 2 R/2 R-2 R/3 R (rs34743033), MTHFR genotype 677C/C (rs1801133), wild-type TP53 and KRAS genes. In esophageal cancer, successful therapy appeared to correlate with wild-type TP53. These results may be useful for future research directions to translate reported data into practical clinical use.

  7. ErbB1-4-dependent EGF/neuregulin signals and their cross talk in the central nervous system: pathological implications in schizophrenia and Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Yuriko eIwakura


    Full Text Available Ligands for ErbB1-4 receptor tyrosine kinases, such as epidermal growth factor (EGF and neuregulins, regulate brain development and function. Thus, abnormalities in their signaling are implicated in the etiology or pathology of schizophrenia and Parkinson’s disease. Among the ErbB receptors, ErbB1 and ErbB4 are expressed in dopamine and GABA neurons, while ErbB1, 2, and/or 3 are mainly present in oligodendrocytes, astrocytes and their precursors. Thus, deficits in ErbB signaling might contribute to schizophrenia neuropathology stemming from these cell types. By incorporating the latest cancer molecular biology as well as our recent progress, we discuss signal cross talk between the ErbB1-4 subunits and their neurobiological functions in each cell type. The potential contribution of virus-derived cytokines (virokines that mimic EGF and neuregulin-1 in brain diseases are also discussed.

  8. {sup 18}F-FDG PET/CT in the early prediction of pathological response in aggressive subtypes of breast cancer: review of the literature and recommendations for use in clinical trials

    Energy Technology Data Exchange (ETDEWEB)

    Groheux, David [Saint-Louis Hospital, Department of Nuclear Medicine, Paris Cedex 10 (France); INSERM/CNRS UMR944/7212, University Paris-Diderot, PRES Paris Cite, Paris (France); Mankoff, David [University of Pennsylvania Perelman School of Medicine, Department of Radiology, Philadelphia (United States); Espie, Marc [INSERM/CNRS UMR944/7212, University Paris-Diderot, PRES Paris Cite, Paris (France); Saint-Louis Hospital, Department of Medical Oncology, Breast Diseases Centre, Paris (France); Hindie, Elif [University of Bordeaux, Department of Nuclear Medicine, Haut-Leveque Hospital, Bordeaux (France)


    Early assessment of response to neoadjuvant chemotherapy (NAC) might be helpful in avoiding the toxicity of ineffective chemotherapy and allowing refinement of treatment. We conducted a review of the literature regarding the applicability of {sup 18}F-FDG PET/CT to the prediction of an early pathological response in different subgroups of breast cancer. Clinical research in this field has intensified in the last few years. Early studies by various groups have shown the potential of {sup 18}F-FDG PET/CT in the early assessment of response to NAC. However, interim PET/CT in breast cancer has not yet gained wide acceptance compared to its use in other settings such as lymphomas. This is in part due to a lack of consensus that early evaluation of response can be used to direct change in therapy in the neoadjuvant breast cancer setting, and only limited data showing that response-adaptive therapy leads to improved outcomes. However, one major element that has hampered the use of {sup 18}F-FDG PET/CT in directing neoadjuvant therapy is its evaluation in populations with mixed subtypes of breast cancer. However, major improvements have occurred in recent years. Pilot studies have highlighted the need for considering breast cancer subtype and the type of treatment, and have offered criteria for the use of PET/CT for the early prediction of response in specific settings. {sup 18}F-FDG PET/CT has considerable potential for the early prediction of pathological complete response to NAC in aggressive subtypes such as triple-negative or HER2-positive breast cancers. The results of a multicentre trial that used early metabolic response on {sup 18}F-FDG PET/CT as a means to select poor responders to adapt neoadjuvant treatment have recently been published. Other trials are ongoing or being planned. (orig.)

  9. Eponyms in forensic pathology. (United States)

    Nečas, Pavel; Hejna, Petr


    The phenomenon of eponymous terms in forensic pathology is described in this paper. The authors analyzed representative textbooks (monographs) dealing with forensic pathology in both English and German and identified several eponymous terms. The paper aims to present to the reader the most important eponymous terms in forensic pathology. Included in the paper are the following terms: Beckwith's Sign, Casper's Rule, Krönlein's Shot, Lichtenberg's Figures, Nysten's Law, Paltauf's Spots, Puppe's Rule, Sehrt's Sign, Simon's Sign, Sveshnikov's Sign, Tardieu's Spots, Wischnewski Spots, Wydler's Sign. The spread of eponymous terms throughout various languages is mentioned. The linguistic basis of such terms as well as their advantages and disadvantages in specialist fields, and indeed in even wider circles, is discussed. The authors state that the main function of these terms is to facilitate the open flow of unambiguous information among scholars. Eponymous terms in forensic pathology are characteristic for the German speaking countries and for all countries influenced by the German school of forensic pathology. Their usage in the Anglo-Saxon world is much less widespread, meaning they do not occur very often in English monographs and textbooks.

  10. Cellular mesoblastic nephroma (infantile renal fibrosarcoma): institutional review of the clinical, diagnostic imaging, and pathologic features of a distinctive neoplasm of infancy

    Energy Technology Data Exchange (ETDEWEB)

    Bayindir, Petek [Ege University Medical Faculty, Department of Radiology, Izmir (Turkey); Guillerman, Robert Paul [Texas Children' s Hospital, Department of Radiology, Baylor College of Medicine, Houston, TX (United States); Hicks, M.J. [Texas Children' s Hospital, Department of Pathology, Baylor College of Medicine, Houston, TX (United States); Chintagumpala, M.M. [Texas Children' s Hospital, Department of Hematology-Oncology, Baylor College of Medicine, Houston, TX (United States)


    Cellular mesoblastic nephroma has been associated with a more aggressive course than classic mesoblastic nephroma, including local recurrences and metastases. To define the clinicopathologic and imaging features distinguishing cellular from classic mesoblastic nephroma. Retrospective review of clinical charts and imaging studies of ten children with mesoblastic nephroma from 1996 to 2007 at a large children's hospital. In six children the mesoblastic nephroma was pure cellular, in two mixed, and in two classic. The mean ages at diagnosis were 107 days for those with the cellular form, and 32 days for those with the classic form. Hypoechoic or low-attenuation regions representing necrosis or hemorrhage were found in all children with the cellular form and in none of those with the classic form. Hypertension was present in 70% and hypercalcemia in 20% of the children and resolved following nephrectomy. Two cellular tumors encased major abdominal vessels. Local recurrence and metastases occurred within 6 months of tumor resection in two children with the cellular form. Intraspinal extension and intratumoral pseudoaneurysm were seen in one child with the cellular form. The cellular tumors shared histopathologic features with infantile fibrosarcoma (IFS), and RT-PCR testing in two children with the cellular form revealed the t(12;15) ETV6-NTRK3 gene fusion common to IFS. Distinct from the classic form, cellular mesoblastic nephroma is more heterogeneous in appearance on imaging, tends to be larger and present later in infancy, and can exhibit aggressive behavior including vascular encasement and metastasis. Intraspinal extension and intratumoral pseudoaneurysm are previously unreported findings encountered in our cellular mesoblastic nephroma series. The shared histopathology and translocation gene fusion support the concept of cellular mesoblastic nephroma as the renal form of IFS. (orig.)

  11. Clinico-pathologic presentation and management of neurofibromatosis type 1(Von Recklinghausen′s disease among north-eastern Nigerians: A six year review

    Directory of Open Access Journals (Sweden)

    Y W Nyandaiti


    Full Text Available Objective: Neurofibromatosis type 1 is not an uncommon disorder, its prevalence is said to be around 1 in 2000-4000 live birth. It has diverse manifestations that may affect any part of the body and present to clinician of any specialty, however, little or no attention have been given to area of neurological, ophthalmological and auditory complications in these patients. This study is aimed at evaluating the clinical, histological presentation and to highlight the need of multi disciplinary approach in the management of this condition. Methodology: The case records of patients who presented with clinical signs and request form with histologically proven neurofibrom atosis were retrieved and reviewed from University of Maiduguri Teaching Hospital and Federal Medical Center Azare from January 2000-December 2005. The clinical characteristics, histological reports and complications were evaluated. Information such as the age, sex, site and histological diagnosis were extracted from the patient′s case notes and histology request form. Results: Forty seven patients fulfill the diagnostics criteria of the national institute of health consensus development conference NIHCDC. The age range was 10-65yrs, with the mean of 27.85yrs. There were 23 males and 24 fern ales, sixteen patients had a positive family history of sim ilar condition in a first degree relative and three are from same parents. Forty one had cutaneous fibroma (87.2% while 6 (12.8% were plexiform. Twenty-nine patients had cafe a laic lesion (61.7%, while 30(63.8% presented with axillaiy and or inguinal freckling. One of the cases presented with osseous lesion and hypertension. The commonest site of neurofibroma was the trunk 16(34%, head and face 11(23%, then the lower limb 10(21.8%. Treatment modality was mainly excision of neurofibroma. Conclusion:This study have documented that NF1 is not an uncommon disorder in this region and has no sex predilection and present commonly within the

  12. Fish Habitat Improvement Projects in the Fifteenmile Creek and Trout Creek Basins of Central Oregon: Field Review and Management Recommendations.

    Energy Technology Data Exchange (ETDEWEB)

    Kauffman, J. Boone


    A field review of stream habitat improvement project sites in the lower Deschutes River Basin was conducted by riparian ecology, fisheries, and hydrology specialists. Habitat management objectives, limiting factors, project implementation, land use history, and other factors were discussed at each site. This information, in conjunction with the reviewer`s field inspections of portions of a particular habitat project, provided the basis for this report.

  13. Medium Increased Risk for Central Sleep Apnea but Not Obstructive Sleep Apnea in Long-Term Opioid Users: A Systematic Review and Meta-Analysis (United States)

    Filiatrault, Marie-Lou; Chauny, Jean-Marc; Daoust, Raoul; Roy, Marie-Pier; Denis, Ronald; Lavigne, Gilles


    Study Objective: Opioids are associated with higher risk for ataxic breathing and sleep apnea. We conducted a systematic literature review and meta-analysis to assess the influence of long-term opioid use on the apnea-hypopnea and central apnea indices (AHI and CAI, respectively). Methods: A systematic review protocol (Cochrane Handbook guidelines) was developed for the search and analysis. We searched Embase, Medline, ACP Journal Club, and Cochrane Database up to November 2014 for three topics: (1) narcotics, (2) sleep apnea, and (3) apnea-hypopnea index. The outcome of interest was the variation in AHI and CAI in opioid users versus non-users. Two reviewers performed the data search and extraction, and disagreements were resolved by discussion. Results were combined by standardized mean difference using a random effect model, and heterogeneity was tested by χ2 and presented as I2 statistics. Results: Seven studies met the inclusion criteria, for a total of 803 patients with obstructive sleep apnea (OSA). We compared 2 outcomes: AHI (320 opioid users and 483 non-users) and 790 patients with CAI (315 opioid users and 475 non-users). The absolute effect size for opioid use was a small increased in apnea measured by AHI = 0.25 (95% CI: 0.02–0.49) and a medium for CAI = 0.45 (95% CI: 0.27–0.63). Effect consistency across studies was calculated, showing moderate heterogeneity at I2 = 59% and 29% for AHI and CAI, respectively. Conclusions: The meta-analysis results suggest that long-term opioid use in OSA patients has a medium effect on central sleep apnea. Citation: Filiatrault ML, Chauny JM, Daoust R, Roy MP, Denis R, Lavigne G. Medium increased risk for central sleep apnea but not obstructive sleep apnea in long-term opioid users: a systematic review and meta-analysis. J Clin Sleep Med 2016;12(4):617–625. PMID:26943709

  14. Review of the general geology and solid-phase geochemical studies in the vicinity of the Central Oklahoma aquifer (United States)

    Mosier, Elwin L.; Bullock, John H.


    The Central Oklahoma aquifer is the principal source of ground water for municipal, industrial, and rural use in central Oklahoma. Ground water in the aquifer is contained in consolidated sedimentary rocks consisting of the Admire, Council Grove, and Chase Groups, Wellington Formation, and Garber Sandstone and in the unconsolidated Quaternary alluvium and terrace deposits that occur along the major stream systems in the study area. The Garber Sandstone and the Wellington Formation comprise the main flow system and, as such, the aquifer is often referred to as the 'Garber-Wellington aquifer.' The consolidated sedimentary rocks consist of interbedded lenticular sandstone, shale, and siltstone beds deposited in similar deltaic environments in early Permian time. Arsenic, chromium, and selenium are found in the ground water of the Central Oklahoma aquifer in concentrations that, in places, exceed the primary drinking-water standards of the Environmental Protection Agency. Gross-alpha concentrations also exceed the primary standards in some wells, and uranium concentrations are uncommonly high in places. As a prerequisite to a surface and subsurface solid-phase geochemical study, this report summarizes the general geology of the Central Oklahoma study area. Summaries of results from certain previously reported solid-phase geochemical studies that relate to the vicinity of the Central Oklahoma aquifer are also given; including a summary of the analytical results and distribution plots for arsenic, selenium, chromium, thorium, uranium, copper, and barium from the U.S. Department of Energy's National Uranium Resource Evaluation (NURE) Program.

  15. Detection of bacterial antigens and Alzheimer’s disease-like pathology in the central nervous system of BALB/c mice following intranasal infection with a laboratory isolate of Chlamydia pneumoniae

    Directory of Open Access Journals (Sweden)

    Christopher Scott Little


    Full Text Available Pathology consistent with that observed in Alzheimer’s disease (AD has previously been documented following intranasal infection of normal wild-type mice with Chlamydia pneumoniae (Cpn isolated from an AD brain (96-41. In the current study, BALB/c mice were intranasally infected with a laboratory strain of Cpn, AR-39, and brain and olfactory bulbs were obtained at 1-4 months post-infection (pi. Immunohistochemistry for amyloid beta or Cpn antigens was performed on sections from brains of infected or mock-infected mice. Chlamydia-specific immunolabeling was identified in olfactory bulb tissues and in cerebrum of AR-39 infected mice. The Cpn specific labeling was most prominent at 1 month pi and the greatest burden of amyloid deposition was noted at 2 months pi, whereas both decreased at 3 and 4 months. Viable Cpn was recovered from olfactory bulbs of 3 of 3 experimentally infected mice at 1 and 3 months pi, and in 2 of 3 mice at 4 months pi. In contrast, in cortical tissues of infected mice at 1 and 4 months pi no viable organism was obtained. At 3 months pi, only 1 of 3 mice had a measurable burden of viable Cpn from the cortical tissues. Mock-infected mice (0 of 3 had no detectable Cpn in either olfactory bulbs or cortical tissues. These data indicate that the AR-39 isolate of Cpn establishes a limited infection predominantly in the olfactory bulbs of BALB/c mice. Although infection with the laboratory strain of Cpn promotes deposition of amyloid beta, this appears to resolve following reduction of the Cpn antigen burden over time. Our data suggest that infection with the AR-39 laboratory isolate of Cpn results in a different course of amyloid beta deposition and ultimate resolution than that observed following infection with the human AD-brain Cpn isolate, 96-41. These data further support that there may be differences, possibly in virulence factors, between Cpn isolates in the generation of sustainable AD pathology.

  16. Next-Generation Pathology. (United States)

    Caie, Peter D; Harrison, David J


    The field of pathology is rapidly transforming from a semiquantitative and empirical science toward a big data discipline. Large data sets from across multiple omics fields may now be extracted from a patient's tissue sample. Tissue is, however, complex, heterogeneous, and prone to artifact. A reductionist view of tissue and disease progression, which does not take this complexity into account, may lead to single biomarkers failing in clinical trials. The integration of standardized multi-omics big data and the retention of valuable information on spatial heterogeneity are imperative to model complex disease mechanisms. Mathematical modeling through systems pathology approaches is the ideal medium to distill the significant information from these large, multi-parametric, and hierarchical data sets. Systems pathology may also predict the dynamical response of disease progression or response to therapy regimens from a static tissue sample. Next-generation pathology will incorporate big data with systems medicine in order to personalize clinical practice for both prognostic and predictive patient care.

  17. Pathological Gambling Subtypes (United States)

    Vachon, David D.; Bagby, R. Michael


    Although pathological gambling (PG) is regarded in the 4th edition of the "Diagnostic and Statistical Manual of Mental Disorders" (American Psychiatric Association, 1994) as a unitary diagnostic construct, it is likely composed of distinct subtypes. In the current report, the authors used cluster analyses of personality traits with a…

  18. 原发性中枢神经系统淋巴瘤的MRI影像诊断及病理特点%MRI Diagnosis of Primary Central Nervous System Lymphomas and Pathological Features

    Institute of Scientific and Technical Information of China (English)

    刘玲; 肖家和; 魏懿; 杨雯娟


    Purpose To evaluate MRI manifestations of PCNSL in immunocompetent patients, so as to improve MRI diagnostic accuracy of PCNSL.Materials and Methods The MRI and pathological findings in 23 patients with confirmed PCNSL were retrospectively analyzed.Results 41 lesions were identified in 23 patients, 16(69.6%) patients with solitary tumor focus and the other 7(30.4%)presenting a multifoeal form up to 25 lesions.39 of 41 lesions located at supratentorial brain, the other two at infratentorial brain.The most frequent locations were the cerebral hemispheres, the corpus callosum and periventricular white matter.78.1 % (32/41)lesions with isointense or hypointense on T1-weighted images and isointense or slightly hypointense on T2-weighted images were detected.All lesions showed no "blood flow".70.7%(29/41)lesions were found with obvious homogenous enhancement, typical with "incision sign" and "angular sign", especially for those lesions adjacent to the subarachnoid space.9.6% (4/41)lesions showed microcystic foci and "ring sign" after gadolinium enjection.All the 23 patients were pathologically diagnosed as B cell lymphoma, one of whom as Burkitt lymphoma, the other 22 as diffuse larger B-cell lymphoma.Under light microscope, the tumor cells were diffusely distributed and roughly same-sized with less cytoplasm and enlarged nucleus, infiltrating into the circumference of the vessels.The tumor was rich in fibers and showed no hemorrhage, necrosis or calcification.Conclusion Conventional MRI plays an important role in making accurate diagnosis in most patients with PCNSL.The MRI features of PCNSL base on its pathological characteristics and final diagnosis of the entity depends on pathology.%目的:分析免疫力正常患者的原发性中枢神经系统淋巴瘤(PCNSL)的MRI特征,提高对该病的术前影像诊断.材料和方法:回顾性分析23例经病理证实的PCNSL的MRI资料和病理资料.结果:23例PCNSL中,单发16例(69.6%),多发7例(30.4%),

  19. Does standardised structured reporting contribute to quality in diagnostic pathology? The importance of evidence-based datasets. (United States)

    Ellis, D W; Srigley, J


    Key quality parameters in diagnostic pathology include timeliness, accuracy, completeness, conformance with current agreed standards, consistency and clarity in communication. In this review, we argue that with worldwide developments in eHealth and big data, generally, there are two further, often overlooked, parameters if our reports are to be fit for purpose. Firstly, population-level studies have clearly demonstrated the value of providing timely structured reporting data in standardised electronic format as part of system-wide quality improvement programmes. Moreover, when combined with multiple health data sources through eHealth and data linkage, structured pathology reports become central to population-level quality monitoring, benchmarking, interventions and benefit analyses in public health management. Secondly, population-level studies, particularly for benchmarking, require a single agreed international and evidence-based standard to ensure interoperability and comparability. This has been taken for granted in tumour classification and staging for many years, yet international standardisation of cancer datasets is only now underway through the International Collaboration on Cancer Reporting (ICCR). In this review, we present evidence supporting the role of structured pathology reporting in quality improvement for both clinical care and population-level health management. Although this review of available evidence largely relates to structured reporting of cancer, it is clear that the same principles can be applied throughout anatomical pathology generally, as they are elsewhere in the health system.

  20. 原发性骨平滑肌肉瘤的临床、影像学和病理分析及文献复习%Clinical, imaging and pathological analysis of primary leiomyosarcoma of bone and literature review

    Institute of Scientific and Technical Information of China (English)

    高振华; 尹军强; 孟悛非


    目的 分析原发性骨平滑肌肉瘤(PLB)的临床、影像学和病理学表现.方法 回顾性分析6例PLB的临床资料,结合1980-2010年相关国内文献,观察其临床、影像学表现和病理学特点.结果 6例PLB中,病变位于胫骨上段2例,股骨下段1例,股骨干1例,肱骨远端1例,骶骨1例,均未见骨膜新生骨;4例表现为边界不清的溶骨性骨质破坏,2例表现为边界较清的囊状骨质破坏;3例MR T1WI呈等信号,T2WI稍高信号,增强扫描有明显强化;免疫组化Vim、Actin和SMA均阳性,S-100阴性.复习文献中的53例PLB,单骨受累50例,多骨受累3例;39例有X线片资料,37例可见边界不清的溶骨性骨质破坏,2例见边界较清的囊状骨质破坏,其中2例可见病理性骨折伴骨膜新生骨.结论 PLB罕见,多表现为单骨溶骨性骨质破坏,无骨膜新生骨,但其临床和影像学表现并不典型,术前诊断需要依赖免疫组化.%To investigate the clinical, imaging and pathological features of primary leiomyosarcoma of bone (PLB). Methods Totally 6 patients with PLB were collected. The clinical manifestations, imaging findings and pathologic appearances in 6 cases with PLB were retrospectively analyzed and the domestic related literatures from 1980 to 2010 were reviewed. Results Of 6 patients, the tumor located in upper tibia (2 cases) , lower femur (1 case) , femoral shaft (1 case) , distal humerus (1 case) and sacrum (1 case). There was no periosteal new bone formation in all 6 cases. Ill-defined osteo-lytic destruction was detected in 4 patients, while well-defined cystic destruction was found in the other 2 patients. The tumors showed iso-intensity signal on T1WI, hyper-intensity signal on T2WI and obvious enhancement after injection of Gd-DTPA. Immunohistochemically, all tumors reacted positively with Vim, Actin and SMA, but the S-100 were negative. Reviewing domestic literatures, 53 cases of PLB were analyzed, 50 involved single bone and 3


    Directory of Open Access Journals (Sweden)



    Full Text Available The modern data on the lipofuscin role in the processes of intracellular exchange have been analysed in the review. The ambiguity of the interpretation of lipofuscin accumulation according to its importance in involutive and pathological processes has been considered in the study. Nowadays there are no data of morphological character, which allow objectively (in a digital equivalent to find out the solution of the question about the functional importance of lipofuscin during the ageing of an organism or development of pathological processes.

