Using the modified Delphi method to establish clinical consensus for the diagnosis and treatment of patients with rotator cuff pathology.

PubMed

Eubank, Breda H; Mohtadi, Nicholas G; Lafave, Mark R; Wiley, J Preston; Bois, Aaron J; Boorman, Richard S; Sheps, David M

2016-05-20

Patients presenting to the healthcare system with rotator cuff pathology do not always receive high quality care. High quality care occurs when a patient receives care that is accessible, appropriate, acceptable, effective, efficient, and safe. The aim of this study was twofold: 1) to develop a clinical pathway algorithm that sets forth a stepwise process for making decisions about the diagnosis and treatment of rotator cuff pathology presenting to primary, secondary, and tertiary healthcare settings; and 2) to establish clinical practice guidelines for the diagnosis and treatment of rotator cuff pathology to inform decision-making processes within the algorithm. A three-step modified Delphi method was used to establish consensus. Fourteen experts representing athletic therapy, physiotherapy, sport medicine, and orthopaedic surgery were invited to participate as the expert panel. In round 1, 123 best practice statements were distributed to the panel. Panel members were asked to mark "agree" or "disagree" beside each statement, and provide comments. The same voting method was again used for round 2. Round 3 consisted of a final face-to-face meeting. In round 1, statements were grouped and reduced to 44 statements that met consensus. In round 2, five statements reached consensus. In round 3, ten statements reached consensus. Consensus was reached for 59 statements representing five domains: screening, diagnosis, physical examination, investigations, and treatment. The final face-to-face meeting was also used to develop clinical pathway algorithms (i.e., clinical care pathways) for three types of rotator cuff pathology: acute, chronic, and acute-on-chronic. This consensus guideline will help to standardize care, provide guidance on the diagnosis and treatment of rotator cuff pathology, and assist in clinical decision-making for all healthcare professionals.

Comparison of saline infusion sonohysterography and hysteroscopy in diagnosis of premenopausal women with abnormal uterine bleeding.

PubMed

Soguktas, Suna; Cogendez, Ebru; Kayatas, Semra Eser; Asoglu, Mehmet Resit; Selcuk, Selcuk; Ertekin, Aktug

2012-03-01

The aim of this study was to compare the diagnostic effectiveness of transvaginal sonography (TVS), saline infusion sonohysterography (SIS), and diagnostic hysteroscopy (HS), with the pathologic specimen as a gold standard diagnostic method, in detecting endometrial pathology in premenopausal women with abnormal uterine bleeding. This prospective cohort study was conducted at Zeynep Kamil Education and Training Hospital, Istanbul, Turkey, and included 89 premenopausal women. All participants were examined first by TVS, further investigated with SIS and HS, and finally dilatation and curettage was performed when needed. The results obtained from these three methods were compared with the pathologic diagnoses. The positive and negative likelihood ratios (LR+ and LR-) of TVS, SIS and HS were calculated by comparison with the final pathological diagnosis. In addition, area under the curve (AUC) values were also calculated. Polypoid lesion was the most common abnormal pathology. LR+ and LR- of TVS, SIS, and HS were 3.13 and 0.15, 9.83 and 0.07, 13.7 and 0.02 respectively in detection of any abnormal pathology, and the AUCs of TVS, SIS, and HS were 0.804, 0.920, and 0.954 respectively. When the three procedures were compared with each other separately, HS had the best diagnostic accuracy, and the diagnostic accuracy of HS and SIS was superior to TVS (p(1)=0.000, p(2)=0.000). For the detection of polypoid lesions, HS was the most accurate diagnostic procedure (AUC=0.947), followed by SIS (AUC=0.894) and TVS (AUC=0.778). HS provides the most accurate diagnosis and allows treatment in the same session in premenopausal women with abnormal uterine bleeding. Published by Elsevier Ireland Ltd.

How to investigate a child with excessive growth?

PubMed

Coutant, Régis; Donzeau, Aurélie; Decrequy, Anne; Louvigné, Mathilde; Bouhours-Nouet, Natacha

2017-06-01

The diagnostic approach to tall stature in children is based on collecting birth data (macrosomia), sizes and family puberty, a family history of constitutional or pathological tall stature, search for a delay of development, dysmorphia, disproportion, analysis of the growth velocity (normal or accelerated), general examination and assessment of puberty, and bone age. When there is a history of psychomotor retardation, a family history of pathological tall stature, or a disproportion in the clinical examination, the genetic causes of tall stature will be mentioned. The most frequent causes are Marfan syndrome and similar, Sotos syndrome, Beckwith-Wiedemann syndrome, Klinefelter syndrome, and MEN2B. There are many genetic syndromes with tall stature, justifying consultation with the geneticist. When the speed of growth is accelerated, first of all it evokes puberty and early pseudopuberty, obesity and acromegaly. Finally, when the growth velocity is regular, and the parents are of tall stature, it evokes constitutional tall stature: this is the most frequent diagnosis, to retain after having rejected pathological tall statures. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Pathological and Protective Immunity to Pneumocystis Infection

PubMed Central

Eddens, Taylor; Kolls, Jay K.

2014-01-01

Pneumocystis jirovecii is a common opportunistic infection in the HIV-positive population and is re-emerging as a growing clinical concern in the HIV-negative immunosuppressed population. Newer targeted immunosuppressive therapies and the discovery of rare genetic mutations have furthered our understanding of the immunity required to clear Pneumocystis infection. The immune system can also mount a pathologic response against Pneumocystis following removal of immunosuppression and result in severe damage to the host lung. The current review will examine the most recent epidemiologic studies about the incidence of Pneumocystis in the HIV-positive and HIV-negative populations in the developing and developed world and will detail methods of diagnosis for Pneumocystis pneumonia. Finally, this review aims to summarize the known mediators of immunity to Pneumocystis and detail the pathologic immune response leading to Pneumocystis-related immune reconstitution inflammatory syndrome. PMID:25420451

Quantification of the pathological response and fate in the lung and pleura of chrysotile in combination with fine particles compared to amosite-asbestos following short-term inhalation exposure

PubMed Central

Bernstein, DM; Rogers, RA; Sepulveda, R; Donaldson, K; Schuler, D; Gaering, S; Kunzendorf, P; Chevalier, J; Holm, SE

2011-01-01

The marked difference in biopersistence and pathological response between chrysotile and amphibole asbestos has been well documented. This study is unique in that it has examined a commercial chrysotile product that was used as a joint compound. The pathological response was quantified in the lung and translocation of fibers to and pathological response in the pleural cavity determined. This paper presents the final results from the study. Rats were exposed by inhalation 6 h/day for 5 days to a well-defined fiber aerosol. Subgroups were examined through 1 year. The translocation to and pathological response in the pleura was examined by scanning electron microscopy and confocal microscopy (CM) using noninvasive methods.The number and size of fibers was quantified using transmission electron microscopy and CM. This is the first study to use such techniques to characterize fiber translocation to and the response of the pleural cavity. Amosite fibers were found to remain partly or fully imbedded in the interstitial space through 1 year and quickly produced granulomas (0 days) and interstitial fibrosis (28 days). Amosite fibers were observed penetrating the visceral pleural wall and were found on the parietal pleural within 7 days postexposure with a concomitant inflammatory response seen by 14 days. Pleural fibrin deposition, fibrosis, and adhesions were observed, similar to that reported in humans in response to amphibole asbestos. No cellular or inflammatory response was observed in the lung or the pleural cavity in response to the chrysotile and sanded particles (CSP) exposure. These results provide confirmation of the important differences between CSP and amphibole asbestos. PMID:21639706

Flexner 3.0-Democratization of Medical Knowledge for the 21st Century: Teaching Medical Science Using K-12 General Pathology as a Gateway Course.

PubMed

Weinstein, Ronald S; Krupinski, Elizabeth A; Weinstein, John B; Graham, Anna R; Barker, Gail P; Erps, Kristine A; Holtrust, Angelette L; Holcomb, Michael J

2016-01-01

A medical school general pathology course has been reformatted into a K-12 general pathology course. This new course has been implemented at a series of 7 to 12 grade levels and the student outcomes compared. Typically, topics covered mirrored those in a medical school general pathology course serving as an introduction to the mechanisms of diseases. Assessment of student performance was based on their score on a multiple-choice final examination modeled after an examination given to medical students. Two Tucson area schools, in a charter school network, participated in the study. Statistical analysis of examination performances showed that there were no significant differences as a function of school ( F = 0.258, P = .6128), with students at school A having an average test scores of 87.03 (standard deviation = 8.99) and school B 86.00 (standard deviation = 8.18; F = 0.258, P = .6128). Analysis of variance was also conducted on the test scores as a function of gender and class grade. There were no significant differences as a function of gender ( F = 0.608, P = .4382), with females having an average score of 87.18 (standard deviation = 7.24) and males 85.61 (standard deviation = 9.85). There were also no significant differences as a function of grade level ( F = 0.627, P = .6003), with 7th graders having an average of 85.10 (standard deviation = 8.90), 8th graders 86.00 (standard deviation = 9.95), 9th graders 89.67 (standard deviation = 5.52), and 12th graders 86.90 (standard deviation = 7.52). The results demonstrated that middle and upper school students performed equally well in K-12 general pathology. Student course evaluations showed that the course met the student's expectations. One class voted K-12 general pathology their "elective course-of-the-year."

Zika Fetal Neuropathogenesis: Etiology of a Viral Syndrome

PubMed Central

Klase, Zachary A.; Khakhina, Svetlana; Schneider, Adriano De Bernardi; Callahan, Michael V.; Glasspool-Malone, Jill

2016-01-01

The ongoing Zika virus epidemic in the Americas and the observed association with both fetal abnormalities (primary microcephaly) and adult autoimmune pathology (Guillain–Barré syndrome) has brought attention to this neglected pathogen. While initial case studies generated significant interest in the Zika virus outbreak, larger prospective epidemiology and basic virology studies examining the mechanisms of Zika viral infection and associated pathophysiology are only now starting to be published. In this review, we analyze Zika fetal neuropathogenesis from a comparative pathology perspective, using the historic metaphor of “TORCH” viral pathogenesis to provide context. By drawing parallels to other viral infections of the fetus, we identify common themes and mechanisms that may illuminate the observed pathology. The existing data on the susceptibility of various cells to both Zika and other flavivirus infections are summarized. Finally, we highlight relevant aspects of the known molecular mechanisms of flavivirus replication. PMID:27560129

Intraoperative ultrasound control of surgical margins during partial nephrectomy.

PubMed

Alharbi, Feras M; Chahwan, Charles K; Le Gal, Sophie G; Guleryuz, Kerem M; Tillou, Xavier P; Doerfler, Arnaud P

2016-01-01

To evaluate a simple and fast technique to ensure negative surgical margins on partial nephrectomies, while correlating margin statuses with the final pathology report. This study was conducted for patients undergoing partial nephrectomy (PN) with T1-T2 renal tumors from January 2010 to the end of December 2015. Before tumor removal, intraoperative ultrasound (US) localization was performed. After tumor removal and before performing hemostasis of the kidney, the specimens were placed in a saline solution and a US was performed to evaluate if the tumor's capsule were intact, and then compared to the final pathology results. In 177 PN(s) (147 open procedures and 30 laparoscopic procedures) were performed on 147 patients. Arterial clamping was done for 32 patients and the mean warm ischemia time was 19 ± 6 min. The mean US examination time was 41 ± 7 s. The US analysis of surgical margins was negative in 172 cases, positive in four, and in only one case it was not possible to conclude. The final pathology results revealed one false positive surgical margin and one false negative surgical margin, while all other margins were in concert with US results. The mean tumor size was 3.53 ± 1.43 cm, and the mean surgical margin was 2.8 ± 1.5 mm. The intraoperative US control of resection margins in PN is a simple, efficient, and effective method for ensuring negative surgical margins with a small increase in warm ischemia time and can be conducted by the operating urologist.

The Diagnostic Accuracy of Incisional Biopsy in the Oral Cavity.

PubMed

Chen, Sara; Forman, Michael; Sadow, Peter M; August, Meredith

2016-05-01

To determine the accuracy of incisional biopsy examination to diagnose oral lesions. This retrospective cohort study was performed to determine the concordance rate between incisional biopsy examination and definitive resection diagnosis for different oral lesions. The study sample was derived from the population of patients who presented to the Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital (Boston, MA) from January 2005 through December 2012. Inclusion criteria were the diagnosis of an oral lesion from an incisional biopsy examination, subsequent diagnosis from the definitive resection of the same lesion, and complete clinical and pathologic patient records. The predictor variables were the origin and size of the lesion. The primary outcome variable was concordance between the provisional incisional biopsy diagnosis and definitive pathologic resection diagnosis. The secondary outcome variable was type of biopsy error for the discordant cases. Incisional biopsy errors were assessed and grouped into 5 categories: 1) sampling error; 2) insufficient tissue for diagnosis; 3) presence of inflammation making diagnosis difficult; 4) artifact; and 5) pathologist discordance. A total of 272 patients met the inclusion criteria. The study sample had a mean age of 47.4 years and 55.7% were women. Of these cases, 242 (88.9%) were concordant when comparing the biopsy and final resection pathology reports. At histologic evaluation, 60.0% of discordant findings were attributed to sampling error, 23.3% to pathologist discrepancy, 13.3% to insufficient tissue provided in the biopsy specimen, and 3.4% to inflammation obscuring diagnosis. Overall, concordant cases had a larger average biopsy volume (1.53 cm(3)) than discordant cases (0.42 cm(3)). The data collected indicate an 88.9% diagnostic concordance with final pathologic results for incisional oral biopsy diagnoses. Sixty percent of discordance was attributed to sampling error when sampled tissue was not representative of the lesion in toto. Multiple-site biopsy specimens and larger-volume samples allowed for a more accurate diagnosis. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Modulation of neuroinflammation and pathology in the 5XFAD mouse model of Alzheimer's disease using a biased and selective beta-1 adrenergic receptor partial agonist.

PubMed

Ardestani, Pooneh Memar; Evans, Andrew K; Yi, Bitna; Nguyen, Tiffany; Coutellier, Laurence; Shamloo, Mehrdad

2017-04-01

Degeneration of noradrenergic neurons occurs at an early stage of Alzheimer's Disease (AD). The noradrenergic system regulates arousal and learning and memory, and has been implicated in regulating neuroinflammation. Loss of noradrenergic tone may underlie AD progression at many levels. We have previously shown that acute administration of a partial agonist of the beta-1 adrenergic receptor (ADRB1), xamoterol, restores behavioral deficits in a mouse model of AD. The current studies examined the effects of chronic low dose xamoterol on neuroinflammation, pathology, and behavior in the pathologically aggressive 5XFAD transgenic mouse model of AD. In vitro experiments in cells expressing human beta adrenergic receptors demonstrate that xamoterol is highly selective for ADRB1 and functionally biased for the cAMP over the β-arrestin pathway. Data demonstrate ADRB1-mediated attenuation of TNF-α production with xamoterol in primary rat microglia culture following LPS challenge. Finally, two independent cohorts of 5XFAD and control mice were administered xamoterol from approximately 4.0-6.5 or 7.0-9.5 months, were tested in an array of behavioral tasks, and brains were examined for evidence of neuroinflammation, and amyloid beta and tau pathology. Xamoterol reduced mRNA expression of neuroinflammatory markers (Iba1, CD74, CD14 and TGFβ) and immunohistochemical evidence for microgliosis and astrogliosis. Xamoterol reduced amyloid beta and tau pathology as measured by regional immunohistochemistry. Behavioral deficits were not observed for 5XFAD mice. In conclusion, chronic administration of a selective, functionally biased, partial agonist of ADRB1 is effective in reducing neuroinflammation and amyloid beta and tau pathology in the 5XFAD model of AD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Higher brain BDNF gene expression is associated with slower cognitive decline in older adults.

PubMed

Buchman, Aron S; Yu, Lei; Boyle, Patricia A; Schneider, Julie A; De Jager, Philip L; Bennett, David A

2016-02-23

We tested whether brain-derived neurotrophic factor (BDNF) gene expression levels are associated with cognitive decline in older adults. Five hundred thirty-five older participants underwent annual cognitive assessments and brain autopsy at death. BDNF gene expression was measured in the dorsolateral prefrontal cortex. Linear mixed models were used to examine whether BDNF expression was associated with cognitive decline adjusting for age, sex, and education. An interaction term was added to determine whether this association varied with clinical diagnosis proximate to death (no cognitive impairment, mild cognitive impairment, or dementia). Finally, we examined the extent to which the association of Alzheimer disease (AD) pathology with cognitive decline varied by BDNF expression. Higher brain BDNF expression was associated with slower cognitive decline (p < 0.001); cognitive decline was about 50% slower with the 90th percentile BDNF expression vs 10th. This association was strongest in individuals with dementia. The level of BDNF expression was lower in individuals with pathologic AD (p = 0.006), but was not associated with macroscopic infarcts, Lewy body disease, or hippocampal sclerosis. BDNF expression remained associated with cognitive decline in a model adjusting for age, sex, education, and neuropathologies (p < 0.001). Furthermore, the effect of AD pathology on cognitive decline varied by BDNF expression such that the effect was strongest for high levels of AD pathology (p = 0.015); thus, in individuals with high AD pathology (90th percentile), cognitive decline was about 40% slower with the 90th percentile BDNF expression vs 10th. Higher brain BDNF expression is associated with slower cognitive decline and may also reduce the deleterious effects of AD pathology on cognitive decline. © 2016 American Academy of Neurology.

Histopathological reporting of corneal pathology by a biomedical scientist: the Sheffield Experience.

PubMed

Meeney, A; Mudhar, H S

2013-02-01

The advanced specialist diploma in ophthalmic pathology was jointly ratified by the Royal College of Pathologists and the Institute of Biomedical Science in 2008. It results in extended roles for suitably qualified Biomedical Scientists (BMSs) in ophthalmic pathology specimen dissection and histological reporting of selected specimens, specifically non-neoplastic corneas. This study aimed to examine the reporting of corneal histology by a BMS training towards this diploma in comparison with a Consultant Ophthalmic Pathologist. This report covers a non-interventional, prospective examination of BMS's diagnostic skills. After 6 months training, 50 consecutive corneal cases were reported by the BMS and the same case reported by the consultant ophthalmic pathologist. The BMS's diagnosis was compared with the final consultant's diagnosis. This exercise was then repeated after 24 months of training. After 6 months, the BMS's diagnoses matched the consultant diagnoses in 44/50 (88%) cases. After 24 months, the BMS's diagnoses matched the consultant diagnoses in 48/50 (96%) of cases. The results indicate that BMS's reporting of corneal histology is a real and safe possibility. Furthermore, it indicated deficiencies in BMS's diagnostic skills to inform further training/knowledge acquisition.

Complete pathological response (ypT0N0M0) after preoperative chemotherapy alone for stage IV rectal cancer.

PubMed

Naiken, Surennaidoo P; Toso, Christian; Rubbia-Brandt, Laura; Thomopoulos, Theodoros; Roth, Arnaud; Mentha, Gilles; Morel, Philippe; Gervaz, Pascal

2014-01-17

Complete pathological response occurs in 10-20% of patients with rectal cancer who are treated with neoadjuvant chemoradiation therapy prior to pelvic surgery. The possibility that complete pathological response of rectal cancer can also occur with neoadjuvant chemotherapy alone (without radiation) is an intriguing hypothesis. A 66-year old man presented an adenocarcinoma of the rectum with nine liver metastases (T3N1M1). He was included in a reverse treatment, aiming at first downsizing the liver metastases by chemotherapy, and subsequently performing the liver surgery prior to the rectum resection. The neoadjuvant chemotherapy consisted in a combination of oxaliplatin, 5-FU, irinotecan, leucovorin and bevacizumab (OCFL-B). After a right portal embolization, an extended right liver lobectomy was performed. On the final histopathological analysis, all lesions were fibrotic, devoid of any viable cancer cells. One month after liver surgery, the rectoscopic examination showed a near-total response of the primary rectal adenocarcinoma, which convinced the colorectal surgeon to perform the low anterior resection without preoperative radiation therapy. Macroscopically, a fibrous scar was observed at the level of the previously documented tumour, and the histological examination of the surgical specimen did not reveal any malignant cells in the rectal wall as well as in the mesorectum. All 15 resected lymph nodes were free of tumour, and the final tumour stage was ypT0N0M0. Clinical outcome was excellent, and the patient is currently alive 5 years after the first surgery without evidence of recurrence. The presented patient with stage IV rectal cancer and liver metastases was in a unique situation linked to its inclusion in a reversed treatment and the use of neoadjuvant chemotherapy alone. The observed achievement of a complete pathological response after chemotherapy should promote the design of prospective randomized studies to evaluate the benefits of chemotherapy alone in patients with stages II-III rectal adenocarcinoma (without metastasis).

Gonioscopy in primary angle closure glaucoma.

PubMed

Bruno, Christina A; Alward, Wallace L M

2002-06-01

Primary angle closure is a condition characterized by obstruction to aqueous humor outflow by the peripheral iris, and results in changes in the iridocorneal angle that are visible through gonioscopic examination. Gonioscopy in these eyes, however, can be difficult. This chapter discusses techniques that might help in the examination. These include beginning the examination with the inferior angle, methods to help in looking over the iris, cycloplegia, locating the corneal wedge, indentation, van Herick estimation, examining the other eye, and topical glycerin. Finally, there is a discussion about the pathology associated with the closed angle, with emphasis on the appearance of iris bombé, plateau iris, and the distinction between iris processes and peripheral anterior synechiae.

Thyroid Nodule Size at Ultrasound as a Predictor of Malignancy and Final Pathologic Size.

PubMed

Cavallo, Allison; Johnson, Daniel N; White, Michael G; Siddiqui, Saaduddin; Antic, Tatjana; Mathew, Melvy; Grogan, Raymon H; Angelos, Peter; Kaplan, Edwin L; Cipriani, Nicole A

2017-05-01

Thyroid-related mortality has remained constant despite the increasing incidence of thyroid carcinoma. Most thyroid nodules are benign; therefore, ultrasound and fine needle aspiration (FNA) are integral in cancer screening. We hypothesize that increased nodule size at ultrasound does not predict malignancy and correlation between nodule size at ultrasound and pathologic exam is good. Resected thyroids with preoperative ultrasounds were identified. Nodule size at ultrasound, FNA diagnosis by Bethesda category, size at pathologic examination, and final histologic diagnosis were recorded. Nodule characteristics at ultrasound and FNA diagnoses were correlated with gross characteristics and histologic diagnoses. Nodules for which correlation could not be established were excluded. Of 1003 nodules from 659 patients, 26% were malignant. Nodules <2 cm had the highest malignancy rate (∼30%). Risk was similar (∼20%) for nodules ≥2 cm. Of the 548 subject to FNA, 38% were malignant. Decreasing malignancy rates were observed with increasing size (57% for nodules <1 cm to 20% for nodules >6 cm). At ultrasound size cutoffs of 2, 3, 4, and 5 cm, smaller nodules had higher malignancy rates than larger nodules. Of the 455 not subject to FNA, 11% were malignant. Ultrasound size alone is a poor predictor of malignancy, but a relatively good predictor of final pathologic size (R 2  = 0.748), with less correlation at larger sizes. In nodules subject to FNA, false negative diagnoses were highest (6-8%) in nodules 3-6 cm, mostly due to encapsulated follicular variant of papillary carcinoma. Thyroid nodule size is inversely related to malignancy risk, as larger nodules have lower malignancy rates. However, the relationship of size to malignancy varies by FNA status. All nodules (regardless of FNA status) demonstrate a risk trough at ≥2 cm. Nodules subject to FNA show step-wise decline in malignancy rates by size, demonstrating that size alone should not be considered as an independent risk factor. Size at ultrasound shows relatively good correlation with final pathologic size. False negative rates are low in this series. Lesions with the appropriate constellation of clinical and radiographic findings should undergo FNA regardless of size. Both size and FNA diagnosis should influence the clinical decision-making process.

Endoscopic low coherence interferometry in upper airways

NASA Astrophysics Data System (ADS)

Delacrétaz, Yves; Boss, Daniel; Lang, Florian; Depeursinge, Christian

2009-07-01

We introduce Endoscopic Low Coherence Interferometry to obtain topology of upper airways through commonly used rigid endoscopes. Quantitative dimensioning of upper airways pathologies is crucial to provide maximum health recovery chances, for example in order to choose the correct stent to treat endoluminal obstructing pathologies. Our device is fully compatible with procedures used in day-to-day examinations and can potentially be brought to bedside. Besides this, the approach described here can be almost straightforwardly adapted to other endoscopy-related field of interest, such as gastroscopy and arthroscopy. The principle of the method is first exposed, then filtering procedure used to extract the depth information is described. Finally, demonstration of the method ability to operate on biological samples is assessed through measurements on ex-vivo pork bronchi.

The American Society for Clinical Pathology resident in-service examination: does resident performance provide insight into the effectiveness of clinical pathology education?

PubMed

McKenna, Barbara J

2007-06-01

The resident in-service examination in pathology is an in-training exercise that is taken by virtually all pathology residents in the United States as well as by some participants in Canada, Ireland, and Lebanon. Although all of the anatomic pathology topics in the examination, with only one exception-forensic pathology, show significant improvement in scores over the 4 years of residency training, three areas of clinical pathology training (laboratory administration, clinical chemistry, and microbiology) show significantly lower improvement in performance over the years of residency training. By contrast, transfusion medicine, hematopathology and the special topics section of the examination all demonstrate improved performance by residents over time. While the reason behind these differences must remain speculative at this time, these findings suggest that measures to improve effectiveness in clinical pathology training might be suggested by examining the differences between residency training practices between higher and lower performing areas of clinical pathology.

Flexner 3.0—Democratization of Medical Knowledge for the 21st Century

PubMed Central

Krupinski, Elizabeth A.; Weinstein, John B.; Graham, Anna R.; Barker, Gail P.; Erps, Kristine A.; Holtrust, Angelette L.; Holcomb, Michael J.

2016-01-01

A medical school general pathology course has been reformatted into a K-12 general pathology course. This new course has been implemented at a series of 7 to 12 grade levels and the student outcomes compared. Typically, topics covered mirrored those in a medical school general pathology course serving as an introduction to the mechanisms of diseases. Assessment of student performance was based on their score on a multiple-choice final examination modeled after an examination given to medical students. Two Tucson area schools, in a charter school network, participated in the study. Statistical analysis of examination performances showed that there were no significant differences as a function of school (F = 0.258, P = .6128), with students at school A having an average test scores of 87.03 (standard deviation = 8.99) and school B 86.00 (standard deviation = 8.18; F = 0.258, P = .6128). Analysis of variance was also conducted on the test scores as a function of gender and class grade. There were no significant differences as a function of gender (F = 0.608, P = .4382), with females having an average score of 87.18 (standard deviation = 7.24) and males 85.61 (standard deviation = 9.85). There were also no significant differences as a function of grade level (F = 0.627, P = .6003), with 7th graders having an average of 85.10 (standard deviation = 8.90), 8th graders 86.00 (standard deviation = 9.95), 9th graders 89.67 (standard deviation = 5.52), and 12th graders 86.90 (standard deviation = 7.52). The results demonstrated that middle and upper school students performed equally well in K-12 general pathology. Student course evaluations showed that the course met the student’s expectations. One class voted K-12 general pathology their “elective course-of-the-year.” PMID:28725762

Modeling the Association between 43 Different Clinical and Pathological Variables and the Severity of Cognitive Impairment in a Large Autopsy Cohort of Elderly Persons

PubMed Central

Nelson, Peter T.; Abner, Erin L.; Schmitt, Frederick A.; Kryscio, Richard J.; Jicha, Gregory A.; Smith, Charles D.; Davis, Daron G.; Poduska, John W.; Patel, Ela; Mendiondo, Marta S.; Markesbery, William R.

2009-01-01

We evaluated the association between mini-mental status examination (MMSE) scores proximal to death and the values of 43 different clinical and pathological parameters. Studies were performed using data from 334 elderly, longitudinally evaluated research subjects who had undergone autopsy and satisfied inclusion criteria from an initial study group of 501. Interindividual variance in MMSE scores was used as a surrogate for the severity of cognitive impairment linked to aging (CILA). A statistical linear regression-based model provided a framework for assessing the parameters with significant, direct impact on CILA severity. Strong association between CILA and Alzheimer’s disease (AD) pathology, especially isocortical neurofibrillary tangles, was evident. The pattern of association between AD lesion densities with cognitive impairment severity was biologically informative, with neuritic plaques having more impact in relatively high-functioning individuals. Abundant isocortical Lewy bodies tended to be an additive pathology correlating with final MMSE scores approximately 10 points lower. In a subset of cases we found evidence for association between TDP-43-related pathology and CILA severity, independent of AD or hippocampal sclerosis. There was no support for independent association between CILA severity and most evaluated indices including diffuse plaques, argyrophilic grains, heart disease, education level, apolipoprotein E alleles or diabetes. PMID:19021630

Pathological findings and probable causes of the death of Stejneger's beaked whales (Mesoplodon stejnegeri) stranded in Japan from 1999 and 2011.

PubMed

Tajima, Yuko; Maeda, Kaori; Yamada, Tadasu K

2015-01-01

One hundred and twenty stranding events of Stejneger's beaked whales were reported in Japan between 1999 and 2011. The purpose of this study is to introduce pathological data and to discuss probable causes of death for 44 Stejneger's beaked whales among them. The significant pathological findings were the pulmonary edema, parasitic granulomatous nephritis, emaciation, amyloidosis, suppurative bronchopneumonia and so on. The probable causes of death were categorized as noninfectious in 43 of the cases, which included drowning, starvation and secondary amyloidosis. One individual was diagnosed with septicemia, which was the only example of an infectious disease. Because we could not always perform advanced analyses, such as microbiology tests, biotoxin examinations or contaminant analyses, the finality of our findings may be impaired. However, the present study has broad implications on the causes of death of Stejneger's beaked whales of the seas around Japan, which are valuable for the future studies and for the detection of emerging diseases.

Computed tomographic contrast tenography of the digital flexor tendon sheath of the equine hindlimb.

PubMed

Agass, Rachel; Dixon, Jonathon; Fraser, Barny

2018-05-01

Pre-surgical investigation of digital flexor tendon sheath pathology remains challenging with current standard imaging techniques. The aim of this prospective, anatomical, pilot study was to describe the anatomy of the equine hind limb digital flexor tendon sheath using a combination of computed tomography (CT) and computed tomographic contrast tenography in clinically normal cadaver limbs. Ten pairs of hind limbs with no external abnormalities were examined from the level of the tarsometatarsal joint distally. Limbs initially underwent non-contrast CT examination using 120 kVp, 300 mAs, and 1.5 mm slice thickness. Sixty millilitres of ioversol iodinated contrast media and saline (final concentration 100 mg/ml) were injected using a basilar sesamoidean approach. The computed tomographic contrast tenography examination was then repeated, before dissection of the specimens to compare gross and imaging findings. The combined CT and computed tomographic contrast tenography examinations provided excellent anatomical detail of intra-thecal structures. The borders of the superficial and deep digital flexor tendons, and the manica flexoria were consistently identifiable in all limbs. Detailed anatomy including that of the mesotenons, two of which are previously undescribed, and the plantar annular ligament were also consistently identifiable. Dissection of all 10 pairs of limbs revealed there to be no pathology, in accordance with the imaging findings. In conclusion, the combination of CT and computed tomographic contrast tenography may be useful adjunctive diagnostic techniques to define digital flexor tendon sheath pathology prior to surgical exploration in horses. © 2017 American College of Veterinary Radiology.

Thyroid Ultrasound Pitfalls: Esophageal Fibrovascular Polyp Mimicking Thyroid Nodule

PubMed Central

Brigante, G.; Madeo, B.

2016-01-01

Background. Ultrasound (US) is the most accurate tool in the diagnosis of thyroid nodules if performed by expert physician. Misdiagnosis due to extrathyroidal lesions mimicking thyroid nodules is reported in literature. We describe the first case of an esophageal fibrovascular polyp misdiagnosed as a thyroid nodule on US examination. Patient Findings. A 54-year-old woman presented to emergency department for headache and underwent carotid Doppler extended to neck ultrasound with incidental finding of a nodule in the posterior side of the left thyroid lobe. A following thyroid US performed by an endocrinologist allowed the characterization of the lesion as an esophageal pathology, considering the extrathyroidal position, the typical peripheral hyperechoic spots and hypoechoic rim, the connection to the esophagus, and the swallowing connected movement. The patient was addressed to further investigations and finally to anterior pharyngotomy with histological diagnosis of esophageal fibrovascular polyp. Summary. Differential diagnosis between thyroid nodules and other neck lesions is important to prevent an unnecessary fine needle aspiration biopsy and to treat the extrathyroidal pathology. In this case, an US performed by an expert endocrinologist allowed detecting an esophageal fibrovascular polyp requiring surgical removal. In conclusion, the possibility of an esophageal pathology, and even fibrovascular polyp, should be considered during US thyroid examination. PMID:27022492

Roles and regulation of the matrix metalloproteinase system in parturition.

PubMed

Geng, Junnan; Huang, Cong; Jiang, Siwen

2016-04-01

Significant tissue destruction, repair, and remodeling are involved in parturition, which involves fetal membrane rupture, cervical ripening, and uterine contraction and its subsequent involution. Extracellular matrix degradation and remodeling by proteolytic enzymes, such as matrix metalloproteinases (MMPs), are required for the final steps of parturition. MMPs participate in physiological degradation and remodeling through their proteolytic activities on specific substrates, and are balanced by the action of their inhibitors. Disruption to this balance can result in pathological stress that ends with preterm or post-term birth or pre-eclampsia. In this review, we examine the roles and regulation of the MMP system in physiological and pathological labor, and propose a model that illustrates the mechanisms by which the MMP system contributes to these processes. © 2016 Wiley Periodicals, Inc.

Brain Ultrasonography Findings in Neonatal Seizure; a Cross-sectional Study.

PubMed

Nabavi, Seyed Saeed; Partovi, Parinaz

2017-01-01

Screening of newborns with seizure, who have curable pathologic brain findings, might be able to improve their final outcome by accelerating treatment intervention. The present study aimed to evaluate the brain ultrasonography findings of newborns hospitalized with complaint of seizure. The present cross-sectional study designed to evaluate brain ultrasonography findings of hospitalized newborns complaining seizure. Neonatal seizure was defined as presence of tonic, clonic, myoclonic, and subtle attacks in 1 - 28 day old newborns. 100 newborns with the mean age of 5.82 ± 6.29 days were evaluated (58% male). Most newborns were in the < 10 days age range (76%), term (83%) and with normal birth weight (81%). 22 (22%) of the ultrasonography examinations showed a pathologic finding. A correlation was only found between birth age and probability of the presence of a pathologic problem in the brain as the frequency of these problems was significantly higher in pre-term newborns (p = 0.023). Based on the findings of the present study, frequency of pathologic findings in neonatal brain ultrasonography was 22%. Hemorrhage (12%) and hydrocephaly (7%) were the most common findings. The only factor correlating with increased probability of positive findings was the newborns being pre-term.

Positive and negative eating expectancies in disordered eating among women and men.

PubMed

Hayaki, Jumi; Free, Sarah

2016-08-01

Deficits in emotion regulation are known to characterize disordered eating patterns including binge eating, purging, and dietary restraint, though much of this work has been conducted exclusively on women. Eating expectancies, or expectations regarding reinforcement from food and eating, constitute one cognitive mechanism that is thought to serve as a proximal influence on eating behavior. Previous research shows that eating to manage negative affect (a negative eating expectancy) is associated with eating pathology in women, but less is known about eating as a reward or for pleasure (a positive eating expectancy). In addition, no prior work has examined eating expectancies among men. This study examines the role of emotion regulation and eating expectancies on disordered eating in women and men. Participants were 121 female and 80 male undergraduates who completed self-report measures of emotion regulation, eating expectancies, and disordered eating. In women, body mass index (BMI), emotion regulation, and eating to manage negative affect directly predicted disordered eating in the final multivariate model, whereas eating for pleasure or reward was inversely associated with disordered eating. However, in men, emotion regulation predicted disordered eating, but not when eating expectancies were added to the model. In the final model, only BMI and eating to manage negative affect contributed significantly to the variance in disordered eating. These findings suggest that some correlates of eating pathology, particularly eating expectancies, may vary by gender. Future research should continue to examine gender differences in the explanatory mechanisms underlying disordered eating. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessing dependency using self-report and indirect measures: examining the significance of discrepancies.

PubMed

Cogswell, Alex; Alloy, Lauren B; Karpinski, Andrew; Grant, David A

2010-07-01

The present study addressed convergence between self-report and indirect approaches to assessing dependency. We were moderately successful in validating an implicit measure, which was found to be reliable, orthogonal to 2 self-report instruments, and predictive of external criteria. This study also examined discrepancies between scores on self-report and implicit measures, and has implications for their significance. The possibility that discrepancies themselves are pathological was not supported, although discrepancies were associated with particular personality profiles. Finally, this study offered additional evidence for the relation between dependency and depressive symptomatology and identified implicit dependency as contributing unique variance in predicting past major depression.

Surgical Pathology Resident Rotation Restructuring at a Tertiary Care Academic Center.

PubMed

Mehr, Chelsea R; Obstfeld, Amrom E; Barrett, Amanda C; Montone, Kathleen T; Schwartz, Lauren E

2017-01-01

Changes in the field of pathology and resident education necessitate ongoing evaluation of residency training. Evolutionary change is particularly important for surgical pathology rotations, which form the core of anatomic pathology training programs. In the past, we organized this rotation based on subjective insight. When faced with the recent need to restructure the rotation, we strove for a more evidence-based process. Our approach involved 2 primary sources of data. We quantified the number of cases and blocks submitted per case type to estimate workload and surveyed residents about the time required to gross specimens in all organ systems. A multidisciplinary committee including faculty, residents, and staff evaluated the results and used the data to model how various changes to the rotation would affect resident workload, turnaround time, and other variables. Finally, we identified rotation structures that equally distributed work and created a point-based system that capped grossing time for residents of different experience. Following implementation, we retrospectively compared turnaround time and duty hour violations before and after these changes and surveyed residents about their experiences with both systems. We evaluated the accuracy of the point-based system by examining grossing times and comparing them to the assigned point values. We found overall improvement in the rotation following the implementation. As there is essentially no literature on the subject of surgical pathology rotation organization, we hope that our experience will provide a road map to improve pathology resident education at other institutions.

Predicting Problematic Alcohol Use with the DSM-5 Alternative Model of Personality Pathology

PubMed Central

Creswell, Kasey G.; Bachrach, Rachel L.; Wright, Aidan G.C.; Pinto, Anthony; Ansell, Emily

2015-01-01

There is high comorbidity between personality disorders and alcohol use disorders, which appears related to individual differences in underlying personality dimensions of behavioral undercontrol and affective dysregulation. Very little is known about how the DSM-5 Section III trait model of personality pathology relates to alcohol problems, however, or how the strength of the relationship between personality pathology and alcohol problems changes with age and across gender. The current study examined these questions in a sample of 877 participants using the General Assessment of Personality Disorder to assess general personality dysfunction, the Personality Inventory for DSM-5 to measure specific traits, and the Alcohol Use Disorder Identification Test to assess problematic alcohol use. Results demonstrated that general personality pathology (Criterion A) was significantly related to problematic alcohol use after controlling for age and gender effects. Further, two of the five higher-order personality trait domains (Criterion B), Antagonism and Disinhibition, remained significant predictors of problematic alcohol use after accounting for the influence of general personality pathology; however, general personality pathology no longer predicted hazardous alcohol use once Antagonism and Disinhibition were added into the model. Finally, these two specific traits interacted with age, such that Antagonism was a stronger predictor of AUDIT scores among older individuals and Disinhibition was a stronger predictor of alcohol problems among younger individuals. Findings support the general validity of this new personality disorder diagnostic system and suggest important age effects in the relationship between traits and problematic alcohol use. PMID:26389625

Speech pathology student clinician attitudes and beliefs towards people who stutter: A mixed-method pilot study.

PubMed

Koutsodimitropoulos, Ellen; Buultjens, Melissa; St Louis, Kenneth O; Monfries, Melissa

2016-03-01

Stuttering is a disorder of fluency that extends beyond its physical nature and has social, emotional and vocational impacts. Research shows that individuals often exhibit negative attitudes towards people who stutter; however, there is limited research on the attitudes and beliefs of speech pathology students towards people who stutter in Australia. Existing research is predominantly quantitative; whereas this mixed-method study placed an emphasis on the qualitative component. The purpose of this study was to explore the attitudes and beliefs of final year Australian speech pathology students towards people who stutter. This mixed-method study applied the Public Opinion Survey of Human Attributes - Stuttering (POSHA-S) and semi-structured interviews to gather data from final year speech pathology students from a major university in Australia. The overall qualitative findings identified that final year Australian speech pathology students exhibit positive attitudes towards people who stutter. The results also illustrated the role of education in influencing attitudes of students as well as increasing their confidence to work with people who stutter. This research revealed that Australian final year speech pathology students exhibit positive attitudes towards people who stutter. They displayed an understanding that people who stutter may have acquired traits such as shyness as a response to their personal situation and environment, rather than those traits being endemic to them. Results also suggested that education can play a role in creating confident student clinicians in their transition to practice, and positively influence their attitudes and beliefs. Copyright © 2015 Elsevier Inc. All rights reserved.

A Team Approach to Training Early Intervention and Preschool Personnel in Speech-Language Pathology, 1998-2000. Final Report.

ERIC Educational Resources Information Center

San Jose State Univ., CA.

This final report discusses the activities and outcomes of a project designed to train specialists to work collaboratively across settings to improve the outcomes of young children with language and learning disabilities. It provided education for trainees that led to a Masters degree in speech-language pathology with a specialty in early…

High-grade dysplasia and adenocarcinoma are frequent in side-branch intraductal papillary mucinous neoplasm measuring less than 3 cm on endoscopic ultrasound.

PubMed

Wong, Joyce; Weber, Jill; Centeno, Barbara A; Vignesh, Shivakumar; Harris, Cynthia L; Klapman, Jason B; Hodul, Pamela

2013-01-01

Surgical resection for intraductal papillary mucinous neoplasm (IPMN) of the pancreas has increased over the last decade. While IPMN with main duct communication are generally recommended for resection, indications for resection of side-branch IPMN (SDIPMN) have been less clear. We reviewed our single institutional experience with SDIPMN and indications for resection. Patients who underwent resection for IPMN were identified from a prospectively maintained IRB-approved database. Patients with main pancreatic duct communication were excluded. Outcome, clinical and pathologic characteristics were correlated with endoscopic ultrasound (EUS) findings. From 2000 to 2010, 105 patients who underwent preoperative EUS evaluation and resection for SDIPMN were identified. The mean age was within the sixth decade of life, and there was a slight female predominance (55 vs. 45 %). The most common presenting symptom was abdominal pain (N = 47, 45 %), followed by jaundice (N = 24, 23 %) and weight loss (N = 24, 23 %). Only ten patients (10 %) were asymptomatic at presentation; seven (70 %) had suspicious features on EUS. Of the total cohort, few patients had intracystic septations (N = 27, 26 %) or presence of mural nodules (N = 2, 2 %) on EUS. Of 39 patients who had invasive pancreatic ductal adenocarcinoma (PDAC) on final pathology, EUS-fine needle aspiration (EUS-FNA) demonstrated malignancy in only 21 (54 %). An additional seven (18 %) had EUS-FNA findings of atypia or concern for mucinous neoplasm. EUS evaluation of cyst size was correlated with final pathology. Of 70 patients with EUS cyst size <3 cm, 12 (17 %) had a preoperative EUS diagnosis of malignancy. Final pathology revealed 24 (34 %) to have PDAC: 1 of 7 (14 %) patients with cyst size <1 cm, 2 of 19 (11 %) with cyst size 1-2 cm, and 21of 44 (48 %) with cyst size 2-3 cm. Fifteen of 35 (43 %) patients with cyst size >3 cm had PDAC on final pathology. Of the patients with cyst size <3 cm, 16 (23 %) had high-grade dysplasia on final pathology: 3 of 7 (43 %) with cyst size <1 cm, 3 of 19 (16 %) with cyst size 1-2 cm, and 10 of 44 (23 %) with cyst size 2-3 cm. Seven of 35 (20 %) patients with cyst size >3 cm had high-grade dysplasia on final pathology. Although overall survival (OS) at 48 months stratified by EUS cyst size did not significantly differ between groups, patients with PDAC on final pathology had significantly worse OS compared to noninvasive pathology. A total of eight patients (8 %) developed recurrent disease, all of whom had PDAC on final pathology. EUS is a helpful modality for the diagnostic evaluation of SDIPMN. Considering the high incidence of malignancy as well as high-grade dysplasia in SDIPMN greater than 2 cm, EUS features should be used in conjunction with other clinical criteria to guide management decisions. Patients with SDIPMN greater than 2 cm that do not undergo surgical resection may benefit from more intensive surveillance.

Primary Intimal Sarcoma of Thoracic Aorta Presenting as Hypertensive Crisis

PubMed Central

Lin, Shu-I; Su, Min-I; Tsai, Cheng-Ting

2015-01-01

We report a 45-year-old woman who presented to our facility in a hypertensive crisis. Computed tomography (CT) revealed a thoracic aortic tumor, and tissues obtained via endovascular biopsy revealed undifferentiated sarcoma. A final diagnosis of intimal sarcoma was made by intra-operative pathological examination. Despite undergoing surgical resection followed by adjuvant chemotherapy, the patient died from progressive multiple metastasis and severe sepsis. Although aortic sarcoma is rarely diagnosed, it should be considered a possible etiology of hypertensive crisis. PMID:27122923

ARFI-based tissue elasticity quantification and kidney graft dysfunction: first clinical experiences.

PubMed

Stock, K F; Klein, B S; Cong, M T Vo; Regenbogen, C; Kemmner, S; Büttner, M; Wagenpfeil, S; Matevossian, E; Renders, L; Heemann, U; Küchle, C

2011-01-01

Beyond the medical history, the clinical exam and lab findings, non-invasive ultrasound parameters such as kidney size and Doppler values (e.g. the resistive index) are important tools assisting clinical decision making in the monitoring of renal allografts. The gold standard for the diagnosis of renal allograft dysfunction remains the renal biopsy; while an invasive procedure, the justifiable necessity for this derives from its definitive nature a requirement beyond the synopses of all non-invasive tools. "Acoustic Radiation Force Impulse Imaging"(ARFI)-quantification is a novel ultrasound-based technology measuring tissue elasticity properties. So far experience related to this new method has not been reported in renal transplant follow-up. The purpose of this study was to evaluate changes in ARFI-measurements between clinically stable renal allografts and biopsy-proven transplant dysfunction. We employed "Virtual Touch™ tissue quantification" (Siemens Acuson, S2000) for the quantitative measurement of tissue stiffness in the cortex of transplant kidneys. We performed initial baseline and later disease-evaluative ultrasound examinations in 8 renal transplant patients in a prospective study design. Patients were first examined during stable allograft function with a routine post-transplant renal ultrasound protocol. A second follow-up examination was carried out on subsequent presentation with transplant dysfunction prior to allograft biopsy and histological evaluation. All patiens were examined using ARFI-quantification (15 measurements/kidney). Resistive indices (RI) were calculated using pulsed-wave Doppler ultrasound, and transplant kidney size was measured on B-mode ultrasound images. All biopsies were evaluated histologically by a reference nephropathologist unaware of the results of the ultrasound studies. Histopathological diagnoses were based on biopsy results, taking clinical and laboratory findings into account. Finally we calculated the relative changes in ARFI-quantification, resistive indices and the absolute change of kidney size on a percentage basis at these defined assessment times and compared the results with the final pathologic diagnosis. Histological results enumerated five cases of acute T-cell-mediated rejection, one case of calcineurin inhibitor toxicity and two cases of acute tubular necrosis. Calcineurin inhibitor toxicity and acute tubular necrosis were subsumed as "other pathologies". Mean ARFI-values showed an average increase of more than 15% percent in transplants with histologically proven acute rejection whereas no increase was seen in transplants with other pathologies. Mean RI-values showed no increase either in the diagnostic group of acute rejection, nor in the group with other pathologies. Kidney size showed a mean absolute increase of 0.5 centimetres in allografts with acute rejection, whereas a mean decrease of 0.17 centimetres was seen in the group with other pathologies. As shown before in other studies, RI values and kidney size are of doubtful utility in the evaluation of kidney allograft dysfunction. ARFI-based elasticity measurement shows promise as a complementary non-invasive parameter in follow-on diagnosis of renal allograft rejection.

An Empirical Study of Personality Disorders Among Treatment-Seeking Problem Gamblers.

PubMed

Brown, M; Oldenhof, E; Allen, J S; Dowling, N A

2016-12-01

The primary aims of this study were to examine the prevalence of personality disorders in problem gamblers, to explore the relationship between personality disorders and problem gambling severity, and to explore the degree to which the psychological symptoms highlighted in the biosocial developmental model of borderline personality disorder (impulsivity, distress tolerance, substance use, PTSD symptoms, psychological distress and work/social adjustment) are associated with problem gambling. A secondary aim was to explore the strength of the relationships between these symptoms and problem gambling severity in problem gamblers with and without personality disorder pathology. Participants were 168 consecutively admitted problem gamblers seeking treatment from a specialist outpatient gambling service in Australia. The prevalence of personality disorders using the self-report version of the Iowa Personality Disorders Screen was 43.3 %. Cluster B personality disorders, but not Cluster A or C personality disorders, were associated with problem gambling severity. All psychological symptoms, except alcohol and drug use, were significantly higher among participants with personality disorder pathology compared to those without. Finally, psychological distress, and work and social adjustment were significantly associated with problem gambling severity for problem gamblers with personality disorder pathology, while impulsivity, psychological distress, and work and social adjustment were significantly associated with problem gambling severity for those without personality disorder pathology. High rates of comorbid personality disorders, particularly Cluster B disorders, necessitate routine screening in gambling treatment services. More complex psychological profiles may complicate treatment for problem gamblers with comorbid personality disorders. Future research should examine the applicability of the biosocial developmental model to problem gambling in community studies.

The use of contrasted transvaginal sonography in the diagnosis of gynecologic diseases: a preliminary study.

PubMed

Testa, Antonia Carla; Ferrandina, Gabriella; Fruscella, Erika; Van Holsbeke, Caroline; Ferrazzi, Enrico; Leone, Francesco P G; Arduini, Domenico; Exacoustos, Caterina; Bokor, Daniela; Scambia, Giovanni; Timmerman, Dirk

2005-09-01

The purpose of this study was to evaluate the efficacy of a new contrast-dedicated ultrasound technology, contrast-tuned imaging (CnTI), implemented on an endovaginal probe and using the second-generation contrast agent SonoVue (Bracco International BV, Amsterdam, the Netherlands), compared with the standard ultrasound examination in different gynecologic diseases. Eighty-nine patients were enrolled in the study in 4 different clinical centers. The study included 40 patients with uncertain pelvic adnexal masses, 10 patients with pelvic masses indicative of recurrences of gynecologic tumors, 26 patients with uterine pathologic features, and 13 patients with cervical lesions. Application of CnTI technology after the SonoVue injection gave a picture of the intralesional microvascularization dramatically different from that obtained during color Doppler examination. Of the 40 pelvic masses, 15 (37.5%) were considered benign and 25 (62.5%) were considered malignant at B-mode and color Doppler examinations. Contrast-enhanced sonography showed no intralesional contrast perfusion in 11 (73%) of 15 cases, and all these were benign at final diagnosis. Of the 4 (27%) cases that had perfusion, 2 were malignant. Conversely, of the 25 cases with positive findings at color Doppler examination and therefore expected to show the appearance of contrast tissue-filling morphologic characteristics, 13 (52%) were malignant at final diagnosis. For evaluation of uterine pathologic features, the CnTI-SonoVue technology did not appear to be superior to the B-mode and color Doppler examinations; however, for the evaluation of cervical cancer, CnTI-SonoVue technology revealed a better definition of the margins of the neoplastic lesions in 4 (40%) of 10 cases. In the evaluation of uncertain pelvic masses, the CnTI technology led to an improvement in the ability of the practitioner to differentiate benign from malignant adnexal lesions.

The Regulation of Steroid Action by Sulfation and Desulfation

PubMed Central

Mueller, Jonathan W.; Gilligan, Lorna C.; Idkowiak, Jan; Arlt, Wiebke

2015-01-01

Steroid sulfation and desulfation are fundamental pathways vital for a functional vertebrate endocrine system. After biosynthesis, hydrophobic steroids are sulfated to expedite circulatory transit. Target cells express transmembrane organic anion-transporting polypeptides that facilitate cellular uptake of sulfated steroids. Once intracellular, sulfatases hydrolyze these steroid sulfate esters to their unconjugated, and usually active, forms. Because most steroids can be sulfated, including cholesterol, pregnenolone, dehydroepiandrosterone, and estrone, understanding the function, tissue distribution, and regulation of sulfation and desulfation processes provides significant insights into normal endocrine function. Not surprisingly, dysregulation of these pathways is associated with numerous pathologies, including steroid-dependent cancers, polycystic ovary syndrome, and X-linked ichthyosis. Here we provide a comprehensive examination of our current knowledge of endocrine-related sulfation and desulfation pathways. We describe the interplay between sulfatases and sulfotransferases, showing how their expression and regulation influences steroid action. Furthermore, we address the role that organic anion-transporting polypeptides play in regulating intracellular steroid concentrations and how their expression patterns influence many pathologies, especially cancer. Finally, the recent advances in pharmacologically targeting steroidogenic pathways will be examined. PMID:26213785

The emergence of psychiatric semiology during the Age of Revolution: evolving concepts of 'normal' and 'pathological'.

PubMed

Londoño, Diego Enrique; Dening, Tom

2016-06-01

This article addresses some important questions in psychiatric semiology. The concept of a sign is crucial in psychiatry. How do signs emerge, and what gives them validity and legitimacy? What are the boundaries of 'normal' and 'pathological' behaviour and mental experiences? To address these issues, we analyse the characteristics and rules that govern semiological signs and clinical elements. We examine 'normality' from the perspective of Georges Canguilehm and compare the differences of 'normal' in physiology and psychiatry. We then examine the history and the philosophical, linguistic and medical-psychiatric origins of semiology during the eighteenth and nineteenth centuries (the Age of Revolution). The field of rhetoric and oratory has emphasized the importance of passions, emotions and language as applied to signs of madness. Another perspective on semiology, provided by Michel Foucault, lays stress on the concept of 'instinct' and the axis of voluntary-involuntary behaviour. Finally, we analyse how statistics and eugenics have played an important role in our current conceptualization of the norm and therefore the scientific discourse behind the established clinical signs. © The Author(s) 2016.

[Diagnostic accuracy research of needle puncture biopsy during operation for pulmonary single nodules].

PubMed

Chen, Jin-feng; Liu, Yi-nan; Wu, Nan; Feng, Yuan; Wang, Jia; Lü, Chao; Wang, Yu-zhao; Pei, Yu-quan; Yan, Shi; Zheng, Qing-feng; Zhang, Li-jian; Yang, Yue

2012-04-01

To investigate the diagnostic accuracy of needle puncture biopsy and pathological examination of frozen during operation for pulmonary nodules, and whether this diagnostic method can replace tumor resection examination. Totally 50 patients (28 males and 22 females, average age was 59 years) who had the single nodule after imaging examination without any pathological diagnostic from January to October 2010 were selected in this research work. During open operation or video assisted thoracic surgery, needle (14 G model) was used to puncture biopsy for pathological examination of frozen. All the adverse events during puncture biopsy would be recorded. The resection specimens would be accepted paraffin pathological examination. The relationship between puncture frozen pathological and paraffin pathological examination was analyzed. All tumor sizes were ranged from 1.0 cm × 0.6 cm to 5.6 cm × 9.0 cm. The paraffin pathological examination after operation as the golden standard, there were 7 cases of benign tumor and 43 cases of malignant tumor. The diagnostic sensitivity of puncture biopsy was 90.7%, the specificity was 100%, the positive predictive value was 100% and the negative predictive value was 63.6%. There were 11 cases of benign tumor diagnosed by needle puncture biopsy, among which 4 cases were proved as malignant tumor by paraffin pathology, and the false negative rate was 9.3%. The main risk of puncture biopsy was bleeding after puncture immediately, and the rate was 4.0% (2/50). The puncture biopsy during operation had a high specificity for malignant lung tumor, and there was a certain false negative rate for benign tumor. Puncture biopsy and pathological examination of frozen tissue can replace tumor section biopsy in a way.

Reliability of Frozen Section Examination in a Large Cohort of Testicular Masses: What Did We Learn?

PubMed

Matei, Deliu Victor; Vartolomei, Mihai Dorin; Renne, Giuseppe; Tringali, Valeria Maria Lucia; Russo, Andrea; Bianchi, Roberto; Cozzi, Gabriele; Bottero, Danilo; Musi, Gennaro; Mazzarol, Giovanni; Ferro, Matteo; de Cobelli, Ottavio

2017-08-01

Frozen section examination (FSE) for testicular masses is gaining popularity because of the possibility of performing testis-sparing surgery (TSS) on the basis of the FSE results. The aim of our study was to investigate the reliability of FSE in the diagnosis of testicular masses. From 1999 to 2016, 144 of 692 patients who underwent surgery in our tertiary center for testicular masses had FSE. The indications for FSE were: masses < 1 cm, nonpalpable, multiple, or with unusual presentation. Mean follow-up for patients was 25.5 months. The algorithm of surgery determined by FSE was: orchiectomy if malignant or nonconclusive pathology; TSS if benign or nontumor pathology. FSE data were analyzed retrospectively. Specificity and sensitivity of the method was calculated for benign, malignant, seminoma, and nonseminoma tumors. Intraoperative FSE was conducted on 21% of candidates for surgery on testicular masses. The sensitivity and specificity of FSE were 93% and 98%, respectively, for malignant tumors, and 90% and 99%, respectively, for benign tumors. The κ agreement coefficient between FSE and final histopathology was statistically significant (0.76). TSS was performed in 57 (40%) patients, including 6 of 23 monorchid patients. FSE correlates well with final histopathological diagnosis of testicular masses. Thus, it reliably identifies patients who might benefit from TSS. FSE should be considered always in small, nonpalpable, multiple, or uncommonly presenting masses in solitary testis or both testes. Copyright © 2017 Elsevier Inc. All rights reserved.

Surgical removal of subfoveal choroidal neovascularization in pathologic myopia: a 12-year follow-up study.

PubMed

Hera, R; Chiquet, C; Romanet, J P

2013-12-01

The purpose of this study was to review the 12-year visual outcomes of patients who underwent surgical removal for subfoveal choroidal neovascularization (CNV) attributable to pathologic myopia. This retrospective study included 14 patients, with a mean age of 45.8 years, high myopia (>6 D) and classic subfoveal CNV. They were treated with pars plana vitrectomy and surgical removal of CNV. All patients were followed up every 3 months for 2 years, with visual acuity (VA), fundus examination, and fluorescein angiography and then every year for 5 years. Ten patients underwent a final visit with VA and fundus examination after a minimum 12-year follow-up. The main outcome measurement was VA and the secondary outcome measurement was the lesion size. After 12 years of follow-up, the mean VA did not significantly change over time, with a mean gain of 0.22 logMAR at 1 year, and 0.18, 0.12 and 0.05 at 2, 5 and 12 years, respectively. The anatomical evolution was characterized by a significant enlargement of the lesion size at 5 years. This study showed that final VA after surgical treatment with 12 years of follow-up was poor, due to the significant CNV scar enlargement over time. These results should prompt a prospective randomized study of other medical treatments, particularly anti-vascular endothelial growth factor therapy.

Strategies for laboratory cost containment and for pathologist shortage: centralised pathology laboratories with microwave-stimulated histoprocessing and telepathology.

PubMed

Leong, Anthony S Y; Leong, F Joel W M

2005-02-01

The imposition of laboratory cost containment, often from external forces, dictates the necessity to develop strategies to meet laboratory cost savings. In addition, the national and worldwide shortage of anatomical pathologists makes it imperative to examine our current practice and laboratory set-ups. Some of the strategies employed in other areas of pathology and laboratory medicine include improvements in staff productivity and the adoption of technological developments that reduce manual intervention. However, such opportunities in anatomical pathology are few and far between. Centralisation has been an effective approach in bringing economies of scale, the adoption of 'best practices' and the consolidation of pathologists, but this has not been possible in anatomical pathology because conventional histoprocessing takes a minimum of 14 hours and clinical turnaround time requirements necessitate that the laboratory and pathologist be in proximity and on site. While centralisation of laboratories for clinical chemistry, haematology and even microbiology has been successful in Australia and other countries, the essential requirements for anatomical pathology laboratories are different. In addition to efficient synchronised courier networks, a method of ultra-rapid tissue processing and some expedient system of returning the prepared tissue sections to the remote laboratory are essential to maintain the turnaround times mandatory for optimal clinical management. The advent of microwave-stimulated tissue processing that can be completed in 30-60 minutes and the immediate availability of compressed digital images of entire tissue sections via telepathology completes the final components of the equation necessary for making centralised anatomical pathology laboratories a reality.

Portal venous gas detected on computed tomography in emergency situations: surgery is still necessary.

PubMed

Monneuse, Olivier; Pilleul, Frank; Barth, Xavier; Gruner, Laurent; Allaouchiche, Bernard; Valette, Pierre-Jean; Tissot, E

2007-05-01

Portal venous gas (PVG) has been reported to be associated with lethal surgical diagnosis. Recent studies tend to confirm the clinical significance of gas in the portal vein; however, some patients are managed without surgical treatment. The aim of this study was to assess both the diagnoses and the treatment of patients with PVG in an emergency surgical setting. We performed a retrospective chart review of 15 patients with PVG in the emergency setting detected by computed tomography (CT) between July 1999 and July 2004. Characteristics assessed included age, sex, clinical presentation, first CT diagnosis of both PVG and the underlying pathology, American Society of Anesthesiologists (ASA) score, surgical findings, final clinical diagnosis, duration of hospitalization, and evolution of the illness/mortality. All patients were examined one month after operation. This series of 5 women and 10 men ranged in age from 38 to 90 years at the time they underwent emergency surgical treatment. The mean preoperative ASA score was 4.20. Computed tomography diagnosed the underlying pathology in all cases: bowel obstruction (4 cases), bowel necrosis (9 cases), and diffuse peritonitis (2 cases). The mean length of hospital stay was 12.4 days. The mortality rate was 46.6%; (7 patients). A wide range of pathologies can generate PVG. Computed tomography can detect both the presence of gas and the underlying pathology. In emergency situations, all the diagnosed causal pathologies required a surgical procedure without delay. We report that the prognosis was related to the pathology itself and was not influenced by the presence of PVG.

Predicting problematic alcohol use with the DSM-5 alternative model of personality pathology.

PubMed

Creswell, Kasey G; Bachrach, Rachel L; Wright, Aidan G C; Pinto, Anthony; Ansell, Emily

2016-01-01

High comorbidity between personality disorders and alcohol use disorders appears related to individual differences in underlying personality dimensions of behavioral undercontrol and affective dysregulation. However, very little is known about how the Diagnostic and Statistical Manual of Mental Disorders (5th edition; DSM-5) Section III trait model of personality pathology relates to alcohol problems or how the strength of the relationship between personality pathology and alcohol problems changes with age and across gender. The current study examined these questions in a sample of 877 participants using the General Assessment of Personality Disorder to assess general personality dysfunction, the Personality Inventory for DSM-5 to measure specific traits, and the Alcohol Use Disorder Identification Test (AUDIT) to assess problematic alcohol use. Results demonstrated that general personality pathology (Criterion A) was significantly related to problematic alcohol use after controlling for age and gender effects. Furthermore, 2 of the 5 higher-order personality trait domains (Criterion B), Antagonism and Disinhibition, remained significant predictors of problematic alcohol use after accounting for the influence of general personality pathology; however, general personality pathology no longer predicted hazardous alcohol use once Antagonism and Disinhibition were added into the model. Finally, these 2 specific traits interacted with age, such that Antagonism was a stronger predictor of AUDIT scores among older individuals and Disinhibition was a stronger predictor of alcohol problems among younger individuals. Findings support the general validity of this new personality disorder diagnostic system and suggest important age effects in the relationship between traits and problematic alcohol use. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Assessing Dependency using Self-report and Indirect Measures: Examining the Significance of Discrepancies

PubMed Central

Cogswell, Alex; Alloy, Lauren B.; Karpinski, Andrew; Grant, David

2011-01-01

The present study addressed convergence between self-report and indirect approaches to assessing dependency. The study was moderately successful in validating an implicit measure, which was found to be reliable, orthogonal to two self-report instruments, and predictive of external criteria. This study also examined discrepancies between scores on self-report and implicit measures, and has implications for their significance. The possibility that discrepancies themselves are pathological was not supported, although discrepancies were associated with particular personality profiles. Finally, this study offered additional evidence for the relation between dependency and depressive symptomatology, and identified implicit dependency as contributing unique variance in predicting past major depression. PMID:20552505

Forensic Pathology Education in Pathology Residency: A Survey of Current Practices, a Novel Curriculum, and Recommendations for the Future.

PubMed

Spencer, Amanda; Ross, Wayne K; Domen, Ronald E

2017-01-01

Forensic pathology is a fundamental part of anatomic pathology training during pathology residency. However, the lack of information on forensic teaching suggests the highly variable nature of forensic education. A survey of pathology residency program directors was performed to determine key aspects of their respective forensic rotations and curriculum. A total of 38.3% of programs from across the country responded, and the survey results show 5.6% don't require a forensic pathology rotation. In those that do, most forensic pathology rotations are 4 weeks long, are done at a medical examiner's office, and require set prerequisites. A total of 21.1% of responding programs have residents who are not receiving documented evaluations for this rotation. While 39.6% of programs have a defined forensics curriculum, as many as 15% do not. Furthermore, nearly 43% of programs place no limit on counting forensic autopsies when applying for pathology board examinations. Our survey confirmed the inconsistent nature of forensic pathology training in resident education. Additionally, our curriculum was reorganized to create a more robust educational experience. A pre- and post-forensic lecture quiz and Resident In-Service Examination scores were analyzed to determine our curriculum's impact and effectiveness. Analysis of our pre- and post-lecture quiz showed an improved overall average as well as an increase in Resident In-Service Examination scores, indicating improved general forensic pathology knowledge. Using this knowledge, along with changes in our curriculum, we generated a number of recommendations for improving forensic pathology education in pathology residency.

Ultrasound assessment of endometrial cavity in perimenopausal women on oral progesterone for abnormal uterine bleeding: comparison of diagnostic accuracy of imaging with hysteroscopy-guided biopsy.

PubMed

Dasgupta, Subhankar; Dasgupta, Shyamal; Sharma, Partha Pratim; Mukherjee, Amitabha; Ghosh, Tarun Kumar

2011-11-01

To investigate the effect of oral progesterone on the accuracy of imaging studies performed to detect endometrial pathology in comparison to hysteroscopy-guided biopsy in perimenopausal women on progesterone treatment for abnormal uterine bleeding. The study population comprised of women aged 40-55 years with complaints of abnormal uterine bleeding who were also undergoing oral progesterone therapy. Women with a uterus ≥ 12 weeks' gestation size, previous abnormal endometrial biopsy, cervical lesion on speculum examination, abnormal Pap smear, active pelvic infection, adnexal mass on clinical examination or during ultrasound scan and a positive pregnancy test were excluded. A transvaginal ultrasound followed by saline infusion sonography were done. On the following day, a hysteroscopy followed by a guided biopsy of the endometrium or any endometrial lesion was performed. Comparison between the results of the imaging study with the hysteroscopy and guided biopsy was done. The final analysis included 83 patients. For detection of overall pathology, polyp and fibroid transvaginal ultrasound had a positive likelihood ratio of 1.65, 5.45 and 5.4, respectively, and a negative likelihood ratio of 0.47, 0.6 and 0.43, respectively. For detection of overall pathology, polyp and fibroid saline infusion sonography had a positive likelihood ratio of 4.4, 5.35 and 11.8, respectively, and a negative likelihood ratio of 0.3, 0.2 and 0.15, respectively. In perimenopausal women on oral progesterone therapy for abnormal uterine bleeding, imaging studies cannot be considered as an accurate method for diagnosing endometrial pathology when compared to hysteroscopy and guided biopsy. © 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.

Primary Intimal Sarcoma of Thoracic Aorta Presenting as Hypertensive Crisis.

PubMed

Lin, Shu-I; Su, Min-I; Tsai, Cheng-Ting

2015-11-01

We report a 45-year-old woman who presented to our facility in a hypertensive crisis. Computed tomography (CT) revealed a thoracic aortic tumor, and tissues obtained via endovascular biopsy revealed undifferentiated sarcoma. A final diagnosis of intimal sarcoma was made by intra-operative pathological examination. Despite undergoing surgical resection followed by adjuvant chemotherapy, the patient died from progressive multiple metastasis and severe sepsis. Although aortic sarcoma is rarely diagnosed, it should be considered a possible etiology of hypertensive crisis. Aortic tumor; Endovascular biopsy; Hypertension crisis; Intimal sarcoma.

Performance of residents using digital images versus glass slides on certification examination in anatomical pathology: a mixed methods pilot study

PubMed Central

Mirham, Lorna; Naugler, Christopher; Hayes, Malcolm; Ismiil, Nadia; Belisle, Annie; Sade, Shachar; Streutker, Catherine; MacMillan, Christina; Rasty, Golnar; Popovic, Snezana; Joseph, Mariamma; Gabril, Manal; Barnes, Penny; Hegele, Richard G.; Carter, Beverley; Yousef, George M.

2016-01-01

Background: It is anticipated that many licensing examination centres for pathology will begin fully digitizing the certification examinations. The objective of our study was to test the feasibility of a fully digital examination and to assess the needs, concerns and expectations of pathology residents in moving from a glass slide-based examination to a fully digital examination. Methods: We conducted a mixed methods study that compared, after randomization, the performance of senior residents (postgraduate years 4 and 5) in 7 accredited anatomical pathology training programs across Canada on a pathology examination using either glass slides or digital whole-slide scanned images of the slides. The pilot examination was followed by a post-test survey. In addition, pathology residents from all levels of training were invited to participate in an online survey. Results: A total of 100 residents participated in the pilot examination; 49 were given glass slides instead of digital images. We found no significant difference in examination results between the 2 groups of residents (estimated marginal mean 8.23/12, 95% confidence interval [CI] 7.72-8.87, for glass slides; 7.84/12, 95% CI 7.28-8.41, for digital slides). In the post-test survey, most of the respondents expressed concerns with the digital examination, including slowly functioning software, blurring and poor detail of images, particularly nuclear features. All of the respondents of the general survey (n = 179) agreed that additional training was required if the examination were to become fully digital. Interpretation: Although the performance of residents completing pathology examinations with glass slides was comparable to that of residents using digital images, our study showed that residents were not comfortable with the digital technology, especially given their current level of exposure to it. Additional training may be needed before implementing a fully digital examination, with consideration for a gradual transition. PMID:27280119

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Validation of organ procurement and transplant network (OPTN)/united network for organ sharing (UNOS) criteria for imaging diagnosis of hepatocellular carcinoma.

PubMed

Fowler, Kathryn J; Karimova, E Jane; Arauz, Anthony R; Saad, Nael E; Brunt, Elizabeth M; Chapman, William C; Heiken, Jay P

2013-06-27

Imaging diagnosis of hepatocellular carcinoma (HCC) presents an important pathway for transplant exception points and priority for cirrhotic patients. The purpose of this retrospective study is to evaluate the validity of the new Organ Procurement and Transplant Network (OPTN) classification system on patients undergoing transplantation for HCC. One hundred twenty-nine patients underwent transplantation for HCC from April 14, 2006 to April 18, 2011; a total of 263 lesions were reported as suspicious for HCC on pretransplantation magnetic resonance imaging. Magnetic resonance imaging examinations were reviewed independently by two experienced radiologists, blinded to final pathology. Reviewers identified major imaging features and an OPTN classification was assigned to each lesion. Final proof of diagnosis was pathology on explant or necrosis along with imaging findings of ablation after transarterial chemoembolization. Application of OPTN imaging criteria in our population resulted in high specificity for the diagnosis of HCC. Sensitivity in diagnosis of small lesions (≥1 and <2 cm) was low (range, 26%-34%). Use of the OPTN system would have resulted in different management in 17% of our population who had received automatic exception points for HCC based on preoperative imaging but would not have met criteria under the new system. Eleven percent of the patients not meeting OPTN criteria were found to have T2 stage tumor burden on pathology. The OPTN imaging policy introduces a high level of specificity for HCC but may decrease sensitivity for small lesions. Management may be impacted in a number of patients, potentially requiring longer surveillance periods or biopsy to confirm diagnosis.

A Comparative Study of Activity-Based Costing vs. Current Pricing System for Pathology Examinations at Okmeydani Training and Research Hospital, Turkey.

PubMed

Yarikkaya, Enver; Özekinci, Selver; Sargan, Aytül; Durmuş, Şenay Erdoğan; Yildiz, Fetin Rüştü

2017-01-01

To provide real cost data for pathology examinations by using activity-based costing method, in order to provide means to departments, health administrators and the social security institution to achieve improvements in financial planning, quality and cost control. The cost of the histopathological examinations, which were accepted by the Department of Pathology at Okmeydanı Training and Research Hospital during August 2014, was calculated using the activity-based costing method. The costs were compared with the amounts specified in the Healthcare Implementation Notification Tariff and the conventional volume-based costing. Most pathology examinations listed within a given band in the Healthcare Implementation Notification Tariff show variations in unit costs. The study found that the costs of 77.4% of the examinations were higher than the prices listed in the Healthcare Implementation Notification Tariff. The pathology examination tariffs specified in the Healthcare Implementation Notification do not reflect the real costs of the examinations. The costs that are calculated using the activity-based costing system may vary according to the service types and levels of health care institutions. However, the main parameters of the method used in the study reflect the necessity of a more accurate banding of pathology examinations. The banding specified by the Healthcare Implementation Notification Tariff needs to be revised to reflect the real costs in Turkey.

[Clinical analysis of 31 patients with gastric stromal tumors].

PubMed

Li, Junxia; Liu, Ping; Wang, Huahong; Yu, Jing; Xie, Pengyan; Liu, Xinguang

2002-11-01

To investigate the clinical manifestations, diagnosis and treatment of gastric stromal tumors. 31 patients with gastric stromal tumors treated from 1993, 1 - 2001, 9 were analyzed retrospectively. All cases were diagnosed by pathological and immunohistochemistry examinations. According to Levin's standard combining with Hurliman's and Goldbum's methods, the patients were classified. There are no significant difference between male and female patients. 50 - 60 years old patients have high incidence. The distribution of gastric tromal tumors is fundus > body > antrum. Diagnosis of this condition is sometimes difficult and treatment is often delayed because patients usually present with nonspecific abdominal symptoms. The main manifestations of gastric stromal tumors are upper gastrointestinal hemorrhage 61.3% (19/31), 7 patients with acute hemorrhage and 12 with chronic hemorrhage. Most of them were malignant. Abdominal malaises and/or distention 32.3% (10/31) and abdominal pain 22.6% (7/31). Gastroscopy, ultrasound gastroscopy, computed tomography, B type ultrasound and upper gastrointestinal X-ray series are helpful to diagnosis. But the final diagnosis is decided by pathological and immunohistochemistry examinations. Gastric stromal tumors exhibit consistent immunohistochemical expressions of CD(117) and/or CD(34). The operative treatment is thought of the first choice. Effect of the chemotherapy isn't satisfied. There is no standard chemotherapy for gastric stromal tumors. Gastric stromal tumor is a kind of separated submucosal tumor which is different from leiomyoma, leiomyosarcoma and neurogenic tumors. Pathological and immunohistochemistry inspectations are very important to make clear diagnosis. Early diagnosis and rational treatment are the keys to improve the prognosis.

Magnetic resonance imaging-ultrasound fusion biopsy for prediction of final prostate pathology.

PubMed

Le, Jesse D; Stephenson, Samuel; Brugger, Michelle; Lu, David Y; Lieu, Patricia; Sonn, Geoffrey A; Natarajan, Shyam; Dorey, Frederick J; Huang, Jiaoti; Margolis, Daniel J A; Reiter, Robert E; Marks, Leonard S

2014-11-01

We explored the impact of magnetic resonance imaging-ultrasound fusion prostate biopsy on the prediction of final surgical pathology. A total of 54 consecutive men undergoing radical prostatectomy at UCLA after fusion biopsy were included in this prospective, institutional review board approved pilot study. Using magnetic resonance imaging-ultrasound fusion, tissue was obtained from a 12-point systematic grid (mapping biopsy) and from regions of interest detected by multiparametric magnetic resonance imaging (targeted biopsy). A single radiologist read all magnetic resonance imaging, and a single pathologist independently rereviewed all biopsy and whole mount pathology, blinded to prior interpretation and matched specimen. Gleason score concordance between biopsy and prostatectomy was the primary end point. Mean patient age was 62 years and median prostate specific antigen was 6.2 ng/ml. Final Gleason score at prostatectomy was 6 (13%), 7 (70%) and 8-9 (17%). A tertiary pattern was detected in 17 (31%) men. Of 45 high suspicion (image grade 4-5) magnetic resonance imaging targets 32 (71%) contained prostate cancer. The per core cancer detection rate was 20% by systematic mapping biopsy and 42% by targeted biopsy. The highest Gleason pattern at prostatectomy was detected by systematic mapping biopsy in 54%, targeted biopsy in 54% and a combination in 81% of cases. Overall 17% of cases were upgraded from fusion biopsy to final pathology and 1 (2%) was downgraded. The combination of targeted biopsy and systematic mapping biopsy was needed to obtain the best predictive accuracy. In this pilot study magnetic resonance imaging-ultrasound fusion biopsy allowed for the prediction of final prostate pathology with greater accuracy than that reported previously using conventional methods (81% vs 40% to 65%). If confirmed, these results will have important clinical implications. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Accuracy of pre-operative hysteroscopic guided biopsy for predicting final pathology in uterine malignancies.

PubMed

Martinelli, Fabio; Ditto, Antonino; Bogani, Giorgio; Signorelli, Mauro; Chiappa, Valentina; Lorusso, Domenica; Haeusler, Edward; Raspagliesi, Francesco

2017-07-01

To evaluate concordance (C) between pre-operative hysteroscopic-directed sampling and final pathology in uterine cancers. A retrospective cross-sectional evaluation of prospectively collected data of women who underwent hysterectomy for uterine malignancies and a previous hysteroscopic-guided biopsy was performed. Diagnostic concordance between pre-operative (hysteroscopic biopsy) and postoperative (uterine specimen) histology was evaluated. In endometrioid-endometrial cancers cases Kappa (k) statistics was applied to evaluate agreement for grading (G) between the preoperative and final pathology. A total 101 hysterectomies for uterine malignancies were evaluated. There were 23 non-endometrioid cancers: 7 serous (C:5/7, 71.4%); 10 carcinosarcomas (C:7/10, 70%, remaining 3 cases only epithelial component diagnosed); 3 clear cell (C:3/3, 100%); 3 sarcomas (C:3/3, 100%). In 78 cases an endometrioid endometrial cancer was found. In 63 cases there was a histological C (63/78, 80.8%) between hysteroscopic-guided biopsy and final pathology, while in 15 cases (19.2%) only hyperplasia (with/without atypia) was found preoperatively. Overall accuracy to detect endometrial cancer was 80.2%. In 50 out of 63 endometrial cancers (79.4%) grading was concordant. The overall level of agreement between preoperative and postoperative grading was "substantial" according to Kappa (k) statistics (k 0.64; 95% CI: 0.449-0.83; p < 0.001), as well as for G1 (0.679; 95% CI: 0.432-0.926; p < 0.001) and G3 (0.774; 94% CI: 0.534-1; p < 0.001), while for G2 (0.531; 95% CI: 0.286-0.777; p < 0.001) it was moderate. In our series we found an 80% C between pre-operative hysteroscopic-guided biopsy and final pathology, in uterine malignancies. Moreover, hysteroscopic biopsy accurately predicted endometrial cancer in 80% of cases and "substantially" predicted histological grading. Hysteroscopic-guided uterine sampling could be a useful tool to tailor treatment in patients with uterine malignancies.

Ovarian Fibroma: A Clinico-pathological Study of 23 Cases with Review of Literature.

PubMed

Parwate, Nikhil Sadanand; Patel, Shilpa M; Arora, Ruchi; Gupta, Monisha

2016-12-01

The purpose of this study was to correlate the clinical findings, RMI-4 index and frozen section, in cases of ovarian fibroma with the final histopathology. This is a retrospective study of clinical and pathological features of 23 patients of ovarian fibroma. The patient's age ranged from 34 to 66 years (mean-49 years). The most common presenting symptom was abdominal pain. On clinical examination, the mean size of ovarian tumor was 9.5 cm, CA-125 levels were found to be raised in 14 patients, and it was associated with ascites in 10 patients. USG showed a well-circumscribed mass (with a mean size of 14 cm), on the left side in 14 cases and on the right side in 9 patients. RMI-4 was calculated in all the patients, and it revealed the possibility of a benign histology in 17 patients. All patients underwent exploratory laparotomy with the removal of ovarian tumor followed by frozen section examination. All but one (22/23) patient had positive correlation among frozen section and final histopathological findings. Ovarian fibroma generally tends to occur in post-menopausal women. All the patients in our study of ovarian fibroma were symptomatic, with the presence of palpable mass in majority of patients. RMI-4 Index correlated very well with benign nature of disease. Frozen section has an invaluable role at surgery; fertility-conserving surgery is the choice in young women. Clinical findings, RMI-4 Index and frozen section, play vital roles before and during surgery in cases of benign ovarian tumors.

Value of Specialist Pathology Review in a Single Statewide Gynecologic Cancer Service.

PubMed

Melon, Jerome; Leung, Yee; Salfinger, Stuart G; Tan, Jason; Mohan, Ganendra; Cohen, Paul A

2017-01-01

A case review by specialist diagnostic pathologists as part of a Gynecologic Oncology Multi-disciplinary Tumor group has the potential to influence the management of patients with cancer. The primary aim of this study was to determine the frequency of diagnostic discrepancies between the initial (nonspecialist) and final pathological diagnoses in cases referred to the Gynecologic Oncology Tumor Conference (TC) in Western Australia and the impact of such revised diagnosis on clinical management. A secondary aim was to assess the evolving workload encountered by the TC during a 5-year interval. The records of the weekly TC for the 2 calendar years 2008 and 2013 were examined, and histological and cytological specimens that had been initially assessed by "outside" (nonspecialist) pathology departments, and subsequently reviewed by specialist pathologists, were assessed. The initial and final diagnoses were compared, and where the pathological findings were amended upon review, it was determined whether the change affected clinical management. Diagnostic discrepancies that resulted in a change in patient management were classified as major, whereas discrepancies that did not affect patient management were classified as minor. A total of 481 outside cases were included among 2387 cases presented for histological review at the TC during the 2 years. For outside cases alone, the incidence of major diagnostic discrepancies was 3.4% in 2008, 5.5% in 2013 (no significant difference, P = 0.3787), and 4.6% for the 2 years combined. A recommendation for surgery was the most common change in clinical management as a result of major discrepancy. The minor discrepancy rate was 4.4% of outside cases for both years combined. Pathological discrepancies (major and minor) of the uterine corpus and cervix were most frequent, followed by those of the vulva and ovary. There was a 48.4% increase in total case discussions at the TC during the interval period with a significant rise in nonmalignant cases, 29.8% of the total cases in 2008 compared with 36.8% in 2013 (P = 0.0004). Nonspecialist pathology departments maintained a high level of reporting accuracy during the interval period, with the major discrepancy rate not changing significantly between 2008 and 2013. Specimens from the uterine corpus and cervix in particular may prove diagnostically challenging on occasion. A pathology review of outside cases by a tertiary-based laboratory in conjunction with a TC can identify a small but clinically significant number of cases that lead to a change in clinical management. It is uncertain whether this affects patient outcomes.

Evaluation of common elbow pathologies: a focus on physical examination.

PubMed

Laratta, Joseph; Caldwell, Jon-Michael; Lombardi, Joseph; Levine, William; Ahmad, Christopher

2017-05-01

Elbow tendinopathy accounts for the majority of elbow pathology in patients presenting to upper extremity and sports medicine surgeons. With increased participation in overhead sports in an aging population, the incidence of elbow injuries has risen. A comprehensive knowledge of elbow anatomy and biomechanical function of the elbow complex is prerequisite in the assessment of patients with elbow injuries; however, a thorough understanding of alternative and confounding pathologies is essential for accurate diagnosis. Because tendinopathy, tendonitis, and tendon tears have an anatomic basis for their pathology, a targeted history and meticulous physical examination often yields an accurate clinical diagnosis. The importance of physical examination and provocative examination maneuvers must be stressed in a technologically advanced era where clinical diagnosis is too commonly attained solely by advanced imaging modalities. A revived dedication to the physical examination may enhance our ability to correctly diagnose various pathologies about the elbow. Early and accurate clinical diagnosis is the first step in the proper initiation of treatment modalities and improvement in overall patient outcome.

Forensic Pathology Education in Pathology Residency

PubMed Central

Ross, Wayne K.; Domen, Ronald E.

2017-01-01

Forensic pathology is a fundamental part of anatomic pathology training during pathology residency. However, the lack of information on forensic teaching suggests the highly variable nature of forensic education. A survey of pathology residency program directors was performed to determine key aspects of their respective forensic rotations and curriculum. A total of 38.3% of programs from across the country responded, and the survey results show 5.6% don’t require a forensic pathology rotation. In those that do, most forensic pathology rotations are 4 weeks long, are done at a medical examiner’s office, and require set prerequisites. A total of 21.1% of responding programs have residents who are not receiving documented evaluations for this rotation. While 39.6% of programs have a defined forensics curriculum, as many as 15% do not. Furthermore, nearly 43% of programs place no limit on counting forensic autopsies when applying for pathology board examinations. Our survey confirmed the inconsistent nature of forensic pathology training in resident education. Additionally, our curriculum was reorganized to create a more robust educational experience. A pre- and post-forensic lecture quiz and Resident In-Service Examination scores were analyzed to determine our curriculum’s impact and effectiveness. Analysis of our pre- and post-lecture quiz showed an improved overall average as well as an increase in Resident In-Service Examination scores, indicating improved general forensic pathology knowledge. Using this knowledge, along with changes in our curriculum, we generated a number of recommendations for improving forensic pathology education in pathology residency. PMID:28913415

Successful treatment of suspected organizing pneumonia in a patient without typical imaging and pathological characteristic: A case report.

PubMed

Ailing, Liu; Ning, Xu; Tao, Qu; Aijun, Li

2017-01-01

Organizing pneumonia (OP) is a clinicopathological entity characterized by granulation tissue plugs in the lumen of small airways, alveolar ducts, and alveoli. Diagnosis of OP needs the combination of clinical features, imaging and pathology. But it occurs often that there are no typical pathological features to support the diagnosis, which poses a challenge for clinicians' diagnosis and treatment. We diagnosed a case of OP without typical imaging and pathological characteristic and treated successfully. Finally we confirmed the pathological diagnosis. Not every OP case is supported by pathological evidence and typical imaging changes. It is important for us to judge and decide the diagnosis according to clinical experience.

A team-based approach to autopsy education: integrating anatomic and clinical pathology at the rotation level.

PubMed

Hébert, Tiffany Michele; Maleki, Sara; Vasovic, Ljiljana V; Arnold, Jeffrey L; Steinberg, Jacob J; Prystowsky, Michael B

2014-03-01

Pathology residency training programs should aim to teach residents to think beyond the compartmentalized data of specific rotations and synthesize data in order to understand the whole clinical picture when interacting with clinicians. To test a collaborative autopsy procedure at Montefiore Medical Center (Bronx, New York), linking residents and attending physicians from anatomic and clinical pathology in the autopsy process from the initial chart review to the final report. Residents consult with clinical pathology colleagues regarding key clinical laboratory findings during the autopsy. This new procedure serves multiple functions: creating a team-based, mutually beneficial educational experience; actively teaching consultative skills; and facilitating more in-depth analysis of the clinical laboratory findings in autopsies. An initial trial of the team-based autopsy system was done from November 2010 to December 2012. Residents were then surveyed via questionnaire to evaluate the frequency and perceived usefulness of clinical pathology autopsy consultations. Senior residents were the most frequent users of clinical pathology autopsy consultation. The most frequently consulted services were microbiology and chemistry. Eighty-nine percent of the residents found the clinical pathology consultation to be useful in arriving at a final diagnosis and clinicopathologic correlation. The team-based autopsy is a novel approach to integration of anatomic and clinical pathology curricula at the rotation level. Residents using this approach develop a more holistic approach to pathology, better preparing them for meaningful consultative interaction with clinicians. This paradigm shift in training positions us to better serve in our increasing role as arbiters of outcomes measures in accountable care organizations.

Normal pelvic ultrasound or MRI does not rule out neoplasm in patients with gonadal dysgenesis and Y chromosome material.

PubMed

Ebert, Kristin M; Hewitt, Geri D; Indyk, Justin A; McCracken, Katherine A; Nahata, Leena; Jayanthi, Venkata R

2018-04-01

Patients with gonadal dysgenesis (GD) with a Y chromosome have an increased risk of gonadal neoplasm. Few data exist on the ability of imaging to detect malignancy in intra-abdominal gonads in these patients. We aimed to determine the correlation between preoperative imaging findings and gonadal pathology in GD patients with Y chromosome material. A retrospective review was performed of patients with XY or XO/XY GD who underwent gonadectomy at our institution from 2003 to 2017. Patients were assessed preoperatively with ultrasonography; some additionally underwent MRI. The series consisted of 10 patients, all with female gender and non-palpable gonads. Median age was 13.1 years (range 2.4-18.3 years). Overall, four of the ten patients (40%) had a tumor (gonadoblastoma or dysgerminoma) on final pathology. Four patients had a gonad or gonads that were definitively seen on ultrasonography. All visualized gonads were described as "normal" or "small" with the exception of one patient, who had a normal MRI. Three of the four patients in this group had a tumor on final pathology. The remaining six patients had a gonad or gonads that were not definitively visualized on ultrasound; one patient in this group had a tumor on final pathology. Overall, five of seven gonads (71%) definitively visualized on ultrasound had tumor on final pathology, and two of thirteen gonads (15%) not visualized on ultrasound had tumor on final pathology; this difference was statistically significant (p = 0.012). Three patients were imaged with MRI. Of the gonads that could be visualized on MRI, no definitive abnormalities were seen. All patients imaged with MRI had tumors on final pathology. Both ultrasound and MRI are relatively poor at identifying and characterizing intra-abdominal gonads in GD patients. The majority of patients who had a neoplasm had normal imaging findings. Gonads that were definitively visualized on ultrasound were more likely to contain neoplasms that could not be visualized, which perhaps because of tumor growth. No other consistent imaging findings of malignancy were found. Our study included ultrasound evaluations that were completed over 10 years ago and not performed by pediatric ultrasonographers, which may have biased the results. However, results suggest that when discussing gonadectomy with GD patients, one should not be reassured by "normal" imaging findings. Neither ultrasound nor MRI should be relied on for surveillance in GD patients who decide against gonadectomy. A normal ultrasound or MRI does not rule out neoplasm in GD patients with intra-abdominal gonads. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

A mediational model of self-esteem and social problem-solving in anorexia nervosa.

PubMed

Paterson, Gillian; Power, Kevin; Collin, Paula; Greirson, David; Yellowlees, Alex; Park, Katy

2011-01-01

Poor problem-solving and low self-esteem are frequently cited as significant factors in the development and maintenance of anorexia nervosa. The current study examines the multi-dimensional elements of these measures and postulates a model whereby self-esteem mediates the relationship between social problems-solving and anorexic pathology and considers the implications of this pathway. Fifty-five inpatients with a diagnosis of anorexia nervosa and 50 non-clinical controls completed three standardised multi-dimensional questionnaires pertaining to social problem-solving, self-esteem and eating pathology. Significant differences were yielded between clinical and non-clinical samples on all measures. Within the clinical group, elements of social problem-solving most significant to anorexic pathology were positive problem orientation, negative problem orientation and avoidance. Components of self-esteem most significant to anorexic pathology were eating, weight and shape concern but not eating restraint. The mediational model was upheld with social problem-solving impacting on anorexic pathology through the existence of low self-esteem. Problem orientation, that is, the cognitive processes of social problem-solving appear to be more significant than problem-solving methods in individuals with anorexia nervosa. Negative perceptions of eating, weight and shape appear to impact on low self-esteem but level of restriction does not. Finally, results indicate that self-esteem is a significant factor in the development and execution of positive or negative social problem-solving in individuals with anorexia nervosa by mediating the relationship between those two variables. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.

Original research in pathology: judgment, or evidence-based medicine?

PubMed

Crawford, James M

2007-02-01

Pathology is both a medical specialty and an investigative scientific discipline, concerned with understanding the essential nature of human disease. Ultimately, pathology is accountable as well, as measured by the accuracy of our diagnoses and the resultant patient care outcomes. As such, we must consider the evidence base underlying our practices. Within the realm of Laboratory Medicine, extensive attention has been given to testing accuracy and precision. Critical examination of the evidence base supporting the clinical use of specific laboratory tests or technologies is a separate endeavor, to which specific attention must be given. In the case of anatomic pathology and more specifically surgical pathology, the expertise required to render a diagnosis is derived foremost from experience, both personal and literature-based. In the first instance, knowledge of the linkage between one's own diagnoses and individual patient outcomes is required, to validate the role of one's own interpretations in the clinical course of patients. Experience comes from seeing this linkage first hand, from which hopefully comes wisdom and, ultimately, good clinical judgment. In the second instance, reading the literature and learning from experts is required. Only a minority of the relevant literature is published in pathology journals to which one may subscribe. A substantial portion of major papers relevant to the practice of anatomic pathology are published in collateral clinical specialty journals devoted to specific disease areas or organs. Active effort is therefore required to seek out the literature beyond the domain of pathology journals. In examining the published literature, the essential question then becomes: Does the practice of anatomic pathology fulfill the tenets of 'evidence-based medicine' (EBM)? If the pinnacle of EBM is 'systematic review of randomized clinical trials, with or without meta-analysis', then anatomic pathology falls far short. Our published literature is largely observational in nature, with reports of case series (with or without statistical analysis) constituting the majority of our 'evidence base'. Moreover, anatomic pathology is subject to 'interobserver variation', and potentially to 'error'. Taken further, individual interpretation of tissue samples is not an objective endeavor, and it is not easy to fulfill the role of a 'gold standard'. Both for rendering of an overall interpretation, and for providing the semi-quantitative and quantitative numerical 'scores' which support evidence-based clinical treatment algorithms, the Pathologist has to exercise a high level of interpretive judgment. Nevertheless, the contribution of anatomic pathology to 'EBM' is remarkably strong. To the extent that our judgmental interpretations become data, our tissue interpretations become the arbiters of patient care management decisions. In a more global sense, we support highly successful cancer screening programs, and play critical roles in the multidisciplinary management of complex patients. The true error is for the clinical practitioners of 'EBM' to forget the contribution to the supporting evidence base of the physicians that are Anatomic Pathologists. Finally, the academic productivity of pathology faculty who operate in the clinical realm must be considered. A survey of six North American academic pathology departments reveals that 26% of all papers published in 2005 came from 'unfunded' clinical faculty. While it is likely that their academic productivity is lower than that of 'funded' research faculty, the contribution of clinical faculty to the knowledge base for the practice of modern medicine, and to the academic reputation of the department, must not be overlooked. The ability of clinical faculty in academic departments of pathology to pursue original scholarship must be supported if our specialty is to retain its preeminence as an investigative scientific discipline in the age of EBM.

Monophasic Synovial Sarcoma of Prostatic Fascia: Case Report and Literature Review.

PubMed

Olivetti, Lucio; Benecchi, Luigi; Corti, Serena; Del Boca, Carlo; Ferrari, Matteo; Sergio, Pietro; Bercich, Luisa; Tanzi, Giulia

2015-01-01

Synovial sarcoma (SS) primarily occurs in the para-articular soft tissue of the lower extremities in young adults and it is extremely rare in the prostatic region. We report a case of a 46-year-old man who presented with urinary retention. Pelvic ultrasound (US) examination, computed tomography (CT), and magnetic resonance imaging (MRI) demonstrated an 8.5 cm mass that appeared to originate in the prostatic fascia of the right lobe. Preoperative prostatic ultrasound transrectal needle biopsy revealed mesenchymal neoplastic tissue. Patient underwent surgery. The final pathologic findings were consistent with the diagnosis of monophasic synovial sarcoma.

Large intramuscular lipoma of the tongue.

PubMed

Fitzgerald, Kara; Sanchirico, Paul J; Pfeiffer, David C

2018-04-01

We describe a case of a 57-year-old man referred to an oral maxillofacial surgeon for a nontender, large intramuscular tongue mass. A computed tomography scan with contrast showed a homogenous right tongue intramuscular fatty mass measuring 3.8 cm × 2.8 cm in the axial dimension and 2.2 cm in the craniocaudal dimension. Histologic examination revealed multiple lobulated sections of mature adipocytes and occasional entrapped skeletal muscle fibers. The final pathologic diagnosis was intramuscular lipoma. Although lipomas account for approximately 50% of all soft tissue neoplasms, intramuscular (infiltrating) lipoma of the tongue is exceedingly rare.

Cheating and sports: history, diagnosis and treatment.

PubMed

Kamis, Danielle; Newmark, Thomas; Begel, Daniel; Glick, Ira D

2016-12-01

This paper focuses on "cheating" in modern day athletics from youth through professional sports. We briefly summarize a history of cheating in the sports world. We examine the current role cheating plays in sports as well as its causes including, psychodynamic issues, the development of personality disorders and how personality traits become pathological resulting in deception, dishonesty, and underhandedness. We describe management and treatment including psychotherapeutic intervention as well as medication. Finally we discuss a systems approach involving outreach to coaches, families, and related sports organizations (like FIFA, WADA, etc) or the professional leagues which have institutional control and partial influence on the athlete.

Occupational pulmonary aluminosis: a case report.

PubMed

Smolková, Petra; Nakládalová, Marie; Tichý, Tomáš; Hampalová, Marie; Kolek, Vítězslav

2014-01-01

The authors present a case of occupational lung damage from exposure to dust containing aluminium. The first detected objective pathological finding was that of dispersed micronodules in the lungs seen in a chest radiograph. The final diagnosis of pulmonary aluminosis was established after three years of gradual exclusion of other interstitial lung diseases. The diagnosis was supported by the occupational history confirmed by hygiene assessment of the patient's workplace and especially by histological examination with elemental analysis of the lung tissue. The possibility of development of this rare condition should not be underestimated in workers at high-risk jobs.

Placenta: chronicle of intrauterine growth restriction.

PubMed

Dicke, Jeffrey M

2010-09-23

The foundation for adult health is laid in utero and requires a healthy placenta. A common manifestation of abnormal placental development is impaired fetal growth. While placental pathology is the final common denominator in many cases of fetal growth restriction, a variety of discreet lesions have been described involving both the maternal and fetal circulations at their confluence in the placenta. Detailed examination of the placenta provides a means of elucidating the pathophysiology of poor fetal growth. This is an essential step in developing effective strategies for the prediction, prevention, and possible treatment of the growth restricted fetus.

Rhabdomyosarcoma of Cervix: A Case Report.

PubMed

Hosseini, Maryam Sadat; Ashrafganjoei, Tahereh; Sourati, Ainaz; Tabatabeifar, Morteza; Mohamadianamiri, Mahdiss

2016-06-01

Rhabdomyosarcoma has known as a highly malignant soft tissue sarcoma. It has been the most common soft tissue sarcoma in childhood, accounting for about 3 to 4 % of all cases of childhood cancer. Rhabdomyosarcoma was rare in adults, accounting for 3% of all soft-tissue sarcomas. embryonal rhabdomyosarcoma of female genital tract including uterine cervix in an adult was rare. This study has reported a 33-year-old woman presented with abnormal vaginal discharge. Gynecologic examination revealed a cervical mass with grape- like feature protruding into vagina with posterior- superior vaginal wall involvement. Biopsy has performed and pathologic examination was consistent with embryonal botryoid type rhabdomyosarcoma. She has undergone the staging work up measurements including thoracic computed tomography (CT) scan, abdominopelvic magnetic resonance imaging (MRI), bone scan and bone marrow examination. In exception of abdominopelvic MRI, with 2 suspicious pelvic lymph nodes in addition of cervical mass, all others were normal. Radical hysterectomy with lymph node debulking and ovarian preservation has performed. Final results have shown embryonal botryoid type rhabdomyosarcoma of cervix. ovaries, endometrium, parametrium, and follopian tubes were unremarkable. Pelvic lymph nodes pathology and intraabdominal fluid cytology were negative for malignancy. Lymphovascular invasion was identified. She has advised for adjuvant chemotherapy. This case has reminded that embryonal rhabdomyosarcoma could occur in uncommon site and older female. Longer follow up of these cases has required due to lack of survival data for embryonal rhabdomyosarcoma of this site and age group.

Preoperative vocal cord paralysis and its association with malignant thyroid disease and other pathological features.

PubMed

Kay-Rivest, Emily; Mitmaker, Elliot; Payne, Richard J; Hier, Michael P; Mlynarek, Alex M; Young, Jonathan; Forest, Véronique-Isabelle

2015-09-11

Vocal cord paralysis (VCP) is found in both benign and malignant thyroid disease. This study was performed to determine if the presence of preoperative VCP predicts malignancy. A retrospective analysis was performed on a cohort of 1923 consecutive patients undergoing thyroid surgery. The incidence of preoperative VCP was recorded. Patient and nodule characteristics were correlated with final pathology. 1.3% of our cohort was found to have preoperative VCP. Malignant pathology was discovered in 76% of patients with preoperative VCP. Among these patients, 72% had a left sided paralysis. 10.5% of patients with preoperative VCP had perineural invasion (PNI) on final pathology, compared to 1.1% of patients with normal VC function. Preoperative VCP appears to be a strong, though not an absolute, indicator of malignancy. Most VCP were on the left side. Assessing for preoperative VCP is crucial in all patients who need thyroid surgery, as even benign nodules can be accompanied by preoperative vocal cord paralysis.

Accuracy of Physical Examination, Ultrasonography, and Mammography in Predicting Residual Pathologic Tumor Size in Patients Treated With Neoadjuvant Chemotherapy

PubMed Central

Chagpar, Anees B.; Middleton, Lavinia P.; Sahin, Aysegul A.; Dempsey, Peter; Buzdar, Aman U.; Mirza, Attiqa N.; Ames, Fredrick C.; Babiera, Gildy V.; Feig, Barry W.; Hunt, Kelly K.; Kuerer, Henry M.; Meric-Bernstam, Funda; Ross, Merrick I.; Singletary, S Eva

2006-01-01

Objective: To assess the accuracy of physical examination, ultrasonography, and mammography in predicting residual size of breast tumors following neoadjuvant chemotherapy. Background: Neoadjuvant chemotherapy is an accepted part of the management of stage II and III breast cancer. Accurate prediction of residual pathologic tumor size after neoadjuvant chemotherapy is critical in guiding surgical therapy. Although physical examination, ultrasonography, and mammography have all been used to predict residual tumor size, there have been conflicting reports about the accuracy of these methods in the neoadjuvant setting. Methods: We reviewed the records of 189 patients who participated in 1 of 2 protocols using doxorubicin-containing neoadjuvant chemotherapy, and who had assessment by physical examination, ultrasonography, and/or mammography no more than 60 days before their surgical resection. Size correlations were performed using Spearman rho analysis. Clinical and pathologic measurements were also compared categorically using the weighted kappa statistic. Results: Size estimates by physical examination, ultrasonography, and mammography were only moderately correlated with residual pathologic tumor size after neoadjuvant chemotherapy (correlation coefficients: 0.42, 0.42, and 0.41, respectively), with an accuracy of ±1 cm in 66% of patients by physical examination, 75% by ultrasonography, and 70% by mammography. Kappa values (0.24–0.35) indicated poor agreement between clinical and pathologic measurements. Conclusion: Physical examination, ultrasonography, and mammography were only moderately useful for predicting residual pathologic tumor size after neoadjuvant chemotherapy. PMID:16432360

Mathematical Pathologies as Pathways into Creativity

ERIC Educational Resources Information Center

Sriraman, Bharath; Dickman, Benjamin

2017-01-01

In this paper, the role of mathematical pathologies as a means of fostering creativity in the classroom is discussed. In particular, it delves into what constitutes a mathematical pathology, examines historical mathematical pathologies as well as pathologies in contemporary classrooms, and indicates how the Lakatosian heuristic can be used to…

Telangiectatic osteosarcoma--a case report.

PubMed Central

Suh, Y. L.; Chi, J. G.

1989-01-01

Telangiectatic osteosarcoma is a rare and special variant of osteogenic sarcoma with distinct radiologic, gross and microscopic features. This tumor is predominantly lytic, destructive tumor without sclerosis on roentgenogram, and is soft and cystic on gross examination. Histologically aneurysmally dilated spaces lined or traversed by stromal cells producing osteoid are noted. This report concerns a case of telangiectatic osteosarcoma occurring in a 7 years old boy. He presented with pathologic fracture of the right distal tibia, followed by a purely lytic lesion on X-ray examination. This lesion recurred five times during a span of one year. Microscopic features of the biopsy specimen was difficult to differentiate from aneurysmal bone cyst because of prominant blood-filled cyst formation. It was finally identified as osteosarcoma from the below-knee amputation specimen through the close examination for anaplastic osteoid-producing stromal cells in the septa that separate the blood cysts. PMID:2597366

[Applications and advantages of a multimedia system for autopsies ].

PubMed

Gualco, M; Benzi, D; Fulcheri, E

2001-10-01

This work evaluates the benefits and applications of computers and multimedia systems in post-mortem examination practice and, more in particular, in the definition of data collection protocols. We examined issues concerning the different aims of autopsy (e.g. diagnostic, scientific, educational, legal), and found that the pathologist's main duty is to acquire a large amount of data in the best possible way. However, despite the will to carry out detailed post-mortem examinations, many pathologic anatomy services face objective difficulties in doing so, especially due to understaffing, lack of time and high costs. The Institute for Pathologic Anatomy of the University of Genoa has developed software for data handling and for outcome reporting, a particularly important aspect in fetal-perinatal diagnosis. The system consists of a relational database in a client-server environment (Fourth Dimension) with two integrated parts. The first part, with unrestricted access, contains patients' personal data, including gender, age, time and date of death, hospital department of origin, person and department requiring the post-mortem examination, hour and time of autopsy, pathologist's name, and clinical diagnosis of death. Using a scanner, a copy of the autopsy application is also field, together with the patient's medical file and any diagnostic images useful to document the case history. The second part of the information system is accessible by pathologists only, and contains the autopsy report. This part is organized to balance two different needs: it allows sufficient space and freedom for autopsy description while providing guidelines for presentation of the report. The structure of the conventional autopsy protocol has been maintained, with subdivisions for all the organs and apparatuses according to topographic criteria. Before this part, a section is dedicated to external cadaver examination and anthropometric data; weight, shape, volume and texture are described for each organ, together with external and cut-surface features. A third section allows the examiner to report other observations not requested previously, while a final section is also provided for the epicrisis and for the formulation of the final diagnosis, the same as that reported in the first form. The database is coupled with an interactive system for collecting voice comments, thereby replacing the need for tape-recorders in the autopsy room. The user can recall a dictation window, dictate a text, check spelling and insert additional text. The database is also coupled to an image acquisition system, on the assumption that moving images allow a more faithful documentation of reality. Therefore, all rooms in which autopsies are carried out on fetuses or neonates have been equipped with a fixed camera linked to a monitor and a video-recorder. A PCB, used for image digitalization, recognizes up to 16,000,000 different colors. Guided by dedicated software, image files are transferred to a computer and then saved with the autoptic report. The database can be consulted and queried in two principle ways: by key words in the contents or main disease descriptions, or by individual words or phrases contained within the complete text of the reports. The present database system for autopsy reporting has proved itself useful in a pathological anatomy service. The combined presence of images and texts renders the system useful also as a research tool. By linking to a Web site dedicated to pathologic anatomy, it will be possible to display online rare cases involving diagnostic difficulties. The system offers great advantages for present and retrospective diagnostics, as well as for research and education purposes.

Perigastric lymph node metastasis from papillary thyroid carcinoma in a patient with early gastric cancer: the first case report.

PubMed

Jeong, Gui-Ae; Kim, Hyung-Chul; Kim, Hee-Kyung; Cho, Gyu-Seok

2014-09-01

Distant metastasis from papillary thyroid carcinoma (PTC), particularly from papillary thyroid microcarcinoma, is rare. We present a case of perigastric lymph node metastasis from PTC in a patient with early gastric cancer and breast cancer. During post-surgical follow-up for breast cancer, a 56-year-old woman was diagnosed incidentally with early gastric cancer and synchronous left thyroid cancer. Therefore, laparoscopic distal gastrectomy with lymph node dissection and left thyroidectomy were performed. On the basis of the pathologic findings of the surgical specimens, the patient was diagnosed to have papillary thyroid microcarcinoma with perigastric lymph node metastasis and early gastric cancer with mucosal invasion. Finally, on the basis of immunohistochemical staining with galectin-3, the diagnosis of perigastric lymph node metastasis from PTC was made. When a patient has multiple primary malignancies with lymph node metastasis, careful pathologic examination of the surgical specimen is necessary; immunohistochemical staining may be helpful in determining the primary origin of lymph node metastasis.

PRospective Imaging of CErvical cancer and neoadjuvant treatment (PRICE) study: role of ultrasound to predict partial response in locally advanced cervical cancer patients undergoing chemoradiation and radical surgery.

PubMed

Testa, A C; Ferrandina, G; Moro, F; Pasciuto, T; Moruzzi, M C; De Blasis, I; Mascilini, F; Foti, E; Autorino, R; Collarino, A; Gui, B; Zannoni, G F; Gambacorta, M A; Valentini, A L; Rufini, V; Scambia, G

2018-05-01

Chemoradiation-based neoadjuvant treatment followed by radical surgery is an alternative therapeutic strategy for locally advanced cervical cancer (LACC), but ultrasound variables used to predict partial response to neoadjuvant treatment are not well defined. Our goal was to analyze prospectively the potential role of transvaginal ultrasound in early prediction of partial pathological response, assessed in terms of residual disease at histology, in a large, single-institution series of LACC patients triaged to neoadjuvant treatment followed by radical surgery. Between October 2010 and June 2014, we screened 108 women with histologically documented LACC Stage IB2-IVA, of whom 88 were included in the final analysis. Tumor volume, three-dimensional (3D) power Doppler indices and contrast parameters were obtained before (baseline examination) and after 2 weeks of treatment. The pathological response was defined as complete (absence of any residual tumor after treatment) or partial (microscopic and/or macroscopic residual tumor at pathological examination). Complete-response and partial-response groups were compared and receiver-operating characteristics (ROC) curves were generated for ultrasound variables that were statistically significant on univariate analysis to evaluate their diagnostic ability to predict partial pathological response. There was a complete pathological response to neoadjuvant therapy in 40 (45.5%) patients and a partial response in 48 (54.5%). At baseline examination, tumor volume did not differ between the two groups. However, after 2 weeks of neoadjuvant treatment, the tumor volume was significantly greater in patients with partial response than it was in those with complete response (P = 0.019). Among the 3D vascular indices, the vascularization index (VI) was significantly lower in the partial-response compared with the complete-response group, both before and after 2 weeks of treatment (P = 0.037 and P = 0.024, respectively). At baseline examination in the contrast analysis, women with partial response had lower tumor peak enhancement (PE) as well as lower tumor wash-in rate (WiR) and longer tumor rise time (RT) compared with complete responders (P = 0.006, P = 0.003, P = 0.038, respectively). There was no difference in terms of contrast parameters after 2 weeks of treatment. ROC-curve analysis of baseline parameters showed that the best cut-offs for predicting partial pathological response were 41.5% for VI (sensitivity, 63.6%; specificity, 66.7%); 16123.5 auxiliary units for tumor PE (sensitivity, 47.9%; specificity, 84.2%); 7.8 s for tumor RT (sensitivity, 68.8%; specificity, 57.9%); and 4902 for tumor WiR (sensitivity, 77.1%; specificity, 60.5%). ROC curves of parameters after 2 weeks of treatment showed that the best cut-off for predicting partial pathological response was 18.1 cm 3 for tumor volume (sensitivity, 70.8%; specificity 60.0%) and 39.5% for VI (sensitivity; 62.5%; specificity, 73.5%). Ultrasound and contrast parameters differ between LACC patients with complete response and those with partial response before and after 2 weeks of neoadjuvant treatment. However, neither ultrasound parameters before treatment nor those after 2 weeks of treatment had cut-off values with acceptable sensitivity and specificity for predicting partial pathological response to neoadjuvant therapy. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Use of contextual inquiry to understand anatomic pathology workflow: Implications for digital pathology adoption

PubMed Central

Ho, Jonhan; Aridor, Orly; Parwani, Anil V.

2012-01-01

Background: For decades anatomic pathology (AP) workflow have been a highly manual process based on the use of an optical microscope and glass slides. Recent innovations in scanning and digitizing of entire glass slides are accelerating a move toward widespread adoption and implementation of a workflow based on digital slides and their supporting information management software. To support the design of digital pathology systems and ensure their adoption into pathology practice, the needs of the main users within the AP workflow, the pathologists, should be identified. Contextual inquiry is a qualitative, user-centered, social method designed to identify and understand users’ needs and is utilized for collecting, interpreting, and aggregating in-detail aspects of work. Objective: Contextual inquiry was utilized to document current AP workflow, identify processes that may benefit from the introduction of digital pathology systems, and establish design requirements for digital pathology systems that will meet pathologists’ needs. Materials and Methods: Pathologists were observed and interviewed at a large academic medical center according to contextual inquiry guidelines established by Holtzblatt et al. 1998. Notes representing user-provided data were documented during observation sessions. An affinity diagram, a hierarchal organization of the notes based on common themes in the data, was created. Five graphical models were developed to help visualize the data including sequence, flow, artifact, physical, and cultural models. Results: A total of six pathologists were observed by a team of two researchers. A total of 254 affinity notes were documented and organized using a system based on topical hierarchy, including 75 third-level, 24 second-level, and five main-level categories, including technology, communication, synthesis/preparation, organization, and workflow. Current AP workflow was labor intensive and lacked scalability. A large number 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. PMID:23243553

Prostate Health Index (PHI) Predicts High-stage Pathology in African American Men.

PubMed

Schwen, Zeyad R; Tosoian, Jeffrey J; Sokoll, Lori J; Mangold, Leslie; Humphreys, Elizabeth; Schaeffer, Edward M; Partin, Alan W; Ross, Ashley E

2016-04-01

To evaluate the association between the Prostate Health Index (PHI) and adverse pathology in a cohort of African American (AA) men undergoing radical prostatectomy. Eighty AA men with prostate-specific antigen (PSA) of 2-10 ng/mL underwent measurement of PSA, free PSA (fPSA), and p2PSA prior to radical prostatectomy. PHI was calculated as [(p2PSA/fPSA) × (PSA)(½)]. Biomarker association with pT3 disease was assessed using logistic regression, and covariates were added to a baseline multivariable model including digital rectal examination. Biomarker ability to predict pT3 disease was measured using the area under the receiver operator characteristic curve. Sixteen men (20%) demonstrated pT3 disease on final pathology. Mean age, PSA, and %fPSA were similar in men with and without pT3 disease (all P  >  .05), whereas PHI was significantly greater in men with pT3 disease (mean 57.2 vs 46.6, P  =  .04). Addition of PHI to the baseline multivariable model improved discriminative ability by 12.9% (P  =. .04) and yielded greater diagnostic accuracy than models, including other individual biomarkers. In AA men with PSA of 2-10 ng/mL, PHI was predictive of pT3 prostate cancer and may help to identify men at increased risk of adverse pathology. Additional studies are needed to substantiate these findings and identify appropriate thresholds for clinical use. Copyright © 2016 Elsevier Inc. All rights reserved.

The Rehabilitation Counselor's Guide to Psychopathology. Final Report.

ERIC Educational Resources Information Center

Atkinson, John; Phelps, William R.

This paper is prepared for the rehabilitation practitioner and hopefully will meet some of the needs of the academician as well. The data covers the following major areas: How personality develops, How emotional pathology develops, Defense mechanisms, Classification of psychological makeup, Treatment of emotional pathology, Commonly used glossary,…

Clinico-pathological study to evaluate oral lichen planus for the establishment of clinical and histopathological diagnostic criteria.

PubMed

Hiremath, Santhosh; Kale, Alka D; Hallikerimath, Seema

2015-01-01

Lichen planus and lichenoid lesions affecting the oral cavity show similar clinico-pathological features creating a diagnostic dilemma. Hence, the aim of the present study was to establish a clinical and histopathological correlation in the diagnosis of oral lichen planus, based on the modified WHO diagnostic criteria of oral lichen planus and oral lichenoid lesions proposed by Van der Meij and Van der Waal in 2003. In the present study, 100 cases of oral lichen planus were clinically and histopathologically analyzed. Out of the 100 cases, 50 were prospective and 50 were retrospective cases. Prospective cases were collected based on the clinical diagnosis of oral lichen planus and oral lichenoid lesion. Retrospective cases were collected based on the histopathological diagnosis of oral lichen planus. Both the clinical and histopathological analyses were performed based on a proposal for a set of modified diagnostic criteria of oral lichen planus and oral lichenoid lesion. A final diagnosis of oral lichen planus was made only after the correlation of the clinical diagnosis with the histopathological diagnosis. The interobserver agreement among three observers for both prospective and retrospective cases in the final diagnosis of oral lichen planus was found to be "good" to "very good" indicating high reproducibility. However, the final diagnoses of true oral lichen planus after clinico-pathological correlation in prospective and retrospective study groups appeared to be 38.0% and 54.0% respectively. The results of the present study revealed mild to moderate clinico-pathological correlation in the final diagnosis of oral lichen planus for the prospective and retrospective study groups respectively.

Imaging microscopic structures in pathological retinas using a flood-illumination adaptive optics retinal camera

NASA Astrophysics Data System (ADS)

Viard, Clément; Nakashima, Kiyoko; Lamory, Barbara; Pâques, Michel; Levecq, Xavier; Château, Nicolas

2011-03-01

This research is aimed at characterizing in vivo differences between healthy and pathological retinal tissues at the microscopic scale using a compact adaptive optics (AO) retinal camera. Tests were performed in 120 healthy eyes and 180 eyes suffering from 19 different pathological conditions, including age-related maculopathy (ARM), glaucoma and rare diseases such as inherited retinal dystrophies. Each patient was first examined using SD-OCT and infrared SLO. Retinal areas of 4°x4° were imaged using an AO flood-illumination retinal camera based on a large-stroke deformable mirror. Contrast was finally enhanced by registering and averaging rough images using classical algorithms. Cellular-resolution images could be obtained in most cases. In ARM, AO images revealed granular contents in drusen, which were invisible in SLO or OCT images, and allowed the observation of the cone mosaic between drusen. In glaucoma cases, visual field was correlated to changes in cone visibility. In inherited retinal dystrophies, AO helped to evaluate cone loss across the retina. Other microstructures, slightly larger in size than cones, were also visible in several retinas. AO provided potentially useful diagnostic and prognostic information in various diseases. In addition to cones, other microscopic structures revealed by AO images may also be of interest in monitoring retinal diseases.

Emergent Functional Network Effects in Parkinson Disease.

PubMed

Gratton, Caterina; Koller, Jonathan M; Shannon, William; Greene, Deanna J; Snyder, Abraham Z; Petersen, Steven E; Perlmutter, Joel S; Campbell, Meghan C

2018-06-06

The hallmark pathology underlying Parkinson disease (PD) is progressive synucleinopathy, beginning in caudal brainstem that later spreads rostrally. However, the primarily subcortical pathology fails to account for the wide spectrum of clinical manifestations in PD. To reconcile these observations, resting-state functional dysfunction across connectivity (FC) can be used to examine dysfunction across distributed brain networks. We measured FC in a large, single-site study of nondemented PD (N = 107; OFF medications) and healthy controls (N = 46) incorporating rigorous quality control measures and comprehensive sampling of cortical, subcortical and cerebellar regions. We employed novel statistical approaches to determine group differences across the entire connectome, at the network-level, and for select brain regions. Group differences respected well-characterized network delineations producing a striking "block-wise" pattern of network-to-network effects. Surprisingly, these results demonstrate that the greatest FC differences involve sensorimotor, thalamic, and cerebellar networks, with notably smaller striatal effects. Split-half replication demonstrates the robustness of these results. Finally, block-wise FC correlations with behavior suggest that FC disruptions may contribute to clinical manifestations in PD. Overall, these results indicate a concerted breakdown of functional network interactions, remote from primary pathophysiology, and suggest that FC deficits in PD are related to emergent network-level phenomena rather than focal pathology.

Objective review of mediastinal lymph node examination in a lung cancer resection cohort.

PubMed

Osarogiagbon, Raymond U; Allen, Jeffrey W; Farooq, Aamer; Wu, James T

2012-02-01

Accurate staging of resected lung cancer requires mediastinal lymph node (MLN) examination. MLN dissection (MLND) and systematic sampling (SS) are acceptable procedures; random sampling (RS) and no sampling (NS) are not. Forty percent of US lung cancer resections have NS. We closely examined the pattern of MLN examination in a lung resection cohort. This is a retrospective review of all lung cancer resections in Memphis, TN, from 2004 to 2007. We compared operating surgeons' claims to the pathology report and an audit of the operation narrative by an independent surgeon. Forty-five percent of resections were reported by surgeons as MLND, 8% RS, and 48% NS. None met pathology criteria for MLND, 9% were SS, 50% were RS, and 42% were NS. The concordance rate between the operating surgeon and pathology report was 39%. The surgeon audit suggested 29% of resections had MLND, 26% RS, and 45% NS. Concordance between operating and auditing surgeons was 71%. Sublobar resection, T1 stage, and age were associated with NS. Most resections had suboptimal MLN examination. Concordance was poor between surgeon claims, objective review of pathology reports, and an independent surgeon audit. The higher concordance between operating and auditing surgeons may suggest incomplete pathology examination of MLN material. The terms used by operating surgeons to describe MLN retrieval were often inaccurate.

Examining the influence of actual-ideal self-discrepancies, depression, and escapism, on pathological gaming among massively multiplayer online adolescent gamers.

PubMed

Li, Dongdong; Liau, Albert; Khoo, Angeline

2011-09-01

This study examined whether actual-ideal self-discrepancy (AISD) is related to pathological gaming through escapism as a means of reducing depression for adolescent massively multiplayer online gamers. A Discrepancy-reduction Motivation model of pathological video gaming was tested. A survey was conducted on 161 adolescent gamers from secondary schools. Two mediation effects were tested using path analysis: (a) depression would mediate the relationship between AISDs and escapism, and (b) escapism would mediate the relationship between depression and pathological gaming. Results support the hypotheses stated above. The indirect effects of both AISD and depression were significant on pathological gaming. AISD and escapism also had direct effects on pathological gaming. The present study suggests that pathological behaviors may be over-regulated coping strategies of approaching the ideal self and avoiding the actual self.

Might telesonography be a new useful diagnostic tool aboard merchant ships? A pilot study.

PubMed

Nikolić, Nebojsa; Mozetić, Vladimir; Modrcin, Bob; Jaksić, Slaven

2006-01-01

Developments of new, ultra-light diagnostic ultrasound systems (UTS) and modern satellite telecommunication networks are opening new potential applications for diagnostic sonography. One such area is maritime medicine. It is our belief that ship officers can be trained to use diagnostic ultrasound systems with the aim to generate ultrasound images of sufficient quality to be interpreted by medical professionals qualified to read sonograms. To test our thesis we included lectures and hands on scanning practice to the current maritime medicine curriculum at the Faculty of Maritime Studies at the University of Rijeka. Following the didactic and practical training all participating students examined several patients, some with pathology some without. Images obtained by students were then submitted for interpretation to a qualified physician (specialist of general surgery trained in UTS) who was unaware of the patient's pathology. In total, 37 students performed 37 examinations and made 45 ultrasound images, on 3 patients. In this paper, results on this pilot study are presented. It is possible to teach ship officers to produce diagnostically usable ultrasound pictures aboard ships at sea. But before reaching final conclusion about applicability of telesonography on board merchant ships, further studies are necessary, that would include studies of economic feasibility, and on validity of introducing such a diagnostic tool to the maritime medical practice.

Disruptive Influences on Research in Academic Pathology Departments: Proposed Changes to the Common Rule Governing Informed Consent for Research Use of Biospecimens and to Rules Governing Return of Research Results.

PubMed

Sobel, Mark E; Dreyfus, Jennifer C

2017-01-01

Academic pathology departments will be dramatically affected by proposed United States federal government regulatory initiatives. Pathology research will be substantially altered if proposed changes to the Common Rule (Code of Federal Regulations: Protection of Human Subjects title 45 CFR 46) and regulations governing the return of individual research results are approved and finalized, even more so now that the Precision Medicine initiative has been launched. Together, these changes are disruptive influences on academic pathology research as we know it, straining limited resources and compromising advances in diagnostic and academic pathology. Academic research pathologists will be challenged over the coming years and must demonstrate leadership to ensure the continued availability of and the ethical use of research pathology specimens. Copyright © 2017 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

The dysraphic state of the posterior fossa. Clinical review of the Dandy-Walker syndrome and the so-called arachnoid cysts.

PubMed

Carteri, A; Gerosa, M; Gaini, S M; Villani, R

1979-01-01

The Authors report their case material concerning some basic items of the dysraphic pathology of the Posterior Fossa: 22 cases of Dandy Walker syndromes (DWS) and "Arachnoid Cysts" (PFC). The mean clinical findings (predominant involvement of the vestibular structures of the brain stem in the DWS, frequent epileptic seizures and some cases of hypothalamic disturbances in the PFC) are discussed in the light of current embryological theories on Weed's "area membranacea". Finally the results of differential surgical treatments are examined: good or satisfactory results were obtained with shunts, while still debatable seems to be the direct surgical approach.

A case of thymic Langerhans cell histiocytosis with diabetes insipidus as the first presentation.

PubMed

Chen, Xiaoyan; Huang, Xiaochun; Qiu, Yuan; Chen, Hanzhang; Fu, Yingyu; Li, Xinchun

2013-03-01

Langerhans cell histiocytosis (LCH) is an idiopathic group of reactive proliferative diseases linked to aberrant immunity, pathologically characterized by clonal proliferation of Langerhans cells. LCH rarely involves the thymus. We report a case of thymic LCH with diabetes insipidus as the first presentation, without evidence of myasthenia gravis and without evidenced involvement of the skin, liver, spleen, bones, lungs and superficial lymph nodes. This present case may have important clinical implications. In screening for LCH lesions, attention should be attached to rarely involved sites in addition to commonly involved organs. Follow-up and imageological examination are very important to a final diagnosis.

Non puerperal uterine inversion in a young female- a case report.

PubMed

Rathod, Setu; Samal, Sunil Kumar; Pallavee, P; Ghose, Seetesh

2014-09-01

We report a case of 28-year-old, primipara who presented with complaints of mass descending per vaginum along with excessive bleeding and foul smelling vaginal discharge for the past six months. Clinical examination revealed an inverted uterus, cervix and vagina with a large submucosal fundal fibroid. A diagnosis of non-puerperal uterine inversion was made. Surgical management included vaginal myomectomy with repositioning of the uterus using an abdomino-vaginal approach and a successful outcome. Histopathology confirmed the diagnosis of leiomyoma. Hence, we conclude that uterus-sparing surgery should be considered in young females desirous for future pregnancy until the final pathology is known.

Untangling Autophagy Measurements: All Fluxed Up

PubMed Central

Gottlieb, Roberta A.; Andres, Allen M.; Sin, Jon; Taylor, David

2015-01-01

Autophagy is an important physiological process in the heart, and alterations in autophagic activity can exacerbate or mitigate injury during various pathological processes. Methods to assess autophagy have changed rapidly as the field of research has expanded. As with any new field, methods and standards for data analysis and interpretation evolve as investigators acquire experience and insight. The purpose of this review is to summarize current methods to measure autophagy, selective mitochondrial autophagy (mitophagy), and autophagic flux. We will examine several published studies where confusion arose in in data interpretation, in order to illustrate the challenges. Finally we will discuss methods to assess autophagy in vivo and in patients. PMID:25634973

State of the art in pathology business process analysis, modeling, design and optimization.

PubMed

Schrader, Thomas; Blobel, Bernd; García-Rojo, Marcial; Daniel, Christel; Słodkowska, Janina

2012-01-01

For analyzing current workflows and processes, for improving them, for quality management and quality assurance, for integrating hardware and software components, but also for education, training and communication between different domains' experts, modeling business process in a pathology department is inevitable. The authors highlight three main processes in pathology: general diagnostic, cytology diagnostic, and autopsy. In this chapter, those processes are formally modeled and described in detail. Finally, specialized processes such as immunohistochemistry and frozen section have been considered.

Multiple pathologies are common and related to dementia in the oldest-old

PubMed Central

Kim, Ronald C.; Sonnen, Joshua A.; Bullain, Szofia S.; Trieu, Thomas; Corrada, María M.

2015-01-01

Objective: The purpose of this study was to examine the role of multiple pathologies in the expression of dementia in the oldest-old. Methods: A total of 183 participants of The 90+ Study with longitudinal follow-up and autopsy were included in this clinical-pathologic investigation. Eight pathologic diagnoses (Alzheimer disease [AD], microinfarcts, hippocampal sclerosis, macroinfarcts, Lewy body disease, cerebral amyloid angiopathy, white matter disease, and others) were dichotomized. We estimated the odds of dementia in relation to each individual pathologic diagnosis and to the total number of diagnoses. We also examined dementia severity in relation to number of pathologic diagnoses. Results: The presence of multiple pathologic diagnoses was common and occurred more frequently in those with dementia compared with those without dementia (45% vs 14%). Higher numbers of pathologic diagnoses were also associated with greater dementia severity. Participants with intermediate/high AD pathology alone were 3 times more likely to have dementia (odds ratio = 3.5), but those with single non-AD pathologies were 12 times more likely to have dementia (odds ratio = 12.4). When a second pathology was present, the likelihood of dementia increased 4-fold in those with intermediate/high AD pathology but did not change in those with non-AD pathologies, suggesting that pathologies may interrelate in different ways. Conclusions: In the oldest-old, the presence of multiple pathologies is associated with increased likelihood and severity of dementia. The effect of the individual pathologies may be additive or perhaps synergistic and requires further research. Multiple pathologies will need to be targeted to reduce the burden of dementia in the population. PMID:26180144

Activity-based costing for pathology examinations and comparison with the current pricing system in Turkey.

PubMed

Ergün, Ferda A K; Ağirbaş, Ismail; Kuzu, Işınsu

2013-01-01

To demonstrate the real cost data of the pathology examinations by using the activity-based costing method and to contribute to the financial planning of the departments, health managers and also the social security institution. Forty-four examinations selected from the Healthcare Implementation Notification system list and performed at the Ankara University Faculty of Medicine Pathology Department during September 2010 were studied. The analysis and the real cost calculations were done according to the duration of the procedures. Calculated costs were compared with the Healthcare Implementation Notification system and Medicare price lists. The costs of the pathology tests listed within the same pricing levels in the Healthcare Implementation Notification system list showed great differences. The minimum and maximum costs in level 1, 2, 3, and 4 were 15,98-80,15 TL, 15,95-258,59 TL, 42,38- 236,87 TL, and 124,42-406,76 TL, respectively. Medicare price levels were more consistent with the real costs of the examinations compared to the Healthcare Implementation Notification system price list. The prices of the pathology examination listed at different levels in the Healthcare Implementation Notification system lists do not cover the real costs of the work done. The principal parameters of Activity-Based Costing system are more suitable for making the most realistic cost categorization. Although the prices could differ between countries, the Medicare system categories are more realistic than the Healthcare Implementation Notification system. The Healthcare Implementation Notification system list needs to be revised in order to reflect the real costs of the pathology examinations.

[The role of preoperative (18)F-FDG PET-CT in lymphatic metastasis diagnosis of cutaneous malignant melanoma on extremities and trunk].

PubMed

Zhang, X X; Fang, Y; Xu, L B; Xu, S F; Zhao, Z G; Sun, C; Ma, P Q; Liu, T; Yu, S J; Zhang, W J

2018-05-23

Objective: To evaluate the clinical value of preoperative (18)F-Fludeoxyglucose ((18)F-FDG PET-CT) in lymphatic metastasis diagnosis of cutaneous melanoma on extremities and trunk. Methods: 112 patients with cutaneous melanoma pathologically of extremities and trunk from January 2006 to December 2016, who received (18)F-FDG PET-CT examination preoperatively, were retrospectively reviewed. The correlations between the maximal diameters of lymph nodes, the maximal standard uptake value (SUV) and the diagnostic impression grades of PET-CT examination, and the final pathological diagnosis were analyzed. The correlations between Breslow thickness of primary lesions and the diagnostic impression of PET-CT examination were also analyzed. All the above were analyzed with Receiver Operating Characteristic (ROC) curve to get the cut-off value. Based on the final results of pathological diagnosis of lymph nodes as the golden standard, the statistically significant indicators of ROC curve analysis were used to evaluate the diagnostic effect, as well as to calculate the sensitivity, specificity and accuracy. With gender, age, maximal diameter of lymph nodes, maximal SUV, diagnosis impressions, and Breslow thickness as the independent variables and pathological diagnosis results of lymph nodes as the dependent variable, two-class stepwise Logistic regression analysis was used to determine the independence of diagnostic indicators. ROC curve analysis and log rank test were used to analyze the relationship between Breslow thickness and patient survival. Results: To evaluate melanoma patients' lymph node status, the results of ROC curve analysis showed that the area under the curve of lymph node maximal diameter, maximal SUV, diagnosis impression of PET-CT examinations were 0.789, 0.786 and 0.816, respectively (all P <0.05). The cut-off values were 0.85 cm, 1.45 and 2.5, respectively. The sensitivity of the cut-off values to determine the status of lymph nodes in melanoma patients were 71.4%, 64.9% and 72.1% respectively, and the specificities were 85.2%, 88.7% and 87.0% respectively. Multivariate Logistic regression analysis showed that PET-CT diagnosis impressions had independent diagnostic significance for the lymph node status of melanoma patients ( OR =11.296, 95% CI : 2.550~50.033). The area under the curve of Breslow thickness evaluating PET-CT diagnostic impression is 0.664 ( P =0.042) and the cut-off value was 4.25 mm. The survival rate of the patients with Breslow thickness ≥ 4.25 mm was lower than that in the group <4.25 mm ( P =0.006). Conclusions: (18)F-FDG PET-CT can help to evaluate metastases and make treatment decisions for cutaneous melanoma of extremities and trunk, especially for patients whose primary lesion's Breslow thickness has reached more than 4.25 mm. For the patients whose maximal SUV of regional lymph node is higher than 1.45 and short diameter of the largest lymph node is larger than 0.85cm, the possibility of metastases should be considered.

The Effects of Pathological Gaming on Aggressive Behavior

ERIC Educational Resources Information Center

Lemmens, Jeroen S.; Valkenburg, Patti M.; Peter, Jochen

2011-01-01

Studies have shown that pathological involvement with computer or video games is related to excessive gaming binges and aggressive behavior. Our aims for this study were to longitudinally examine if pathological gaming leads to increasingly excessive gaming habits, and how pathological gaming may cause an increase in physical aggression. For this…

[Diagnostic strategy for shoulder pathology?].

PubMed

Noël, Eric

2006-09-30

Faced to shoulder pathology, the way of investigating must be very systematic. Before doing sophisticated explorations (arthroCT, MRI), we first have to use the triad "interrogatory-clinical examination-standard X Rays". This first step is absolutely necessary; it must allow to make the diagnosis to which the therapy must be adapted. The rotator cuff pathology is the most frequent one. Its frequency depends on patient's age, precessive trauma or not and the pratice of activities using the arm up (sports, leasures, works). A stiff shoulder must never be neglected, the diagnosis is done by clinical examination and its origine is very often precised by standard Xrays. Others diagnosis are done by the conjunction of several elements (pathologic context, clinical examination, standard Xrays). In some complex situations, other investigations (US, arthroCT, MRI) will be needed.

Accuracy of Intraoperative Frozen Section Diagnosis of Borderline Ovarian Tumors by Hospital Type.

PubMed

Shah, Jaimin S; Mackelvie, Michael; Gershenson, David M; Ramalingam, Preetha; Kott, Marylee M; Brown, Jubilee; Gauthier, Polly; Nugent, Elizabeth; Ramondetta, Lois M; Frumovitz, Michael

2018-04-19

To compare the accuracy of frozen section diagnosis of borderline ovarian tumors among 3 distinct types of hospital-academic hospital with gynecologic pathologists, academic hospital with nongynecologic pathologists, and community hospital with nongynecologic pathologists-and to determine if surgical staging alters patient care or outcomes for women with a frozen section diagnosis of borderline ovarian tumor. Retrospective study (Canadian Task Force classification II-1). Tertiary care, academic, and community hospitals. Women with an intraoperative frozen section diagnosis of borderline ovarian tumor at 1 of 3 types of hospital from April 1998 through June 2016. Comparison of final pathology with intraoperative frozen section diagnosis. Two hundred twelve women met the inclusion criteria. The frozen section diagnosis of borderline ovarian tumor correlated with the final pathologic diagnosis in 192 of 212 cases (90.6%), and the rate of correlation did not differ among the 3 hospital types (p = .82). Seven tumors (3.3%) were downgraded to benign on final pathologic analysis and 13 (6.1%) upgraded to invasive carcinoma. The 3 hospital types did not differ with respect to the proportion of tumors upgraded to invasive carcinoma (p = .62). Mucinous (odds ratio, 7.1; 95% confidence interval, 2.1-23.7; p = .002) and endometrioid borderline ovarian tumors (odds ratio, 32.4; 95% confidence interval, 1.8-595.5; p = .02) were more likely than serous ovarian tumors to be upgraded to carcinoma. Only 88 patients (41.5%) underwent lymphadenectomy, and only 1 (1.1%) had invasive carcinoma in a lymph node. A frozen section diagnosis of borderline ovarian tumor correlates with the final pathologic diagnosis in a variety of hospital types. Copyright © 2018 American Association of Gynecologic Laparoscopists. Published by Elsevier Inc. All rights reserved.

Lateral hip pain: findings from magnetic resonance imaging and clinical examination.

PubMed

Woodley, Stephanie J; Nicholson, Helen D; Livingstone, Vicki; Doyle, Terence C; Meikle, Grant R; Macintosh, Janet E; Mercer, Susan R

2008-06-01

Prospective cross-sectional study. To examine the radiological and physical therapy diagnoses of lateral hip pain (LHP), and determine the validity of selected clinical variables for predicting gluteal tendon pathology. LHP is frequently encountered by clinicians. Further investigation is required to establish the specific pathologies implicated in the cause of LHP, and which clinical tests are useful in the assessment of this problem. Forty patients with unilateral LHP underwent a physical therapy examination followed by magnetic resonance imaging (MRI) studies. Three radiologists analyzed the images of both hips for signs of pathology. Interobserver reliability of the image analyses, the agreement between the physical therapy and radiological diagnoses, and the validity of the clinical tests were examined. Gluteus medius tendon pathology, bursitis, osteoarthritis and gluteal muscle atrophy (predominantly affecting gluteus minimus) were all implicated in the imaging report of LHP. While prevalent in symptomatic hips, abnormalities were also identified in asymptomatic hips, particularly relating to the diagnosis of bursitis. The strength of agreement between radiologists was variable and little agreement existed between the physical therapy and radiological diagnoses of pathology. Nine of the 26 clinical variables examined in relation to gluteal tendon pathology had likelihood ratios above 2.0 or below 0.5, but the associated 95% confidence intervals were large. The diagnosis of LHP is challenging and our results highlight some problems associated with the use of MRI as a diagnostic reference standard. This factor, together with the imprecise point estimates of the likelihood ratios, means that no firm conclusions can be made regarding the diagnostic utility of the clinical tests used in the assessment of gluteal tendon pathology.

Mixed pathology is more likely in black than white decedents with Alzheimer dementia

PubMed Central

Leurgans, Sue; Aggarwal, Neelum T.; Shah, Raj C.; Arvanitakis, Zoe; James, Bryan D.; Buchman, Aron S.; Bennett, David A.; Schneider, Julie A.