  2. Pathologic approach to spinal cord infections. (United States)

    Tihan, Tarik


    The pathologic evaluation of spinal cord infections requires comprehensive clinical, radiological, and laboratory correlation, because the histologic findings in acute, chronic, or granulomatous infections rarely provide clues for the specific cause. This brief review focuses on the pathologic mechanisms as well as practical issues in the diagnosis and reporting of infections of the spinal cord. Examples are provided of the common infectious agents and methods for their diagnosis. By necessity, discussion is restricted to the infections of the medulla spinalis proper and its meninges, and not bone or soft tissue infections.

  3. Severe osteolysis and soft tissue mass around total hip arthroplasty: Description of four cases and review of the literature with respect to clinico-radiographic and pathologic differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Fabbri, N., E-mail: [Orthopedic Surgery, Istituto Ortopedico Rizzoli, Bologna (Italy); Rustemi, E.; Masetti, C.; Kreshak, J. [Orthopedic Surgery, Istituto Ortopedico Rizzoli, Bologna (Italy); Gambarotti, M. [Department of Surgical Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Vanel, D. [Department of Radiology, Istituto Ortopedico Rizzoli, Bologna (Italy); Toni, A.; Mercuri, M. [Orthopedic Surgery, Istituto Ortopedico Rizzoli, Bologna (Italy)


    Periprosthetic osteolysis is a well known phenomenon caused by wear particle-induced bone resorption, particularly common and extensively reported in total hip arthroplasty. Its typical radiographic feature is a radiolucent area adjacent to an implant, sometimes associated with a soft tissue mass. Osteolytic changes may be caused by numerous other pathologic processes, including infection, metabolic disease, and neoplasia. Four cases of massive periprosthetic bone destruction associated with a large soft tissue mass around a failed total hip replacement are presented. In three cases, a diagnosis of periprosthetic osteolysis was correctly made and managed by revision surgery. However, in one case angiosarcoma of the ipsilateral hemipelvis went long unrecognized despite aggressive clinical course, requiring hind-quarter amputation and ultimately resulting in the patient's death. Periprosthetic malignancy in the form of either primary sarcoma or metastatic cancer is a very rare yet reported event in the setting of previous hip replacement, likely leading to catastrophic consequences when diagnosis is not established in a timely manner. The differential diagnosis of periprosthetic osteolysis should consider the entire spectrum of conditions that can present with radiolucent changes. Thorough review of patient's history and course of symptoms, along with careful evaluation of standard roentgenograms should be always performed and possibly integrated with imaging modalities such as CT, MRI, and bone scintigraphy in order to increase diagnostic accuracy. If uncertainty remains, biopsy should always be considered to rule out malignancy.

  4. A Review of the Comparative Anatomy, Histology, Physiology and Pathology of the Nasal Cavity of Rats, Mice, Dogs and Non-human Primates. Relevance to Inhalation Toxicology and Human Health Risk Assessment. (United States)

    Chamanza, R; Wright, J A


    There are many significant differences in the structural and functional anatomy of the nasal cavity of man and laboratory animals. Some of the differences may be responsible for the species-specific nasal lesions that are often observed in response to inhaled toxicants. This paper reviews the comparative anatomy, physiology and pathology of the nasal cavity of the rat, mouse, dog, monkey and man, highlighting factors that may influence the distribution of nasal lesions. Gross anatomical variations such as turbinate structure, folds or grooves on nasal walls, or presence or absence of accessory structures, may influence nasal airflow and species-specific uptake and deposition of inhaled material. In addition, interspecies variations in the morphological and biochemical composition and distribution of the nasal epithelium may affect the local tissue susceptibility and play a role in the development of species-specific nasal lesions. It is concluded that, while the nasal cavity of the monkey might be more similar to that of man, each laboratory animal species provides a model that responds in a characteristic and species-specific manner. Therefore for human risk assessment, careful consideration must be given to the anatomical differences between a given animal model and man.

  5. A review of the genus Agapetus Curtis (Trichoptera: Glossosomatidae) in eastern and central North America, with description of 12 new species (United States)

    Etnier, David A.; Parker, Charles R.; Baxter, John T.; Long, Todd M.


    Twenty-nine species of caddisflies in the genus Agapetus Curtis in eastern and central North America are reviewed. Twelve are described as new species: Agapetus aphallus (known only from females); Agapetus baueri, Agapetus flinti, Agapetus harrisi, Agapetus hesperus, Agapetus ibis, Agapetus kirchneri, Agapetus meridionalis, Agapetus pegram, Agapetus ruiteri, Agapetus stylifer, and Agapetus tricornutus. Agapetus rossi Denning 1941 is recognized as a junior subjective synonym of Agapetus walkeri (Betten and Mosely 1940), new synonym. A key to males is provided, and species’ distributions are mapped.

  6. Pathology informatics fellowship training: Focus on molecular pathology

    Directory of Open Access Journals (Sweden)

    Diana Mandelker


    Full Text Available Background: Pathology informatics is both emerging as a distinct subspecialty and simultaneously becoming deeply integrated within the breadth of pathology practice. As specialists, pathology informaticians need a broad skill set, including aptitude with information fundamentals, information systems, workflow and process, and governance and management. Currently, many of those seeking training in pathology informatics additionally choose training in a second subspecialty. Combining pathology informatics training with molecular pathology is a natural extension, as molecular pathology is a subspecialty with high potential for application of modern biomedical informatics techniques. Methods and Results: Pathology informatics and molecular pathology fellows and faculty evaluated the current fellowship program′s core curriculum topics and subtopics for relevance to molecular pathology. By focusing on the overlap between the two disciplines, a structured curriculum consisting of didactics, operational rotations, and research projects was developed for those fellows interested in both pathology informatics and molecular pathology. Conclusions: The scope of molecular diagnostics is expanding dramatically as technology advances and our understanding of disease extends to the genetic level. Here, we highlight many of the informatics challenges facing molecular pathology today, and outline specific informatics principles necessary for the training of future molecular pathologists.

  7. Sub-tidal benthic habitats of central San Francisco Bay and offshore Golden Gate area: a review (United States)

    Greene, H. Gary; Endris, Charles; Vallier, Tracy; Golden, Nadine E.; Cross, Jeffery; Ryan, Holly F.; Dieter, Bryan; Niven, Eric; Barnard, P.L.; Jaffee, B.E.; Schoellhamer, D.H.


    Deep-water potential estuarine and marine benthic habitat types were defined from a variety of new and interpreted data sets in central San Francisco Bay and offshore Golden Gate area including multibeam echosounder (MBES), side-scan sonar and bottom grab samples. Potential estuarine benthic habitats identified for the first time range from hard bedrock outcrops on island and mainland flanks and some Bay floor

  8. Clinical Pathological Analysis and Literature Review of Papillary Renal Cell Carcinoma%乳头状肾细胞癌临床病理分析并文献复习

    Institute of Scientific and Technical Information of China (English)

    王海艳; 吴永芳; 张博; 许春伟; 邵云; 李晓兵; 刘甲子


    Objective To investigate and discuss the clinical pathological features,diagnosis and differential diagnosis, treatment and prognosis of papillary renal cell carcinoma.Methods Clinical pathological and immunohistochemical features of 9 cases of papillary renal cell carcinoma were compared,and the review of the literatures were analyzed.Results 9 cases of papil-lary renal cell carcinoma had similar histology shape,these tumors had no envelope,and infiltrating growth.The tumor cells had e-osinophilic or basophilous cytoplasm,and had papillary,papillary-bridge or papillary-solid architecture.Foam cells were seen in some papillary cores and stroma.Immunohistochemically, the tumor cells universally showed positive immunostaining for CK, EMA,CD10,Vimentin.Conclusion Papillary renal cell carcinoma is relatively rare in renal epithelial tumors,whose incidence is less than 15%,their typical histology shape and immunohistochemistry staining are helpful for diagnosis and differential diagno-sis.%目的:探讨乳头状肾细胞癌的临床病理特征、诊断及鉴别诊断、治疗方法和预后。方法对9例乳头状肾细胞癌的临床病理和免疫组织化学特点进行分析对比,并结合相关文献复习。结果9例肾乳头状肾细胞癌组织学形态相似,癌瘤无包膜,呈浸润性生长,癌细胞胞质嗜酸性和(或)嗜碱性,并呈乳头状、乳头小梁状或乳头实体状排列,乳头有纤维血管轴心,轴心内易见泡沫细胞。免疫组化结果显示,癌细胞CK、EMA、CD10、Vimentin普遍呈阳性。结论乳头状肾细胞癌在肾上皮性肿瘤中相对少见,发生率不足15%,根据其典型的组织学形态并结合免疫组织化学染色有助于诊断及鉴别诊断。

  9. 氧化应激与阿尔茨海默病:病理学与治疗学综述%Oxidative stress and Alzheimer disease:A pathological and therapeutic review

    Institute of Scientific and Technical Information of China (English)

    孙振令; 蒋圣娟


    BACKGROUND: Alzheimer disease(AD) is a kind of neuro-degenerativediseases. The pathogenesis that leads to AD is still unclear.OBJECTIVE: To analyze the relationship between oxidative stress and ADand the implications for therapy.DESIGN: Relevant literature analysis.SETTING and PARTICIPANTS: Reviewed the relationship between oxidative stress and AD from reports in relevant journals, and treatment effects by traditional Chinese medicine for those patients.medicine.MAIN OUTCOME MEASURES: Oxidative stress in the pathology of AD;approaches in the treatment of AD by traditional Chinese medicine.RESULTS: The role of oxidative stress played in the pathology of AD and relevant therapeutic approaches against oxidative stress including those practiced in traditional Chinese medicine were discussed in biomedical literature of recent years.CONCLUSION: Oxidative stress is an important factor that leads to AD.Antioxidants and multiple-component formula pertinent to antioxidants in traditional Chinese medicine are promising to be developed into drugs against AD.%背景:在神经退行性疾病中,阿尔茨海默病的发病机制尚不十分清楚.目的:分析氧化应激与阿尔茨海默病的关系及其在治疗上的作用.设计:相关文献分析.地点和对象:综述若干相关杂志中氧化应激与阿尔茨海默病的发病的关系,及患者采用中医治疗后的效果.干预:①抗氧化剂.②中医中药治疗.主要观察指标:阿尔茨海默病病理过程中的氧化应激,中医药治疗阿尔茨海默病新方法.结果:近年的生物医学文献中探讨了氧化应激在阿尔茨海默病的致病过程中的作用以及相应的治疗对策,尤其是中医药在这一领域的研究成果颇多.结论:氧化应激是导致阿尔茨海默病的一种重要致病因素,抗氧化剂和一些有关的中药复方有望成为有效治疗阿尔茨海默病的药物.

  10. Feline oral pathology


    Costa, S.; Pais, B.; Almeida, D.; Simões, J.; Mega, A. C.; Vala, Helena


    The main pathologies of the oral cavity are of utmost importance, not only by the number of exposed individuals, but also by the consequences which stems. With the development of this work, we intend to conduct a brief approach to the same, since, specifically affecting domestic felines. Feline Lymphoplasmatic Gingivostomatitis (GELF), the Feline Odontoclastic Reabsorption Lesions (LROF) Complex and gingivitis-stomatitis-pharyngitis, have been studied, some of which are considered an enigma i...

  11. Arson in review. From profit to pathology. (United States)

    Geller, J L


    Arson is a crime committed by thousands of people throughout our nation for nearly every reason, justification or excuse known to mankind ... Arson is one of the easiest crimes to commit but the hardest to prevent or prove ... Arson is a crime which involves little skill, as the weapon used is legally carried and too readily available ... Unlike many other covert criminal activities, the impact of increased major arsons has a direct visible effect on the lives of the average citizen. Insurance premiums are raised, property is destroyed, people are killed or maimed, and the quality of life in the area affected by arson is diminished considerably. These statements, taken from US Senate hearings on arson in the late 1970s, are as true and as troubling today as they were over a decade ago. Many who set fires need mental health services of some kind, a fact alluded to even in popular literature. Dick Francis, a well-known author of British mysteries, writes, "There are people in this world who cause trouble because it makes them feel important. They're ineffectual, eh? in their lives. So they burn things ..." But nobody wants these arsonists in their midst. Psychiatric facilities do not want them so they end up in prison: Yet another case has been reported of a mentally disordered person being sent to prison because there is no other institution willing to receive her ... a severely mentally disordered woman aged 22 [was sentenced] to life imprisonment for arson ... in default of other appropriate facilities ... to protect the public. And general hospital emergency rooms cannot find anyplace to send them: "The hardest patients to sell are the repeaters with bad reputations, the firesetters and those who are potentially violent." Any arson episode is an act the magnitude of which the perpetrator cannot predict accurately. Once set, the fire is no longer responsive to the desires or dictates of the firesetter. To address the problem of arson in our times, arson investigators for law enforcement agencies and for insurance companies, fire chiefs, and mental health professionals must develop a joint commitment to public education, cooperative plans for prevention and intervention, and a shared research agenda.(ABSTRACT TRUNCATED AT 400 WORDS)

  12. Hygrothermal behavior, building pathology and durability

    Energy Technology Data Exchange (ETDEWEB)

    Peixoto de Freitas V.; Delgado, J.M.P.Q. (eds.) [Porto Univ. (Portugal). Building Physics Lab.


    Includes a set of new developments in the field of building physics and hygrothermal behavior. Presents a new durability approach for historical and old buildings. Reviews the current state of knowledge. The main purpose of this book, Hygrothermal, Building Pathology and Durability, is to provide a collection of recent research works to contribute to the systematization and dissemination of knowledge related to construction pathology, hygrothermal behaviour of buildings, durability and diagnostic techniques and, simultaneously, to show the most recent advances in this domain. It includes a set of new developments in the field of building physics and hygrothermal behaviour, durability approach for historical and old buildings and building pathology vs. durability. The book is divided in several chapters that are a resume of the current state of knowledge for benefit of professional colleagues, scientists, students, practitioners, lecturers and other interested parties to network.

  13. Masochism and pathological gambling. (United States)

    Rosenthal, Richard J


    That all pathological gamblers have an "unconscious wish to lose," an idea first expressed by Freud and Bergler, is neither true nor useful; wrong as well, however, are the reasons for neglecting masochism in relation to gambling. There is a small but clinically significant subgroup of pathological gamblers who are masochistic. I present clinical vignettes and a more extended treatment account to illustrate its importance. Masochism has been a confusing concept. As used here it refers to the deliberate seeking of pain, loss, suffering, or humiliation. There may be pleasure in pain, or an obligatory combining of pleasure and pain. A sense of power and control may be achieved through suffering. The case material illustrates clinically useful types (sexual masochism, masochistic personality disorder, moral masochism, relational masochism) as well as some common masochistic dynamics encountered in the treatment of pathological gamblers. These masochistic patterns are often identifiable during the initial evaluation. Distinguishing features may include a reversal of normal attitudes about winning and losing, the absence of an early winning phase, sometimes a memorable early loss. Gamblers may sabotage opportunities for success or create unnecessary obstacles for themselves. Losing may be more comfortable than winning or may be overtly sexualized.

  14. Highly Aggressive HPV-related Oropharyngeal Cancer: Clinical, Radiologic, and Pathologic Characteristics (United States)

    Kaka, Azeem S.; Kumar, Bhavna; Kumar, Pawan; Wakely, Paul E.; Kirsch, Claudia M.; Old, Matthew O.; Ozer, Enver; Agrawal, Amit; Carrau, Ricardo E.; Schuller, David E.; Siddiqui, Farzan; Teknos, Theodoros N.


    Objectives While the majority of HPV+ oropharyngeal squamous cell carcinomas have a favorable prognosis, we search for markers of poor prognosis by carefully examining a subset of highly-aggressive cases. Study Design Seven patients with HPV+ oropharyngeal cancer who presented with non-pulmonary distant metastasis or developed distant metastasis post-treatment were identified. Eight control cases were chosen which responded well to treatment. Pathology and radiological studies were reviewed and compared. Results Two cases displayed a small cell carcinoma (SmCC) component upon pathologic review. Biomarker analysis revealed lower expression of NOTCH1 in the aggressive cohort in comparison to controls (p=0.04). Cases showed a predominance of clustering of lymph nodes, extracapsular spread and central tumor necrosis. Conclusion While most HPV-related oropharyngeal cancers display a positive prognosis, it is evident that there is a subset, which behave more aggressively. This early investigation identifies pathologic and radiologic features that may help to predict this behavior. PMID:23770280

  15. Isolated angiitis of the central nervous system with tumor-like lesion, mimicking brain malignant glioma: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Li Guilin


    Full Text Available Abstract Background Isolated angiitis of the central nervous system (IACNS is a rare but severe vascular disease, which could present like an isolated inflammatory lesion on magnetic resonance imaging (MRI. To date, only a few such cases with tumor-like IACNS have been reported. Case Presentation A 35-year-old woman presented with headache and left-sided weakness. MRI scans initially mislead us to a diagnosis of glioblastoma (GBM. Surgery was performed. The mass was sub-totally resected. Pathological examination confirmed a cerebral vasculitis. Radiological features, such as disproportionate mass effect, striped hemorrhage and abnormal enhancement of adjacent vessels, could be helpful to distinguish a tumor-like IACNS from a GBM. Single therapy with high doses of steroid did not improve the patient's condition. Combined therapy with prednisolone and cyclophosphamide showed great benefit to the patient. No relapse occurred during the period of 18 months follow-up. Conclusions Although a tumor-like IACNS has no established imaging features, a diagnosis of tumor-like IACNS should be suspected when MRI shows inappropriate presentations of a tumor. Greater awareness of this potential manifestation of IACNS may facilitate more prompt diagnosis and treatment.

  16. A Systematic Review of Peripheral and Central Nervous System Involvement of Rheumatoid Arthritis, Systemic Lupus Erythematosus, Primary Sjögren’s Syndrome, and Associated Immunological Profiles

    Directory of Open Access Journals (Sweden)

    Anastasia Bougea


    Full Text Available Both central (CNS and peripheral nervous system (PNS complications are frequent and varied in connective tissue diseases. A systematic review was conducted between 1989 and 2014 in the databases Medline, Scopus, and Cochrane Library using the search terms, peripheral and central nervous complications and immunological profiles, to identify studies in specific connective tissue disorders such as rheumatoid arthritis, systemic lupus erythematosus, and primary Sjögren’s syndrome. A total of 675 references were identified, of which 118 were selected for detailed analysis and 22 were included in the final review with a total of 2338 participants. Our search focused only on studies upon connective tissue disorders such as rheumatoid arthritis, systemic lupus erythematosus, and primary Sjögren’s syndrome associated with seroimmunological data. The reported prevalence of CNS involvement ranges from 9 to 92% across the reported studies. However, the association between CNS and PNS manifestations and seroimmunological profiles remains controversial. Τo date, no laboratory test has been shown as pathognomonic neither for CNS nor for PNS involvement.

  17. Alteration in the etiology of penile fracture in the Middle East and Central Asia regions in the last decade; a literature review

    Directory of Open Access Journals (Sweden)

    Ahmad A Majzoub


    Full Text Available Penile fracture is a well-recognized, relatively uncommon medical condition and its etiology differs according to geographic area. In this review article, we evaluated literature reported in the past decade, aiming to verify whether there has been any change in the etiology of this condition. A literature review was done for studies published in the past 10 years and focusing on the etiology of penile fracture. Inclusion criteria comprised articles in English language, of sample size more than 10 patients and originating from the Middle East and Central Asia. Data relating to the studied population, etiology of penile fracture, clinical presentation, investigations, management, and outcome was analyzed. One thousand six hundred and twenty-nine patients from 21 original articles were included in the study. The mean age ΁ standard deviation of the patients was 33.3 ΁ 3.23 years. Etiologies of penile fracture were vigorous sexual intercourse, manual bending of erect penis, vigorous masturbation, rolling over in bed and blunt trauma in 41%, 29%, 10%, 14% and 6% patients, respectively. Treatment choices were surgery and conservative, in 1580 (95%, 83 (5% patients, respectively. A higher incidence of complications was found in conservatively treated patients. As a conclusion, in the last 10 years, vigorous sexual intercourse was the commonest etiology of penile fracture in the Middle East and Central Asia regions. Surgery remains the preferred treatment option for patients diagnosed with penile fracture.

  18. Cortical myoclonus and cerebellar pathology

    NARCIS (Netherlands)

    Tijssen, MAJ; Thom, M; Ellison, DW; Wilkins, P; Barnes, D; Thompson, PD; Brown, P


    Objective To study the electrophysiologic and pathologic findings in three patients with cortical myoclonus. In two patients the myoclonic ataxic syndrome was associated with proven celiac disease. Background: The pathologic findings in conditions associated with cortical myoclonus commonly involve

  19. Central venous catheter-related bacteremia caused by Kocuria kristinae: Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    David Michael Z


    Full Text Available Abstract Kocuria species are unusual human pathogens isolated most commonly from immunocompromised hosts, such as transplant recipients and cancer patients undergoing chemotherapy, or from patients with chronic medical conditions. A case of catheter-related bacteremia with pulmonary septic emboli in a pregnant adult female without chronic medical conditions is described. A review of other reported Kocuria infections is provided.

  20. Central African Republic Public Expenditure Review : Creating Fiscal Space to Transition Out of Fragility Through Growth and Poverty Reduction


    World Bank


    This public expenditure review (PER) aims to assist the government in its efforts to achieve a transition out of fragility through growth and development. Higher and sustained per capita real gross domestic product (GDP) growth to raise the income of the population and create employment is needed to reduce poverty and lower the risk of reversion to conflict. Significant productive investme...