2015-01-01

Objective: To compare the burden of neuropathology in black and white participants with clinical Alzheimer disease (AD). Methods: Participants included 122 persons enrolled in the Rush Alzheimer's Disease Clinical Core, a prospective cohort study of AD. Forty-one black decedents were matched two-to-one to 81 white decedents according to age at death, sex, years of education, and cognition proximate to death. We examined common brain pathologies related to dementia (AD, Lewy body, and macroscopic and microinfarct pathology) and arteriolar sclerosis and atherosclerosis. We calculated the frequency of each dementia pathology both alone and in combination (mixed pathologies). Racial differences in the odds of a single pathology vs mixed pathologies, and in the odds of vessel disease and its severity, were examined using logistic regression analyses. Results: AD pathology was confirmed in >93% of both black and white decedents with AD dementia. However, black decedents were less likely to have Alzheimer pathology as a single dementia pathology than white decedents (19.5% vs 42.0%), and were more likely to have AD mixed with an additional pathology (70.7% vs 50.6%), particularly Alzheimer pathology and Lewy bodies, and Alzheimer pathology, Lewy bodies, and infarcts. Black decedents also had more severe arteriolar sclerosis and atherosclerosis. Conclusion: Black decedents with AD dementia are more likely to have mixed brain pathologies compared with age-, sex-, education-, and cognition-matched white decedents with AD dementia. PMID:26180136

Reactive microglia drive tau pathology and contribute to the spreading of pathological tau in the brain

PubMed Central

Maphis, Nicole; Xu, Guixiang; Kokiko-Cochran, Olga N.; Jiang, Shanya; Cardona, Astrid; Ransohoff, Richard M.; Lamb, Bruce T.

2015-01-01

Pathological aggregation of tau is a hallmark of Alzheimer’s disease and related tauopathies. We have previously shown that the deficiency of the microglial fractalkine receptor (CX3CR1) led to the acceleration of tau pathology and memory impairment in an hTau mouse model of tauopathy. Here, we show that microglia drive tau pathology in a cell-autonomous manner. First, tau hyperphosphorylation and aggregation occur as early as 2 months of age in hTauCx3cr1−/− mice. Second, CD45+ microglial activation correlates with the spatial memory deficit and spread of tau pathology in the anatomically connected regions of the hippocampus. Third, adoptive transfer of purified microglia derived from hTauCx3cr1−/− mice induces tau hyperphosphorylation within the brains of non-transgenic recipient mice. Finally, inclusion of interleukin 1 receptor antagonist (Kineret®) in the adoptive transfer inoculum significantly reduces microglia-induced tau pathology. Together, our results suggest that reactive microglia are sufficient to drive tau pathology and correlate with the spread of pathological tau in the brain. PMID:25833819

Successful medical treatment for globe penetration following tooth extraction in a dog.

PubMed

Guerreiro, Cleo E; Appelboam, Helen; Lowe, Robert C

2014-03-01

A five-year-old entire male Tibetan Terrier was referred for left-sided periorbital swelling and blepharospasm 4 days following ipsilateral maxillary tooth extraction. Examination of the left eye revealed mild exophthalmos, pain on retropulsion, and absent menace response and pupillary light reflexes. Examination of the posterior segment was not possible owing to the anterior segment pathology. Differential diagnoses considered were iatrogenic globe penetration and peribulbar abscess/cellulitis. Ocular ultrasound was consistent with a penetrating wound to the globe. Treatment with systemic prednisolone and marbofloxacin, and topical atropine sulfate 1%, prednisolone acetate, and brinzolamide was started. Marked clinical improvement allowed visual confirmation of the perforation. Oral prednisolone was tapered over the following 10 weeks. At final re-examination (10 months), the patient was visual, and fundic examination revealed an additional chorioretinal scar, most likely an exit wound that was obscured by vitreal debris on initial examinations. Neither scar was associated with retinal detachment. To the authors' knowledge, this is the first reported case of successful medical management of iatrogenic globe penetration following exodontic procedures. © 2013 American College of Veterinary Ophthalmologists.

Functional Assessment of Synoptic Pathology Reporting for Ovarian Cancer.

PubMed

Słodkowska, Janina; Cierniak, Szczepan; Patera, Janusz; Kopik, Jarosław; Baranowski, Włodzimierz; Markiewicz, Tomasz; Murawski, Piotr; Buda, Irmina; Kozłowski, Wojciech

2016-01-01

Ovarian cancer has one of the highest death/incidence rates and is commonly diagnosed at an advanced stage. In the recent WHO classification, new histotypes were classified which respond differently to chemotherapy. The e-standardized synoptic cancer pathology reports offer the clinicians essential and reliable information. The aim of our project was to develop an e-template for the standardized synoptic pathology reporting of ovarian carcinoma [based on the checklist of the College of American Pathologists (CAP) and the recent WHO/FIGO classification] to introduce a uniform and improved quality of cancer pathology reports. A functional and qualitative evaluation of the synoptic reporting was performed. An indispensable module for e-synoptic reporting was developed and integrated into the Hospital Information System (HIS). The electronic pathology system used a standardized structure with drop-down lists of defined elements to ensure completeness and consistency of reporting practices with the required guidelines. All ovarian cancer pathology reports (partial and final) with the corresponding glass slides selected from a 1-year current workflow were revised for the standard structured reports, and 42 tumors [13 borderline tumors and 29 carcinomas (mainly serous)] were included in the study. Analysis of the reports for completeness against the CAP checklist standard showed a lack of pTNM staging in 80% of the partial or final unstructured reports; ICD-O coding was missing in 83%. Much less frequently missed or unstated data were: ovarian capsule infiltration, angioinvasion and implant evaluation. The e-records of ovarian tumors were supplemented with digital macro- and micro-images and whole-slide images. The e-module developed for synoptic ovarian cancer pathology reporting was easily incorporated into HIS.CGM CliniNet and facilitated comprehensive reporting; it also provided open access to the database for concerned recipients. The e-synoptic pathology reports appeared more accurate, clear and conclusive than traditional narrative reports. Standardizing structured reporting and electronic tools allows open access and downstream utilization of pathology data for clinicians and tumor registries. © 2016 S. Karger AG, Basel.

Regulatory mechanism of microRNA-128 in osteosarcoma tumorigenesis and evolution through targeting SASH1

PubMed Central

Li, Zi; Ni, Jiangdong; Song, Deye; Ding, Muliang

2018-01-01

Osteosarcoma, which commonly occurs in young individuals, is a type of malignant tumor of growing bones. MicroRNAs (miRNAs) have been found to be involved in various cancer-related processes. In the present study, it was reported that miRNA-128 (miR-128) was overexpressed in pathological tissues from patients with osteosarcoma. The present study investigated the possible regulatory mechanism of miR-128 on the progression of osteosarcoma and offered a foundation for clinical therapeutics in osteosarcoma. First, the expressions levels of miR-128 and its target gene, SAM and SH3 domain-containing 1 (SASH1), were measured in tissues from patients with osteosarcoma, and their correlation with osteosarcoma in terms of the pathological level were examined. The effects of miR-128 on osteosarcoma cell proliferation and apoptosis were examined, and its regulation of the expression levels of SASH1 and associated proteins was analyzed. Subsequently, the association between SASH1 and miR-128 was evaluated using a dual luciferase gene reporter assay. Finally, an in vivo xenograft tumor mouse model of osteosarcoma was established to confirm the in vitro results. The results demonstrated a higher expression of miR-128 in pathological tissues, compared with that in normal tissues. From examining the patient osteosarcoma tissues, marked correlations were found between the expression of miR-128 and that of SASH1, particularly with tumor size, invasion depth, lymph node metastasis, and tumor-node-metastasis stage. Compared with the negative control group and blank control group, the results showed that the inhibition of miR-128 led to a lower cell proliferation rate and higher apoptotic rate in MG-63 cells (P<0.05). Additionally, the expression of B-cell lymphoma 2 (Bcl-2) was downregulated in the miR-128-inhibited group, compared with that in the control group, whereas the expression levels of SASH1, Bcl-2-associated X protein and caspase-3 were upregulated in the group with miR-128 inhibition (P<0.05). SASH1 was confirmed as a direct target of miR-128 using a dual luciferase gene reporter assay. Finally, the downregulation of miR-128 was found to induce tumor suppressive effects on xenograft tumor models of osteosarcoma in mice in vivo. The results of the present study suggested that miR-128 may regulate the tumorigenesis and evolution of osteosarcoma through targeting SASH1. PMID:29805606

Regulatory mechanism of microRNA-128 in osteosarcoma tumorigenesis and evolution through targeting SASH1.

PubMed

Li, Zi; Ni, Jiangdong; Song, Deye; Ding, Muliang

2018-06-01

Osteosarcoma, which commonly occurs in young individuals, is a type of malignant tumor of growing bones. MicroRNAs (miRNAs) have been found to be involved in various cancer-related processes. In the present study, it was reported that miRNA-128 (miR-128) was overexpressed in pathological tissues from patients with osteosarcoma. The present study investigated the possible regulatory mechanism of miR-128 on the progression of osteosarcoma and offered a foundation for clinical therapeutics in osteosarcoma. First, the expressions levels of miR-128 and its target gene, SAM and SH3 domain-containing 1 (SASH1), were measured in tissues from patients with osteosarcoma, and their correlation with osteosarcoma in terms of the pathological level were examined. The effects of miR-128 on osteosarcoma cell proliferation and apoptosis were examined, and its regulation of the expression levels of SASH1 and associated proteins was analyzed. Subsequently, the association between SASH1 and miR-128 was evaluated using a dual luciferase gene reporter assay. Finally, an in vivo xenograft tumor mouse model of osteosarcoma was established to confirm the in vitro results. The results demonstrated a higher expression of miR-128 in pathological tissues, compared with that in normal tissues. From examining the patient osteosarcoma tissues, marked correlations were found between the expression of miR-128 and that of SASH1, particularly with tumor size, invasion depth, lymph node metastasis, and tumor-node-metastasis stage. Compared with the negative control group and blank control group, the results showed that the inhibition of miR-128 led to a lower cell proliferation rate and higher apoptotic rate in MG-63 cells (P<0.05). Additionally, the expression of B-cell lymphoma 2 (Bcl-2) was downregulated in the miR-128-inhibited group, compared with that in the control group, whereas the expression levels of SASH1, Bcl-2-associated X protein and caspase-3 were upregulated in the group with miR-128 inhibition (P<0.05). SASH1 was confirmed as a direct target of miR-128 using a dual luciferase gene reporter assay. Finally, the downregulation of miR-128 was found to induce tumor suppressive effects on xenograft tumor models of osteosarcoma in mice in vivo . The results of the present study suggested that miR-128 may regulate the tumorigenesis and evolution of osteosarcoma through targeting SASH1.

The association of "food addiction" with disordered eating and body mass index.

PubMed

Gearhardt, Ashley N; Boswell, Rebecca G; White, Marney A

2014-08-01

The contribution of an addictive process to elevated body mass index (BMI) and disordered eating is an area of growing interest. Yet, little is known about how "food addiction" may be related to disordered eating and obesity. The ability of addictive-like eating to account for eating pathology not captured by traditional eating disorders is unknown. No prior research has examined the association of "food addiction" with bulimia nervosa (BN). Finally, little is understood about the association of "food addiction" with patterns of dieting and weight gain. The current study was conducted to address these gaps in the literature. Participants (N=815) were recruited from online advertisements nationwide and completed measures related to "food addiction", BMI, weight history, and disordered eating. Addictive-like eating was associated with elevated current and lifetime highest BMI, weight cycling, and eating pathology. The prevalence of "food addiction" was higher in participants with BN than in those with binge eating disorder (BED). "Food addiction" continued to be related to clinically relevant variables, especially elevated BMI, even when participants did not meet criteria for BED or BN. The co-occurrence of "food addiction" with eating disorders appears to be associated with a more severe variant of eating pathology. An addictive-type response to highly palatable food may be contributing to eating-related problems, including obesity and eating disorders. BN relative to BED appears to be more strongly associated with "food addiction." Additionally, the concept of "food addiction" appears to capture clinically relevant information in participants who do not meet criteria for either BN or BED. Further examination of "food addiction" may be important in understanding the mechanisms underlying certain types of problematic eating behavior. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Association of “Food Addiction” with Disordered Eating and Body Mass Index

PubMed Central

Gearhardt, Ashley N.; Boswell, Rebecca G.; White, Marney A.

2014-01-01

Introduction The contribution of an addictive process to elevated body mass index (BMI) and disordered eating is an area of growing interest. Yet, little is known about how “food addiction” may be related to disordered eating and obesity. The ability of addictive-like eating to account for eating pathology not captured by traditional eating disorders is unknown. No prior research has examined the association of “food addiction” with bulimia nervosa (BN). Finally, little is understood about the association of “food addiction” with patterns of dieting and weight gain. The current study was conducted to address these gaps in the literature. Material and Methods Participants (N = 815) were recruited from online advertisements nationwide and completed measures related to “food addiction”, BMI, weight history, and disordered eating. Results Addictive-like eating was associated with elevated current and lifetime highest BMI, weight cycling, and eating pathology. The prevalence of “food addiction” was higher in participants with BN than in those with binge eating disorder (BED). “Food addiction” continued to be related to clinically relevant variables, especially elevated BMI, even when participants did not meet criteria for BED or BN. The co-occurrence of “food addiction” with eating disorders appears to be associated with a more severe variant of eating pathology. Discussion An addictive-type response to highly palatable food may be contributing to eating-related problems, including obesity and eating disorders. BN relative to BED appears to be more strongly associated with “food addiction.” Additionally, the concept of “food addiction” appears to capture clinically relevant information in participants who do not meet criteria for either BN or BED. Further examination of “food addiction” may be important in understanding the mechanisms underlying certain types of problematic eating behavior. PMID:25064294

Emotion Self-Regulation Moderates the Association Between Symptoms of ADHD and Weight Loss After Bariatric Surgery.

PubMed

Williamson, Tamara M; Campbell, Tavis S; Telfer, Jo Ann; Rash, Joshua A

2018-06-01

This study aimed to examine the combined effect of pre-surgical emotion self-regulation (ESR) and symptoms of attention deficit hyperactivity disorder (sADHD, i.e., inattention, impulsivity, and hyperactivity) on weight loss 12 months following bariatric surgery independent of psychological distress and eating pathology. Adults with obesity were recruited from a bariatric surgery specialty clinic in Canada. Patients completed measures of psychological distress (i.e., Beck Depression Inventory II and Beck Anxiety Inventory), eating pathology (i.e., Eating Disorder Examination Questionnaire), ESR (i.e., "Managing Own Emotions" subscale of the Schutte Emotional Intelligence Test), and sADHD (i.e., Adult ADHD Self-Report Scale) prior to surgery. Measures of height and weight were obtained and used to calculate percent excess weight loss (%EWL) of body mass index (BMI) pre- and 12 months post-surgery. Thirty-seven patients were recruited. The final sample consisted of 30 patients (80% female; mean age = 48 years; mean BMI = 49.32). Patients experienced significant weight loss and reported significant improvement in anxiety, depressed mood, and eating pathology from pre- to 12 months post-surgery. A significant sADHD by ESR interaction on %EWL (F(1, 21) = 6.43, p = .019) was observed and accounted for 13% of unique variance after adjusting for relevant covariates. Probing the interaction with the Johnson-Neyman technique indicated that there was a significant inverse association between sADHD and %EWL among individuals who scored ≤ 0.15 SD below the mean on ESR. ESR moderated the association between sADHD and %EWL, suggesting that sADHD may attenuate weight loss following bariatric surgery among individuals deficient in ESR. This finding has implications for bariatric surgery pre-surgical psychological assessment.

Examination of changes in pathology tests ordered by Diagnosis-Related Group (DRGs) following CPOE introduction.

PubMed

Vecellio, Elia; Georgiou, Andrew; Toouli, George; Eigenstetter, Alex; Li, Ling; Wilson, Roger; Westbrook, Johanna I

2013-01-01

Electronic test ordering, via the Electronic Medical Record (EMR), which incorporates computerised provider order entry (CPOE), is widely considered as a useful tool to support appropriate pathology test ordering. Diagnosis-related groups (DRGs) are clinically meaningful categories that allow comparisons in pathology utilisation by patient groups by controlling for many potentially confounding variables. This study used DRG data linked to pathology test data to examine changes in rates of test ordering across four years coinciding with the introduction of an EMR in six hospitals in New South Wales, Australia. This method generated a list of high pathology utilisation DRGs. We investigated patients with a Chest pain DRG to examine whether tests rates changed for specific test groups by hospital emergency department (ED) pre- and post-EMR. There was little change in testing rates between EDs or between time periods pre- and post-EMR. This is a valuable method for monitoring the impact of EMR and clinical decision support on test order rates.

Opportunities for Improvement in Pathology Reporting of Childhood Nonrhabdomyosarcoma Soft Tissue Sarcomas:  A Report From Children's Oncology Group (COG) Study ARST0332.

PubMed

Black, Jennifer O; Coffin, Cheryl M; Parham, David M; Hawkins, Douglas S; Speights, Rose A; Spunt, Sheri L

2016-09-01

Treatment of soft tissue tumors in young patients relies on the diagnostic information conveyed in the pathology report. We examined pathology reports from Children's Oncology Group ARST0332 for inclusion of data elements required in published guidelines. Pathology reports for 551 eligible patients were examined for required data elements defined by the College of American Pathologists, including tissue type, procedure, tumor site, tumor maximum diameter, macroscopic extent of tumor, histologic type, mitotic rate, extent of necrosis, tumor grade, margin status, use of ancillary studies, and pathologic stage. Only 65 (12%) of 551 reports included all required data elements. Of reports containing synoptic templates, 57% were complete. This study reveals significant opportunity to improve the quality of pathology reports in young patients with soft tissue tumors. Use of templates or checklists improves completeness of reports. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Uncovering students' misconceptions by assessment of their written questions.

PubMed

Olde Bekkink, Marleen; Donders, A R T Rogier; Kooloos, Jan G; de Waal, Rob M W; Ruiter, Dirk J

2016-08-24

Misconceptions are ideas that are inconsistent with current scientific views. They are difficult to detect and refractory to change. Misconceptions can negatively influence how new concepts in science are learned, but are rarely measured in biomedical courses. Early identification of misconceptions is of critical relevance for effective teaching, but presents a difficult task for teachers as they tend to either over- or underestimate students' prior knowledge. A systematic appreciation of the existing misconceptions is desirable. This explorative study was performed to determine whether written questions generated by students can be used to uncover their misconceptions. During a small-group work (SGW) session on Tumour Pathology in a (bio)medical bachelor course on General Pathology, students were asked to write down a question about the topic. This concerned a deepening question on disease mechanisms and not mere factual knowledge. Three independent expert pathologists determined whether the content of the questions was compatible with a misconception. Consensus was reached in all cases. Study outcomes were to determine whether misconceptions can be identified in students' written questions, and if so, to measure the frequency of misconceptions that can be encountered, and finally, to determine if the presence of such misconceptions is negatively associated with the students' course formal examination score. A subgroup analysis was performed according to gender and discipline. A total of 242 students participated in the SGW sessions, of whom 221 (91 %) formulated a question. Thirty-six questions did not meet the inclusion criteria. Of the 185 questions rated, 11 % (n = 20) was compatible with a misconception. Misconceptions were only found in medical students' questions, not in biomedical science students' questions. Formal examination score on Tumour Pathology was 5.0 (SD 2.0) in the group with misconceptions and 6.7 (SD 2.4) in the group without misconceptions (p = 0.003). This study demonstrates that misconceptions can be uncovered in students' written questions. The occurrence of these misconceptions was negatively associated with the formal examination score. Identification of misconceptions creates an opportunity to repair them during the remaining course sessions, in advance of the formal examination.

Cognitive and Social Lifestyle: Links with Neuropathology and Cognition in Late Life

PubMed Central

Bennett, David A.; Arnold, Steven E.; Valenzuela, Michael J; Brayne, Carol; Schneider, Julie A.

2014-01-01

Many studies report an association of cognitive and social experiential factors and related traits with dementia risk. Further, many clinical-pathologic studies find a poor correspondence between levels of neuropathology and the presence of dementia and level of cognitive impairment. The poor correspondence suggests that other factors contribute to the maintenance or loss of cognitive function, with factors associated with the maintenance of function referred to as neural or cognitive reserve. This has led investigators to examine the associations of cognitive and social experiential factors with neuropathology as a first step in disentangling the complex associations between these experiential risk factors, neuropathology, and cognitive impairment. Despite the consistent associations of a range of cognitive and social lifestyle factors with cognitive decline and dementia risk, the extant clinical pathologic data finds only a single factor from one cohort, linguistic ability, related to AD pathology. Other factors, including education, harm avoidance, and emotional neglect, are associated with cerebrovascular disease. Overall, the associations are weak. Some factors, such as education, social networks, and purpose in life modify the relation of neuropathology to cognition. Finally, some factors such as cognitive activity appear to bypass known pathologies altogether suggesting a more direct association with biologic indices that promote person-specific differences in reserve and resilience. Future work will first need to replicate findings across more studies to ensure the veracity of the existing data. Second, effort is need to identify the molecular substrates of neural reserve as potential mediators of the association of lifestyle factors with cognition. PMID:24356982

Reliability Exercise for the Polymyalgia Rheumatica Classification Criteria Study: The Oranjewoud Ultrasound Substudy

PubMed Central

Scheel, Alexander K.; Matteson, Eric L.; Dasgupta, Bhaskar; Bruyn, George A. W.; Ohrndorf, Sarah; Werner, Carola; Schmidt, Wolfgang A.

2009-01-01

Objective. A study supported by the EULAR and the ACR being conducted to establish classification criteria for polymyalgia rheumatica (PMR) will include ultrasound examination of the shoulders and hips. Ultrasound (US) depicts glenohumeral joint effusion, biceps tenosynovitis, subdeltoid bursitis, hip joint synovitis, and trochanteric bursitis in PMR. These findings may aid in distinguishing PMR from other diseases. The purpose of this study was to assess standards and US interreader agreement of participants in the PMR classification criteria study. Methods. Sixteen physicians in four groups examined shoulders and hips of 4 patients and 4 healthy adults with ultrasound. Overall agreement and interobserver agreement were calculated. Results. The overall agreement (OA) between groups was 87%. The OA for healthy shoulders was 88.8%, for healthy hips 100%, for shoulders with pathology 85.2%, and 74.3% for hips with pathology, respectively. Conclusion. There was a high degree of agreement found for the examination of healthy shoulders and pathologic hips. Agreement was moderate for pathologic shoulders and perfect for healthy hips. US of shoulder and hips performed by different examiners is a reliable and feasible tool for assessment of PMR related disease pathology and can be incorporated into a classification criteria study. PMID:20130800

Colorectal tumors: the histology report.

PubMed

Lanza, Giovanni; Messerini, Luca; Gafà, Roberta; Risio, Mauro

2011-03-01

Epithelial colorectal tumors are common pathologic entities. Their histology report should be comprehensive of a series of pathologic parameters essential for the correct clinical management of the patients. Diagnostic histologic criteria of adenomatous, serrated, inflammatory, and hamartomatous polyps and of polyposis syndromes are discussed. In addition, the pathologic features of early and advanced colorectal cancer are described and a checklist is given. Finally, molecular prognostic and predictive factors currently employed in the treatment of colorectal cancer are discussed. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

The Association Between Molecular Markers in Colorectal Sessile Serrated Polyps and Colorectal Cancer Risk

DTIC Science & Technology

2016-08-01

subsequent colorectal neoplasia and interval cancers were identified, the pathology review form and protocol were finalized, assays for 6 out of the 11...methylation markers were optimized, tissue blocks and clinical H&E slides were pulled for standard pathology review. Also, Dr. Burnett-Hartman...10 9. Appendix I: Pathology Review Form…………………………………….. 11 10. Appendix II: Research Support: Burnett-Hartman…………………….. 12 11. Appendix III

Analysis of pathology department Web sites and practical recommendations.

PubMed

Nero, Christopher; Dighe, Anand S

2008-09-01

There are numerous customers for pathology departmental Web sites, including pathology department staff, clinical staff, residency applicants, job seekers, and other individuals outside the department seeking department information. Despite the increasing importance of departmental Web sites as a means of distributing information, no analysis has been done to date of the content and usage of pathology department Web sites. In this study, we analyzed pathology department Web sites to examine the elements present on each site and to evaluate the use of search technology on these sites. Further, we examined the usage patterns of our own departmental Internet and internet Web sites to better understand the users of pathology Web sites. We reviewed selected departmental pathology Web sites and analyzed their content and functionality. Our institution's departmental pathology Web sites were modified to enable detailed information to be stored regarding users and usage patterns, and that information was analyzed. We demonstrate considerable heterogeneity in departmental Web sites with many sites lacking basic content and search features. In addition, we demonstrate that increasing the traffic of a department's informational Web sites may result in reduced phone inquiries to the laboratory. We propose recommendations for pathology department Web sites to maximize promotion of a department's mission. A departmental pathology Web site is an essential communication tool for all pathology departments, and attention to the users and content of the site can have operational impact.

Multimodal assessment of emotional reactivity in borderline personality pathology: The moderating role of posttraumatic stress disorder symptoms

PubMed Central

Dixon-Gordon, Katherine L.; Gratz, Kim L.; Tull, Matthew T.

2013-01-01

Emotional reactivity has been theorized to play a central role in borderline personality (BP) pathology. Although growing research provides evidence for subjective emotional reactivity in BP pathology, research on physiological or biological reactivity among people with BP pathology is less conclusive. With regard to biological reactivity in particular, research on cortisol reactivity (a neurobiological marker of emotional reactivity) in response to stressors among individuals with BP pathology has produced contradictory results and highlighted the potential moderating role of PTSD-related pathology. Thus, this study sought to examine the moderating role of PTSD symptoms in the relation between BP pathology and both subjective (self-report) and biological (cortisol) emotional reactivity to a laboratory stressor. Participants were 171 patients in a residential substance use disorder treatment center. Consistent with hypotheses, results revealed a significant main effect of BP pathology on subjective emotional reactivity to the laboratory stressor. Furthermore, results revealed a significant interaction between BP pathology and PTSD symptoms in the prediction of cortisol reactivity, such that BP pathology was associated with heightened cortisol reactivity only among participants with low levels of PTSD symptoms. Similar findings were obtained when examining the interaction between BP pathology and the reexperiencing and avoidance/numbing symptoms of PTSD specifically. Results highlight the moderating role of PTSD symptoms in the BP-reactivity relation. PMID:23375184

An examination of professional and ethical issues in the fellowship application process in pathology.

PubMed

Domen, Ronald E; Wehler, Amanda Brehm

2008-04-01

Approximately 34 medical specialty and subspecialty fellowship programs in the United States have formalized the application process through the National Resident Matching Program. This approach sets standards for the application process, offers a formalized match similar to that for residency programs, functions within a specific timeline, and establishes binding rules of behavior for both applicants and programs. For fellowship programs that operate outside the National Resident Matching Program, such as those in pathology, no published guidelines exist to help programs and applicants address the many questions and problems that can arise. As a result, programs are free to set their own timelines for interviews, application requirements, contract negotiations and finalizations, and other details. Consequently, applicants often feel pressured to apply earlier and earlier in their residency for competitive fellowship programs, are often required to fill out multiple unique applications, may feel no "loyalty" toward honoring an acceptance without a contract, and often feel disenfranchised by the whole process. This article addresses professional and ethical aspects of the current application process and offers possible solutions for improving it.

Hyaluronan – A Functional and Structural Sweet Spot in the Tissue Microenvironment

PubMed Central

Monslow, James; Govindaraju, Priya; Puré, Ellen

2015-01-01

Transition from homeostatic to reactive matrix remodeling is a fundamental adaptive tissue response to injury, inflammatory disease, fibrosis, and cancer. Alterations in architecture, physical properties, and matrix composition result in changes in biomechanical and biochemical cellular signaling. The dynamics of pericellular and extracellular matrices, including matrix protein, proteoglycan, and glycosaminoglycan modification are continually emerging as essential regulatory mechanisms underlying cellular and tissue function. Nevertheless, the impact of matrix organization on inflammation and immunity in particular and the consequent effects on tissue healing and disease outcome are arguably under-studied aspects of adaptive stress responses. Herein, we review how the predominant glycosaminoglycan hyaluronan (HA) contributes to the structure and function of the tissue microenvironment. Specifically, we examine the evidence of HA degradation and the generation of biologically active smaller HA fragments in pathological settings in vivo. We discuss how HA fragments versus nascent HA via alternate receptor-mediated signaling influence inflammatory cell recruitment and differentiation, resident cell activation, as well as tumor growth, survival, and metastasis. Finally, we discuss how HA fragmentation impacts restoration of normal tissue function and pathological outcomes in disease. PMID:26029216

A unique case of phaeohyphomycosis subretinal abscess in a patient with arthropathy and lung pathology.

PubMed

Matthews, Bryan J; Partridge, David; Sheard, Richard M; Rennie, Ian G; Mudhar, Hardeep Singh

2013-12-01

A 67-year-old former gold miner with rheumatoid arthritis, treated with steroids and methotrexate, presented to eye casualty with a painful right eye. Examination revealed an anterior uveitis and despite an initial response to topical steroids, the intraocular inflammation worsened with anterior and posterior uveitis development. Re-examination showed a white mass in the peripheral nasal retina initially suspected of being active Toxoplasmosis infection and anti-toxoplasmosis treatment commenced. After improvement and tapering of this treatment, the intraocular inflammation reoccurred. Cytopathological examination of a pars plana vitrectomy obtained vitreous sample that showed a non-diagnostic non-infectious chronic vitritis. The vitreoretinal surgeons elected to do a direct biopsy of the white subretinal mass in the peripheral nasal area. This revealed, quite unexpectedly, an abscess containing pigmented phaeohyphomycosis fungi. This case report documents the multidisciplinary approach that assisted in clinching a final diagnosis and the role of sub-retinal biopsy in this unprecedented scenario.

A unique case of phaeohyphomycosis subretinal abscess in a patient with arthropathy and lung pathology

PubMed Central

Matthews, Bryan J.; Partridge, David; Sheard, Richard M; Rennie, Ian G; Mudhar, Hardeep Singh

2013-01-01

A 67-year-old former gold miner with rheumatoid arthritis, treated with steroids and methotrexate, presented to eye casualty with a painful right eye. Examination revealed an anterior uveitis and despite an initial response to topical steroids, the intraocular inflammation worsened with anterior and posterior uveitis development. Re-examination showed a white mass in the peripheral nasal retina initially suspected of being active Toxoplasmosis infection and anti-toxoplasmosis treatment commenced. After improvement and tapering of this treatment, the intraocular inflammation reoccurred. Cytopathological examination of a pars plana vitrectomy obtained vitreous sample that showed a non-diagnostic non-infectious chronic vitritis. The vitreoretinal surgeons elected to do a direct biopsy of the white subretinal mass in the peripheral nasal area. This revealed, quite unexpectedly, an abscess containing pigmented phaeohyphomycosis fungi. This case report documents the multidisciplinary approach that assisted in clinching a final diagnosis and the role of sub-retinal biopsy in this unprecedented scenario. PMID:24413827

Emerging Themes in Image Informatics and Molecular Analysis for Digital Pathology.

PubMed

Bhargava, Rohit; Madabhushi, Anant

2016-07-11

Pathology is essential for research in disease and development, as well as for clinical decision making. For more than 100 years, pathology practice has involved analyzing images of stained, thin tissue sections by a trained human using an optical microscope. Technological advances are now driving major changes in this paradigm toward digital pathology (DP). The digital transformation of pathology goes beyond recording, archiving, and retrieving images, providing new computational tools to inform better decision making for precision medicine. First, we discuss some emerging innovations in both computational image analytics and imaging instrumentation in DP. Second, we discuss molecular contrast in pathology. Molecular DP has traditionally been an extension of pathology with molecularly specific dyes. Label-free, spectroscopic images are rapidly emerging as another important information source, and we describe the benefits and potential of this evolution. Third, we describe multimodal DP, which is enabled by computational algorithms and combines the best characteristics of structural and molecular pathology. Finally, we provide examples of application areas in telepathology, education, and precision medicine. We conclude by discussing challenges and emerging opportunities in this area.

Emerging Themes in Image Informatics and Molecular Analysis for Digital Pathology

PubMed Central

Bhargava, Rohit; Madabhushi, Anant

2017-01-01

Pathology is essential for research in disease and development, as well as for clinical decision making. For more than 100 years, pathology practice has involved analyzing images of stained, thin tissue sections by a trained human using an optical microscope. Technological advances are now driving major changes in this paradigm toward digital pathology (DP). The digital transformation of pathology goes beyond recording, archiving, and retrieving images, providing new computational tools to inform better decision making for precision medicine. First, we discuss some emerging innovations in both computational image analytics and imaging instrumentation in DP. Second, we discuss molecular contrast in pathology. Molecular DP has traditionally been an extension of pathology with molecularly specific dyes. Label-free, spectroscopic images are rapidly emerging as another important information source, and we describe the benefits and potential of this evolution. Third, we describe multimodal DP, which is enabled by computational algorithms and combines the best characteristics of structural and molecular pathology. Finally, we provide examples of application areas in telepathology, education, and precision medicine. We conclude by discussing challenges and emerging opportunities in this area. PMID:27420575

Intra-articular soft-tissue masses of the ankle. Meniscoid lesions and transarticular fibrous bands.

PubMed

Stienstra, J J

1994-07-01

Meniscoid lesions and fibrous bands are unique lesions, most likely of differing origin. Although they are similar in clinical presentation, their appearance at arthroscopy is clearly different. The meniscoid lesion is attached only at its origin at the inferolateral gutter on the anterior talofibular ligament. Fibrous bands are attached at two ends and may be found anywhere in the joint but are most common extending dramatically over the anterior joint line. Unexpected encountering of a fibrous band should alert the surgeon to carefully inspect the joint for other associated (occult) pathology. Because of the frequent association of bands with antecedent fracture, the observation of this lesion should lead the clinician to consider antecedent intra-articular fracture (transchondral fracture, malleolar fracture, and tibial pilon fracture) as a likely co-pathology. Careful examination of the ankle and review of the radiographs and other available images may be helpful in assessing the joint for these injuries when fibrous bands are encountered. The association of meniscoid lesion with prior soft tissue injury (sprain) is also important to understanding this lesion. Excision of both these abnormal lesions in concert with repair of coexistent pathology is associated with improvement of symptoms. Finally, both fibrous bands and meniscoid lesions are associated with symptoms that warrant closer inspection and observation. Whether the operative intervention is open or closed, the reader can benefit from the information presented.

Pathological examination of cerebral amyloid angiopathy in patients who underwent removal of lobar hemorrhages.

PubMed

Lin, Chien-Min; Arishima, Hidetaka; Kikuta, Ken-Ichiro; Naiki, Hironobu; Kitai, Ryuhei; Kodera, Toshiaki; Matsuda, Ken; Hashimoto, Norichika; Isozaki, Makoto; Tsunetoshi, Kenzo; Neishi, Hiroyuki; Higashino, Yoshifumi; Akazawa, Ayumi; Arai, Hiroshi; Yamada, Shinsuke

2018-03-01

Cerebral amyloid angiopathy (CAA) is a degenerative disorder characterized by amyloid-β (Aβ) deposition in the brain microvessels. CAA is also known to contribute not only to cortical microbleeds but also lobar hemorrhages. This retrospective study examined CAA pathologically in patients who underwent direct surgeries for lobar hemorrhage. Thirty-three patients with lobar hemorrhage underwent open surgery with biopsy from 2007 to 2016 in our hospital. Cortical tissues over hematomas obtained surgically were pathologically examined using hematoxylin, eosin stain, and anti-Aβ antibody to diagnose CAA. We also investigated the advanced degree of CAA and clinical features of each patient with lobar hemorrhage. In the 33 patients, 4 yielded specimens that were insufficient to evaluate CAA pathologically. Twenty-four of the remaining 29 patients (82.8%) were pathologically diagnosed with CAA. The majority of CAA-positive patients had moderate or severe CAA based on a grading scale to estimate the advanced degree of CAA. About half of the CAA-positive patients had hypertension, and four took anticoagulant or antiplatelet agents. In five patients who were not pathologically diagnosed with CAA, one had severe liver function disorder, three had uncontrollable hypertension, and one had no obvious risk factor. Our pathological findings suggest that severe CAA with vasculopathic change markedly contributes to lobar hemorrhage. The coexistence of severe CAA and risk factors such as hypertension, anticoagulants or antiplatelets may readily induce lobar hemorrhage.

The ECVP/ESVP summer school in veterinary pathology: high-standard, structured training for young veterinary pathologists.

PubMed

Kipar, Anja; Aleksandersen, Mona; Benazzi, Cinzia; Hodge, Thomas; Sukura, Antti; Wyers, Monique

2007-01-01

This article describes the ECVP/ESVP Summer School in Veterinary Pathology, a new annual two-week European training facility established by the European College of Veterinary Pathologists (ECVP) in collaboration with the European Society of Veterinary Pathology (ESVP). The aim of the Summer Schools is to provide Europe-wide, harmonized, top-standard theoretical and practical post-graduate training for veterinarians specializing in veterinary pathology. In particular, it aims to support trainees in veterinary pathology in their individual preparation for the ECVP certifying examination. Ultimately, it aims to provide young pathologists with the skills and knowledge necessary to participate in international, high-quality research and the tools for applying international standards to their own research and for independent study for the ECVP certifying examination, even if they do not work in comparable academic environments and do not have the same level of local support and training. The ECVP/ESVP Summer Schools take place in European countries, with local organization from a university department of veterinary pathology. Each event comprises modules provided by internationally recognized specialists in their specific fields of expertise on different organ systems, diseases of specific species, specific techniques, and specific topics relevant to pathology, forming a cycle of four events to cover all major topics. Every two years a mock exam is organized as a tool to monitor individual progress in preparing for the ECVP certifying examination.

Melanocytic nevi and non-neoplastic hyperpigmentations.

PubMed

Clemente, C

2017-06-01

This is the first of three chapters that will be progressively published on Pathologica as updating activity of the Italian Study Group of Dermatopathology (GISD), Italian Society of Pathology and Cytology (SIAPeC IAP). The first chapter concerns non-neoplastic hyperpigmented skin lesions and nevi, the second will address the topics of dysplastic nevus, borderline and low malignant potential melanocytic proliferations and the third melanoma in its variants and differential diagnoses with a supplement on the immunohistochemistry and molecular support to diagnostic and prognostic definition of nevi and melanomas. Although we believe that great advances were made in the application of ancillary genetic, immunohistochemical and molecular techniques, for the diagnosis and biological characterization of melanocytic tumors the morphology still remains the gold standard. These chapters are not intended as substitutes or even claim to be compared to the numerous and valuable texts that are also recently published, but they want to present, concisely and quickly available, all of those traits that we believe essential to the histopathological evaluation of a melanocytic lesion. No morphological parameter is exclusive and individually sufficient to make the correct diagnosis of nevus or melanoma but to reach a final conclusive and appropriate interpretation a set of morphological characters must be evaluated and compared. I was lucky enough to be able to examine several thousand cases and to draw lessons from each of these increasing my diagnostic experience. I had a great lesson by my teacher and good friend Prof. Martin C. Mihm Jr of Boston, dermato-pathologist with undisputed international reputation, who, with great passion, patience and friendship, transferred me much of his experience and knowledge and for which I always thank him. Special thanks I would like to address Dr. Agostino Crupi, dermatologist, skin-oncologist and brilliant dermatoscopist who taught me how the diagnosis of melanocytic lesions starts from the clinic examination and the mutual comparison between dermatologist and pathologist is a great richness of knowledge for both. Finally thank to my collaborators Barbara Rubino, Barbara Bruni and Antonella Festa for the large number of material collected in these years at the Pathology Service of the IRCCS Policlinico San Donato and a particular thank to Marco Turina who collaborated in the drafting of this text. © Copyright Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.

Carcinosarcoma of the Extrahepatic Bile Duct Presenting with Stone-like Radiological Findings.

PubMed

Kumei, Shinsuke; Onishi, Yutaka; Ogura, Takeshi; Kusumoto, Chosei; Matsuno, Yasuko; Nishigami, Takashi; Maeda, Mitsuo; Harada, Masaru

2015-01-01

A 73-year-old woman was referred to our hospital due to epigastralgia and jaundice. The radiological findings showed a stone-like tumor in the extrahepatic bile duct. The patient was initially thought to have adenocarcinoma of the bile duct based on the findings of a pathological examination of the bile duct biopsy specimen and underwent pancreaticoduodenectomy; the final diagnosis of the lesion was so-called carcinosarcoma of the extrahepatic bile duct. She died of liver metastasis six months after the surgery. This case suggests that surgical resection is not adequate for achieving a radical cure, and the optimal treatment for extrahepatic bile duct carcinosarcoma should be established immediately.

Vision rehabilitation in the case of blindness.

PubMed

Veraart, Claude; Duret, Florence; Brelén, Marten; Oozeer, Medhy; Delbeke, Jean

2004-09-01

This article examines the various vision rehabilitation procedures that are available for early and late blindness. Depending on the pathology involved, several vision rehabilitation procedures exist, or are in development. Visual aids are available for low vision individuals, as are sensory aids for blind persons. Most noninvasive sensory substitution prostheses as well as implanted visual prostheses in development are reviewed. Issues dealing with vision rehabilitation are also discussed, such as problems of biocompatibility, electrical safety, psychosocial aspects, and ethics. Basic studies devoted to vision rehabilitation such as simulation in mathematical models and simulation of artificial vision are also presented. Finally, the importance of accurate rehabilitation assessment is addressed, and tentative market figures are given.

Recurrent Scapular Metastasis From Hepatoblastoma Shown on FDG PET/CT and F-DOPA PET/CT.

PubMed

Zhang, Bing; He, Qiao; Shi, Xinchong; Wang, Xiaoyan; Zhang, Xiangsong

2017-10-01

We report the case of a 4-year-old girl with a biochemical relapse (plasma α-fetoprotein of 57,987.6 μg/L) after hepatoblastoma and extrahepatic metastases removal and adjuvant chemotherapy. Abdominal ultrasound, CT, and MRI failed to determine the site of recurrence. F-FDG PET/CT showed increased activity in the region of left scapula and adjacent soft tissue, which was incorrectly interpreted as the postoperative repair or inflammatory change. F-DOPA PET/CT showed increased activity and noticeable progressed lesion in the same place. Finally, the left scapula was identified as the site of recurrent metastasis from hepatoblastoma by pathological examination.

Finding regions of interest in pathological images: an attentional model approach

NASA Astrophysics Data System (ADS)

Gómez, Francisco; Villalón, Julio; Gutierrez, Ricardo; Romero, Eduardo

2009-02-01

This paper introduces an automated method for finding diagnostic regions-of-interest (RoIs) in histopathological images. This method is based on the cognitive process of visual selective attention that arises during a pathologist's image examination. Specifically, it emulates the first examination phase, which consists in a coarse search for tissue structures at a "low zoom" to separate the image into relevant regions.1 The pathologist's cognitive performance depends on inherent image visual cues - bottom-up information - and on acquired clinical medicine knowledge - top-down mechanisms -. Our pathologist's visual attention model integrates the latter two components. The selected bottom-up information includes local low level features such as intensity, color, orientation and texture information. Top-down information is related to the anatomical and pathological structures known by the expert. A coarse approximation to these structures is achieved by an oversegmentation algorithm, inspired by psychological grouping theories. The algorithm parameters are learned from an expert pathologist's segmentation. Top-down and bottom-up integration is achieved by calculating a unique index for each of the low level characteristics inside the region. Relevancy is estimated as a simple average of these indexes. Finally, a binary decision rule defines whether or not a region is interesting. The method was evaluated on a set of 49 images using a perceptually-weighted evaluation criterion, finding a quality gain of 3dB when comparing to a classical bottom-up model of attention.

Risk factors contributing to a poor prognosis of papillary thyroid carcinoma: validity of UICC/AJCC TNM classification and stage grouping.

PubMed

Ito, Yasuhiro; Miyauchi, Akira; Jikuzono, Tomoo; Higashiyama, Takuya; Takamura, Yuuki; Miya, Akihiro; Kobayashi, Kaoru; Matsuzuka, Fumio; Ichihara, Kiyoshi; Kuma, Kanji

2007-04-01

In 2002, the UICC/AJCC TNM classification for papillary thyroid carcinoma was revised. In this study, we examined the validity of this classification system by investigating the predictors of disease-free survival (DFS) and cause-specific survival (CSS) in patients. We examined various clinicopathological features, including the component of the TNM classification, for 1,740 patients who underwent initial and curative surgery for papillary carcinoma between 1987 and 1995. Clinical and pathological T4a, clinical N1b in the TNM classification, and patient age were recognized as independent predictors of not only DFS, but also CSS of patients. Tumor size, male gender, and central node metastasis independently affected DFS only. There were 1,005 pathological N1b patients, but pathological N1b did not independently affect either DFS or CSS. Regarding the stage grouping, clinical stage IVA including clinical N1b more clearly affected DFS and CSS than pathological stage IVA including pathological N1b. Clinical stage grouping was more useful than pathological stage grouping for predicting the prognosis of papillary carcinoma patients possibly because pathological stage overestimates the biological characteristics of many pathological N1b tumors.

Rare presentation of a testicular angiofibroma treated with testis sparing surgery.

PubMed

Leone, Luca; Fulvi, Paola; Sbrollini, Giulia; Filosa, Alessandra; Caraceni, Enrico; Marronaro, Angelo; Galosi, Andrea B

2016-12-30

Testicular benign tumors are very rare (< 5%). Testicular Angiofibroma (AF) is one of those, however the gold standard of treatment and follow-up is still unclear. A 47 years-old man with only one functioning testis was referred to our clinic for a palpable right testicular mass and atrophic contralateral testis. Patient underwent testis-sparing surgery with inguinal approach and intraoperative frozen sections examination with diagnosis of AF. Final histology confirmed AF. Post-operative follow-up was uneventful. Clinical and ultrasonographic follow-up was negative after 8 months. We report a conservative surgery in a patient with AF of the solitary testis. AF is a benign para-testicular fibrous neoplasm that could be misinterpreted as malignant tumor and treated with orchiectomy. Testis-sparing surgery is recommended in this case with intraoperative pathological examination. The excision of the mass is enough but in front of a possible recurrence a long follow-up is advisable.

Erythrocytosis caused by giant chromophobe renal cell carcinoma: a case report indicating a 9-year misdiagnosis of polycythemia vera.

PubMed

Guo, Renbo; Liang, Yiran; Yan, Lei; Xu, Zhonghua; Ren, Juchao

2017-09-06

Erythrocytosis, a rare paraneoplastic syndrome, generally occurs in patients with clear cell renal cell carcinoma and has never been reported in patients with chromophobe renal cell carcinoma. We report a case of a young man suffering from a giant (22-cm) mass on his left kidney. Because of a history of polycythemia vera, the patient had been treated for the condition for 9 years. Radical nephrectomy was successfully performed, and the postoperative pathologic examination confirmed a diagnosis of chromophobe renal cell carcinoma. Unexpectedly, the symptom of erythrocytosis disappeared after the surgery. Further examination and analysis were performed, and we finally attributed his erythrocytosis to chromophobe renal cell carcinoma. Chromophobe renal cell carcinoma could cause erythrocytosis, but the clear-cut mechanism needs further research. Secondary erythrocytosis such as those related with renal tumors should be taken into consideration during the diagnosis of polycythemia vera.

An introduction to data reduction: space-group determination, scaling and intensity statistics.

PubMed

Evans, Philip R

2011-04-01

This paper presents an overview of how to run the CCP4 programs for data reduction (SCALA, POINTLESS and CTRUNCATE) through the CCP4 graphical interface ccp4i and points out some issues that need to be considered, together with a few examples. It covers determination of the point-group symmetry of the diffraction data (the Laue group), which is required for the subsequent scaling step, examination of systematic absences, which in many cases will allow inference of the space group, putting multiple data sets on a common indexing system when there are alternatives, the scaling step itself, which produces a large set of data-quality indicators, estimation of |F| from intensity and finally examination of intensity statistics to detect crystal pathologies such as twinning. An appendix outlines the scoring schemes used by the program POINTLESS to assign probabilities to possible Laue and space groups.

Love, Sex, and Personality Pathology: A Life History View of Personality Pathologies and Sociosexuality.

PubMed

Jonason, Peter K; Zeigler-Hill, Virgil; Hashmani, Talia

2018-05-24

Love and sex are fundamental needs of most people, yet little research has examined such aspects of life in relation to personality pathologies. We examined the associations between pathological personality traits (i.e., negative affectivity, disinhibition, antagonism, psychoticism, and detachment) and sociosexuality (i.e., short-term mating orientation, long-term mating orientation, and sexual behavior) among 702 university students. In addition, we examined the mediating role of life history speed and tested whether sex moderated the associations that these pathological personality traits had with sociosexuality. Detachment, antagonism, disinhibition, and psychoticism had positive associations with short-term mating interests and negative associations with long-term mating interests. Life history speed mediated the associations that detachment and disinhibition had with short-term mating orientation and long-term mating orientation. Although sex did moderate the association that negative affectivity had with previous sexual behavior, we found no evidence that these mediational processes differed between men and women. Results are discussed in terms of the way personality traits shape the sociosexuality of men and women using a life history paradigm.

A Meta-Analysis Examining the Influence of Pro-Eating Disorder Websites on Body Image and Eating Pathology.

PubMed

Rodgers, Rachel F; Lowy, Alice S; Halperin, Daniella M; Franko, Debra L

2016-01-01

Previous research has indicated that exposure to pro-eating disorder websites might increase eating pathology; however, the magnitude of this effect is unknown. This study aimed to conduct a systematic review and meta-analysis to examine the effect of exposure to pro-eating disorder websites on body image and eating pathology. Studies examining the relationship between exposure to pro-eating disorder websites and eating pathology-related outcomes were included. The systematic review identified nine studies. Findings revealed significant effect sizes of exposure to pro-eating disorder websites on body image dissatisfaction (five studies), d = .41, p = .003; dieting (six studies), d = .68, p < .001, and negative affect (three studies), d = 1.00, p < .001. No effect emerged for bulimic symptoms (four studies), d = .22, p = .73. Findings confirmed the effect of pro-eating disorder websites on body image and eating pathology, highlighting the need for enforceable regulation of these websites. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Rectal Carcinoma Model: A Novel Simulation in Pathology Training.

PubMed

Pongpaibul, Ananya; Chiravirakul, Prattana; Leksrisakul, Piyawadee; Silakorn, Phadungsak; Chumtap, Wangcha; Chongpipatchaipron, Somchai; Jaitrong, Peerasak; Jitvichai, Ekachai

2017-06-01

Until now, the apprenticeship training model is used to train pathology residents. Pathology residents are trained using patient specimens that are received during the course of normal daily pathology service. However, this training method could result in inconsistency in knowledge and experience among trainees because of variation in specimens that are received for analysis. The use of simulated specimens in pathology residency training could help ensure that all pathology residents receive consistent knowledge and experience. The aim of this study was to develop prototype rectal carcinoma model to be used as a simulation tool and to evaluate its effectiveness in pathology training. Five units of a prototype rectal carcinoma model were produced in latex rubber. The model was used as a simulation tool for training in 12 pathology residents and 7 pathologist assistants. Pretesting and posttesting of each participant was conducted by multiple choice question test. A questionnaire was also given to study participants to elicit their views regarding the fidelity of the model and the model's efficacy and usefulness relative to the gross examination technique. Among the 19 participants, the mean pretest score was 79.24% and the mean posttest score was 88.54% (P = 0.045). The fidelity of the model was rated as moderate to marked by all participants. Most participants (94.74%) rated the models efficacy and usefulness relative to the gross examination technique as being moderate to marked. The rectal carcinoma model introduced in this study was found to be an effective simulation tool for pathology training. The model had good fidelity on appearance and good efficacy as well as usefulness relative to the gross examination technique.

Tumor size measured by preoperative ultrasonography and postoperative pathologic examination in papillary thyroid carcinoma: relative differences according to size, calcification and coexisting thyroiditis.

PubMed

Yoon, Young Hoon; Kwon, Ki Ryun; Kwak, Seo Young; Ryu, Kyeung A; Choi, Bobae; Kim, Jin-Man; Koo, Bon Seok

2014-05-01

Ultrasonography (US) is a useful diagnostic modality for evaluation of the size and features of thyroid nodules. Tumor size is a key indicator of the surgical extent of thyroid cancer. We evaluated the difference in tumor sizes measured by preoperative US and postoperative pathologic examination in papillary thyroid carcinoma (PTC). We reviewed the medical records of 172 consecutive patients, who underwent thyroidectomy for PTC treatment. We compared tumor size, as measured by preoperative US, with that in postoperative specimens. And we analyzed a number of factors potentially influencing the size measurement, including cancer size, calcification and coexisting thyroiditis. The mean size of the tumor measured by preoperative US was 11.4, and 10.2 mm by postoperative pathologic examination. The mean percentage difference (US-pathology/US) of tumor sizes measured by preoperative US and postoperative pathologic examination was 9.9 ± 19.3%, which was statistically significant (p < 0.001). When the effect of tumor size (≤10.0 vs. 10.1-20.0 vs. >20.0 mm) and the presence of calcification or coexisting thyroiditis on the tumor size discrepancy between the two measurements was analyzed, the mean percentage differences according to tumor size (9.1 vs. 11.2% vs. 9.8%, p = 0.842), calcification (9.2 vs. 10.2%, p = 0.756) and coexisting thyroiditis (17.6 vs. 9.5%, p = 0.223) did not show statistical significance. Tumor sizes measured in postoperative pathology were ~90% of those measured by preoperative US in PTC; this was not affected by tumor size, the presence of calcification or coexisting thyroiditis. When the surgical extent of PTC treatment according to tumor size measured by US is determined, the relative difference between tumor sizes measured by preoperative US and postoperative pathologic examination should be considered.

Quality of life in pathological gamblers in a multiethnic Asian setting.

PubMed

Mythily, Subramaniam; Edimansyah, Abdin; Qiu, Shijia; Munidasa, Winslow

2011-06-01

Few studies have examined the impact of pathological gambling on quality of life especially in the Asian context. The aim of the current study was to examine the quality of life in pathological gamblers in a multiracial population in Singapore and we hypothesised that those with pathological gambling would have poorer quality of life as compared to controls. Forty subjects with "compulsive gambling behaviour" were recruited and matched (for gender and age) with 40 controls. Subjects with pathological gambling were compared with control subjects with regard to sociodemographic data as well as on the World Health Organization Quality of Life assessment - abbreviated version (WHOQOL-BREF). A one-way MANOVA revealed that pathological gamblers had significantly diminished quality of life as compared with the healthy controls using the summary scores of the 4 domains of quality of life (Pillai's Trace = 0.338, F = 9.5, P <0.001). Univariate tests indicated subjects with pathological gambling scored significantly lower on physical health, psychological, social relationships and environment domains of quality of life compared with subjects without pathological gambling. Our study found that those with pathological gambling had lower scores than the controls in all the domains of the quality of life scale. The impact and the extent of pathological gambling on the quality of life should be borne in mind -- not only as a consideration in the management but also as an important indicator of treatment outcome of pathological gamblers.

Imaging-Assisted Large-Format Breast Pathology: Program Rationale and Development in a Nonprofit Health System in the United States

PubMed Central

Tucker, F. Lee

2012-01-01

Modern breast imaging, including magnetic resonance imaging, provides an increasingly clear depiction of breast cancer extent, often with suboptimal pathologic confirmation. Pathologic findings guide management decisions, and small increments in reported tumor characteristics may rationalize significant changes in therapy and staging. Pathologic techniques to grossly examine resected breast tissue have changed little during this era of improved breast imaging and still rely primarily on the techniques of gross inspection and specimen palpation. Only limited imaging information is typically conveyed to pathologists, typically in the form of wire-localization images from breast-conserving procedures. Conventional techniques of specimen dissection and section submission destroy the three-dimensional integrity of the breast anatomy and tumor distribution. These traditional methods of breast specimen examination impose unnecessary limitations on correlation with imaging studies, measurement of cancer extent, multifocality, and margin distance. Improvements in pathologic diagnosis, reporting, and correlation of breast cancer characteristics can be achieved by integrating breast imagers into the specimen examination process and the use of large-format sections which preserve local anatomy. This paper describes the successful creation of a large-format pathology program to routinely serve all patients in a busy interdisciplinary breast center associated with a community-based nonprofit health system in the United States. PMID:23316372

[The importance and possibilities of cognitive reconstructing in the therapy of pathological gambling].

PubMed

Körmendi, Attila

2009-01-01

Cognitive reconstructing is a major component of cognitive and cognitive-behavioural therapies. Cognitive reconstructing means identification and modification of cognitive distortions. Research into this field has shown that cognitive distortions about gambling are clearly implicated in the development and persistence of pathological gambling. This paper outlines the use of cognitive reconstructing for the therapy of pathological gambling. It highlights the type of cognitive distortions most common to this population and outlines the role of semistructured interviews as tool for exploring these distortions. Modification of these beliefs with Socratic dialog is also discussed in the paper. Finally, it describes the studies conducted so far to assess the therapeutic efficacy of cognitive reconstructing in treating pathological gambling.

Postmortem examination of Australian sea snakes ( Hydrophiinae): Anatomy and common pathologic conditions.

PubMed

Gillett, Amber K; Ploeg, Richard; Flint, Mark; Mills, Paul C

2017-09-01

There is limited published information about disease in wild sea snakes and no standardized guideline for postmortem examination of sea snakes. Identifying causes of morbidity and mortality of marine vertebrate species has been pivotal to understanding disease factors implicated in stranding events and assisting with the formulation of conservation plans. Additionally, postmortem findings can provide valuable information on life history traits and the ecology of these reclusive species. Sick, moribund, or dead sea snakes are intermittently washed ashore along Australian and international beaches and provide an opportunity to examine a subset of the population and identify causes of population decline. We present an illustrated description of sea snake anatomy and describe a systematic approach to postmortem examination of sea snakes. We describe common pathologic conditions identified from clinical and postmortem examinations of stranded Australian sea snakes from southeast Queensland. Notable pathologic conditions include traumatic injury, inflammatory conditions, parasitic infections, and neoplasia.

Diagnostic accuracy of shear wave elastography for prediction of breast malignancy in patients with pathological nipple discharge

PubMed Central

Guo, Xiaobo; Liu, Ying; Li, Wanhu

2016-01-01

Objectives Pathological nipple discharge (PND) may indicate malignant breast lesions. As the role of shear wave elastography (SWE) in predicting these malignant lesions has not yet been evaluated, we aim to evaluate the diagnostic value of SWE for this condition. Design Prospective diagnostic accuracy study comparing a combination of qualitative and quantitative measurements of SWE (index test) to a ductoscopy and microdochectomy for histological diagnosis (reference test). Setting Fuzhou General Hospital of Nanjing military command. Participants A total of 379 patients with PND were finally included from January, 2011 to March 2014, after we screened 1084 possible candidates. All participants were evaluated through SWE, with qualitative parameters generated by Virtual Touch tissue imaging (VTI) and quantitative parameters generated by Virtual Touch tissue quantification (VTQ). All the patients were consented to receive a ductoscopy and microdochectomy for histological diagnosis, and the results were set as a reference test. Outcome measures Sensitivity and specificity of the combined VTI and VTQ of the SWE for detection of malignancy in patients with PND. Results The 379 participants presented with 404 lesions. The results of pathological examination showed that 326 (80.7%) of the 404 lesions were benign and the other 78 (19.3%) were malignant. An area under the curve of elasticity score, VTQm and VTQc, were 0.872, 0.825 and 0.857, respectively, with the corresponding cut-off point as 2.50, 2.860 m/s and 3.015 m/s, respectively. After a combination of these measurements, the sensitivity, specificity, and positive and negative predictive value (PPV and NPV), were 89.7%, 72.1%, 43.5% and 96.7%, respectively. The sensitivity analysis showed 82% of the sensitivity and 96.8% of the specificity, in which patients with no pathological findings in ductoscopy were excluded. Conclusions Ultrasonographic elastography is sensitive for patients with PND and could be used as a triage test before ductoscopy examination. Studies for further improvement of diagnostic sensitivity are warranted. PMID:26801462

The role of exercise dependence for the relationship between exercise behavior and eating pathology: mediator or moderator?

PubMed

Cook, Brian J; Hausenblas, Heather A

2008-05-01

Our study examined the potential mediating or moderating effect of exercise dependence on the exercise-eating pathology relationship. Female university students (N = 330) completed Internet-based self-report measures of exercise behavior, exercise dependence, and eating pathology. Exercise dependence served as a mediator for the relationship between exercise and eating pathology. This unidirectional causal model suggests that an individual's pathological motivation or compulsion to exercise is the critical mediating component in the exercise-eating pathology relationship. The best target for removing the link between exercise behavior and eating pathology may be reformulating exercise dependence symptoms.

Data Representation, Coding, and Communication Standards.

PubMed

Amin, Milon; Dhir, Rajiv

2015-06-01

The immense volume of cases signed out by surgical pathologists on a daily basis gives little time to think about exactly how data are stored. An understanding of the basics of data representation has implications that affect a pathologist's daily practice. This article covers the basics of data representation and its importance in the design of electronic medical record systems. Coding in surgical pathology is also discussed. Finally, a summary of communication standards in surgical pathology is presented, including suggested resources that establish standards for select aspects of pathology reporting. Copyright © 2015 Elsevier Inc. All rights reserved.

Anomia-Pathological Verbal Dominance. Agnosic Behavior in Anomia: A Case of Pathological Verbal Dominance

ERIC Educational Resources Information Center

McGlannan, Frances, Ed.

1975-01-01

Summarized are three articles concerned with research on neurological aspects of learning disabilities entitled "Anomia-A Case of Pathological Verbal Dominance;""Brain--Right Hemisphere--Man's So Called 'Minor Hemisphere;""Neurology-A Special Neurological Examination of Children with Learning Disabilities". (DB)

Accuracy of Teledentistry for Diagnosing Dental Pathology Using Direct Examination as a Gold Standard: Results of the Tel-e-dent Study of Older Adults Living in Nursing Homes.

PubMed

Queyroux, Alain; Saricassapian, Bernard; Herzog, Daniel; Müller, Karin; Herafa, Isabelle; Ducoux, Dorothée; Marin, Benoît; Dantoine, Thierry; Preux, Pierre-Marie; Tchalla, Achille

2017-06-01

Dental neglect and high levels of unmet dental needs are becoming increasingly prevalent among elderly residents of long-term care facilities, although frail, elderly, and dependent populations are the most in need of professional dental care. Little is known about the validity of teledentistry for diagnosing dental pathology in nursing home residents. To evaluate the accuracy of teledentistry for diagnosing dental pathology, assessing the rehabilitation status of dental prostheses, and evaluating the chewing ability of older adults living in nursing homes (using direct examination as a gold standard). Multicenter diagnostic accuracy study performed in France and Germany. Eight nursing homes in France and Germany. Nursing home residents with oral or dental complaints, self-reported or reported by caregivers, willing to receive oral or dental preventive care. In total, 235 patients were examined. The mean age was 84.4 ± 8.3 years, and 59.1% of the subjects were female. The patients were examined twice. Each patient was his or her own control. First, the dental surgeon established a diagnosis by reviewing a video recorded in the nursing home and accessed remotely. Second, within a maximum of 7 days, patients were examined conventionally (face-to-face) by the same surgeon who established the initial diagnosis. All residents received a comprehensive clinical examination in their home by a trained geriatrician and underwent a dental hygiene evaluation that used the Silness-Loe and Greene-Vermillion dental hygiene assessment indices. The diagnoses established via the video recording and in the face-to-face setting were compared. The main outcome measure was number of dental pathologies. In total, 128 (55.4%) patients had a dental pathology. The sensitivity of teledentistry for diagnosing dental pathology was 93.8% (95% confidence interval [CI] 90.7-96.9), and the specificity was 94.2% (95% CI 91.2-97.2). Among the 128 cases of dental pathology identified by teledentistry, 6 (4.8%) were false positives. The teledentistry assessments were quicker than the face-to-to-face examinations (12 and 20 minutes, respectively). Teledentistry showed excellent accuracy for diagnosing dental pathology in older adults living in nursing homes; its use may allow more regular checkups to be carried out by dental professionals. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

[Diagnosis of temporo-mandibular joint dysfunction caused by occlusion pathology and treatment of such patients].

PubMed

Semkin, V A; Rabukhina, N A; Kravchenko, D V

2007-01-01

Patients with temporo-mandibular joint (TMJ) dysfunction need complex treatment that includes prosthetic treatment in intrajoint relation stabilization. In cases of TMJ pathology it is necessary to examine patients and make axiography, function analysis, MPI-analysis, magnetic resonance tomography and zonography of TMJ, electromyography of the masticatory muscles. The authors examined 47 patients with TMJ dysfunction, 43 of them had occlusion pathology. We managed to eliminate the dysfunction symptoms and to receive stable result of the treatment in all the patients.

Risk for exercise dependence, eating disorder pathology, alcohol use disorder and addictive behaviors among clients of fitness centers.

PubMed

Müller, Astrid; Loeber, Sabine; Söchtig, Johanna; Te Wildt, Bert; De Zwaan, Martina

2015-12-01

Exercise dependence (EXD) is considered a behavioral addiction that is often associated with eating disorders. To date, only few studies examined the potential overlap between EXD and other addictive behaviors. Therefore, the present study aimed at investigating the relationship of EXD with pathological buying, pathological video gaming (offline and online), hypersexual behavior, and alcohol use disorder in a sample of clients of fitness centers. The following questionnaires were answered by 128 individuals (age M = 26.5, SD = 6.7 years; 71.7% men, 74.2% university students): Exercise Dependence Scale, Eating Disorder Examination-Questionnaire, Compulsive Buying Scale, Pathological Computer-Gaming Scale, Hypersexual Behavior Inventory, and Alcohol Use Disorders Identification Test (AUDIT). 7.8% of the sample were at-risk for EXD, 10.9% reported eating disorder pathology, 2.3% pathological buying, 3.1% hypersexual behavior, and none of the participants suffered from pathological video gaming. The criteria for severe alcohol disorder pathology (AUDIT ≥ 16) were fulfilled by 10.2%. With regard to continuous symptom scores, EXD symptoms were positively correlated with both eating disorder pathology and pathological buying but not with pathological video gaming, hypersexuality or alcohol use disorder. It is noteworthy that more symptoms of pathological buying corresponded with more symptoms of hypersexual behavior. The correlation pattern did not differ by gender. The co-occurrence of EXD, pathological buying and hypersexual behavior on a subclinical level or in the early stage of the disorders should be taken into account when assessing and treating patients. More research is warranted in order to investigate possible interactions between these conditions.

Risk for exercise dependence, eating disorder pathology, alcohol use disorder and addictive behaviors among clients of fitness centers

PubMed Central

Müller, Astrid; Loeber, Sabine; Söchtig, Johanna; Te Wildt, Bert; De Zwaan, Martina

2015-01-01

Background and Aims Exercise dependence (EXD) is considered a behavioral addiction that is often associated with eating disorders. To date, only few studies examined the potential overlap between EXD and other addictive behaviors. Therefore, the present study aimed at investigating the relationship of EXD with pathological buying, pathological video gaming (offline and online), hypersexual behavior, and alcohol use disorder in a sample of clients of fitness centers. Methods The following questionnaires were answered by 128 individuals (age M = 26.5, SD = 6.7 years; 71.7% men, 74.2% university students): Exercise Dependence Scale, Eating Disorder Examination-Questionnaire, Compulsive Buying Scale, Pathological Computer-Gaming Scale, Hypersexual Behavior Inventory, and Alcohol Use Disorders Identification Test (AUDIT). Results 7.8% of the sample were at-risk for EXD, 10.9% reported eating disorder pathology, 2.3% pathological buying, 3.1% hypersexual behavior, and none of the participants suffered from pathological video gaming. The criteria for severe alcohol disorder pathology (AUDIT ≥ 16) were fulfilled by 10.2%. With regard to continuous symptom scores, EXD symptoms were positively correlated with both eating disorder pathology and pathological buying but not with pathological video gaming, hypersexuality or alcohol use disorder. It is noteworthy that more symptoms of pathological buying corresponded with more symptoms of hypersexual behavior. The correlation pattern did not differ by gender. Discussion The co-occurrence of EXD, pathological buying and hypersexual behavior on a subclinical level or in the early stage of the disorders should be taken into account when assessing and treating patients. More research is warranted in order to investigate possible interactions between these conditions. PMID:26690622

TERT, HRAS, and EIF1AX Mutations in a Patient with Follicular Adenoma.

PubMed

Topf, Michael C; Wang, Zi-Xuan; Tuluc, Madalina; Pribitkin, Edmund A

2018-06-01

Molecular markers are increasingly used as diagnostic tools in the management of thyroid nodules. There is a paucity of studies evaluating the prevalence of molecular markers in benign lesions. A 68-year-old woman with hypothyroidism presented with a right thyroid nodule, which was atypia of undetermined significance on cytology. The fine-needle aspirate of the nodule was examined with next-generation sequencing and found to harbor a C228T mutation in the TERT gene, a Q61R mutation in the HRAS gene, and an A113_splice mutation in the EIF1AX gene. Right thyroid lobectomy was performed, with final pathology showing follicular adenoma. All three mutations detected in the original fine-needle aspirate specimen were detected in the final surgical specimen as well. A rare case of TERT, HRAS, and EIF1AX mutations is reported in a patient with follicular adenoma. TERT promoter mutations may be an early genetic event in the molecular pathogenesis of follicular thyroid carcinoma.

EUS-FNA for suspected malignant biliary strictures after negative endoscopic transpapillary brush cytology and forceps biopsy.