  1. Pathology Gross Photography: The Beginning of Digital Pathology. (United States)

    Rampy, B Alan; Glassy, Eric F


    The underutilized practice of photographing anatomic pathology specimens from surgical pathology and autopsies is an invaluable benefit to patients, clinicians, pathologists, and students. Photographic documentation of clinical specimens is essential for the effective practice of pathology. When considering what specimens to photograph, all grossly evident pathology, absent yet expected pathologic features, and gross-only specimens should be thoroughly documented. Specimen preparation prior to photography includes proper lighting and background, wiping surfaces of blood, removing material such as tubes or bandages, orienting the specimen in a logical fashion, framing the specimen to fill the screen, positioning of probes, and using the right-sized scale.

  2. Reviews (United States)


    WEB WATCH (204) Try unearthing some interesting information about archaeology BOOK REVIEWS (206) Teaching and assessing practical skills Book Review: Learn to drive with Sir Isaac Newton DVD REVIEW (207) Bring some sunshine into the classroom EQUIPMENT REVIEWS (208) Robust air puck takes a kicking Flowlog offers sensing options plus multimode datalogging Mastering Chladni figures takes practice but it offers surprises

  3. Imaging and pathological findings of AIDS complicated by pulmonary Rhodococcus equi infection

    Institute of Scientific and Technical Information of China (English)

    LI Hong-jun; CHENG Jing-liang


    Background Rhodococcus equi (R.equi) infection commonly occurs in grazing areas,especially in patients with AIDS or with T-lymphocyte immuno-deficiencies. Literature reviews revealed that cases radiologically and pathologically diagnosed of AIDS complicated by R. equi infection are rare. This study aimed to investigate the imaging features and pathological basis of AIDS complicated by pulmonary R. equi infection.Methods A total of 13 cases of AIDS complicated by pulmonary R. equi infection were retrospectively analyzed based on their imaging,bacterial culture and pathological data,including 10 cases by chest CT scanning and X-ray radiology and 3 cases by only X-ray radiology. All 13 cases were definitely diagnosed by bacterial culture,including one by CT-guided pulmonary puncture with following H&E staining and periodic acid-Schiff (PAS) staining for diagnostic biopsy and another one by bronchial biopsy with following H&E staining and PAS staining for pathological diagnosis. The imaging findings and the pathological findings of AIDS complicated by pulmonary R. equi infection were compared and evaluated.Results Totally 9 subjects (70%) had radiological demonstrations of central ball liked high density shadows in unilateral pulmonary hilus areas;10 (77%),cavities and liquefied levels;3 (23%),pleural effussion. The foci were found in pulmonary inner zone in 10 subjects (77%) and in pulmonary outer zone in one subject (7%). The pathological findings included intra-alveolar hemorrhage,lymphocyte infiltration and granulation tissue proliferation,which were in line with the pathological process of necrotic pneumonia. After 8-month follow-up of anti-R. equi therapy of these 13 cases,9 cases had obviously decreased or shrunk pulmonary cavities,one died,one missed follow-up,one completely absorbed foci and one did not receive reexaminations.Conclusions The radiological demonstrations of AIDS complicated by pulmonary R. equiinfection are central ball liked high density areas

  4. Twenty-Year Outcome Following Central Duct Resection for Bloody Nipple Discharge (United States)

    Nelson, R Scott; Hoehn, James L.


    Background: Patients found with pathologic nipple discharge present a diagnostic dilemma to surgeons. No one diagnostic test, including cytology or radiologic imaging, has proved superior to any other in the differentiation of benign versus malignant sources of pathologic nipple discharge. Ductoscopy has been introduced as a way to assist with identification of potential sources of pathologic nipple discharge. Ductoscopy is also useful in the resection of deep or peripheral masses that may be missed with standard blind resection. This report evaluates the risk of missed malignancy following central duct resection (CDR). Methods: Records of 56 patients who underwent CDR for pathologic nipple discharge greater than 15 years previous were reviewed. Data including type of nipple discharge, future biopsy, and pathology reports were all examined. Results: Of the 56 patients, 36 had bloody, 18 serous, and 2 green initial discharges. Fifty-seven percent were found to have intraductal papilloma as the source of discharge, with fibrocystic disease and ductal ectasia providing the next most common causes. One woman was found to have ductal cancer and one lobular carcinoma in situ at time of CDR. Patients were followed for a mean period of 22 years. Fourteen women required future biopsy. Of these, 10 had benign disease and 4 had cancer, 3 on the ipsilateral side. The 3 women with breast cancer were 9, 13, and 17 years from initial resection. Conclusions: CDR for pathologic nipple discharge is an effective way to diagnose and treat pathologic nipple discharge without missing underlying cancers. PMID:16552204

  5. Osteosarcoma of Mandible: Report of Two Cases with Review of Literature Oral and Maxillofacial Pathology Journal, July-December 2015;6(2:625-627 625 OMPJ Osteosarcoma of Mandible: Report of Two Cases with Review of Literature

    Directory of Open Access Journals (Sweden)

    P Wankhedkar Divyesh


    Full Text Available Primary neoplasms of human skeleton are rare, accounting for 0.2% of overall human tumor burden. Osteosarcoma (OS accounts for 15 to 35% of all primary bone tumors, in jaw bones, it is even, rarer representing 4 to 8% of all OS . Peak incidence for jaw OS is in 3rd to 4th decades while in long bones, it shows a bimodal age distribution. It may occur inside the bones (in the intramedullary or intracortical compartment, on the surfaces of bones and in extraosseous sites. Dental professionals may be first to detect jaw OS in their initial stages. Regardless of the favorable biologic behavior, the patients of jaw OS usually exhibit advanced tumor as it often goes unnoticed thus it is important for early diagnosing this lesion. Here, we report 2 cases of OS with different histological subtypes (chrondro - blastic and osteoblastic and review of literature

  6. Could the 2012 Drought in Central U.S. Have Been Anticipated? A Review of NASA Working Group Research (United States)

    Wang, S.-Y. Simon; Barandiaran, Danny; Hilburn, Kyle; Houser, Paul; Oglesby, Bob; Pan, Ming; Pinker, Rachel; Santanello, Joe; Schubert, Siegfried; Wang, Hailan; Gillies, Robert


    This paper summarizes research related to the 2012 record drought in the central United States conducted by members of the NASA Energy and Water cycle Study (NEWS) Working Group. Past drought patterns were analyzed for signal coherency with latest drought and the contribution of long-term trends in the Great Plains low-level jet, an important regional circulation feature of the spring rainy season in the Great Palins. Long-term changes in the seasonal transition from rainy spring into dry summer were also examined. Potential external forcing from radiative processes, soil-air interactions, and ocean teleconnections were assessed as contributors to the intensity of the drought. The atmospheric Rossby wave activity was found to be a potential source of predictability for the onset of drought. A probabilistic model was introduced and evaluated for its performance in predicting drought recovery in the Great Plains.

  7. Growth hormone deficiency and central precocious puberty in Klinefelter syndrome: report of a case and review of KIGS database. (United States)

    Gonzales-Ellis, Bryn A; Pingul, Mia M; Reddy, Sujana; Boney, Charlotte M; Wajnrajch, Michael P; Quintos, Jose Bernarto


    Growth hormone deficiency (GHD) and central precocious puberty (CPP) have each, individually, been described in patients with Klinefelter syndrome. However, the combination of GHD, CPP, and Klinefelter syndrome has never been reported. We described a Klinefelter syndrome patient who developed GHD at age 2 10/12 years and CPP at 8 6/12 years. Despite CPP, GnRH agonist therapy was not initiated because of his excellent predicted adult height. At 11 8/12 years, his height was 164.6 cm, close to his mid-parental target height of 165 cm. We report an additional nine patients with Klinefelter syndrome and GHD from the Pfizer International Growth Study (KIGS) database, none of whom had CPP. We conclude that the combination of GHD and CPP is very rare in Klinefelter syndrome and that CPP is unlikely to compromise final adult height.

  8. Pathology of the vestibulocochlear nerve

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    De Foer, Bert [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail:; Kenis, Christoph [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail:; Van Melkebeke, Deborah [Department of Neurology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail:; Vercruysse, Jean-Philippe [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail:; Somers, Thomas [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail:; Pouillon, Marc [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail:; Offeciers, Erwin [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail:; Casselman, Jan W. [Department of Radiology, AZ Sint-Jan AV Hospital, Ruddershove 10, Bruges (Belgium); Consultant Radiologist, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium); Academic Consultent, University of Ghent (Belgium)], E-mail:


    There is a large scala of pathology affecting the vestibulocochlear nerve. Magnetic resonance imaging is the method of choice for the investigation of pathology of the vestibulocochlear nerve. Congenital pathology mainly consists of agenesis or hypoplasia of the vestibulocochlear nerve. Tumoral pathology affecting the vestibulocochlear nerve is most frequently located in the internal auditory canal or cerebellopontine angle. Schwannoma of the vestibulocochlear nerve is the most frequently found tumoral lesion followed by meningeoma, arachnoid cyst and epidermoid cyst. The most frequently encountered pathologies as well as some more rare entities are discussed in this chapter.

  9. [(Impending) pathological fracture]. (United States)

    Sutter, P M; Regazzoni, P


    Pathological fractures will be encountered in increasing frequency due to more patients with cancer, surviving a longer period. The skeleton is the third most frequent localization for metastases. Breast cancer is still the most common primary tumor, but bone metastases from lung cancer seem to be diagnosed more and more. Despite of finding metastases most often in the spinal column, fractures are seen mostly at the femoral site. A pathological fracture and, in almost all cases, an impending fracture are absolute indication for operation. An exact definition of an "impending fracture" is still lacking; it is widely accepted, that 50 per cent of bone mass must be destroyed before visualization in X-ray is possible, thus defining an impending fracture. The score system by Mirels estimates the fracture risk by means of four parameters (localization, per cent of destructed bone mass, type of metastasis, pain). Improving quality of life, relieving pain, preferably with a single operation and a short length of stay are the goals of (operative) treatment. For fractures of the proximal femur, prosthetic replacement, for fractures of the subtrochanteric region or the shaft, intramedullary nails are recommended. Postoperative radiation therapy possibly avoids tumor progression. In patient with a good long term prognosis, tumor should be removed locally aggressive.

  10. Pathology of intrahepatic cholangiocarcinoma (United States)

    Vijgen, Sandrine; Terris, Benoit


    Intrahepatic cholangiocarcinoma (iCC) is a primary carcinoma of the liver with increasing significance and major pathogenic, clinical and therapeutic challenges. Classically, it arises from malignant transformation of cholangiocytes bordering small portal bile duct (BD) to second-order segmental large BDs. It has three major macroscopic growth pattern [mass-forming (MF), periductal infiltrative (PI), and intraductal growth (IG)] and histologically is a desmoplastic stroma-rich adenocarcinoma with cholangiocyte differentiation. Recent data pointed out noteworthy degree of heterogeneity in regards of their epidemiology and risk factors, pathological and molecular features, pathogenesis, clinical behaviors and treatment. Notably, several histological variants are described and can coexist within the same tumor. Several different cells of origin have also been depicted in a fraction of iCCs, amongst which malignant transformation of ductules, of hepatic stem/progenitor cells, of periductal glands or through oncogenic reprogramming of adult hepatocytes. A degree of pathological overlap with hepatocellular carcinoma (HCC) may be observed in a portion of iCC. A series of precursor lesions are today characterized and emphasize the existence of a multistep carcinogenesis process. Overall, these new data have brought up in proposal of new histological or molecular classifications, which could soon replace current anatomic-based classification and could have major impact on establishment of prognosis and on development of novel target treatment approaches. PMID:28261592

  11. The research station "Vaskiny Dachi", Central Yamal, West Siberia, Russia – a review of 25 years of permafrost studies

    Directory of Open Access Journals (Sweden)

    Marina O. Leibman


    Full Text Available The research station "Vaskiny Dachi" on the Yamal Peninsula was established in 1988. Activities aimed at monitoring of permafrost and related environmental features under a relatively low level of nature disturbances caused by gas field development. Cryogenic processes that may affect the environment and their structures have been of primary interest. Landslides are the most common cryogenic processes in Central Yamal in general and also in the proximity of the station. Field surveys of numerous landslides, analysis of their dependence on climatic parameters and their fluctuations resulted in novel classification of cryogenic landslides based on mechanisms of their development. Dating by radiocarbon and dendrochronology allows the separation of cycles of landslide activation. Cryogenic landslides control the development of other processes, such as thermal erosion, river channel erosion and thermokarst. It also affects topography, vegetation pattern, geochemistry of vegetation, ground water and soils. As a result, permafrost parameters, specifically active layer depth and ground temperature, moisture and ice content in the active layer, depend indirectly on landsliding. Monitoring within the framework of the main programs of the International Permafrost Association, such as Circumarctic Active Layer Monitoring (CALM, since 1993 and Thermal State of Permafrost (TSP, since 2011, play an important role among the research activities. From the collected data one can conclude that ground temperature increased on average by about 1 °C since the 1990s. At the same time, active layer fluctuations do not exactly follow the air temperature changes. Spatial changes in ground temperature are controlled by the redistribution of snow which is resulting from strong winds characteristic for tundra environments and the highly dissected relief of Central Yamal. Temporal variations rather depend on air temperature fluctuations but the rate differs in various

  12. The Adverse Effects of Heavy Metals with and without Noise Exposure on the Human Peripheral and Central Auditory System: A Literature Review. (United States)

    Castellanos, Marie-Josée; Fuente, Adrian


    Exposure to some chemicals in the workplace can lead to occupational chemical-induced hearing loss. Attention has mainly focused on the adverse auditory effects of solvents. However, other chemicals such as heavy metals have been also identified as ototoxic agents. The aim of this work was to review the current scientific knowledge about the adverse auditory effects of heavy metal exposure with and without co-exposure to noise in humans. PubMed and Medline were accessed to find suitable articles. A total of 49 articles met the inclusion criteria. Results from the review showed that no evidence about the ototoxic effects in humans of manganese is available. Contradictory results have been found for arsenic, lead and mercury as well as for the possible interaction between heavy metals and noise. All studies found in this review have found that exposure to cadmium and mixtures of heavy metals induce auditory dysfunction. Most of the studies investigating the adverse auditory effects of heavy metals in humans have investigated human populations exposed to lead. Some of these studies suggest peripheral and central auditory dysfunction induced by lead exposure. It is concluded that further evidence from human studies about the adverse auditory effects of heavy metal exposure is still required. Despite this issue, audiologists and other hearing health care professionals should be aware of the possible auditory effects of heavy metals.

  13. Primary meningeal melanocytoma of the central nervous system: report of 3 cases with literature reviews%中枢神经系统脑脊膜黑色素细胞瘤三例及文献复习

    Institute of Scientific and Technical Information of China (English)

    崔华娟; 王卓才; 王炜; 赖日权; 彭大云; 陈敬文


    目的 探讨中枢神经系统脑脊膜黑色素细胞瘤(PMM)临床及病理学特征.方法 结合文献复习,回顾性分析3例中枢神经系统原发的脑脊膜黑色素细胞瘤.结果 2例肿瘤位于椎管内,1例位于小脑脑桥角.肿瘤外观呈黑色,部分肿瘤包膜完整.光镜下见瘤细胞由上皮样细胞和梭形细胞混合而成,细胞无明显异型,核仁明显.大部分瘤细胞质内含有大量黑色素颗粒.例1、例3肿瘤核分裂像无或偶见(0~1个/10 HPF),例2核分裂像较多(2~3个/10 HPF).免疫表型HMB45、MelanA和S-100蛋白呈阳性表达.例1、例2肿瘤完全切除,例3部分切除,随访均无复发.结论 原发性脑脊膜黑色素细胞瘤是一种罕见的交界性或低度恶性肿瘤,具有一定的病理学特征,可局部复发或发生恶变,需要与原发或转移的恶性黑色素瘤、黑色素性脑膜瘤及黑色素性神经鞘瘤进行鉴别.%Objective To investigate the clinical and pathological features of central nervous system primary meningeal melanocytoma.Methods Combined with Chosen literature reviews,the clinical data of three patients suffering from central nervous system primary meningeal melanocytoma was analyzed.Results Two tumors were found in the leptomeninges of the spinal cord,while one was found in the cerebellopontine.Imaging studies revealed nodal lesions.Two tumors out of the three were encapsulated black masses.Histologically,epithelioid and spindle cells with abundant cytoplasms were arranged in loose nests.No cellular pleomorphism was seen and nucleoli were evidently.Fine melaningranules were the in the cytoplasm of tumor cells in all cases.The mitotic indexes for the two cases were zero or one per 10 HPFs and the index of one case was 2 ~ 3/10 HPF.Immunnohistochemical studies of the tumors confirmed the presence of HMB45,MelanA,and S-100 proteins.The tumors in Case 1 and 2 were totally removed by operation,while the tumor in Case 2 was incompletely removed

  14. Fetal laser therapy: applications in the management of fetal pathologies. (United States)

    Mathis, Jérôme; Raio, Luigi; Baud, David


    Fetoscopic coagulation of placental anastomoses is the treatment of choice for severe twin-to-twin transfusion syndrome. In the present day, fetal laser therapy is also used to treat amniotic bands, chorioangiomas, sacrococcygeal teratomas, lower urinary tract obstructions and chest masses, all of which will be reviewed in this article. Amniotic band syndrome can cause limb amputation by impairing downstream blood flow. Large chorioangiomas (>4 cm), sacrococcygeal teratomas or fetal hyperechoic lung lesions can lead to fetal compromise and hydrops by vascular steal phenomenon or compression. Renal damage, bladder dysfunction and lastly death because of pulmonary hypolasia may be the result of megacystis caused by a posterior urethral valve. The prognosis of these pathologies can be dismal, and therapy options are limited, which has brought fetal laser therapy to the forefront. Management options discussed here are laser release of amniotic bands, laser coagulation of the placental or fetal tumor feeding vessels and laser therapy by fetal cystoscopy. This review, largely based on case reports, does not intend to provide a level of evidence supporting laser therapy over other treatment options. Centralized evaluation by specialists using strict selection criteria and long-term follow-up of these rare cases are now needed to prove the value of endoscopic or ultrasound-guided laser therapy.

  15. Central venous catheter - dressing change (United States)

    ... during cancer treatment Bone marrow transplant - discharge Central venous catheter - flushing Peripherally inserted central catheter - flushing Sterile technique Surgical wound care - open Review Date 9/17/2016 Updated by: ...

  16. Faulting in the Yucca Mountain region: Critical review and analyses of tectonic data from the central Basin and Range

    Energy Technology Data Exchange (ETDEWEB)

    Ferrill, D.A.; Stirewalt, G.L.; Henderson, D.B.; Stamatakos, J.; Morris, A.P.; Spivey, K.H. [Southwest Research Inst., San Antonio, TX (United States). Center for Nuclear Waste Regulatory Analyses; Wernicke, B.P. [California Inst. of Tech., Pasadena, CA (United States). Div. of Geological and Planetary Sciences


    Yucca Mountain, Nevada, has been proposed as the potential site for a high-level waste (HLW) repository. The tectonic setting of Yucca Mountain presents several potential hazards for a proposed repository, such as potential for earthquake seismicity, fault disruption, basaltic volcanism, magma channeling along pre-existing faults, and faults and fractures that may serve as barriers or conduits for groundwater flow. Characterization of geologic structures and tectonic processes will be necessary to assess compliance with regulatory requirements for the proposed high level waste repository. In this report, we specifically investigate fault slip, seismicity, contemporary stain, and fault-slip potential in the Yucca Mountain region with regard to Key Technical Uncertainties outlined in the License Application Review Plan (Sections through and These investigations center on (i) alternative methods of determining the slip history of the Bare Mountain Fault, (ii) cluster analysis of historic earthquakes, (iii) crustal strain determinations from Global Positioning System measurements, and (iv) three-dimensional slip-tendency analysis. The goal of this work is to assess uncertainties associated with neotectonic data sets critical to the Nuclear Regulatory Commission and the Center for Nuclear Waste Regulatory Analyses` ability to provide prelicensing guidance and perform license application review with respect to the proposed HLW repository at Yucca Mountain.

  17. Pathological gambling and couple: towards an integrative systemic model. (United States)

    Cunha, Diana; Relvas, Ana Paula


    This article is a critical literature review of pathological gambling focused in the family factors, particularly in the couple dynamics. Its main goal is to develop an explicative integrative systemic model of pathological gambling, based in these couple dynamics. To achieve that aim, a bibliography search was made, using on-line data bases (e.g., EBSCO Host) and recognized books in pathological gambling subject, as well as in the systemic approach in general. This process privileged the recent works (about 70 % of the reviewed literature was published in the last decade), however, also considered some classic works (the oldest one dates back to 1970). The guiding focus of this literature search evolves according to the following steps: (1) search of general comprehension of pathological gambling (19 references), (2) search specification to the subject "pathological gambling and family" (24 references), (3) search specification to the subject "pathological gambling and couple"(11 references), (4) search of systemic information which integrates the evidence resulted in the previous steps (4 references). The developed model is constituted by different levels of systemic complexity (social context, family of origin, couple and individual) and explains the problem as a signal of perturbation in the marital subsystem vital functions (e.g., power and control) though the regularities of marital dynamics of pathological gamblers. Furthermore, it gives theoretical evidence of the systemic familiar intervention in the pathological gambling.

  18. Lumbar vertebral pedicles: radiologic anatomy and pathology

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    Patel, N.P.; Kumar, R.; Kinkhabwala, M.; Wengrover, S.I.


    With the advancement of high-resolution computed tomography (CT) scanning the spine has added new knowledge to the various conditions affecting the pedicles. We wish to review the entire spectrum of pedicular lesions: the embryology, normal anatomy, normal variants, pitfalls, congenital anomalies, and pathological conditions are discussed. Different imaging modalities involving CT, isotope bone scanning, and Magnetic Resonance Imaging (MRI) are used to complement plain films of the lumbar spine. This subject review is an excellent source for future reference to lumbar pedicular lesions. 27 references.

  19. Primary plasmablastic lymphoma of the central nervous system in an immunocompetent man: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Rama Kumari Badyal


    Full Text Available Plasmablastic lymphoma (PBL is an aggressive non-Hodgkin lymphoma classically occurring in individuals infected with human immunodeficiency virus (HIV. It has a predilection for the oral cavity and jaw. However, recent case reports have shown this variety of lymphoma in the stomach, lung, nasal cavity, cervical lymph nodes and jejunum in HIV-negative individuals. In this manuscript we report a case of primary PBL of brain in an HIV-negative heterosexual man, who presented with multiple episodes of seizures and hemiparesis. It proved a diagnostic challenge as initial stereotactic brain biopsy showed only few necrotic fragments and possibility of glioblastoma multiforme was rendered. Later patient underwent craniotomy and subsequent histopathology combined with immunohistochemistry led us in making a correct diagnosis of extramedullary PBL. Extensive systemic work up failed to reveal any disease outside the central nervous system. Only single case of primary PBL of brain in HIV-negative individual has been reported until date. To the best of our knowledge, this is the second report to suggest such an association.

  20. After the flood is before the next flood - post event review of the Central European Floods of June 2013. Insights, recommendations and next steps for future flood prevention (United States)

    Szoenyi, Michael; Mechler, Reinhard; McCallum, Ian


    In early June 2013, severe flooding hit Central and Eastern Europe, causing extensive damage, in particular along the Danube and Elbe main watersheds. The situation was particularly severe in Eastern Germany, Austria, Hungary and the Czech Republic. Based on the Post Event Review Capability (PERC) approach, developed by Zurich Insurance's Flood Resilience Program to provide independent review of large flood events, we examine what has worked well (best practice) and opportunities for further improvement. The PERC overall aims to thoroughly examine aspects of flood resilience, flood risk management and catastrophe intervention in order to help build back better after events and learn for future events. As our research from post event analyses shows a lot of losses are in fact avoidable by taking the right measures pre-event and these measures are economically - efficient with a return of 4 Euro on losses saved for every Euro invested in prevention on average (Wharton/IIASA flood resilience alliance paper on cost benefit analysis, Mechler et al. 2014) and up to 10 Euros for certain countries. For the 2013 flood events we provide analysis on the following aspects and in general identify a number of factors that worked in terms of reducing the loss and risk burden. 1. Understanding risk factors of the Central European Floods 2013 We review the precursors leading up to the floods in June, with an extremely wet May 2013 and an atypical V-b weather pattern that brought immense precipitation in a very short period to the watersheds of Elbe, Donau and partially the Rhine in the D-A-CH countries and researched what happened during the flood and why. Key questions we asked revolve around which protection and risk reduction approaches worked well and which did not, and why. 2. Insights and recommendations from the post event review The PERC identified a number of risk factors, which need attention if risk is to be reduced over time. • Yet another "100-year flood" - risk



    Hashem Sharifian


    Purpose: The aim of this study is to improvethe radiologic knowledge of skull base anatomy and pathologies. Content: Skull base is composed of multiple complex bones and soft tissues. So many pathologies as tumoral, infectious and traumatic can involve it. With a brief discussion of the anatomy, we review various pathologic conditions in this region.

  2. Advances in GBA-associated Parkinson's disease--Pathology, presentation and therapies. (United States)

    Barkhuizen, Melinda; Anderson, David G; Grobler, Anne F


    GBA mutations are to date the most common genetic risk factor for Parkinson's disease. The GBA gene encodes the lysomal hydrolase glucocerebrosidase. Whilst bi-allelic GBA mutations cause Gaucher disease, both mono- and bi-allelic mutations confer risk for Parkinson's disease. Clinically, Parkinson's disease patients with GBA mutations resemble idiopathic Parkinson's disease patients. However, these patients have a modest reduction in age-of-onset of disease and a greater incidence of cognitive decline. In some cases, GBA mutations are also responsible for familial Parkinson's disease. The accumulation of α-synuclein into Lewy bodies is the central neuropathological hallmark of Parkinson's disease. Pathologic GBA mutations reduce enzymatic function. A reduction in glucocerebrosidase function increases α-synuclein levels and propagation, which in turn inhibits glucocerebrosidase in a feed-forward cascade. This cascade is central to the neuropathology of GBA-associated Parkinson's disease. The lysosomal integral membrane protein type-2 is necessary for normal glucocerebrosidase function. Glucocerebrosidase dysfunction also increases in the accumulation of β-amyloid and amyloid-precursor protein, oxidative stress, neuronal susceptibility to metal ions, microglial and immune activation. These factors contribute to neuronal death. The Mendelian Parkinson's disease genes, Parkin and ATP13A2, intersect with glucocerebrosidase. These factors sketch a complex circuit of GBA-associated neuropathology. To clinically interfere with this circuit, central glucocerebrosidase function must be improved. Strategies based on reducing breakdown of mutant glucocerebrosidase and increasing the fraction that reaches the lysosome has shown promise. Breakdown can be reduced by interfering with the ability of heat-shock proteins to recognize mutant glucocerebrosidase. This underlies the therapeutic efficacy of certain pharmacological chaperones and histone deacetylase inhibitors. These

  3. Exposure to environmental factors and risk of tumours in the central nervous system of children: A systematic review and meta-analysis

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    María M. Morales Suárez-Varela


    Full Text Available We analyzed the risk of tumors in the central nervous system of children in relation to exposure to environmental factors such as radiation (ionizing, non-ionizing, chemicals (pesticides, cosmetics, air pollutants and foods. We performed a systematic review and meta-analysis of studies identified through a PubMed search (1987-2013. The results obtained from OR values show that the risk of tumors in the central nervous system of children is significantly associated with parental exposure and that the prenatal period is a critical window for several of the environmental factors considered. Although the risk fraction attributable to each factor is still unknown, a statistical analysis allowed to determine significant relations for chemical factors such as pesticides (OR: 1.93; 95% IC 1.51-2.47, air pollutants (OR: 1.45; 95% IC 1.17-1.80 and foods with N-nitrous compounds (OR: 1.96; 95% IC 1.40-2.73 especially for prenatal exposure.

  4. A review of neogene and quaternary snakes of Central and Eastern Europe. Part 11: natricinae, elapidae, viperidae

    Directory of Open Access Journals (Sweden)

    Szyndlar, Z.


    Full Text Available Remains of Neogene and Quaternary "natricine" colubrids, elapids and viperids, including snakes previously described and those undescribed yet, coming from Poland, Ukraine, Moldavia, Czechoslovakia, Austria, Hungary, Romania, Bulgaria, and Greece are discussed. The following taxa, including 11 extinct species, were recognized: "Natricinae": Neonatrix nova, Neonatrix sp., Palaeonatrix silesiaca, Palaeonatrix lehmani, Natrix longivertebrata, Natrix cf. N. longivertebrata, Natrix natrix, Natrix tesselata, Natrix cf. N. tesselata, Natrix sp., "Natricinae" indet.; Elapidae: Naja romani, Naja sp., cf. Naja sp.; Viperidae: Vipera platyspondyla, Vipera sarmatica, Vipera burgenlandica, Vipera gedulyi, Vipera kuchurganica, Vipera antiqua, Vipera cf. V. ammodytes, Vipera berus, Vipera sp ('Oriental vipers' group, Vipera sp. ('aspis' group, Vipera sp. ('berus' group, Vipera sp. . (status unknown. Taxonomic status of two other extinct species, Natrix parva and Laophis crotaloides, is uncertain. Modern species appeared fírst in Central and East Europe in the middle Pliocene (MN 15. Older snakes belonged to extinct species of either extinct or extant genera; taxonomic distinction of most extinct genera is, however, not fully demonstrated. Best recognized oldest snakes from the area (Elapidae, Viperidae, and sorne Colubridae are clearly referable to modern genera and intrageneric subdivisions occurring today are observed in oldest (Iower Miocene remains; closest living relatives of these fossils are presently distributed in the Oriental Realm.Se revisan y estudian los restos neógenos y cuaternarios de colúbridos «natricinos», elápidos y vipéridos, incluyendo tanto serpientes previamente descritas como- otras inéditas. Los materiales analizados proceden de Polonia, Ukrania, Moldavia, Checoslovaquia, Austria, Hungría, Rumania, Bulgaria y Grecia. Se reconocen los siguientes taxones, incluyendo 11 especies extinguidas: Natricinae: Neonatrix nova

  5. A review of Neogene and Quaternary snakes of central and eastern Europe. Part 1: Scolecophidia, Boidae, Colubrinae

    Directory of Open Access Journals (Sweden)

    Szyndlar, Z.


    Full Text Available Remains of Neogene and Quaternary seoleeophidians, boids and «eolubrine» eolubrids, including snakes previously deseribed and those undeseribed yet, eoming fram Poland, Ukraine, Moldavia, Czeehoslovakia, Austria, Hungary, Romania, Bulgaria, and Greece are diseussed. The following taxa, including 7 extinet speeies, were reeognized: Seoleeophidia indet.; Boidae: Bransateryx septentrionalis, Bransateryx sp., Albaneryx volynicus, cf., Gongylophis sp., Eryx jaculus, Eryx sp., eL Eryx sp., Eryeinae indet.; Colubridae: Texasophis bohemiacus, Coluber dolnicensis, Coluber planicarinatus, Coluber viridij1avus, cf. Coluber viridiflavus, Coluber caspius, Coluber gemonensis, cf. Coluber gemonensis, Coluber sp., Coronella austriaca, Coronella sp., cf. Coronella sp., Elaphe kohfidischi, cf. Elaphe kohfidischi, Elaphe paralongissima, Elaphe longissima, cf. Elaphe longissima, Elaphe quatuorlineata, cf. Elaphe quatuorlineata, eL Elaphe situla, Elaphe sp., cf. Malpolon sp., Telescopus sp., «Colubrinae» indet.Revisión de las serpientes neógenas y cuaternarias de Europa central y oriental. Parte 1: Scolecophidia, Boidae, Colubrinae. Se estudian restos neógenos y cuaternarios de escolecofidios, boidos y colúbridos «colubrinos», incluyendo tanto formas ya descritas como inéditas, y procedentes de Polonia, Ucrania, Moldavia, Checoslovaquia, Austria, Hungría, Rumanía, Bulgaria y Grecia. Se reconocen los siguientes taxones: Scolecophidia indet.; Boidae: Bransateryx septentrionalis, Bransateryx sp., Albaneryx volynicus, cf. Gongylophis sp., Eryx jaculus, Eryx sp., cf. Eryx sp., Erycinae indet.; Colubridae: Texasophis bohemiacus, Coluber dolnicensis, Coluber planicarinatus, Coluber viridij1avus, cf., Coluber viridiflavus, Coluber caspius, Coluber gemonensis, eL Coluber gemonensis, Coluber sp., Coronella austriaca, Coronella sp., cf. Coronella sp., Elaphe kohfidischi, cf. Elaphe kohfidischi, Elaphe paralongissima, Elaphe longissima, cf. Elaphe

  6. A Review of a Successful Unsubsidized Market-Based Rural Solar Development Initiative in Laikipia District, Central Kenya

    Directory of Open Access Journals (Sweden)

    O. Wambuguh


    Full Text Available The development of renewable energy technologies (RETs in many areas far from grid-based electricity have primarily involved solar photovoltaics (SPVs which tap solar radiation to provide heat, light, hot water, electricity, and cooling for homes, businesses, and industry. A study on RETs took place in the Wiyumiririe Location of Laikipia District (north-central Kenya, a rich agricultural region. To explore this solar initiative in such a remote part of the country, a purposive randomized convenience sample of 246 households was selected and landowner interviews conducted, followed by field visits and observations. Although more than half of the households visited had SPV installations, solar energy was found to contribute only 18% of household estimated total energy needs; most residents still primarily relying on traditional energy sources. Several types of solar panels of different capacities and costs were utilized. Many landowners had at least one or two rooms using solar energy for household lighting, for appliance charging and to power radio and television. Almost all respondents appreciated that solar energy was clean renewable energy that greatly improved household living conditions; gave them some prestige; was easy to use and maintain; and was available year around. Although such significant benefits were associated with SPVs, only about 40% of residents interviewed were somehow satisfied with its development. Respondents expressed specific developmental initiatives that were closely associated with the availability of solar energy. Nevertheless, a number of challenges were raised associated with SPVs primarily investment capital and equipment costs and maintenance. As solutions to capital building will not solely rely on subsidies or individual farmer inputs, strategies must be found to mobilize the essential and tested tools for success including sustainable capital generation, building local institutions and capacities that

  7. Mobile Technology for the Practice of Pathology. (United States)

    Hartman, Douglas J


    Recently, several technological advances have been introduced to mobile phones leading some people to refer to them as "smartphones." These changes have led to widespread consumer adoption. A similar adoption has occurred within the medical field and this revolution is changing the practice of medicine, including pathology. Several mobile applications have been published for dermatology, orthopedics, ophthalmology, neurosurgery, and clinical pathology. The applications are wide ranging, including mobile technology to increase patient engagement, self-monitoring by patients, clinical algorithm calculation, facilitation between experts to resource-poor environments. These advances have been received with mixed reviews. For anatomic pathology, mobile technology applications can be broken into 4 broad categories: (a) educational uses, (b) microscope with mobile phone, (c) mobile phone as microscope/acquisition device, and (d) miscellaneous. Using a mobile phone as an acquisition device paired with a microscope seems to be the most interesting current application because of the need for expert consultation with resource-poor environments. However, several emerging uses for mobile technology may become more prominent as the technology matures including image analysis, alternative light sources, and increased opportunities for clinician and patient engagement. The flexibility represented by mobile technology represents a burgeoning field in pathology informatics.

  8. [Psychiatric comorbidity in pathological gambling]. (United States)

    Skokauskas, Norbertas; Satkeviciūte, Regina; Burba, Benjaminas


    In this article the peculiarities of psychiatric comorbidity in pathological gambling were investigated. The authors were based both on the data of many foreign scientists and on their own one. Our data on 77 cases of pathological gambling were collected based on interviews of Lithuanian psychiatrists and psychotherapists about their patients with gambling addiction in period from 1991 to 2001. The data that we publish and analyze allows us to make conclusions that pathological gambling can reveal together with very wide spectrum of psychiatric disorders, but more often with alcoholism and depression. The mechanism of psychiatric comorbidity in pathological gambling is very complex.

  9. Adult neural stem cells in the mammalian central nervous system

    Institute of Scientific and Technical Information of China (English)

    Dengke K Ma; Michael A Bonaguidi; Guo-li Ming; Hongjun Song


    Neural stem cells (NSCs) are present not only during the embryonic development but also in the adult brain of all mammalian species, including humans. Stem cell niche architecture in vivo enables adult NSCs to continuously generate functional neurons in specific brain regions throughout life. The adult neurogenesis process is subject to dynamic regulation by various physiological, pathological and pharmacological stimuli. Multipotent adult NSCs also appear to be intrinsically plastic, amenable to genetic programing during normal differentiation, and to epigenetic reprograming during de-differentiation into pluripotency. Increasing evidence suggests that adult NSCs significantly contribute to specialized neural functions under physiological and pathological conditions. Fully understanding the biology of adult NSCs will provide crucial insights into both the etiology and potential therapeutic interventions of major brain disorders. Here, we review recent progress on adult NSCs of the mammalian central nervous system, in-cluding topics on their identity, niche, function, plasticity, and emerging roles in cancer and regenerative medicine.

  10. [Diagnostic significance of pathologic synkinesis for detection of pyramidal pathology]. (United States)

    Baliasnyĭ, M M


    Five types of pathological synkinesis (++blepharo-ocular, ++blepharo-facial, ++bucco-manual, ++digito-digital on the hands, ++pedo-digital) are described. They are of definite importance for revealing pyramidal pathology including its early stages as well as for objective evaluation and observation of the time-course of changes in the illness.

  11. Autoimmune muscular pathologies. (United States)

    Dalakas, M C


    The T cell-mediated mechanism responsible for Polymyositis and inclusion Body Myositis and the complement-mediated microangiopathy associated with Dermatomyositis are reviewed. The management of autoimmune myopathies with the presently available immunotherapeutic agents as well as new therapies and ongoing trials are discussed.

  12. Contribution of oxidative stress to pathology in diaphragm and limb muscles with Duchenne muscular dystrophy. (United States)

    Kim, Jong-Hee; Kwak, Hyo-Bum; Thompson, LaDora V; Lawler, John M


    Duchenne muscular dystrophy (DMD) is a degenerative skeletal muscle disease that makes walking and breathing difficult. DMD is caused by an X-linked (Xp21) mutation in the dystrophin gene. Dystrophin is a scaffolding protein located in the sarcolemmal cytoskeleton, important in maintaining structural integrity and regulating muscle cell (muscle fiber) growth and repair. Dystrophin deficiency in mouse models (e.g., mdx mouse) destabilizes the interface between muscle fibers and the extracellular matrix, resulting in profound damage, inflammation, and weakness in diaphragm and limb muscles. While the link between dystrophin deficiency with inflammation and pathology is multi-factorial, elevated oxidative stress has been proposed as a central mediator. Unfortunately, the use of non-specific antioxidant scavengers in mouse and human studies has led to inconsistent results, obscuring our understanding of the importance of redox signaling in pathology of muscular dystrophy. However, recent studies with more mechanistic approaches in mdx mice suggest that NAD(P)H oxidase and nuclear factor-kappaB are important in amplifying dystrophin-deficient muscle pathology. Therefore, more targeted antioxidant therapeutics may ameliorate damage and weakness in human population, thus promoting better muscle function and quality of life. This review will focus upon the pathobiology of dystrophin deficiency in diaphragm and limb muscle primarily in mouse models, with a rationale for development of targeted therapeutic antioxidants in DMD patients.

  13. CT in vascular pathologies

    Energy Technology Data Exchange (ETDEWEB)

    Bartolozzi, C.; Neri, E.; Caramella, D. [Diagnostic and Interventional Radiology Department of Oncology, University of Pisa, Via Roma 67, I-56100 Pisa (Italy)


    Since the introduction of helical scanners, CT angiography (CTA) has achieved an essential role in many vascular applications that were previously managed with conventional angiography. The performance of CTA is based on the accurate selection of collimation width, pitch, reconstruction spacing and scan delay, which must be modulated on the basis of the clinical issue. However, the major improvement of CT has been provided by the recent implementation of many post-processing techniques, such as multiplanar reformatting, shaded surface display, maximum intensity projections, 3D perspectives of surface and volume rendering, which simulate virtual intravascular endoscopy. The integration of the potentialities of the scanner and of the image processing techniques permitted improvement of: (a) the evaluation of aneurysms, dissection and vascular anomalies involving the thoracic aorta; (b) carotid artery stenosis; (c) aneurysms of abdominal aorta; (d) renal artery stenosis; (e) follow-up of renal artery stenting; and (f) acute or chronic pulmonary embolism. Our experience has shown that the assessment of arterial pathologies with CTA requires the integration of 3D post-processing techniques in most applications. (orig.) With 4 figs., 34 refs.

  14. Epstein-Barr virus associated central nervous system leiomyosarcoma occurring after renal transplantation: case report and review of the literature; Leiomyosarcome primitif du systeme nerveux central associe au virus d'Epstein-Barr (EBV) et survenu apres transplantation renale: a propos d'un cas et revue de la litterature

    Energy Technology Data Exchange (ETDEWEB)

    Tahri, A.; Noel, G.; Feuvret, L.; Jauffret, E.; Brun, B.; Mazeron, J.J.; Baillet, F. [Centre des Tumeurs, Groupe Hospitalier Universitaire Pitie-Salpetriere, 75 - Paris (France); Feuvret, L. [Centre de Protontherapie d' Orsay, 91 (France); Figuerella-Branger, D. [Hopital de la Timone, Service d' Anatomopathologie, 13 - Marseille (France); Goncalves, A. [Institut Paoli-Calmettes, Service d' Oncologie Medicale, 13 - Marseille (France)


    Central nervous system leiomyosarcomas are extremely rare, however, they became more frequent among immuno-deficient patients, either in a patients infected with human immunodeficiency virus (HIV), or after organ transplantation. The data of the literature indicate that the infection by Epstein-Barr virus (EBV) plays a causal role in the development of these tumours but its precise role in the onco-genesis remains unresolved. We report a new case of EBV associated leiomyosarcoma of the left cavernous sinus occurring after renal transplantation. The epidemiological, clinical, pathological and therapeutic characteristics of these tumours are discussed. (authors)

  15. Estudio retrospectivo de las neoplasias de sistema nervioso central en caninos en el laboratorio de patología veterinaria de la Universidad Nacional de Colombia entre los años 1977 y 2009 / Retrospective study of the central nervous system neoplasm in dogs in the laboratory of veterinary pathology at Universidad Nacional de Colombia between 1977 and 2009


    Collazos Paz, Mauricio A.


    Los tumores de Sistema Nervioso Central (S.N.C) se clasifican en primarios aquellos que se derivan directamente a partir del tejido nervioso encefálico y/o medular espinal, y secundarios aquellos tumores que se originan en tejidos extraneurales. En caninos se han reportado diversos tumores primarios y se han clasificado en grupos de acuerdo al tejido de origen: tumores de los nervios, tumores de origen glial, gliomas mixtos, tumores originados de la meninge, tumores del epéndima y plexo coroi...

  16. Pathologic overproduction: the bad side of adenosine. (United States)

    Borea, Pier Andrea; Gessi, Stefania; Merighi, Stefania; Vincenzi, Fabrizio; Varani, Katia


    Adenosine is an endogenous ubiquitous purine nucleoside, increased by hypoxia, ischemia and tissue damage that mediates a number of physiopathological effects by interacting with four G-protein-coupled receptors, identified as A1 , A2A , A2B , and A3 . Physiological and acutely-increased adenosine is associated with beneficial effects mostly including vasodilation and decrease of inflammation. In contrast chronic overproduction of adenosine occurs in important pathological states, where long lasting increases in the nucleoside levels are responsible for the bad side of adenosine associated with chronic inflammation, fibrosis and organ damage. In this review we describe and critically discuss the pathologic overproduction of adenosine analysing when, where and how adenosine exerts its detrimental effects through the body.