PubMed

Ohshima, Yasuhiro; Yasuda, Ichiro; Kawakami, Hiroshi; Kuwatani, Masaki; Mukai, Tsuyoshi; Iwashita, Takuji; Doi, Shinpei; Nakashima, Masanori; Hirose, Yoshinobu; Asaka, Masahiro; Moriwaki, Hisataka

2011-07-01

Endoscopic transpapillary brush cytology and forceps biopsy are widely used for the pathological diagnosis of suspected malignant biliary strictures (MBS). However, the sensitivity of these methods remains insufficient, and it can be difficult to confirm the diagnosis. We aimed to evaluate the diagnostic ability of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and the impact of this technique on clinical management in patients with suspected MBS where endoscopic brush cytology and biopsy yielded negative results. This study included 225 consecutive patients with suspected MBS, who underwent endoscopic brush cytology and biopsy at our institutions. Negative results were obtained for these pathological tests in 75 patients, and EUS-FNA was performed in 22 of these patients. We retrospectively compared the EUS-FNA results with the final diagnosis and examined the influence of the EUS-FNA diagnosis on treatment selection. FNA specimens were successfully obtained in all patients, and the pathological results confirmed malignancy in 16 cases and predicted that the other 6 cases were benign. Of the 6 cases that were suspected to be benign, 3 patients were diagnosed with xanthogranulomatous cholecystitis by surgical pathology, and the remaining 3 patients were diagnosed with benign diseases at a follow-up after 12-18 months. Thus, the EUS-FNA-based diagnosis was proven correct for all the patients. In addition, the treatment strategy was altered as a result of the EUS-FNA results in the above 6 patients (27%). EUS-FNA is a sensitive and safe diagnostic modality for patients with suspected MBS and can be an additional option in cases where endoscopic brush cytology and biopsy have produced negative results.

ASCCP Colposcopy Standards: Role of Colposcopy, Benefits, Potential Harms, and Terminology for Colposcopic Practice.

PubMed

Khan, Michelle J; Werner, Claudia L; Darragh, Teresa M; Guido, Richard S; Mathews, Cara; Moscicki, Anna-Barbara; Mitchell, Martha M; Schiffman, Mark; Wentzensen, Nicolas; Massad, L Stewart; Mayeaux, E J; Waxman, Alan G; Conageski, Christine; Einstein, Mark H; Huh, Warner K

2017-10-01

The American Society for Colposcopy and Cervical Pathology Colposcopy Standards address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. Working Group 1 was tasked with defining the role of colposcopy, describing benefits and potential harms, and developing an official terminology. A systematic literature review was performed. A national survey of American Society for Colposcopy and Cervical Pathology members provided input on current terminology use. The 2011 International Federation for Cervical Pathology and Colposcopy terminology was used as a template and modified to fit colposcopic practice in the United States. For areas without data, expert consensus guided the recommendation. Draft recommendations were posted online for public comment and presented at an open session of the 2017 International Federation for Cervical Pathology and Colposcopy World Congress for further comment. All comments were considered for the final version. Colposcopy is used in the evaluation of abnormal or inconclusive cervical cancer screening tests. Colposcopy aids the identification of cervical precancers that can be treated, and it allows for conservative management of abnormalities unlikely to progress. The potential harms of colposcopy include pain, psychological distress, and adverse effects of the procedure. A comprehensive colposcopy examination should include documentation of cervix visibility, squamocolumnar junction visibility, presence of acetowhitening, presence of a lesion(s), lesion(s) visibility, size and location of lesions, vascular changes, other features of lesion(s), and colposcopic impression. Minimum criteria for reporting include squamocolumnar junction visibility, presence of acetowhitening, presence of a lesion(s), and colposcopic impression. A recommended terminology for use in US colposcopic practice was developed, with comprehensive and minimal criteria for reporting.

Corticobasal degeneration initially developing motor versus non-motor symptoms: a comparative clinicopathological study.

PubMed

Ikeda, Chikako; Yokota, Osamu; Nagao, Shigeto; Ishizu, Hideki; Morisada, Yumi; Terada, Seishi; Nakashima, Yoshihiko; Akiyama, Haruhiko; Uchitomi, Yosuke

2014-09-01

Clinical presentations of pathologically confirmed corticobasal degeneration (CBD) vary, and the heterogeneity makes its clinical diagnosis difficult, especially when a patient lacks any motor disturbance in the early stage. We compared clinical and pathological features of four pathologically confirmed CBD cases that initially developed non-motor symptoms, including behavioural and psychiatric symptoms but without motor disturbance (CBD-NM), and five CBD cases that initially developed parkinsonism and/or falls (CBD-M). The age range at death for the CBD-NM and CBD-M subjects (58-85 years vs 45-67 years) and the range of disease duration (2-18 years vs 2-6 years) did not significantly differ between the groups. Prominent symptoms in the early stage of CBD-NM cases included self-centred behaviours such as frontotemporal dementia (n = 1), apathy with and without auditory hallucination (n = 2), and aggressive behaviours with delusion and visual hallucination (n = 1). Among the four CBD-NM cases, only one developed asymmetric motor disturbance, and two could walk without support throughout the course. Final clinical diagnoses of the CBD-NM cases were frontotemporal dementia (n = 2), senile psychosis with delirium (n = 1), and schizophrenia (n = 1). Neuronal loss was significantly less severe in the subthalamic nucleus and substantia nigra in the CBD-NM cases than in the CBD-M cases. The severity of tau pathology in all regions examined was comparable in the two groups. CBD cases that initially develop psychiatric and behavioural changes without motor symptoms may have less severe degenerative changes in the subthalamic nucleus and substantia nigra, and some CBD cases can lack motor disturbance not only in the early stage but also in the last stage of the course. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

Neuropathological and transcriptomic characteristics of the aged brain

PubMed Central

Miller, Jeremy A; Guillozet-Bongaarts, Angela; Gibbons, Laura E; Postupna, Nadia; Renz, Anne; Beller, Allison E; Sunkin, Susan M; Ng, Lydia; Rose, Shannon E; Smith, Kimberly A; Szafer, Aaron; Barber, Chris; Bertagnolli, Darren; Bickley, Kristopher; Brouner, Krissy; Caldejon, Shiella; Chapin, Mike; Chua, Mindy L; Coleman, Natalie M; Cudaback, Eiron; Cuhaciyan, Christine; Dalley, Rachel A; Dee, Nick; Desta, Tsega; Dolbeare, Tim A; Dotson, Nadezhda I; Fisher, Michael; Gaudreault, Nathalie; Gee, Garrett; Gilbert, Terri L; Goldy, Jeff; Griffin, Fiona; Habel, Caroline; Haradon, Zeb; Hejazinia, Nika; Hellstern, Leanne L; Horvath, Steve; Howard, Kim; Howard, Robert; Johal, Justin; Jorstad, Nikolas L; Josephsen, Samuel R; Kuan, Chihchau L; Lai, Florence; Lee, Eric; Lee, Felix; Lemon, Tracy; Li, Xianwu; Marshall, Desiree A; Melchor, Jose; Mukherjee, Shubhabrata; Nyhus, Julie; Pendergraft, Julie; Potekhina, Lydia; Rha, Elizabeth Y; Rice, Samantha; Rosen, David; Sapru, Abharika; Schantz, Aimee; Shen, Elaine; Sherfield, Emily; Shi, Shu; Sodt, Andy J; Thatra, Nivretta; Tieu, Michael; Wilson, Angela M; Montine, Thomas J; Larson, Eric B; Bernard, Amy; Crane, Paul K; Ellenbogen, Richard G

2017-01-01

As more people live longer, age-related neurodegenerative diseases are an increasingly important societal health issue. Treatments targeting specific pathologies such as amyloid beta in Alzheimer’s disease (AD) have not led to effective treatments, and there is increasing evidence of a disconnect between traditional pathology and cognitive abilities with advancing age, indicative of individual variation in resilience to pathology. Here, we generated a comprehensive neuropathological, molecular, and transcriptomic characterization of hippocampus and two regions cortex in 107 aged donors (median = 90) from the Adult Changes in Thought (ACT) study as a freely-available resource (http://aging.brain-map.org/). We confirm established associations between AD pathology and dementia, albeit with increased, presumably aging-related variability, and identify sets of co-expressed genes correlated with pathological tau and inflammation markers. Finally, we demonstrate a relationship between dementia and RNA quality, and find common gene signatures, highlighting the importance of properly controlling for RNA quality when studying dementia. PMID:29120328

Pathological gambling in Estonia: relationships with personality, self-esteem, emotional States and cognitive ability.

PubMed

Kaare, Pille-Riin; Mõttus, René; Konstabel, Kenn

2009-09-01

Due to changes in gambling accessibility during the last decade gambling has become more widespread in Estonia and the prevalence of pathological gambling has sharply increased. The present study attempts to identify psychological characteristics of Estonian pathological gamblers. It has been shown that a wide range of social, economic, and individual factors (e.g. personality traits and emotional states) predict the likelihood of becoming a pathological gambler. In the present study, pathological gamblers' (N = 33) personality traits, self-esteem, self-reported emotional states and cognitive ability were compared to the respective characteristics in a non-gambling control group (N = 42) matched for age, gender and educational level. It was found that compared to controls, pathological gamblers had higher scores on Neuroticism (especially on its immoderation facet) and lower scores on Conscientiousness (especially on its dutifulness and cautiousness facets) and on self-esteem scale. They reported more negative emotional states during the previous month (especially depression and anxiety). Finally, pathological gamblers had lower general cognitive ability. In a logistic regression model, the likelihood of being a pathological gambler was best predicted by high immoderation score and low cognitive ability.

Virtual microscopy and digital pathology in training and education.

PubMed

Hamilton, Peter W; Wang, Yinhai; McCullough, Stephen J

2012-04-01

Traditionally, education and training in pathology has been delivered using textbooks, glass slides and conventional microscopy. Over the last two decades, the number of web-based pathology resources has expanded dramatically with centralized pathological resources being delivered to many students simultaneously. Recently, whole slide imaging technology allows glass slides to be scanned and viewed on a computer screen via dedicated software. This technology is referred to as virtual microscopy and has created enormous opportunities in pathological training and education. Students are able to learn key histopathological skills, e.g. to identify areas of diagnostic relevance from an entire slide, via a web-based computer environment. Students no longer need to be in the same room as the slides. New human-computer interfaces are also being developed using more natural touch technology to enhance the manipulation of digitized slides. Several major initiatives are also underway introducing online competency and diagnostic decision analysis using virtual microscopy and have important future roles in accreditation and recertification. Finally, researchers are investigating how pathological decision-making is achieved using virtual microscopy and modern eye-tracking devices. Virtual microscopy and digital pathology will continue to improve how pathology training and education is delivered. © 2012 The Authors APMIS © 2012 APMIS.

Interpersonal perception of pathological narcissism: a social relations analysis.

PubMed

Lukowitsky, Mark R; Pincus, Aaron L

2013-01-01

Impairments in self and interpersonal functioning are core features of personality pathology. Clinical theory and research indicate that compromised self-awareness and distorted interpersonal perceptions are particularly prominent in individuals exhibiting pathological narcissism and Narcissistic Personality Disorder. Therefore we conducted a study to gain a better understanding of interpersonal perception of pathological narcissism. A large sample (N=437) of moderately acquainted individuals assigned to 1 of 93 small mixed-sex groups completed self- and informant ratings on the Pathological Narcissism Inventory (PNI) in a round-robin design. The social relations model (SRM) was used to partition the variance in dyadic ratings to investigate several hypotheses about interpersonal perception of pathological narcissism. SRM analyses demonstrated evidence of assimilation (the tendency to perceive and rate others similarly) and consensus (the extent to which multiple observers form similar impressions of another person) in interpersonal perception of pathological narcissism. Results also indicated modest self-other agreement and assumed similarity (the tendency for people to perceive others as similar to themselves) for PNI higher order factors and subscale ratings. Finally, results suggested that individuals high in pathological narcissism had some awareness of how peers would rate them (metaperception) but believed that others would rate them similarly to how they rated themselves.

Pathological Dissociation as Measured by the Child Dissociative Checklist

ERIC Educational Resources Information Center

Wherry, Jeffrey N.; Neil, Debra A.; Taylor, Tamara N.

2009-01-01

The component structure of the Child Dissociative Checklist was examined among abused children. A factor described as pathological dissociation emerged that was predicted by participants being male. There also were differences in pathological dissociation between groups of sexually abused and physically abused children. Replication of this factor…

Integration of Traditional and E-Learning Methods to Improve Learning Outcomes for Dental Students in Histopathology.

PubMed

Ariana, Armin; Amin, Moein; Pakneshan, Sahar; Dolan-Evans, Elliot; Lam, Alfred K

2016-09-01

Dental students require a basic ability to explain and apply general principles of pathology to systemic, dental, and oral pathology. Although there have been recent advances in electronic and online resources, the academic effectiveness of using self-directed e-learning tools in pathology courses for dental students is unclear. The aim of this study was to determine if blended learning combining e-learning with traditional learning methods of lectures and tutorials would improve students' scores and satisfaction over those who experienced traditional learning alone. Two consecutive cohorts of Bachelor of Dentistry and Oral Health students taking the general pathology course at Griffith University in Australia were compared. The control cohort experienced traditional methods only, while members of the study cohort were also offered self-directed learning materials including online resources and online microscopy classes. Final assessments for the course were used to compare the differences in effectiveness of the intervention, and students' satisfaction with the teaching format was evaluated using questionnaires. On the final course assessments, students in the study cohort had significantly higher scores than students in the control cohort (p<0.01). Analysis of questionnaire results showed improved student satisfaction with the course in the study cohort. These findings suggest that the use of e-learning tools such as virtual microscopy and interactive online resources for delivering pathology instruction can be an effective supplement for developing dental students' competence, confidence, and satisfaction.

Effectiveness of Implemented Interventions on Pathologic Nodal Staging of Non-Small Cell Lung Cancer.

PubMed

Ray, Meredith A; Faris, Nicholas R; Smeltzer, Matthew P; Fehnel, Carrie; Houston-Harris, Cheryl; Levy, Paul; Wiggins, Lynn; Sachdev, Vishal; Robbins, Todd; Spencer, David; Osarogiagbon, Raymond U

2018-03-10

Accurate pathologic nodal staging improves early-stage non-small-cell lung cancer survival. In an ongoing implementation study, we measured the impact of a surgical lymph node specimen collection kit and a more thorough pathologic gross dissection method, on attainment of guideline-recommended pathologic nodal staging quality. We prospectively collected data on curative-intent non-small cell lung cancer resections from 2009-2016 from 11 hospitals in 4 contiguous Dartmouth Hospital Referral Regions. We categorized patients into 4 groups based on exposure to the two interventions in our staggered implementation study design. We used Chi-squared tests to examine the differences in demographic and disease characteristics and surgical quality criteria across implementation groups. Of 2,469 patients, 1,615 (65%) received neither intervention; 167 (7%) received only the pathology intervention; 264 (11%) received only the surgery intervention; 423 (17%) had both. Rates of non-examination of lymph nodes reduced sequentially in the order of no intervention, novel dissection, kit, and combined interventions, including non-examination of: any lymph nodes, hilar/intrapulmonary and mediastinal nodes (p<0.001 for all comparisons). The rates of attainment of National Comprehensive Cancer Network, Commission on Cancer, American Joint Committee on Cancer, and American College of Surgeons Oncology Group guidelines increased significantly in the same sequential order (p<0.001 for all comparisons). The combined effect of two interventions to improve pathologic lymph node examination has a greater effect on attainment of a range of surgical quality criteria than either intervention alone. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics.

PubMed

Mota de Almeida, F J; Knutsson, K; Flygare, L

2014-01-01

The aim was to assess to what extent cone beam CT (CBCT) used in accordance with current European Commission guidelines in a normal clinical setting has an impact on therapeutic decisions in a population referred for endodontic problems. The study includes data of consecutively examined patients collected from October 2011 to December 2012. From 2 different endodontic specialist clinics, 57 patients were referred for a CBCT examination using criteria in accordance with current European guidelines. The CBCT examinations were performed using similar equipment and standardized among clinics. After a thorough clinical examination, but before CBCT, the examiner made a preliminary therapy plan which was recorded. After the CBCT examination, the same examiner made a new therapy plan. Therapy plans both before and after the CBCT examination were plotted for 53 patients and 81 teeth. As four patients had incomplete protocols, they were not included in the final analysis. 4% of the patients referred to endodontic clinics during the study period were examined with CBCT. The most frequent reason for referral to CBCT examination was to differentiate pathology from normal anatomy, this was the case in 24 patients (45% of the cases). The primary outcome was therapy plan changes that could be attributed to CBCT examination. There were changes in 28 patients (53%). CBCT has a significant impact on therapeutic decision efficacy in endodontics when used in concordance with the current European Commission guidelines.

Can a Modified Bosniak Classification System Risk Stratify Pediatric Cystic Renal Masses?

PubMed

Saltzman, Amanda F; Carrasco, Alonso; Colvin, Alexandra N; Meyers, Mariana L; Cost, Nicholas G

2018-03-20

We characterize and apply the modified Bosniak classification system to a cohort of children with cystic renal lesions and known surgical pathology. We identified all patients at our institution with cystic renal masses who also underwent surgery for these lesions. Patients without available preoperative imaging or pathology were excluded. All radiological imaging was independently reviewed by a pediatric radiologist blinded to pathological findings. Imaging characteristics (size, border, septations, calcifications, solid components, vascularity) were recorded from the most recent preoperative ultrasounds and computerized tomograms. The modified Bosniak classification system was applied to these scans and then correlated with final pathology. A total of 22 patients met study criteria. Median age at surgery was 6.1 years (range 11 months to 16.8 years). Of the patients 12 (54.5%) underwent open nephrectomy, 6 (27.3%) open partial nephrectomy, 2 (9.1%) laparoscopic cyst decortication, 1 (4.5%) open renal biopsy and 1 (4.5%) laparoscopic partial nephrectomy. Final pathology was benign in 9 cases (41%), intermediate in 6 (27%) and malignant in 7 (32%). All malignant lesions were modified Bosniak class 4, all intermediate lesions were modified class 3 or 4 and 8 of 9 benign lesions (89%) were modified class 1 or 2. Cystic renal lesions in children with a modified Bosniak class of 1 or 2 were most often benign, while class 3 or 4 lesions warranted surgical excision since more than 90% of masses harbored intermediate or malignant pathology. The modified Bosniak classification system appears to allow for a reasonable clinical risk stratification of pediatric cystic renal masses. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Augmented Reality Technology Using Microsoft HoloLens in Anatomic Pathology.

PubMed

Hanna, Matthew G; Ahmed, Ishtiaque; Nine, Jeffrey; Prajapati, Shyam; Pantanowitz, Liron

2018-05-01

Context Augmented reality (AR) devices such as the Microsoft HoloLens have not been well used in the medical field. Objective To test the HoloLens for clinical and nonclinical applications in pathology. Design A Microsoft HoloLens was tested for virtual annotation during autopsy, viewing 3D gross and microscopic pathology specimens, navigating whole slide images, telepathology, as well as real-time pathology-radiology correlation. Results Pathology residents performing an autopsy wearing the HoloLens were remotely instructed with real-time diagrams, annotations, and voice instruction. 3D-scanned gross pathology specimens could be viewed as holograms and easily manipulated. Telepathology was supported during gross examination and at the time of intraoperative consultation, allowing users to remotely access a pathologist for guidance and to virtually annotate areas of interest on specimens in real-time. The HoloLens permitted radiographs to be coregistered on gross specimens and thereby enhanced locating important pathologic findings. The HoloLens also allowed easy viewing and navigation of whole slide images, using an AR workstation, including multiple coregistered tissue sections facilitating volumetric pathology evaluation. Conclusions The HoloLens is a novel AR tool with multiple clinical and nonclinical applications in pathology. The device was comfortable to wear, easy to use, provided sufficient computing power, and supported high-resolution imaging. It was useful for autopsy, gross and microscopic examination, and ideally suited for digital pathology. Unique applications include remote supervision and annotation, 3D image viewing and manipulation, telepathology in a mixed-reality environment, and real-time pathology-radiology correlation.

The use of ultrasound in the assessment of the glenoid labrum of the glenohumeral joint. Part II: Examples of labral pathologies.

PubMed

Krzyżanowski, Wojciech; Tarczyńska, Marta

2012-09-01

Labral pathologies of the glenohumeral joint are most commonly caused by trauma. The majority of lesions affect the anterior part of labrum, resulting from much higher frequency of anterior shoulder dislocations over posterior ones. Another subgroup of labral lesions, not directly related to joint instability, are SLAP tears. Other findings include degenerative changes of labrum and paralabral cysts. Diagnostic imaging is crucial for making a decision regarding operative treatment. Apart from a standard X-ray examination, the imaging mainly relies on magnetic resonance or computed tomography arthrography. Based on their own experience, the authors propose the use of ultrasound in the assessment of labral tears of the glenohumeral joint. Different signs indicating labral pathology may be discovered and assessed during ultrasound examination. They include permanent displacement of the labrum onto the glenoid, labral instability during dynamic examination, lack of the labrum in the anatomical position, hypoechoic zone at the base of the labrum >2 mm in width, residual or swollen labrum as well as paralabral cyst(s). The most frequent appearance of labral pathology is displacement of the anteroinferior labrum onto the external aspect of the glenoid typically seen after anterior shoulder dislocation. The another most important US feature is labral instability while dynamically examined. The swelling or reduced size of the labrum usually indicates degeneration. This article presents sonographic images of selected labral pathologies.

Behavioral Treatment for Pathological Gambling in Persons with Acquired Brain Injury

ERIC Educational Resources Information Center

Guercio, John M.; Johnson, Taylor; Dixon, Mark R.

2012-01-01

The present investigation examined a behavior-analytic clinical treatment package designed to reduce the pathological gambling of 3 individuals with acquired brain injury. A prior history of pathological gambling of each patient was assessed via caregiver report, psychological testing, and direct observation of gambling behavior. Using an 8-week…

Early Experience after Developing a Pathology Laboratory in Malawi, with Emphasis on Cancer Diagnoses

PubMed Central

Horner, Marie-Josephe; Shores, Carol G.; Alide, Noor; Kamiza, Steve; Kampani, Coxcilly; Chimzimu, Fred; Fedoriw, Yuri; Dittmer, Dirk P.; Hosseinipour, Mina C.; Hoffman, Irving F.

2013-01-01

Background Despite increasing cancer burden in Malawi, pathology services are limited. We describe operations during the first 20 months of a new pathology laboratory in Lilongwe, with emphasis on cancer diagnoses. Methods and Findings We performed a cross-sectional study of specimens from the Kamuzu Central Hospital pathology laboratory between July 1, 2011 and February 28, 2013. Patient and specimen characteristics, and final diagnoses are summarized. Diagnoses were categorized as malignant, premalignant, infectious, other pathology, normal or benign, or nondiagnostic. Patient characteristics associated with premalignancy and malignancy were assessed using logistic regression. Of 2772 specimens, 2758 (99%) with a recorded final diagnosis were included, drawn from 2639 unique patients. Mean age was 38 years and 63% were female. Of those with documented HIV status, 51% had unknown status, and 36% with known status were infected. Histologic specimens comprised 91% of cases, and cytologic specimens 9%. Malignant diagnoses were most common overall (n = 861, 31%). Among cancers, cervical cancer was most common (n = 117, 14%), followed by lymphoma (n = 91, 11%), esophageal cancer (n = 86, 10%), sarcoma excluding Kaposi sarcoma (n = 75, 9%), and breast cancer (n = 61, 7%). HIV status was known for 95 (11%) of malignancies, with HIV prevalence ranging from 9% for breast cancer to 81% for cervical cancer. Increasing age was consistently associated with malignancy [bivariable odds ratio 1.24 per decade increase (95% CI 1.19–1.29) among 2685 patients with known age; multivariable odds ratio 1.33 per decade increase (95% CI 1.14–1.56) among 317 patients with known age, gender, and HIV status], while HIV infection and gender were not. Conclusions Despite selection and referral bias inherent in these data, a new pathology laboratory in Lilongwe has created a robust platform for cancer care and research. Strategies to effectively capture clinical information for pathologically confirmed cancers can allow these data to complement population-based registration. PMID:23950924

System for pathology categorization and retrieval in chest radiographs

NASA Astrophysics Data System (ADS)

Avni, Uri; Greenspan, Hayit; Konen, Eli; Sharon, Michal; Goldberger, Jacob

2011-03-01

In this paper we present an overview of a system we have been developing for the past several years for efficient image categorization and retrieval in large radiograph archives. The methodology is based on local patch representation of the image content, using a bag of visual words approach and similarity-based categorization with a kernel based SVM classifier. We show an application to pathology-level categorization of chest x-ray data, the most popular examination in radiology. Our study deals with pathology detection and identification of individual pathologies including right and left pleural effusion, enlarged heart and cases of enlarged mediastinum. The input from a radiologist provided a global label for the entire image (healthy/pathology), and the categorization was conducted on the entire image, with no need for segmentation algorithms or any geometrical rules. An automatic diagnostic-level categorization, even on such an elementary level as healthy vs pathological, provides a useful tool for radiologists on this popular and important examination. This is a first step towards similarity-based categorization, which has a major clinical implications for computer-assisted diagnostics.

Risk of incident clinical diagnosis of AD-type dementia attributable to pathology-confirmed vascular disease

PubMed Central

Dodge, Hiroko H.; Zhu, Jian; Woltjer, Randy; Nelson, Peter T.; Bennett, David A.; Cairns, Nigel J.; Fardo, David W.; Kaye, Jeffrey A.; Lyons, Deniz-Erten; Mattek, Nora; Schneider, Julie A; Silbert, Lisa C.; Xiong, Chengjie; Yu, Lei; Schmitt, Frederick A.; Kryscio, Richard J.; Abner, Erin L.

2016-01-01

Introduction Presence of cerebrovascular pathology may increase the risk of clinical diagnosis of AD. Methods We examined excess risk of incident clinical diagnosis of AD (probable and possible AD) posed by the presence of lacunes and large infarcts beyond AD pathology using data from the Statistical Modelling of Aging and Risk of Transition (SMART) study, a consortium of longitudinal cohort studies with over 2000 autopsies. We created six mutually exclusive pathology patterns combining three levels of AD pathology (low, moderate or high AD pathology) and two levels of vascular pathology (without lacunes and large infarcts or with lacunes and/or large infarcts). Results The coexistence of lacunes and large infarcts results in higher likelihood of clinical diagnosis of AD only when AD pathology burden is low. Discussion Our results reinforce the diagnostic importance of AD pathology in clinical AD. Further harmonization of assessment approaches for vascular pathologies is required. PMID:28017827

Relationship between thoracic auscultation and lung pathology detected by ultrasonography in sheep.

PubMed

Scott, Phil; Collie, Dave; McGorum, Bruce; Sargison, Neil

2010-10-01

The utility of routine auscultation to detect and characterise the nature of a range of superficial lung and pleural pathologies in domestic sheep was assessed using ultrasonographic examination to indicate and localise pathologies pre-mortem. Necropsy examination was then used to fully characterise the nature and extent of the lesions. Auscultation recordings were made from 10 normal sheep with no clinical evidence of respiratory disease and with absence of significant superficial lung pathology, which was confirmed initially by ultrasound examination and subsequently at necropsy examination. A further two sheep with endotoxaemia and 30 sheep with well-defined lung lesions were also examined. Increased audibility of normal lung sounds in 4/10 normal sheep was associated with tachypnoea as a consequence of handling and transport during hot weather and was also observed in the two sheep with endotoxaemia. Moderate to severe coarse crackles detected in all advanced cases of ovine pulmonary adenocarcinoma (n=16) were audible over an area larger than the lesion distribution identified during ultrasound examination, and confirmed later at necropsy. Auscultation did not detect abnormal sounds in any of the five sheep with focal pleural abscesses (up to 10 cm diameter). Unilateral pyothorax caused attenuation of sounds relative to the contra-lateral normal lung in all three sheep with this condition. Marked fibrinous pleurisy caused attenuation of sounds relative to normal areas of lung in six sheep. No sounds resembling the description of pleural frictions rubs were heard in the sheep with marked fibrinous pleurisy (n=6) or associated with focal pleural abscesses (n=5). Routine interpretation of auscultated sound did not allow the presence of superficial lung pathology or its distribution to be accurately defined in the respiratory diseases represented in this study. Copyright © 2009 Elsevier Ltd. All rights reserved.

[Analysis of the diagnosis and treatment of desmoplastic small round cell tumor].

PubMed

Lu, Baojian; Zhang, Wei; Shang, Zhiqun; Sun, Erlin; Nian, Xuewu; Gao, Jingda; Ma, Chengquan; Han, Ruifa

2015-09-01

To explore the clinical diagnostic features and treatment of desmoplastic small round cell tumor (DSRCT), and to improve the understanding and management of this tumor. The clinicopathological data of nine patients treated in our hospital from October 2004 to June 2014 were retrospectively analyzed and a review of the literature was made. The clinical manifestations, pathological characteristics, diagnosis and differential diagnosis, treatment and prognosis of this tumor were summarized and analyzed. Nine patients with DSRCT, 5 males and 4 females, with an average age of 21 years (range 8-56 years) were included in this study. Ultrasound examination revealed irregular low-density mass shadow in the abdominal cavity. CT examination found that 6 cases had abdominal and retroperitoneal multiple solid tumor nodules, uneven density, and visible low density fluid area. Postoperative pathological examination revealed that the tumor cells were small, mostly elliptic, gathered to form clear structure of nests with clear irregular boundaries. The central portion of large tumor nests often showed necrosis. Scattered fibroblasts and large amount of hyalinization of collagen fibers were seen in the interstitial tissue around the nests. Six patients received laparotomy surgery, however, all failed to resect the tumor completely. Three patients received postoperative chemotherapy, i. e. two cases had carboplatin and paclitaxel chemotherapy, and one case of chemotherapy regimen not specified. Two patients had radiation and chemotherapy (no concrete plan was available). Another case was lost to follow-up. Two of the three patients without surgery received chemotherapy with CAP (cyclophosphamide+adriamycin+carboplatin) and total rectal lesions, pelvic and inguinal lymph nodes, ilium metastases radiation therapy. Another one patient received EP regimen (DDP+VP16) which was then changed into a TP chemotherapy alone. Eight of the nine cases died shortly after surgery, and only one patient treated with chemotherapy alone was still alive after 11 months of follow-up. Desmoplastic small round cell tumor is a very rare, special type of soft tissue tumor, with very poor prognosis. This tumor may be preliminarily diagnosed according to the imaging characteristics and detection of tumor markers, however, final diagnosis is made by pathology. Surgery is the priority of treatment, combined with complementary radiation and chemotherapy.

[Pancreatic serous cystadenoma associated with pancreatic heterotopia].

PubMed

Mohamed, Hedfi; Dorra, Belghachem; Hela, Bouhafa; Cherif, Abdelhedi; Azza, Sridi; Karim, Sassi; Khadija, Bellil; Adnen, Chouchene

2016-01-01

Pancreatic heterotopias (HP) are rare. They can occur at any age with a slight male predominance. These lesions are usually asymptomatic and they are often found incidentally during upper or lower GI endoscopy or during the anatomo-pathological examination of an organ which was resected for other reasons; they can be isolated or associated with a digestive pathology. We report, through observation, the association of HP with serous cystadenoma of the pancreas discovered during examinations to identify the etiology of isolated abdominal pain. The aim of this study is to analyse clinical and histological features of this rare pathology.

Drug abuse: consequences in terms of family pathology and disintegration.

PubMed

Visser, L

1991-01-01

This article examines some of the consequences of drug addiction in terms of family pathology and family disintegration. It briefly elucidates the role of the family in developing and maintaining drug addiction in family members. The concept of 'secondary' sufferers of the illness of drug addiction is examined. An actual case history will be presented in order to facilitate analysis of some of the forms of pathology and disintegration so often seen in the family of the drug addict. Within the family context, the question of who, if anyone, is the victim of drug addiction, is raised.

Common threads in cardiac fibrosis, infarct scar formation, and wound healing.

PubMed

Czubryt, Michael P

2012-11-01

Wound healing, cardiac fibrosis, and infarct scar development, while possessing distinct features, share a number of key functional similarities, including extracellular matrix synthesis and remodeling by fibroblasts and myofibroblasts. Understanding the underlying mechanisms that are common to these processes may suggest novel therapeutic approaches for pathologic situations such as fibrosis, or defective wound healing such as hypertrophic scarring or keloid formation. This manuscript will briefly review the major steps of wound healing, and will contrast this process with how cardiac infarct scar formation or interstitial fibrosis occurs. The feasibility of targeting common pro-fibrotic growth factor signaling pathways will be discussed. Finally, the potential exploitation of novel regulators of wound healing and fibrosis (ski and scleraxis), will be examined.

Clinical findings, rhinoscopy and histological evaluation of 54 dogs with chronic nasal disease.

PubMed

Pietra, Marco; Spinella, Giuseppe; Pasquali, Flavio; Romagnoli, Noemi; Bettini, Giuliano; Spadari, Alessandro

2010-09-01

Nasal diseases are very common in dogs and rhinoscopy is often required for a definitive diagnosis. Rhinoscopy, while superficial in nature, can guide the clinician to the final diagnosis. In this study, rhinoscopy was performed on 54 dogs with symptoms of chronic nasopharyngeal disease. The endoscopic diagnosis of neoplasia or chronic nasal inflammation was validated with histological examination of pathological samples, in order to evaluate the degree of concordance between endoscopic findings and histological diagnosis. The agreement between endoscopy and histology was tested by application of Cohen's kappa coefficient. We conclude that correlation between endoscopic results and histological diagnosis, expressed by a Cohen's kappa coefficient of 0.73, is only possible with a constant cooperation between the clinician and the pathologist.

The lower cranial nerves: IX, X, XI, XII.

PubMed

Sarrazin, J-L; Toulgoat, F; Benoudiba, F

2013-10-01

The lower cranial nerves innervate the pharynx and larynx by the glossopharyngeal (CN IX) and vagus (CN X) (mixed) nerves, and provide motor innervation of the muscles of the neck by the accessory nerve (CN XI) and the tongue by the hypoglossal nerve (CN XII). The symptomatology provoked by an anomaly is often discrete and rarely in the forefront. As with all cranial nerves, the context and clinical examinations, in case of suspicion of impairment of the lower cranial nerves, are determinant in guiding the imaging. In fact, the impairment may be located in the brain stem, in the peribulbar cisterns, in the foramens or even in the deep spaces of the face. The clinical localization of the probable seat of the lesion helps in choosing the adapted protocol in MRI and eventually completes it with a CT-scan. In the bulb, the intra-axial pathology is dominated by brain ischemia (in particular, with Wallenberg syndrome) and multiple sclerosis. Cisternal pathology is tumoral with two tumors, schwannoma and meningioma. The occurrence is much lower than in the cochleovestibular nerves as well as the leptomeningeal nerves (infectious, inflammatory or tumoral). Finally, foramen pathology is tumoral with, outside of the usual schwannomas and meningiomas, paragangliomas. For radiologists, fairly hesitant to explore these lower cranial pairs, it is necessary to be familiar with (or relearn) the anatomy, master the exploratory technique and be aware of the diagnostic possibilities. Copyright © 2013 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Is Dysregulation of the HPA-Axis a Core Pathophysiology Mediating Co-Morbid Depression in Neurodegenerative Diseases?

PubMed Central

Du, Xin; Pang, Terence Y.

2015-01-01

There is increasing evidence of prodromal manifestation of neuropsychiatric symptoms in a variety of neurodegenerative diseases such as Parkinson’s disease (PD) and Huntington’s disease (HD). These affective symptoms may be observed many years before the core diagnostic symptoms of the neurological condition. It is becoming more apparent that depression is a significant modifying factor of the trajectory of disease progression and even treatment outcomes. It is therefore crucial that we understand the potential pathophysiologies related to the primary condition, which could contribute to the development of depression. The hypothalamic–pituitary–adrenal (HPA)-axis is a key neuroendocrine signaling system involved in physiological homeostasis and stress response. Disturbances of this system lead to severe hormonal imbalances, and the majority of such patients also present with behavioral deficits and/or mood disorders. Dysregulation of the HPA-axis is also strongly implicated in the pathology of major depressive disorder. Consistent with this, antidepressant drugs, such as the selective serotonin reuptake inhibitors have been shown to alter HPA-axis activity. In this review, we will summarize the current state of knowledge regarding HPA-axis pathology in Alzheimer’s, PD and HD, differentiating between prodromal and later stages of disease progression when evidence is available. Both clinical and preclinical evidence will be examined, but we highlight animal model studies as being particularly useful for uncovering novel mechanisms of pathology related to co-morbid mood disorders. Finally, we purpose utilizing the preclinical evidence to better inform prospective, intervention studies. PMID:25806005

Gynecological care in young women: a high-risk period of life.

PubMed

Bitzer, Johannes; Sultan, Charles; Creatsas, George; Palacios, Santiago

2014-08-01

Adolescence has been described as period of life when emotions are heightened and regulatory controls are reduced, and this can result in an escalation in risk-taking. Importantly for younger females, risk behaviors associated with the onset of sexual activity, and alcohol and substance abuse may coincide with pathologies such as polycystic ovary syndrome (PCOS) and abnormal uterine bleeding, an iron-deficient diet (vegetarian or vegan) and a negative body image leading to eating disorders. Girls transitioning through adolescence face a number of specific emotional and physical issues related to the onset of menarche and regular menstrual cycles. Menstruation combined with these risk behaviors and pathologies, and the rapid growth and development that is taking place, often results in numerous unwanted effects including iron deficiency. A low iron level is the most common cause of anemia in adolescent girls and can be detrimental to mood and cognition as well as physical well-being. In this article we review the impact of menarche, poor nutrition and some of the risk behaviors and pathologies that predispose females to challenges associated with adolescence, including anemia. We also examine factors that need to be taken into consideration during the initial, and follow-up, consultations with young women. Finally, we present some of the latest advice regarding nutrition and oral iron supplementation, particularly extended-release ferrous sulfate with mucoproteose, with a view to minimizing the development and risks of anemia in this vulnerable population.

Interpersonal guilt in college student pathological gamblers

PubMed Central

Locke, Geoffrey W.; Shilkret, Robert; Everett, Joyce E.; Petry, Nancy M.

2013-01-01

Background Interpersonal guilt is associated with psychopathology, but its relationship to pathological gambling has not been studied. Objectives This study examined the relationship between interpersonal guilt and pathological gambling. Methods In total, 1,979 college students completed a questionnaire containing the South Oaks Gambling Screen, Interpersonal Guilt Questionnaire, and questions about substance use. Students identified as pathological gamblers (n = 145) were matched to non-problem gamblers with respect to demographics and substance use. Results Pathological gamblers had significantly higher interpersonal guilt than their non-problem gambling peers. Conclusions and Scientific Significance Pathological gambling college students have excessive interpersonal guilt, and these findings may lead to novel treatment approaches. PMID:22746179

Evaluation of diagnostic value of CT scan, physical examination and ultrasound based on pathological findings in patients with pelvic masses.

PubMed

Firoozabadi, Razieh Dehghani; Karimi Zarchi, Mojgan; Mansurian, Hamid Reza; Moghadam, Bita Rafiei; Teimoori, Soraya; Naseri, Ali

2011-01-01

Because benign and malignant cervical and ovarian masses occur with different percentages in different age groups, the importance of primary diagnosis and selection of a suitable surgical procedure is underlined. Diagnosis of pelvic masses is carried out using ultrasound, physical examination, CT scan and MRI. The objective of this study is to evaluate the diagnostic value of CT scan in pelvic masses in comparison with physical examination-ultrasound based on pathology of the lesion in patients undergoing laparotomic surgery. This analytic-descriptive study focused on age, sonographic findings, physical examinations, CT scan and pathological findings in 139 patients with pelvic mass, gathered with questionnaires and statistically analayzed using the SPSS software programme. Of 139 patients with pelvic mass (patients aged from 17 to 75 years old), 62 (44%) cases were diagnosed as benign and 77 (55.4%) as malignant; among them malignant tratoma serocyst adenocarsinoma with 33 (23.7%) cases and benign myoma with 21 (15.2%) cases comprised the most frequent cases. The sensitivity and specificity of sonography-physical examination were 51.9% and 87.9% respectively and the sensitivity and specificity of CT scan images were 79.2% and 91.6% respectively. It was shown that CT scan images were more consistant with pathological findings in predicting appropriate surgical procedures than do sonography-physical examinations. The sensitivity of CT scan is far higher than that of sonography-physical examination in the diagnosis of pelvic mass malignancy.

Team-Based Learning in a Capstone Course in Speech-Language Pathology: Learning Outcomes and Student Perceptions

ERIC Educational Resources Information Center

Wallace, Sarah E.

2015-01-01

Team-based learning (TBL), although found to increase student engagement and higher-level thinking, has not been examined in the field of speech-language pathology. The purpose of this study was to examine the effect of integrating TBL into a capstone course in evidence-based practice (EBP). The researcher evaluated 27 students' understanding of…

Pathological Correlates of Cognitive Impairment in The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age.

PubMed

Robinson, Andrew C; Davidson, Yvonne S; Horan, Michael A; Pendleton, Neil; Mann, David M A

2018-01-01

The neuropathological changes responsible for cognitive impairment and dementia remain incompletely understood. Longitudinal studies with a brain donation end point allow the opportunity to examine relationships between cognitive status and neuropathology. We report on the first 97 participants coming to autopsy with sufficient clinical information from The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age. This study began in 1983 and recruited 6,542 healthy individuals between 1983 and 1994, 312 of whom consented to brain donation. Alzheimer-type pathology was common throughout the cohort and generally correlated well with cognitive status. However, there was some overlap between cognitive status and measures of Alzheimer pathology with 26% of cognitively intact participants reaching either CERAD B or C, 11% reaching Thal phase 4 or 5, and 29% reaching Braak stage III- VI. Cerebral amyloid angiopathy(CAA), α-synuclein, and TDP-43 pathology was less common, but when present correlated well with cognitive status. Possession of APOEɛ4 allele(s) was associated with more severe Alzheimer-type and CAA pathology and earlier death, whereas possession of APOEɛ2 allele(s) had no effect on pathology but was more common in cognitively intact individuals. The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age cohort is pathologically representative when compared with similar studies. Cognitive impairment in life correlates strongly with all pathologies examined and the APOE status of an individual can affect pathology severity and longevity.

Automatic detection of referral patients due to retinal pathologies through data mining.

PubMed

Quellec, Gwenolé; Lamard, Mathieu; Erginay, Ali; Chabouis, Agnès; Massin, Pascale; Cochener, Béatrice; Cazuguel, Guy

2016-04-01

With the increased prevalence of retinal pathologies, automating the detection of these pathologies is becoming more and more relevant. In the past few years, many algorithms have been developed for the automated detection of a specific pathology, typically diabetic retinopathy, using eye fundus photography. No matter how good these algorithms are, we believe many clinicians would not use automatic detection tools focusing on a single pathology and ignoring any other pathology present in the patient's retinas. To solve this issue, an algorithm for characterizing the appearance of abnormal retinas, as well as the appearance of the normal ones, is presented. This algorithm does not focus on individual images: it considers examination records consisting of multiple photographs of each retina, together with contextual information about the patient. Specifically, it relies on data mining in order to learn diagnosis rules from characterizations of fundus examination records. The main novelty is that the content of examination records (images and context) is characterized at multiple levels of spatial and lexical granularity: 1) spatial flexibility is ensured by an adaptive decomposition of composite retinal images into a cascade of regions, 2) lexical granularity is ensured by an adaptive decomposition of the feature space into a cascade of visual words. This multigranular representation allows for great flexibility in automatically characterizing normality and abnormality: it is possible to generate diagnosis rules whose precision and generalization ability can be traded off depending on data availability. A variation on usual data mining algorithms, originally designed to mine static data, is proposed so that contextual and visual data at adaptive granularity levels can be mined. This framework was evaluated in e-ophtha, a dataset of 25,702 examination records from the OPHDIAT screening network, as well as in the publicly-available Messidor dataset. It was successfully applied to the detection of patients that should be referred to an ophthalmologist and also to the specific detection of several pathologies. Copyright © 2016 Elsevier B.V. All rights reserved.

Purification and Characterization of Mouse Soluble Receptor for Advanced Glycation End Products (sRAGE)*

PubMed Central

Hanford, Lana E.; Enghild, Jan J.; Valnickova, Zuzana; Petersen, Steen V.; Schaefer, Lisa M.; Schaefer, Todd M.; Reinhart, Todd A.; Oury, Tim D.

2007-01-01

The receptor for advanced glycation end products (RAGE) is a member of the immunoglobulin superfamily of cell surface proteins that has been implicated as a progression factor in a number of pathologic conditions from chronic inflammation to cancer to Alzheimer’s disease. In such conditions, RAGE acts to facilitate pathogenic processes. Its secreted isoform, soluble RAGE or sRAGE, has the ability to prevent RAGE signaling by acting as a decoy. sRAGE has been used successfully in animal models of a range of diseases to antagonize RAGE-mediated pathologic processes. In humans, sRAGE results from alternative splicing of RAGE mRNA. This study was aimed to determine whether the same holds true for mouse sRAGE and, in addition, to biochemically characterize mouse sRAGE. The biochemical characteristics examined include glycosylation and disulfide patterns. In addition, sRAGE was found to bind heparin, which may mediate its distribution in the extracellular matrix and cell surfaces of tissues. Finally, our data indicated that sRAGE in the mouse is likely produced by carboxyl-terminal truncation, in contrast to the alternative splicing mechanism reported in humans. PMID:15381690

NEC violation in mimetic cosmology revisited

DOE PAGES

Ijjas, Anna; Ripley, Justin; Steinhardt, Paul J.

2016-06-28

In the context of Einstein gravity, if the null energy condition (NEC) is satisfied, the energy density in expanding space–times always decreases while in contracting space–times the energy density grows and the universe eventually collapses into a singularity. In particular, no non-singular bounce is possible. It is, though, an open question if this energy condition can be violated in a controlled way, i.e., without introducing pathologies, such as unstable negative-energy states or an imaginary speed of sound. In this letter, we will re-examine the claim that the recently proposed mimetic scenario can violate the NEC without pathologies. We show thatmore » mimetic cosmology is prone to gradient instabilities even in cases when the NEC is satisfied (except for trivial examples). Most interestingly, the source of the instability is always the Einstein–Hilbert term in the action. The matter stress-energy component does not contribute spatial gradient terms but instead makes the problematic curvature modes dynamical. Finally, we also show that mimetic cosmology can be understood as a singular limit of known, well-behaved theories involving higher-derivative kinetic terms and discuss ways of removing the instability.« less

NEC violation in mimetic cosmology revisited

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ijjas, Anna; Ripley, Justin; Steinhardt, Paul J.

In the context of Einstein gravity, if the null energy condition (NEC) is satisfied, the energy density in expanding space–times always decreases while in contracting space–times the energy density grows and the universe eventually collapses into a singularity. In particular, no non-singular bounce is possible. It is, though, an open question if this energy condition can be violated in a controlled way, i.e., without introducing pathologies, such as unstable negative-energy states or an imaginary speed of sound. In this letter, we will re-examine the claim that the recently proposed mimetic scenario can violate the NEC without pathologies. We show thatmore » mimetic cosmology is prone to gradient instabilities even in cases when the NEC is satisfied (except for trivial examples). Most interestingly, the source of the instability is always the Einstein–Hilbert term in the action. The matter stress-energy component does not contribute spatial gradient terms but instead makes the problematic curvature modes dynamical. Finally, we also show that mimetic cosmology can be understood as a singular limit of known, well-behaved theories involving higher-derivative kinetic terms and discuss ways of removing the instability.« less

Lung cancer mimicking lung abscess formation on CT images.

PubMed

Taira, Naohiro; Kawabata, Tsutomu; Gabe, Atsushi; Ichi, Takaharu; Kushi, Kazuaki; Yohena, Tomofumi; Kawasaki, Hidenori; Yamashiro, Toshimitsu; Ishikawa, Kiyoshi

2014-01-01

Male, 64 FINAL DIAGNOSIS: Lung pleomorphic carcinoma Symptoms: Cough • fever - Clinical Procedure: - Specialty: Oncology. Unusual clinical course. The diagnosis of lung cancer is often made based on computed tomography (CT) image findings if it cannot be confirmed on pathological examinations, such as bronchoscopy. However, the CT image findings of cancerous lesions are similar to those of abscesses.We herein report a case of lung cancer that resembled a lung abscess on CT. We herein describe the case of 64-year-old male who was diagnosed with lung cancer using surgery. In this case, it was quite difficult to distinguish between the lung cancer and a lung abscess on CT images, and a lung abscess was initially suspected due to symptoms, such as fever and coughing, contrast-enhanced CT image findings showing a ring-enhancing mass in the right upper lobe and the patient's laboratory test results. However, a pathological diagnosis of lung cancer was confirmed according to the results of a rapid frozen section biopsy of the lesion. This case suggests that physicians should not suspect both a lung abscesses and malignancy in cases involving masses presenting as ring-enhancing lesions on contrast-enhanced CT.

Making Blood: The Haematopoietic Niche throughout Ontogeny

PubMed Central

Al-Drees, Mohammad A.; Yeo, Jia Hao; Boumelhem, Badwi B.; Antas, Veronica I.; Brigden, Kurt W. L.; Colonne, Chanukya K.; Fraser, Stuart T.

2015-01-01

Approximately one-quarter of all cells in the adult human body are blood cells. The haematopoietic system is therefore massive in scale and requires exquisite regulation to be maintained under homeostatic conditions. It must also be able to respond when needed, such as during infection or following blood loss, to produce more blood cells. Supporting cells serve to maintain haematopoietic stem and progenitor cells during homeostatic and pathological conditions. This coalition of supportive cell types, organised in specific tissues, is termed the haematopoietic niche. Haematopoietic stem and progenitor cells are generated in a number of distinct locations during mammalian embryogenesis. These stem and progenitor cells migrate to a variety of anatomical locations through the conceptus until finally homing to the bone marrow shortly before birth. Under stress, extramedullary haematopoiesis can take place in regions that are typically lacking in blood-producing activity. Our aim in this review is to examine blood production throughout the embryo and adult, under normal and pathological conditions, to identify commonalities and distinctions between each niche. A clearer understanding of the mechanism underlying each haematopoietic niche can be applied to improving ex vivo cultures of haematopoietic stem cells and potentially lead to new directions for transplantation medicine. PMID:26113865

Suicidal insulin poisoning with nine day survival: recovery in bile at autopsy by radioimmunoassay

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sturner, W.Q.; Putnam, R.S.

1972-10-01

The discovery of insulin fifty years ago enabled doctors to successfully treat an eleven year old boy dying from diabetes mellitus and thereby ushered in a new medical era. While millions of subsequent patients were thus able to lead productive lives, others turned this miraculous substance into self-destructive purposes, while a few attempted (and possibly succeeded in) carefully concealed homicidal undertakings. The first ''murder by insulin'' case, prosecuted with a conviction in Great Britain fifteen years ago, employed a laborious bioassay method to demonstrate the hormone at the site of injection. A recent series of insulin poisonings in California wasmore » dependent on pathological changes in the brain from anoxia (hypoglycemia) coupled with history and investigation rather than chemical measurements, although an immunoassay method was used for confirmation in the final case. Instances of suicidal attempts by self- administered insulin have been reported with analyses performed by radioimmunoassay, now employed in clinical laboratories to measure many hormonal and therapeutic substances. We have applied this principle from pathologic and toxicologic aspects in an effort to enhance the diagnostic capability of the forensic pathologist, who must examine and properly certify such deaths. (auth)« less

ASCCP Colposcopy Standards: How Do We Perform Colposcopy? Implications for Establishing Standards.

PubMed

Waxman, Alan G; Conageski, Christine; Silver, Michelle I; Tedeschi, Candice; Stier, Elizabeth A; Apgar, Barbara; Huh, Warner K; Wentzensen, Nicolas; Massad, L Stewart; Khan, Michelle J; Mayeaux, Edward J; Einstein, Mark H; Schiffman, Mark H; Guido, Richard S

2017-10-01

The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. Working group 3 defined colposcopy procedure guidelines for minimum and comprehensive colposcopy practice and evaluated the use of colposcopy adjuncts. The working group performed a systematic literature review to identify best practices in colposcopy methodology and to evaluate the use of available colposcopy adjuncts. The literature provided little evidence to support specific elements of the procedure. The working group, therefore, implemented a national survey of current and recent ASCCP members to evaluate common elements of the colposcopy examination. The findings of this survey were modified by expert consensus from the ASCCP Colposcopy Standards Committee members to create guidelines for performing colposcopy. The draft recommendations were posted online for public comment and presented at an open session of the International Federation for Cervical Pathology and Colposcopy 2017 World Congress for further comment. All comments were considered in the development of final recommendations. Minimum and comprehensive colposcopy practice guidelines were developed. These guidelines represent recommended practice in all parts of the examination including the following: precolposcopy evaluation, performing the procedure, documentation of findings, biopsy practice, and postprocedure follow-up. These guidelines are intended to serve as a guide to standardize colposcopy across the United States.

Twenty-first century pathology sign-out.

PubMed

Tomlins, Scott; Robinson, Daniel; Penny, Robert J; Hess, Jay L

2012-12-01

It is difficult to imagine a field that is changing as rapidly as pathology. A convergence of factors including not only scientific and technological advances but also changes in business models is transforming the field, particularly in the area of cancer diagnostics. The authors examine 8 themes, or "forces of change," in pathology and speculate on how these will affect pathology sign-out and the future role of pathologists in patient care. Copyright © 2012 Elsevier Inc. All rights reserved.

Pathological Gambling and Associated Drug and Alcohol Abuse, Emotion Regulation, and Anxious-Depressive Symptomatology.

PubMed

Jauregui, Paula; Estévez, Ana; Urbiola, Irache

2016-06-01

Background and aims Pathological gambling is associated with comorbid disorders, such as anxiety, depression, and drug and alcohol abuse. Difficulties of emotion regulation may be one of the factors related to the presence of addictive disorders, along with comorbid symptomatology in pathological gamblers. Therefore, the aim of this study was to evaluate the difficulties of emotion regulation, drug and alcohol abuse, and anxious and depressive symptomatology in pathological gamblers, and the mediating role of difficulties of emotion regulation between anxiety and pathological gambling. Methods The study sample included 167 male pathological gamblers (mean age = 39.29 years) and 107 non-gamblers (mean age = 33.43 years). Pathological gambling (SOGS), difficulties of emotion regulation (DERS), drug and alcohol abuse (MUTICAGE CAD-4), and anxious and depressive symptomatology (SA-45) were measured. Student's t, Pearson's r, stepwise multiple linear regression and multiple mediation analyses were conducted. The study was approved by an Investigational Review Board. Results Relative to non-gamblers, pathological gamblers exhibited greater difficulties of emotion regulation, as well as more anxiety, depression, and drug abuse. Moreover, pathological gambling correlated with emotion regulation difficulties, anxiety, depression, and drug abuse. Besides, emotion regulation difficulties correlated with and predicted pathological gambling, drug and alcohol abuse, and anxious and depressive symptomatology. Finally, emotion regulation difficulties mediated the relationship between anxiety and pathological gambling controlling the effect of age, both when controlling and not controlling for the effect of other abuses. Discussion and conclusions These results suggest that difficulties of emotion regulation may provide new keys to understanding and treating pathological gambling and comorbid disorders.

Acceptance and Commitment Therapy versus Cognitive Therapy for the Treatment of Comorbid Eating Pathology

ERIC Educational Resources Information Center

Juarascio, Adrienne S.; Forman, Evan M.; Herbert, James D.

2010-01-01

Previous research has indicated that although eating pathology is prevalent in college populations, both CBT and non-CBT-based therapies achieve only limited effectiveness. The current study examined several questions related to the treatment of eating pathology within the context of a larger randomized controlled trial that compared standard CBT…

Flow and dissociation: examination of mean levels, cross-links, and links to emotional well-being across sports and recreational and pathological gambling.

PubMed

Wanner, Brigitte; Ladouceur, Robert; Auclair, Amélie V; Vitaro, Frank

2006-01-01

To examine whether flow (Csikszentmihalyi (1990). Flow: The psychology of optimal experience. NY: Harper & Row) and dissociation (Jacobs (1986). Journal of Gambling Behavior, 2, 15-31) are experienced across sports and recreational and pathological gambling, we assessed a sample of 511 college students (256 females and 255 males, M age = 19.54) that was comprised of 14 pathological gamblers, 21 non-addicted gamblers, and 476 athletes. The findings showed that both flow and dissociation lay on a continuum of subjective experiences across activity groups. Specifically, pathological gamblers experienced lower levels of flow than athletes, whereas recreational gamblers lay in between the previous groups in this regard. In contrast, pathological gamblers experienced higher mean levels of dissociation than athletes and recreational gamblers who, in turn, were similar in this regard. A LISREL model showed that flow was positively associated with general emotional well-being, whereas dissociation was negatively associated with well-being.

Effective use of sertraline for pathological laughing after severe vasospasm due to aneurysmal subarachnoid hemorrhage: case report.

PubMed

Takeuchi, Hayato; Iwamoto, Kazuhide; Mukai, Mao; Fujita, Tomoaki; Tsujino, Hitoshi; Iwamoto, Yoshihiro

2014-01-01

Pathological laughing, one subgroup of psuedobulbar affect, is known as laughter inappropriate to the patient's external circumstances and unrelated to the patient's internal emotional state. The authors present the case of a 76-year-old woman with no significant medical history who experienced pathological laughing after subarachnoid hemorrhage (SAH) due to rupture of an aneurysm, which was successfully treated with craniotomy for aneurysm clipping. In the acute stage after the operation she suffered from severe vasospasm and resulting middle cerebral artery territory infarction and conscious disturbance. As she regained consciousness she was afflicted by pathological laughing 6 months after the onset of SAH. Her involuntary laughter was inappropriate to the situation and was incongruent with the emotional state, and she could not control by herself. Finally the diagnosis of pathological laughing was made and treatment with sertraline, a selective serotonin reuptake inhibitor (SSRI), effectively cured the symptoms. Her pathological laughing was estimated to be consequence of infarction in the right prefrontal cortex and/or corona radiata, resulting from vasospasm. To the authors' knowledge, this is the first report of pathological laughing after aneurysmal SAH. The authors offer insight into the pathophysiology of this rare phenomenon. Effectiveness of sertraline would widen the treatment modality against pathological laughing.

Effective Use of Sertraline for Pathological Laughing after Severe Vasospasm Due to Aneurysmal Subarachnoid Hemorrhage: Case Report

PubMed Central

TAKEUCHI, Hayato; IWAMOTO, Kazuhide; MUKAI, Mao; FUJITA, Tomoaki; TSUJINO, Hitoshi; IWAMOTO, Yoshihiro

2014-01-01

Pathological laughing, one subgroup of psuedobulbar affect, is known as laughter inappropriate to the patient's external circumstances and unrelated to the patient's internal emotional state. The authors present the case of a 76-year-old woman with no significant medical history who experienced pathological laughing after subarachnoid hemorrhage (SAH) due to rupture of an aneurysm, which was successfully treated with craniotomy for aneurysm clipping. In the acute stage after the operation she suffered from severe vasospasm and resulting middle cerebral artery territory infarction and conscious disturbance. As she regained consciousness she was afflicted by pathological laughing 6 months after the onset of SAH. Her involuntary laughter was inappropriate to the situation and was incongruent with the emotional state, and she could not control by herself. Finally the diagnosis of pathological laughing was made and treatment with sertraline, a selective serotonin reuptake inhibitor (SSRI), effectively cured the symptoms. Her pathological laughing was estimated to be consequence of infarction in the right prefrontal cortex and/or corona radiata, resulting from vasospasm. To the authors' knowledge, this is the first report of pathological laughing after aneurysmal SAH. The authors offer insight into the pathophysiology of this rare phenomenon. Effectiveness of sertraline would widen the treatment modality against pathological laughing. PMID:24201096

Communication skills in diagnostic pathology.

PubMed

Lehr, Hans-Anton; Bosman, Fred T

2016-01-01

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.

Transgenic over-expression of YY1 induces pathologic cardiac hypertrophy in a sex-specific manner

PubMed Central

Stauffer, Brian L.; Dockstader, Karen; Russell, Gloria; Hijmans, Jamie; Walker, Lisa; Cecil, Mackenzie; Demos-Davies, Kimberly; Medway, Allen; McKinsey, Timothy A.; Sucharov, Carmen C.

2015-01-01

YY1 can activate or repress transcription of various genes. In cardiac myocytes in culture YY1 has been shown to regulate expression of several genes involved in myocyte pathology. YY1 can also acutely protect the heart against detrimental changes in gene expression. In this study we show that cardiac over-expression of YY1 induces pathologic cardiac hypertrophy in male mice, measured by changes in gene expression and lower ejection fraction/fractional shortening. In contrast, female animals are protected against pathologic gene expression changes and cardiac dysfunction. Furthermore, we show that YY1 regulates, in a sex-specific manner, the expression of mammalian enable (Mena), a factor that regulates cytoskeletal actin dynamics and whose expression is increased in several models of cardiac pathology, and that Mena expression in humans with heart failure is sex-dependent. Finally, we show that sex differences in YY1 expression are also observed in human heart failure. In summary, this is the first work to show that YY1 has a sex-specific effect in the regulation of cardiac pathology. PMID:25935483

Exit competencies in pathology and laboratory medicine for graduating medical students: the Canadian approach.

PubMed

Ford, Jason; Pambrun, Chantale

2015-05-01

Physicians in every medical and surgical field must be able to use pathology concepts and skills in their practice: for example, they must order and interpret the correct laboratory tests, they must use their understanding of pathogenesis to diagnose and treat, and they must work with the laboratory to care for their patients. These important concepts and skills may be ignored by medical schools and even national/international organizations setting graduation expectations for medical students. There is an evolving international consensus about the importance of exit competencies for medical school graduates, which define the measurable or observable behaviors each graduate must be able to demonstrate. The Canadian Association of Pathologists (CAP) Education Group set out to establish the basic competencies in pathology and laboratory medicine which should be expected of every medical graduate: not competencies for pathologists, but for medical graduates who intend to enter any residency program. We defined 4 targets for pathology and laboratory medicine exit competencies: that they represent only measurable behaviors, that they be clinically focused, that they be generalizable to every medical graduate, and that the final competency document be user-friendly. A set of competencies was developed iteratively and underwent final revision at the 2012 CAP annual meeting. These competencies were subsequently endorsed by the CAP executive and the Canadian Leadership Council on Laboratory Medicine. This clinically focused consensus document provides the first comprehensive list of exit competencies in pathology and laboratory medicine for undergraduate medical education. Copyright © 2015 Elsevier Inc. All rights reserved.

The use of ultrasound in the assessment of the glenoid labrum of the glenohumeral joint. Part II: Examples of labral pathologies

PubMed Central

Tarczyńska, Marta

2012-01-01

Labral pathologies of the glenohumeral joint are most commonly caused by trauma. The majority of lesions affect the anterior part of labrum, resulting from much higher frequency of anterior shoulder dislocations over posterior ones. Another subgroup of labral lesions, not directly related to joint instability, are SLAP tears. Other findings include degenerative changes of labrum and paralabral cysts. Diagnostic imaging is crucial for making a decision regarding operative treatment. Apart from a standard X-ray examination, the imaging mainly relies on magnetic resonance or computed tomography arthrography. Based on their own experience, the authors propose the use of ultrasound in the assessment of labral tears of the glenohumeral joint. Different signs indicating labral pathology may be discovered and assessed during ultrasound examination. They include permanent displacement of the labrum onto the glenoid, labral instability during dynamic examination, lack of the labrum in the anatomical position, hypoechoic zone at the base of the labrum >2 mm in width, residual or swollen labrum as well as paralabral cyst(s). The most frequent appearance of labral pathology is displacement of the anteroinferior labrum onto the external aspect of the glenoid typically seen after anterior shoulder dislocation. The another most important US feature is labral instability while dynamically examined. The swelling or reduced size of the labrum usually indicates degeneration. This article presents sonographic images of selected labral pathologies. PMID:26672471

A report on the clinical-pathological correlations of 788 gingival lesion

PubMed Central

Carbone, Mario; Broccoletti, Roberto; Carcieri, Paola; Conrotto, Davide; Carrozzo, Marco; Arduino, Paolo G.

2017-01-01

Background The diagnosis and treatment of a variety of non-plaque related gingival diseases have become an integrated aspect of everyday dentistry. The aim of this study was to analyse the relationship between clinical appearance and histopathological features of gingival lesions in a large Northern Italian population. Material and Methods A retrospective study of 788 cases of gingival and alveolar mucosal biopsies was set up. Statistical analysis was performed by calculating the odds ratio and 95% confidence interval (C.I.), in order to assess the degree of association between the clinical parameters considered (primary lesions) and the single pathologies, statistically evaluated by Mantel-Haenszel tests. The correlation between clinical and histological diagnosis was classified as follow: 1) expected data (ED): provisional clinical diagnosis; 2) real data (RD): final histopathology diagnosis; 3) concordant data (CD): correspondence between the expected data and real data. The correlation was calculated as follow: CC (complete concordance) = CD x 100 / ED, this expressing the percentage in which the clinical and the histological diagnosis overlapped. Results The most frequently observed and biopsied primary lesions resulted to be exophytic, followed by mucosal colour changes and finally by losses of substance. The statistically significant association between primary lesion and their manifestation in gingival pathologies was reported. Volume increases, for instance, were positively correlated to plasma cell epulis, pyogenic granuloma, fibrous reactive hyperplasia and hemangioma. Verrucous-papillary lesions were most often seen in verrucous carcinoma, verrucous leukoplakia and mild dysplasia. White lesion resulted to be related to leukoplakia or oral lichen planus. Red lesions resulted to be related only oral lichen planus. Erosive vesicle-bullous lesions were linked to disimmune pathologies. Ulcerative lesions were positively associated to oral squamous cell cancer. Finally, potentially malignant disorders have the most percentage high concordance. Among the malignant lesions, the correlation increased up to the squamous cell carcinoma and leukaemia. Conclusions This article presented the frequency and the clinico-pathological concordance of all primary lesions and the histopathological diagnosis of gingival lesions. For every primary lesion, it is possible to correlate a specific histopathological diagnosis in a statistical manner. This can be a valuable aid for not specialist clinicians who daily observe mucosae and have the opportunity to intercept major diseases. Key words:Gingival lesions; clinical appearance; histological analysis; clinico-pathological correlation. PMID:29053652

[Discussion on relationship between hepatobiliary pathological changes under B-ultrasound and Clonorchis sinensis infection].

PubMed

Liang, Zhi-cheng; Qiu, Shou-zhong; Luo, Li-xuan

2015-12-01

To explore the relationship between the hepatobiliary pathological changes under B-ultrasound examinations and Clonorchis sinensis infection, so as to provide the evidence for further prevention and control. The stool test and ELISA were applied to test the pathogeny and antibody to C. sinensis of the suspicious patients who had the hepatobiliary pathological changes under B-ultrasound examinations in People's Hospital of Wuxuan County from Jan. 2010 to Dec. 2013. Totally 113 suspicious patients of C. sinensis infection were investigated, and the positive rates of egg and serum antibody were 64.60% (73 cases) and 66.37% (75 cases) respectively. The positive rates of the male and those aged ≥ 50 years were significantly higher than those of the female and the cases younger than 50 years respectively (χ² = 3.554, 6.267, both P < 0.05). In the C. sinensis infected patients, the degree of pathological changes of hepatobiliary was positively correlated with the infectiosity of C. sinensis (χ² = 64.952, P < 0.01). The hepatobiliary pathological changes under B-ultrasound examinations may be resulted from the infection of C. sinensis, and the patients with the changes should be further investigated for the pathogen and antibody to C. sinensis.

Increased Frequency of α-Synuclein in the Substantia Nigra in HIV Infection

PubMed Central

Khanlou, Negar; Moore, David J.; Chana, Gursharan; Cherner, Mariana; Lazzaretto, Deborah; Dawes, Sharron; Grant, Igor; Masliah, Eliezer; Everall, Ian P.

2014-01-01

The frequency of neurodegenerative markers among long surviving HIV infected individuals is unknown, therefore, the present study investigated the frequency of α-synuclein, β-amyloid and HIV-associated brain pathology in the brains of older HIV infected individuals. We examined the substantia nigra of 73 clinically well-characterized HIV infected individuals aged 50 to 76 years from the National NeuroAIDS Tissue Consortium. We also examined the frontal and temporal cortical regions of a subset of 36 individuals. The brain regions were examined for the presence of α-synuclein, β-amyloid and HIV-associated brain pathology. Neuritic α-synuclein expression was found in 16% (12/73) of the substantia nigra of the HIV+ cases and none of the older control cases (0/18). β-amyloid deposits were prevalent and found in nearly all of the HIV+ cases (35/36). Despite these increases of degenerative pathology, HIV-associated brain pathology was present in only 10% of cases. Among older HIV+ adults HIV-associated brain pathology does not appear elevated; however, the frequency of both α-synuclein and β-amyloid is higher than that found in older healthy persons. The increased prevalence of α-synuclein and β-amyloid in the brains of older HIV-infected individuals may predict an increased risk of developing neurodegenerative disease. PMID:19115126

Clinical image and pathology of hypertrophic cranial pachymeningitis.

PubMed

Shi, C H; Niu, S T; Zhang, Z Q

2014-12-12

The objective of this study was to examine the clinical findings, magnetic resonance imaging (MRI), pathological features, and treatment experiments of patients with hypertrophic cranial pachymeningitis (HCP). The clinical findings, MRI, and pathological appearances of 9 patients with HCP were analyzed retrospectively. The thickened dura mater was markedly enhanced after contrast media injection. The lesion near the brain hemisphere presented long regions of T1- and T2-weighted abnormal signal intensities. The abnormal signal intensities of the brain tissue were decreased significantly. Pathological examination demonstrated chronic inflammation changes, with cerebral dura mater fibrous tissue showing obvious hyperplasia, and the periphery of the blood vessel showing a great quantity of infiltrating phlegmonosis cells. HCP mainly presents headache and paralysis of multiple cranial nerves. The distinctive signs on brain MRIs involve strengthening the signal in the cerebral dura.

Changes in eating pathology and associated symptoms among chronically ill adults attending a brief psychoeducational group.

PubMed

von Ranson, Kristin M; Stevenson, Andrea S; Cannon, Colleen K; Shah, Wendy

2010-08-01

Two quasi-experimental pilot studies examined eating pathology, eating self-efficacy, shame, guilt, and pride in adults with chronic illness before and after participating in brief cognitive-behavioral psychoeducational groups addressing eating concerns. In Study 1, 60 adults completed assessments before and after a series of two groups; in Study 2, 21 adults also completed an assessment five weeks prior to the first group to identify time-related changes in symptoms. Study 1 participants improved across domains, whereas Study 2 analyses also examining time-related changes showed improvements in eating self-efficacy, shame, guilt, and pride, but not in eating pathology. Psychoeducational groups may help improve symptoms including eating pathology, eating self-efficacy, shame, guilt, and pride among chronically-ill adults with eating concerns. 2009 Elsevier Ltd. All rights reserved.