  17. Metallothioneins are multipurpose neuroprotectants during brain pathology

    DEFF Research Database (Denmark)

    Penkowa, Milena


    Metallothioneins (MTs) constitute a family of cysteine-rich metalloproteins involved in cytoprotection during pathology. In mammals there are four isoforms (MT-I - IV), of which MT-I and -II (MT-I + II) are the best characterized MT proteins in the brain. Accumulating studies have demonstrated MT......-I + II as multipurpose factors important for host defense responses, immunoregulation, cell survival and brain repair. This review will focus on expression and roles of MT-I + II in the disordered brain. Initially, studies of genetically modified mice with MT-I + II deficiency or endogenous MT......-I overexpression demonstrated the importance of MT-I + II for coping with brain pathology. In addition, exogenous MT-I or MT-II injected intraperitoneally is able to promote similar effects as those of endogenous MT-I + II, which indicates that MT-I + II have both extra- and intracellular actions. In injured brain...

  18. Pathology of Coronary Chronic Total Occlusion

    Directory of Open Access Journals (Sweden)

    Kenichi Sakakura


    Full Text Available There is an increasing need for percutaneous revascularization procedures of coronary Chronic Total Occlusion (CTO, because many patients with severe coronary artery disease have limited options for revascularization. Although the success rate of percutaneous revascularization of CTOs was unsatisfactory from the 1990s to the 2000s, recent technological advances in interventional strategies have improved the success rate to 85%. Detailed histological assessment of human autopsy studies of CTO has contributed significantly to the refinement in Percutaneous Coronary Intervention (PCI techniques and device development. We have recently reported the pathological findings and characteristics of CTOs that occur in different clinical scenarios. In this review, we discuss the pathology of CTOs to facilitate greater understanding of revascularization strategies for CTOs.

  19. Incidental bony pathology when reporting trauma orthopantomograms

    Energy Technology Data Exchange (ETDEWEB)

    Macanovic, M., E-mail: [Derriford Hospital NHS Trust, Plymouth (United Kingdom); Gangidi, S.; Porter, G.; Brown, S.; Courtney, D. [Derriford Hospital NHS Trust, Plymouth (United Kingdom); Porter, J. [Community Dental Service, Plymouth Primary Care Trust, Plymouth, Devon (United Kingdom)


    Radiologists frequently report orthopantomograms (OPTs) and other views of the mandible, most often in patients who have suffered facial trauma. These examinations may reveal incidental pathology. It is important that radiologists are aware of the radiological appearances and the clinical significance of these lesions. In this review we will present examples of the more common odontogenic lesions including: radicular cyst, odontogenic keratocyst, dentigerous cyst, ameloblastoma, and also examples of non-odontogenic pathology: bisphosphonate-related osteonecrosis of the jaw (BRONJ) and chronic osteomyelitis. Although some of the lesions will require computed tomography (CT) or magnetic resonance imaging (MRI) for further lesion characterization and evaluation of the surrounding tissues, we are going to focus on the plain film appearances. We will also briefly discuss the pathogenesis, epidemiology, and treatment of these lesions.

  20. [Pathology and viral metagenomics, a recent history]. (United States)

    Bernardo, Pauline; Albina, Emmanuel; Eloit, Marc; Roumagnac, Philippe


    Human, animal and plant viral diseases have greatly benefited from recent metagenomics developments. Viral metagenomics is a culture-independent approach used to investigate the complete viral genetic populations of a sample. During the last decade, metagenomics concepts and techniques that were first used by ecologists progressively spread into the scientific field of viral pathology. The sample, which was first for ecologists a fraction of ecosystem, became for pathologists an organism that hosts millions of microbes and viruses. This new approach, providing without a priori high resolution qualitative and quantitative data on the viral diversity, is now revolutionizing the way pathologists decipher viral diseases. This review describes the very last improvements of the high throughput next generation sequencing methods and discusses the applications of viral metagenomics in viral pathology, including discovery of novel viruses, viral surveillance and diagnostic, large-scale molecular epidemiology, and viral evolution.

  1. Digital pathology: A systematic evaluation of the patent landscape


    Cucoranu, Ioan C.; Anil V. Parwani; Suryanarayana Vepa; Weinstein, Ronald S.; Liron Pantanowitz


    Introduction: Digital pathology is a relatively new field. Inventors of technology in this field typically file for patents to protect their intellectual property. An understanding of the patent landscape is crucial for companies wishing to secure patent protection and market dominance for their products. To our knowledge, there has been no prior systematic review of patents related to digital pathology. Therefore, the aim of this study was to systematically identify and evaluate United State...

  2. Central administration of murine interferon-α induces depressive-like behavioral, brain cytokine and neurochemical alterations in mice: a mini-review and original experiments. (United States)

    Hayley, Shawn; Scharf, Jeff; Anisman, Hymie


    A role for pro-inflammatory cytokines and their neuroinflammatory signaling cascades in depressive pathology has increasingly gained acceptance. In this regard, several lines of evidence suggested that interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) can provoke neurochemical and hormonal changes akin to those associated with psychological stressors, and that these cytokines also induce sickness behaviors that resemble some of the neurovegetative features of depression. Similarly, human depressed patients often display marked changes of pro-inflammatory cytokine levels and immune cell activity. Perhaps more germane in the analysis of the cytokine-depression connection, reports of humans undergoing interferon-α (IFN-α) treatment for certain cancers or viral infections have indicated that the pro-inflammatory cytokine caused signs of major depression in a substantial subset of those treated. In the present investigation, we demonstrated that acute or repeated infusion of IFN-α into the lateral ventricles provoked depressive-like behavior and concomitant changes in serotonin (5-HT) and mRNA expression of particular 5-HT receptors and pro-inflammatory cytokines. These actions were less evident following administration directly into the prefrontal cortex and not apparent at all when administered to the dorsal raphe nucleus. The data are discussed in relation to the induction of depression elicited by IFN-α, and are presented in the context of a mini-review that highlights potential mechanisms through which the cytokine might act to promote psychomotor and affective disturbances and interact with stressors.

  3. Molecular pathology of retinoblastoma

    Directory of Open Access Journals (Sweden)

    Kandalam Mallikarjuna


    Full Text Available Retinoblastoma (RB is an embryonic neoplasm of retinal origin. For many years, scientists have sought the fundamental origins of tumorigenesis, with the ultimate hope of discovering a cure. Indeed, these efforts have led to a significant understanding that multiple molecular and genetic aberrations, such as uncontrolled proliferation and the inhibition of apoptosis that contribute to the canonical characteristics of tumor biology. Despite these advances, a thorough understanding, such as the precise cells, which are the targets of neoplastic transformation, especially in solid tumors, is currently lacking. The focus of this review is to emphasize the molecular defects involved in the RB tumor progression and mechanisms associated with inhibition of tumor cell apoptotic processes. This review also discusses the importance of target molecules characterization and their potential therapeutic or prognostic use in RB disease.

  4. Podocyte Pathology and Nephropathy

    Directory of Open Access Journals (Sweden)

    Sandra eMerscher


    Full Text Available Sphingolipids are components of the lipid rafts in plasma membranes, which are important for proper function of podocytes, a key element of the glomerular filtration barrier. Research revealed an essential role of sphingolipids and sphingolipid metabolites in glomerular disorders of genetic and non-genetic origin. The discovery that glucocerebrosides accumulate in Gaucher disease in glomerular cells and are associated with clinical proteinuria initiated intensive research into the function of other sphingolipids in glomerular disorders. The accumulation of sphingolipids in other genetic diseases including Tay-Sachs, Sandhoff, Fabry, hereditary inclusion body myopathy 2, Niemann-Pick and nephrotic syndrome of the Finnish type and its implications with respect to glomerular pathology will be discussed. Similarily, sphingolipid accumulation occurs in glomerular diseases of non-genetic origin including diabetic kidney disease (DKD, HIV-associated nephropathy, focal segmental glomerulosclerosis (FSGS and lupus nephritis. Sphingomyelin metabolites, such as ceramide, sphingosine and sphingosine-1-phosphate have also gained tremendous interest. We recently described that sphingomyelin phosphodiesterase acid-like 3b (SMPDL3b is expressed in podocytes where it modulates acid sphingomyelinase (ASMase activity and acts as a master modulator of danger signaling. Decreased SMPDL3b expression in post-reperfusion kidney biopsies from transplant recipients with idiopathic FSGS correlates with the recurrence of proteinuria in patients and in experimental models of xenotransplantation. Increased SMPDL3b expression is associated with DKD. The consequences of differential SMPDL3b expression in podocytes in these diseases with respect to their pathogenesis will be discussed. Finally, the role of sphingolipids in the formation of lipid rafts in podocytes and their contribution to the maintenance of a functional slit diaphragm in the glomerulus will be discussed.

  5. Best practices for clinical pathology testing in carcinogenicity studies. (United States)

    Young, Jamie K; Hall, Robert L; O'Brien, Peter; Strauss, Volker; Vahle, John L


    The Society of Toxicologic Pathology (STP) and American Society for Veterinary Clinical Pathology (ASCVP) convened a Clinical Pathology in Carcinogenicity Studies Working Group to recommend best practices for inclusion of clinical pathology testing in carcinogenicity studies. Regulatory guidance documents and literature were reviewed, and veterinary pathologists from North America, Japan, and Europe were surveyed regarding current practices, perceived value, and recommendations for clinical pathology testing in carcinogenicity studies. For two-year rodent carcinogenicity studies, the Working Group recommends that clinical pathology testing be limited to collection of blood smears at scheduled and unscheduled sacrifices to be examined only if indicated to aid in the diagnosis of possible hematopoietic neoplasia following histopathologic evaluation. Additional clinical pathology testing is most appropriately used to address specific issues from prior toxicity studies or known test article-related class effects. Inadequate data were available to make a recommendation concerning clinical pathology testing for alternative six-month carcinogenicity assays using genetically modified mice, although the Working Group suggests that it may be appropriate to use the same approach as for two-year carcinogenicity studies since the study goal is the same.

  6. Reviews

    NARCIS (Netherlands)

    Donk, M.A.; Maas Geesteranus, R.A.


    There are few groups, even among the notorious pyrenomycetes, that have been the source of new species to such an extent as the one covered by this monograph. Its author recognizes a big central and rather heterogeneous genus Pleospora (with 100 species) and some affiliated smaller genera, Platyspor

  7. Reviews. (United States)

    Greenleaf, Floyd; And Others


    Reviews eight textbooks, readers, and books. Topics include Latin America, colonial America, the Carolinians, women in French textbooks, the Vikings, the Soviet Union, nineteenth-century Black America, and Ernest Rutherford. (TRS)

  8. Reviews. (United States)

    Science Teacher, 1987


    Provides reviews of four computer software packages designed for use in science education. Describes courseware dealing with a variety of tips for teaching physics concepts, chemical reactions in an aqueous solution, mitosis and meiosis, and photosynthesis. (TW)

  9. Ataxia-telangiectasia: some historic, clinical and pathologic observations. (United States)

    Boder, E


    Although an isolated clinical case report was published in 1926 and another in 1941, ataxia-telangiectasia (A-T) was not established as a distinct entity until 1957, when it was first delineated clinicopathologically. Susceptibility to sinopulmonary infection was identified as the main cause of death and as the third major component of the syndrome; its heredofamilial nature was documented, and it was designated "ataxia-telangiectasia." In a later review of 101 published cases, lymphoreticular malignancy emerged as the second most frequent cause of death. Although the thymus was found to be absent in the first reported autopsy in 1957 and the serum IgA deficiency was first recorded in 1961, A-T was not established as an immunodeficiency disease until 1963. Thymic abnormality and dysgammaglobulinemia explain the 2 main causes of death, sinopulmonary and neoplastic, but the immunodeficiency is probably not the central defect. It does not appear to explain either of the 2 main clinical diagnostic keys, the ataxia and the telangiectasia, or any of the other seemingly unrealted multisystemic facets of this complex disorder. Some of our most provocative long-term clinical observations and recent pathologic findings in our series of 9 autopsies are discussed.

  10. Utilization management in anatomic pathology. (United States)

    Lewandrowski, Kent; Black-Schaffer, Steven


    There is relatively little published literature concerning utilization management in anatomic pathology. Nonetheless there are many utilization management opportunities that currently exist and are well recognized. Some of these impact only the cost structure within the pathology department itself whereas others reduce charges for third party payers. Utilization management may result in medical legal liabilities for breaching the standard of care. For this reason it will be important for pathology professional societies to develop national utilization guidelines to assist individual practices in implementing a medically sound approach to utilization management.

  11. Primary lymphoma of the central nervous system: a clinical-pathological and immunohistochemical study of ten autopsy cases Linfoma primário do sistema nervoso central: estudo clínico-patológico e imuno-histoquímico de dez casos de necropsia

    Directory of Open Access Journals (Sweden)

    Henrique Costa


    Full Text Available CONTEXT: Primary central nervous system lymphomas (PCNSL are a rare subgroup of lymphomas generally associated with HIV and EBV. OBJECTIVE: To study ten autopsy cases of PCNSL, to describe the neuropathological findings, to characterize the phenotype of the neoplastic cells, to detect EBV in the lesion and to compare the findings with the clinical and laboratory data of the patients. METHOD: The clinical, histological and immunohistochemical data of ten cases of PCNSL, eight cases from patients with AIDS, identified among 265 autopsies of these patients were analyzed. RESULTS: Seven patients were males and the mean age was 40.9 years. The most frequent symptomatology was focal neurologic deficit (70%. Six patients presented with only one lesion. Histologically, densely cellular and polymorphous neoplasms with angiocentrism were observed, in 90% of cases. An association with other diseases was observed in four cases. Most patients had diffuse large B cell non-Hodgkin’s lymphoma. EBV was detected by immunohistochemistry in only one case. The lack of detection of the virus might have been due to the long time of fixation of the brain which might have inactivate epitopes therefore compromising the testing. CONCLUSION: In the present series, PCNSL presented with focal symptoms, with unifocal or multifocal lesions, with a predominant B-cell CD20 positive phenotype, rarely associated with EBV.CONTEXTO: Linfoma primário do sistema nervoso central (LP-SNC é raro subgrupo de linfomas relacionado à AIDS, geralmente associado EBV. OBJETIVO: Identificar os achados clínico-patológicos dos pacientes com LP-SNC. MÉTODO: Foram analisados dados clínicos, histológicos e imuno-histoquímicos de dez necrópsias de LP-SNC, oito deles de pacientes com AIDS, identificados entre 265 autopsias destes. RESULTADOS: Sete pacientes foram masculinos e a idade média foi 40,9 anos. A sintomatologia neurológica mais freqüente era focal (70%. Seis exibiram les

  12. Noninflammatory fallopian tube pathology in children

    Energy Technology Data Exchange (ETDEWEB)

    Merlini, Laura; Anooshiravani, Mehrak; Hanquinet, Sylviane [University Hospital HUG, Unit of Pediatric Radiology, Geneva (Switzerland); Vunda, Aaron [University Hospital, Clinic of Pediatric Surgery, Geneva (Switzerland); Borzani, Irene; Napolitano, Marcello [Ospedale Buzzi, Pediatric Radiology, Milan (Italy)


    Noninflammatory tubal abnormalities are rare in children and usually not well covered by traditional educational material. The presenting symptoms are nonspecific and are common to many other conditions, so its preoperative diagnosis is rarely made. The purpose of this study was to review the hospital charts and imaging findings in children and sexually inactive adolescents who showed fallopian tube pathology. Understanding of the pertinent findings of previous imaging examinations might assist radiologists in making the correct preoperative diagnosis and increase the likelihood of preserving the fallopian tubes. The clinical entities described in this article include isolated tubal torsion, paratubal cysts, hydrosalpinx, undescended/ectopic fallopian tube, and tubal inguinal hernia. (orig.)

  13. Hydatidiform mole clinical and pathological characteristics


    Pacheco D., José; Instituto de Patología, UNMSM; Instituto de Medicina Legal; Alegre, Jaime; Hospital Nacional Dos de Mayo, Lima, Perú; Paniagua, Gissela; Instituto de Patología de la UNMSM


    Objective: To determine clinical and pathological findings in hydatidiform mole. Design: Descriptive retrospective study. Material and methods: All cases de molar pregnancy attended at Dos de Mayo National Hospital (HNDM) between 1998 and 2001 were reviewed. Results: Twenty-four cases of hydatidiform mole were attended; mean age was 26,4 years ± 6,4 and gestational age 13,1 weeks ± 3,3. Past history only showed 1 and 3 cases of hyperemesis gravidarum and previous abortions, respectively; 18 p...

  14. Risk of extravasation after power injection of contrast media via the proximal port of multilumen central venous catheters. Case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Schummer, C.; Sakr, Y.; Reinhart, K. [Jena Univ. (Germany). Klinik fuer Anaestesiologie und Intensivtherapie; Steenbeck, J. [Jena Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Gugel, M. [Zentralklinik Bad Berka (Germany). Klinik fuer Anaesthesiologie und Intensivtherapie; Schummer, W. [SRH Zentralklinikum Suhl (Germany). Dept. of Anaesthesiology and Intensive Care Medicine


    Multilumen central venous catheters (CVCs) are not commonly used for power injection. However, in critically ill patients, CVCs - most of which do not have FDA approval for power injection - may be the only available venous access. The pitfalls of multilumen CVCs are illustrated by a case report of a patient in whom extravasation of intravenously administered contrast medium occurred after power injection in a triple-lumen CVC using the lumen with the port furthest from the catheter tip. The underlying mechanisms for the displacement of the initially correctly placed right subclavian CVC could include elevation of both arms of the obese patient or the power injection itself. The distances between port openings and catheter tips of various commercially available multilumen CVCs are assessed. We examine the possible caveats of ECG-guided CVC placement for optimal tip position, discuss technical difficulties related to power injection via CVCs, and review commonly used drugs that may cause extravasation injury. Knowledge of the distances between CVC port openings and the catheter tip are essential for safe intravasal administration of fluids. (orig.)

  15. Leadership is Central to the Organizational Success of Libraries. A review of: Mullins, John, and Margaret Linehan. “The Central Role of Leaders in Public Libraries.” Library Management 26.6/7 (2005: 386‐96.

    Directory of Open Access Journals (Sweden)

    Pamela Haley


    Full Text Available Objective – To provide an understanding of the concept of leadership as perceived and practised by a group of international public library leaders, thereby contributing to the existing body of literature on this topic.Design – Qualitative study employing in depth, face‐to‐face interviews with 3 subjects and 27 e‐mail interviews based on 30 structured questions formulated from a review of the literature.Setting – Nottingham and Rotherham, two cities in the Public libraries in Ireland, Britain, and the east coast of the United States during 2003/04.Subjects – Thirty senior public library leaders.Methods – Thirty top level library leaders, 50% of whom came from outside Ireland, were selected based on the following rationale concerning their institutions: have a history of providing publicly funded public libraries; are under‐researched; and, accessibility for the authors. Irish librarians were chosen based on their national profile, geographic convenience to the researchers, and availability/cooperation. Only libraryl eaders or deputy leaders were considered. Interviews for 27 candidates where scheduled via e‐mail and 3 were arranged through face‐to‐face meetings. Participants were asked 30 structured questions drawn from the current literature on leadership. Responses were recorded electronically and later transcribed for analysis via a grounded theory approach that categorized the data. This method of analysis endeavours to provide theory based on research observations that begin from qualitative data and then go through a process of sifting and categorization, which leads to a hypothesis.Main results – Nine broad categories emerged from the “grounded theory analysis.” The paper deals with only 1 ‐ the central role of the library leader. In response to queries by the authors, 67% (20 agreed that leadership took precedence over all other factors as a determinant for organizational success. Ten (33% disagreed and

  16. Giant cell granuloma: a cross- sectional study in oral and maxillofacial pathology department of dental faculty of Tehran University of Medical Sciences (1986-2000

    Directory of Open Access Journals (Sweden)

    Jalayer Naderi N.


    Full Text Available Statement of Problem: Giant cell granuloma (G.C.G is a reactive lesion which affects the jaws and oral mucosa of gingiva.This lesion is classified to central and peripheral ones. The histopathologic aspects of central and peripheral G.C.G is the same. The central lesions are aggressive and cause osseous destruction. The peripheral G.C.G produces ulcerative swellings similar to pyogenic granuloma or peripheral ossifying fibroma. Since the peripheral and central G.C.G are common lesions, the awareness of dentists of different aspect of G.C.G is very important. Purpose: The aim of this study was a statistical evaluation of variables such as age, gender and location of peripheral and central G.C.G in oral and maxillofacial pathology department of Dental Faculty of Tehran University of Medical Sciences. Materials and Methods: This study was a cross-sectional, case series one. The medical records of oral and maxillofacial pathology department of Dental Faculty of Tehran University of Medical Sciences was assessed in two steps: In the first stage, the medical records of patients with pathologic report of peripheral and central G.C.G were selected and reviewed. In the next step, the informations such as age, gender and location of peripheral and central G.C.G were registered in data forms. The obtained data were analyzed by SPSS statistical software. Results: The results showed that the age range in peripheral and central G.C.G were 2- 90 and 4-70 years, respectively. The peak incidence of peripheral and central G.C.G was in the third and second decades, respectively. The peripheral G.C.G was more common in men (52.70% than women (47.30%. This finding in central G.C.G was 37.19% for men and 62.88% for women. 57.06% of peripheral G.C.G cases were in mandible and 42.94% in maxilla. The occurrence of central G.C.G was 67.07% in mandible and 32.93 % in maxilla. Conclusion: Based on this study, the peripheral lesions were more frequent in men, third decade

  17. The Application of Digital Pathology to Improve Accuracy in Glomerular Enumeration in Renal Biopsies.

    Directory of Open Access Journals (Sweden)

    Avi Z Rosenberg

    Full Text Available In renal biopsy reporting, quantitative measurements, such as glomerular number and percentage of globally sclerotic glomeruli, is central to diagnostic accuracy and prognosis. The aim of this study is to determine the number of glomeruli and percent globally sclerotic in renal biopsies by means of registration of serial tissue sections and manual enumeration, compared to the numbers in pathology reports from routine light microscopic assessment.We reviewed 277 biopsies from the Nephrotic Syndrome Study Network (NEPTUNE digital pathology repository, enumerating 9,379 glomeruli by means of whole slide imaging. Glomerular number and the percentage of globally sclerotic glomeruli are values routinely recorded in the official renal biopsy pathology report from the 25 participating centers. Two general trends in reporting were noted: total number per biopsy or average number per level/section. Both of these approaches were assessed for their accuracy in comparison to the analogous numbers of annotated glomeruli on WSI.The number of glomeruli annotated was consistently higher than those reported (p<0.001; this difference was proportional to the number of glomeruli. In contrast, percent globally sclerotic were similar when calculated on total glomeruli, but greater in FSGS when calculated on average number of glomeruli (p<0.01. The difference in percent globally sclerotic between annotated and those recorded in pathology reports was significant when global sclerosis is greater than 40%.Although glass slides were not available for direct comparison to whole slide image annotation, this study indicates that routine manual light microscopy assessment of number of glomeruli is inaccurate, and the magnitude of this error is proportional to the total number of glomeruli.

  18. Pathological study on severe acute respiratory syndrome

    Institute of Scientific and Technical Information of China (English)

    郎振为; 张立洁; 张世杰; 孟忻; 李俊强; 宋晨朝; 孙琳; 周育森


    Objective To study the pathological characteristics of severe acute respiratory syndrome (SARS) and its relationship to clinical manifestation. Methods Tissue specimens from 3 autopsies of probable SARS cases were studied by microscope, and the clinical data was reviewed.Results The typical pathological changes of lungs were diffuse hemorrhaging on the surface. A combination of serous, fibrinous and hemorrhagic inflammation was seen in most of the pulmonary alveoli with the engorgement of capillaries and detection of micro-thrombosis in some of these capillaries. Pulmonary alveoli thickened with interstitial mononuclear inflammatory infiltrates, suffered diffuse alveolar damage, experienced desquamation of pneumocytes and had hyaline-membrane formation, fibrinoid materials, and erythrocytes in alveolar spaces. There were thromboembolisms in some bronchial arteries. Furthermore, hemorrhagic necrosis was also evident in lymph nodes and spleen with the attenuation of lymphocytes. Other atypical pathological changes, such as hydropic degeneration, fatty degeneration, interstitial cell proliferation and lesions having existed before hospitalization were observed in the liver, heart, kidney and pancreas.Conclusion Severe damage to the pulmonary and immunological systems is responsible for the clinical features of SARS and may lead to the death of patients.

  19. Unexpected cellular players in Rett syndrome pathology. (United States)

    Cronk, James C; Derecki, Noel C; Litvak, Vladimir; Kipnis, Jonathan


    Rett syndrome is a devastating neurodevelopmental disorder, primarily caused by mutations of methyl CpG-binding protein 2 (MeCP2). Although the genetic cause of disease was identified over a decade ago, a significant gap still remains in both our clinical and scientific understanding of its pathogenesis. Neurons are known to be primary players in pathology, with their dysfunction being the key in Rett syndrome. While studies in mice have demonstrated a clear causative - and potential therapeutic - role for neurons in Rett syndrome, recent work has suggested that other tissues also contribute significantly to progression of the disease. Indeed, Rett syndrome is known to present with several common peripheral pathologies, such as osteopenia, scoliosis, gastrointestinal problems including nutritional defects, and general growth deficit. Mouse models assessing the potential role of non-neuronal cell types have confirmed both roles in disease and potential therapeutic targets. A new picture is emerging in which neurons both initiate and drive pathology, while dysfunction of other cell types and peripheral tissues exacerbate disease, possibly amplifying further neurologic problems, and ultimately result in a positive feedback loop of progressively worsening symptoms. Here, we review what is known about neuronal and non-neuronal cell types, and discuss how this new, integrative understanding of the disease may allow for additional clinical and scientific pathways for treating and understanding Rett syndrome.

  20. MLE's bias pathology motivates MCMLE


    Yatracos, Yannis G.


    Maximum likelihood estimates are often biased. It is shown that this pathology is inherent to the traditional ML estimation method for two or more parameters, thus motivating from a different angle the use of MCMLE.

  1. Reviews


    Revista alicantina de estudios ingleses


    Contiene: M. Carmen África Vidal Claramonte. Traducción, manipulación, desconstrucción. Colección Biblioteca Filológica de Salamanca. Salamanca: Ediciones Colegio de España, 1995 / reviewed by Enrique Alcaraz Varó; Diccionario de uso inglés-español/Spanish-English. Directed by Aquilino Sánchez. Madrid: SGEL, 1993, 450 pp. Diccionario de uso pocket inglés-español/Spanish- English. Directed by Aquilino Sánchez. Madrid: SGEL, 1993, 274 pages / reviewed by Miguel Ángel Campos Pardillo...

  2. [Methods and methodology of pathology]. (United States)

    Lushnikov, E F


    The lecture gives the state-of-the-art of the methodology of human pathology that is an area of the scientific and practice activity of specialists to produce and systematize objective knowledge of pathology and to use the knowledge in clinical medicine. It considers the objects and subjects of an investigation, materials and methods of a pathologist, and the results of his/her work.

  3. Systemic disorders affecting dental pathology

    Directory of Open Access Journals (Sweden)

    Knežević Milan R


    Full Text Available A retrospective overview of systemic disorders which might be associated with dental pathology is made. They are grouped as follows: (a congenital dental developmental disorders, (b chromosomal anomalies, (c radiations, (d immune disorders, (e intoxications, (f neurological alterations, (g gastrointestinal diseases, (h osteodystrophy and associated conditions, (i skin diseases, (j metabolic and endocrine disorders, (k craniofacial malformation syndromes and other congenital general malformations. The associated dental pathology is described in each case.

  4. Development of pathology in Turkey

    Directory of Open Access Journals (Sweden)

    Gökhan GEDİKOĞLU


    Full Text Available Autospy is an important tool for the development of pathology as a science. In western civilisation dissection of human body became widespread with Renaissance, in contrast in the Ottoman Empire first dissection was not performed until the 19th century. Mustafa Behçet Efendi, head physician of the Empire, was one of the Ottoman physician who suggested the importance of dissection in the medical education. The first dissection was however performed by Charles Ambroise Bernard, a foreign physician who had been invited to help establishing a new medical school; “Mekteb-i Tıbbiye-i Adliye-i Şâhâne”, in 1843. The first modern medical schools called “Tıphane” and “Cerrahhane-i Amire” which were founded in 1827, did not have pathology courses. Pathology courses began in “Mekteb-i Tıbbiye-i Adliyei Şâhâne”. Dr. Hamdi Suat (Aknar, educated in anatomic pathology in Germany, was the first pathologist who established the modern pathology in Turkey in “İstanbul Darülfünun” medical school. In 1933 “Darülfünün” was closed and İstanbul University was built and the “University Reform Commission” invited many scientists escaping from Nazi government to study in İstanbul University. Dr. Philipp Schwartz had an important role both in the invitation of these scientists and establishment of the pathology department in İstanbul University. Practical courses were increased, clinicopathologic courses were organized for the first time and a lot of autopsies were performed, as high as 1000 autopsy per year, by Dr. Philipp Schwartz. More progress has takes place in Turkey over the years since pathology was first established. Today Turkey has many pathology departments which keep up with the worldwide advances in the field.

  5. The history of pathology informatics: A global perspective (United States)

    Park, Seung; Parwani, Anil V.; Aller, Raymond D.; Banach, Lech; Becich, Michael J.; Borkenfeld, Stephan; Carter, Alexis B.; Friedman, Bruce A.; Rojo, Marcial Garcia; Georgiou, Andrew; Kayser, Gian; Kayser, Klaus; Legg, Michael; Naugler, Christopher; Sawai, Takashi; Weiner, Hal; Winsten, Dennis; Pantanowitz, Liron


    Pathology informatics has evolved to varying levels around the world. The history of pathology informatics in different countries is a tale with many dimensions. At first glance, it is the familiar story of individuals solving problems that arise in their clinical practice to enhance efficiency, better manage (e.g., digitize) laboratory information, as well as exploit emerging information technologies. Under the surface, however, lie powerful resource, regulatory, and societal forces that helped shape our discipline into what it is today. In this monograph, for the first time in the history of our discipline, we collectively perform a global review of the field of pathology informatics. In doing so, we illustrate how general far-reaching trends such as the advent of computers, the Internet and digital imaging have affected pathology informatics in the world at large. Major drivers in the field included the need for pathologists to comply with national standards for health information technology and telepathology applications to meet the scarcity of pathology services and trained people in certain countries. Following trials by a multitude of investigators, not all of them successful, it is apparent that innovation alone did not assure the success of many informatics tools and solutions. Common, ongoing barriers to the widespread adoption of informatics devices include poor information technology infrastructure in undeveloped areas, the cost of technology, and regulatory issues. This review offers a deeper understanding of how pathology informatics historically developed and provides insights into what the promising future might hold. PMID:23869286

  6. Atypical central nervous system Whipple's disease: a case report and review of the literature%不典型性中枢神经系统Whipple病:一例报告并文献复习

    Institute of Scientific and Technical Information of China (English)

    钱海蓉; 孟宇宏; 王巍; 卢德宏; 朴月善; 戚晓昆


    Objective To report the first case of central nervous system Whipple's disease (WD) with relatively good prognosis in China and present a brief review of central nervous system WD so as to improve the understanding of the diagnosis and treatment of this rare disease. Methods The clinical data of diagnosis, treatment and prognosis of one case of 35-year-old female was analysed in detail. Results Headache, hemiplesia and dementia were the main symptoms of this case and hypercranial pressure crisis occurred. During the course of disease, the patient successively presented paroxysmal extremity convulsion, right leg weakness, urinary incontinence, overeating, body mass increase. Despite of high dose of corticosteroid, penicillin and compound sulfamethoxazole were used, no effect was seen. Along with the increasing of intracranial pressure, cerebral hernia occurred. Cerebrospinal fluid examination indicated that glucose and chloride were normal while protein was obviously increased to 1700 mg/L. Electrocardiography (EEG) showed slow wave in right frontal and temporal lobes. Serial magnetic resonance imaging (MRI) revealed mutiple long Ti and long T2 signals mainly in right cerebral hemisphere, frontal parietal temporal lobes, seraioval center and basal ganglion, with edema and irregular loose contrast and extended to left cerebral. Brain biopsy showed large pieces of necrosis at right fronto-temporal lobe with massive infiltration of lymphocytes and plasmocytes at perivascular and brain tissue, and exudation of glitter cells. Positive PAS and methenamine silver staining revealed bacterial particles inglitter cells. Central nervous systemtumor, demyelinating disease and inflammatory pseudotumor were excluded. Both clinical symptoms and neuroimging recovered well after regular antibiotic therapy.Conclusion Central nervous system WD is a rare disease with complicated symptoms and imaging characters challenging diagnosis and treatment. The pathological findings may only

  7. Pathology of Minamata disease. (United States)

    Eto, K


    Minamata disease, or methylmercury poisoning, was first discovered in 1956 around Minamata Bay, Kumamoto Prefecture, Japan. A similar epidemic occurred in 1965 along the Agano River, Niigata Prefecture, Japan. The neuropathology of Minamata disease has been well studied; this review focuses on human cases of Minamata disease in Kumamoto Prefecture. Nervous system lesions associated with Minamata disease have a characteristic distribution. In the cerebral cortex, the calcarine cortex was found to be involved in all cases of Minamata disease, particularly along the calcarine fissure. The destruction of nerve tissue was prominent in the anterior portions of the calcarine cortex. Occasionally, the centrifugal route from the visual and visual association areas (internal sagittal stratum) showed secondary degeneration in prolonged cases after acute onset. Postcentral, precentral, and temporal transverse cortices showed similar changes, though they were less severe. Intense lesions in the precentral cortex caused the development of secondary bilateral degeneration of the pyramidal tracts. In the cerebellum, the lesions occurred deeper in the hemisphere. The granule cell population was most affected. In the peripheral nerves, sensory nerves were more affected than motor nerves. Secondary degeneration of Goll's tracts was occasionally seen in prolonged or chronic cases.

  8. Reviews. (United States)

    Repak, Arthur J.; And Others


    Computer software, audiovisuals, and books are reviewed. Includes topics on interfacing, ionic equilibrium, space, the classification system, Acquired Immune Disease Syndrome, evolution, human body processes, energy, pesticides, teaching school, cells, and geological aspects. Availability, price, and a description of each are provided. (RT)

  9. Reviews

    NARCIS (Netherlands)

    Adema, Frits


    This is the second volume of a revision of Tabernaemontana (Apocynaceae). The volume covers the New World species (44) and the genus Stemmadenia (10 species). This part of the revision of Tabernaemontana comes up to the high standards set in the first volume [see the review by Leenhouts, Blumea 38 (

  10. Review

    NARCIS (Netherlands)

    Wilde, de W.J.J.O.


    This review marks the appearance of Volume II, after the publication of Volume I, Pteridophytes and Gymnosperms, in 1990; several more volumes are expected in the future before completion of the Vascular plants as a whole. The present volume contains 73 families out of some 250-500 families which ca

  11. Reviews

    NARCIS (Netherlands)

    Sleumer, H.; Steenis, van C.G.G.J.


    An exhaustive Flora of Delhi, compiled by J. K. Maheshwari, was published by C.S.I.R. in 1963 (for a review see Blumea 13, 1965, p. 174). During the compilation of that flora, 278 line-drawings, illustrating the habits and chief features of the plants found in Delhi, were prepared; they form a welco

  12. Reviews

    NARCIS (Netherlands)



    BALGOOY, M.M.J, VAN. 1998. Malesian Seed Plants. Volume 2. Portraits of tree families. 307 pp., numerous text figures. Published by Rijksherbarium/Hortus Botanicus, Leiden. ISBN 90-71236-36-6. Paperback. Price: NLG 100.00. This is the second volume of a trilogy [see the review of ‘Spot-characters’ b

  13. Review

    DEFF Research Database (Denmark)

    Van Den Hazel, H B; Kielland-Brandt, Morten; Winther, Jakob R.


    The yeast vacuole, which is equivalent to the lysosome of higher eukaryotes, is one of the best characterized degradative organelles. This review describes the biosynthesis and function of yeast vacuolar proteases. Most of these enzymes are delivered to the vacuole via the early compartments...

  14. Reviews. (United States)

    Journal of Chemical Education, 1988


    Reviews three computer software packages for chemistry education including "Osmosis and Diffusion" and "E.M.E. Titration Lab" for Apple II and "Simplex-V: An Interactive Computer Program for Experimental Optimization" for IBM PC. Summary ratings include ease of use, content, pedagogic value, student reaction, and…

  15. Use of contextual inquiry to understand anatomic pathology workflow: Implications for digital pathology adoption

    Directory of Open Access Journals (Sweden)

    Jonhan Ho


    of processes that may possibly improve following the introduction of digital pathology systems were identified. These work processes included case management, case examination and review, and final case reporting. Furthermore, a digital slide system should integrate with the anatomic pathologic laboratory information system. Conclusions: To our knowledge, this is the first study that utilized the contextual inquiry method to document AP workflow. Findings were used to establish key requirements for the design of digital pathology systems.

  16. Deployable centralizers

    Energy Technology Data Exchange (ETDEWEB)

    Grubelich, Mark C.; Su, Jiann-Cherng; Knudsen, Steven D.


    A centralizer assembly is disclosed that allows for the assembly to be deployed in-situ. The centralizer assembly includes flexible members that can be extended into the well bore in situ by the initiation of a gas generating device. The centralizer assembly can support a large load carrying capability compared to a traditional bow spring with little or no installation drag. Additionally, larger displacements can be produced to centralize an extremely deviated casing.

  17. Pathology of the Nervous System in Von Hippel-Lindau Disease

    Directory of Open Access Journals (Sweden)

    Alexander O. Vortmeyer


    Full Text Available Von Hippel-Lindau (VHL disease is a tumor syndrome that frequently involves the central nervous system (CNS. It is caused by germline mutation of the VHL gene. Subsequent VHL inactivation in selected cells is followed by numerous well-characterized molecular consequences, in particular, activation and stabilization of hypoxia-inducible factors HIF1 and HIF2. The link between VHL gene inactivation and tumorigenesis remains poorly understood. Hemangioblastomas are the most common manifestation in the CNS; however, CNS invasion by VHL disease-associated endolymphatic sac tumors or metastatic renal cancer also occur, and their differentiation from primary hemangioblastoma may be challenging. Finally, in this review, we present recent morphologic insights on the developmental concept of VHL tumorigenesis which is best explained by pathologic persistence of temporary embryonic progenitor cells. 

  18. Wnt and lithium: a common destiny in the therapy of nervous system pathologies? (United States)

    Meffre, Delphine; Grenier, Julien; Bernard, Sophie; Courtin, Françoise; Dudev, Todor; Shackleford, Ghjuvan'Ghjacumu; Jafarian-Tehrani, Mehrnaz; Massaad, Charbel


    Wnt signaling is required for neurogenesis, the fate of neural progenitors, the formation of neuronal circuits during development, neuron positioning and polarization, axon and dendrite development and finally for synaptogenesis. This signaling pathway is also implicated in the generation and differentiation of glial cells. In this review, we describe the mechanisms of action of Wnt signaling pathways and their implication in the development and correct functioning of the nervous system. We also illustrate how a dysregulated Wnt pathway could lead to psychiatric, neurodegenerative and demyelinating pathologies. Lithium, used for the treatment of bipolar disease, inhibits GSK3β, a central enzyme of the Wnt/β-catenin pathway. Thus, lithium could, to some extent, mimic Wnt pathway. We highlight the possible dialogue between lithium therapy and modulation of Wnt pathway in the treatment of the diseases of the nervous system.

  19. Role of ROBO4 Signalling in Developmental and Pathological Angiogenesis

    Directory of Open Access Journals (Sweden)

    Suresh Singh Yadav


    Full Text Available Transmembrane roundabout receptor family members (ROBO1–ROBO4 principally orchestrate the neuronal guidance mechanism of the nervous system. Secreted glycoprotein SLITs are the most appreciated ligands for ROBOs. Recently identified ROBO4 is the key mediator of SLIT-ROBO mediated developmental and pathological angiogenesis. Although SLIT2 has been shown to interact with ROBO4 as ligand, it remains an open question whether this protein is the physiologic partner of ROBO4. The purpose of this review is to summarise how reliable SLIT2 as ligand for ROBO4 is, if not what the other possible mechanisms demonstrated till date for ROBO4 mediated developmental and pathological angiogenesis are. We conclude that ROBO4 is expressed specially in vascular endothelial cells and maintains the vascular integrity via either SLIT2 dependent or SLIT2 independent manner. On the contrary, it promotes the pathological angiogenesis by involving different signalling arm(s/unknown ligand(s. This review explores the interactions SLIT2/ROBO1, SLIT2/ROBO1–ROBO4, ROBO1/ROBO4, and ROBO4/UNC5B which can be promising and potential therapeutic targets for developmental angiogenesis defects and pathological angiogenesis. Finally we have reviewed the ROBO4 signalling pathways and made an effort to elaborate the insight of this signalling as therapeutic target of pathological angiogenesis.

  20. Digital pathology and image analysis in tissue biomarker research. (United States)

    Hamilton, Peter W; Bankhead, Peter; Wang, Yinhai; Hutchinson, Ryan; Kieran, Declan; McArt, Darragh G; James, Jacqueline; Salto-Tellez, Manuel


    Digital pathology and the adoption of image analysis have grown rapidly in the last few years. This is largely due to the implementation of whole slide scanning, advances in software and computer processing capacity and the increasing importance of tissue-based research for biomarker discovery and stratified medicine. This review sets out the key application areas for digital pathology and image analysis, with a particular focus on research and biomarker discovery. A variety of image analysis applications are reviewed including nuclear morphometry and tissue architecture analysis, but with emphasis on immunohistochemistry and fluorescence analysis of tissue biomarkers. Digital pathology and image analysis have important roles across the drug/companion diagnostic development pipeline including biobanking, molecular pathology, tissue microarray analysis, molecular profiling of tissue and these important developments are reviewed. Underpinning all of these important developments is the need for high quality tissue samples and the impact of pre-analytical variables on tissue research is discussed. This requirement is combined with practical advice on setting up and running a digital pathology laboratory. Finally, we discuss the need to integrate digital image analysis data with epidemiological, clinical and genomic data in order to fully understand the relationship between genotype and phenotype and to drive discovery and the delivery of personalized medicine.

  1. Gastric schwannomas: radiological features with endoscopic and pathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Hong, H.S. [Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seodaemoon-gu, Seoul (Korea, Republic of); Ha, H.K. [Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of)], E-mail:; Won, H.J.; Byun, J.H.; Shin, Y.M.; Kim, A.Y.; Kim, P.N.; Lee, M.-G. [Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of); Lee, G.H. [Internal Medicine, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of); Kim, M.J. [Pathology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of)


    Aim: To describe the radiological, endoscopic, and pathological findings of gastric schwannomas in 16 patients. Materials and methods: The radiological, endoscopic, and pathological findings of 16 surgically proven cases of gastric schwannoma were retrospectively reviewed. All patients underwent computed tomography (CT) and four patients were evaluated with upper gastrointestinal series. Two radiologists reviewed the CT and upper gastrointestinal series images by consensus with regard to tumour size, contour, margin, and growth pattern, the presence or absence of ulcer, cystic change, and the CT enhancement pattern. Endoscopy was performed in eight of these 16 patients. Six patients underwent endoscopic ultrasonography. Pathological specimens were obtained from and reviewed in all 16 patients. Immunohistochemistry was performed for c-kit, CD34, smooth muscle actin, and S-100 protein. Results: On radiographic examination, gastric schwannomas appeared as submucosal tumours with the CT features of well-demarcated, homogeneous, and uncommonly ulcerated masses. Endoscopy with endoscopic ultrasonography demonstrated homogeneous, submucosal masses contiguous with the muscularis propria in all six examined cases. On pathological examination, gastric schwannomas appeared as well-circumscribed and homogeneous tumours in the muscularis propria and consisted microscopically of interlacing bundles of spindle cells. Strong positivity for S-100 protein was demonstrated in all 16 cases on immunohistochemistry. Conclusion: Gastric schwannomas appear as submucosal tumours of the stomach and have well-demarcated and homogeneous features on CT, endoscopic ultrasonography, and gross pathology. Immunohistochemistry consistently reveals positivity for S-100 protein in the tumours.