The association between sports participation and athletic identity with eating pathology among college-aged males and females.

PubMed

Fay, K; Economos, C; Lerner, R M; Becker, A E; Sacheck, J

2011-06-01

The current study examined associations among sports participation (SP), athletic identity (AI), weight status, and eating pathology, and whether these relations differed by gender. Data come from male and female first-year college students who participated in the Tufts Longitudinal Health Study (TLHS) between 1999-2007 (N=712). Relations among SP, AI, actual and perceived weight statuses, Eating Disorders Inventory (EDI) subscale scores, and indices of body shape concern and restrictive eating were examined with hierarchical ordinary least squares (OLS) regression. Associations between SP and eating pathology among females were moderated by perceived weight status. By contrast, relations between males' EDI subscales scores and SP were moderated by ethnicity, as well as by actual weight status. Our findings support that sports participation alone neither promotes nor protects against eating pathology among males and females.

Clinical rotation in pathology: description of a case based approach.

PubMed

Bezuidenhout, J; Wasserman, E; Mansvelt, E; Meyer, C; van Zyl, G; Orth, H; Els, A

2006-04-01

The implementation of a system based, integrated curriculum at the Faculty of Health Sciences of Stellenbosch University, Western Cape, South Africa, resulted in less contact time for the pathology disciplines during theoretical modules, while a weekly rotation in pathology was introduced during clinical training in the fourth and fifth years. To describe a problem based approach for this rotation. Students are presented with a clinical "paper" case daily, integrating as many of the pathology disciplines as possible to demonstrate the interdependence of the various disciplines. They receive chemical pathology tutorials, visit the various laboratories, and receive practical training in fine needle aspiration biopsy. On the final day, the case studies are assessed and discussed. Most students appreciated all activities. This rotation enhanced student interactivity and autonomy and guaranteed immediate feedback. On evaluation of the rotation it was found that the students enjoyed the rotation, learnt something new, and realised the value of group work. This innovation integrates pathology with clinical practice and illustrates the use of laboratory medicine in the management of common diseases seen in this country. Students appreciate learning practical skills and having to request special investigations under a pathologist's supervision changes their approach to pathology requests. Familiarity with the pathology environment empowers the student to use pathology with greater ease. A bank of case studies that can be expanded to include all medical disciplines will facilitate the application of a problem based approach and enhance communication between the basic science disciplines and the clinical and pathology disciplines.

Case Report: SPECT/CT as the New Diagnostic Tool for Specific Wrist Pathology.

PubMed

Linde, Musters; Ten Broek, M; Kraan, G A

2017-01-01

Single photon emission computed tomography has been introduced as a promising new diagnostic tool in orthopaedic pathology since the early 90'. Computed tomography, the combined with SPECT, gives insight in the specific sight of wrist pathology. Literature already supports introduction of SPECT/CT in wrist pathology, but clinical application is lagging. A 40yr old patient reported first in 2004 with persisting pain after a right distal radius fracture. Several diagnostics and operative interventions were performed, all unsuccessful. Because of the persisting pain a SPECT-CT was performed which showed a cyst in the hamate bone, which was successfully enucleated. The patient was finally pain free at recent follow-up. With a QDash-score of 43 and a PRW (H) E-DLV-score of 58/150. In this case report, SPECT/CT proved a very sensitive diagnostic tool for specific pathology of the wrist. It offered precise localisation and thereby the clinically suspected diagnosis was confirmed and the patient successfully treated.

Differentiating Community Dwellers at Risk for Pathological Narcissism From Community Dwellers at Risk for Psychopathy Using Measures of Emotion Recognition and Subjective Emotional Activation.

PubMed

Fossati, Andrea; Somma, Antonella; Pincus, Aaron; Borroni, Serena; Dowgwillo, Emily A

2017-06-01

The Italian translations of the Pathological Narcissism Inventory (PNI) and Triarchic Psychopathy Measure (TriPM) were administered to 609 community dwelling adults. Participants who scored in the upper 10% of the distribution of the PNI total score were assigned to the group of participants at risk for pathological narcissism, whereas participants who scored in the upper 10% of the distribution of the TriPM total score were assigned to the group of participants at risk for psychopathy. The final sample included 126 participants who were administered the Reading the Mind in the Eyes Test (RMET) and emotion-eliciting movie clips. Participants at risk for pathological narcissism scored significantly lower on the RMET total score than participants who were not at risk for pathological narcissism. Participants at risk for psychopathy showed a significant reduction in the subjective experience of disgust, fear, sadness, and tenderness compared to participants who were not at risk for psychopathy.

Electron microscopic examination of the myelinated axons of corpus callosum in perfused young and old rats.

PubMed

Sargon, Mustafa F; Denk, C Cem; Celik, H Hamdi; Surucu, H Selcuk; Aldur, M Mustafa

2007-07-01

In this study, the myelinated axons of parts of the corpus callosums of young and old rats were examined under the electron microscope and a grading system was performed for quantitating the ultrastructural pathological changes of these axons. Except the old splenium group, the only ultrastructural pathological change, observed in the myelinated axons was the separation in myelin configuration. In addition to this finding, in the old splenium group, in some of the myelinated axons, an interruption was observed in the myelin configuration. Additionally, these ultrastructural pathological findings were present in the larger sized myelinated axons of the corpus callosum.

Toxoplasmosis presented as a submental mass: a common disease, uncommon presentation

PubMed Central

Li, Bo; Zou, Jian; Wang, Wei-Ya; Liu, Shi-Xi

2015-01-01

Submental mass secondary to toxoplasmosis is not common in clinical work. A diagnosis of toxoplasmosis is rarely considered by physicians. Here we describe a 50-year-old woman presented with a progressive, painful, submental and left neck swelling for 1 month. After having obtained an insufficient evidence from the fine-needle biopsy, the patient finally received an excisional biopsy which highly indicated the possibility of lymphadenopathy consistent with toxoplasmosis. Diagnosis of toxoplasmosis was finally established by a combination of the pathological criteria, together with the positive serological finding. According to review the clinical presentations, pathological characteristics, diagnostic standard and treatment of this disease, the article aims to remind otolaryngologists who are evaluating a neck mass should be aware of the infectious cause of lymphadenopathy and the possibility of toxoplasmosis. PMID:26045858

Toxoplasmosis presented as a submental mass: a common disease, uncommon presentation.

PubMed

Li, Bo; Zou, Jian; Wang, Wei-Ya; Liu, Shi-Xi

2015-01-01

Submental mass secondary to toxoplasmosis is not common in clinical work. A diagnosis of toxoplasmosis is rarely considered by physicians. Here we describe a 50-year-old woman presented with a progressive, painful, submental and left neck swelling for 1 month. After having obtained an insufficient evidence from the fine-needle biopsy, the patient finally received an excisional biopsy which highly indicated the possibility of lymphadenopathy consistent with toxoplasmosis. Diagnosis of toxoplasmosis was finally established by a combination of the pathological criteria, together with the positive serological finding. According to review the clinical presentations, pathological characteristics, diagnostic standard and treatment of this disease, the article aims to remind otolaryngologists who are evaluating a neck mass should be aware of the infectious cause of lymphadenopathy and the possibility of toxoplasmosis.

[TREATMENT OF SHORT STATURE PATIENTS WITH NOPMAL GROWTH HORMONE SECRETION OF HYPOPHIS].

PubMed

Sprinchuk, N A; Samson, O J; Bol'shova, E V

2014-12-01

The article presents the treatment outcome in 86 children with short stature associated with different endocrine pathology and saved growth hormone secretion (congenital adrenal hyperplasia chondrodystrophy, Turner syndrome, idiopathic short stature, syndrome biologically inactive growth hormone and other genetically determined pathology). This study extends prior knowledge about the outcomes of the treatment with recombinant growth hormone and luteinizing hormone--releasing hormone analogue (alone or in combination) in short patients with poor prognosis of final height.

A convex optimization approach for identification of human tissue-specific interactomes.

PubMed

Mohammadi, Shahin; Grama, Ananth

2016-06-15

Analysis of organism-specific interactomes has yielded novel insights into cellular function and coordination, understanding of pathology, and identification of markers and drug targets. Genes, however, can exhibit varying levels of cell type specificity in their expression, and their coordinated expression manifests in tissue-specific function and pathology. Tissue-specific/tissue-selective interaction mechanisms have significant applications in drug discovery, as they are more likely to reveal drug targets. Furthermore, tissue-specific transcription factors (tsTFs) are significantly implicated in human disease, including cancers. Finally, disease genes and protein complexes have the tendency to be differentially expressed in tissues in which defects cause pathology. These observations motivate the construction of refined tissue-specific interactomes from organism-specific interactomes. We present a novel technique for constructing human tissue-specific interactomes. Using a variety of validation tests (Edge Set Enrichment Analysis, Gene Ontology Enrichment, Disease-Gene Subnetwork Compactness), we show that our proposed approach significantly outperforms state-of-the-art techniques. Finally, using case studies of Alzheimer's and Parkinson's diseases, we show that tissue-specific interactomes derived from our study can be used to construct pathways implicated in pathology and demonstrate the use of these pathways in identifying novel targets. http://www.cs.purdue.edu/homes/mohammas/projects/ActPro.html mohammadi@purdue.edu. © The Author 2016. Published by Oxford University Press.

Coauthorship in Pathology, a Comparison With Physics and a Survey-Generated and Member-Preferred Authorship Guideline

PubMed Central

Cohen, Michael B; Tarnow, Eugen; De Young, Barry R

2004-01-01

In a large and detailed survey of scientific coauthorship in pathology, 3500 members of the US and Canadian Academy of Pathology (USCAP) were surveyed via the Internet with a final response rate of 22.5%. The results were compared with a previous survey of members of the American Physical Society (APS). The fields are found to be very similar. For example, there is no well-defined way to determine coauthorship: the byline is arrived at without the use of public coauthorship standards according to 90% of respondents (92% in physics). A substantial amount of inappropriate authorship is present in both fields using a variety of authorship guidelines. For example, using the guideline of the International Committee of Medical Journal Editors (the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals" [ICMJE]), the average number of coauthors judged to be inappropriate in pathology on papers with 4 coauthors is 1.0 (1.2 in physics), and using the guideline requiring "direct contributions to scientific discovery or invention," we find 1.6 (1.5 in physics). Finally, it is suggested that authorship guidelines should be constructed by public surveys rather than closed-door committees: an authorship guideline constructed from previous survey feedback (from APS members) was found to be preferable to USCAP members (it received 40% of the vote, the ICMJE received 24% of the vote). PMID:15520623

Coauthorship in pathology, a comparison with physics and a survery-generated and member-preferred authorship guideline.

PubMed

Tarnow, Eugen; De Young, Barry R; Cohen, Michael B

2004-07-22

In a large and detailed survey of scientific coauthorship in pathology, 3500 members of the US and Canadian Academy of Pathology (USCAP) were surveyed via the Internet with a final response rate of 22.5%. The results were compared with a previous survey of members of the American Physical Society (APS). The fields are found to be very similar. For example, there is no well-defined way to determine coauthorship: the byline is arrived at without the use of public coauthorship standards according to 90% of respondents (92% in physics). A substantial amount of inappropriate authorship is present in both fields using a variety of authorship guidelines. For example, using the guideline of the International Committee of Medical Journal Editors (the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals" [ICMJE]), the average number of coauthors judged to be inappropriate in pathology on papers with 4 coauthors is 1.0 (1.2 in physics), and using the guideline requiring "direct contributions to scientific discovery or invention," we find 1.6 (1.5 in physics). Finally, it is suggested that authorship guidelines should be constructed by public surveys rather than closed-door committees: an authorship guideline constructed from previous survey feedback (from APS members) was found to be preferable to USCAP members (it received 40% of the vote, the ICMJE received 24% of the vote).

A meta-analysis of the relationships between body checking, body image avoidance, body image dissatisfaction, mood, and disordered eating.

PubMed

Walker, D Catherine; White, Emily K; Srinivasan, Vamshek J

2018-04-16

Body checking (BC) and body image avoidance (BIA) have been proposed as etiological and maintaining mechanisms for eating disorder (ED) pathology. To date, no comprehensive review summarizes the relationships of BC and BIA with ED pathology, body image dissatisfaction, or mood/affect. Meta-analyses examined the relationships of BC and BIA with ED pathology, body image dissatisfaction, and mood/affect. Gender, publication status, and presence or absence of ED diagnoses were examined as potential moderators. Results showed strong relationships between BC and ED pathology (ρ = 0.588) and BC and body image dissatisfaction (ρ = 0.631) and a moderate relationship between BC and mood/affect (ρ = 0.385). Similarly, results showed strong relationships between BIA and ED pathology (ρ = 0.553) and BIA and body image dissatisfaction (ρ = 0.543) and a moderate relationship between BIA and mood/affect (ρ = 0.392). Overall, limited evidence supported publication bias; however, publication bias may exist in the relationship between BIA and body image dissatisfaction in the literature. Subgroup moderator analyses suggested that gender moderates the strength of the relationships between BC and ED pathology, body image dissatisfaction, and mood/affect and between BIA and body image dissatisfaction. Results are consistent with cognitive-behavioral models of ED pathology that suggest BC and BIA are behavioral expressions of overvaluation of weight and shape. Notably, more published research has investigated BC than BIA. Future studies, incorporating methods such as meta-analytic structural equation modeling, should examine these variables to further test cognitive-behavioral models of ED development and maintenance. © 2018 Wiley Periodicals, Inc.

The relation between pathological worrying and fatigue in a working population.

PubMed

Andrea, H; Beurskens, A J H M; Kant, Ij; Davey, G C L; Field, A P; van Schayck, C P

2004-10-01

This study aimed to explore cross-sectional and longitudinal associations between pathological worry and fatigue in a working population. In employees with very low or very high fatigue levels, psychometrics of the Penn State Worry Questionnaire (PSWQ; measuring pathological worry) and the Checklist Individual Strength (CIS; measuring fatigue) were examined and their cross-sectional and longitudinal associations were explored. Pathological worry and fatigue can be measured as different constructs. However, pathological worry and fatigue were also associated on a cross-sectional level. Pathological worry predicted fatigue level 10 months later, but this association disappeared after adjustment for the cross-sectional association between pathological worry and fatigue. Although they can be measured as different constructs, pathological worry and fatigue seem to be associated. When studying longitudinal relations between pathological worry and fatigue, their cross-sectional association should be taken into account. Pathological worry might not be a risk factor for fatigue per se, but might act more like a mediating factor.

Impulsivity as a Moderator and Mediator between Life Stress and Pathological Gambling among Chinese Treatment-Seeking Gamblers

ERIC Educational Resources Information Center

Tang, Catherine So-kum; Wu, Anise M. S.

2012-01-01

This study examined the role of impulsivity and its interplay with gambling correlates in influencing the severity of pathological gambling in Chinese societies. It also investigated the extent to which impulsivity would moderate and/or mediate the relationship between life stress and pathological gambling in 94 Chinese treatment-seeking gamblers.…

An Examination of a Proposed DSM-IV Pathological Gambling Hierarchy in a Treatment Seeking Population: Similarities with Substance Dependence and Evidence for Three Classification Systems.

PubMed

Christensen, Darren R; Jackson, Alun C; Dowling, Nicki A; Volberg, Rachel A; Thomas, Shane A

2015-09-01

Toce-Gerstein et al. (Addiction 98:1661-1672, 2003) investigated the distribution of Diagnostic and Statistical Manual for Mental Disorders, 4th edition (DSM-IV) pathological gambling criteria endorsement in a U.S. community sample for those people endorsing a least one of the DSM-IV criteria (n = 399). They proposed a hierarchy of gambling disorders where endorsement of 1-2 criteria were deemed 'At-Risk', 3-4 'Problem gamblers', 5-7 'Low Pathological', and 8-10 'High Pathological' gamblers. This article examines these claims in a larger Australian treatment seeking population. Data from 4,349 clients attending specialist problem gambling services were assessed for meeting the ten DSM-IV pathological gambling criteria. Results found higher overall criteria endorsement frequencies, three components, a direct relationship between criteria endorsement and gambling severity, clustering of criteria similar to the Toce-Gerstein et al. taxonomy, high accuracy scores for numerical and criteria specific taxonomies, and also high accuracy scores for dichotomous pathological gambling diagnoses. These results suggest significant complexities in the frequencies of criteria reports and relationships between criteria.

Brain pathology after mild traumatic brain injury: an exploratory study by repeated magnetic resonance examination.

PubMed

Lannsjö, Marianne; Raininko, Raili; Bustamante, Mariana; von Seth, Charlotta; Borg, Jörgen

2013-09-01

To explore brain pathology after mild traumatic brain injury by repeated magnetic resonance examination. A prospective follow-up study. Nineteen patients with mild traumatic brain injury presenting with Glasgow Coma Scale (GCS) 14-15. The patients were examined on day 2 or 3 and 3-7 months after the injury. The magnetic resonance protocol comprised conventional T1- and T2-weighted sequences including fluid attenuated inversion recovery (FLAIR), two susceptibility-weighted sequences to reveal haemorrhages, and diffusion-weighted sequences. Computer-aided volume comparison was performed. Clinical outcome was assessed by the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), Hospital Anxiety and Depression Scale (HADS) and Glasgow Outcome Scale Extended (GOSE). At follow-up, 7 patients (37%) reported ≥  3 symptoms in RPQ, 5 reported some anxiety and 1 reported mild depression. Fifteen patients reported upper level of good recovery and 4 patients lower level of good recovery (GOSE 8 and 7, respectively). Magnetic resonance pathology was found in 1 patient at the first examination, but 4 patients (21%) showed volume loss at the second examination, at which 3 of them reported < 3 symptoms and 1 ≥ 3 symptoms, all exhibiting GOSE scores of 8. Loss of brain volume, demonstrated by computer-aided magnetic resonance imaging volumetry, may be a feasible marker of brain pathology after mild traumatic brain injury.

Nodular hidradenocarcinoma over the parotid gland: a pathologic presentation.

PubMed

Verret, D J; Kabbani, Wareef; DeFatta, Robert J

2007-02-01

Nodular hidradenocarcinoma (NHAC), an eccrine carcinoma, has been reported in the dermatology and pathology literature, but few references have been made in the otolaryngology literature even though the head and neck is a common site of occurrence. A case report of a 37-year-old Hispanic man with a right-sided neck mass diagnosed preoperatively as a parotid mass by imaging and fine-needle aspiration is presented. After presentation at our multidisciplinary tumor board, excision of the mass was undertaken. Final pathology revealed a NHAC, which is presented in our report. NHAC is an aggressive malignant tumor that is often misdiagnosed preoperatively and that must be treated with aggressive multimodality therapy for increased survival.

[Sacroiliac joint dysfunction with groin pain after an operation for lumbar spinal disorder. A case report].

PubMed

Shimoda, Yusuke; Morimoto, Daijiro; Isu, Toyohiko; Motegi, Hiroaki; Imai, Tetsuaki; Matsumoto, Ryouji; Isobe, Masanori; Kim, Kyongsong; Sugawara, Atsushi

2010-11-01

A 75-year-old male presented with groin pain after an operation to treat lumbar spondylolisthesis (L5). Groin tenderness was localized to the medial border of the anterior superior iliac spine (ASIS). Radiographical and physical examination raised the suspicion of sacroiliac joint (SIJ) dysfunction. Injection of a painkiller into the SIJ relieved symptoms, including groin tenderness. Symptoms improved gradually, and finally disappeared after five SIJ injections. Groin pain has been reported as a referred symptom of SIJ dysfunction in 9.3-23% of patients. Prior to the patient undergoing surgery to treat lumbar spondylolisthesis, SIJ dysfunction had not been noted on physical examination. Long periods spent in the abnormal posture due to lumbar spondylolisthesis induced SIJ stress. After the operation, an improvement in daily activity actually increased stress on the SIJ, resulting in SIJ dysfunction. Certain pathologies, including SIJ dysfunction, should be considered as residual symptoms after operations for lumbar spinal diseases.

Association of Brain DNA methylation in SORL1, ABCA7, HLA-DRB5, SLC24A4, and BIN1 with pathological diagnosis of Alzheimer disease.

PubMed

Yu, Lei; Chibnik, Lori B; Srivastava, Gyan P; Pochet, Nathalie; Yang, Jingyun; Xu, Jishu; Kozubek, James; Obholzer, Nikolaus; Leurgans, Sue E; Schneider, Julie A; Meissner, Alexander; De Jager, Philip L; Bennett, David A

2015-01-01

Recent large-scale genome-wide association studies have discovered several genetic variants associated with Alzheimer disease (AD); however, the extent to which DNA methylation in these AD loci contributes to the disease susceptibility remains unknown. To examine the association of brain DNA methylation in 28 reported AD loci with AD pathologies. Ongoing community-based clinical pathological cohort studies of aging and dementia (the Religious Orders Study and the Rush Memory and Aging Project) among 740 autopsied participants 66.0 to 108.3 years old. DNA methylation levels at individual CpG sites generated from dorsolateral prefrontal cortex tissue using a bead assay. Pathological diagnosis of AD by National Institute on Aging-Reagan criteria following a standard postmortem examination. Overall, 447 participants (60.4%) met the criteria for pathological diagnosis of AD. Brain DNA methylation in SORL1, ABCA7, HLA-DRB5, SLC24A4, and BIN1 was associated with pathological AD. The association was robustly retained after replacing the binary trait of pathological AD with 2 quantitative and molecular specific hallmarks of AD, namely, Aβ load and paired helical filament tau tangle density. Furthermore, RNA expression of transcripts of SORL1 and ABCA7 was associated with paired helical filament tau tangle density, and the expression of BIN1 was associated with Aβ load. Brain DNA methylation in multiple AD loci is associated with AD pathologies. The results provide further evidence that disruption of DNA methylation is involved in the pathological process of AD.

Physical frailty in older persons is associated with Alzheimer disease pathology.

PubMed

Buchman, Aron S; Schneider, Julie A; Leurgans, Sue; Bennett, David A

2008-08-12

We examined the extent to which physical frailty in older persons is associated with common age-related brain pathology, including cerebral infarcts, Lewy body pathology, and Alzheimer disease (AD) pathology. We studied brain autopsies from 165 deceased participants from the Rush Memory and Aging Project, a longitudinal clinical-pathologic study of aging. Physical frailty, based on four components, including grip strength, time to walk 8 feet, body composition, and fatigue, was assessed at annual clinical evaluations. Multiple regression analyses were used to examine the relation of postmortem neuropathologic findings to frailty proximate to death, controlling for age, sex, and education. The mean age at death was 88.1 years (SD = 5.7 years). The level of AD pathology was associated with frailty proximate to death ( = 0.252, SE = 0.077, p = 0.001), accounting for 4% of the variance of physical frailty. Neither cerebral infarcts ( = -0.121, SE = 0.115, p = 0.294) nor Lewy body disease pathology ( = 0.07, SE = 0.156, p = 0.678) was associated with frailty. These associations were unchanged after controlling for the time interval from last clinical evaluation to autopsy. The association of AD pathology with frailty did not differ by the presence of dementia, and this association was unchanged even after considering potential confounders, including physical activity; parkinsonian signs; pulmonary function; or history of chronic diseases, including vascular risk factors, vascular disease burden, falls, joint pain, or use of antipsychotic or antihypertensive medications. Physical frailty in old age is associated with Alzheimer disease pathology in older persons with and without dementia.

The effect of cone beam CT (CBCT) on therapeutic decision-making in endodontics

PubMed Central

Knutsson, K; Flygare, L

2014-01-01

Objectives: The aim was to assess to what extent cone beam CT (CBCT) used in accordance with current European Commission guidelines in a normal clinical setting has an impact on therapeutic decisions in a population referred for endodontic problems. Methods: The study includes data of consecutively examined patients collected from October 2011 to December 2012. From 2 different endodontic specialist clinics, 57 patients were referred for a CBCT examination using criteria in accordance with current European guidelines. The CBCT examinations were performed using similar equipment and standardized among clinics. After a thorough clinical examination, but before CBCT, the examiner made a preliminary therapy plan which was recorded. After the CBCT examination, the same examiner made a new therapy plan. Therapy plans both before and after the CBCT examination were plotted for 53 patients and 81 teeth. As four patients had incomplete protocols, they were not included in the final analysis. Results: 4% of the patients referred to endodontic clinics during the study period were examined with CBCT. The most frequent reason for referral to CBCT examination was to differentiate pathology from normal anatomy, this was the case in 24 patients (45% of the cases). The primary outcome was therapy plan changes that could be attributed to CBCT examination. There were changes in 28 patients (53%). Conclusions: CBCT has a significant impact on therapeutic decision efficacy in endodontics when used in concordance with the current European Commission guidelines. PMID:24766060

A concise evidence-based physical examination for diagnosis of acromioclavicular joint pathology: a systematic review.

PubMed

Krill, Michael K; Rosas, Samuel; Kwon, KiHyun; Dakkak, Andrew; Nwachukwu, Benedict U; McCormick, Frank

2018-02-01

The clinical examination of the shoulder joint is an undervalued diagnostic tool for evaluating acromioclavicular (AC) joint pathology. Applying evidence-based clinical tests enables providers to make an accurate diagnosis and minimize costly imaging procedures and potential delays in care. The purpose of this study was to create a decision tree analysis enabling simple and accurate diagnosis of AC joint pathology. A systematic review of the Medline, Ovid and Cochrane Review databases was performed to identify level one and two diagnostic studies evaluating clinical tests for AC joint pathology. Individual test characteristics were combined in series and in parallel to improve sensitivities and specificities. A secondary analysis utilized subjective pre-test probabilities to create a clinical decision tree algorithm with post-test probabilities. The optimal special test combination to screen and confirm AC joint pathology combined Paxinos sign and O'Brien's Test, with a specificity of 95.8% when performed in series; whereas, Paxinos sign and Hawkins-Kennedy Test demonstrated a sensitivity of 93.7% when performed in parallel. Paxinos sign and O'Brien's Test demonstrated the greatest positive likelihood ratio (2.71); whereas, Paxinos sign and Hawkins-Kennedy Test reported the lowest negative likelihood ratio (0.35). No combination of special tests performed in series or in parallel creates more than a small impact on post-test probabilities to screen or confirm AC joint pathology. Paxinos sign and O'Brien's Test is the only special test combination that has a small and sometimes important impact when used both in series and in parallel. Physical examination testing is not beneficial for diagnosis of AC joint pathology when pretest probability is unequivocal. In these instances, it is of benefit to proceed with procedural tests to evaluate AC joint pathology. Ultrasound-guided corticosteroid injections are diagnostic and therapeutic. An ultrasound-guided AC joint corticosteroid injection may be an appropriate new standard for treatment and surgical decision-making. II - Systematic Review.

An orthopedist's guide to shoulder ultrasound: a systematic review of examination protocols.

PubMed

Amoo-Achampong, Kelms; Nwachukwu, Benedict U; McCormick, Frank

2016-11-01

The utilization of musculoskeletal ultrasound has expanded within the setting of the orthopedic clinic as a cost-effective, point-of-care diagnostic tool for shoulder pathology. In experienced hands, ultrasound exhibits capabilities equivalent to that of magnetic resonance imaging in the diagnosis of many shoulder diseases including full-thickness and partial-thickness rotator cuff tears. Although similarly effective in identifying additional shoulder disease processes, major obstacles to its widespread use include user dependence and intrinsic limitation to extra-articular diagnosis. The purpose of this review is to present a step-by-step guide of how to perform a comprehensive shoulder examination and to discuss the appropriate use, economic benefit and implementation of ultrasound within the clinic. A systematic search (June 2016) of PubMed, Scopus, and EMBASE databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for literature presenting shoulder ultrasound examination protocols. Included studies were peer-reviewed articles or academic society endorsed protocols presenting comprehensive sonographic examinations of the adult shoulder. Papers with limited or single structure examination descriptions, non-English language, and publication dates before 1980 were excluded. Final papers meeting criteria were secondarily screened for publication after 2005 to reflect the current state of ultrasound imaging. The search yielded 1,725 unique articles with 17 studies meeting final selection criteria. Information from identified studies was summarized to formulate a 4-part shoulder examination protocol, including steps most pertinent to orthopedic in-office diagnoses. In agreement with previous studies, the inexperienced orthopedic surgeon can be quickly trained to expert level proficiency in shoulder ultrasound diagnosis. Using an established protocol, a comprehensive, yet effective shoulder ultrasound examination can be performed within ten minutes. Further, ultrasound provides opportunity to off-set costs through the engagement of revenue generating activity for the orthopedic practice.

Pathological Gambling and Associated Drug and Alcohol Abuse, Emotion Regulation, and Anxious-Depressive Symptomatology

PubMed Central

Jauregui, Paula; Estévez, Ana; Urbiola, Irache

2016-01-01

Background and aims Pathological gambling is associated with comorbid disorders, such as anxiety, depression, and drug and alcohol abuse. Difficulties of emotion regulation may be one of the factors related to the presence of addictive disorders, along with comorbid symptomatology in pathological gamblers. Therefore, the aim of this study was to evaluate the difficulties of emotion regulation, drug and alcohol abuse, and anxious and depressive symptomatology in pathological gamblers, and the mediating role of difficulties of emotion regulation between anxiety and pathological gambling. Methods The study sample included 167 male pathological gamblers (mean age = 39.29 years) and 107 non-gamblers (mean age = 33.43 years). Pathological gambling (SOGS), difficulties of emotion regulation (DERS), drug and alcohol abuse (MUTICAGE CAD-4), and anxious and depressive symptomatology (SA-45) were measured. Student’s t, Pearson’s r, stepwise multiple linear regression and multiple mediation analyses were conducted. The study was approved by an Investigational Review Board. Results Relative to non-gamblers, pathological gamblers exhibited greater difficulties of emotion regulation, as well as more anxiety, depression, and drug abuse. Moreover, pathological gambling correlated with emotion regulation difficulties, anxiety, depression, and drug abuse. Besides, emotion regulation difficulties correlated with and predicted pathological gambling, drug and alcohol abuse, and anxious and depressive symptomatology. Finally, emotion regulation difficulties mediated the relationship between anxiety and pathological gambling controlling the effect of age, both when controlling and not controlling for the effect of other abuses. Discussion and conclusions These results suggest that difficulties of emotion regulation may provide new keys to understanding and treating pathological gambling and comorbid disorders. PMID:27348555

A Cross Sectional Study of Problem and Pathological Gambling in Patients with Schizophrenia/Schizoaffective Disorder

PubMed Central

Desai, Rani A.; Potenza, Marc N.

2013-01-01

Background Community data suggest frequent co-occurrence between schizophrenia/schizoaffective disorder and problem gambling. However, gambling behaviors in large samples of patients with schizophrenia/schizoaffective disorder have not been systematically examined to date. Methods A sample of outpatient subjects (n=337) diagnosed with schizophrenia/schizoaffective disorder or schizoaffective disorder and treated in either a VA hospital or a local state mental health center was interviewed in order to examine the prevalence estimates and clinical correlates of problem and pathological gambling. Multinomial logistic regression models investigated clinically relevant measures in recreational or problem/pathological gamblers, as compared to non-gamblers. Results Sixty-five participants (19%) met criteria for past-year problem/pathological gambling, with 10% meeting criteria for pathological gambling. Significant correlates of problem and pathological gambling from multivariable models included greater alcohol use severity (p=0.007), higher depression scores (p=0.04), and more outpatient mental health care utilization (p=0.03). Participants with problem/pathological gambling were more likely than recreational gamblers to gamble for excitement, gamble more frequently and heavily, and report either sports or card gambling as favorite. Conclusions A substantial proportion of individuals in treatment for psychotic disorders report past-year gambling problems. Patients with co-occurring alcohol use problems and depression may be at particularly high risk. These findings suggest the need for improved prevention and treatment efforts related to problem/pathological gambling in individuals with psychotic disorders. PMID:19538900

Sonography of suspected acute appendicitis in children: Evaluation of the progress in performance of senior residents.

PubMed

Gerbier, Pierre; Binet, Aurélien; Etancelin, Mathilde; Barteau, Emmanuel; Auger, Marie; Morales, Luciano; Bertrand, Philippe; Sirinelli, Dominique; Morel, Baptiste

2018-04-01

The objective of this study was to evaluate the progress in performance of senior residents in diagnosing acute appendicitis. Results were collected and compared of ultrasound examinations performed for suspected acute appendicitis by three senior residents and two faculty members over a six-month period in a university hospital setting. A grid with the sonographic findings was completed separately by the residents and the faculty members immediately after each examination. The duration of each examination was reported. The final ultrasound diagnosis was compared to the surgical and pathological results and to the clinical follow-up. The residents and faculty members performed 171 consecutive ultrasound examinations including 49 children with acute appendicitis and 122 with normal appendices. The accuracy of the diagnosis by the residents was 96%, and was similar to that of the faculty members (kappa=0.90) over the six months. The duration of the resident ultrasound examinations was significantly shorter during the second three-month period (p=0.01). No significant differences in diagnostic accuracy were demonstrated by the residents between the first and second three-month periods (p=0.06). The residents performed well when using sonography to diagnose acute appendicitis in children, and were faster during the second three-month period. I. Copyright © 2017 Elsevier Inc. All rights reserved.

[Gymnema sylvestre leaf extract: a 52-week dietary toxicity study in Wistar rats].

PubMed

Ogawa, Yukio; Sekita, Kiyoshi; Umemura, Takashi; Saito, Minoru; Ono, Atsushi; Kawasaki, Yasushi; Uchida, Osayuki; Matsushima, Yuko; Inoue, Tohru; Kanno, Jun

2004-02-01

A 52-week study of oral-repeated-dose toxicity for the extraction powder of Gymnema sylvestre (GS), Indian-native genus, Metaplexis japonica, was conducted in both genders of Wistar rats. The rats were administered a graded dose of GS at 0.01, 0.10 and 1.00% of basal powder diet, along with a group fed solely with the basal powder diet without GS, for 52 weeks. General conditions were recorded daily. Body weights and food consumptions were recorded weekly up to 12 weeks, and thereafter at longer intervals. At 26 weeks, for an intermediate examination, and 52 weeks, for the final examination, animals were subjected to hematology, serum chemistry, and pathological examination. None of the animals died in the period up to 52 weeks. No exposure-related changes in body-weight, in the food consumption, in the hematological examinations, or in the serum biochemical examinations were recognized. No histopathological alterations were seen. Thus, it was concluded that there was no toxic effect in rats treated with GS at up to 1.00% in the diet for 52 weeks. The no-observable-effect level from this study is 1.00% GS, i.e., 504 mg/kg/day for male and 563 mg/kg/day for female as mean daily intake, for 52 weeks.

Eating Pathology, Emotion Regulation, and Emotional Overeating in Obese Adults with Binge Eating Disorder

PubMed Central

Gianini, Loren M.; White, Marney A.; Masheb, Robin M.

2013-01-01

Objective The purpose of the current study was to examine the relationship among emotional regulation, emotional overeating, and general eating pathology in a treatment seeking sample of adults with Binge Eating Disorder (BED). Method The sample was composed of 326 adults (248 women, 78 men) who were obese and met DSM-IV-TR criteria for BED. Prior to treatment, participants completed the Difficulties in Emotion Regulation Scale (DERS), Emotional Overeating Questionnaire (EOQ), Beck Depression Inventory (BDI), and Eating Disorder Examination-Questionnaire (EDE-Q) as part of a larger assessment battery. Results A series of hierarchical regression analyses indicated that difficulties with emotion regulation accounted for unique variance in both emotional overeating and general eating pathology above and beyond sex and negative affect. Discussion Emotion regulation may play a significant role in the maintenance of emotional overeating and eating pathology in obese adults with BED. PMID:23910772

Eating pathology, emotion regulation, and emotional overeating in obese adults with Binge Eating Disorder.

PubMed

Gianini, Loren M; White, Marney A; Masheb, Robin M

2013-08-01

The purpose of the current study was to examine the relationship among emotional regulation, emotional overeating, and general eating pathology in a treatment seeking sample of adults with Binge Eating Disorder (BED). The sample was composed of 326 adults (248 women, 78 men) who were obese and met DSM-IV-TR criteria for BED. Prior to treatment, participants completed the Difficulties in Emotion Regulation Scale (DERS), Emotional Overeating Questionnaire (EOQ), Beck Depression Inventory (BDI), and Eating Disorder Examination-Questionnaire (EDE-Q) as part of a larger assessment battery. A series of hierarchical regression analyses indicated that difficulties with emotion regulation accounted for unique variance in both emotional overeating and general eating pathology above and beyond sex and negative affect. Emotion regulation may play a significant role in the maintenance of emotional overeating and eating pathology in obese adults with BED. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Correlation between iridology and general pathology].

PubMed

Demea, Sorina

2002-01-01

The research proposal is to evaluate the association between certain irian signs and general pathology of studied patients. There were studied 57 hospitalized patients; there was taken over all their iris images, which were analyzed through iridological protocols; in the same time the pathology of these patients was noted from their records in the hospital, concordant with the clinical diagnosis; all these information were included in a database for a computerised processing. The correlations resulted from, shows a high connection between the irian constitution establish through iridological criteria and the existent pathology. Iris examination can be very useful for diagnosis of a certain general pathology, in a holistic approach of the patient.

Lethal injection of potassium chloride: first description of the pathological appearance of organs.

PubMed

Coulibaly, Béma; Piercecchi-Marti, Marie-Dominique; Bartoli, Christophe; Liprandi, Agnes; Léonetti, Georges; Pellissier, Jean-François

2010-05-01

Lethal injection of potassium chloride (KCl) can be used as a method of either suicide or homicide. As biological tests are still inadequate to differentiate endogenous from exogenous potassium, at the scene of death the cause can only be suspected. We wished to determine the usefulness of conventional pathological examination in this context and carried out a study in four fetuses after medical termination of pregnancy for serious disease. Pregnancy was terminated by KCl injection in two cases and by injection of lidocaine and sufentanil in the other two cases. In each of the two fetuses in which KCl injection was performed, macroscopic examination showed whitish deposits on the tissues and histological examination showed clumps of lanceolate crystals in the internal organs. In the two fetuses which received lidocaine and sufentanil injection, no deposits were visible on macroscopic examination and no crystals were seen on histological examination. These findings suggest that pathological study may have useful applications in forensic medicine when death by potassium injection is suspected. 2009 John Wiley & Sons, Ltd.

The Role of Extracellular Adenosine Generation in the Development of Autoimmune Diseases

PubMed Central

Rizzo, R.; Malavasi, F.

2018-01-01

Adenosine (ADO) is an immunosuppressive molecule, which suppresses the immune responses by interacting with specific receptors expressed by immune effector cells. ADO is produced from ATP through the enzymatic activities of CD39 and CD73. Alternatively, ADO can be generated starting from NAD+, which is metabolized by the concerted action of CD38, CD203a/PC-1, and CD73. The role of ADO in immunity has been characterized in the last years in physiology and in pathological settings. This review examines a panel of reports focused on the functions of ADO in the context of human autoimmune/inflammatory diseases and the selected animal models. The final aim is to consider the role of adenosinergic ectoenzymes and ADO receptors as novel therapeutic targets for selected diseases. PMID:29769837

[ISO 15189, Up-To-Date Information and Prospective View].

PubMed

Shimoda, Katsuji

2016-02-01

"Accreditation Activities for Medical Laboratories in Japan" Audits for transition to ISO 15189:2012 continue to progress. Besides the continual increase of accreditations for medical laboratory testing and pathological examinations, preparations for the addition of physiological testing to the scope of accreditation have finally been completed. As a part of the revision to Japan's Medical Service Act, the external evaluation of medical laboratories is now a requirement to approve clinical trial core hospitals. Accordingly, the importance of third-party accreditation in medical laboratory testing is attracting a growing level of attention. World Accreditation Day 2015 "Accreditation: Supporting the Delivery of Health and Social Care" JAB is being used to make every effort to contribute to this system in order to improve the quality of healthcare in Japan and the health of its citizens.

Nociceptin and the nociceptin receptor in learning and memory.

PubMed

Andero, Raül

2015-10-01

There are many processes in which the neuropeptide nociceptin/orphanin FQ (N/OFQ or nociceptin) is involved in the brain. The role of nociceptin in learning and memory holds promise in modulating these processes in health and disease in the human brain. This review summarizes the body of research focused on N/OFQ and its specific receptor, the nociceptin receptor (NOP receptor), in learning and memory, and its potential mechanisms of action, in which acetylcholine, NMDA receptor, and noradrenaline may be critical. Finally, the association between NOP receptor and posttraumatic stress disorder (PTSD), a psychiatric disorder with altered fear learning, is examined as one of the potential outcomes resulting from pathological consequences of dysregulation of N/OFQ-NOP receptor in the brain. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinical findings, rhinoscopy and histological evaluation of 54 dogs with chronic nasal disease

PubMed Central

Pietra, Marco; Pasquali, Flavio; Romagnoli, Noemi; Bettini, Giuliano; Spadari, Alessandro

2010-01-01

Nasal diseases are very common in dogs and rhinoscopy is often required for a definitive diagnosis. Rhinoscopy, while superficial in nature, can guide the clinician to the final diagnosis. In this study, rhinoscopy was performed on 54 dogs with symptoms of chronic nasopharyngeal disease. The endoscopic diagnosis of neoplasia or chronic nasal inflammation was validated with histological examination of pathological samples, in order to evaluate the degree of concordance between endoscopic findings and histological diagnosis. The agreement between endoscopy and histology was tested by application of Cohen's kappa coefficient. We conclude that correlation between endoscopic results and histological diagnosis, expressed by a Cohen's kappa coefficient of 0.73, is only possible with a constant cooperation between the clinician and the pathologist. PMID:20706033

Left atrial function: evaluation by strain analysis

PubMed Central

Gan, Gary C. H.; Ferkh, Aaisha; Boyd, Anita

2018-01-01

The left atrium has an important role in modulating left ventricular filling and is an important biomarker of cardiovascular disease and adverse cardiovascular outcomes. While previously left atrial (LA) size was utilised, the role of LA function as a biomarker is increasingly being evaluated, both independently and also in combination with LA size. Strain analysis has been utilised for evaluation of LA function and can be measured throughout the cardiac cycle, thereby enabling the evaluation of LA reservoir, conduit and contractile function. Strain evaluates myocardial deformation while strain rate examines the rate of change in strain. This review will focus on the various types of strain analysis for evaluation of LA function, alterations in LA strain in physiological and pathologic states that alter LA function and finally evaluate its utility as a prognostic marker. PMID:29541609

A generalized procedure for analyzing sustained and dynamic vocal fold vibrations from laryngeal high-speed videos using phonovibrograms.

PubMed

Unger, Jakob; Schuster, Maria; Hecker, Dietmar J; Schick, Bernhard; Lohscheller, Jörg

2016-01-01

This work presents a computer-based approach to analyze the two-dimensional vocal fold dynamics of endoscopic high-speed videos, and constitutes an extension and generalization of a previously proposed wavelet-based procedure. While most approaches aim for analyzing sustained phonation conditions, the proposed method allows for a clinically adequate analysis of both dynamic as well as sustained phonation paradigms. The analysis procedure is based on a spatio-temporal visualization technique, the phonovibrogram, that facilitates the documentation of the visible laryngeal dynamics. From the phonovibrogram, a low-dimensional set of features is computed using a principle component analysis strategy that quantifies the type of vibration patterns, irregularity, lateral symmetry and synchronicity, as a function of time. Two different test bench data sets are used to validate the approach: (I) 150 healthy and pathologic subjects examined during sustained phonation. (II) 20 healthy and pathologic subjects that were examined twice: during sustained phonation and a glissando from a low to a higher fundamental frequency. In order to assess the discriminative power of the extracted features, a Support Vector Machine is trained to distinguish between physiologic and pathologic vibrations. The results for sustained phonation sequences are compared to the previous approach. Finally, the classification performance of the stationary analyzing procedure is compared to the transient analysis of the glissando maneuver. For the first test bench the proposed procedure outperformed the previous approach (proposed feature set: accuracy: 91.3%, sensitivity: 80%, specificity: 97%, previous approach: accuracy: 89.3%, sensitivity: 76%, specificity: 96%). Comparing the classification performance of the second test bench further corroborates that analyzing transient paradigms provides clear additional diagnostic value (glissando maneuver: accuracy: 90%, sensitivity: 100%, specificity: 80%, sustained phonation: accuracy: 75%, sensitivity: 80%, specificity: 70%). The incorporation of parameters describing the temporal evolvement of vocal fold vibration clearly improves the automatic identification of pathologic vibration patterns. Furthermore, incorporating a dynamic phonation paradigm provides additional valuable information about the underlying laryngeal dynamics that cannot be derived from sustained conditions. The proposed generalized approach provides a better overall classification performance than the previous approach, and hence constitutes a new advantageous tool for an improved clinical diagnosis of voice disorders. Copyright © 2015 Elsevier B.V. All rights reserved.

Of von Willebrand factor and platelets.

PubMed

Bryckaert, Marijke; Rosa, Jean-Philippe; Denis, Cécile V; Lenting, Peter J

2015-01-01

Hemostasis and pathological thrombus formation are dynamic processes that require multiple adhesive receptor-ligand interactions, with blood platelets at the heart of such events. Many studies have contributed to shed light on the importance of von Willebrand factor (VWF) interaction with its platelet receptors, glycoprotein (GP) Ib-IX-V and αIIbβ3 integrin, in promoting primary platelet adhesion and aggregation following vessel injury. This review will recapitulate our current knowledge on the subject from the rheological aspect to the spatio-temporal development of thrombus formation. We will also discuss the signaling events generated by VWF/GPIb-IX-V interaction, leading to platelet activation. Additionally, we will review the growing body of evidence gathered from the recent development of pathological mouse models suggesting that VWF binding to GPIb-IX-V is a promising target in arterial and venous pathological thrombosis. Finally, the pathological aspects of VWF and its impact on platelets will be addressed.

[Ultrasound in complex of radiological studies in diagnosis of ankle joint medial aspect pathologies].

PubMed

Gurgenidze, T; Mizandari, M

2011-10-01

The aim of the research is to study sonosemiotics of ankle joint pathology by means of ultrasound in order to optimize the diagnostic process and improve the treatment. 130 patients (age ranges from 5 to 70 years) underwent the radiological study of ankle joint medial aspect. Pathology types: degenerative-dystrophic diseases - 39 (30%), inflammatory pathology - 21 (16.2%), traumatic injuries - 20 (15.2%), vascular pathologies - 26 (20%), neurogenic problems -7 (5.4%), soft tissue neoplasms - 5 (3.8%), congenital anomalies - 7 (5.4%) and vertebral pathology - 5 (4.0%). The diagnostic studies include: a) Ultrasound, performed on digital ultrasound system using high frequency (7.5-12.0 MHz) linear probe with Doppler capability (all patients); b) X-Ray filming in antero-posterior and lateral projections (6 patients- 4.5%); c) MRI - T1 and T2 weighted images in saggital and transverse planes 10 patients (10.0%) and d) CT - 2 patients (1.5%); To 2 (1.5%) patient biopsy has been performed. This study showed that ultrasound was successful in ankle joint medial aspect pathology diagnosis in 108 cases (84.0%); It was ineffective in osseous pathology definition. In final diagnosis of impingment syndrom MRI was required in 4 (3.6%) cases. It is concluded that ultrasound should be used as a Gold Standard in diagnosis of localized pain and swelling in the ankle joint.

Computational analysis identifies putative prognostic biomarkers of pathological scarring in skin wounds.

PubMed

Nagaraja, Sridevi; Chen, Lin; DiPietro, Luisa A; Reifman, Jaques; Mitrophanov, Alexander Y

2018-02-20

Pathological scarring in wounds is a prevalent clinical outcome with limited prognostic options. The objective of this study was to investigate whether cellular signaling proteins could be used as prognostic biomarkers of pathological scarring in traumatic skin wounds. We used our previously developed and validated computational model of injury-initiated wound healing to simulate the time courses for platelets, 6 cell types, and 21 proteins involved in the inflammatory and proliferative phases of wound healing. Next, we analysed thousands of simulated wound-healing scenarios to identify those that resulted in pathological (i.e., excessive) scarring. Then, we identified candidate proteins that were elevated (or decreased) at the early stages of wound healing in those simulations and could therefore serve as predictive biomarkers of pathological scarring outcomes. Finally, we performed logistic regression analysis and calculated the area under the receiver operating characteristic curve to quantitatively assess the predictive accuracy of the model-identified putative biomarkers. We identified three proteins (interleukin-10, tissue inhibitor of matrix metalloproteinase-1, and fibronectin) whose levels were elevated in pathological scars as early as 2 weeks post-wounding and could predict a pathological scarring outcome occurring 40 days after wounding with 80% accuracy. Our method for predicting putative prognostic wound-outcome biomarkers may serve as an effective means to guide the identification of proteins predictive of pathological scarring.

Immunomodulation and Anti-Inflammatory Effects of Garlic Compounds

PubMed Central

Arreola, Rodrigo; Quintero-Fabián, Saray; López-Roa, Rocío Ivette; Flores-Gutiérrez, Enrique Octavio; Reyes-Grajeda, Juan Pablo; Carrera-Quintanar, Lucrecia; Ortuño-Sahagún, Daniel

2015-01-01

The benefits of garlic to health have been proclaimed for centuries; however, only recently have Allium sativum and its derivatives been proposed as promising candidates for maintaining the homeostasis of the immune system. The complex biochemistry of garlic makes it possible for variations in processing to yield different preparations with differences in final composition and compound proportion. In this review, we assess the most recent experimental results, which indicate that garlic appears to enhance the functioning of the immune system by stimulating certain cell types, such as macrophages, lymphocytes, natural killer (NK) cells, dendritic cells, and eosinophils, by mechanisms including modulation of cytokine secretion, immunoglobulin production, phagocytosis, and macrophage activation. Finally, because immune dysfunction plays an important role in the development and progress of several diseases, we critically examined immunoregulation by garlic extracts and compounds isolated, which can contribute to the treatment and prevention of pathologies such as obesity, metabolic syndrome, cardiovascular disorders, gastric ulcer, and even cancer. We concluded that A. sativum modulates cytokine secretion and that such modulation may provide a mechanism of action for many of their therapeutic effects. PMID:25961060

Immunomodulation and anti-inflammatory effects of garlic compounds.

PubMed

Arreola, Rodrigo; Quintero-Fabián, Saray; López-Roa, Rocío Ivette; Flores-Gutiérrez, Enrique Octavio; Reyes-Grajeda, Juan Pablo; Carrera-Quintanar, Lucrecia; Ortuño-Sahagún, Daniel

2015-01-01

The benefits of garlic to health have been proclaimed for centuries; however, only recently have Allium sativum and its derivatives been proposed as promising candidates for maintaining the homeostasis of the immune system. The complex biochemistry of garlic makes it possible for variations in processing to yield different preparations with differences in final composition and compound proportion. In this review, we assess the most recent experimental results, which indicate that garlic appears to enhance the functioning of the immune system by stimulating certain cell types, such as macrophages, lymphocytes, natural killer (NK) cells, dendritic cells, and eosinophils, by mechanisms including modulation of cytokine secretion, immunoglobulin production, phagocytosis, and macrophage activation. Finally, because immune dysfunction plays an important role in the development and progress of several diseases, we critically examined immunoregulation by garlic extracts and compounds isolated, which can contribute to the treatment and prevention of pathologies such as obesity, metabolic syndrome, cardiovascular disorders, gastric ulcer, and even cancer. We concluded that A. sativum modulates cytokine secretion and that such modulation may provide a mechanism of action for many of their therapeutic effects.

Discordance between Ureteroscopic Biopsy and Final Pathology for Upper Tract Urothelial Carcinoma.

PubMed

Margolin, Ezra J; Matulay, Justin T; Li, Gen; Meng, Xiaosong; Chao, Brian; Vijay, Varun; Silver, Hayley; Clinton, Timothy N; Krabbe, Laura-Maria; Woldu, Solomon L; Singla, Nirmish; Bagrodia, Aditya; Margulis, Vitaly; Huang, William C; Bjurlin, Marc A; Shah, Ojas; Anderson, Christopher B

2018-06-01

We evaluated the discordance between ureteroscopic biopsy and surgical pathology findings for grading and staging upper tract urothelial carcinoma. We also sought to establish preoperative predictors of aggressive tumors. We retrospectively reviewed the records of 314 patients who underwent ureteroscopic biopsy followed by surgical management of upper tract urothelial carcinoma from 2000 to 2016 at a total of 3 institutions. Our primary outcomes were muscle invasive (pT2 or greater) disease at surgical pathology and upgrading of clinical low grade tumors to pathological high grade. At biopsy 61% of the patients had clinical high grade tumors and 21% had subepithelial connective tissue invasion (cT1+). On final pathology 79% of the patients had pathological high grade tumors and 45% had stage pT2 or greater. On multivariate analysis advanced patient age, clinical high grade and cT1+ were independently associated with pT2 or greater. The combined presence of clinical high grade and cT1+ had 86% positive predictive value for muscle invasion while the combined absence of clinical high grade and cT1+ had 80% negative predictive value. The likelihood of missing invasion on biopsy in patients with muscle invasive disease was increased when biopsy fragments were limited to 1 mm or less. Of clinical low grade cases on biopsy 51% were upgraded at surgery. The presence of positive urine cytology was associated with an increased risk of upgrading but this was not statistically significant. Clinical high grade, cT1+ on biopsy and advanced patient age are independent risk factors for muscle invasive upper tract urothelial carcinoma. There is a significant risk of upgrading in patients with clinical low grade tumors on biopsy, especially when urine cytology is positive. The predictive value of biopsy can likely be improved by more extensive ureteroscopic sampling. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Positive surgical margins in robot-assisted partial nephrectomy: a multi-institutional analysis of oncologic outcomes (leave no tumor behind).

PubMed

Khalifeh, Ali; Kaouk, Jihad H; Bhayani, Sam; Rogers, Craig; Stifelman, Michael; Tanagho, Youssef S; Kumar, Ramesh; Gorin, Michael A; Sivarajan, Ganesh; Samarasekera, Dinesh; Allaf, Mohamad E

2013-11-01

Expanding indications for robot-assisted partial nephrectomy raise major oncologic concerns for positive surgical margins. Previous reports showed no correlation between positive surgical margins and oncologic outcomes. We report a multi-institutional experience with the oncologic outcomes of positive surgical margins on robot-assisted partial nephrectomy. Pathological and clinical followup data were reviewed from an institutional review board approved, prospectively maintained joint database from 5 institutions. Tumors with malignant pathology were isolated and statistically analyzed for demographics and oncologic followup. The log rank test was used to compare recurrence-free and metastasis-free survival between patients with positive and negative surgical margins. The proportional hazards method was used to assess the influence of multiple factors, including positive surgical margins, on recurrence and metastasis. A total of 943 robot-assisted partial nephrectomies for malignant tumors were successfully completed. Of the patients 21 (2.2%) had positive surgical margins on final pathological assessment, resulting in 2 groups, including the 21 with positive surgical margins and 922 with negative surgical margins. Positive surgical margin cases had higher recurrence and metastasis rates (p<0.001). As projected by the Kaplan-Meier method in the population as a whole at followup out to 63.6 months, 5-year recurrence-free and metastasis-free survival was 94.8% and 97.5%, respectively. There was a statistically significant difference in recurrence-free and metastasis-free survival between patients with positive and negative surgical margins (log rank test<0.001), which favored negative surgical margins. Positive surgical margins showed an 18.4-fold higher HR for recurrence when adjusted for multiple tumors, tumor size, tumor growth pattern and pathological stage. Positive surgical margins on final pathological evaluation increase the HR of recurrence and metastasis. In addition to pathological and molecular tumor characteristics, this should be considered to plan appropriate management. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

The effect of funding cuts on the utilization of an oral pathology diagnostic service.

PubMed

Chugh, Deepika; McComb, R John; Mock, David

2009-09-01

To examine what impact the loss of funding had on the utilization of the oral pathology service. Biopsy records were retrieved and examined in the two year period before and after the elimination of the subsidies in 2003. After the loss of funding, there was a 31% decrease in the number of specimens submitted from practitioners in private practice, with the greatest drop noted in submissions from endodontists. Despite the immediate decrease in the number of biopsies submitted after the introduction of fee-for-service, the number of specimens being submitted appears to be on the rise again, as practitioners appear to recognize the value of a specialized oral pathology diagnostic service.

Financial and Health Literacy Predict Incident Alzheimer's Disease Dementia and Pathology.

PubMed

Yu, Lei; Wilson, Robert S; Schneider, Julie A; Bennett, David A; Boyle, Patricia A

2017-01-01

Domain specific literacy is a multidimensional construct that requires multiple resources including cognitive and non-cognitive factors. We test the hypothesis that domain specific literacy is associated with Alzheimer's disease (AD) dementia and AD pathology after controlling for cognition. Participants were community-based older persons who completed a baseline literacy assessment, underwent annual clinical evaluations for up to 8 years, and agreed to organ donation after death. Financial and health literacy was measured using 32 questions and cognition was measured using 19 tests. Annual diagnosis of AD dementia followed standard criteria. AD pathology was examined postmortem by quantifying plaques and tangles. Cox models examined the association of literacy with incident AD dementia. Performance of model prediction for incident AD dementia was assessed using indices for integrated discrimination improvement and continuous net reclassification improvement. Linear regression models examined the independent association of literacy with AD pathology in autopsied participants. All 805 participants were free of dementia at baseline and 102 (12.7%) developed AD dementia during the follow-up. Lower literacy was associated with higher risk for incident AD dementia (p < 0.001), and the association persisted after controlling for cognition (hazard ratio = 1.50, p = 0.004). The model including the literacy measure had better predictive performance than the one with demographics and cognition only. Lower literacy also was associated with higher burden of AD pathology after controlling for cognition (β= 0.07, p = 0.035). Literacy predicts incident AD dementia and AD pathology in community-dwelling older persons, and the association is independent of traditional measures of cognition.

Specific features of cytological and colposcopical pattern in pregnant women with benign cervix uteri pathology in anamnesis.

PubMed

Bysaha, Nataliya Yu

2016-01-01

a tendency of increasing incidence of the cervix uteri precancer and cancer in women of reproductive age is noticed recently being related to the growth of number of the sexually-transmitted infections. The cervix uteri pathology incidence in women of fertile age is 20-25%. to study the specific features of the cytological and colposcopical pattern in pregnant patients with benign cervix uteri pathology in the anamnesis and the character of its change post partum. we have examined 195 women during their pregnancy and 3-5 months post partum. All pregnant women, alongside with generally accepted clinical and laboratory examinations, were subjected to the simple and extended colposcopy, cytology of the targeted smears and, according to indications, the histological studies of bioptate. according to the results of the colcoscopical studies and the signs of the cervix uteri pathology found, the patients were divided into several groups. A control group included 49 pregnant women. The clinical and instrumental examination of 146 women with cervix uteri pathology has been carried out both during pregnancy and post partum. the structure of the clinical forms of benign and premalignant changes in the cervix uteri epithelium in pregnant patients has been found. Specific features of the cytological and colposcopical pattern in pregnant patients with benign cervix uteri pathology in anamnesis have been studied. The relationship between the parity of pregnancy, delivery, route of delivery and regress of both benign and premalignant changes in the cervix uteri epithelium 3-5 months post partum has been determined.

Financial and health literacy predict incident AD dementia and AD pathology

PubMed Central

Yu, Lei; Wilson, Robert S.; Schneider, Julie A.; Bennett, David A.; Boyle, Patricia A.

2017-01-01

Background Domain specific literacy is a multidimensional construct that requires multiple resources including cognitive and non-cognitive factors. Objective We test the hypothesis that domain specific literacy is associated with AD dementia and AD pathology after controlling for cognition. Methods Participants were community based older persons who completed a baseline literacy assessment, underwent annual clinical evaluations for up to 8 years and agreed to organ donation after death. Financial and health literacy was measured using 32 questions and cognition was measured using 19 tests. Annual diagnosis of AD dementia followed standard criteria. AD pathology was examined post-mortem by quantifying plaques and tangles. Cox models examined the association of literacy with incident AD dementia. Performance of model prediction for incident AD dementia was assessed using indices for integrated discrimination improvement and continuous net reclassification improvement. Linear regression models examined the independent association of literacy with AD pathology in autopsied participants. Results All 805 participants were free of dementia at baseline and 102 (12.7%) developed AD dementia during the follow-up. Lower literacy was associated with higher risk for incident AD dementia (p<0.001), and the association persisted after controlling for cognition (Hazard Ratio=1.50, p=0.004). The model including the literacy measure had better predictive performance than the one with demographics and cognition only. Lower literacy also was associated with higher burden of AD pathology after controlling for cognition (β=0.07, p=0.035). Conclusion Literacy predicts incident AD dementia and AD pathology in community-dwelling older persons, and the association is independent of traditional measures of cognition. PMID:28157101

Hippocampal sclerosis of aging, a prevalent and high-morbidity brain disease

PubMed Central

Smith, Charles D.; Abner, Erin L.; Wilfred, Bernard J.; Wang, Wang-Xia; Neltner, Janna H.; Baker, Michael; Fardo, David W.; Kryscio, Richard J.; Scheff, Stephen W.; Jicha, Gregory A.; Jellinger, Kurt A.; Van Eldik, Linda J.; Schmitt, Frederick A.

2013-01-01

Hippocampal sclerosis of aging (HS-Aging) is a causative factor in a large proportion of elderly dementia cases. The current definition of HS-Aging rests on pathologic criteria: neuronal loss and gliosis in the hippocampal formation that is out of proportion to AD-type pathology. HS-Aging is also strongly associated with TDP-43 pathology. HS-Aging pathology appears to be most prevalent in the oldest-old: autopsy series indicate that 5–30 % of nonagenarians have HS-Aging pathology. Among prior studies, differences in study design have contributed to the study-to-study variability in reported disease prevalence. The presence of HS-Aging pathology correlates with significant cognitive impairment which is often misdiagnosed as AD clinically. The antemortem diagnosis is further confounded by other diseases linked to hippocampal atrophy including frontotemporal lobar degeneration and cerebrovascular pathologies. Recent advances characterizing the neurocognitive profile of HS-Aging patients have begun to provide clues that may help identify living individuals with HS-Aging pathology. Structural brain imaging studies of research subjects followed to autopsy reveal hippocampal atrophy that is substantially greater in people with eventual HS-Aging pathology, compared to those with AD pathology alone. Data are presented from individuals who were followed with neurocognitive and neuroradiologic measurements, followed by neuropathologic evaluation at the University of Kentucky. Finally, we discuss factors that are hypothesized to cause or modify the disease. We conclude that the published literature on HS-Aging provides strong evidence of an important and under-appreciated brain disease of aging. Unfortunately, there is no therapy or preventive strategy currently available. PMID:23864344

Transgenic Mice Overexpressing Amyloid Precursor Protein Exhibit Early Metabolic Deficits and a Pathologically Low Leptin State Associated with Hypothalamic Dysfunction in Arcuate Neuropeptide Y Neurons

PubMed Central

Ishii, Makoto; Wang, Gang; Racchumi, Gianfranco; Dyke, Jonathan P.

2014-01-01

Weight loss is a prominent early feature of Alzheimer's disease (AD) that often precedes the cognitive decline and clinical diagnosis. While the exact pathogenesis of AD remains unclear, accumulation of amyloid-β (Aβ) derived from the amyloid precursor protein (APP) in the brain is thought to lead to the neuronal dysfunction and death underlying the dementia. In this study, we examined whether transgenic mice overexpressing the Swedish mutation of APP (Tg2576), recapitulating selected features of AD, have hypothalamic leptin signaling dysfunction leading to early body weight deficits. We found that 3-month-old Tg2576 mice, before amyloid plaque formation, exhibit decreased weight with markedly decreased adiposity, low plasma leptin levels, and increased energy expenditure without alterations in feeding behavior. The expression of the orexigenic neuropeptide Y (NPY) in the hypothalamus to the low leptin state was abnormal at basal and fasting conditions. In addition, arcuate NPY neurons exhibited abnormal electrophysiological responses to leptin in Tg2576 hypothalamic slices or wild-type slices treated with Aβ. Finally, the metabolic deficits worsened as Tg2576 mice aged and amyloid burden increased in the brain. These results indicate that excess Aβ can potentially disrupt hypothalamic arcuate NPY neurons leading to weight loss and a pathologically low leptin state early in the disease process that progressively worsens as the amyloid burden increases. Collectively, these findings suggest that weight loss is an intrinsic pathological feature of Aβ accumulation and identify hypothalamic leptin signaling as a previously unrecognized pathogenic site of action for Aβ. PMID:24990930

Urinary Angiostatin - A Novel Putative Marker of Renal Pathology Chronicity in Lupus Nephritis*

PubMed Central

Wu, Tianfu; Du, Yong; Han, Jie; Singh, Sandeep; Xie, Chun; Guo, Yuyuan; Zhou, Xin J.; Ahn, Chul; Saxena, Ramesh; Mohan, Chandra

2013-01-01

There is a critical need to identify biomarkers for Systemic Lupus Erythematosus (SLE) which has a high prevalence of renal failure. When urine from patients with lupus nephritis was recently screened for the levels of ∼280 molecules using an exploratory array-based proteomic platform, elevated angiostatin levels were noted. Angiostatin is a bioactive fragment of plasminogen, and has been known to have modulatory function in angiogenesis and inflammation. The significant elevation in urinary angiostatin was next validated in an independent cohort of SLE patients (n = 100) using ELISA. Among patients with SLE, urine angiostatin was significantly increased in active SLE compared with inactive SLE, correlating well with the SLEDAI disease activity index and SLICC renal activity score (r = 0.66, p < 0.0001). ROC curve analysis further confirmed that urinary angiostatin had the capacity to discriminate patients with active SLE from those with inactive disease. Patients with Class IV lupus nephritis exhibited the highest levels of urinary angiostatin. Immunohistochemistry staining localized angiostatin expression to the renal tubular cells in these patients. Finally, when paired urine-kidney samples procured concurrently from patients with LN were next examined, urine angiostatin levels correlated strongly with the renal pathology chronicity index, but not with the activity index. Given that Class IV lupus nephritis and renal pathology chronicity changes forebode poor renal and patient survival, urinary angiostatin emerges as a novel noninvasive marker of renal disease in SLE. Longitudinal studies are in progress to further assess the disease-predictive potential of urinary angiostatin. PMID:23345539

Effect of Fluvoxamine on Amyloid-β Peptide Generation and Memory.

PubMed

Kim, Woojin Scott; Fu, Yuhong; Dobson-Stone, Carol; Hsiao, Jen-Hsiang T; Shang, Kani; Hallupp, Marianne; Schofield, Peter R; Garner, Brett; Karl, Tim; Kwok, John B J

2018-01-01

Alzheimer's disease is characterized by abnormal amyloid-β (Aβ) peptide accumulation beginning decades before symptom onset. An effective prophylactic treatment aimed at arresting the amyloidogenic pathway would therefore need to be initiated prior to the occurrence of Aβ pathology. The SIGMAR1 gene encodes a molecular chaperone that modulates processing of the amyloid-β protein precursor (AβPP). Fluvoxamine is a selective serotonin reuptake inhibitor and a potent SIGMAR1 agonist. We therefore hypothesized that fluvoxamine treatment would reduce Aβ production and improve cognition. We firstly investigated the impact of SIGMAR1 on AβPP processing, and found that overexpression and knockdown of SIGMAR1 significantly affected γ-secretase activity in SK-N-MC neuronal cells. We then tested the impact of fluvoxamine on Aβ production in an amyloidogenic cell model, and found that fluvoxamine significantly reduced Aβ production by inhibiting γ-secretase activity. Finally, we assessed the efficacy of long-term treatment (i.e., ∼8 months) of 10 mg/kg/day fluvoxamine in the J20 amyloidogenic mouse model; the treatment was initiated prior to the occurrence of predicted Aβ pathology. Physical examination of the animals revealed no overt pathology or change in weight. We conducted a series of behavioral tests to assess learning and memory, and found that the fluvoxamine treatment significantly improved memory function as measured by novel object recognition task. Two other tests revealed no significant change in memory function. In conclusion, fluvoxamine has a clear impact on γ-secretase activity and AβPP processing to generate Aβ, and may have a protective effect on cognition in the J20 mice.

The relationship between early biochemical failure and perineural invasion in pathological T2 prostate cancer.

PubMed

Endrizzi, J; Seay, T

2000-04-01

To evaluate, in patients with pathologically localized prostate cancer, the relationship between early biochemical failure, i.e. an increasing prostate-specific antigen (PSA) level, and perineural invasion (PNI) on final pathology. The records were reviewed of 171 patients with prostate cancer who underwent prostatectomy at one institution between January 1992 and December 1995. Data on the histology, therapy and PSA level were collected and evaluated. Of the 171 patients with pathologically localized (pT2) prostate cancer, 131 were evaluable; 17 (13%) had a detectable PSA level in the first 5 years after surgery and 63 had PNI in the pathological specimen. Of those with PSA recurrence, 14 had PNI, one had no PNI and in two there was no comment on PNI. In comparison, only 10 of the 17 patients with recurrence had a Gleason sum of >/= 7. Perineural invasion seems to be an important predictor of early outcome in patients with organ-confined prostate cancer treated by prostatectomy. In this series it was the most sensitive predictor of biochemical failure. A more detailed pathological evaluation of prostate cancer may allow the clinician to provide closer surveillance and better informed clinical decision-making.

[Innovations in medical undergraduate pathology education: The Paris Descartes medicine faculty experience].

PubMed

Just, Pierre-Alexandre; Verkarre, Virginie; Mansuet-Lupo, Audrey; Rabant, Marion; Daniliuc, Cristina; Radenen, Brigitte; Harent, Marion; Cassanelli, Lucien; Cherel, Éric; Javaux, Hubert; Tesniere, Antoine; Terris, Benoît; Badoual, Cécile

2016-08-01

At the Paris Descartes medicine faculty, we tested some newly developed tools to enhance the pedagogic value of the pathology teaching. In our faculty, this teaching is largely multidisciplinary and integrated in various teaching units; a large part is dedicated to practice works with thirteen 90min sessions. Virtual slides have been used for years in numerous medicine faculties; we successfully implemented this tool by adding contextual annotations, which facilitate students revising. We showed that rewarding students' assiduity enhanced their exam success. To do so, we now propose a short continuous assessment exam at the beginning of each practice session in the form of electronic multi-choice questions. Finally, we now propose a completely computerized final exam, on touchpads, that enhanced its docimologic value. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Differential induction and spread of tau pathology in young PS19 tau transgenic mice following intracerebral injections of pathological tau from Alzheimer’s disease or corticobasal degeneration brains

PubMed Central

Boluda, Susana; Iba, Michiyo; Zhang, Bin; Raible, Kevin M.; Lee, Virginia M-Y.; Trojanowski, John Q.

2015-01-01

Filamentous tau pathologies are hallmark lesions of several neurodegenerative tauopathies including Alzheimer’s disease (AD) and corticobasal degeneration (CBD) which show cell type-specific and topographically distinct tau inclusions. Growing evidence supports templated transmission of tauopathies through functionally interconnected neuroanatomical pathways suggesting that different self-propagating strains of pathological tau could account for the diverse manifestations of neurodegenerative tauopathies. Here, we describe the rapid and distinct cell type-specific spread of pathological tau following intracerebral injections of CBD or AD brain extracts enriched in pathological tau (designated CBD-Tau and AD-Tau, respectively) in young human mutant P301S tau transgenic (Tg) mice (line PS19) ~6–9 months before they show onset of mutant tau transgene-induced tau pathology. At 1 month post-injection of CBD-Tau, tau inclusions developed predominantly in oligodendrocytes of the fimbria and white matter near the injection sites with infrequent intraneuronal tau aggregates. In contrast, injections of AD-Tau in young PS19 mice induced tau pathology predominantly in neuronal perikarya with little or no oligodendrocyte involvement 1 month post-injection. With longer post-injection survival intervals of up to 6 months, CBD-Tau- and AD-Tau-induced tau pathology spread to different brain regions distant from the injection sites while maintaining the cell type-specific pattern noted above. Finally, CA3 neuron loss was detected 3 months post-injection of AD-Tau but not CBD-Tau. Thus, AD-Tau and CBD-Tau represent specific pathological tau strains that spread differentially and may underlie distinct clinical and pathological features of these two tauopathies. Hence, these strains could become targets to develop disease-modifying therapies for CBD and AD. PMID:25534024

Examining the Pathologic Adaptation Model of Community Violence Exposure in Male Adolescents of Color

PubMed Central

Gaylord-Harden, Noni K.; So, Suzanna; Bai, Grace J.; Henry, David B.; Tolan, Patrick H.

2017-01-01

The current study examined a model of desensitization to community violence exposure—the pathologic adaptation model—in male adolescents of color. The current study included 285 African American (61%) and Latino (39%) male adolescents (W1 M age = 12.41) from the Chicago Youth Development Study to examine the longitudinal associations between community violence exposure, depressive symptoms, and violent behavior. Consistent with the pathologic adaptation model, results indicated a linear, positive association between community violence exposure in middle adolescence and violent behavior in late adolescence, as well as a curvilinear association between community violence exposure in middle adolescence and depressive symptoms in late adolescence, suggesting emotional desensitization. Further, these effects were specific to cognitive-affective symptoms of depression and not somatic symptoms. Emotional desensitization outcomes, as assessed by depressive symptoms, can occur in male adolescents of color exposed to community violence and these effects extend from middle adolescence to late adolescence. PMID:27653968

Treatment of gastric epithelial tumours by endoscopic submucosal dissection using an insulated-tip diathermic knife

PubMed Central

Hua, Xu Li; Bo, Qian Jun; Gen, Gu Liu; Fei, Lu; Min, Wang Ya; Ming, Li Yu; Sheng, Lu Hua

2011-01-01

BACKGROUND: Endoscopic submucosal dissection (ESD) is a promising technique for the treatment of large, pre- and early malignant gastrointestinal lesions. OBJECTIVE: To assess the rates of en bloc resection, incidence of complications, procedure times and therapeutic outcomes of ESD using an insulated-tip diathermic knife; and to investigate predictors of these outcomes based on the final pathological features of biopsy specimens. METHODS: One hundred twenty patients with endoscopically suspected gastric epithelial tumours who were treated with ESD from January 2006 to December 2009 were evaluated. RESULTS: The mean diameter of the gastric epithelial tumours in the present cohort was 1.88 cm. The mean diameter of the resected specimens was 3.33 cm. The en bloc resection rate was 90% (108 of 120). The median length of the operation was 64.6 min. The bleeding and perforation complication rates were 5.0% (six of 120) and 2.5% (three of 120), respectively. Of 10 gastric tumours initially diagnosed as adenocarcinoma on biopsy, four were found to be low-grade dysplasia and six were found to be high-grade dysplasia after resection and final pathological examination. A total of 112 (93.33%) patients underwent curative treatment, eight patients (6.67%) underwent noncurative treatment with ESD, and two patients (1.67%) experienced local recurrence and subsequently underwent surgery. CONCLUSIONS: ESD is a promising local curative treatment option for gastric epithelial tumours, but still carries the risks of bleeding and/or perforation. Differences in the interpretation of histological results among different pathologists and/or between biopsy specimens before ESD and the en bloc tissue specimens after ESD will result in discrepancies. PMID:21321682

Fluorescence confocal microscopy for pathologists.

PubMed

Ragazzi, Moira; Piana, Simonetta; Longo, Caterina; Castagnetti, Fabio; Foroni, Monica; Ferrari, Guglielmo; Gardini, Giorgio; Pellacani, Giovanni

2014-03-01

Confocal microscopy is a non-invasive method of optical imaging that may provide microscopic images of untreated tissue that correspond almost perfectly to hematoxylin- and eosin-stained slides. Nowadays, following two confocal imaging systems are available: (1) reflectance confocal microscopy, based on the natural differences in refractive indices of subcellular structures within the tissues; (2) fluorescence confocal microscopy, based on the use of fluorochromes, such as acridine orange, to increase the contrast epithelium-stroma. In clinical practice to date, confocal microscopy has been used with the goal of obviating the need for excision biopsies, thereby reducing the need for pathological examination. The aim of our study was to test fluorescence confocal microscopy on different types of surgical specimens, specifically breast, lymph node, thyroid, and colon. The confocal images were correlated to the corresponding histological sections in order to provide a morphologic parallel and to highlight current limitations and possible applications of this technology for surgical pathology practice. As a result, neoplastic tissues were easily distinguishable from normal structures and reactive processes such as fibrosis; the use of fluorescence enhanced contrast and image quality in confocal microscopy without compromising final histologic evaluation. Finally, the fluorescence confocal microscopy images of the adipose tissue were as accurate as those of conventional histology and were devoid of the frozen-section-related artefacts that can compromise intraoperative evaluation. Despite some limitations mainly related to black/white images, which require training in imaging interpretation, this study confirms that fluorescence confocal microscopy may represent an alternative to frozen sections in the assessment of margin status in selected settings or when the conservation of the specimen is crucial. This is the first study to employ fluorescent confocal microscopy on surgical specimens other than the skin and to evaluate the diagnostic capability of this technology from pathologists' viewpoint.

False negative cytology in large thyroid nodules.

PubMed

Giles, Wesley H; Maclellan, Reid A; Gawande, Atul A; Ruan, Daniel T; Alexander, Erik K; Moore, Francis D; Cho, Nancy L

2015-01-01

Controversy exists regarding the accuracy of fine-needle aspiration (FNA) in large thyroid nodules. Recent surgical series have documented false-negative rates ranging from 0.7 to 13 %. We examined the accuracy of benign FNA cytology in patients with thyroid nodules ≥3 cm who underwent surgical resection and identified features characteristic of false-negative results. We retrospectively studied all thyroidectomy specimens between January 2009 and October 2011 and identified nodules ≥3 cm with corresponding benign preoperative FNA cytology. We collected clinical information regarding patient demographics, nodule size, symptoms, sonographic features, FNA results, and final surgical pathology. For comparison, we analyzed nodules <3 cm from this cohort also with benign FNA cytology. A total of 323 nodules with benign preoperative cytology were identified. Eighty-three nodules were <3 cm, 94 nodules were 3-3.9 cm, and 146 nodules were ≥4 cm in size. The false-negative rate was 11.7 % for all nodules ≥3 cm and 4.8 % for nodules <3 cm (p = 0.03). Subgroup analysis of nodules ≥3 cm revealed a false-negative rate of 12.8 % for nodules 3-3.9 cm and 11 % for nodules ≥4 cm. Age ≥55 years and asymptomatic clinical status were the only patient characteristics that reached statistical significance as risk factors. Final pathology of the false-negative specimens consisted mainly of follicular variant of papillary thyroid cancer and follicular thyroid cancer. When referred for thyroidectomy, patients with large thyroid nodules demonstrate a modest, yet significant, false-negative rate despite initial benign aspiration cytology. Therefore, thyroid nodules ≥3 cm may be considered for removal even when referred with benign preoperative cytology.

Normative development of the Child Behavior Checklist Dysregulation Profile from early childhood to adolescence: Associations with personality pathology.

PubMed

Deutz, Marike H F; Vossen, Helen G M; De Haan, Amaranta D; Deković, Maja; Van Baar, Anneloes L; Prinzie, Peter

2018-05-01

The Dysregulation Profile (DP) is a broad indicator of concurrent affective, behavioral, and cognitive dysregulation, often measured with the anxious/depressed, aggressive behavior, and attention problems syndrome scales of the Child Behavior Checklist. Despite an expanding body of research on the DP, knowledge of the normative developmental course of the DP from early childhood to adolescence is lacking. Furthermore, although we know that the DP longitudinally predicts personality pathology, no research yet has examined whether next to the DP in early childhood, the rate of change of the DP across development predicts personality pathology. Therefore, using cohort-sequential latent growth modeling in a population-based sample (N = 668), we examined the normative developmental course of mother-reported DP from ages 4 to 17 years and its associations with a wide range of adolescent-reported personality pathology dimensions 3 years later. The results showed that the DP follows a nonlinear developmental course with a peak in early adolescence. The initial level of the DP at age 4 and, to a lesser extent, the rate of change in the DP predicted a range of personality pathology dimensions in late adolescence. The findings suggest that the DP is a broad developmental precursor of personality pathology in late adolescence.

The use of pathological grief outcomes in bereavement studies on African Americans.

PubMed

Granek, Leeat; Peleg-Sagy, Tal

2017-06-01

Pathological bereavement outcomes (i.e., complicated grief, traumatic grief, prolonged grief disorder) are a robust and growing research area in the psychological and medical sciences. Although grief is considered to be a universal phenomenon, it is well documented that grieving processes and outcomes are culturally and contextually bound. The objectives of this study were: (a) to examine representations of African Americans in the grief and mourning literature and to assess the extent to which this research utilizes pathological grief outcomes; and (b) to examine the characteristics of pathological grief constructs in the literature to assess their relevance for African American populations. We conducted comprehensive searches of three scientific databases including PsycNET, Medline, and CINAHL, which contain the majority of grief and mourning literature published between January 1998 and February 2014. We found 59 studies addressing grief and mourning in African Americans. Thirteen of these studies used pathological grief outcomes. Pathological grief outcomes that were constructed and validated on White populations were frequently used as outcome variables with African American participants. We discuss the implications for the grief and mourning field and argue that the failure to use culturally sensitive outcome measures in research studies is a form of epistemological violence that may have negative research and clinical implications for African Americans and other ethnic minorities.

Whole slide images and digital media in pathology education, testing, and practice: the Oklahoma experience.

PubMed

Fung, Kar-Ming; Hassell, Lewis A; Talbert, Michael L; Wiechmann, Allan F; Chaser, Brad E; Ramey, Joel

2012-01-01

Examination of glass slides is of paramount importance in pathology training. Until the introduction of digitized whole slide images that could be accessed through computer networks, the sharing of pathology slides was a major logistic issue in pathology education and practice. With the help of whole slide images, our department has developed several online pathology education websites. Based on a modular architecture, this program provides online access to whole slide images, still images, case studies, quizzes and didactic text at different levels. Together with traditional lectures and hands-on experiences, it forms the back bone of our histology and pathology education system for residents and medical students. The use of digitized whole slide images has a.lso greatly improved the communication between clinicians and pathologist in our institute.

Mitosis-specific phosphorylation of amyloid precursor protein at Threonine 668 leads to its altered processing and association with centrosomes

PubMed Central

2011-01-01

Background Atypical expression of cell cycle regulatory proteins has been implicated in Alzheimer's disease (AD), but the molecular mechanisms by which they induce neurodegeneration are not well understood. We examined transgenic mice expressing human amyloid precursor protein (APP) and presenilin 1 (PS1) for changes in cell cycle regulatory proteins to determine whether there is a correlation between cell cycle activation and pathology development in AD. Results Our studies in the AD transgenic mice show significantly higher levels of cyclin E, cyclin D1, E2F1, and P-cdc2 in the cells in the vicinity of the plaques where maximum levels of Threonine 668 (Thr668)-phosphorylated APP accumulation was observed. This suggests that the cell cycle regulatory proteins might be influencing plaque pathology by affecting APP phosphorylation. Using neuroglioma cells overexpressing APP we demonstrate that phosphorylation of APP at Thr668 is mitosis-specific. Cells undergoing mitosis show altered cellular distribution and localization of P-APP at the centrosomes. Also, Thr668 phosphorylation in mitosis correlates with increased processing of APP to generate Aβ and the C-terminal fragment of APP, which is prevented by pharmacological inhibitors of the G1/S transition. Conclusions The data presented here suggests that cell cycle-dependent phosphorylation of APP may affect its normal cellular function. For example, association of P-APP with the centrosome may affect spindle assembly and cell cycle progression, further contributing to the development of pathology in AD. The experiments with G1/S inhibitors suggest that cell cycle inhibition may impede the development of Alzheimer's pathology by suppressing modification of βAPP, and thus may represent a novel approach to AD treatment. Finally, the cell cycle regulated phosphorylation and processing of APP into Aβ and the C-terminal fragment suggest that these proteins may have a normal function during mitosis. PMID:22112898

Systemic Inflammation: Methodological Approaches to Identification of the Common Pathological Process.

PubMed

Zotova, N V; Chereshnev, V A; Gusev, E Yu

2016-01-01

We defined Systemic inflammation (SI) as a "typical, multi-syndrome, phase-specific pathological process, developing from systemic damage and characterized by the total inflammatory reactivity of endotheliocytes, plasma and blood cell factors, connective tissue and, at the final stage, by microcirculatory disorders in vital organs and tissues." The goal of the work: to determine methodological approaches and particular methodical solutions for the problem of identification of SI as a common pathological process. SI can be defined by the presence in plasma of systemic proinflammatory cell stress products-cytokines and other inflammatory mediators, and also by the complexity of other processes signs. We have developed 2 scales: 1) The Reactivity Level scale (RL)-from 0 to 5 points: 0-normal level; RL-5 confirms systemic nature of inflammatory mediator release, and RL- 2-4 defines different degrees of event probability. 2) The SI scale, considering additional criteria along with RL, addresses more integral criteria of SI: the presence of ≥ 5 points according to the SI scale proves the high probability of SI developing. To calculate the RL scale, concentrations of 4 cytokines (IL-6, IL-8, IL-10, TNF-α) and C-reactive protein in plasma were examined. Additional criteria of the SI scale were the following: D-dimers>500ng/ml, cortisol>1380 or <100nmol/l, troponin I≥0.2ng/ml and/or myoglobin≥800ng/ml. 422 patients were included in the study with different septic (n-207) and aseptic (n-215) pathologies. In 190 cases (of 422) there were signs of SI (lethality 38.4%, n-73). In only 5 of 78 cases, lethality was not confirmed by the presence of SI. SI was registered in 100% of cases with septic shock (n-31). There were not significant differences between AU-ROC of CR, SI scale and SOFA to predict death in patients with sepsis and trauma.

Neuroinflammation and brain atrophy in former NFL players: An in vivo multimodal imaging pilot study.

PubMed

Coughlin, Jennifer M; Wang, Yuchuan; Munro, Cynthia A; Ma, Shuangchao; Yue, Chen; Chen, Shaojie; Airan, Raag; Kim, Pearl K; Adams, Ashley V; Garcia, Cinthya; Higgs, Cecilia; Sair, Haris I; Sawa, Akira; Smith, Gwenn; Lyketsos, Constantine G; Caffo, Brian; Kassiou, Michael; Guilarte, Tomas R; Pomper, Martin G

2015-02-01

There are growing concerns about potential delayed, neuropsychiatric consequences (e.g, cognitive decline, mood or anxiety disorders) of sports-related traumatic brain injury (TBI). Autopsy studies of brains from a limited number of former athletes have described characteristic, pathologic changes of chronic traumatic encephalopathy (CTE) leading to questions about the relationship between these pathologic and the neuropsychiatric disturbances seen in former athletes. Research in this area will depend on in vivo methods that characterize molecular changes in the brain, linking CTE and other sports-related pathologies with delayed emergence of neuropsychiatric symptoms. In this pilot project we studied former National Football League (NFL) players using new neuroimaging techniques and clinical measures of cognitive functioning. We hypothesized that former NFL players would show molecular and structural changes in medial temporal and parietal lobe structures as well as specific cognitive deficits, namely those of verbal learning and memory. We observed a significant increase in binding of [(11)C]DPA-713 to the translocator protein (TSPO), a marker of brain injury and repair, in several brain regions, such as the supramarginal gyrus and right amygdala, in 9 former NFL players compared to 9 age-matched, healthy controls. We also observed significant atrophy of the right hippocampus. Finally, we report that these same former players had varied performance on a test of verbal learning and memory, suggesting that these molecular and pathologic changes may play a role in cognitive decline. These results suggest that localized brain injury and repair, indicated by increased [(11)C]DPA-713 binding to TSPO, may be linked to history of NFL play. [(11)C]DPA-713 PET is a promising new tool that can be used in future study design to examine further the relationship between TSPO expression in brain injury and repair, selective regional brain atrophy, and the potential link to deficits in verbal learning and memory after NFL play. Copyright © 2014 Elsevier Inc. All rights reserved.

Oral and cranio-maxillofacial surgery in Byzantium.

PubMed

Mylonas, Anastassios I; Poulakou-Rebelakou, Eleftheria-Fotini; Androutsos, Georgios I; Seggas, Ioannis; Skouteris, Christos A; Papadopoulou, Evangelia Chr

2014-03-01

Byzantine physicians (4th-7th and 8th-12th centuries A.D.), especially those interested in Surgery, developed a number of interesting concepts, views and opinions referring to the field now recognized as Oral and Cranio-maxillofacial Surgery and Pathology. The original texts of Byzantine physicians, written in ancient Greek, and now preserved in the electronic platform Thesaurus Linguae Graecae, at the University of California, Irvine, CA, USA, were investigated in relation to Oral and Cranio-maxillofacial Surgery and Pathology. The most eminent physicians of the Early (4th-7th century A.D.) and Middle (8th-12th century A.D.) Byzantine Period, in particular Oribasius Pergamenus, Aëtius Amidenus, Alexander Trallianus, Theophilus Protospatharius, Paulus Aegineta, Meletius Monachos, and Leo Medicus, in their works deal with topographic and surgical anatomy of the head and neck, and a large list of related topics, including dentoalveolar surgery, oral and cervicofacial infections, trauma of viscerocranium and neurocranium as well as the biomechanics of traumatic brain injuries, temporomandibular joints dysfunction as a consequence of mandibular dislocation, surgical oncology and reconstructive surgery of the head and neck, oral pathology, surgical pathology of salivary glands, therapeutic management of facial nerve dysfunction, preprosthetic surgery, craniofacial surgery, and deformities of the facial skeleton involving anthropologic and craniometric observations. Clinical examination of patients presenting corresponding functional and esthetic problems is considered, using recognizable orthodontic and orthognathic surgical approaches. Finally, specific bandages of the head and neck are described, for treating traumatic injuries of the viscerocranium and neurocranium, diastasis of the cranial sutures, dislocations of the mandible (unilateral and bilateral), as well as inflammatory diseases of the parotids and the neck. Byzantine physicians had been particularly interested in various subjects of the mouth, jaws, face, and head and neck in general, in the frame of course of their general surgery practice. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Tooth damage in captive orcas (Orcinus orca).

PubMed

Jett, John; Visser, Ingrid N; Ventre, Jeffrey; Waltz, Jordan; Loch, Carolina

2017-12-01

Tooth damage as a result of oral stereotypies is evident in captive orca, yet little research on the topic exists. This study examines the associations between dental pathology, sex, facility, duration of captivity and other factors in captive orca. We evaluated mandibular and maxillary teeth from dental images of 29 captive orca owned by a US-based theme park. Each tooth was scored for coronal wear, wear at or below gum line and bore holes. Fractured and missing teeth were also noted. Summary statistics described the distribution and severity of pathologies; inferential statistics examined how pathologies differed between sexes, between wild-captured and captive-born orcas and between captive orca at four facilities. We also evaluated how dental pathology and duration of captivity were related. Approximately 24% of whales exhibited "major" to "extreme" mandibular coronal tooth wear, with coronal wear and wear at or below gum line highly correlated. More than 60% of mandibular teeth 2 and 3 exhibited fractures. Bore holes were observed primarily among anterior mandibular teeth, with more than 61% of teeth 2 and 3 bearing evidence of having been drilled. Four of five orca with the highest age-adjusted tooth pathology indices were captive-born. Various dental pathologies were observed across all whales, with pathologies beginning at a young age. Oral stereotypies exhibited by captive orca contributed to the observed dental damage. By making dental and health records of captive whales publicly available, the theme park industry is uniquely positioned to provide further insight into dental pathology and resultant health consequences in captive orca. Copyright © 2017 Elsevier Ltd. All rights reserved.

Automatic intelligibility classification of sentence-level pathological speech

PubMed Central

Kim, Jangwon; Kumar, Naveen; Tsiartas, Andreas; Li, Ming; Narayanan, Shrikanth S.

2014-01-01

Pathological speech usually refers to the condition of speech distortion resulting from atypicalities in voice and/or in the articulatory mechanisms owing to disease, illness or other physical or biological insult to the production system. Although automatic evaluation of speech intelligibility and quality could come in handy in these scenarios to assist experts in diagnosis and treatment design, the many sources and types of variability often make it a very challenging computational processing problem. In this work we propose novel sentence-level features to capture abnormal variation in the prosodic, voice quality and pronunciation aspects in pathological speech. In addition, we propose a post-classification posterior smoothing scheme which refines the posterior of a test sample based on the posteriors of other test samples. Finally, we perform feature-level fusions and subsystem decision fusion for arriving at a final intelligibility decision. The performances are tested on two pathological speech datasets, the NKI CCRT Speech Corpus (advanced head and neck cancer) and the TORGO database (cerebral palsy or amyotrophic lateral sclerosis), by evaluating classification accuracy without overlapping subjects’ data among training and test partitions. Results show that the feature sets of each of the voice quality subsystem, prosodic subsystem, and pronunciation subsystem, offer significant discriminating power for binary intelligibility classification. We observe that the proposed posterior smoothing in the acoustic space can further reduce classification errors. The smoothed posterior score fusion of subsystems shows the best classification performance (73.5% for unweighted, and 72.8% for weighted, average recalls of the binary classes). PMID:25414544

Task-evoked fMRI changes in attention networks are associated with preclinical Alzheimer's disease biomarkers.

PubMed

Gordon, Brian A; Zacks, Jeffrey M; Blazey, Tyler; Benzinger, Tammie L S; Morris, John C; Fagan, Anne M; Holtzman, David M; Balota, David A

2015-05-01

There is a growing emphasis on examining preclinical levels of Alzheimer's disease (AD)-related pathology in the absence of cognitive impairment. Previous work examining biomarkers has focused almost exclusively on memory, although there is mounting evidence that attention also declines early in disease progression. In the current experiment, 2 attentional control tasks were used to examine alterations in task-evoked functional magnetic resonance imaging data related to biomarkers of AD pathology. Seventy-one cognitively normal individuals (females = 44, mean age = 63.5 years) performed 2 attention-demanding cognitive tasks in a design that modeled both trial- and task-level functional magnetic resonance imaging changes. Biomarkers included amyloid β42, tau, and phosphorylated tau measured from cerebrospinal fluid and positron emission tomography measures of amyloid deposition. Both tasks elicited widespread patterns of activation and deactivation associated with large task-level manipulations of attention. Importantly, results from both tasks indicated that higher levels of tau and phosphorylated tau pathologies were associated with block-level overactivations of attentional control areas. This suggests early alteration in attentional control with rising levels of AD pathology. Copyright © 2015 Elsevier Inc. All rights reserved.

The Effects of Pathological Gaming on Aggressive Behavior

PubMed Central

Valkenburg, Patti M.; Peter, Jochen

2010-01-01

Studies have shown that pathological involvement with computer or video games is related to excessive gaming binges and aggressive behavior. Our aims for this study were to longitudinally examine if pathological gaming leads to increasingly excessive gaming habits, and how pathological gaming may cause an increase in physical aggression. For this purpose, we conducted a two-wave panel study among 851 Dutch adolescents (49% female) of which 540 played games (30% female). Our analyses indicated that higher levels of pathological gaming predicted an increase in time spent playing games 6 months later. Time spent playing violent games specifically, and not just games per se, increased physical aggression. Furthermore, higher levels of pathological gaming, regardless of violent content, predicted an increase in physical aggression among boys. That this effect only applies to boys does not diminish its importance, because adolescent boys are generally the heaviest players of violent games and most susceptible to pathological involvement. PMID:20549320

The effects of pathological gaming on aggressive behavior.

PubMed

Lemmens, Jeroen S; Valkenburg, Patti M; Peter, Jochen

2011-01-01

Studies have shown that pathological involvement with computer or video games is related to excessive gaming binges and aggressive behavior. Our aims for this study were to longitudinally examine if pathological gaming leads to increasingly excessive gaming habits, and how pathological gaming may cause an increase in physical aggression. For this purpose, we conducted a two-wave panel study among 851 Dutch adolescents (49% female) of which 540 played games (30% female). Our analyses indicated that higher levels of pathological gaming predicted an increase in time spent playing games 6 months later. Time spent playing violent games specifically, and not just games per se, increased physical aggression. Furthermore, higher levels of pathological gaming, regardless of violent content, predicted an increase in physical aggression among boys. That this effect only applies to boys does not diminish its importance, because adolescent boys are generally the heaviest players of violent games and most susceptible to pathological involvement.

MRI of suspected appendicitis during pregnancy: interradiologist agreement, indeterminate interpretation and the meaning of non-visualization of the appendix.

PubMed

Tsai, Richard; Raptis, Constantine; Fowler, Kathryn J; Owen, Joseph W; Mellnick, Vincent M

2017-11-01

To determine the degree of interradiologist agreement between the MRI features of appendicitis during pregnancy, the outcomes associated with an indeterminate interpretation and the negative predictive value of non-visualization of the appendix. Our study was approved by the institutional review board at the Washington University in St. Louis, Missouri (WUStL) and was HIPAA (Health Insurance Portability and Accountability Act of 1996)-compliant. The informed consent requirement was waived. Cases of suspected appendicitis during pregnancy evaluated using MRI were retrospectively identified using search queries. Scans were re-reviewed by two radiologists (7 and 9 years experience, respectively) to evaluate the interradiologist agreement of different MRI features of appendicitis during pregnancy (visualization of the appendix, appendiceal diameter, appendiceal wall thickening, periappendiceal fat stranding, fluid-filled appendix and periappendiceal fluid). The radiologists were blinded to patient outcome, patient intervention, laboratory data, demographic data and the original MRI reports. Clinical outcomes were documented by surgical pathology or clinical observation. Interradiologist agreement was analysed using Cohen's κ, while patient demographic and clinical data was analysed using Student's t-testing. 233 females with suspected appendicitis during pregnancy were evaluated using MRI over a 13-year period (mean age, 28.4 years; range, 17-38 years). There were 14 (6%) positive examinations for appendicitis during pregnancy, including 1 patient whose MRI was interpreted as negative, proven by surgical pathology. The presence of periappendiceal soft-tissue stranding and the final overall impression had the most interradiologist agreement (к = 0.81-1). There were no pregnant patients found to have acute appendicitis who had an indeterminate MR interpretation or when the appendix could not be visualized. The final impression by the two retrospectively reviewing radiologists of MR examinations performed for suspected appendicitis during pregnancy had near-perfect agreement. In patients where the appendix could not be visualized or in patients that were interpreted as indeterminate, no patients had acute appendicitis. Advances in knowledge: MR impression for suspected appendicitis in the pregnant patient has high interradiologist agreement, and a non-visualized appendix or lack of inflammatory findings at the time of MR, reliably excludes surgical appendicitis.

Tumor histology predicts mediastinal nodal status and may be used to guide limited lymphadenectomy in patients with clinical stage I non-small cell lung cancer.

PubMed

Cheng, Xinghua; Zheng, Difan; Li, Yuan; Li, Hang; Sun, Yihua; Xiang, Jiaqing; Chen, Haiquan

2018-06-01

Methods to minimize surgical trauma from mediastinal lymphadenectomy in patients with early-stage lung cancer are still immature. This study aimed to identify predictors of negative pathologic N2, which may be used to select patients for limited mediastinal lymphadenectomy. Clinicopathologic features of 1430 patients with resected clinical stage I non-small cell lung cancer and complete mediastinal lymphadenectomy were retrospectively analyzed for variables associated with negative N2 nodal metastasis (2008-2015). Overall and recurrence-free survival in patients after complete or limited mediastinal lymphadenectomy were assessed via Kaplan-Meier survival analysis and log-rank testing. The accuracy of frozen section diagnosis for predicting final pathology was retrospectively assessed in 126 randomly selected patients after the surgery. Multivariable analysis revealed that tumor size ≤2 cm, negative pN1, lymphovascular invasion, and lepidic adenocarcinoma were associated with negative mediastinal nodal metastasis. Notably, none of the patients with histology of adenocarcinoma in situ, minimally invasive adenocarcinoma, or lepidic pattern-predominant adenocarcinoma on final pathology had pN2 disease, and the 5-year overall and recurrence free-survival of these patients (99.3% and 99.3%, respectively) was not different from those after limited mediastinal lymphadenectomy (98.7% and 100%, P = .582 and .511, respectively). If these subtypes were classified together as the low-risk group, the concordance rate between frozen section and final pathology diagnosis was 88.9% in the retrospective test cohort. Tumor histology may predict negative mediastinal metastasis in patients with early-stage lung cancer. Future prospective studies are merited to validate the feasibility of using frozen section to select patients for limited mediastinal lymphadenectomy. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Temporal variation and interaction between nutritional and developmental instability in prehistoric Japanese populations.

PubMed

Hoover, Kara C; Matsumura, Hirofumi

2008-12-01

We examined nutritional and developmental instability in prehistoric Japan, using data from 49 individuals across 13 archaeological sites. Hypoplasia incidence was used as a measure of nutritional stress, and fluctuating asymmetry (of upper facial breath, orbital breadth, and orbital height) as an indirect assessment of developmental instability. Abundant resources due to a stable climate during the Middle Jomon (5,000-3,000 BP) encouraged population growth, which led to regional cultural homogeneity and complexity. A population crash on Honshu in the Late/Final Jomon (roughly 4,000-2,000 BP) led to regionally divergent subsistence economies and settlement patterns. We find that the nutritional stress was consistent between periods, but developmental instability (DI) decreased in the Late/Final Jomon. While the DI values were not statistically significant, the higher values for Middle Jomon may result from sedentism, social stratification, and differential access to resources. On Hokkaido, Jomon culture persisted until the Okhotsk period (1,000-600 BP), marked by the arrival of immigrants from Sakhalin. Nutritional stress was consistent between Middle and Late/Final Jomon, but DI increased in the Late/Final. Nutritional and developmental instability decreased from Late/Final to Okhotsk, suggesting a positive immigrant effect. We expected to find an association between stress markers due to the synergistic relationship between nutrition and pathology. The data support this hypothesis, but only one finding was statistically significant. While high critical values from small sample sizes place limits on the significance of our results, we find that the impact of environmental and cultural change to prehistoric Japanese populations was minimal. (c) 2008 Wiley-Liss, Inc.

The 1980 and 1981 Accident Experience of Civil Airmen with Selected Visual Pathology,

DTIC Science & Technology

1983-07-01

contact lens users did not. The present study examined the 1980-81 accident experience of 4,169 monocular pilots, 1,299 with amblyopia , 969 with aphakia...organic lesions, and others had an entry of "no fusion" on their reports of examination, the amblyopia and tropia categories were also scheduled for...the 10 selected eye pathologies (diplopia, tropia, aphakia, lens implants, blindness or absence of an eye, amblyopia , right hyperphoria >1 diopter

On the Structure of Personality Disorder Traits: Conjoint Analyses of the CAT-PD, PID-5, and NEO-PI-3 Trait Models

PubMed Central

Wright, Aidan G.C.; Simms, Leonard J.

2014-01-01

The current study examines the relations among contemporary models of pathological and normal range personality traits. Specifically, we report on (a) conjoint exploratory factor analyses of the Computerized Adaptive Test of Personality Disorder static form (CAT-PD-SF) with the Personality Inventory for the DSM-5 (PID-5; Krueger et al., 2012) and NEO Personality Inventory-3 First Half (NEI-PI-3FH; McCrae & Costa, 2007), and (b) unfolding hierarchical analyses of the three measures in a large general psychiatric outpatient sample (N = 628; 64% Female). A five-factor solution provided conceptually coherent alignment among the CAT-PD-SF, PID-5, and NEO-PI-3FH scales. Hierarchical solutions suggested that higher-order factors bear strong resemblance to dimensions that emerge from structural models of psychopathology (e.g., Internalizing and Externalizing spectra). These results demonstrate that the CAT-PD-SF adheres to the consensual structure of broad trait domains at the five-factor level. Additionally, patterns of scale loadings further inform questions of structure and bipolarity of facet and domain level constructs. Finally, hierarchical analyses strengthen the argument for using broad dimensions that span normative and pathological functioning to scaffold a quantitatively derived phenotypic structure of psychopathology to orient future research on explanatory, etiological, and maintenance mechanisms. PMID:24588061

Primary biliary cirrhosis: From bench to bedside

PubMed Central

Kouroumalis, Elias; Notas, George

2015-01-01

Primary biliary cirrhosis (PBC) is a chronic non-suppurative destructive intrahepatic cholangitis leading to cirrhosis after a protractive non cirrhotic stage. The etiology and pathogenesis are largely unknown and autoimmne mechanisms have been implicated to explain the pathological lesions. Many epitopes and autoantigens have been reported as crucial in the pathophysiology of the disease and T and B cells abnormalities have been described, the exact pathways leading to the destruction of small intrahepatic ductules are mostly speculative. In this review we examined the various epidemiologal and geoepidemiological data as well as the complex pathogenetic aspects of this disease, focusing on recent in vivo and in vitro studies in this field. Initiation and progression of PBC is believed to be a multifactorial process with strong infuences from the patient’s genetic background and by various environmental factors. The role of innate and adaptive immunity, including cytokines, chemokines, macrophages and the involvement of apoptosis and reactive oxygen species are outlined in detailed. The current pathogenetic aspects are presented and a novel pathogenetic theory unifying the accumulated clinical information with in vitro and in vivo data is formulated. A review of clinical manifestations and immunological and pathological diagnosis was presented. Treatment modalities, including the multiple mechanisms of action of ursodeoxycholate were finally discussed. PMID:26261733

On the structure of personality disorder traits: conjoint analyses of the CAT-PD, PID-5, and NEO-PI-3 trait models.

PubMed

Wright, Aidan G C; Simms, Leonard J

2014-01-01

The current study examines the relations among contemporary models of pathological and normal range personality traits. Specifically, we report on (a) conjoint exploratory factor analyses of the Computerized Adaptive Test of Personality Disorder static form (CAT-PD-SF) with the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and NEO Personality Inventory-3 First Half, and (b) unfolding hierarchical analyses of the three measures in a large general psychiatric outpatient sample (n = 628; 64% Female). A five-factor solution provided conceptually coherent alignment among the CAT-PD-SF, PID-5, and NEO-PI-3FH scales. Hierarchical solutions suggested that higher-order factors bear strong resemblance to dimensions that emerge from structural models of psychopathology (e.g., Internalizing and Externalizing spectra). These results demonstrate that the CAT-PD-SF adheres to the consensual structure of broad trait domains at the five-factor level. Additionally, patterns of scale loadings further inform questions of structure and bipolarity of facet and domain level constructs. Finally, hierarchical analyses strengthen the argument for using broad dimensions that span normative and pathological functioning to scaffold a quantitatively derived phenotypic structure of psychopathology to orient future research on explanatory, etiological, and maintenance mechanisms.

Specific Impairments in the Recognition of Emotional Facial Expressions in Parkinson’s Disease

PubMed Central

Clark, Uraina S.; Neargarder, Sandy; Cronin-Golomb, Alice

2008-01-01

Studies investigating the ability to recognize emotional facial expressions in non-demented individuals with Parkinson’s disease (PD) have yielded equivocal findings. A possible reason for this variability may lie in the confounding of emotion recognition with cognitive task requirements, a confound arising from the lack of a control condition using non-emotional stimuli. The present study examined emotional facial expression recognition abilities in 20 non-demented patients with PD and 23 control participants relative to their performances on a non-emotional landscape categorization test with comparable task requirements. We found that PD participants were normal on the control task but exhibited selective impairments in the recognition of facial emotion, specifically for anger (driven by those with right hemisphere pathology) and surprise (driven by those with left hemisphere pathology), even when controlling for depression level. Male but not female PD participants further displayed specific deficits in the recognition of fearful expressions. We suggest that the neural substrates that may subserve these impairments include the ventral striatum, amygdala, and prefrontal cortices. Finally, we observed that in PD participants, deficiencies in facial emotion recognition correlated with higher levels of interpersonal distress, which calls attention to the significant psychosocial impact that facial emotion recognition impairments may have on individuals with PD. PMID:18485422

The role of glia in late-life depression.

PubMed

Paradise, Matt Bennett; Naismith, Sharon Linda; Norrie, Louisa Margaret; Graeber, Manuel Benedikt; Hickie, Ian Bernard

2012-12-01

Late-life depression (LLD) has a complex and multifactoral etiology. There is growing interest in elucidating how glia, acting alone or as part of a glial-neuronal network, may contribute to the pathophysiology of depression. In this paper, we explore results from neuroimaging studies showing gray-matter volume loss in key frontal and subcortical structures implicated in LLD, and present the few histological studies that have examined neuronal and glial densities in these regions. Compared to results in younger people with depression, there appear to be age-dependent differences in neuronal pathology but the changes in glial pathology may be more subtle, perhaps reflecting a longer-term compensatory gliosis to earlier damage. We then consider the mechanisms by which both astrocytes and microglia may mediate and modulate neuronal dysfunction and possible degeneration in depression. These include a critical role in the response to peripheral inflammation and central microglial activation, as well as a key role in glutamate metabolism. Advances in our understanding of glia are highlighted, including the role of microglia as "electricians" of the brain and astrocytes as key communicating cells, an integral part of the tripartite synapse. Finally, implications for clinicians are discussed, including the consideration of glia as biomarkers for LLD and incorporation of glia into future therapeutic strategies.

The effect of three different surgical techniques for colon anastomosis on regional postoperative microperfusion: Laser Doppler Flowmetry study in pigs.

PubMed

Kaska, Milan; Blazej, Slavomir; Turek, Zdenek; Ryska, Ales; Jegorov, Boris; Radochova, Vera; Bezouska, Jan; Paral, Jiri

2018-01-01

The optimal surgical approach to reconnecting bowel ends safely after resection is of great importance. This project is focused on assessment of the perianastomotic microcirculation quality in the short postoperative period when using three different anastomosis techniques in experimental animal. The experimental study involved 27 young female domestic pigs divided into three subgroups of 9 animals according to each surgical method of anastomosis construction in the sigmoid colon region: by manual suture, by stapler, or by gluing. Blood microcirculation in the anastomosis region was monitored using Laser Doppler Flowmetry (LDF). Anastomosis healing was evaluated by macroscopic and histological examination. Evaluation of the microcirculation in the anastomosis region showed the smallest decrease in perfusion values in animals reconstructed by suturing (Δ= -38.01%). A significantly more profound drop was observed postoperatively after stapling or gluing (Δ= -52.42% and Δ= -59.53%, respectively). All performed anastomoses healed without any signs of tissue and function pathology. Sewing, stapling, and gluing techniques for bowel anastomosis each have a different effect on regional microcirculation during 120 min. postoperatively. Nevertheless, the final results of anastomosis healing were found without of any pathology in all experimental animals managed by above mentioned anastomotic techniques.

Targeted metabolomic profiling in rat tissues reveals sex differences.

PubMed

Ruoppolo, Margherita; Caterino, Marianna; Albano, Lucia; Pecce, Rita; Di Girolamo, Maria Grazia; Crisci, Daniela; Costanzo, Michele; Milella, Luigi; Franconi, Flavia; Campesi, Ilaria

2018-03-16

Sex differences affect several diseases and are organ-and parameter-specific. In humans and animals, sex differences also influence the metabolism and homeostasis of amino acids and fatty acids, which are linked to the onset of diseases. Thus, the use of targeted metabolite profiles in tissues represents a powerful approach to examine the intermediary metabolism and evidence for any sex differences. To clarify the sex-specific activities of liver, heart and kidney tissues, we used targeted metabolomics, linear discriminant analysis (LDA), principal component analysis (PCA), cluster analysis and linear correlation models to evaluate sex and organ-specific differences in amino acids, free carnitine and acylcarnitine levels in male and female Sprague-Dawley rats. Several intra-sex differences affect tissues, indicating that metabolite profiles in rat hearts, livers and kidneys are organ-dependent. Amino acids and carnitine levels in rat hearts, livers and kidneys are affected by sex: male and female hearts show the greatest sexual dimorphism, both qualitatively and quantitatively. Finally, multivariate analysis confirmed the influence of sex on the metabolomics profiling. Our data demonstrate that the metabolomics approach together with a multivariate approach can capture the dynamics of physiological and pathological states, which are essential for explaining the basis of the sex differences observed in physiological and pathological conditions.

Pure Lymphoepithelioma-Like Carcinoma Originating from the Urinary Bladder

PubMed Central

Nagai, Takashi; Naiki, Taku; Kawai, Noriyasu; Iida, Keitaro; Etani, Toshiki; Ando, Ryosuke; Hamamoto, Shuzo; Sugiyama, Yosuke; Okada, Atsushi; Mizuno, Kentaro; Umemoto, Yukihiro; Yasui, Takahiro

2016-01-01

Lymphoepithelioma-like carcinoma of the urinary bladder (LELCB) is a rare variant of infiltrating urothelial carcinoma. We report a case of LELCB in a 43-year-old man. Ultrasonography and cystoscopy revealed two bladder tumors, one on the left side of the trigone and the other on the right side of the trigone. Transurethral resection of the bladder tumors was performed and pathological analysis revealed undifferentiated carcinoma. We therefore performed radical cystectomy and urinary diversion. Immunohistochemically the tumor cells were positive for cytokeratin, but negative for Epstein-Barr virus-encoded small RNA in situ hybridization as found for previous cases of LELCB. The final pathological diagnosis was a lymphoepithelioma-like variant of urothelial carcinoma with perivesical soft tissue invasion. For adjuvant systemic chemotherapy, three courses of cisplatin were administered. The patient subsequently became free of cancer 72 months postoperatively. Based on the literature, pure or predominant LELCB types show favorable prognoses due to their sensitivity to chemotherapy or radiotherapy. An analysis of the apparent diffusion coefficient (ADC) values of bladder tumors examined in our institution revealed that the ADC value measured for this LELCB was relatively low compared to conventional urothelial carcinomas. This suggests that measuring the ADC value of a lymphoepithelioma-like carcinoma prior to operation may be helpful in predicting LELCB. PMID:27099604

Evaluation of Hands-On Clinical Exam Performance Using Marker-less Video Tracking.

PubMed

Azari, David; Pugh, Carla; Laufer, Shlomi; Cohen, Elaine; Kwan, Calvin; Chen, Chia-Hsiung Eric; Yen, Thomas Y; Hu, Yu Hen; Radwin, Robert

2014-09-01

This study investigates the potential of using marker-less video tracking of the hands for evaluating hands-on clinical skills. Experienced family practitioners attending a national conference were recruited and asked to conduct a breast examination on a simulator that simulates different clinical presentations. Videos were made of the clinician's hands during the exam and video processing software for tracking hand motion to quantify hand motion kinematics was used. Practitioner motion patterns indicated consistent behavior of participants across multiple pathologies. Different pathologies exhibited characteristic motion patterns in the aggregate at specific parts of an exam, indicating consistent inter-participant behavior. Marker-less video kinematic tracking therefore shows promise in discriminating between different examination procedures, clinicians, and pathologies.

Altered neural reward representations in pathological gamblers revealed by delay and probability discounting.

PubMed

Miedl, Stephan F; Peters, Jan; Büchel, Christian

2012-02-01

The neural basis of excessive delay discounting and reduced risk sensitivity of pathological gamblers with a particular focus on subjective neural reward representations has not been previously examined. To examine how pathological gamblers represent subjective reward value at a neural level and how this is affected by gambling severity. Model-based functional magnetic resonance imaging study with patients and control subjects. Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf. Participants were recruited from the local community by advertisement and through self-help groups. A sample of 16 pathological gamblers (according to the DSM-IV definition) was matched by age, sex, smoking status, income, educational level, and handedness to 16 healthy controls. Pathological gamblers showed increased discounting of delayed rewards and a trend toward decreased discounting of probabilistic rewards compared with matched controls. At the neural level, a significant group × condition interaction indicated that reward representations in the gamblers were modulated in a condition-specific manner, such that they exhibited increased (delay discounting) and decreased (probability discounting) neural value correlations in the reward system. In addition, throughout the reward system, neuronal value signals for delayed rewards were negatively correlated with gambling severity. The results extend previous reports of a generally hypoactive reward system in pathological gamblers by showing that, even when subjective reward valuation is accounted for, gamblers still show altered reward representations. Furthermore, results point toward a gradual degradation of mesolimbic reward representations for delayed rewards during the course of pathological gambling.

Gallium 68 PSMA-11 PET/MR Imaging in Patients with Intermediate- or High-Risk Prostate Cancer.

PubMed

Park, Sonya Youngju; Zacharias, Claudia; Harrison, Caitlyn; Fan, Richard E; Kunder, Christian; Hatami, Negin; Giesel, Frederik; Ghanouni, Pejman; Daniel, Bruce; Loening, Andreas M; Sonn, Geoffrey A; Iagaru, Andrei

2018-05-16

Purpose To report the results of dual-time-point gallium 68 ( 68 Ga) prostate-specific membrane antigen (PSMA)-11 positron emission tomography (PET)/magnetic resonance (MR) imaging prior to prostatectomy in patients with intermediate- or high-risk cancer. Materials and Methods Thirty-three men who underwent conventional imaging as clinically indicated and who were scheduled for radical prostatectomy with pelvic lymph node dissection were recruited for this study. A mean dose of 4.1 mCi ± 0.7 (151.7 MBq ± 25.9) of 68 Ga-PSMA-11 was administered. Whole-body images were acquired starting 41-61 minutes after injection by using a GE SIGNA PET/MR imaging unit, followed by an additional pelvic PET/MR imaging acquisition at 87-125 minutes after injection. PET/MR imaging findings were compared with findings at multiparametric MR imaging (including diffusion-weighted imaging, T2-weighted imaging, and dynamic contrast material-enhanced imaging) and were correlated with results of final whole-mount pathologic examination and pelvic nodal dissection to yield sensitivity and specificity. Dual-time-point metabolic parameters (eg, maximum standardized uptake value [SUV max ]) were compared by using a paired t test and were correlated with clinical and histopathologic variables including prostate-specific antigen level, Gleason score, and tumor volume. Results Prostate cancer was seen at 68 Ga-PSMA-11 PET in all 33 patients, whereas multiparametric MR imaging depicted Prostate Imaging Reporting and Data System (PI-RADS) 4 or 5 lesions in 26 patients and PI-RADS 3 lesions in four patients. Focal uptake was seen in the pelvic lymph nodes in five patients. Pathologic examination confirmed prostate cancer in all patients, as well as nodal metastasis in three. All patients with normal pelvic nodes in PET/MR imaging had no metastases at pathologic examination. The accumulation of 68 Ga-PSMA-11 increased at later acquisition times, with higher mean SUV max (15.3 vs 12.3, P < .001). One additional prostate cancer was identified only at delayed imaging. Conclusion This study found that 68 Ga-PSMA-11 PET can be used to identify prostate cancer, while MR imaging provides detailed anatomic guidance. Hence, 68 Ga-PSMA-11 PET/MR imaging provides valuable diagnostic information and may inform the need for and extent of pelvic node dissection. © RSNA, 2018 Online supplemental material is available for this article.

A study of bedside ocular ultrasonography in the emergency department.

PubMed

Blaivas, Michael; Theodoro, Daniel; Sierzenski, Paul R

2002-08-01

The use of ocular ultrasonography for the evaluation of emergency patients has recently been described in the emergency medicine (EM) literature. There are a number of potential uses that may greatly aid the emergency physician (EP) and avoid lengthy consultation or other diagnostic tests. To examine the accuracy of bedside ultrasonography as performed by EPs for the evaluation of ocular pathology. This prospective, observational study took place in a high-volume, suburban community hospital with an EM residency program. All patients arriving with a history of eye trauma or acute change in vision were eligible to participate in the study. A 10-MHz linear-array transducer was used for imaging. All imaging was performed through a closed eyelid, using water-soluble ultrasound gel. Investigators filled out standardized data sheets and all examinations were taped for review. All ultrasound examinations were followed by orbital computed tomography or complete ophthalmologic evaluation from the ophthalmology service. Statistical analysis included sensitivity, specificity, and positive and negative predictive values. Sixty-one patients were enrolled in the study; 26 were found to have intraocular pathology on ultrasound. Of these, three had penetrating globe injuries, nine had retinal detachments, one had central retinal artery occlusion, and two had lens dislocations. The remaining pathology included vitreous hemorrhage and vitreous detachment. Emergency sonologists were in agreement with the criterion standard examination in 60 out of 61 cases. Emergency bedside ultrasound is highly accurate for ruling out and diagnosing ocular pathology in patients presenting to the emergency department. Further, it accurately differentiates between pathology that needs immediate ophthalmologic consultation and that which can be followed up on an outpatient basis.

Seven basic dimensions of personality pathology and their clinical consequences: Are all personalities equally harmful?

PubMed

Vall, Gemma; Gutiérrez, Fernando; Peri, Josep M; Gárriz, Miguel; Ferraz, Liliana; Baillés, Eva; Obiols, Jordi E

2015-11-01

Dimensional pathology models are increasingly being accepted for the assessment of disordered personalities, but their ability to predict negative outcomes is yet to be studied. We examine the relative clinical impact of seven basic dimensions of personality pathology through their associations with a wide range of clinical outcomes. A sample of 960 outpatients was assessed through a 7-factor model integrating the Cloninger, the Livesley, and the DSM taxonomies. Thirty-six indicators of clinical outcome covering three areas - dissatisfaction, functional difficulties, and clinical severity - were also assessed. The unique contribution of each personality dimension to clinical outcome was estimated through multiple regressions. Overall, personality dimensions explained 17.6% of the variance of clinical outcome, but varied substantially in terms of their unique contributions. Negative Emotionality had the greatest impact in all areas, contributing 43.9% of the explained variance. The remaining dimensions led to idiosyncratic patterns of clinical outcomes but had a comparatively minor clinical impact. A certain effect was also found for combinations of dimensions such as Negative Emotionality × Impulsive Sensation Seeking, but most interactions were clinically irrelevant. Our findings suggest that the most relevant dimensions of personality pathology are associated with very different clinical consequences and levels of harmfulness. The relative clinical impact of seven basic dimensions of personality pathology is examined. Negative Emotionality (Neuroticism) is 6-14 times as harmful as other pathological dimensions. The remaining dimensions and their interactions have very specific and comparatively minor clinical consequences. We examine only a handful of clinical outcomes. Our results may not be generalizable to other clinical or life outcomes. Our variables are self-reported and hence susceptible to bias. Our design does not allow us to establish causal relationships between personality and clinical outcomes. © 2015 The British Psychological Society.

Disrupted Intrinsic Networks Link Amyloid-β Pathology and Impaired Cognition in Prodromal Alzheimer's Disease.

PubMed

Koch, Kathrin; Myers, Nicholas E; Göttler, Jens; Pasquini, Lorenzo; Grimmer, Timo; Förster, Stefan; Manoliu, Andrei; Neitzel, Julia; Kurz, Alexander; Förstl, Hans; Riedl, Valentin; Wohlschläger, Afra M; Drzezga, Alexander; Sorg, Christian

2015-12-01

Amyloid-β pathology (Aβ) and impaired cognition characterize Alzheimer's disease (AD); however, neural mechanisms that link Aβ-pathology with impaired cognition are incompletely understood. Large-scale intrinsic connectivity networks (ICNs) are potential candidates for this link: Aβ-pathology affects specific networks in early AD, these networks show disrupted connectivity, and they process specific cognitive functions impaired in AD, like memory or attention. We hypothesized that, in AD, regional changes of ICNs, which persist across rest- and cognitive task-states, might link Aβ-pathology with impaired cognition via impaired intrinsic connectivity. Pittsburgh compound B (PiB)-positron emission tomography reflecting in vivo Aβ-pathology, resting-state fMRI, task-fMRI, and cognitive testing were used in patients with prodromal AD and healthy controls. In patients, default mode network's (DMN) functional connectivity (FC) was reduced in the medial parietal cortex during rest relative to healthy controls, relatively increased in the same region during an attention-demanding task, and associated with patients' cognitive impairment. Local PiB-uptake correlated negatively with DMN connectivity. Importantly, corresponding results were found for the right lateral parietal region of an attentional network. Finally, structural equation modeling confirmed a direct influence of DMN resting-state FC on the association between Aβ-pathology and cognitive impairment. Data provide evidence that disrupted intrinsic network connectivity links Aβ-pathology with cognitive impairment in early AD. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Best practices for clinical pathology testing in carcinogenicity studies.

PubMed

Young, Jamie K; Hall, Robert L; O'Brien, Peter; Strauss, Volker; Vahle, John L

2011-02-01

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.

Exploring the relationship between client perspectives, clinical expertise and research evidence.

PubMed

Roulstone, Sue

2015-06-01

This paper examines the relationship between components of evidence-based practice (clinical expertise, patient perspective and research evidence). Findings are examined from two research programs: the Better Communication Research Program and Child Talk, including exploratory studies of the views of parents and children regarding speech-language pathology and studies of current practice by SLPs in England. Systematic reviews of the research literature were also undertaken. The paper analyses relationships between outcomes valued by children and parents and those reported in the literature and in practice, parents' perspectives regarding intervention in comparison with clinicians' reports of practice and the extent to which research evidence underpins current practice is examined. Parents and children value functional outcomes and positive experiences; these are not routinely measured in research or practice. Therapy is perceived positively by most parents; however, some are ambivalent and less clear about the rationale. Commonly used interventions are supported by evidence, but there are gaps regarding some critical therapy components. The paper discusses four challenges to evidence-based practice: the consistency and clarity of descriptions of interventions; consensus based models of practice; understanding of the mechanisms of change; and, finally, the operationalization of client preferences within an evidence-based practice framework.

New Trends of Emerging Technologies in Digital Pathology.

PubMed

Bueno, Gloria; Fernández-Carrobles, M Milagro; Deniz, Oscar; García-Rojo, Marcial

2016-01-01

The future paradigm of pathology will be digital. Instead of conventional microscopy, a pathologist will perform a diagnosis through interacting with images on computer screens and performing quantitative analysis. The fourth generation of virtual slide telepathology systems, so-called virtual microscopy and whole-slide imaging (WSI), has allowed for the storage and fast dissemination of image data in pathology and other biomedical areas. These novel digital imaging modalities encompass high-resolution scanning of tissue slides and derived technologies, including automatic digitization and computational processing of whole microscopic slides. Moreover, automated image analysis with WSI can extract specific diagnostic features of diseases and quantify individual components of these features to support diagnoses and provide informative clinical measures of disease. Therefore, the challenge is to apply information technology and image analysis methods to exploit the new and emerging digital pathology technologies effectively in order to process and model all the data and information contained in WSI. The final objective is to support the complex workflow from specimen receipt to anatomic pathology report transmission, that is, to improve diagnosis both in terms of pathologists' efficiency and with new information. This article reviews the main concerns about and novel methods of digital pathology discussed at the latest workshop in the field carried out within the European project AIDPATH (Academia and Industry Collaboration for Digital Pathology). © 2016 S. Karger AG, Basel.

Hierarchical Diagnosis of Vocal Fold Disorders

NASA Astrophysics Data System (ADS)

Nikkhah-Bahrami, Mansour; Ahmadi-Noubari, Hossein; Seyed Aghazadeh, Babak; Khadivi Heris, Hossein

This paper explores the use of hierarchical structure for diagnosis of vocal fold disorders. The hierarchical structure is initially used to train different second-level classifiers. At the first level normal and pathological signals have been distinguished. Next, pathological signals have been classified into neurogenic and organic vocal fold disorders. At the final level, vocal fold nodules have been distinguished from polyps in organic disorders category. For feature selection at each level of hierarchy, the reconstructed signal at each wavelet packet decomposition sub-band in 5 levels of decomposition with mother wavelet of (db10) is used to extract the nonlinear features of self-similarity and approximate entropy. Also, wavelet packet coefficients are used to measure energy and Shannon entropy features at different spectral sub-bands. Davies-Bouldin criterion has been employed to find the most discriminant features. Finally, support vector machines have been adopted as classifiers at each level of hierarchy resulting in the diagnosis accuracy of 92%.

Whole Slide Images and Digital Media in Pathology Education, Testing, and Practice: The Oklahoma Experience

PubMed Central

Fung, Kar-Ming; Hassell, Lewis A.; Talbert, Michael L.; Wiechmann, Allan F.; Chaser, Brad E.; Ramey, Joel

2012-01-01

Examination of glass slides is of paramount importance in pathology training. Until the introduction of digitized whole slide images that could be accessed through computer networks, the sharing of pathology slides was a major logistic issue in pathology education and practice. With the help of whole slide images, our department has developed several online pathology education websites. Based on a modular architecture, this program provides online access to whole slide images, still images, case studies, quizzes and didactic text at different levels. Together with traditional lectures and hands-on experiences, it forms the back bone of our histology and pathology education system for residents and medical students. The use of digitized whole slide images has a.lso greatly improved the communication between clinicians and pathologist in our institute. PMID:21965282

Relationship status predicts lower restrictive eating pathology for bisexual and gay men across 10-year follow-up.

PubMed

Brown, Tiffany A; Keel, Pamela K

2015-09-01

Cross-sectional studies support that bisexual and gay (BG) men are at increased risk for eating pathology, and romantic relationships may buffer against risk; however, no studies have examined this association longitudinally. The current study examined how romantic relationships impact the trajectory of eating pathology in BG versus heterosexual men. BG (n = 51) and heterosexual (n = 522) men completed surveys of health and eating behaviors at baseline and 10-year follow-up. For BG men, being single at baseline prospectively predicted an increase in Drive for Thinness scores over 10-year follow-up. Additionally, for BG men in relationships at baseline, lower relationship satisfaction predicted an increase in Drive for Thinness scores over time. Conversely, these relationship variables did not predict trajectory of eating pathology for heterosexual men. Implications for theoretical models of risk, including objectification theory and sexual minority stress theory, and prevention, including peer-led cognitive dissonance based interventions, are discussed. © 2015 Wiley Periodicals, Inc.

Relationship Status Predicts Lower Restrictive Eating Pathology for Bisexual and Gay Men across 10-year Follow-up

PubMed Central

Brown, Tiffany A.; Keel, Pamela K.

2015-01-01

Objective Cross-sectional studies support that bisexual and gay (BG) men are at increased risk for eating pathology, and romantic relationships may buffer against risk; however, no studies have examined this association longitudinally. The current study examined how romantic relationships impact the trajectory of eating pathology in BG versus heterosexual men. Method BG (n=51) and heterosexual (n=522) men completed surveys of health and eating behaviors at baseline and 10-year follow-up. Results For BG men, being single at baseline prospectively predicted an increase in Drive for Thinness scores over 10-year follow-up. Additionally, for BG men in relationships at baseline, lower relationship satisfaction predicted an increase in Drive for Thinness scores over time. Conversely, these relationship variables did not predict trajectory of eating pathology for heterosexual men. Discussion Implications for theoretical models of risk, including objectification theory and sexual minority stress theory, and prevention, including peer-led cognitive dissonance based interventions, are discussed. PMID:26172055

A Family Study of the DSM-5 Section III Personality Pathology Model Using the Personality Inventory for the DSM-5 (PID-5).

PubMed

Katz, Andrea C; Hee, Danelle; Hooker, Christine I; Shankman, Stewart A

2017-10-03

In Section III of the DSM-5, the American Psychiatric Association (APA) proposes a pathological personality trait model of personality disorders. The recommended assessment instrument is the Personality Inventory for the DSM-5 (PID-5), an empirically derived scale that assesses personality pathology along five domains and 25 facets. Although the PID-5 demonstrates strong convergent validity with other personality measures, no study has examined whether it identifies traits that run in families, another important step toward validating the DSM-5's dimensional model. Using a family study method, we investigated familial associations of PID-5 domain and facet scores in 195 families, examining associations between parents and offspring and across siblings. The Psychoticism, Antagonism, and Detachment domains showed significant familial aggregation, as did facets of Negative Affect and Disinhibition. Results are discussed in the context of personality pathology and family study methodology. The results also help validate the PID-5, given the familial nature of personality traits.

Survey of physician requirements in six specialties: manpower needs in anesthesiology, neurology, nuclear medicine, pathology, physical medicine and rehabilitation, radiology. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wills, J.

1980-07-01

This report was prepared to assist the Graduate Medical Education National Advisory Committee (GMENAC) in its efforts to model physician manpower requirements in six specialties: anesthesiology, neurology, nuclear medicine, pathology, physical medicine and rehabilitation, and radiology. The purpose of this report is to (1) survey and present the existing literature on manpower requirements in each of these six specialties, and (2) discuss the special problems present in each specialty in modeling manpower requirements, and where possible, suggest possible avenues of resolution.

Vocal Fold Vibration Following Surgical Intervention in Three Vocal Pathologies: A Preliminary Study.

PubMed

Chen, Wenli; Woo, Peak; Murry, Thomas

2017-09-01

High-speed videoendoscopy captures the cycle-to-cycle vibratory motion of each individual vocal fold in normal and severely disordered phonation. Therefore, it provides a direct method to examine the specific vibratory changes following vocal fold surgery. The purpose of this study was to examine the vocal fold vibratory pattern changes in the surgically treated pathologic vocal fold and the contralateral vocal fold in three vocal pathologies: vocal polyp (n = 3), paresis or paralysis (n = 3), and scar (n = 3). Digital kymography was used to extract high-speed kymographic vocal fold images at the mid-membranous region of the vocal fold. Spectral analysis was subsequently applied to the digital kymography to quantify the cycle-to-cycle movements of each vocal fold, expressed as a spectrum. Surgical modification resulted in significantly improved spectral power of the treated pathologic vocal fold. Furthermore, the contralateral vocal fold also presented with improved spectral power irrespective of vocal pathology. In comparison with normal vocal fold spectrum, postsurgical vocal fold vibrations continued to demonstrate decreased vibratory amplitude in both vocal folds. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Rectal bleeding in patients with haemorrhoids. Coincidental findings in colon and rectum.

PubMed

Koning, M V; Loffeld, R J L F

2010-06-01

Rectal bleeding is a very common clinical sign. It is often caused by haemorrhoids. However, it can be a symptom of other pathology in the rectum or colon. There are little data coincidental pathology in patients with haemorrhoids and rectal bleeding. To examine coincidental pathology in patients with rectal bleeding and haemorrhoids, especially with respect to age. Prospectively, 290 consecutive patients presenting with bleeding and haemorrhoids were analysed. All patients had an endoscopic examination. All significant endoscopic findings (diverticuli, polyps, cancer, angiodysplasia and varices or colitis) were recorded. The patients were divided into two groups. Group 1 consisted of patients with only haemorrhoids (n = 129, % male: 41.1, mean age: 53.6 +/- 12.7 years). Group 2 consisted of patients with haemorrhoids and coincidental pathology (n = 161, % male: 46.6, mean age: 67.3 +/- 13.7 years). There was no difference in gender or in the type of endoscopy. However, patients in Group 2 were significantly older. It can be concluded that in cases of rectal bleeding and haemorrhoids, coincidental pathology occurs in a large proportion of patients, especially the elderly. Omitting endoscopy in these patients can lead to major doctors delay.

Localization of Pathology on Complex Architecture Building Surfaces

NASA Astrophysics Data System (ADS)

Sidiropoulos, A. A.; Lakakis, K. N.; Mouza, V. K.

2017-02-01

The technology of 3D laser scanning is considered as one of the most common methods for heritage documentation. The point clouds that are being produced provide information of high detail, both geometric and thematic. There are various studies that examine techniques of the best exploitation of this information. In this study, an algorithm of pathology localization, such as cracks and fissures, on complex building surfaces is being tested. The algorithm makes use of the points' position in the point cloud and tries to distinguish them in two groups-patterns; pathology and non-pathology. The extraction of the geometric information that is being used for recognizing the pattern of the points is being accomplished via Principal Component Analysis (PCA) in user-specified neighborhoods in the whole point cloud. The implementation of PCA leads to the definition of the normal vector at each point of the cloud. Two tests that operate separately examine both local and global geometric criteria among the points and conclude which of them should be categorized as pathology. The proposed algorithm was tested on parts of the Gazi Evrenos Baths masonry, which are located at the city of Giannitsa at Northern Greece.

A practical, evidence-based, comprehensive (PEC) physical examination for diagnosing pathology of the long head of the biceps.

PubMed

Rosas, Samuel; Krill, Michael K; Amoo-Achampong, Kelms; Kwon, KiHyun; Nwachukwu, Benedict U; McCormick, Frank

2017-08-01

Clinical examination of the shoulder joint has gained attention as clinicians aim to use an evidence-based examination of the biceps tendon, with the desire for a proper diagnosis while minimizing costly imaging procedures. The purpose of this study is to create a decision tree analysis that enables the development of a clinical algorithm for diagnosing long head of biceps (LHB) pathology. A literature review of Level I and II diagnostic studies was conducted to extract characteristics of clinical tests for LHB pathology through a systematic review of PubMed, Medline, Ovid, and Cochrane Review databases. Tests were combined in series and parallel to determine sensitivities and specificities, and positive and negative likelihood ratios were determined for each combination using a subjective pretest probability. The "gold standard" for diagnosis in all included studies was arthroscopy or arthrotomy. The optimal testing modality was use of the uppercut test combined with the tenderness to palpation of the biceps tendon test. This combination achieved a sensitivity of 88.4% when performed in parallel and a specificity of 93.8% when performed in series. These tests used in combination optimize post-test probability accuracy greater than any single individual test. Performing the uppercut test and biceps groove tenderness to palpation test together has the highest sensitivity and specificity of known physical examinations maneuvers to aid in the diagnosis of LHB pathology compared with diagnostic arthroscopy (practical, evidence-based, comprehensive examination). A decision tree analysis aides in the practical, evidence-based, comprehensive examination diagnostic accuracy post-testing based on the ordinal scale pretest probability. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

The current state of resident training in genomic pathology: a comprehensive analysis utilizing the Resident In-Service Exam (RISE)

PubMed Central

Haspel, Richard L.; Rinder, Henry M.; Frank, Karen M.; Wagner, Jay; Ali, Asma M.; Fisher, Patrick B.; Parks, Eric R.

2014-01-01

Objectives To determine the current state of pathology resident training in genomic and molecular pathology. Methods The Training Residents in Genomics (TRIG) Working Group developed survey and knowledge questions for the 2013 Pathology Resident In-Service Examination (RISE). Sixteen demographic questions related to amount of training, current and predicted future use, and perceived ability in molecular pathology vs. genomic medicine were included along with five genomic pathology and 19 molecular pathology knowledge questions. Results A total of 2,506 pathology residents took the 2013 RISE with approximately 600 individuals per post-graduate year (PGY). For genomic medicine, 42% of PGY-4 respondents stated they had no training compared to 7% for molecular pathology (p<0.001). PGY-4 resident perceived ability in genomic medicine, comfort in discussing results, and predicted future use as a practicing pathologist were less than reported for molecular pathology (p<0.001). There was a greater increase by PGY in knowledge question scores for molecular than for genomic pathology. Conclusions The RISE is a powerful tool in assessing the state of resident training in genomic pathology and current results suggest a significant deficit. The results also provide a baseline to assess future initiatives to improve genomics education for pathology residents such as those developed by the TRIG Working Group. PMID:25239410

Ankle pain and peroneal tendon pathology.

PubMed

Baumhauer, Judith F; Nawoczenski, Deborah A; DiGiovanni, Benedict F; Flemister, A Samuel

2004-01-01

Chronic ankle pain can be due to multiple causes. A thorough review of the patient's history with a physical examination concentrating on anatomic structures surrounding the ankle is imperative. The most common of causes have been presented. The addition of provocative testing and radiographic examinations can aid in elucidating the pathology. After treatment of the injury, attention to training technique, shoe and insert usage as well as individual gait abnormalities are integrated into global patient education to decrease the incidence of injury recurrence.

Bell's palsy: excluding serious illness in urgent and emergency care settings.

PubMed

Mower, Sean

2017-04-13

Bell's palsy is a relatively benign condition that affects about 20 in every 100,000 patients a year, and in most cases the signs and symptoms resolve fully within around six months. The defining characteristic of the condition is a unilateral facial palsy, but this is also apparent in other conditions with a more serious prognosis, including strokes, some viral infections and tumours. This article reviews the literature on recognition of Bell's palsy, examines the underlying pathology, and compares it with other conditions associated with facial palsy. The article critically analyses the evidence and guidelines to identify best practice, and considers areas for improvement. Finally, it discusses how this information can be incorporated into practice, and provides guidance for clinicians on differentiating between conditions in which patients present with facial palsy to ensure they are managed appropriately.

[Composite pheochromocytoma: A rare adrenal tumor].