  2. Subperiosteal osteoid osteoma: radiographic and pathologic manifestations

    Energy Technology Data Exchange (ETDEWEB)

    Shankman, S. [Department of Radiology, Hospital for Joint Diseases/OI, 301 East 17th Street, New York, NY 10003 (United States); Desai, P. [Department of Pathology, Hospital for Joint Diseases/OI, 301 East 17th Street, New York, NY 10003 (United States); Beltran, J. [Department of Radiology, Hospital for Joint Diseases/OI, 301 East 17th Street, New York, NY 10003 (United States)


    Objective.To demonstrate the radiologic and pathologic manifestations of osteoid osteoma arising beneath the periosteum, on the surface of the bone. Design. One hundred and sixty osteoid osteomas were seen over a 30-year period. The radiologic, pathologic and operative findings of those that were subperiosteal were reviewed. Patients. Eleven patients with subperiosteal osteoid osteoma were reviewed. The patients ranged in age from 13 to 36 years with a mean of 24 years. Eight were male and three were female. Results and conclusion. Eleven subperiosteal lesions were studied. The reactive periostitis of four lesions was atypical and misleading. Four lesions had features similar to the more common intracortical variety. Three lesions occurring within the joint like other intra-articular lesions were barely seen on plain radiographs. Bone scan and CT scan were virtually diagnostic. The histopathology of these lesions was also atypical though not misleading. In conclusion, subperiosteal osteoid osteoma is a rare lesion with atypical radiographic and histopathologic features. The unusual reactive periostitis seen in several extra-articular cases may suggest other diagnoses. (orig.). With 4 figs., 2 tabs.

  3. Misdiagnosis of chondromyxoid fibroma with pathological fracture of ilium:a case report and literature review%髂骨软骨黏液样纤维瘤合并病理性骨折误诊1例分析并文献复习

    Institute of Scientific and Technical Information of China (English)

    张乾营; 李嘉家


    To investigate the clinical feature and imaging diagnosis of chondromyxoid fibroma. Methods To report one case of chondromyxoid fibroma with pathological fracture and review the related literatures,and investigate the imaging and pathological characteristics,and study the effect and prognosis of treatment. Result Chondromyxoid fibroma with pathological fracture, which the first choice for surgical treatment, was very rare. For lack of characteristic imaging should be differentiated with giant cell tumor of bone and bone cyst. Conclusion The imaging diagnosis of chondromyxoid fibroma with pathological fracture is difficult. The disease with surgical therapy is good progosis.but which has high recurrence rates.%目的 探讨软骨黏液样纤维瘤的影像诊断及临床特征.方法 左髂骨软骨黏液样纤维瘤合并病理性骨折l例,复习相关文献并分析临床、影像学及病理,探讨其诊断治疗及预后.结果 髂骨软骨黏液样纤维瘤比较少见,合并病理性骨折更是罕见,缺乏特征性影像学表现,术前诊断困难,需与骨巨细胞瘤、骨囊肿等疾病相鉴别,外科治疗为首选.结论 软骨黏液样纤维瘤影像诊断存在一定难度,外科治疗预后较好,但是术后复发率较高.

  4. Reviews

    Directory of Open Access Journals (Sweden)

    Philip Barker


    Full Text Available There were two copy-editing blunders in Clive Betts's review, in ALT-J 5 (3, of Shirley Fletcher's Designing Competence-Based Training, one in paragraph 2 line 1, the other in paragraph 3 line 8. The errors (the result of the Editor, Gabriel Jacobs, trying to perform a final proof of the journal at lightning speed in order to meet the printing deadline, and not of any mistake on the part of either Philip Barker or the University of Wales Press hardly affected meaning, but the fact that they appeared in a review of a book on competence makes the embarrassment all the more telling. The Editor apologizes, and thanks eagle-eyed readers. He has decided to read the book in the hope that such errors will not recur.

  5. Processos educativos em saúde vocal do professor: análise da literatura da Fonoaudiologia brasileira Educative processes in the vocal health of teachers: a literature review of Brazilian studies in Speech-Language Pathology and Audiology

    Directory of Open Access Journals (Sweden)

    Regina Zanella Penteado


    Full Text Available Este artigo de revisão analisa os processos educativos das ações coletivas de saúde vocal do professor descritas na literatura fonoaudiológica brasileira. O material de análise foi constituído por 63 publicações referentes a intervenções de caráter coletivo, no período entre 1994 e 2008. A análise focaliza a distribuição das publicações ao longo do tempo; a caracterização do tipo de processo educativo (unilateral ou dialógico, democrático, participante e problematizador; os temas/conteúdos abordados; a forma de desenvolvimento (pontual ou processual; e a organização das ações (centrada no indivíduo ou ampliada para as questões do trabalho. Nota-se que 74% das ações foram desenvolvidas de maneira processual, como cursos, oficinas ou vivências de voz, sendo que o tempo de duração de cada encontro variou entre 20 minutos e quatro horas. O caráter de 79% das estratégias educativas é unilateral, incompatível com propostas orientadas pela perspectiva da promoção da saúde. Prevaleceram os temas e conteúdos: hábitos/comportamentos vocais e cuidados de higiene/saúde vocal (71%; aquecimento e desaquecimento, exercícios e técnicas vocais (50%; anatomia e fisiologia da produção vocal e SSMO (44%; parâmetros vocais (23%; ambiente de trabalho (22% e uso da voz, comunicação e expressividade (20%. O foco do processo educativo recaiu sobre o indivíduo (100%, em geral de maneira desarticulada das condições de trabalho, saúde e qualidade de vida. Aspectos do ambiente de trabalho foram contemplados em apenas 17%; a organização do trabalho docente em 6% e a comunidade escolar em 1%. Há necessidade de organização e revisão das formas de desenvolvimento, dinâmicas, estratégias, temas e conteúdos, tipo e foco do processo educativo das ações coletivas em saúde vocal docente, na perspectiva da promoção da saúde.This literature review analyzes the educative processes of vocal health actions aimed at

  6. Immunohistochemistry in diagnostic veterinary pathology: a critical review Imuno-histoquímica na patologia veterinária diagnóstica: uma revisão crítica

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    Felipe Sueiro Ruiz


    Full Text Available Immunohistochemistry has become a practical and widely used tool for diagnosis in human pathology since the 70's. However, its application in veterinary diagnostic pathology has not been so common, especially due to the lack of specific antibodies. To overcome this drawback, antibodies which present cross reactivity with human and animal antigens have been applied. The purpose of the present study was to test the cross reactivity of some antibodies intended for the human pathology, which may be used in animal tissues, with the help of antigen retrieval and amplification systems. In the present study it was confirmed that many of the antibodies produced for use in human histopathology might be applied in veterinary pathology. Further studies are needed to increase the list of applicability of these antibodies to different animal species. It must be stressed that in this type of study some variables, such as clone of antibody, dilution, antigen retrieval method, and detection system, have to be evaluated.A técnica de imuno-histoquímica é usada na rotina diagnóstica e na pesquisa em patologia humana desde 1970, porém seu uso na patologia veterinária é relativamente recente, principalmente com objetivo diagnóstico. A maior dificuldade no uso da imuno-histoquímica na patologia veterinária tem sido a falta de anticorpos específicos para os tecidos animais. Na falta de anticorpos específicos para as espécies domésticas, a patologia veterinária freqüentemente faz uso de anticorpos que apresentam reatividade cruzada entre antígenos humanos e animais. O objetivo deste trabalho foi testar a reatividade cruzada de diversos anticorpos feitos para uso humano em tecido parafinado de algumas espécies animais, utilizando-se dos novos métodos de recuperação antigênica e amplificação da reação imuno-histoquímica. No presente estudo foi possível confirmar a aplicabilidade de que muitos anticorpos produzidos para diagnóstico imuno

  7. Effects of β-Blockers With and Without Vasodilating Properties on Central Blood Pressure: Systematic Review and Meta-Analysis of Randomized Trials in Hypertension. (United States)

    Pucci, Giacomo; Ranalli, Maria Giovanna; Battista, Francesca; Schillaci, Giuseppe


    β-Blockers are less effective than other antihypertensive drug classes in reducing central systolic blood pressure (cSBP) as compared with peripheral SBP (pSBP). Whether this effect is less pronounced with vasodilating β-blockers (VBB) when compared with nonvasodilating β-blockers (NVBB) remains unsettled. We conducted a systematic review and meta-analysis of randomized trials exploring the effects of β-blockers on both pSBP and cSBP in hypertension. We selected 20 studies, for a total of 32 treatment arms (n=21 for NVBB, n=11 for VBB) and 1263 participants (n=962 for NVBB, n=301 for VBB). pSBP decreased from 150 to 133 mm Hg for NVBB and from 145 to 134 mm Hg for VBB. cSBP decreased from 137 to 126 mm Hg for NVBB and from 132 to 123 mm Hg for VBB. SBP amplification (pSBP-cSBP) decreased significantly under VBB (-5.6 mm Hg; 95% confidence interval, -7.8, -3.4 mm Hg), but not under NVBB (-1.1 mm Hg; 95% confidence interval, -3.4, +1.2 mm Hg; Phigh heterogeneity both within and between β-blockers subclasses. In a meta-regression model, the weighted difference in treatment-induced changes in SBP amplification between NVBB and VBB lost its significance after adjustment for mean age and baseline pSBP and heart rate (-2.9±2.3 mm Hg; P=0.22) and was almost abolished after adjustment for treatment-induced heart rate changes (-0.1±0.5 mm Hg; P=0.78). In conclusion, NVBBs, but not VBBs, determine a lower reduction in cSBP than in pSBP. However, the difference in treatment-induced SBP amplification changes between NVBB and VBB is nearly abolished after accounting for differences in heart rate changes.

  8. Pathological Plasticity in Fragile X Syndrome

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    Brandon S. Martin


    Full Text Available Deficits in neuronal plasticity are common hallmarks of many neurodevelopmental disorders. In the case of fragile-X syndrome (FXS, disruption in the function of a single gene, FMR1, results in a variety of neurological consequences directly related to problems with the development, maintenance, and capacity of plastic neuronal networks. In this paper, we discuss current research illustrating the mechanisms underlying plasticity deficits in FXS. These processes include synaptic, cell intrinsic, and homeostatic mechanisms both dependent on and independent of abnormal metabotropic glutamate receptor transmission. We place particular emphasis on how identified deficits may play a role in developmental critical periods to produce neuronal networks with permanently decreased capacity to dynamically respond to changes in activity central to learning, memory, and cognition in patients with FXS. Characterizing early developmental deficits in plasticity is fundamental to develop therapies that not only treat symptoms but also minimize the developmental pathology of the disease.

  9. 中枢神经系统非典型畸胎样/横纹肌样瘤的影像与病理学研究%Imaging and pathological features of atypical teratoid/rhabdoid tumors in the central nervous system

    Institute of Scientific and Technical Information of China (English)

    朱华晨; 周剑; 王志平; 周楠; 高培毅


    Objective To investigate the imaging and pathological features of atypical teratoid/rhab doid tumor (AT/RT)occur-ring in the central nervous system (CNS).Methods The CT and MRI findings of 1 6 patients with CNS AT/RT were retrospectively analyzed,and their pathological and immunohistochemical results were studied.Results There were 12 males and 4 females. Tumors located is at supratentorial in 10 and infratentorial in 6.Cystic changes in tumors were noted in 12 cases.The solid portion of tumors was isointense on T2-weighted images relative to normal brain grey matter in 9 patients.Extensive peritumoral edema was observed in 1 1 lesions.The tumors showed bandlike rim of significant enhancement in 10 cases.The incidence of hemorrhage and calcification in tumors were 43.8% and 41.7% respectively.Histopathologically,AT/RT was characterized by the presence of rhab-doid cells associated with variable components of epithelial,primitive neuroectodermal and mesenchymal differentiation.Conclusion Atypical teratoid/rhabdoid tumor is several imaging findings which are relatively specific on CT and MR images.CT and MRI may provide valuable information for pre-operation diagnosis and prognostic evaluation in patients with CNS AT/RT.%目的:探讨中枢神经系统非典型畸胎样/横纹肌样瘤(AT/RT)的影像表现和病理学特征。方法对16例颅内 AT/RT患者的 CT、MRI 影像资料以及病理和免疫组织化学结果进行回顾性分析。结果16例 AT/RT 患者中,男12例,女4例;肿瘤位于幕上10例,幕下6例,肿瘤发生囊变12例,实性部分与灰质呈等信号9例,肿瘤周围明显水肿11例,增强扫描呈带状环形强化10例,肿瘤出血和钙化发生率分别为43.8%和41.7%。组织病理学检查肿瘤组织内可见特征性的横纹肌样细胞,伴有不同程度的上皮组织、胚胎性细胞和间质分化。结论中枢神经系统 AT/RT 具有特征性的影像表现,CT 和 MRI 可为 AT/RT 的术前诊断和预后评估提供有价值的信息。


    Directory of Open Access Journals (Sweden)

    Parul Dutta


    Full Text Available The hip joint is a large and complex articulation and can be involved by numerous pathologic conditions like congenital and developmental, infective, arthritic, and neoplastic. Early diagnosis and characterisation of pathology has vital role in proper management and follow up of the disease for the clinicians. Present study was conducted in 45 patients who underwent clinical, radiological, and pathological examination in GMCH. Maximum no of patient between age group of 10-30 yrs. male-female ratio was 1.8:1 and 30% cases are unilateral. FSE STAIR images were most useful in delineating pathologies. Gadolinium-enhanced scan were used to evaluate the extent of the disease and the pattern of involvement. AVN was the most common pathology detected comprising 29%. The next common abnormality detected was infective arthritis found in 26% of cases. In case of Legg-Calve-Perthes disease, there was abnormal linear increase in the signal intensity at junction of the epiphyseal cartilage. Ultrasonography is useful for the screening of paediatric hip cases and also for guided aspiration for histopathology. CT scan shows better resolution of soft tissue then the radiograph. The importance of early diagnosis can be gauzed from the fact that early initiation of treatment creates the difference between a responsible, worthwhile life, and a cripple handicapped life. The role of imaging can never be undermined considering the fact that early suspicion and detection is within the realms of imaging.

  11. Communication skills in diagnostic pathology. (United States)

    Lehr, Hans-Anton; Bosman, Fred T


    Communication is an essential element of good medical practice also in pathology. In contrast to technical or diagnostic skills, communication skills are not easy to define, teach, or assess. Rules almost do not exist. In this paper, which has a rather personal character and cannot be taken as a set of guidelines, important aspects of communication in pathology are explored. This includes what should be communicated to the pathologist on the pathology request form, communication between pathologists during internal (interpathologist) consultation, communication around frozen section diagnoses, modalities of communication of a final diagnosis, with whom and how critical and unexpected findings should be communicated, (in-)adequate routes of communication for pathology diagnoses, who will (or might) receive pathology reports, and what should be communicated and how in case of an error or a technical problem. An earlier more formal description of what the responsibilities are of a pathologist as communicator and as collaborator in a medical team is added in separate tables. The intention of the paper is to stimulate reflection and discussion rather than to formulate strict rules.

  12. Review


    Kalkman, C.


    The first volume of this series was published in 1991, and reviewed in Blumea 38, p. 216. The treatments of volumes 2 and 3 are each based on a doctor’s thesis by the first author, elaborated under supervision of Dr. Panigrahi. Volume 2 contains regional revisions of six genera: Prunus, Prinsepia, Maddenia, Rosa, Malus, and Pyrus. Prunus is taken in the inclusive sense and has 38 species in India, including a number of non-indigenous but cultivated and sometimes naturalized species. Prinsepia...

  13. Reviews

    Directory of Open Access Journals (Sweden)

    Philip Barker


    Full Text Available For a variety of different reasons, increasing use is now being made of the Internet for the delivery of course materials and/or for the support of teaching and learning activities. The details of the mechanisms used will obviously vary from one situation to another, depending upon the types of problem to be addressed. These may involve mentoring, teaching, monitoring, recording, tutoring, assessing, and so on. In this book, the author attempts to review the educational and administrative considerations of offering courses, course materials or course delivery via the Internet.

  14. Counselling in the Treatment of Pathological Gambling: An Overview. (United States)

    Griffiths, Mark D.; MacDonald, Helen F.


    Reviews the gambling literature and the phases of the pathological gambler's career. Examines counseling approaches that have been used in the treatment of gambling, including psychotherapy, conjoint marital therapy, minimal interventions, behavioral counseling, and practical approaches to the treatment of adolescent problem gamblers. (Author/GCP)

  15. The Top 10 fungal pathogens in molecular plant pathology

    NARCIS (Netherlands)

    Dean, R.; Kan, van J.A.L.; Pretorius, Z.A.; Hammond-Kosack, K.E.; Pietro, Di A.; Spanu, P.D.; Rudd, J.J.; Dickman, M.; Kahmann, R.; Ellis, J.; Foster, G.D.


    The aim of this review was to survey all fungal pathologists with an association with the journal Molecular Plant Pathology and ask them to nominate which fungal pathogens they would place in a ‘Top 10’ based on scientific/economic importance. The survey generated 495 votes from the international co

  16. Optimal breast cancer pathology manifesto. (United States)

    Tot, T; Viale, G; Rutgers, E; Bergsten-Nordström, E; Costa, A


    This manifesto was prepared by a European Breast Cancer (EBC) Council working group and launched at the European Breast Cancer Conference in Glasgow on 20 March 2014. It sets out optimal technical and organisational requirements for a breast cancer pathology service, in the light of concerns about variability and lack of patient-centred focus. It is not a guideline about how pathology services should be performed. It is a call for all in the cancer community--pathologists, oncologists, patient advocates, health administrators and policymakers--to check that services are available that serve the needs of patients in a high quality, timely way.

  17. REVIEW

    Directory of Open Access Journals (Sweden)

    N. F. Bugay


    Full Text Available Review of Study Guide: «KUBAN STUDIES. KUBAN IN THE XX CENTURY – THE BEGINNING OF THE XXI CENTURY. HISTORY. PEOPLE SOCIETY.» Study Guide (electronic version to grade 11 of educational institutions. A.A. Zaitsev, E.V. Morozova, N.V. Plotichkina and O.A. Borisko, M.A. Egupova, A.B. Sazantovich, I.S. Bashkakov, T.I. Belyaeva. Krasnodar: Perspectives on Education, 2015.In a review of a thorough analysis of all the component parts of the book that will surely attract the attention first of all history teachers and students in 11 classes of educational institutions of the region. A comprehensive presentation of the material significantly adds to the course of modern history of Russia and enrich its specific material about the life of the Russian Cossacks and as part of the – of the Kuban Cossacks. Along with the reference materials of pure nature that is needed for this kind of research are presented and informative sections on the socio-economic condition of the region, the interests of different strata of the population, the multinational factor and the religious beliefs of the population. Cossacks in its warlike mentality, and this trait is passed from generation to generation. But the aspirations of the Cossacks in this respect are transparent – protecting the integrity of the Fatherland, faithful service to him, boundless devotion to the Orthodox faith. The important story is linked with the identity of the Russian Cossacks, its mentality, "Kuban" specificity, especially for the rule on different sections of history, to various of its exponents, both military and civilians. As is known from the Cossacks received a development institute of judging for each Ataman smoking, working village judge. Cossacks series comply with the law as applied his own family, and chic plan – in the state, fought against offenders, it is considered in relation to the Cossacks and representatives of different ethnic communities living with the Cossacks, and

  18. [Prostate cancer. Part 2: Review of the various tumor grading systems over the years 1966-2015 and future perspectives of the new grading of the International Society of Urological Pathology (ISUP)]. (United States)

    Helpap, B; Bubendorf, L; Kristiansen, G


    The continued development of methods in needle biopsies and radical prostatectomy for treatment of prostate cancer has given special emphasis to the question of the prognostic relevance of the various systems of grading. The classical purely histological grading system of Gleason has been modified several times in the past decades and cleared the way for a new grading system by the prognostic grading of Epstein. Assessment of the old and also modified combined histological and cytological grading of Mostofi, the World health Organization (WHO) and the urologic-pathological working group of prostate cancer in connection with the Gleason grading (combined Gleason-Helpap grading), has led to considerably improved rates of concordance between biopsy and radical prostatectomy and to improved estimations of prognosis beside its contribution to the development of a more practicable grading system for clinical use.

  19. Relationship of rotator cuff tendon pathology with obesity, chronic diseases and steroid use


    Ayse Umul; Hakan Demirtas; Ahmet Orhan Celik; Mustafa Kara; Omer Yilmaz; Bumin Degirmenci; Hasan Ali Eksili; Hikmet Orhan


    Purpose: To investigate the possible relationship between rotator cuff tendon pathologies detected with magnetic resonance imaging and obesity and chronic diseases. Materials and Methods: Two hundred and sixty seven patients, who underwent shoulder MRI between 2014 January and October 2014 for pain and limitation of motion in the shoulder, were reviewed retrospectively. Tendon pathology was detected in 153 patients and they were included in the study. Tendon pathologies were examined by t...

  20. Giving your heart to pathology. (United States)

    Klaassen, Jim


    Jim KIaassen recently joined Axiom Veterinary Laboratories as a clinical pathologist. During his career, Dr Klaassen has worked in small animal practice, lectured in clinical pathology, undertaken preclinical research and held senior roles in commercial veterinary laboratories in the USA, including as chief medical officer of Antech Diagnostics.



    Knezevic R. Milan; Andjelic S. Gordana; Knezevic M. Milena


    A retrospective overview of systemic disorders which might be associated with dental pathology is made. They are grouped as follows: (a) congenital dental developmental disorders, (b) chromosomal anomalies, (c) radiations, (d) immune disorders, (e) intoxications, (f) neurological alterations, (g) gastrointestinal diseases, (h) osteodystrophy and associated conditions, (i) skin diseases, (j) metabolic and endocrine disorders, (k) craniofacial malformation syndromes and other congenital g...