PubMed

Robinet, Gwladys; Rioux-Leclercq, Nathalie; Manunta, Andréa; Mathieu, Romain; Tissier, Frédérique; Peyronnet, Benoit; Kammerer-Jacquet, Solène-Florence

2017-04-01

Composite pheochromocytoma is a rare tumor of the adrenal medulla composed of pheochromocytoma and neuroblastic tumor. We report the case of a composite pheochromocytoma detected in a patient with neurofibromatosis type 1. A 61-year-old male patient presented occasional sweats with palpitation and moderate high blood pressure. Urinary catecholamine level was increased. CT scan showed a heterogeneous tumor limited to the adrenal gland. Histologically, the tumor showed two components: pheochromocytoma and ganglioneuroma and was diagnosed as a composite pheochromocytoma. This tumor is particularly associated with neurofibromatosis type 1, the NF1 germline gene mutation may be involved in its physiopathology. Composite pheochromocytoma is a rare tumor whose pheochromocytoma component is suspected clinically but the final diagnosis is assessed by pathological examination. Prognosis is still difficult to establish due to the rarity of these tumors. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Femoral diaphyseal stress fracture as the initial presentation of acute leukaemia in an adolescent.

PubMed

Chase, Helen Emily; Pang, Joe Hwong; Sanghrajka, Anish Pradip

2016-06-28

A 14-year-old boy was referred to the orthopaedic clinic by his general practitioner, reporting of a 6-week history of left thigh pain. Clinical examination was unremarkable. Radiographs demonstrated a periosteal reaction at the proximal femur. MRI scans demonstrated a stress fracture of the femur, with no associated sinister features and no evidence of a pathological lesion. As the fracture healed and symptoms improved, the patient became unwell with weight loss, lethargy, chest and jaw pain and fevers. After multiple blood tests over a 25-day period, including five full blood counts and two normal blood films, a third blood film finally demonstrated blasts in keeping with acute leukaemia. We discuss a literature review of musculoskeletal manifestations of leukaemia and the often atypical presentations found. 2016 BMJ Publishing Group Ltd.

Corneal topography with high-speed swept source OCT in clinical examination

PubMed Central

Karnowski, Karol; Kaluzny, Bartlomiej J.; Szkulmowski, Maciej; Gora, Michalina; Wojtkowski, Maciej

2011-01-01

We present the applicability of high-speed swept source (SS) optical coherence tomography (OCT) for quantitative evaluation of the corneal topography. A high-speed OCT device of 108,000 lines/s permits dense 3D imaging of the anterior segment within a time period of less than one fourth of second, minimizing the influence of motion artifacts on final images and topographic analysis. The swept laser performance was specially adapted to meet imaging depth requirements. For the first time to our knowledge the results of a quantitative corneal analysis based on SS OCT for clinical pathologies such as keratoconus, a cornea with superficial postinfectious scar, and a cornea 5 months after penetrating keratoplasty are presented. Additionally, a comparison with widely used commercial systems, a Placido-based topographer and a Scheimpflug imaging-based topographer, is demonstrated. PMID:21991558

Second opinion oral pathology referrals in New Zealand.

PubMed

Seo, B; Hussaini, H M; Rich, A M

2017-04-01

Referral for a second opinion is an important aspect of pathology practice, which reduces the rate of diagnostic error and ensures consistency with diagnoses. The Oral Pathology Centre (OPC) is the only specialist oral diagnostic centre in New Zealand. OPC provides diagnostic services to dentists and dental specialists throughout New Zealand and acts as a referral centre for second opinions for oral pathology specimens that have been sent to anatomical pathologists. The aim of this study was to review second opinion referral cases sent to the OPC over a 15-year period and to assess the levels of concordance between the original and final diagnoses. The findings indicated that the majority of referred cases were odontogenic lesions, followed by connective tissue, epithelial and salivary lesions. The most prevalent diagnoses were ameloblastoma and keratocystic odontogenic tumour, followed by oral squamous cell carcinoma. Discordant diagnoses were recorded in 24% of cases. Diagnostic discrepancies were higher in odontogenic and salivary gland lesions, resulting in the change of diagnoses. Second opinion of oral pathology cases should be encouraged in view of the relative rarity of these lesions in general pathology laboratories and the rates of diagnostic discrepancy, particularly for odontogenic and salivary gland lesions. Copyright © 2017 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.

Significance of Ureteroscopic Biopsy Grade in Patients with Upper Tract Urothelial Carcinoma

PubMed Central

Furukawa, Junya; Miyake, Hideaki; Sakai, Iori; Fujisawa, Masato

2013-01-01

Background The objective of this study was to assess the significance of the ureteroscopic biopsy grade for patients with upper tract urothelial carcinoma (UTUC). Patients and Methods This study included 40 patients who were diagnosed with a single focus of UTUC by ureteroscopic biopsy and subsequently underwent nephroureterectomy. The significance of the biopsy grade as a predictive factor for pathological outcomes of nephroureterectomy was retrospectively analyzed. Results Of these 40 patients, 19 (47.5%) and 21 (52.5%) were diagnosed with low and high grade UTUC, respectively. The ureteroscopic biopsy grade matched the pathological grade of surgically resected specimens in 35 of the 40 cases (87.5%), and there was a significant correlation between the biopsy and pathological grades (p < 0.001). Furthermore, the biopsy grade was also shown to be closely associated with the pathological stage (p < 0.001); that is, only 1 of the 19 patients (5.3%) with biopsy low grade UTUC were pathologically diagnosed as having muscle invasive disease, while 17 of the 21 patients (81.0%) with biopsy high grade UTUC appeared to show tumor invasion into muscle or deeper. Conclusions The grade of UTUC on ureteroscopic biopsy could provide accurate diagnostic information on the final pathology of nephroureterectomy specimens. PMID:24917735

The modern role of transoesophageal echocardiography in the assessment of valvular pathologies

PubMed Central

Bull, Sacha; Newton, James

2017-01-01

Despite significant advancements in the field of cardiovascular imaging, transoesophageal echocardiography remains the key imaging modality in the management of valvular pathologies. This paper provides echocardiographers with an overview of the modern role of TOE in the diagnosis and management of valvular disease. We describe how the introduction of 3D techniques has changed the detection and grading of valvular pathologies and concentrate on its role as a monitoring tool in interventional cardiology. In addition, we focus on the echocardiographic and Doppler techniques used in the assessment of prosthetic valves and provide guidance for the evaluation of prosthetic valves. Finally, we summarise quantitative methods used for the assessment of valvular stenosis and regurgitation and highlight the key areas where echocardiography remains superior over other novel imaging modalities. PMID:28096184

The modern role of transoesophageal echocardiography in the assessment of valvular pathologies.

PubMed

Wamil, Malgorzata; Bull, Sacha; Newton, James

2017-01-17

Despite significant advancements in the field of cardiovascular imaging, transoesophageal echocardiography remains the key imaging modality in the management of valvular pathologies. This paper provides echocardiographers with an overview of the modern role of TOE in the diagnosis and management of valvular disease. We describe how the introduction of 3D techniques has changed detection and grading of valvular pathologies and concentrate on its role as a monitoring tool in interventional cardiology. In addition, we focus on the echocardiographic and Doppler techniques used in the assessment of prosthetic valves, and provide guidance for evaluation of prosthetic valves. Finally, we summarise quantitative methods used for the assessment of valvular stenosis and regurgitation and highlight the key areas where echocardiography remains superior over other novel imaging modalities. © 2017 The authors.

[Stroke due to infective endocarditis diagnosed by the retrieved thrombus: a case report].

PubMed

Nakanishi, Kaoru; Kawano, Hiroyuki; Amano, Tatsuo; Omori, Yoshihiko; Kanma, Hiroshi; Hirano, Teruyuki

2018-01-26

A 80-years-old woman suddenly presented with aphasia, right hemiparesis, and dysesthesia. MRA showed the left middle cerebral artery occlusion. She was diagnosed as hyperacute ischemic stroke. She was treated with intravenous recombinant tissue plasminogen activator and underwent endovascular thrombectomy. On admission, she had a fever and high C reactive protein, and was treated with antibiotic therapy. The pathological diagnosis of the retrieved thrombus revealed the cluster of the gram positive cocci. The blood culture was negative and thransthoracic echocardiogram did not detect the vegetation. She was finally diagnosed as cardioembolic stroke due to infective endocarditis based on the pathological diagnosis of the retrieved thrombus. The pathological diagnosis of the retrieved thrombus was quite important to clarify the cause of ischemic stroke.

Cancer biology and genomics: translating discoveries, transforming pathology.

PubMed

Ladanyi, Marc; Hogendoorn, Pancras C W

2011-01-01

Advances in our understanding of cancer biology and discoveries emerging from cancer genomics are being translated into real clinical benefits for patients with cancer. The 2011 Journal of Pathology Annual Review Issue provides a snapshot of recent rapid progress on multiple fronts in the war on cancer or, more precisely, the wars on cancers. Indeed, perhaps the most notable recent shift is reflected by the sharp increase in understanding the biology of multiple specific cancers and using these new insights to inform rationally targeted therapies, with often striking successes. These recent developments, as reviewed in this issue, show how the long-term investments in basic cancer research are finally beginning to bear fruit. Copyright © 2010 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Compulsive exercise as a mediator between clinical perfectionism and eating pathology.

PubMed

Egan, Sarah J; Bodill, Kate; Watson, Hunna J; Valentine, Emily; Shu, Chloe; Hagger, Martin S

2017-01-01

The aim of this study was to examine whether compulsive exercise mediates the relationship between clinical perfectionism and eating pathology, based on the cognitive behavioral model of compulsive exercise. Participants were 368 adults who participated regularly in sport/exercise and completed online measures of perfectionism, compulsive exercise and eating disorders. In support of the well-established link between perfectionism and eating disorders, clinical perfectionism predicted eating pathology both directly and indirectly mediated by compulsive exercise. In addition, there were also direct effects of clinical perfectionism on the avoidance/rule-driven behavior, weight control, and mood improvement subscales of the Compulsive Exercise Test (CET). There was a direct effect of the CET weight control subscale on eating pathology and a negative direct effect of the CET subscale mood improvement on eating pathology. Findings lend support to the cognitive behavioral model of compulsive exercise in which clinical perfectionism is conceptualized as related to eating disorders directly and indirectly through the mediation of compulsive exercise. Compulsive exercise was also found to have a direct effect on eating disorders. Compulsive exercise may be a symptom of eating pathology, rather than an antecedent, however causal inferences could not be established given the correlational design. Longitudinal research using cross-lagged panel designs to examine a bidirectional relationship between compulsive exercise and eating disorders is needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Dynamic nonrobotic telemicroscopy via skype: A cost effective solution to teleconsultation.

PubMed

Sirintrapun, Sahussapont J; Cimic, Adela

2012-01-01

Skype is a peer to peer software application that has been historically used for voice and video calls, instant messaging, and file transfer over the Internet. Few studies are available using Skype specifically for telepathology. Our aim is to show that dynamic nonrobotic teleconsultation is possible and even effective via means of a standard microscope camera capable of live acquisition, Skype, an established broad band internet connection, and experienced pathologists. Both the consulting "sending" pathologist and consultant "receiving" pathologist are reasonably experienced general surgical pathologists at junior attending level with several years of experience in sign out. Forty-five cases were chosen encompassing a broad range of surgical pathology specimens. The cases were prospectively evaluated with the consultant diagnosis used as a preliminary pathologic impression with the final diagnosis being confirmation. Versions of Skype 5.0 and above were used along with established broadband internet connections, usually between academic medical institutions. Forty of forty-five cases (89%) were essentially concordant. In four of forty-five cases (9%), the consulting impression gave a differential, but favored an entity which did not match the final diagnosis. Only one case (2%) did the consulting impression not match the final diagnosis; a discordant opinion. The image quality via Skype screen sharing option is excellent. Essentially no lag time was seen. We have shown in our small pilot study that Skype is an effective cost-efficient means for teleconsultation, particularly in the setting of entity-related differential diagnoses in surgical pathology and when both the consulting and consultant pathologists are reasonably experienced.

Greater magnitude tibiofemoral contact forces are associated with reduced prevalence of osteochondral pathologies 2-3 years following anterior cruciate ligament reconstruction.

PubMed

Saxby, David John; Bryant, Adam L; Van Ginckel, Ans; Wang, Yuanyuan; Wang, Xinyang; Modenese, Luca; Gerus, Pauline; Konrath, Jason M; Fortin, Karine; Wrigley, Tim V; Bennell, Kim L; Cicuttini, Flavia M; Vertullo, Christopher; Feller, Julian A; Whitehead, Tim; Gallie, Price; Lloyd, David G

2018-06-07

External loading of osteoarthritic and healthy knees correlates with current and future osteochondral tissue state. These relationships have not been examined following anterior cruciate ligament reconstruction. We hypothesised greater magnitude tibiofemoral contact forces were related to increased prevalence of osteochondral pathologies, and these relationships were exacerbated by concomitant meniscal injury. This was a cross-sectional study of 100 individuals (29.7 ± 6.5 years, 78.1 ± 14.4 kg) examined 2-3 years following hamstring tendon anterior cruciate ligament reconstruction. Thirty-eight participants had concurrent meniscal pathology (30.6 ± 6.6 years, 83.3 ± 14.3 kg), which included treated and untreated meniscal injury, and 62 participants (29.8 ± 6.4 years, 74.9 ± 13.3 kg) were free of meniscal pathology. Magnetic resonance imaging of reconstructed knees was used to assess prevalence of tibiofemoral osteochondral pathologies (i.e., cartilage defects and bone marrow lesions). A calibrated electromyogram-driven neuromusculoskeletal model was used to predict medial and lateral tibiofemoral compartment contact forces from gait analysis data. Relationships between contact forces and osteochondral pathology prevalence were assessed using logistic regression models. In patients with reconstructed knees free from meniscal pathology, greater medial contact forces were related to reduced prevalence of medial cartilage defects (odds ratio (OR) = 0.7, Wald χ 2 (2) = 7.9, 95% confidence interval (CI) = 0.50-95, p = 0.02) and medial bone marrow lesions (OR = 0.8, Wald χ 2 (2) = 4.2, 95% CI = 0.7-0.99, p = 0.04). No significant relationships were found in lateral compartments. In reconstructed knees with concurrent meniscal pathology, no relationships were found between contact forces and osteochondral pathologies. In patients with reconstructed knees free from meniscal pathology, increased contact forces were associated with fewer cartilage defects and bone marrow lesions in medial, but not, lateral tibiofemoral compartments. No significant relationships were found between contact forces and osteochondral pathologies in reconstructed knees with meniscal pathology for any tibiofemoral compartment. Future studies should focus on determining longitudinal effects of contact forces and changes in osteochondral pathologies. IV.

Clinical and pathological manifestations of cardiovascular disease in rat models: the influence of acute ozone exposure

EPA Science Inventory

This paper shows that rat models of cardiovascular diseases have differential degrees of underlying pathologies at a young age. Rodent models of cardiovascular diseases (CVD) and metabolic disorders are used for examining susceptibility variations to environmental exposures. How...

Expanding the Nomological Net of the Pathological Narcissism Inventory: German Validation and Extension in a Clinical Inpatient Sample.

PubMed

Morf, Carolyn C; Schürch, Eva; Küfner, Albrecht; Siegrist, Philip; Vater, Aline; Back, Mitja; Mestel, Robert; Schröder-Abé, Michela

2017-06-01

The Pathological Narcissism Inventory (PNI) is a multidimensional measure for assessing grandiose and vulnerable features in narcissistic pathology. The aim of the present research was to construct and validate a German translation of the PNI and to provide further information on the PNI's nomological net. Findings from a first study confirm the psychometric soundness of the PNI and replicate its seven-factor first-order structure. A second-order structure was also supported but with several equivalent models. A second study investigating associations with a broad range of measures ( DSM Axis I and II constructs, emotions, personality traits, interpersonal and dysfunctional behaviors, and well-being) supported the concurrent validity of the PNI. Discriminant validity with the Narcissistic Personality Inventory was also shown. Finally, in a third study an extension in a clinical inpatient sample provided further evidence that the PNI is a useful tool to assess the more pathological end of narcissism.

[Cerebral MRT in neurofibromatosis: gliosis versus neoplasia?].

PubMed

Mautner, V F; Pressler, M; Fünsterer, C; Schneider, E

1989-08-01

15 patients aged 1-39 years with documented neurofibromatosis had MR examinations of the cerebrum within the scope of a basic diagnosis and therapy programme. Clinical examination did not lead to pathologic findings for 7 of the patients; 3 patients suffered from general developmental disabilities. A neurologico-psychiatric examination showed pathological findings in 5 patients. Signal-intense foci in proton density and T2-weighted MR images were found in the globus pallidus, thalamus, hippocampus, cerebellum and midbrain. In 2 patients, these foci could be found as well in T1-weighted images. Differentiation between gliosis areas and low grade astrocytomas was not possible in MR.

Challenging previous conceptions of vegetarianism and eating disorders.

PubMed

Fisak, B; Peterson, R D; Tantleff-Dunn, S; Molnar, J M

2006-12-01

The purpose of this study was to replicate and expand upon previous research that has examined the potential association between vegetarianism and disordered eating. Limitations of previous research studies are addressed, including possible low reliability of measures of eating pathology within vegetarian samples, use of only a few dietary restraint measures, and a paucity of research examining potential differences in body image and food choice motives of vegetarians versus nonvegetarians. Two hundred and fifty-six college students completed a number of measures of eating pathology and body image, and a food choice motives questionnaire. Interestingly, no significant differences were found between vegetarians and nonvegetarians in measures of eating pathology or body image. However, significant differences in food choice motives were found. Implications for both researchers and clinicians are discussed.

Understanding the roles of self-esteem, self-compassion, and fear of self-compassion in eating disorder pathology: an examination of female students and eating disorder patients.

PubMed

Kelly, Allison C; Vimalakanthan, Kiruthiha; Carter, Jacqueline C

2014-08-01

The present study examined the relative contributions of self-compassion, fear of self-compassion, and self-esteem in eating disorder pathology. One-hundred and fifty-five female undergraduate students and 97 females entering eating disorder treatment completed the Self-Compassion Scale, Fears of Compassion Scale, Rosenberg Self-Esteem Inventory, and Eating Disorder Examination Questionnaire. T-tests revealed that the patient group had lower mean self-compassion and higher mean fear of self-compassion than the student group. When controlling for self-esteem, high fear of self-compassion emerged as the strongest predictor of eating disorder pathology in the patient group, whereas low self-compassion was the strongest predictor in the student group. These preliminary results suggest that targeting fear of self-compassion may be important when intervening with individuals suffering from an eating disorder, whereas building self-compassion may be a valuable approach for eating disorder prevention. Copyright © 2014 Elsevier Ltd. All rights reserved.

Examination of the liver in personnel working with liquid rocket propellant

PubMed Central

Petersen, Palle; Bredahl, Erik; Lauritsen, Ove; Laursen, Thomas

1970-01-01

Petersen, P., Bredahl, E., Lauritsen, O., and Laursen, T. (1970).Brit. J. industr. Med.,27, 141-146. Examination of the liver in personnel working with liquid rocket propellants. Personnel working with liquid rocket propellants were subjected to routine health examinations, including liver function tests, as the propellant, unsymmetrical dimethylhydrazine (UDMH) is potentially toxic to the liver. In 46 persons the concentrations of serum alanine aminotransferase (SGPT) were raised. Liver biopsy was performed in 26 of these men; 6 specimens were pathological (fatty degeneration), 5 were uncertain, and 15 were normal. All 6 pathological biopsies were from patients with a raised SGPT at the time of biopsy. Of the 15 persons with a normal liver biopsy, 14 had a normal SGPT, while one (who was an alcoholic) had a raised SGPT. The connection between SGPT and histology of the liver, as well as the possible causal relation between the pathological findings and exposure to UDMH, is discussed. Images PMID:5428632

Esophageal Reconstruction with the Stomach, a Functional Dilemma?

PubMed

Predescu, Dragoş; Constantinoiu, Silviu

2018-01-01

Background: A few decades ago, esophageal substitution was mainly dedicated particularly in postcaustic esophageal stenosis; currently, the reconstruction has expanded its palette of indications to other areas of benign esophageal pathology (severe motor disorders, esophageal achalasia with multiple relapses, peptic stenosis, etc.) but has also become a quasi-obligatory final time in the esophagectomy for cancer whenever it is possible. The techniques of esophageal reconstruction using the stomach, regardless of the indication and the chosen technical option, remain a valuable and effective method. A number of striking arguments advocate for one or another type of gastric graft: anatomic factors more than convenient (vascularization, sufficient length, a wall structure favorable for suture, etc.) and a sustainable surgical intervention (length, approach, complexity of the surgical steps digestive disorders after surgery, post-therapeutic functionality, etc.). Choosing a technique or another, beyond pathological arguments, should take into account remote functionality, with a clear impact on metabolic status and quality of life. So, according to this criterion, can we functionally justify a type or another of gastric restoration? Finally, the proof of an adequate solution is relatively easy to appreciate: has swallowing been restored and if so, the result has been maintained over time? For oncological cases, the assessment should also take into account the chronological criterion of the postoperative survival rate. Methods: The statistically rated lot ranged from 1981 to 2016 and included 268 patients with surgical interventions for esophageal stenosis, distributed according to etiopathogenesis and indication in 201 reconstructions for post-caustic stenosis, and 67 for post-esophagectomy replacement for neoplasm. The techniques used for remote functional evaluation included: barium swallow, endoscopy + biopsy, and in cases with obvious changes pH measurement/24 h and manometry and, only in exceptional cases, scintigraphy with marked foods. Results: two types of problems have been identified: a particular type of neuro-motor dysfunction of the esophageal substitute in 6 patients (1 patient with Gavriliu reconstruction and 5 with Nakayama reconstruction, using the whole stomach), with difficulty, delayed gastric graft evacuation, with major stasis and abdominal discomfort vomiting, inability to eat, aspiration phenomena) respectively a reflux pathology - 8 patients, being proved by a specific simptomatology, barium lunch, endoscopic examination and pH-metric examination. Reflux was alkaline in 7 patients, all with pyloroplasty, 5 with whole stomach and 2 with Akiyama procedure; in 1 case with Gavriliu procedure the reflux was acid. Conclusions: Stomach is a good option in esophageal substitution. Concerning the remote results, a good functionality is found with a reasonable metabolic status. The two phenomena on which the function of the graft depends - secretory activity and motor activity - seem to be restored in time but these does not occur concurrently, the recovery of the secretory function being much faster. Celsius.

Pathological motivations for exercise and eating disorder specific health-related quality of life.

PubMed

Cook, Brian; Engel, Scott; Crosby, Ross; Hausenblas, Heather; Wonderlich, Stephen; Mitchell, James

2014-04-01

To examine associations among pathological motivations for exercise with eating disorder (ED) specific health-related quality of life (HRQOL). Survey data assessing ED severity (i.e., Eating Disorder Diagnostic Survey), ED specific HRQOL (i.e., Eating Disorders Quality of Life Instrument), and pathological motivations for exercise (i.e., Exercise Dependence Scale) were collected from female students (N = 387) at seven universities throughout the United States. Regression analyses were conducted to examine the associations among exercise dependence, ED-specific HRQOL and ED severity, and the interaction of exercise dependence and ED severity on HRQOL scores. The overall model examining the impact of ED severity and exercise dependence (independent variables) on HRQOL (dependent variable) was significant and explained 16.1% of the variance in HRQOL scores. Additionally, the main effects for ED severity and exercise dependence and the interaction among ED severity and exercise dependence were significant, suggesting that the combined effects of ED severity and exercise dependence significantly impacts HRQOL. Our results suggest that pathological motivations for exercise may exacerbate ED's detrimental impact on HRQOL. Our results offer one possible insight into why exercise may be associated with deleterious effects on ED HRQOL. Future research is needed to elucidate the relationship among psychological aspects of exercise, ED, and HRQOL. Copyright © 2013 Wiley Periodicals, Inc.

[Detection of respiratory tract diseases among rural population during the team-work mass screening].

PubMed

Abramson, E Z; Galkin, V B; Stepanova, G Ia

1990-01-01

A screening complex for the examination of the rural population has been worked out to detect bronchopulmonary pathology and form groups of risk for respiratory diseases. The complex of methods included compulsory questionnaires and ++fluoro-functional examination, spirometry if indicated and bacterial tests. Out of 1, 131 persons examined, 328 were found to have respiratory diseases. Chronic non-specific respiratory diseases were detected in 103 subjects, including 62 of them having obstructive bronchitis. A risk group developing chronic non-specific respiratory diseases, including 202 persons with disturbed ventilation activity of the lungs, post-tuberculous inadequate changes and other pathology. Pulmonary tuberculosis was registered in 7 subjects. The given data indicate the necessity of a complex examination of the population.

Physical activity and breast cancer risk by pathological subtype.

PubMed

Lope, Virginia; Martín, Miguel; Castelló, Adela; Casla, Soraya; Ruiz, Amparo; Baena-Cañada, Jose Manuel; Casas, Ana Mª; Calvo, Lourdes; Bermejo, Begoña; Muñoz, Montserrat; Ramos, Manuel; de Juan-Ferré, Ana; Jara, Carlos; Antón, Antonio; Jimeno, Mª Ángeles; Lluch, Ana; Antolín, Silvia; García-Sáenz, José Ángel; Estévez, Purificación; Arriola-Arellano, Esperanza; Gavilá, Joaquín; Pérez-Gómez, Beatriz; Carrasco, Eva; Pollán, Marina

2017-03-01

To examine the influence of physical activity on breast cancer risk and evaluate whether adherence to international recommendations is associated with a decreased risk. This is a multicenter matched case-control study where 698 pairs completed a physical activity questionnaire. Recreational physical activity during the last year was quantified in metabolic equivalent hours per week (MET-h/week) and categorized in activities of moderate (3.0-5.9 MET) and vigorous (>6 MET) intensity. The adherence to World Cancer Research Fund and the American Institute for Cancer Research recommendation was also assessed. The association with breast cancer risk, overall and by pathologic subtype, was evaluated using conditional and multinomial logistic regression models. Mean MET-h/week was 16.6 among cases and 20.4 among controls. Premenopausal breast cancer risk decreased by 5% (P=0.007) for every 6 MET-h/week increase in energy expenditure. By contrast, postmenopausal women needed to do more intense exercise to observe benefits. The protection was more pronounced for nulliparous women, as well as for hormone receptor positive and HER2+ tumors. Physically inactive women displayed a 71% increased risk when compared with those who met the international recommendation (P=0.001). Finally, women who were inactive during the previous year, regardless of the overall physical activity reported in previous periods, showed an increased risk when compared to always active women. Women who report adherence to international physical activity recommendations entail a significant decrease in risk for all pathologic breast cancer subtypes. This is of particular interest in Spain, where a significant increase in overweight and obesity in recent decades is observed. Copyright © 2016. Published by Elsevier Inc.

An update on the clinical diagnostic value of β-hCG and αFP for intracranial germ cell tumors.

PubMed

Hu, Mingming; Guan, Hongzhi; Lau, Ching C; Terashima, Keita; Jin, Zimeng; Cui, Liying; Wang, Yuzhou; Li, Guilin; Yao, Yong; Guo, Yi; Li, Yan Michael; Zhong, Dingrong; Xiao, Juan; Wan, Xirun; Lian, Xin; Feng, Feng; Ren, Haitao; Zhao, Yanhuan; Cheng, Xinqi; Gu, Feng

2016-03-12

Pathological examination combined with tumor markers has become a standard for the diagnosis of intracranial germ cell tumors (ICGCTs), but the current concept of 'secreting germ cell tumors' and three empirically highly specific diagnostic criteria (β-hCG ≥ 50 IU/L or αFP ≥ 10 ng/mL; β-hCG ≥ 100 IU/L or αFP ≥ 50 ng/mL; β-hCG > 50 IU/L or αFP > 25 ng/mL) are not based upon pathology examination or CSF cytology. Further investigation is needed to re-evaluate their value. A multidisciplinary diagnostic team was created. Valid β-hCG/αFP data were collected from cases of ICGCTs confirmed by pathology and CSF cytology (n = 58) between 1991 and 2012, and from suspected ICGCTs cases (n = 17) between 2011 and 2012 as controls [Langerhans cell histiocytosis (LCH), n = 12; and other intracranial tumor (ICT), n = 5]. The cut-off points for β-hCG and αFP were calculated using receiver operating characteristic (ROC) curves. This study clarifies the relative rationality of one criteria (β-hCG > 50 IU/L and αFP > 25 ng/mL); confirms new β-hCG diagnostic cut-off points: CSF β-hCG ≥ 8.2 IU/L and serum β-hCG ≥ 2.5 IU/L (sensitivity of 47 and 34%, respectively, specificity of 100%, both; P < 0.05); and empirically adjusts the criteria for αFP to ≥ 3.8 ng/mL in CSF and to ≥ 25 ng/mL in serum. The total diagnostic sensitivity for ICGCTs finally increased from 34.6 to 65.4% (P < 0.05, diagnostic value of CSF β-hCG exceeds 90%). Subtype diagnosis improved with αFP in 16.7% of non-geminomatous germ cell tumor cases. New evidence-based criteria of β-hCG and αFP can help improving early and formal diagnosis of ICGCTs, and is of great clinical significance.

Polarization-correlation investigation of biotissue multifractal structure and diagnostics of its pathological change

NASA Astrophysics Data System (ADS)

Angelsky, Oleg V.; Pishak, Vasyl P.; Ushenko, Alexander G.; Burkovets, Dimitry N.; Pishak, Olga V.

2001-05-01

The paper presents the results of polarization-correlation investigation of multifractal collagen structure of physiologically normal and pathologically changed tissues of women's reproductive sphere and of skin. The technique of polarization selection of coherent biotissues' images followed by determination of their autocorrelation functions and spectral densities is suggested. The correlation- optical criteria of early diagnostics of pathological changes' appearance of myometry (forming of the germ of fibromyoma) and of skin (psoriasis) are determined. The present paper examines the possibilities of diagnostics of pathological changes of biotissues' morphological structure by means of determining the polarizationally filtered autocorrelation functions (ACF) and corresponding spectral densities of their coherent images.

Pathology resident and fellow education in a time of disruptive technologies.

PubMed

Ziai, James M; Smith, Brian R

2012-12-01

The development of disruptive technologies is changing the practice of pathology. Their implementation challenges traditional educational paradigms. Training programs must adapt to these heuristic needs. The dual explosion of new medical knowledge and innovative methodologies adds new practice aspects to the pathologist's areas of expertise. This transformation potentially challenges the traditional core model of training. It raises questions as to how pathology should incorporate future expanding subspecialty needs into educational and practice models. This article examines the impact of these disruptive technologies on resident and fellow education and explores alternative educational and practice models that may better accommodate pathology's future. Copyright © 2012 Elsevier Inc. All rights reserved.

ERP-based detection of brain pathology in rat models for preclinical Alzheimer's disease

NASA Astrophysics Data System (ADS)

Nouriziabari, Seyed Berdia

Early pathological features of Alzheimer's disease (AD) include the accumulation of hyperphosphorylated tau protein (HP-tau) in the entorhinal cortex and progressive loss of basal forebrain (BF) cholinergic neurons. These pathologies are known to remain asymptomatic for many years before AD is clinically diagnosed; however, they may induce aberrant brain processing which can be captured as an abnormality in event-related potentials (ERPs). Here, we examined cortical ERPs while a differential associative learning paradigm was applied to adult male rats with entorhinal HP-tau, pharmacological blockade of muscarinic acetylcholine receptors, or both conditions. Despite no impairment in differential associative and reversal learning, each pathological feature induced distinct abnormality in cortical ERPs to an extent that was sufficient for machine classifiers to accurately detect a specific type of pathology based on these ERP features. These results highlight a potential use of ERPs during differential associative learning as a biomarker for asymptomatic AD pathology.

Pathological gambling: an impulse control disorder? Measurement of impulsivity using neurocognitive tests.

PubMed

Dannon, Pinhas N; Shoenfeld, Netta; Rosenberg, Oded; Kertzman, Semion; Kotler, Moshe

2010-04-01

Pathological gambling is classified in the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) and in the ICD-10 (International Classification of Disease) as an impulse control disorder. The association between impulsivity and pathological gambling remains a matter of debate: some researchers find high levels of impulsivity within pathological gamblers, others report no difference compared to controls, and yet others even suggest that it is lower. In this review we examine the relationship between pathological gambling and impulsivity assessed by various neurocognitive tests. These tests--the Stroop task, the Stop Signal Task, the Matching Familiar Figures Task, the Iowa Gambling Task, the Wisconsin Card Sorting Test, the Tower of London test, and the Continuous Performance Test--demonstrated less impulsivity in gambling behavior. The differences in performance between pathological gamblers and healthy controls on the neurocognitive tasks could be due to addictive behavior features rather than impulsive behavior.

Bilateral Wilms' tumor with anaplasia: lessons from the National Wilms' Tumor Study.

PubMed

Hamilton, Thomas E; Green, Daniel M; Perlman, Elizabeth J; Argani, Pedram; Grundy, Paul; Ritchey, Michael L; Shamberger, Robert C

2006-10-01

The purpose of this study was to evaluate whether initial diagnostic technique influenced the ability to identify anaplastic histology, to determine the time interval to diagnosis of anaplasia, and to delineate the incidence of discordant pathology in bilateral Wilms' tumor. We hypothesized that delay in diagnosis of anaplasia could affect time to appropriate surgery and intensive multimodality therapy. One hundred eight-nine children were enrolled in the fourth National Wilms' Tumor Study with synchronous bilateral tumors, 27 of whom were eventually shown to have anaplastic histology. Initial diagnostic technique, time interval to diagnosis of anaplasia, and the incidence of discordant pathology were determined. Anaplasia was identified in 0 of 7 tumors by core needle biopsy, 3 of 9 tumors by open wedge biopsy, and in 7 of 9 cases by partial or complete nephrectomy. The mean duration of first chemotherapy regimen (DD or EE) was 20, 39, and 36 weeks, respectively, before anaplasia was identified at second surgery. Discordant pathology between bilateral tumors was identified on final tissue diagnosis in 20 patients. Only 4 patients had anaplastic tumors in both kidneys. Core needle biopsy did not identify anaplasia in 7 of 7 children. Open biopsy or partial/complete nephrectomy identified anaplasia at initial diagnostic procedure in 10 of 18 children. Twenty of 24 patients at final tissue diagnosis had discordant pathology between the 2 kidneys. Earlier interval incisional biopsy or resection may identify anaplastic histology and limit the duration of chemotherapy targeted to favorable histology for children with bilateral Wilms' tumor and anaplasia.

Medical student web-based formative assessment tool for renal pathology.

PubMed

Bijol, Vanesa; Byrne-Dugan, Cathryn J; Hoenig, Melanie P

2015-01-01

Background Web-based formative assessment tools have become widely recognized in medical education as valuable resources for self-directed learning. Objectives To explore the educational value of formative assessment using online quizzes for kidney pathology learning in our renal pathophysiology course. Methods Students were given unrestricted and optional access to quizzes. Performance on quizzed and non-quizzed materials of those who used ('quizzers') and did not use the tool ('non-quizzers') was compared. Frequency of tool usage was analyzed and satisfaction surveys were utilized at the end of the course. Results In total, 82.6% of the students used quizzes. The greatest usage was observed on the day before the final exam. Students repeated interactive and more challenging quizzes more often. Average means between final exam scores for quizzed and unrelated materials were almost equal for 'quizzers' and 'non-quizzers', but 'quizzers' performed statistically better than 'non-quizzers' on both, quizzed (p=0.001) and non-quizzed (p=0.024) topics. In total, 89% of surveyed students thought quizzes improved their learning experience in this course. Conclusions Our new computer-assisted learning tool is popular, and although its use can predict the final exam outcome, it does not provide strong evidence for direct improvement in academic performance. Students who chose to use quizzes did well on all aspects of the final exam and most commonly used quizzes to practice for final exam. Our efforts to revitalize the course material and promote learning by adding interactive online formative assessments improved students' learning experience overall.

Personality Disorder Symptoms and Marital Functioning

ERIC Educational Resources Information Center

South, Susan C.; Turkheimer, Eric; Oltmanns, Thomas F.

2008-01-01

Pathological personality is strongly linked with interpersonal impairment, yet no study to date has examined the relationship between concurrent personality pathology and dysfunction in marriage--a relationship that most people find central to their lives. In a cross-sectional study of a community sample of married couples (N = 82), the authors…

Delusions as harmful malfunctioning beliefs.

PubMed

Miyazono, Kengo

2015-05-01

Delusional beliefs are typically pathological. Being pathological is clearly distinguished from being false or being irrational. Anna might falsely believe that his husband is having an affair but it might just be a simple mistake. Again, Sam might irrationally believe, without good evidence, that he is smarter than his colleagues, but it might just be a healthy self-deceptive belief. On the other hand, when a patient with brain damage caused by a car accident believes that his father was replaced by an imposter or another patient with schizophrenia believes that "The Organization" painted the shops on a street in red and green to convey a message, these beliefs are not merely false or irrational. They are pathological. What makes delusions pathological? This paper explores the negative features because of which delusional beliefs are pathological. First, I critically examine the proposals according to which delusional beliefs are pathological because of (1) their strangeness, (2) their extreme irrationality, (3) their resistance to folk psychological explanations or (4) impaired responsibility-grounding capacities of people with them. I present some counterexamples as well as theoretical problems for these proposals. Then, I argue, following Wakefield's harmful dysfunction analysis of disorder, that delusional beliefs are pathological because they involve some sorts of harmful malfunctions. In other words, they have a significant negative impact on wellbeing (=harmful) and, in addition, some psychological mechanisms, directly or indirectly related to them, fail to perform the jobs for which they were selected in the past (=malfunctioning). An objection to the proposal is that delusional beliefs might not involve any malfunctions. For example, they might be playing psychological defence functions properly. Another objection is that a harmful malfunction is not sufficient for something to be pathological. For example, false beliefs might involve some malfunctions according to teleosemantics, a popular naturalist account of mental content, but harmful false beliefs do not have to be pathological. I examine those objections in detail and show that they should be rejected after all. Copyright © 2014. Published by Elsevier Inc.

New therapeutic potentials of milk thistle (Silybum marianum).

PubMed

Milić, Natasa; Milosević, Natasa; Suvajdzić, Ljiljana; Zarkov, Marija; Abenavoli, Ludovico

2013-12-01

Silymarin is a bioflavonoid complex extract derived from dry seeds of Milk thistle [(Silybum marianum(L.) Gaemrnt. (Fam. Asteraceae/Compositaceae)] whose hepatoprotective effect has clinically been proved. Low toxicity, favorable pharmacokinetics, powerful antioxidant, detoxifying, preventive, protective and regenerative effects and side effects similar to placebo make silymarin extremely attractive and safe for therapeutic use. The medicinal properties of silymarin and its main component silibinin have been studied in the treatment of Alzheimer's disease, Parkinson's disease, sepsis, burns, osteoporosis, diabetes, cholestasis and hypercholesterolemia. Owing to its apoptotic effect, without cytotoxic effects, silymarin possesses potential applications in the treatment of various cancers. Silymarin is being examined as a neuro-, nephro- and cardio-protective in the damage of different etiologies due to its strong antioxidant potentials. Furthermore, it has fetoprotective (against the influence of alcohol) and prolactin effects and is safe to be used during pregnancy and lactation. Finally, the cosmetics industry is examining the antioxidant and UV-protective effects of silymarin. Further clinical studies and scientific evidence that silymarin and silibinin are effective in the therapy of various pathologies are indispensable in order to confirm their different flavonolignan pharmacological effects.

An Organ System Approach to Explore the Antioxidative, Anti-Inflammatory, and Cytoprotective Actions of Resveratrol

PubMed Central

Bath, Sundeep

2015-01-01

Resveratrol is a phenolic phytochemical, with a stilbene backbone, derived from edible plants such as grape and peanut. It is a bioactive molecule with physiological effects on multiple organ systems. Its effects range from the neuroprotective to the nephroprotective, including cardiovascular, neuronal, and antineoplastic responses as a part of its broad spectrum of action. In this review, we examine the effects of resveratrol on the following organ systems: the central nervous system, including neurological pathology such as Parkinson's and Alzheimer's disease; the cardiovascular system, including disorders such as atherosclerosis, ischemia-reperfusion injury, and cardiomyocyte hypertrophy; the kidneys, including primary and secondary nephropathies and nephrolithiasis; multiple forms of cancer; and metabolic syndromes including diabetes. We emphasize commonalities in extracellular matrix protein alterations and intracellular signal transduction system induction following resveratrol treatment. We summarize the known anti-inflammatory, antioxidative, and cytoprotective effects of resveratrol across disparate organ systems. Additionally, we analyze the available literature regarding the pharmacokinetics of resveratrol formulations used in these studies. Finally, we critically examine select clinical trials documenting a lack of effect following resveratrol treatment. PMID:26180596

Effect of pathological use of the internet on adolescent mental health: a prospective study.

PubMed

Lam, Lawrence T; Peng, Zi-Wen

2010-10-01

To examine the effect of pathological use of the Internet on the mental health, including anxiety and depression, of adolescents in China. It is hypothesized that pathological use of the Internet is detrimental to adolescents’ mental health. A prospective study with a randomly generated cohort from the population. High schools in Guangzhou, China. Adolescents aged between 13 and 18 years. Pathological use of the Internet was assessed using the Pathological Use of the Internet Test. Depression and anxiety were assessed by the Zung Depression and Anxiety Scales. After adjusting for potential confounding factors, the relative risk of depression for those who used the Internet pathologically was about 21⁄2 times (incidence rate ratio,2.5;95%confidence interval,1.3-4.3) that of those who did not exhibit the targeted pathological internet use behaviors. No significant relationship between pathological use of the Internet and anxiety at follow-up was observed. Results suggested that young people who are initially free of mental health problems but use the Internet pathologically could develop depression as a consequence. These results have direct implications for the prevention of mental illness in young people, particularly in developing countries.

Digital slides and ACGME resident competencies in anatomic pathology: An altered paradigm for acquisition and assessment

PubMed Central

Hassell, Lewis A.; Fung, Kar-Ming; Chaser, Brad

2011-01-01

Whole slide digital imaging technology has matured considerably over the past decade. Applications in pathology education are widespread and are rapidly transforming the manner in which medical students learn pathology and histology, and they have a novel and significant impact on postgraduate continuing medical education. Whole slide digital images for use in pathology graduate education have been slower in adoption and remain much less widespread. Emphasis on professional competency by the Accreditation Council on Graduate Medical Education (ACGME) and credentialing organizations, however, appear poised to significantly increase. The convergence of these two forces is propitious for pathology training. This article examines the opportunities for the use of whole slide images (WSI) in pathology residency training along with the developing potential uses in each of the areas of competency, as categorized by the ACGME. Barriers to WSI adoption in the pathology community are identified along with potentially significant promoters for adoption in training and practice. Current literature and recent presentations are reviewed. Digital pathology coupled with emphasis on competency is a shift of tremendous magnitude that can dramatically improve our abilities to help trainees acquire, demonstrate, and maintain the skills to practice pathology in the generation ahead. PMID:21773058

Type of gambling as an independent risk factor for suicidal events in pathological gamblers.

PubMed

Bischof, Anja; Meyer, Christian; Bischof, Gallus; John, Ulrich; Wurst, Friedrich Martin; Thon, Natasha; Lucht, Michael; Grabe, Hans-Joergen; Rumpf, Hans-Juergen

2016-03-01

Individuals with pathological gambling have an increased risk for suicidal events. Additionally, the prevalence of comorbid psychiatric disorders is high among pathological gamblers. This study analyzes whether the type of gambling is associated with suicidal events in pathological gamblers independently from comorbidity. Participants were recruited in 4 different ways: via random telephone sample from the general population, via individual invitation for study participation in gambling locations, through various media and the distribution of a leaflet in various settings, and via inpatient treatment facilities for pathological gambling. The final sample included 442 participants with a lifetime diagnosis of pathological gambling. A standardized clinical interview was conducted. High financial losses were associated with suicidal events (odds ratio [OR] = 1.94, 95% 95% confidence interval [CI], [1.11, 3.37]), as were mood disorders (OR = 7.70, 95% CI, [4.44, 13.37]) and female gender (OR = 2.52, 95% CI, [1.20, 5.28]). Gambling on electronic gambling machines in gambling halls or bars was associated with increased odds of suicidal events (OR = 2.94, 95% CI, [1.38, 6.24]). Other types of gambling, such as casino games or betting on sports, or the number of DSM-IV criteria for pathological gambling were not associated independently with suicidal events. Our findings suggest that gambling on electronic gambling machines in gambling halls or bars is associated with suicidal events in pathological gamblers independently of comorbidity. This result shows that the type of gambling needs to be considered as a relevant factor in gambling research. (c) 2016 APA, all rights reserved).

Imaging blood-brain barrier dysfunction as a biomarker for epileptogenesis.

PubMed

Bar-Klein, Guy; Lublinsky, Svetlana; Kamintsky, Lyn; Noyman, Iris; Veksler, Ronel; Dalipaj, Hotjensa; Senatorov, Vladimir V; Swissa, Evyatar; Rosenbach, Dror; Elazary, Netta; Milikovsky, Dan Z; Milk, Nadav; Kassirer, Michael; Rosman, Yossi; Serlin, Yonatan; Eisenkraft, Arik; Chassidim, Yoash; Parmet, Yisrael; Kaufer, Daniela; Friedman, Alon

2017-06-01

A biomarker that will enable the identification of patients at high-risk for developing post-injury epilepsy is critically required. Microvascular pathology and related blood-brain barrier dysfunction and neuroinflammation were shown to be associated with epileptogenesis after injury. Here we used prospective, longitudinal magnetic resonance imaging to quantitatively follow blood-brain barrier pathology in rats following status epilepticus, late electrocorticography to identify epileptic animals and post-mortem immunohistochemistry to confirm blood-brain barrier dysfunction and neuroinflammation. Finally, to test the pharmacodynamic relevance of the proposed biomarker, two anti-epileptogenic interventions were used; isoflurane anaesthesia and losartan. Our results show that early blood-brain barrier pathology in the piriform network is a sensitive and specific predictor (area under the curve of 0.96, P < 0.0001) for epilepsy, while diffused pathology is associated with a lower risk. Early treatments with either isoflurane anaesthesia or losartan prevented early microvascular damage and late epilepsy. We suggest quantitative assessment of blood-brain barrier pathology as a clinically relevant predictive, diagnostic and pharmaco!dynamics biomarker for acquired epilepsy. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The relationships between perfectionism, pathological worry and generalised anxiety disorder.

PubMed

Handley, Alicia K; Egan, Sarah J; Kane, Robert T; Rees, Clare S

2014-04-02

The relationships between perfectionism, pathological worry and generalised anxiety disorder (GAD) were investigated in a clinical sample presenting for treatment of perfectionism. This study explored the utility of perfectionism in predicting pathological worry in a sample of individuals with elevated perfectionism and GAD (n = 36). Following this, the study examined whether perfectionism could predict a principal GAD diagnosis in the full sample (n = 42). Scores on the perfectionism dimensions Concern over Mistakes, Personal Standards, and Clinical Perfectionism significantly predicted pathological worry among participants with GAD after controlling for gender and depression. The perfectionism dimension Doubts about Actions significantly predicted whether individuals from the full sample received a principal diagnosis of GAD. These findings support certain dimensions of perfectionism having significant associations with pathological worry and GAD.

NARCISSISM AND CONCERN: THE RELATIONSHIP OF SELF-OBJECT NEEDS AND NARCISSISTIC SYMPTOMS WITH HEALTHY AND PATHOLOGICAL CONCERN.

PubMed

Friedemann, Yael; Tolmacz, Rami; Doron, Yonit

2016-03-01

While concern and narcissism seem to be contradictory in nature, clinical evidence and theoretical writings on pathological forms of concern--tracing their origin to deficiencies in early relationships with primary caretakers--suggest that the actual relationship between these two characteristics might be much more complicated. We respond to a study aimed to add empirical data to the clinical and theoretical knowledge examined the relationships between self-object functions, types of narcissism and pathological concern. The findings of the study showed that pathological concern was positively associated with self-object needs and that this association was mediated by covert narcissism. Our discussion focuses on the developmental and psychodynamic sources of pathological concern, as well as its significance in the intrapersonal and interpersonal domains.

Ultrasound Evaluation of Thyroid Gland Pathologies After Radiation Therapy and Chemotherapy to Treat Malignancy During Childhood

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lollert, André, E-mail: andre.lollert@unimedizin-mainz.de; Gies, Christina; Laudemann, Katharina

Purpose: The purpose of this study was to evaluate correlations between treatment of malignancy by radiation therapy during childhood and the occurrence of thyroid gland pathologies detected by ultrasonography in follow-up examinations. Methods and Materials: Reductions of thyroid gland volume below 2 standard deviations of the weight-specific mean value, occurrence of ultrasonographically detectable thyroid gland pathologies, and hypothyroidism were retrospectively assessed in 103 children and adolescents 7 months to 20 years of age (median: 7 years of age) at baseline (1997-2013) treated with chemoradiation therapy (with the thyroid gland dose assessable) or with chemotherapy alone and followed by ultrasonography and laboratory examinations throughmore » 2014 (median follow-up time: 48 months). Results: A relevant reduction of thyroid gland volume was significantly correlated with thyroid gland dose in univariate (P<.001) and multivariate analyses for doses above 2 Gy. Odds ratios were 3.1 (95% confidence interval: 1.02-9.2; P=.046) for medium doses (2-25 Gy) and 14.8 (95% confidence interval: 1.4-160; P=.027) for high doses (>25 Gy). Thyroid gland dose was significantly higher in patients with thyroid gland pathologies during follow-up (P=.03). Univariate analysis revealed significant correlations between hypothyroidism and thyroid gland dose (P<.001). Conclusions: Ultrasonographically detectable changes, that is, volume reductions, pathologies, and hypothyroidism, after malignancy treatment during childhood are associated with thyroid gland dose. Both ultrasonography and laboratory follow-up examinations should be performed regularly after tumor therapy during childhood, especially if the treatment included radiation therapy.« less

Ultrasound Evaluation of Thyroid Gland Pathologies After Radiation Therapy and Chemotherapy to Treat Malignancy During Childhood.

PubMed

Lollert, André; Gies, Christina; Laudemann, Katharina; Faber, Jörg; Jacob-Heutmann, Dorothee; König, Jochem; Düber, Christoph; Staatz, Gundula

2016-01-01

The purpose of this study was to evaluate correlations between treatment of malignancy by radiation therapy during childhood and the occurrence of thyroid gland pathologies detected by ultrasonography in follow-up examinations. Reductions of thyroid gland volume below 2 standard deviations of the weight-specific mean value, occurrence of ultrasonographically detectable thyroid gland pathologies, and hypothyroidism were retrospectively assessed in 103 children and adolescents 7 months to 20 years of age (median: 7 years of age) at baseline (1997-2013) treated with chemoradiation therapy (with the thyroid gland dose assessable) or with chemotherapy alone and followed by ultrasonography and laboratory examinations through 2014 (median follow-up time: 48 months). A relevant reduction of thyroid gland volume was significantly correlated with thyroid gland dose in univariate (P<.001) and multivariate analyses for doses above 2 Gy. Odds ratios were 3.1 (95% confidence interval: 1.02-9.2; P=.046) for medium doses (2-25 Gy) and 14.8 (95% confidence interval: 1.4-160; P=.027) for high doses (>25 Gy). Thyroid gland dose was significantly higher in patients with thyroid gland pathologies during follow-up (P=.03). Univariate analysis revealed significant correlations between hypothyroidism and thyroid gland dose (P<.001). Ultrasonographically detectable changes, that is, volume reductions, pathologies, and hypothyroidism, after malignancy treatment during childhood are associated with thyroid gland dose. Both ultrasonography and laboratory follow-up examinations should be performed regularly after tumor therapy during childhood, especially if the treatment included radiation therapy. Copyright © 2016. Published by Elsevier Inc.

Method for procuring specific populations of viable human prostate cells for research.

PubMed

Fischer, A H; Philips, A; Taysavang, P; McKenney, J K; Amin, M B

2001-04-01

A wider range of research can be conducted on viable tissue samples than on fixed or frozen samples. A major obstacle to studying viable prostate tissue samples is the inability to accurately identify cancer on direct examination of unembedded tissue. We used a dissecting microscope to identify cancer in unfixed prostate tissue samples stained on the cut surface with 0.5% aqueous toluidine blue. We measured the diagnostic accuracy of this technique in 25 consecutive prostatectomies, determined the viability of procured samples, and estimated the effect on final pathologic assessment. Both surfaces of a 3- to 5-mm thick cross-section taken midway between base and apex of the prostate were examined. A 4-mm punch biopsy was directed to one benign and one malignant area when clearly present. The dissecting microscope allowed clearcut recognition of carcinoma in 17 of the 25 cross-sections, and carcinoma was confirmed in all 17 (100%). In 8 of 25 cases, no procurement was attempted because no carcinoma was evident in the one cross-section studied. Twenty of 25 cross-sections were adequate for benign tissue procurement; five of the cross-sections were not suitable for procurement because of the presence of extensive carcinoma or atrophy. Seventeen of the 20 were accurately diagnosed as benign (85%); one showed pseudohyperplastic adenocarcinoma, one showed focal high-grade prostatic intraepithelial neoplasia, and one showed urothelial carcinoma in situ. Prostatic epithelium obtained with the technique remains viable and can be separated from stroma. The dissecting microscope technique appears to facilitate rather than interfere with accurate pathologic assessment: extraprostatic extension or positive margins were correctly identified during tissue procurement in three cases. The procedure takes only about 30 minutes.

[Indications for surgery in thyroiditis].

PubMed

Diaconescu, M R; Glod, M; Costea, I; Grigorovici, M; Diaconescu, S

2012-01-01

Inflammatory processes of the thyroid represents a main proportion of the gland's pathology but the majority of them are treated by medical methods, surgery being indicated. In 14 cases (3%) from 464 operations for different thyroid conditions we have encountered authentic inflammatory lesions in 9 cases of Hashimoto's thyroiditis (two associated with papillary thyroid carcinoma and one with malignant lymphoma), two cases of Riedel's thyroiditis and respectively de Quervain thyoiditis, tuberculous thyroiditis and actynomicosis one case each. The common lymphoplasmacytic infiltration in Basedow's disease was not considered likewise as the inflammatory nespecific lesions encountered in benign and malignant pathology of the gland. The clinical and imagistic data, biological evaluation and titer of anticorps but particularly the paraffine examination together with intraoperative estimations are decisive for the diagnosis. Firm diagnosis of thyroiditis was rarely affirmed before operation, surgical indication being formulated on clinical criterions dominated by cancer suspicion. Among these are diffuse or (multi)nodular thyromegaly with a dominant nodule with recent appearance and rapid growing in temporal and geographic proximity of Chemobyl disaster, with hard consistence, celsian or compressive features and adenopathy. More added the imagistic signs but especially suspect aspects of the FNAB (follicular or with Hürthle cells smears) and also of the frozen sections. Certainty diagnosis was established by paraffine examination not always without hesitations or reexamination (Hashimoto's thyroiditis diagnosed in one case was finally a malignant lymphoma). Large removal decided after intraoperative findings induced for the most of patients a definitive hypothyroidism. All the diagnosis resources must be exhausted for the diagnosis of the inflammatory lesions of the thyroid to avoid unnecessary surgery. On the other side the chronic overstimulation by the TSH of the glandular tissue affected by the immune process, represent an important factor of producing neoplasia.

Diagnostic value of 99mTc-bombesin scintigraphy for differentiation of malignant from benign breast lesions.

PubMed

Shariati, Farzaneh; Aryana, Kamran; Fattahi, Asiehsadat; Forghani, Mohammad N; Azarian, Azita; Zakavi, Seyed R; Sadeghi, Ramin; Ayati, Narjes; Sadri, Keyvan

2014-06-01

In this study, we evaluated the diagnostic accuracy of (99m)Tc-bombesin scintigraphy for differentiation of benign from malignant palpable breast lesions. (99m)Tc-Bombesin is a tracer with high affinity for gastrin-releasing peptide receptor, which is overexpressed on a variety of human tumors including breast carcinoma. We examined 33 consecutive women who were referred to our center with suspicious palpable breast lesions but had no definitive diagnosis in other imaging procedures. A volume of 370-444 MBq of (99m)Tc-bombesin was injected and dynamic 1-min images were taken for 20 min immediately after injection in anterior view. Thereafter, two static images in anterior and prone-lateral views were taken for 5 min. Finally, single-photon emission computed tomography images were taken for each patient. Definitive diagnosis was based on biopsy and histopathological evaluation. The scan findings were positive in 19 patients and negative in 11 on visual assessment of the planar and single-photon emission computed tomography images. Pathologic examination confirmed breast carcinoma in 12 patients with positive scans and benign pathology for 18 patients. The overall sensitivity, specificity, negative and positive predictive values, and accuracy of this radiotracer for diagnosis of breast cancer were 100, 66.1, 100, 63, and 76%, respectively. Semiquantitative analysis improved the specificity of the visual assessment from 66 to 84%. Our study showed that (99m)Tc-bombesin scintigraphy has a high sensitivity and negative predictive value for detecting malignant breast lesions, but the specificity and positive predictive value of this radiotracer for differentiation of malignant breast abnormalities from benign ones are relatively low.

Non-traumatic limping in Paediatric Emergencies: Epidemiology, evaluation and results.

PubMed

Lázaro Carreño, M I; Fraile Currius, R; García Clemente, A

Non-traumatic limping is a common reason for consultation in paediatric emergencies. Although transient synovitis of the hip (TS) is the most frequent diagnosis, there are cases of limping secondary to serious pathologies. The aim of this review is to describe the variables related to non-traumatic limp that come to the paediatric emergency department to establish the best management protocol, making the most of resources and speeding up emergency care. A prospective study was conducted, selecting all children less than 15 years old who consulted aspaediatric emergencies for non-traumatic limping during the 2014. Clinical variables, complementary examinations and diagnoses were collected in the emergency room consultation and 6 months after the consultation RESULTS: During 2014, 146 patients (0.69% of the emergencies) were included in the non-traumatic limping study. Four cases of severe limping were diagnosed: 2 leukaemias, 1 septic arthritis and 1 acetabular bone tumour. The most frequent diagnosis was TS (53.16%). At 6 months, 135 children (92.4%) had resolved lameness. The diagnosis was changed in 9 children (6.1%). Children with TS had fewer days of evolution, and 77% were between 3 and 10 years old. Children with a final diagnosis of severe pathology had a limp for longer, fever and did not weight bear on ambulation. In limping of probable hip origin, at the ages of between 3 and 10, without fever or systemic symptoms and of less than one week's onset, it is possible to make a clinical diagnosis of TS limiting the use of complementary examinations. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Suspicious urinary cytology with negative evaluation for malignancy in the diagnostic investigation of haematuria: how to follow up?

PubMed Central

Nabi, G; Greene, D; Donnel, M O

2004-01-01

Aims: To define the natural history of patients with suspicious urinary cytology and negative initial evaluation for malignancy in the investigation of haematuria. Patients and methods: Data from the hospital information support system on urinary cytology examinations carried out at one centre were audited over a period of 24 months. There were 102 patients who had suspicious urinary cytology for malignant cells with negative initial evaluation. Follow up investigations, treatment, and final outcome were noted. Results: There were 102 patients with suspicious urinary cytology and negative initial evaluation for malignancy in 24 months, with a mean follow up of 15.7 months. Seventy patients had no obvious pathology on initial investigations. Forty one patients were found to have urological malignancies (29 bladder, eight ureteric, and four prostate) on follow up. All patients diagnosed as having urothelial malignancies on follow up had either persistent suspicious cytology (29) or recurrent haematuria (eight). The mean duration for appearance of lesions was 5.6 months (range, 3–12 months). Three patients had suspicious digital rectal examination and biopsies confirmed adenocarcinoma of the prostate. One patient had urinary retention and transurethral resection of prostate showed prostatic adenocarcinoma. The presence of suspicious cells on repeat urine analysis was the only significant factor in predicting the presence of urothelial tumours (p  =  0.002). Conclusion: Patients with persistent suspicious/positive cytology or recurrent haematuria need further evaluation and follow up. Asymptomatic patients or patients with obvious benign pathology do not require repeat evaluation. Careful urological evaluation, including prostate, should be carried out in these patients. PMID:15047737

Cost analysis of intraoperative frozen section examinations in thyroid surgery in a Canadian tertiary center.

PubMed

Lai, Philip; Segall, Lorne; de Korompay, Nevin; Witterick, Ian; Freeman, Jeremy

2009-10-01

To perform a cost analysis of the routine intraoperative frozen section (FS) examinations in the management of patients undergoing thyroid surgery for unilateral thyroid nodules with benign or indeterminate cytology on preoperative fine-needle aspiration biopsies (FNABs). A retrospective chart review of 190 consecutive patients with unilateral thyroid nodules undergoing thyroid surgery was undertaken between March 2006 and March 2008. The results of FNAB, FS, and final histology were obtained from the pathology report. A cost analysis was performed to compare the cost of routine FS examinations to determine malignancy with the cost of performing a second surgical procedure. Of the 169 patients evaluated, there were 53 cases of malignant nodules. Malignancy was diagnosed by FS in 16 of these 53 cases, resulting in a total thyroidectomy and thereby avoiding the need for a completion thyroidectomy. The sensitivity and specificity of FS examination were 30.2% and 100.0%, respectively. The routine use of intraoperative FS examination in cases of benign or indeterminate nodules afforded a total cost savings of $3719.27, or a cost savings of $22.01 per patient. FS examination was useful in guiding our intraoperative management for patients with unilateral thyroid nodules with benign or indeterminate preoperative FNAB. The routine use of FS was cost-effective in our Canadian health care system, even without considering the intangible costs, such as patients' anxiety, emotional stress, and the loss of productivity owing to a second surgical procedure.

Detection of intracavitary uterine pathology using offline analysis of three-dimensional ultrasound volumes: interobserver agreement and diagnostic accuracy.

PubMed

Van den Bosch, T; Valentin, L; Van Schoubroeck, D; Luts, J; Bignardi, T; Condous, G; Epstein, E; Leone, F P; Testa, A C; Van Huffel, S; Bourne, T; Timmerman, D

2012-10-01

To estimate the diagnostic accuracy and interobserver agreement in predicting intracavitary uterine pathology at offline analysis of three-dimensional (3D) ultrasound volumes of the uterus. 3D volumes (unenhanced ultrasound and gel infusion sonography with and without power Doppler, i.e. four volumes per patient) of 75 women presenting with abnormal uterine bleeding at a 'bleeding clinic' were assessed offline by six examiners. The sonologists were asked to provide a tentative diagnosis. A histological diagnosis was obtained by hysteroscopy with biopsy or operative hysteroscopy. Proliferative, secretory or atrophic endometrium was classified as 'normal' histology; endometrial polyps, intracavitary myomas, endometrial hyperplasia and endometrial cancer were classified as 'abnormal' histology. The diagnostic accuracy of the six sonologists with regard to normal/abnormal histology and interobserver agreement were estimated. Intracavitary pathology was diagnosed at histology in 39% of patients. Agreement between the ultrasound diagnosis and the histological diagnosis (normal vs abnormal) ranged from 67 to 83% for the six sonologists. In 45% of cases all six examiners agreed with regard to the presence/absence of intracavitary pathology. The percentage agreement between any two examiners ranged from 65 to 91% (Cohen's κ, 0.31-0.81). The Schouten κ for all six examiners was 0.51 (95% CI, 0.40-0.62), while the highest Schouten κ for any three examiners was 0.69. When analyzing stored 3D ultrasound volumes, agreement between sonologists with regard to classifying the endometrium/uterine cavity as normal or abnormal as well as the diagnostic accuracy varied substantially. Possible actions to improve interobserver agreement and diagnostic accuracy include optimization of image quality and the use of a consistent technique for analyzing the 3D volumes. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

Relationships of personality traits and stress to gingival status or soft-tissue oral pathology: an exploratory study.

PubMed

Minneman, M A; Cobb, C; Soriano, F; Burns, S; Schuchman, L

1995-01-01

The purpose of this study was to examine the relationships of personality traits and stress with gingival inflammation and with soft-tissue oral pathology. Personality traits of psychoticism (P), extroversion and introversion (E), and neuroticism (N) were measured with Eysenck's personality questionnaire (EPQ). Stress was measured with a modified organizational and individual assessment survey (OIAS) developed by Hendrix. Military recruits from Ft. Leonard Wood, Missouri, were examined for soft-tissue oral pathology and gingival status at weeks one (n = 241) and six (n = 61) of basic combat training (BCT). The EPQ and OIAS were administered to 217 recruits during week six of BCT. A discriminant analysis was used to determine correlations among study variables. Significant correlations (P < .05) were found between personality traits and various measures of tolerance of stress. Little variance was found between groups originally presenting with or without disease. Only physical stress (P < .005) was shown to affect soft-tissue pathology, while gingival inflammation correlated significantly to E scores (P < .02), tolerance to change (P < .02), and anxiety (P < .05). Data support a possible relationship among certain personality traits, stress variables, and gingival inflammation or soft-tissue pathology in recruits with extreme personality characteristics or perception of high physical stress levels in basic combat training.

Contrasting Pathology of the Stress Granule Proteins TIA-1 and G3BP in Tauopathies

PubMed Central

Vanderweyde, Tara; Yu, Haung; Varnum, Megan; Liu-Yesucevitz, Liqun; Citro, Allison; Ikezu, Tsuneya; Duff, Karen; Wolozin, Benjamin

2012-01-01

Stress induces aggregation of RNA-binding proteins to form inclusions, termed stress granules (SGs). Recent evidence suggests that SG proteins also colocalize with neuropathological structures, but whether this occurs in Alzheimer’s disease is unknown. We examined the relationship between SG proteins and neuropathology in brain tissue from P301L Tau transgenic mice, as well as in cases of Alzheimer’s disease and FTDP-17. The pattern of SG pathology differs dramatically based on the RNA-binding protein examined. SGs positive for T-cell intracellular antigen-1 (TIA-1) or tristetraprolin (TTP) initially do not colocalize with tau pathology, but then merge with tau inclusions as disease severity increases. In contrast, G3BP (ras GAP-binding protein) identifies a novel type of molecular pathology that shows increasing accumulation in neurons with increasing disease severity, but often is not associated with classic markers of tau pathology. TIA-1 and TTP both bind phospho-tau, and TIA-1 overexpression induces formation of inclusions containing phospho-tau. These data suggest that SG formation might stimulate tau pathophysiology. Thus, study of RNA-binding proteins and SG biology highlights novel pathways interacting with the pathophysiology of AD, providing potentially new avenues for identifying diseased neurons and potentially novel mechanisms regulating tau biology. PMID:22699908

Clinical exam of the shoulder.

PubMed

Clarnette, R G; Miniaci, A

1998-04-01

This paper outlines the important features of the clinical assessment of the shoulder in a systematic and thorough manner. We highlight the key symptoms, particularly pain and instability, and describe how they may be associated with the various different pathologies. The physical examination is detailed in order of inspection, palpation, and motion, and then considerable emphasis is given to specific shoulder tests looking for evidence of rotator cuff weakness, impingement, biceps pathology, and instability. A number of specific tests of instability are outlined including an examination technique for posterior instability that has not previously been described.

Elevated numbers of CD163+ macrophages in hearts of simian immunodeficiency virus-infected monkeys correlate with cardiac pathology and fibrosis.

PubMed

Walker, Joshua A; Sulciner, Megan L; Nowicki, Katherine D; Miller, Andrew D; Burdo, Tricia H; Williams, Kenneth C

2014-07-01

The role of macrophage activation, traffic, and accumulation on cardiac pathology was examined in 23 animals. Seventeen animals were simian immunodeficiency virus (SIV) infected, 12 were CD8 lymphocyte depleted, and the remaining six were uninfected controls (two CD8 lymphocyte depleted, four nondepleted). None of the uninfected controls had cardiac pathology. One of five (20%) SIV-infected, non-CD8 lymphocyte-depleted animals had minor cardiac pathology with increased numbers of macrophages in ventricular tissue compared to controls. Seven of the 12 (58%) SIV-infected, CD8 lymphocyte-depleted animals had cardiac pathology in ventricular tissues, including macrophage infiltration and myocardial degeneration. The extent of fibrosis (measured as the percentage of collagen per tissue area) was increased 41% in SIV-infected, CD8 lymphocyte-depleted animals with cardiac pathology compared to animals without pathological abnormalities. The number of CD163+ macrophages increased significantly in SIV-infected, CD8 lymphocyte-depleted animals with cardiac pathology compared to ones without pathology (1.66-fold) and controls (5.42-fold). The percent of collagen (percentage of collagen per total tissue area) positively correlated with macrophage numbers in ventricular tissue in SIV-infected animals. There was an increase of BrdU+ monocytes in the heart during late SIV infection, regardless of pathology. These data implicate monocyte/macrophage activation and accumulation in the development of cardiac pathology with SIV infection.

Introducing 3-Dimensional Printing of a Human Anatomic Pathology Specimen: Potential Benefits for Undergraduate and Postgraduate Education and Anatomic Pathology Practice.

PubMed

Mahmoud, Amr; Bennett, Michael

2015-08-01

Three-dimensional (3D) printing, a rapidly advancing technology, is widely applied in fields such as mechanical engineering and architecture. Three-dimensional printing has been introduced recently into medical practice in areas such as reconstructive surgery, as well as in clinical research. Three-dimensionally printed models of anatomic and autopsy pathology specimens can be used for demonstrating pathology entities to undergraduate medical, dental, and biomedical students, as well as for postgraduate training in examination of gross specimens for anatomic pathology residents and pathology assistants, aiding clinicopathological correlation at multidisciplinary team meetings, and guiding reconstructive surgical procedures. To apply 3D printing in anatomic pathology for teaching, training, and clinical correlation purposes. Multicolored 3D printing of human anatomic pathology specimens was achieved using a ZCorp 510 3D printer (3D Systems, Rock Hill, South Carolina) following creation of a 3D model using Autodesk 123D Catch software (Autodesk, Inc, San Francisco, California). Three-dimensionally printed models of anatomic pathology specimens created included pancreatoduodenectomy (Whipple operation) and radical nephrectomy specimens. The models accurately depicted the topographic anatomy of selected specimens and illustrated the anatomic relation of excised lesions to adjacent normal tissues. Three-dimensional printing of human anatomic pathology specimens is achievable. Advances in 3D printing technology may further improve the quality of 3D printable anatomic pathology specimens.

Ultrasonography of uterine leiomyomas.