  2. Reading performance and central field loss. (United States)

    Kanonidou, E


    Age-related macular degeneration is a major cause of blindness in Europe and the U.S. and a leading cause of significant loss of visual acuity in elderly patients. Reading is a key visual task in everyday living involving a synthesis of a number of different motor, sensory and cognitive functions. When the centre of a reader's visual field is obscured, reading speed declines and oculomotor pattern differs, compared to normal reading. Improvement in the generation of visual stimuli using computer-generated images and projection/display systems as well as advances in eye movement recording techniques, including infrared pupil tracking and magnetic search coils, have contributed greatly to our understanding of these sensorimotor abnormalities. The developed reading strategies have been thoroughly investigated in individuals with central field loss either induced artificially or related to eye pathology.The following review aims at presenting the contemporary literature regarding the sensory and oculomotor deficits in reading ability, resulting from central field loss and should contribute to a greater understanding of the functional visual deficit caused by this visual impairment.

  3. The integripennis species group of Geocharidius Jeannel, 1963 (Carabidae, Bembidiini, Anillina) from Nuclear Central America: a taxonomic review with notes about biogeography and speciation (United States)

    Sokolov, Igor M.; Kavanaugh, David H.


    Abstract Our review recognizes 15 species of the integripennis species group of Geocharidius from Nuclear Central America, include three species previously described (Geocharidius gimlii Erwin, Geocharidius integripennis (Bates) and Geocharidius zullinii Vigna Taglianti) and 12 described here as new. They are: Geocharidius andersoni sp. n. (type locality: Chiapas, Chiapas Highlands, Cerro Huitepec) and Geocharidius vignatagliantii sp. n. (type locality: Chiapas, Motozintla, Sierra Madre de Chiapas, Benito Juárez) from Mexico; Geocharidius antigua sp. n. (type locality: Sacatepéquez, 5 km SE of Antigua), Geocharidius balini sp. n. (type locality: Suchitepéquez, 4 km S of Volcan Atitlán), Geocharidius erwini sp. n. (type locality: Quiché Department, 7 km NE of Los Encuentros), Geocharidius jalapensis sp. n. (type locality: Jalapa Department, 4 km E of Mataquescuintla), Geocharidius longinoi, sp. n. (type locality: El Progreso Department, Cerro Pinalón), and Geocharidius minimus sp. n. (type locality: Sacatepéquez Department, 5 km SE of Antigua) from Guatemala; and Geocharidius celaquensis sp. n. (type locality: Lempira Department, Celaque National Park), Geocharidius comayaguanus sp. n. (type locality: Comayagua Department, 18 km ENE of Comayagua), Geocharidius disjunctus sp. n. (type locality: Francisco Morazán, La Tigra National Park), and Geocharidius lencanus sp. n. (type locality: Lempira Department, Celaque National Park) from Honduras. For all members of the group, adult structural characters, including male and female genitalia, are described, and a taxonomic key for all members of the integripennis species group is presented based on these characters. Behavioral and biogeographical aspects of speciation in the group are discussed, based on the morphological analysis. In all cases of sympatry, pairs of closely related species show greater differences in sizes than pairs of more remotely related species. Integripennis group species occupy six different

  4. The integripennis species group of Geocharidius Jeannel, 1963 (Carabidae, Bembidiini, Anillina from Nuclear Central America: a taxonomic review with notes about biogeography and speciation

    Directory of Open Access Journals (Sweden)

    Igor Sokolov


    Full Text Available Our review recognizes 15 species of the integripennis species group of Geocharidius from Nuclear Central America, include three species previously described (G. gimlii Erwin, G. integripennis (Bates and G. zullinii Vigna Taglianti and 12 described here as new. They are: G. andersoni sp. n. (type locality: Chiapas, Chiapas Highlands, Cerro Huitepec and G. vignatagliantii sp. n. (type locality: Chiapas, Motozintla, Sierra Madre de Chiapas, Benito Juárez from Mexico; G. antigua sp. n. (type locality: Sacatepéquez, 5 km SE of Antigua, G. balini sp. n. (type locality: Suchitepéquez, 4 km S of Volcan Atitlán, G. erwini sp. n. (type locality: Quiché Department, 7 km NE of Los Encuentros, G. jalapensis sp. n. (type locality: Jalapa Department, 4 km E of Mataquescuintla, G. longinoi, sp. n. (type locality: El Progreso Department, Cerro Pinalón, and G. minimus sp. n. (type locality: Sacatepéquez Department, 5 km SE of Antigua from Guatemala; and G. celaquensis sp. n. (type locality: Lempira Department, Celaque National Park, G. comayaguanus sp. n. (type locality: Comayagua Department, 18 km ENE of Comayagua, G. disjunctus sp. n. (type locality: Francisco Morazán, La Tigra National Park, and G. lencanus sp. n. (type locality: Lempira Department, Celaque National Park from Honduras. For all members of the group, adult structural characters, including male and female genitalia, are described, and a taxonomic key for all members of the integripennis species group is presented based on these characters. Behavioral and biogeographical aspects of speciation in the group are discussed, based on the morphological analysis. In all cases of sympatry, pairs of closely related species show greater differences in sizes than pairs of more remotely related species. Integripennis group species occupy six different montane areas at elevations above 1300m, with no species shared among them. Major faunal barriers in the region limiting present species distributions

  5. Fibromyalgia syndrome pathology and environmental influences on afflictions with medically unexplained symptoms. (United States)

    Albrecht, Phillip J; Rice, Frank L


    Fibromyalgia syndrome (FMS) is a clinical disorder predominant in females with unknown etiology and medically unexplained symptoms (MUS), similar to other afflictions, including irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS), post-traumatic stress disorder (PTSD), Gulf War illness (GFI), and others. External environmental stimuli drive behavior and impact physiologic homeostasis (internal environment) via autonomic functioning. These environments directly impact the individual affective state (mind), which feeds back to regulate physiology (body). FMS has emerged as a complex disorder with pathologies identified among neurotransmitter and enzyme levels, immune/cytokine functionality, cortical volumes, cutaneous innervation, as well as an increased frequency among people with a history of traumatic and/or emotionally negative events, and specific personality trait profiles. Yet, quantitative physical evidence of pathology or disease etiology among FMS has been limited (as with other afflictions with MUS). Previously, our group published findings of increased peptidergic sensory innervation associated with the arterio-venous shunts (AVS) in the glabrous hand skin of FMS patients, which provides a plausible mechanism for the wide-spread FMS symptomology. This review focuses on FMS as a model affliction with MUS to discuss the implications of the recently discovered peripheral innervation alterations, explore the role of peripheral innervation to central sensitization syndromes (CSS), and examine possible estrogen-related mechanisms through which external and internal environmental factors may contribute to FMS etiology and possibly other afflictions with MUS.

  6. 皮炎外瓶霉所致中枢神经系统感染一例并文献复习%Central nervous system infection caused by Exophiala dermatitidis in a case and literature review

    Institute of Scientific and Technical Information of China (English)

    胡冰; 李绍英; 胡惠丽; 陈天明; 郭欣; 张智晓; 董芳; 李峥; 王荃


    clinical features,imaging characteristics,diagnosis and treatment of a case with central nervous system infection caused by Exophiala dermatitidis,as well as to review the related literature.Method Associated literature and clinical data of an 8-year-old boy who was diagnosed as central nervous system infection caused by Exophiala dermatitidis in Beijing Children's Hospital Affiliated to Capital Medical University and hospitalized twice from 2012 to 2014 were analyzed retrospectively.Result The boy was 8 years old with the chief complaint of dizziness for 2 months,intermittent fever for 1 month accompanied with spasm twice.He was diagnosed as bile ducts spaceoccupying lesions 2 years ago,when the pathological diagnosis was fungal infection.The boy was treated with iiregular anti-fungal therapy.Then the boy developed nervous symptoms,impaired consciousness and abnormal physical activity that developed gradually.After hospitalization the cerebral MRI of the boy showed space-occupying lesions accompanied with edema of surrounding area.Filamentous fungi was found by brain biopsy,which was culture positive for Exophiala dermatitidis.After diagnosis the boy was treated with amphotericin B (AMB),voriconazole and 5-Fu,as well as symptomatic treatment.The state of the boy was improved gradually.Two months later,the boy could communicate with others normally and move personally.The lesions and edema seen on the MRI was decreased moderately.Accordingly,the boy was treated with oral voriconazole maintenance treatment for about 1 year and 4 months after discharge.During this period,the state of him was stable without symptoms.The lesions shown by MRI did not disappear but decreased on regular examination.However,recently the disease of the boy progressed again,with dizziness,neck pain,headache and progressive nervous symptoms (intermittent spasm,inability to cough,and impaired consciousness).The boy died at last,even with the active treatment at the second hospitalization

  7. Neurocysticercosos in South-Central America and the Indian Subcontinent: a comparative evaluation

    Directory of Open Access Journals (Sweden)

    Gagandeep Singh


    Full Text Available Neurocysticercosis is an important public health problem in South-Central America and South Asia. A review of the differences in epidemiological and clinical attributes of cysticercosis and taeniasis in South Central America and India, respectively, is undertaken in the present communication. Intestinal taeniasis is hyperendemic in several American countries. In comparison, the prevalence of Taenia solium infestation is lower in India. The clinical manifestations in several American neurocysticercosis series comprise epilepsy, intracranial hypertension and meningeal - racemose cysticercosis, in roughly equal proportions. An overwhelming majority of the Indian subjects present with seizures. The commonest pathological substrate of the disorder in Indian patients is the solitary parenchymal degenerating cyst. The reasons for the predominance of solitary forms in India, and of multilesional forms in South Central America are discussed. The magnitude of Taenia solium infestation and the frequency of pork consumption in a given population appear to influence the quantum of cyst load in affected individuals.

  8. [Historical demography in the Central American isthmus]. (United States)

    Perez Brignoli, H


    The author reviews and evaluates sources of information on the demographic history of Central America. Past and present administrative, state, ecclesiastical, and genealogical sources are examined, and recent studies of various Central American countries are cited. A bibliography is provided

  9. Fibroma osificante central en el maxilar superior: reporte de un caso y revisión de la literatura Central ossifying fibroma in the maxilla: a case report and review of the literatur

    Directory of Open Access Journals (Sweden)

    B.R. Chrcanovic


    Full Text Available El fibroma osificante central (fibroma cementificante / fibroma cemento osificante es un tumor benigno óseo bien delimitado, se localiza principalmente en los maxilares aunque se puede presentar en los huesos orbital, frontal, paranasal y temporal. Se caracteriza por presentar un crecimiento y una tumefacción deformante de evolución lenta con una incidencia mayor en la mandíbula. El tratamiento consiste en la extirpación quirúrgica de la lesión. En este artículo se presenta un caso de fibroma osificante central localizado en la región posterior derecha del maxilar superior, de gran dimensión, que acomete a una paciente de sexo femenino de 46 años de edad, revelando datos clínicos, aspectos diagnósticos, imagenológicos, histopatológicos así como su tratamiento.Central ossifying fibroma (cementing fibroma / cemento ossifying fibroma is a bone benign tumor almost exclusively from maxillary region but can be in the orbital bones, frontal, paranasal and temporal. Progressive growth and disfiguring swelling of slow evolution are characteristics with more prevalence in the mandible. The treatment choice is a surgical excision of the lesion. This article presents a case of central ossifying fibroma located in the region of the right posterior maxilla of large dimension of a female patient of 46 years of age, describing clinical, diagnostic, imaging, and histopathological aspects as well as the treatment employed.

  10. Digital pathology in personalized cancer therapy

    Directory of Open Access Journals (Sweden)

    Marcial Garcia Rojo


    Full Text Available The development of small molecule inhibitors of growth factor receptors, and the discovery of somatic mutations of the thyrosine kinase domain, have resulted in new paradigms for cancer therapy. Digital microscopy is an important tool for surgical pathologists. The achievements in the digital pathology field have modified the workflow of pathomorphology labs, enhanced the pathologist’s role in diagnostics, and increased their contribution to personalized targeted medicine. Digital image analysis is now available in a variety of platforms to improve quantification performance of diagnostic pathology. We here describe the state of digital microscopy as it applies to the field of quantitative immunohistochemistry of biomarkers related to the clinical personalized targeted therapy of breast cancer, non-small lung cancer and colorectal cancer: HER-2, EGFR, KRAS and BRAF genes. The information is derived from the experience of the authors and a review of the literature. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 4, pp. 570–578


    Institute of Scientific and Technical Information of China (English)


    Objective To investigate the clinical pathological feature and diagnostic criteria of tongue amyloidosis (AL).Methods During 1992 to 2005, 25 patients pathologically diagnosed as tongue AL in our hospital were reviewed retrospectively, and all of them had no enlarged tongue. Haematoxylin and eosin (HE) and immunohistochemical staining were used to detect the amyloid deposition on the tongue.Results Totally 84 % (21/25) patients had symptoms of xerostomia and taste-blindness, 44 % (11/25) patients complained of activity limitation of tongue. Macroscopic observation showed mucosa pallescence, punctuate hemorrhage, red grain particles, and ulcers on the tongue. HE staining indicated amyloid depositions in basement membrane,muscle cell, vessel wall, and nerve fiber. Immunohistochemical study demonstrated kappa light-chain deposition in 64%(16/25) cases, and lambda light-chain deposition in 36 % (9/25) cases. They presented in vessel wall, nerve fiber, and muscle cells.Conclusion The biopsy is an important means for the diagnosis of early tongue AL, and the wide variety of amyloid light chain is helpful to differential diagnosis.

  12. Evidence-based pathology: umbilical cord coiling. (United States)

    Khong, T Y


    The generation of a pathology test result must be based on criteria that are proven to be acceptably reproducible and clinically relevant to be evidence-based. This review de-constructs the umbilical cord coiling index to illustrate how it can stray from being evidence-based. Publications related to umbilical cord coiling were retrieved and analysed with regard to how the umbilical coiling index was calculated, abnormal coiling was defined and reference ranges were constructed. Errors and other influences that can occur with the measurement of the length of the umbilical cord or of the number of coils can compromise the generation of the coiling index. Definitions of abnormal coiling are not consistent in the literature. Reference ranges defining hypocoiling or hypercoiling have not taken those potential errors or the possible effect of gestational age into account. Even the way numerical test results in anatomical pathology are generated, as illustrated by the umbilical coiling index, warrants a critical analysis into its evidence base to ensure that they are reproducible or free from errors.

  13. Protection by neuroglobin expression in brain pathologies

    Directory of Open Access Journals (Sweden)

    Eliana Baez


    Full Text Available Astrocytes play an important role in physiological, metabolic and structural functions and, when impaired, they can be involved in various pathologies including Alzheimer, focal ischemic stroke and traumatic brain injury. These disorders involve an imbalance in the blood flow and nutrients such as glucose and lactacte, leading to biochemical and molecular changes that cause neuronal damage, which is followed by loss of cognitive and motor functions. Previous studies have shown that astrocytes are more resilient than neurons during brain insults as a consequence of their more effective antioxidant systems, transporters and enzymes, which made them less susceptible to excitotoxicity. In addition, astrocytes synthesize and release different protective molecules for neurons, including neuroglobin, a member of the globin family of proteins. After brain injury neuroglobin expression is induced in astrocytes. Since neuroglobin promotes neuronal survival, its increased expression in astrocytes after brain injury may represent an endogenous neuroprotective mechanism. Here, we review the role of neuroglobin in the CNS, its relationship with different pathologies, and the role of different factors that regulate its expression in astrocytes.

  14. Genetics and underlying pathology of dementia. (United States)

    Ferencz, Beata; Gerritsen, Lotte


    As the population steadily ages, dementia, in all its forms, remains a great societal challenge. Yet, our knowledge of their etiology remains rather limited. To this end, genetic studies can give us insight into the underlying mechanisms that lead to the development of dementia, potentially facilitating treatments in the future. In this review we cover the most recent genetic risk factors associated with the onset of the four most common dementia types today, including Alzheimer's disease (AD), Vascular Dementia (VaD), Frontotemporal Lobar Degeneration (FTLD) and Lewy Body Dementia (LBD). Moreover, we discuss the overlap in major underlying pathologies of dementia derived from their genetic associations. While all four dementia types appear to involve genes associated with tau-pathology and neuroinflammation only LBD, AD and VaD appear to involve amyloid genes while LBD and FTLD share alpha synuclein genes. Together these findings suggest that some of the dementias may exist along a spectrum and demonstrates the necessity to conduct large-scale studies pinpointing the etiology of the dementias and potential gene and environment interactions that may influence their development.

  15. Virtual slides: application in pulmonary pathology consultations.

    Directory of Open Access Journals (Sweden)

    Michał Wojciechowski


    Full Text Available The Virtual Slide (VS is an interactive microscope emulator that presents a complete digitized tissue section via the Internet. A successful implementation of VS has been observed for educational, research venues and quality control. VS acquisition for consultative pathology is not so common. The purpose of this study was to explore the efficacy and usability of VS in the consultative pulmonary telepathology. 20 lung tumors entered the study. The performance was programmed for 2 medical centers specialized in pulmonary pathology (beginner and advancer in telepathology. A high-quality VSs were prepared by Coolscope (Nikon, Eclipsnet VSL, Japan, and were evaluated via the Internet. The cases were reviewed for the second time with conventional light microscope. VS diagnostic accuracy and the interobserver variability were evaluated. Also the time taken by examiners to render the diagnoses and time needed to scan the microscopic slide were analyzed. Percentage concordance between original glass-slides diagnosis and diagnosis for VSs was very high. Pathologists found the download speed of VSs adequate; experience in telepathology reduced the time of VS diagnosis. VS implementation suggests advantages for teleconsulation and education but also indicate some technical limitations. This is the first Polish trial of VS implementation in telepathology consultative service.

  16. Update on pathology of ocular parasitic disease (United States)

    Das, Dipankar; Ramachandra, Varsha; Islam, Saidul; Bhattacharjee, Harsha; Biswas, Jyotirmay; Koul, Akanksha; Deka, Panna; Deka, Apurba


    Parasites are a group of eukaryotic organisms that may be free-living or form a symbiotic or parasitic relationship with the hosts. Consisting of over 800,000 recognized species, parasites may be unicellular (Protozoa) or multicellular (helminths and arthropods). The association of parasites with human population started long before the emergence of civilization. Parasitic zoonotic diseases are prevalent worldwide including India. Appropriate epidemiological data are lacking on existing zoonotic parasitic diseases, and newer diseases are emerging in our scenario. Systemic diseases such as cysticercosis, paragonimiasis, hydatidosis, and toxoplasmosis are fairly common. Acquired Toxoplasma infections are rising in immune-deficient individuals. Amongst the ocular parasitic diseases, various protozoas such as Cystoidea, trematodes, tissue flagellates, sporozoas etc. affect humans in general and eyes in particular, in different parts of the world. These zoonoses seem to be a real health related problem globally. Recent intensification of research throughout the world has led to specialization in biological fields, creating a conducive situation for researchers interested in this subject. The basics of parasitology lie in morphology, pathology, and with recent updates in molecular parasitology, the scope has extended further. The current review is to address the recent update in ophthalmic parasites with special reference to pathology and give a glimpse of further research in this field. PMID:27958200

  17. Update on pathology of ocular parasitic disease

    Directory of Open Access Journals (Sweden)

    Dipankar Das


    Full Text Available Parasites are a group of eukaryotic organisms that may be free-living or form a symbiotic or parasitic relationship with the hosts. Consisting of over 800,000 recognized species, parasites may be unicellular (Protozoa or multicellular (helminths and arthropods. The association of parasites with human population started long before the emergence of civilization. Parasitic zoonotic diseases are prevalent worldwide including India. Appropriate epidemiological data are lacking on existing zoonotic parasitic diseases, and newer diseases are emerging in our scenario. Systemic diseases such as cysticercosis, paragonimiasis, hydatidosis, and toxoplasmosis are fairly common. Acquired Toxoplasma infections are rising in immune-deficient individuals. Amongst the ocular parasitic diseases, various protozoas such as Cystoidea, trematodes, tissue flagellates, sporozoas etc. affect humans in general and eyes in particular, in different parts of the world. These zoonoses seem to be a real health related problem globally. Recent intensification of research throughout the world has led to specialization in biological fields, creating a conducive situation for researchers interested in this subject. The basics of parasitology lie in morphology, pathology, and with recent updates in molecular parasitology, the scope has extended further. The current review is to address the recent update in ophthalmic parasites with special reference to pathology and give a glimpse of further research in this field.

  18. Central obesity and survival in subjects with coronary artery disease: a systematic review of the literature and collaborative analysis with individual subject data

    DEFF Research Database (Denmark)

    Coutinho, Thais; Goel, Kashish; Corrêa de Sá, Daniel;


    The aim of this study was to examine the association of central (waist circumference [WC] and waist-hip ratio [WHR]) and total obesity (body mass index [BMI]) measures with mortality in coronary artery disease (CAD) patients....

  19. Anatomy, pathology, and MRI findings in the sports hernia. (United States)

    Shortt, Conor P; Zoga, Adam C; Kavanagh, Eoin C; Meyers, William C


    "Sports hernia" is a frequently used term on athletic injury reports and in the sportscasting media, but its true definition remains elusive in the medical literature. Magnetic resonance imaging (MRI) is a useful tool in the evaluation of clinical athletic pubalgia, yet specific pathologies associated with this commonly encountered syndrome are poorly described in the imaging literature. In this article we review the musculoskeletal anatomy of the pubic region as well as several reproducible patterns of pathology on MRI we have encountered in patients with a clinical diagnosis of sports hernia.

  20. Mediastinal pathology and the contributions of Dr. Juan Rosai. (United States)

    Wick, Mark R


    Dr. Juan Rosai is one of the most prolific contributors to the literature on mediastinal pathology, and he has added steadily to that body of work over a 50-year period. Rosai has written several landmark articles in this topical area, including articles on thymic epithelial lesions, mediastinal neuroendocrine tumors, mediastinal lymphoma and other hematopoietic lesions, thymolipoma, thymoliposarcoma, mediastinal solitary fibrous tumor, intrathymic langerhans-cell histiocytosis, mediastinal germ cell neoplasms, and multilocular thymic cyst. This review recounts his role as one of the principal figures in the surgical pathology of mediastinal diseases.