PubMed

Woźniak, Andrzej; Woźniak, Sławomir

2017-12-01

Uterine leiomyomas or uterine fibroids are the most common gynaecological tumours and occur in about 20-50% of women around the world. Ultrasonography (USG) is the first-line imaging examination in suspected fibroids and shows high sensitivity and specificity in diagnosing this condition. Ultrasound scans can be performed transvaginally (transvaginal scan - TVS) or transabdominally (transabdominal scan - TAS); both scans have advantages and limitations, but, in general, transvaginal sonography is superior to transabdominal sonography in most cases of pelvic pathology. Whether a leiomyoma is symptomatic or not depends primarily on its size and location. During ultrasound examination, leiomyomas usually appear as well-defined, solid, concentric, hypoechoic masses that cause a variable amount of acoustic shadowing. During the examination of leiomyomas differential diagnosis is important. Some of the most common misdiagnosed pathologies are adenomyosis, solid tumours of adnexa, and endometrial polyps. Misdiagnosis of a leiomyosarcoma has the most negative consequences, presenting symptoms are very similar to benign leiomyoma, and there is no pelvic imaging technique that can reliably differentiate between those pathologies. Magnetic resonance and computer tomography might be helpful in the diagnostics of uterine leiomyoma; however, ultrasound examination is the basic imaging test confirming the existence of leiomyomas, allowing the differentiation of myomas with adenomyosis, endometrial polyps, ovarian tumours, and pregnant uterus.

Periapical lesions are not always a sequelae of pulpal necrosis: a retrospective study of 1521 biopsies.

PubMed

Kontogiannis, T G; Tosios, K I; Kerezoudis, N P; Krithinakis, S; Christopoulos, P; Sklavounou, A

2015-01-01

To record the incidence of lesions that were not the sequelae of pulpal necrosis (non-SPN) amongst 1521 biopsies of periapical lesions submitted with a clinical diagnosis of a sequelae of pulpal necrosis (SPN). A retrospective study of 1521 biopsy request forms of specimens submitted for histopathological examination with a clinical diagnosis 'periapical inflammation', 'periapical abscess', 'periapical granuloma' or 'periapical cyst' during an arbitrarily selected 14-year period was undertaken. Gender and age of the patient, site and maximum diameter of the lesion, symptoms, inclusion of the final diagnosis in the differential diagnosis and specialty of the clinician submitting the biopsy material were recorded in each case. The final diagnosis for each case was extracted from the pathology report, and two groups were formed, SPN and non-SPN lesions. Differences between the respective features of SPN and non-SPN cases were analysed with Yate's chi-square test and t-test (significance level P < 0.05) RESULTS: In 52 of the 1521 cases examined (3.42%), the histological diagnosis was not consistent with a SPN. In most non-SPN cases, the histopathological diagnosis was not included in the differential diagnosis. The keratocystic odontogenic tumour [odontogenic keratocyst (OKC)] was the most frequent non-SPN lesion (34.62%). Other, yet less frequent, non-SPN lesions included glandular odontogenic cysts, lateral periodontal cysts, central ossifying fibromas as well as malignancies (metastatic carcinomas and Langerhans cell histiocytosis). Non-SPN lesions appeared in the periapical region mimicking a SPN, although rarely. Most of them were developmental cysts, in particular OKCs, but odontogenic tumours, such as ameloblastoma, or malignant lesions were also diagnosed. Histological examination of tissue harvested from periapical lesions should be performed, in particular when those lesions are large. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Tuberculous otitis media: two case reports and literature review.

PubMed

Awan, Mohammad Sohail; Salahuddin, Iftikhar

2002-11-01

Tuberculous otitis media can be difficult to diagnose because it can easily be confused with other acute or chronic middle ear conditions. Compounding this problem is the fact that physicians are generally unfamiliar with the typical features of tuberculous otitis media. Finally, the final diagnosis can be difficult because it requires special culture and pathologic studies. To increase awareness of this condition, we describe two cases of tuberculous otitis media and we review the literature.

Resilient Brain Aging: Characterization of Discordance between Alzheimer’s Disease Pathology and Cognition

PubMed Central

Negash, Selam; Wilson, Robert S.; Leurgans, Sue E.; Wolk, David A.; Schneider, Julie A.; Buchman, Aron S.; Bennett, David A.; Arnold, Steven. E.

2014-01-01

Background Although it is now evident that normal cognition can occur despite significant AD pathology, few studies have attempted to characterize this discordance, or examine factors that may contribute to resilient brain aging in the setting of AD pathology. Methods More than 2,000 older persons underwent annual evaluation as part of participation in the Religious Orders Study or Rush Memory Aging Project. A total of 966 subjects who had brain autopsy and comprehensive cognitive testing proximate to death were analyzed. Resilience was quantified as a continuous measure using linear regression modeling, where global cognition was entered as a dependent variable and global pathology was an independent variable. Studentized residuals generated from the model represented the discordance between cognition and pathology, and served as measure of resilience. The relation of resilience index to known risk factors for AD and related variables was examined. Results Multivariate regression models that adjusted for demographic variables revealed significant associations for early life socioeconomic status, reading ability, APOE-ε4 status, and past cognitive activity. A stepwise regression model retained reading level (estimate = 0.10, SE = 0.02; p < 0.0001) and past cognitive activity (estimate = 0.27, SE = 0.09; p = 0.002), suggesting the potential mediating role of these variables for resilience. Conclusions The construct of resilient brain aging can provide a framework for quantifying the discordance between cognition and pathology, and help identify factors that may mediate this relationship. PMID:23919768

Practice of forensic medicine and pathology in Sri Lanka.

PubMed

Balachandra, A Thambirajah; Vadysinghe, Amal N; William, Anita L

2011-02-01

The practice of forensic medicine and pathology in Sri Lanka is based on the British model. Medical students during their third and fourth years receive approximately 50 hours of lectures and tutorials in forensic medicine and pathology and then undergo an examination. After completing an internship, these doctors are sent to various hospitals throughout Sri Lanka where they may be asked to perform medicolegal examinations on victims and suspects in rape cases, persons suspected of being under the influence of drugs and/or alcohol, and, injured live patients. As well, they may be asked to perform medicolegal autopsies. Depending upon their experience, some medical officers may be designated as judicial medical officers and appointed full time to do medicolegal work. Up until 1980, judicial medical officers with at least 2 years of work experience were allowed to obtain their postgraduate qualifications in the United Kingdom. However, since 1981 and the establishment of its own Postgraduate Institute of Medicine in Colombo, Sri Lanka, medical officers are offered 2 postgraduate programs in forensic medicine and pathology, a diploma in legal medicine and a doctorate in medicine (forensic medicine). After completing the doctorate in forensic medicine, doctors are allowed to train abroad for a further year in an approved center. Upon return they can then be appointed as consultant judicial medical officers. The practice of forensic medicine and pathology in Sri Lanka is unique and vibrant. However, due to the country's prevailing civil war, the practice of forensic medicine and pathology is suboptimal.

Key findings from the International Ovarian Tumor Analysis (IOTA) study: an approach to the optimal ultrasound based characterisation of adnexal pathology

PubMed Central

Bourne, Tom; De Rijdt, Sylvie; Van Holsbeke, Caroline; Sayasneh, Ahmad; Valentin, Lil; Van Calster, Ben; Timmerman, Dirk

2015-01-01

Abstract The principal aim of the IOTA project has been to develop approaches to the evaluation of adnexal pathology using ultrasound that can be transferred to all examiners. Creating models that use simple, easily reproducible ultrasound characteristics is one approach. PMID:28191150

Social Strain, Self-Control, and Juvenile Gambling Pathology: Evidence From Chinese Adolescents

ERIC Educational Resources Information Center

Cheung, Nicole W. T.

2016-01-01

Despite recent concerns over youthful problem gambling, few gambling studies have looked into Asian adolescent populations. This study of a stratified, random sample of high school students in Hong Kong is designed to estimate the prevalence of gambling pathology among Chinese adolescents and to examine the relationships between social strain,…

Working Papers in Experimental Speech-Language Pathology and Audiology.

ERIC Educational Resources Information Center

Jablon, Ann, Ed.; And Others

Five papers describe clinical research completed by graduate students in speech-language pathology and audiology. The first study examines the linguistic input of three adults (a mother, teacher, and clinician) to a language impaired 8-year-old. The clinician's approach, less directive than that of the other two, facilitated spontaneous speech and…

Knowledge of Normal versus Pathological Memory Aging among Police Officers

ERIC Educational Resources Information Center

Hawley, Karri S.; Garrity, April W.; Cherry, Katie E.

2005-01-01

The authors examined police officers' knowledge of memory changes in adulthood utilizing the Knowledge of Memory Aging Questionnaire (KMAQ). The KMAQ is a 28-item true/false questionnaire that covers a broad range of topics related to normal memory aging due to maturational processes and pathological memory aging, such as adult dementia. Results…

SLEEP AND GAMBLING SEVERITY IN A COMMUNITY SAMPLE OF GAMBLERS

PubMed Central

Parhami, Iman; Siani, Aaron; Rosenthal, Richard J.; Lin, Stephanie; Collard, Michael; Fong, Timothy W.

2012-01-01

Although sleep has been extensively studied in substance related disorders, it has yet to be examined as thoroughly in gambling-related disorders. The purpose of this study is to examine the relationship between gambling severity and sleep disturbances in a sample of non-treatment seeking gamblers (N = 96) using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Mean ESS scores for recreational, problem, and pathological gamblers were 4.13, 5.81, and 8.69, respectively, with a significant difference between pathological gamblers and both problem (P = .007) and recreational gamblers (P < .001). Mean PSQI scores for recreational, problem, and pathological gamblers were 3.35, 5.30, and 5.44, respectively, with a significant difference in sleep quality between recreational and problem gamblers (P = .018), as well as recreational and pathological gamblers (P = .008). As the first study to use objective sleep measures, these findings will not only increase awareness of this relationship, but also provide a foundation on which others can investigate the benefits of screening and adjunct treatment for sleep disorders in the gambling population. PMID:22356670

[Clinico-pathologic Characteristics of Adult Patients with Atypical Infectious Mononucleosis].

PubMed

Yu, Ya-Ping; Song, Ping; An, Zhi-Ming; Zhou, Xiao-Gang; Li, Feng; Wang, Li-Ping; Mei, Jian-Gang; Zhai, Yong-Ping

2016-12-01

To investigate the clinicopathologic characteristics of adult patients with atypical infectious mononucleosis(IM). From January 2003 to December 2013, a total of 5 cases of atypical IM misdiagnosed as lymphoma were selected, and the clinico-pathological characteristics and efficacy of treatment were analyzed. Biopsy of lymph node or tonsil was performed to evaluate the possibility of lymphoma. Peripheral blood EBV antibody and EBV-DNA were examined by ELISA and real-time fluorescence quantitative PCR, respectively. All the cases were considered as lymphoma on the basis of morphological features in initial evaluation before relapse. These features included a florid immunoblastic proliferation, distortion of the underlying nodal or tonsillar architecture and the presence of necrosis. The immunophenotypic features, EBV encoded RNA (EBER) in situ hybridization and the gene rearrangement of immunoglobulin or T cell receptor may be helpful for the distinction of atypical IM from lymphoma. IM as EBV-related lymphoproliferative process shows marked clinical and histological diversity. Atypical case of IM may mimic many different type of lymphoma in clinical and pathologic features, and the misdiagnosis should be avoided by using molecular and pathological examination.

Enhancement of hepatitis virus immunoassay outcome predictions in imbalanced routine pathology data by data balancing and feature selection before the application of support vector machines.

PubMed

Richardson, Alice M; Lidbury, Brett A

2017-08-14

Data mining techniques such as support vector machines (SVMs) have been successfully used to predict outcomes for complex problems, including for human health. Much health data is imbalanced, with many more controls than positive cases. The impact of three balancing methods and one feature selection method is explored, to assess the ability of SVMs to classify imbalanced diagnostic pathology data associated with the laboratory diagnosis of hepatitis B (HBV) and hepatitis C (HCV) infections. Random forests (RFs) for predictor variable selection, and data reshaping to overcome a large imbalance of negative to positive test results in relation to HBV and HCV immunoassay results, are examined. The methodology is illustrated using data from ACT Pathology (Canberra, Australia), consisting of laboratory test records from 18,625 individuals who underwent hepatitis virus testing over the decade from 1997 to 2007. Overall, the prediction of HCV test results by immunoassay was more accurate than for HBV immunoassay results associated with identical routine pathology predictor variable data. HBV and HCV negative results were vastly in excess of positive results, so three approaches to handling the negative/positive data imbalance were compared. Generating datasets by the Synthetic Minority Oversampling Technique (SMOTE) resulted in significantly more accurate prediction than single downsizing or multiple downsizing (MDS) of the dataset. For downsized data sets, applying a RF for predictor variable selection had a small effect on the performance, which varied depending on the virus. For SMOTE, a RF had a negative effect on performance. An analysis of variance of the performance across settings supports these findings. Finally, age and assay results for alanine aminotransferase (ALT), sodium for HBV and urea for HCV were found to have a significant impact upon laboratory diagnosis of HBV or HCV infection using an optimised SVM model. Laboratories looking to include machine learning via SVM as part of their decision support need to be aware that the balancing method, predictor variable selection and the virus type interact to affect the laboratory diagnosis of hepatitis virus infection with routine pathology laboratory variables in different ways depending on which combination is being studied. This awareness should lead to careful use of existing machine learning methods, thus improving the quality of laboratory diagnosis.

Intramammary Findings on CT of the Chest – a Review of Normal Anatomy and Possible Findings

PubMed Central

Gossner, Johannes

2016-01-01

Summary Computed tomography (CT) is a frequently performed examination in women of all ages. In all thoracic CT examinations of the chest at least parts of the breasts are included. Therefore incidental breast pathology may be observed. It has been suggested that one out of 250 women undergoing chest CT will show a malignant incidental breast lesion. Given the high number of performed chest CT examinations, this contributes to a significant number of malignancies. In this review, after a brief discussion of the value of computed tomography in breast imaging, normal and pathologic findings are discussed to create awareness of this potential “black box” on chest CT. PMID:28058068

Radiologic-Pathologic Analysis of Contrast-enhanced and Diffusion-weighted MR Imaging in Patients with HCC after TACE: Diagnostic Accuracy of 3D Quantitative Image Analysis

PubMed Central

Chapiro, Julius; Wood, Laura D.; Lin, MingDe; Duran, Rafael; Cornish, Toby; Lesage, David; Charu, Vivek; Schernthaner, Rüdiger; Wang, Zhijun; Tacher, Vania; Savic, Lynn Jeanette; Kamel, Ihab R.

2014-01-01

Purpose To evaluate the diagnostic performance of three-dimensional (3Dthree-dimensional) quantitative enhancement-based and diffusion-weighted volumetric magnetic resonance (MR) imaging assessment of hepatocellular carcinoma (HCChepatocellular carcinoma) lesions in determining the extent of pathologic tumor necrosis after transarterial chemoembolization (TACEtransarterial chemoembolization). Materials and Methods This institutional review board–approved retrospective study included 17 patients with HCChepatocellular carcinoma who underwent TACEtransarterial chemoembolization before surgery. Semiautomatic 3Dthree-dimensional volumetric segmentation of target lesions was performed at the last MR examination before orthotopic liver transplantation or surgical resection. The amount of necrotic tumor tissue on contrast material–enhanced arterial phase MR images and the amount of diffusion-restricted tumor tissue on apparent diffusion coefficient (ADCapparent diffusion coefficient) maps were expressed as a percentage of the total tumor volume. Visual assessment of the extent of tumor necrosis and tumor response according to European Association for the Study of the Liver (EASLEuropean Association for the Study of the Liver) criteria was performed. Pathologic tumor necrosis was quantified by using slide-by-slide segmentation. Correlation analysis was performed to evaluate the predictive values of the radiologic techniques. Results At histopathologic examination, the mean percentage of tumor necrosis was 70% (range, 10%–100%). Both 3Dthree-dimensional quantitative techniques demonstrated a strong correlation with tumor necrosis at pathologic examination (R2 = 0.9657 and R2 = 0.9662 for quantitative EASLEuropean Association for the Study of the Liver and quantitative ADCapparent diffusion coefficient, respectively) and a strong intermethod agreement (R2 = 0.9585). Both methods showed a significantly lower discrepancy with pathologically measured necrosis (residual standard error [RSEresidual standard error] = 6.38 and 6.33 for quantitative EASLEuropean Association for the Study of the Liver and quantitative ADCapparent diffusion coefficient, respectively), when compared with non-3Dthree-dimensional techniques (RSEresidual standard error = 12.18 for visual assessment). Conclusion This radiologic-pathologic correlation study demonstrates the diagnostic accuracy of 3Dthree-dimensional quantitative MR imaging techniques in identifying pathologically measured tumor necrosis in HCChepatocellular carcinoma lesions treated with TACEtransarterial chemoembolization. © RSNA, 2014 Online supplemental material is available for this article. PMID:25028783

The value of naked eye examination of biopsied lymph nodes in the diagnosis of tuberculous lymphadenitis.

PubMed

Bem, C

1996-01-01

Tuberculous lymphadenitis is common in Central Africa, where diagnosis by histological examination of a biopsied node is often delayed. In the present study, the naked eye appearance of the cut surface of 306 consecutive biopsied lymph nodes was compared with the histological diagnosis. One hundred and eight-eight nodes showed tuberculosis on histology (including two with coexisting second pathology). One hundred and forty-eight (79%) cases of tuberculous lymphadenitis (including both with coexisting second pathology) showed noncaseating tuberculomata or caseation visible on naked eye examination. Such signs were not seen in other nodes. Other signs were seen in another 18 (10%) tuberculous nodes. It is concluded that naked eye examination of nodes provides useful information for the diagnosis of tuberculous lymphadenitis, pending confirmation by histology.

Advanced imaging of tau pathology in Alzheimer Disease: New perspectives from super resolution microscopy and label-free nanoscopy.

PubMed

Schierle, Gabriele S Kaminski; Michel, Claire H; Gasparini, Laura

2016-08-01

Alzheimer's disease (AD) is the main cause of dementia in the elderly population. Over 30 million people worldwide are living with dementia and AD prevalence is projected to increase dramatically in the next two decades. In terms of neuropathology, AD is characterized by two major cerebral hallmarks: extracellular β-amyloid (Aβ) plaques and intracellular Tau inclusions, which start accumulating in the brain 15-20 years before the onset of symptoms. Within this context, the scientific community worldwide is undertaking a wide research effort to detect AD pathology at its earliest, before symptoms appear. Neuroimaging of Aβ by positron emission tomography (PET) is clinically available and is a promising modality for early detection of Aβ pathology and AD diagnosis. Substantive efforts are ongoing to develop advanced imaging techniques for early detection of Tau pathology. Here, we will briefly describe the key features of Tau pathology and its heterogeneity across various neurodegenerative diseases bearing cerebral Tau inclusions (i.e., tauopathies). We will outline the current status of research on Tau-specific PET tracers and their clinical development. Finally, we will discuss the potential application of novel super-resolution and label-free techniques for investigating Tau pathology at the experimental level and their potential application for AD diagnosis. Microsc. Res. Tech. 79:677-683, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Risk of Pathologic Upgrading or Locally Advanced Disease in Early Prostate Cancer Patients Based on Biopsy Gleason Score and PSA: A Population-Based Study of Modern Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Caster, Joseph M.; Falchook, Aaron D.; Hendrix, Laura H.

Purpose: Radiation oncologists rely on available clinical information (biopsy Gleason score and prostate-specific antigen [PSA]) to determine the optimal treatment regimen for each prostate cancer patient. Existing published nomograms correlating clinical to pathologic extent of disease were based on patients treated in the 1980s and 1990s at select academic institutions. We used the Surveillance, Epidemiology, and End Results (SEER) database to examine pathologic outcomes (Gleason score and cancer stage) in early prostate cancer patients based on biopsy Gleason score and PSA concentration. Methods and Materials: This analysis included 25,858 patients whose cancer was diagnosed between 2010 and 2011, with biopsymore » Gleason scores of 6 to 7 and clinical stage T1 to T2 disease, who underwent radical prostatectomy. In subgroups based on biopsy Gleason score and PSA level, we report the proportion of patients with pathologically advanced disease (positive surgical margin or pT3-T4 disease) or whose Gleason score was upgraded. Logistic regression was used to examine factors associated with pathologic outcomes. Results: For patients with biopsy Gleason score 6 cancers, 84% of those with PSA <10 ng/mL had surgical T2 disease with negative margins; this decreased to 61% in patients with PSA of 20 to 29.9 ng/mL. Gleason score upgrading was seen in 43% (PSA: <10 ng/mL) to 61% (PSA: 20-29.9 ng/mL) of biopsy Gleason 6 patients. Patients with biopsy Gleason 7 cancers had a one-third (Gleason 3 + 4; PSA: <10 ng/mL) to two-thirds (Gleason 4 + 3; PSA: 20-29.9 ng/mL) probability of having pathologically advanced disease. Gleason score upgrading was seen in 11% to 19% of patients with biopsy Gleason 4 + 3 cancers. Multivariable analysis showed that higher PSA and older age were associated with Gleason score upgrading and pathologically advanced disease. Conclusions: This is the first population-based study to examine pathologic extent of disease and pathologic Gleason score upgrading based on clinically available information in modern patients. These data inform the selection of radiation therapy strategies and an understanding of whether prostatectomy alone is likely to be curative for patients with early prostate cancers.« less

[Helicobacter pylori-associated pathology of oral cavity in children (clinical-laboratory study)].

PubMed

Elizarova, V M; Gorelov, A V; Tabolova, E N; Skatova, E A

2006-01-01

As the result of the study of stomatological status indices in children with gastroduodenal pathology associated with Helicobacter pylori it was established that caries incidence in children did not depend upon contamination while caries prevalence in examined children unlike caries incidence was associated with HP-status of the oral cavity. Patients with concomitant gastroduodenal pathology had frequently periodontal disease (PD). In children with chronic antral gastritis associated with Helicobacter pylori clinical manifestations were poor and tended towards inflammatory process chronicity. All the patients had chronic catarrhal gingivitis. In children with Helicobacter pylori associated pathology of GIT it proceeded with 100% contamination of gingival mucous membrane by Helicobacter pylori as shown by bacterioscopic study.

Dynamic nonrobotic telemicroscopy via skype: A cost effective solution to teleconsultation

PubMed Central

Sirintrapun, Sahussapont J.; Cimic, Adela

2012-01-01

Context: Skype is a peer to peer software application that has been historically used for voice and video calls, instant messaging, and file transfer over the Internet. Few studies are available using Skype specifically for telepathology. Aims: Our aim is to show that dynamic nonrobotic teleconsultation is possible and even effective via means of a standard microscope camera capable of live acquisition, Skype, an established broad band internet connection, and experienced pathologists. Settings and Design: Both the consulting “sending” pathologist and consultant “receiving” pathologist are reasonably experienced general surgical pathologists at junior attending level with several years of experience in sign out. Forty-five cases were chosen encompassing a broad range of surgical pathology specimens. The cases were prospectively evaluated with the consultant diagnosis used as a preliminary pathologic impression with the final diagnosis being confirmation. Materials and Methods: Versions of Skype 5.0 and above were used along with established broadband internet connections, usually between academic medical institutions. Results: Forty of forty-five cases (89%) were essentially concordant. In four of forty-five cases (9%), the consulting impression gave a differential, but favored an entity which did not match the final diagnosis. Only one case (2%) did the consulting impression not match the final diagnosis; a discordant opinion. Conclusions: The image quality via Skype screen sharing option is excellent. Essentially no lag time was seen. We have shown in our small pilot study that Skype is an effective cost-efficient means for teleconsultation, particularly in the setting of entity-related differential diagnoses in surgical pathology and when both the consulting and consultant pathologists are reasonably experienced. PMID:23024887

The efficacy and utilisation of preoperative multiparametric magnetic resonance imaging in robot-assisted radical prostatectomy: does it change the surgical dissection plan?

PubMed

Tavukçu, Hasan Hüseyin; Aytaç, Ömer; Balcı, Numan Cem; Kulaksızoğlu, Haluk; Atuğ, Fatih

2017-12-01

We investigated the effect of the use of multiparametric prostate magnetic resonance imaging (mp-MRI) on the dissection plan of the neurovascular bundle and the oncological results of our patients who underwent robot-assisted radical prostatectomy. We prospectively evaluated 60 consecutive patients, including 30 patients who had (Group 1), and 30 patients who had not (Group 2) mp-MRI before robot-assisted radical prostatectomy. Based on the findings of mp-MRI, the dissection plan was changed as intrafascial, interfascial, and extrafascial in the mp-MRI group. Two groups were compared in terms of age, prostate-specific antigen (PSA), Gleason sum scores and surgical margin positivity. There was no statistically significant difference between the two groups in terms of age, PSA, biopsy Gleason score, final pathological Gleason score and surgical margin positivity. mp-MRI changed the initial surgical plan in 18 of 30 patients (60%) in Group 1. In seventeen of these patients (56%) surgical plan was changed from non-nerve sparing to interfascial nerve sparing plan. In one patient dissection plan was changed to non-nerve sparing technique which had extraprostatic extension on final pathology. Surgical margin positivity was similar in Groups 1, and 2 (16% and 13%, respectively) although, Group 1 had higher number of high- risk patients. mp-MRI confirmed the primary tumour localisation in the final pathology in 27 of of 30 patients (90%). Preoperative mp-MRI effected the decision to perform a nerve-sparing technique in 56% of the patients in our study; moreover, changing the dissection plan from non-nerve-sparing technique to a nerve sparing technique did not increase the rate of surgical margin positivity.

How radiologic/clinicopathologic features relate to compressive symptoms in benign thyroid disease.

PubMed

Siegel, Bianca; Ow, Thomas J; Abraham, Suzanne S; Loftus, Patricia A; Tassler, Andrew B; Smith, Richard V; Schiff, Bradley A

2017-04-01

To identify compressive symptomatology in a patient cohort with benign thyroid disease who underwent thyroidectomy. To determine radiographic/clinicopathologic features related to and predictive of a compressive outcome. Retrospective cohort study. Medical records of 232 patients with benign thyroid disease on fine needle aspiration who underwent thyroidectomy from 2009 to 2012 at an academic medical center were reviewed. Data collection and analyses involved subjects' demographics, compressive symptoms, preoperative airway encroachment, intubation complications, specimen weight, and final pathologic diagnosis. Subjects were ages 14 to 86 years (mean: 52.4 years). Ninety-six subjects (41.4%) reported compressive symptomatology of dysphagia (n =74; 32%), dyspnea (n = 39; 17%), and hoarseness (n = 24; 10%). Ninety-seven (42.2%) had preoperative airway encroachment. Dyspnea was significantly related to tracheal compression, tracheal deviation, and substernal extension. Dysphagia was related to tracheal compression and tracheal deviation. Compressive symptoms and preoperative airway encroachment were not related to intubation complications. Final pathologic diagnosis was not related to compressive symptoms, whereas specimen weight was significantly related to dyspnea and dysphagia. Final pathology revealed 74 subjects (32%) with malignant lesions. Malignant and benign nodular subject groups differed significantly in substernal extension, gland weight, tracheal deviation, and dyspnea. Logit modeling for dyspnea was significant for tracheal compression as a predictor for the likelihood of dyspnea. Dyspnea was closely related to preoperative airway encroachment and most indicative of a clinically relevant thyroid in our cohort with benign thyroid disease. Tracheal compression was found to have predictive value for the likelihood of a dyspneic outcome. 4. Laryngoscope, 127:993-997, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

The relationships between perfectionism, pathological worry and generalised anxiety disorder

PubMed Central

2014-01-01

Background The relationships between perfectionism, pathological worry and generalised anxiety disorder (GAD) were investigated in a clinical sample presenting for treatment of perfectionism. Method This study explored the utility of perfectionism in predicting pathological worry in a sample of individuals with elevated perfectionism and GAD (n = 36). Following this, the study examined whether perfectionism could predict a principal GAD diagnosis in the full sample (n = 42). Results Scores on the perfectionism dimensions Concern over Mistakes, Personal Standards, and Clinical Perfectionism significantly predicted pathological worry among participants with GAD after controlling for gender and depression. The perfectionism dimension Doubts about Actions significantly predicted whether individuals from the full sample received a principal diagnosis of GAD. Conclusions These findings support certain dimensions of perfectionism having significant associations with pathological worry and GAD. PMID:24693946

Lifting the veil: how to use clinical neuropsychology to assess dementia.

PubMed

Burrell, James R; Piguet, Olivier

2015-11-01

Neurologists often struggle to interpret the results of neuropsychological testing, even though cognitive assessments are an integral component of the diagnostic process in dementia syndromes. This article reviews the principles underlying clinical neuropsychology, background on common neuropsychological tests, and tips on how to interpret the results when assessing patients with dementia. General cognitive screening tools, appropriate for use by general neurologists and psychiatrists, as well as specific cognitive tests examining the main cognitive domains (attention and orientation, memory, visuospatial function, language and executive function) in patients with dementia are considered. Finally, the pattern of deficits, helpful in defining clinical dementia phenotypes and sometimes in predicting the underlying molecular pathology, are outlined. Such clinicopathological associations will become invaluable as disease-modifying treatments for dementia are developed and implemented. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Toward a more data-driven supervision of collegiate counseling centers.

PubMed

Varlotta, Lori E

2012-01-01

Hearing the national call for higher education accountability, the author of this tripartite article urges university administrators to move towards a more data-driven approach to counseling center supervision. Toward that end, the author first examines a key factor--perceived increase in student pathology--that appears to shape budget and staffing decisions in many university centers. Second, she reviews the emerging but conflicting research of clinician-scholars who are trying to empirically verify or refute that perception; their conflicting results suggest that no study alone should be used as the "final word" in evidence-based decision-making. Third, the author delineates the campus-specific data that should be gathered to guide staffing and budgeting decisions on each campus. She concludes by reminding readers that data-driven decisions can and should foster high-quality care that is concurrently efficient, effective, and in sync with the needs of a particular university and student body.

Ultrasound Contrast Agents

NASA Astrophysics Data System (ADS)

Cachard, Christian; Basset, Olivier

While the use of contrast agents in other imaging modalities (X ray, MRI, PET, …) has been routinely accepted for many years, the development and commercialization of contrast agents designed specifically for ultrasound imaging has occurred only very recently. As in the other imaging modalities, the injection of contrast agents during an ultrasound examination is intended to facilitate the detection and diagnosis of specific pathologies. Contrast agents efficiency is based on the backscattering of ultrasound by microbubbles. These microparticules are intravenously injected in the blood flow. After an introduction and generalities on ultrasound contrast agents (UCA) the microbubble physics in an acoustic field will be developed. Second, physics characteristics of contrast agents will be compared (bubbles with or without shell, gas nature, size distribution). Influence of acoustic pressure on the behaviour of the microparticules (linear, non linear and destruction) will be discussed. Finally, a review of specific imaging adapted to contrast agent properties as harmonic imaging, pulse inversion imaging will be presented.

Solitary small bowel metastasis from breast cancer.

PubMed

Choi, Jung Eun; Park, Shin Young; Jeon, Myung Hoon; Kang, Su Hwan; Lee, Soo Jung; Bae, Young Kyung; Kim, Min Kyoung

2011-03-01

The common sites of metastasis of breast cancer are bone, lung, and liver, but gastrointestinal metastasis from breast cancer is rare. We experienced a case of solitary ileal metastasis from breast cancer. A 45-years-old woman presented with melena for several weeks. She showed no other abdominal symptoms. Colonoscopy findings showed an ulcerative mucosal lesion in the terminal ileum, and biopsy was performed. Pathologic examination revealed metastatic carcinoma, originated from breast. The tumor cells were positive for estrogen receptor and negative for Cdx-2. She had had a previous medical history of bilateral breast cancer and undergone breast conserving surgery with sentinel lymph node biopsy for both breasts. The torso positron emission tomography scan at 19 months after surgery showed mildly increased uptake in the terminal ileum which was considered as inflammation. Finally, she was diagnosed with solitary ileal metastasis from breast cancer at 22 months after surgery.

Delayed appearance of hypaesthesia and paralysis after femoral nerve block

PubMed Central

Landgraeber, Stefan; Albrecht, Thomas; Reischuck, Ulrich; von Knoch, Marius

2012-01-01

We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colour duplex sonography of the femoral artery and computed tomography of the lumbar spine and pelvis yielded no pathological findings. Overnight the neurological deficits decreased without therapy and were finally no longer detectable. We speculate that during the administration of the local anaesthetic a depot formed, localised in the medial femoral intermuscular septa, which was leaked after first mobilisation. To our knowledge no similar case has been published up to now. We conclude that patients who are treated with a nerve block should be informed and physician should be aware that delayed neurological deficits are possible. PMID:22577509

Cutaneous Surgical Denervation: A Method for Testing the Requirement for Nerves in Mouse Models of Skin Disease.

PubMed

Peterson, Shelby C; Brownell, Isaac; Wong, Sunny Y

2016-06-26

Cutaneous somatosensory nerves function to detect diverse stimuli that act upon the skin. In addition to their established sensory roles, recent studies have suggested that nerves may also modulate skin disorders including atopic dermatitis, psoriasis and cancer. Here, we describe protocols for testing the requirement for nerves in maintaining a cutaneous mechanosensory organ, the touch dome (TD). Specifically, we discuss methods for genetically labeling, harvesting and visualizing TDs by whole-mount staining, and for performing unilateral surgical denervation on mouse dorsal back skin. Together, these approaches can be used to directly compare TD morphology and gene expression in denervated as well as sham-operated skin from the same animal. These methods can also be readily adapted to examine the requirement for nerves in mouse models of skin pathology. Finally, the ability to repeatedly sample the skin provides an opportunity to monitor disease progression at different stages and times after initiation.

Oestrogen, ocular function and low-level vision: a review.

PubMed

Hutchinson, Claire V; Walker, James A; Davidson, Colin

2014-11-01

Over the past 10 years, a literature has emerged concerning the sex steroid hormone oestrogen and its role in human vision. Herein, we review evidence that oestrogen (oestradiol) levels may significantly affect ocular function and low-level vision, particularly in older females. In doing so, we have examined a number of vision-related disorders including dry eye, cataract, increased intraocular pressure, glaucoma, age-related macular degeneration and Leber's hereditary optic neuropathy. In each case, we have found oestrogen, or lack thereof, to have a role. We have also included discussion of how oestrogen-related pharmacological treatments for menopause and breast cancer can impact the pathology of the eye and a number of psychophysical aspects of vision. Finally, we have reviewed oestrogen's pharmacology and suggest potential mechanisms underlying its beneficial effects, with particular emphasis on anti-apoptotic and vascular effects. © 2014 Society for Endocrinology.

High-caloric and chocolate stimuli processing in healthy humans: an integration of functional imaging and electrophysiological findings.

PubMed

Asmaro, Deyar; Liotti, Mario

2014-01-10

There has been a great deal of interest in understanding how the human brain processes appetitive food cues, and knowing how such cues elicit craving responses is particularly relevant when current eating behavior trends within Westernized societies are considered. One substance that holds a special place with regard to food preference is chocolate, and studies that used functional magnetic resonance imaging (fMRI) and event-related potentials (ERPs) have identified neural regions and electrical signatures that are elicited by chocolate cue presentations. This review will examine fMRI and ERP findings from studies that used high-caloric food and chocolate cues as stimuli, with a focus on responses observed in samples of healthy participants, as opposed to those with eating-related pathology. The utility of using high-caloric and chocolate stimuli as a means of understanding the human reward system will also be highlighted, as these findings may be particularly important for understanding processes related to pathological overeating and addiction to illicit substances. Finally, research from our own lab that focused on chocolate stimulus processing in chocolate cravers and non-cravers will be discussed, as the approach used may help bridge fMRI and ERP findings so that a more complete understanding of appetitive stimulus processing in the temporal and spatial domains may be established.

Odontogenic cysts: a retrospective study of 1227 cases in an Iranian population from 1987 to 2007.

PubMed

Sharifian, Mohammad J; Khalili, Maryam

2011-09-01

Odontogenic cysts constitute a major part of oral pathological lesions, but little is known about their distribution patterns in various populations. In this retrospective study, patient records from the archive of the Department of Oral and Maxillofacial Pathology at the Faculty of Dentistry affiliated to the Tehran University of Medical Sciences were reviewed. Cases diagnosed as odontogenic cyst from 1987 to 2007 were selected and histopathologically re-evaluated to confirm the diagnosis. Patients' demographic information (age and sex) and location of the lesion were recorded and analyzed using descriptive statistics. From a total of 8529 files reviewed, the diagnosis of odontogenic cyst was confirmed in 1227 cases (14.4%). The overall male to female ratio was 1.33:1. The patients' age ranged from 3 to 84 years with a mean of 28 years. 49% of cysts were found in maxilla and 50.4% in mandible. Radicular cyst was the most common type followed by dentigerous cyst, odontogenic keratocyst, residual cyst and paradental cyst. Lateral periodontal cyst, eruption cyst, glandular odontogenic cyst and gingival cyst of adults were also reported. The distribution pattern of odontogenic cysts in Iran is relatively similar to that in other parts of the world. The importance of complete clinical reports for final diagnosis of these lesions and routine follow-up examinations is emphasized.

Dyspnoea, thoracic pain and fever in a young caucasian female: A case report.

PubMed

Fois, Alessandro Giuseppe; Trisolini, Rocco; Ginesu, Giorgio Carlo; Zinellu, Elisabetta; Negri, Silvia; Cancellieri, Alessandra; Garau, Alessandra; Pirina, Pietro

2018-05-31

The diagnostic approach to patients with mediastinal pathology is not always simple and an improper diagnostic work-up can lead to significant diagnosis delay. We report on the case of a young woman who was admitted to the Emergency Department complaining of thoracic pain, dyspnoea, fever and productive cough. The physical examination showed a painful swelling over the sternum's upper left margin, which had become evident 4 months earlier. A Computer Tomography showed the presence of a retrosternal oval lesion (5.5 x 4 cm) infiltrating the thoracic wall and showed the presence of discretely enlarged mediastinal lymph nodes in several mediastinal stations. The Multidisciplinary Team decided to perform an ultrasound-guided biopsy of the retrosternal mass that showed an inflammatory pattern, whereas microbiology tests proved negative. The lack of improvement with medical therapy (non steroideal anti-inflammatories and antibiotics) and the clinical suspicion of malignancy led us to perform a surgical biopsy of the mass that finally proved to be diagnostic for Hodgkin's lymphoma. Mediastinal masses with an aggressive behavior, should always be considered to be potentially malignant. Surgical biopsy, sometimes, can be the only way to correctly diagnose the pathological process, especially in the case of Hodgkin's lymphoma in which few diagnostic cells (Reed-Sternberg cells) are generally embedded in an abundant inflammatory background tissue. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

The value of forceps biopsy and core needle biopsy in prediction of pathologic complete remission in locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy.

PubMed

Tang, Jing-Hua; An, Xin; Lin, Xi; Gao, Yuan-Hong; Liu, Guo-Chen; Kong, Ling-Heng; Pan, Zhi-Zhong; Ding, Pei-Rong

2015-10-20

Patients with pathological complete remission (pCR) after treated with neoadjuvant chemoradiotherapy (nCRT) have better long-term outcome and may receive conservative treatments in locally advanced rectal cancer (LARC). The study aimed to evaluate the value of forceps biopsy and core needle biopsy in prediction of pCR in LARC treated with nCRT. In total, 120 patients entered this study. Sixty-one consecutive patients received preoperative forceps biopsy during endoscopic examination. Ex vivo core needle biopsy was performed in resected specimens of another 43 consecutive patients. The accuracy for ex vivo core needle biopsy was significantly higher than forceps biopsy (76.7% vs. 36.1%; p < 0.001). The sensitivity for ex vivo core needle biopsy was significantly lower in good responder (TRG 3) than poor responder (TRG ≤ 2) (52.9% vs. 94.1%; p = 0.017). In vivo core needle biopsy was further performed in 16 patients with good response. Eleven patients had residual cancer cells in final resected specimens, among whom 4 (36.4%) patients were biopsy positive. In conclusion, routine forceps biopsy was of limited value in identifying pCR after nCRT. Although core needle biopsy might further identify a subset of patients with residual cancer cells, the accuracy was not substantially increased in good responders.

The value of forceps biopsy and core needle biopsy in prediction of pathologic complete remission in locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy

PubMed Central

Gao, Yuan-Hong; Liu, Guo-Chen; Kong, Ling-Heng; Pan, Zhi-Zhong; Ding, Pei-Rong

2015-01-01

Patients with pathological complete remission (pCR) after treated with neoadjuvant chemoradiotherapy (nCRT) have better long-term outcome and may receive conservative treatments in locally advanced rectal cancer (LARC). The study aimed to evaluate the value of forceps biopsy and core needle biopsy in prediction of pCR in LARC treated with nCRT. In total, 120patients entered this study. Sixty-one consecutive patients received preoperative forceps biopsy during endoscopic examination. Ex vivo core needle biopsy was performed in resected specimens of another 43 consecutive patients. The accuracy for ex vivo core needle biopsy was significantly higher than forceps biopsy (76.7% vs. 36.1%; p < 0.001). The sensitivity for ex vivo core needle biopsy was significantly lower in good responder (TRG 3) than poor responder (TRG ≤ 2) (52.9% vs. 94.1%; p = 0.017). In vivo core needle biopsy was further performed in 16 patients with good response. Eleven patients had residual cancer cells in final resected specimens, among whom 4 (36.4%) patients were biopsy positive. In conclusion, routine forceps biopsy was of limited value in identifying pCR after nCRT. Although core needle biopsy might further identify a subset of patients with residual cancer cells, the accuracy was not substantially increased in good responders. PMID:26416245

High-Caloric and Chocolate Stimuli Processing in Healthy Humans: An Integration of Functional Imaging and Electrophysiological Findings

PubMed Central

Asmaro, Deyar; Liotti, Mario

2014-01-01

There has been a great deal of interest in understanding how the human brain processes appetitive food cues, and knowing how such cues elicit craving responses is particularly relevant when current eating behavior trends within Westernized societies are considered. One substance that holds a special place with regard to food preference is chocolate, and studies that used functional magnetic resonance imaging (fMRI) and event-related potentials (ERPs) have identified neural regions and electrical signatures that are elicited by chocolate cue presentations. This review will examine fMRI and ERP findings from studies that used high-caloric food and chocolate cues as stimuli, with a focus on responses observed in samples of healthy participants, as opposed to those with eating-related pathology. The utility of using high-caloric and chocolate stimuli as a means of understanding the human reward system will also be highlighted, as these findings may be particularly important for understanding processes related to pathological overeating and addiction to illicit substances. Finally, research from our own lab that focused on chocolate stimulus processing in chocolate cravers and non-cravers will be discussed, as the approach used may help bridge fMRI and ERP findings so that a more complete understanding of appetitive stimulus processing in the temporal and spatial domains may be established. PMID:24434747

Confounders in interpreting pathology for safety and risk assessment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wolf, Douglas C.; Mann, Peter C.

2005-02-01

The contribution of pathology to toxicity assessment is invaluable but often not clearly understood. Pathology endpoints are the central response around which human health risk assessment is frequently determined; therefore, it is important that the general toxicology community understand current concepts and nomenclature of toxicologic pathology. Toxicologic pathology encompasses the study of changes in tissue morphology that help define the risk of exposure to xenobiotics. Toxicologic pathology is a discipline that has changed and adapted over time including methods of analysis and nomenclature of lesions. As risk assessments are updated for chemicals in commerce, frequently the older literature must bemore » reviewed and reevaluated. When interpreting pathology data from animal studies, it is important to consider the biological significance of a lesion as well as its relationship to the ultimate adverse health effect. Assessing the potential for a chemical to cause harm to humans must include the examination of the entire pathology database in context of the study design, the mode of action of the chemical of concern, and using the most current interpretation of a lesion to determine the significance for human health effects of a particular tissue response.« less

Expression of Tau Pathology-Related Proteins in Different Brain Regions: A Molecular Basis of Tau Pathogenesis.

PubMed

Hu, Wen; Wu, Feng; Zhang, Yanchong; Gong, Cheng-Xin; Iqbal, Khalid; Liu, Fei

2017-01-01

Microtubule-associated protein tau is hyperphosphorylated and aggregated in affected neurons in Alzheimer disease (AD) brains. The tau pathology starts from the entorhinal cortex (EC), spreads to the hippocampus and frontal and temporal cortices, and finally to all isocortex areas, but the cerebellum is spared from tau lesions. The molecular basis of differential vulnerability of different brain regions to tau pathology is not understood. In the present study, we analyzed brain regional expressions of tau and tau pathology-related proteins. We found that tau was hyperphosphorylated at multiple sites in the frontal cortex (FC), but not in the cerebellum, from AD brain. The level of tau expression in the cerebellum was about 1/4 of that seen in the frontal and temporal cortices in human brain. In the rat brain, the expression level of tau with three microtubule-binding repeats (3R-tau) was comparable in the hippocampus, EC, FC, parietal-temporal cortex (PTC), occipital-temporal cortex (OTC), striatum, thalamus, olfactory bulb (OB) and cerebellum. However, the expression level of 4R-tau was the highest in the EC and the lowest in the cerebellum. Tau phosphatases, kinases, microtubule-related proteins and other tau pathology-related proteins were also expressed in a region-specific manner in the rat brain. These results suggest that higher levels of tau and tau kinases in the EC and low levels of these proteins in the cerebellum may accounts for the vulnerability and resistance of these representative brain regions to the development of tau pathology, respectively. The present study provides the regional expression profiles of tau and tau pathology-related proteins in the brain, which may help understand the brain regional vulnerability to tau pathology in neurodegenerative tauopathies.

Neuroimaging mechanisms of change in psychotherapy for addictive behaviors: emerging translational approaches that bridge biology and behavior.

PubMed

Feldstein Ewing, Sarah W; Chung, Tammy

2013-06-01

Research on mechanisms of behavior change provides an innovative method to improve treatment for addictive behaviors. An important extension of mechanisms of change research involves the use of translational approaches, which examine how basic biological (i.e., brain-based mechanisms) and behavioral factors interact in initiating and sustaining positive behavior change as a result of psychotherapy. Articles in this special issue include integrative conceptual reviews and innovative empirical research on brain-based mechanisms that may underlie risk for addictive behaviors and response to psychotherapy from adolescence through adulthood. Review articles discuss hypothesized mechanisms of change for cognitive and behavioral therapies, mindfulness-based interventions, and neuroeconomic approaches. Empirical articles cover a range of addictive behaviors, including use of alcohol, cigarettes, marijuana, cocaine, and pathological gambling and represent a variety of imaging approaches including fMRI, magneto-encephalography, real-time fMRI, and diffusion tensor imaging. Additionally, a few empirical studies directly examine brain-based mechanisms of change, whereas others examine brain-based indicators as predictors of treatment outcome. Finally, two commentaries discuss craving as a core feature of addiction, and the importance of a developmental approach to examining mechanisms of change. Ultimately, translational research on mechanisms of behavior change holds promise for increasing understanding of how psychotherapy may modify brain structure and functioning and facilitate the initiation and maintenance of positive treatment outcomes for addictive behaviors. 2013 APA, all rights reserved

Neuroimaging mechanisms of change in psychotherapy for addictive behaviors: Emerging translational approaches that bridge biology and behavior

PubMed Central

Feldstein Ewing, Sarah W.; Chung, Tammy

2013-01-01

Research on mechanisms of behavior change provides an innovative method to improve treatment for addictive behaviors. An important extension of mechanisms of change research involves the use of translational approaches, which examine how basic biological (i.e., brain-based mechanisms) and behavioral factors interact in initiating and sustaining positive behavior change as a result of psychotherapy. Articles in this special issue include integrative conceptual reviews and innovative empirical research on brain-based mechanisms that may underlie risk for addictive behaviors and response to psychotherapy from adolescence through adulthood. Review articles discuss hypothesized mechanisms of change for cognitive and behavioral therapies, mindfulness-based interventions, and neuroeconomic approaches. Empirical articles cover a range of addictive behaviors, including use of alcohol, cigarettes, marijuana, cocaine, and pathological gambling and represent a variety of imaging approaches including fMRI, magneto-encephalography, real time fMRI, and diffusion tensor imaging. Additionally, a few empirical studies directly examined brain-based mechanisms of change, whereas others examined brain-based indicators as predictors of treatment outcome. Finally, two commentaries discuss craving as a core feature of addiction, and the importance of a developmental approach to examining mechanisms of change. Ultimately, translational research on mechanisms of behavior change holds promise for increasing understanding of how psychotherapy may modify brain structure and functioning and facilitate the initiation and maintenance of positive treatment outcomes for addictive behaviors. PMID:23815447

Pathology and distribution of sea turtles landed as bycatch in the Hawaii-based North Pacific pelagic longline fishery

USGS Publications Warehouse

Work, Thierry M.; Balazs, George H.

2010-01-01

We examined the gross and microscopic pathology and distribution of sea turtles that were landed as bycatch from the Hawaii, USA–based pelagic longline fishery and known to be forced submerged. Olive ridley turtles (Lepidochelys olivacea) composed the majority of animals examined, and hook-induced perforation of the esophagus was the most common gross lesion followed by perforation of oral structures (tongue, canthus) and of flippers. Gross pathology in the lungs suggestive of drowning was seen in 23 of 71 turtles. Considering only the external gross findings, the pathologist and the observer on board the longline vessel agreed on hook-induced lesions only 60% of the time thereby illustrating the limitations of depending on external examination alone to implicate hooking interactions or drowning as potential cause of sea turtle mortality. When comparing histology of drowned turtles to a control group of nondrowned turtles, the former had significantly more pulmonary edema, hemorrhage, and sloughed columnar epithelium. These microscopic changes may prove useful to diagnose suspected drowning in sea turtles where history of hooking or netting interactions is unknown.

Problem and pathological gambling in a sample of casino patrons.

PubMed

Fong, Timothy W; Campos, Michael D; Brecht, Mary-Lynn; Davis, Alice; Marco, Adrienne; Pecanha, Viviane; Rosenthal, Richard J

2011-03-01

Relatively few studies have examined gambling problems among individuals in a casino setting. The current study sought to examine the prevalence of gambling problems among a sample of casino patrons and examine alcohol and tobacco use, health status, and quality of life by gambling problem status. To these ends, 176 casino patrons were recruited by going to a Southern California casino and requesting that they complete an anonymous survey. Results indicated the following lifetime rates for at-risk, problem, and pathological gambling: 29.2, 10.7, and 29.8%. Differences were found with regards to gambling behavior, and results indicated higher rates of smoking among individuals with gambling problems, but not higher rates of alcohol use. Self-rated quality of life was lower among pathological gamblers relative to non-problem gamblers, but did not differ from at-risk or problem gamblers. Although subject to some limitations, our data support the notion of higher frequency of gambling problems among casino patrons and may suggest the need for increased interventions for gambling problems on-site at casinos.

Investigating tiredness in Australian general practice. Do pathology tests help in diagnosis?

PubMed

Gialamas, Angela; Beilby, Justin J; Pratt, Nicole L; Henning, Rhys; Marley, John E; Roddick, John F

2003-08-01

Tiredness is a common presentation in general practice for which pathology tests are commonly ordered. Our aim was to study their utilisation for tiredness. We examined an integrated database which contains the medical records for 58,139 patients and their 696,518 associated general practitioner encounters. Three hundred and forty-two patients and their 1652 associated encounters were randomly selected out of 12,291 patients and their 26,748 associated encounters that had mentioned tiredness (or a synonym). One hundred and eighty-one patients (53%) had at least one pathology test ordered at any time in their episode of care. Patients over 60 years of age, patients who consulted their GP more than once and patients without comorbidity were more likely to have a pathology test ordered. Only 12 patients (3%) had a significant clinical diagnosis based on an abnormal pathology test. Pathology testing for patients presenting with tiredness is high. Most tests do not yield a significant clinical diagnosis.

Impulsivity, self-regulation,and pathological video gaming among youth: testing a mediation model.

PubMed

Liau, Albert K; Neo, Eng Chuan; Gentile, Douglas A; Choo, Hyekyung; Sim, Timothy; Li, Dongdong; Khoo, Angeline

2015-03-01

Given the potential negative mental health consequences of pathological video gaming, understanding its etiology may lead to useful treatment developments. The purpose of the study was to examine the influence of impulsive and regulatory processes on pathological video gaming. Study 1 involved 2154 students from 6 primary and 4 secondary schools in Singapore. Study 2 involved 191 students from 2 secondary schools. The results of study 1 and study 2 supported the hypothesis that self-regulation is a mediator between impulsivity and pathological video gaming. Specifically, higher levels of impulsivity was related to lower levels of self-regulation, which in turn was related to higher levels of pathological video gaming. The use of impulsivity and self-regulation in predicting pathological video gaming supports the dual-system model of incorporating both impulsive and reflective systems in the prediction of self-control outcomes. The study highlights the development of self-regulatory resources as a possible avenue for future prevention and treatment research. © 2011 APJPH.

Exploring gender differences in body image, eating pathology, and sexual harassment.

PubMed

Buchanan, Nicole T; Bluestein, Brooke M; Nappa, Alexa C; Woods, Krystle C; Depatie, Melissa M

2013-06-01

This study examines the relationship between body image (weight/shape concerns), eating pathology, and sexual harassment among men and women (N=2446). Hierarchical regressions controlling for depression revealed main effects of gender such that women reported greater weight/shape concerns, eating pathology, dietary restraint, eating concerns, and binge eating compared to men. Main effects for sexual harassment indicated that as harassment increased, participants reported increased weight/shape concerns, eating pathology, dietary restraint, eating concerns, binge eating, and compensatory behaviors. There were small but significant interactions between gender and harassment for eating pathology total score (which included each of the domains listed above), weight/shape concerns, dietary restraint, and eating concerns such that the relationship between increased harassment and increased pathology was stronger for women compared to men. The largest interaction was found for compensatory behaviors, such that while women and men's scores both increased as harassment increased, the relationship was stronger for men. Copyright © 2013 Elsevier Ltd. All rights reserved.

Alterations in the Emotional Regulation Process in Gambling Addiction: The Role of Anger and Alexithymia.

PubMed

Maniaci, Giuseppe; Picone, Francesca; van Holst, Ruth J; Bolloni, Corinna; Scardina, Silvana; Cannizzaro, Carla

2017-06-01

This study aims at the assessment of alexithymia and anger levels in 100 treatment-seeking pathological gamblers compared with controls, who were matched for age, gender and education. Furthermore a positive correlation between alexithymia, anger and severity of gambling disorder and a relationship between gambling behaviour and anger after controlling for alexithymia, are investigated. Finally the role that gender plays in anger in pathological gamblers was also evaluated. Psychological assessment includes the South Oaks Gambling Screen, State-Trait Anger Expression Inventory-2 and the twenty-item Toronto Alexithymia Scale. Statistical analysis of the results shows a higher level of anger in pathological gamblers than in controls, together with alterations in emotional processing. Severity of gambling behaviour positively correlates with alexithymia scores, state-anger and trait-anger. Moreover, a significant contribution of anger in predicting gambling behaviour was suggested after controlling for alexithymia. In conclusion, anger and alexithymia must be regarded as relevant components of the assessment of pathological gamblers, in order to select the best therapeutical strategies to prevent self-defeating behaviours and to reduce drop-out from treatments.

Bone Marrow Synoptic Reporting for Hematologic Neoplasms: Guideline From the College of American Pathologists Pathology and Laboratory Quality Center.

PubMed

Sever, Cordelia; Abbott, Charles L; de Baca, Monica E; Khoury, Joseph D; Perkins, Sherrie L; Reichard, Kaaren Kemp; Taylor, Ann; Terebelo, Howard R; Colasacco, Carol; Rumble, R Bryan; Thomas, Nicole E

2016-09-01

-There is ample evidence from the solid tumor literature that synoptic reporting improves accuracy and completeness of relevant data. No evidence-based guidelines currently exist for synoptic reporting for bone marrow samples. -To develop evidence-based recommendations to standardize the basic components of a synoptic report template for bone marrow samples. -The College of American Pathologists Pathology and Laboratory Quality Center convened a panel of experts in hematopathology to develop recommendations. A systematic evidence review was conducted to address 5 key questions. Recommendations were derived from strength of evidence, open comment feedback, and expert panel consensus. -Nine guideline statements were established to provide pathology laboratories with a framework by which to develop synoptic reporting templates for bone marrow samples. The guideline calls for specific data groups in the synoptic section of the pathology report; provides a list of evidence-based parameters for key, pertinent elements; and addresses ancillary testing. -A framework for bone marrow synoptic reporting will improve completeness of the final report in a manner that is clear, succinct, and consistent among institutions.

Immunity and immune response, pathology and pathologic changes: progress and challenges in the immunopathology of yellow fever.

PubMed

Quaresma, Juarez A S; Pagliari, Carla; Medeiros, Daniele B A; Duarte, Maria I S; Vasconcelos, Pedro F C

2013-09-01

Yellow fever is a viral hemorrhagic fever, which affects people living in Africa and South America and is caused by the yellow fever virus, the prototype species in the Flavivirus genus (Flaviviridae family). Yellow fever virus infection can produce a wide spectrum of symptoms, ranging from asymptomatic infection or oligosymptomatic illness to severe disease with a high fatality rate. In this review, we focus in the mechanisms associated with the physiopathology of yellow fever in humans and animal models. It has been demonstrated that several factors play a role in the pathological outcome of the severe form of the disease including direct viral cytopathic effect, necrosis and apoptosis of hepatocyte cells in the midzone, and a minimal inflammatory response as well as low-flow hypoxia and cytokine overproduction. New information has filled several gaps in the understanding of yellow fever pathogenesis and helped comprehend the course of illness. Finally, we discuss prospects for an immune therapy in the light of new immunologic, viral, and pathologic tools. Copyright © 2013 John Wiley & Sons, Ltd.

Privacy and security of patient data in the pathology laboratory.

PubMed

Cucoranu, Ioan C; Parwani, Anil V; West, Andrew J; Romero-Lauro, Gonzalo; Nauman, Kevin; Carter, Alexis B; Balis, Ulysses J; Tuthill, Mark J; Pantanowitz, Liron

2013-01-01

Data protection and security are critical components of routine pathology practice because laboratories are legally required to securely store and transmit electronic patient data. With increasing connectivity of information systems, laboratory work-stations, and instruments themselves to the Internet, the demand to continuously protect and secure laboratory information can become a daunting task. This review addresses informatics security issues in the pathology laboratory related to passwords, biometric devices, data encryption, internet security, virtual private networks, firewalls, anti-viral software, and emergency security situations, as well as the potential impact that newer technologies such as mobile devices have on the privacy and security of electronic protected health information (ePHI). In the United States, the Health Insurance Portability and Accountability Act (HIPAA) govern the privacy and protection of medical information and health records. The HIPAA security standards final rule mandate administrative, physical, and technical safeguards to ensure the confidentiality, integrity, and security of ePHI. Importantly, security failures often lead to privacy breaches, invoking the HIPAA privacy rule as well. Therefore, this review also highlights key aspects of HIPAA and its impact on the pathology laboratory in the United States.

The association of magnetic resonance imaging (MRI)-detected structural pathology of the knee with crepitus in a population-based cohort with knee pain: the MoDEKO study.

PubMed

Crema, M D; Guermazi, A; Sayre, E C; Roemer, F W; Wong, H; Thorne, A; Singer, J; Esdaile, J M; Marra, M D; Kopec, J A; Nicolaou, S; Cibere, J

2011-12-01

Osteoarthritis (OA) is the most common arthropathy of the knee joint(1). Symptoms reported by patients and signs noted during physical examination guide clinicians in identifying subjects with knee OA(2-4). Pain is one of the most important symptoms reported by subjects with knee OA(2,3). Although very common, pain is a non-specific symptom, related to pathology in several structures within the knee joint, and includes synovitis(5), subchondral bone marrow lesions(6), and joint effusion(7). Further, pain is a subjective symptom that cannot be directly measured or assessed during physical examination. Crepitus or crepitation in association with arthritis is defined as a crackling or grinding sound on joint movement with a sensation in the joint. Crepitus may occur with or without pain and is a common finding during physical examination in subjects with knee OA(2-4,8,9). It is not known whether crepitus is related to pathology in various structures within the knee. The aim of our study was to determine the cross-sectional associations of structural pathologies within the knee with crepitus in a population-based cohort with knee pain, using magnetic resonance imaging (MRI). Subjects with knee pain were recruited as a random population sample, with crepitus assessed in each compartment of the knee using a validated and standardized approach during physical examination(10). MRI of the knee was performed to assess cartilage morphology, meniscal morphology, osteophytes, cruciate ligaments, and collateral ligaments. For both compartment-specific and whole-knee analyses, a multiple logistic regression analysis was performed to assess the associations of MRI-detected structural pathology with crepitus, adjusting for potential confounders. Variables were selected by backwards elimination within each compartment and in the overall knee models, and only statistically significant variables remained in the "selected" models; remaining variables in these models are adjusted for each other. An increased risk for compartment-specific crepitus was associated with osteophytes at the patellofemoral (PF) and lateral tibiofemoral (LTF) joints. Crepitus was associated with osteophytes and medial collateral ligament (MCL) pathology at the medial tibiofemoral (MTF) compartment, but cartilage damage was negatively associated with crepitus at this compartment. In the selected whole-knee model, only meniscal tears were associated with an increased risk for general crepitus. Thus, it seems that crepitus may be associated with pathology in several internal structures. Copyright © 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Factors Affecting Feeling-of-Knowing in a Medical Intelligent Tutoring System: The Role of Immediate Feedback as a Metacognitive Scaffold

ERIC Educational Resources Information Center

El Saadawi, Gilan M.; Azevedo, Roger; Castine, Melissa; Payne, Velma; Medvedeva, Olga; Tseytlin, Eugene; Legowski, Elizabeth; Jukic, Drazen; Crowley, Rebecca S.

2010-01-01

Previous studies in our laboratory have shown the benefits of immediate feedback on cognitive performance for pathology residents using an intelligent tutoring system (ITS) in pathology. In this study, we examined the effect of immediate feedback on metacognitive performance, and investigated whether other metacognitive scaffolds will support…

The Perceived Importance of Anatomy and Neuroanatomy in the Practice of Speech-Language Pathology

ERIC Educational Resources Information Center

Martin, Kate; Bessell, Nicola J.; Scholten, Ingrid

2013-01-01

The purpose of this study was to examine the application of anatomy and neuroanatomy knowledge to current practice of speech-language pathology (SLP), based on the perceptions of practicing SLPs, and to elicit information on participants' experiences of learning these subjects in their primary SLP degree with a view to inform potential…

"Coerced Loss and Ambivalent Preservation": Racial Melancholia in "American Born Chinese"

ERIC Educational Resources Information Center

Sarigianides, Sophia Tatiana

2017-01-01

Recent applications of Freud's theory examine the social value of the lost love object as a way of understanding the suffering of non-majority groups. Rather than pathologizing the individual suffering the loss, the lens of racial melancholia pathologizes the discourse that constitutes racially marked others as alien to the majority. Through a…

Spatiotemporal Analysis of High-Speed Videolaryngoscopic Imaging of Organic Pathologies in Males

ERIC Educational Resources Information Center

Bohr, Christopher; Kräck, Angelika; Dubrovskiy Denis; Eysholdt, Ulrich; Svec, Jan; Psychogios, Georgios; Ziethe, Anke; Döllinger, Michael

2014-01-01

Purpose: The aim of this study was to identify parameters that would differentiate healthy from pathological organic-based vocal fold vibrations to emphasize clinical usefulness of high-speed imaging. Method: Fifty-five men (M age = 36 years, SD = 20 years) were examined and separated into 4 groups: 1 healthy (26 individuals) and 3 pathological…

Hypochondriasis as an early manifestation of dementia with Lewy bodies: an autopsied case report.

PubMed

Fujishiro, Hiroshige; Iritani, Shuji; Sekiguchi, Hirotaka; Habuchi, Chikako; Torii, Youta; Matsunaga, Shinji; Ozaki, Norio; Yoshida, Mari; Fujita, Kiyoshi

2016-03-01

Discrepancies between clinical and pathological diagnoses of dementia with Lewy bodies (DLB) may occur because the full disease progression remains unclear, especially during the early stage. Herein, we report the case of a 78-year-old Japanese man with hypochondriasis who had autopsy-confirmed limbic-type DLB pathology. He exhibited no core clinical features of DLB. We attempted to identify the clinicopathological correlations in the early stages of DLB. At the age of 77, he became hypochondriacal and exhibited progressive cognitive decline after the death of his wife. He was concerned about his poor physical condition, but hospital examinations did not identify any overtly abnormal findings. At 78 years of age, he consulted a neurologist with complaints of facial numbness and irritability. Neurological examination revealed no overt abnormality, and he scored 21 points on the Mini-Mental State Examination. Magnetic resonance imaging of the brain showed mild bilateral ventricular enlargement. The patient was clinically diagnosed as having possible Alzheimer's disease. Approximately 1 month after his consult, he died of acute pneumonia in a psychiatric hospital to which he had been admitted for severe aggressive behaviour. He exhibited no core clinical features pointing towards a clinical diagnosis of DLB. Neuropathological investigation revealed limbic-type Lewy body disease with concurrent minimum Alzheimer-type pathology, which corresponds to high-likelihood DLB pathology based on the Third Consortium DLB pathological criteria. The patient had minimum nigral degeneration, which is consistent with the absence of parkinsonism. This autopsied case suggests that some DLB patients exhibit hypochondriasis in the early stage of the disease, even if they lack the core clinical features of DLB. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

Posterior white matter disease distribution as a predictor of amyloid angiopathy

PubMed Central

Thanprasertsuk, Sekh; Martinez-Ramirez, Sergi; Pontes-Neto, Octavio Marques; Ni, Jun; Ayres, Alison; Reed, Anne; Swords, Kyleen; Gurol, M. Edip; Greenberg, Steven M.

2014-01-01

Objectives: We sought to examine whether a posterior distribution of white matter hyperintensities (WMH) is an independent predictor of pathologically confirmed cerebral amyloid angiopathy (CAA) and whether it is associated with MRI markers of CAA, in patients without lobar intracerebral hemorrhage. Methods: We developed a quantitative method to measure anteroposterior (AP) distribution of WMH. A retrospective cohort of patients without intracerebral hemorrhage and with pathologic evaluation of CAA was examined to determine whether posterior WMH distribution was an independent predictor of CAA (n = 59). The relationship of AP distributions of WMH to strictly lobar microbleeds (MBs) (n = 259) and location of dilated perivascular spaces (DPVS) (n = 85) was examined in a separate cohort of patients evaluated in a memory clinic. Results: A more posterior WMH distribution was found to be an independent predictor of pathologic evidence of CAA (p = 0.001, odds ratio [95% confidence interval] = 1.19 [1.07–1.32]), even in the subgroup without lobar MBs (p = 0.016, odds ratio [95% confidence interval] = 1.18 [1.03–1.36]). In the memory clinic cohort, strictly lobar MBs were independently associated with more posterior WMH distribution (p = 0.009). AP distribution of WMH was also associated with location of DPVS (p = 0.001), in that patients with predominant DPVS in the white matter over the basal ganglia harbored a more posterior WMH distribution. Conclusions: Our results suggest that AP distribution of WMH may represent an additional marker of CAA, irrespective of the presence of lobar hemorrhages. Classification of evidence: This study provides Class III evidence that there is a significant association between the AP distribution of WMH on MRI with the presence of pathologically confirmed CAA pathology. PMID:25063759

Discordant correlation of breast adenoid cystic carcinoma on imaging and pathology: A case report and literature review on surgical management.

PubMed

Yan, Zhiyan; Leong, May Ying; Lim, Geok Hoon

2018-01-01

Adenoid cystic carcinomas (ACC) of the breast are extremely rare tumours, accounting for <0.1% of newly diagnosed breast cancer cases. Little data exist regarding the correlation of radiological findings with histology of this rare subtype. To our knowledge, gross size discrepancy between the 2 modalities has not been reported. We describe a case of ACC with appreciable size discordance between imaging and pathology report. A 71 years old lady presented with a painless right breast lump of a few months duration. Clinical examination revealed a 1.5 cm right breast upper outer quadrant mass. Axillary and systemic examinations were unremarkable. Mammogram showed an asymmetric density in the right upper outer quadrant which corresponded to a suspicious nodule measuring about 2 cm on the ultrasound. Ultrasound of the axilla showed an indeterminate right lymph node. Core needle biopsy of the right breast nodule showed ACC while the lymph node biopsy was non- metastatic. Staging scans did not reveal any definite distant metastasis. Her naso-endoscopy and MRI of the neck were normal. She underwent a right mastectomy and sentinel lymph node biopsy. Final histology returned as a grade II 55 mm ACC. Lympho-vascular invasion was absent. The tumour was triple negative for Estrogen receptor (ER), Progesterone receptor (PR) and Human epidermal receptor 2 (HER 2). Sentinel lymph node biopsy was negative for metastasis. She recovered well but declined adjuvant chemotherapy and radiation therapy. She is currently well 6 months post operation. ACC is an extremely rare subtype, therefore there are limited reports in literature on its imaging and pathological characteristics. Of this sparse data, there was no mention that there might be a big size discrepancy between the 2 modalities. This appreciable discrepancy has implications for pre-operative planning and the choice of breast surgery. It will be useful if the pathological extent of ACC could be determined more accurately radiologically. However, there are no distinctive imaging characteristics for ACC. ACC can appear as a smooth round mass similar to that of a benign mass or as an irregular mass on mammogram. On ultrasound, ACC often manifested as a hypo- echoic heterogeneous mass with minimal vascularity on Doppler imaging and may have an indistinct margin. MRI has a higher sensitivity than mammogram and ultrasound in determining the true extent of the tumour, but there remains little data on its usefulness in ACC. ACC can be extensively infiltrative and present much larger than its radiological size, as reported in our case. Use of better imaging modalities judiciously, in these cases, are needed to more accurately predict the true pathological size of ACC to prevent inadequate surgery. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Study of amended reports to evaluate and improve surgical pathology processes.

PubMed

Meier, Frederick A; Varney, Ruan C; Zarbo, Richard J

2011-09-01

: Amended surgical pathology reports record defects in the process of transforming tissue specimens into diagnostic information. : Systematic study of amended reports tests 2 hypotheses: (a) that tracking amendment frequencies and the distribution of amendment types reveals relevant aspects of quality in surgical pathology's daily transformation of specimens into diagnoses and (b) that such tracking measures the effect, or lack of effect, of efforts to improve surgical pathology processes. : We applied a binary definition of altered reports as either amendments or addenda and a taxonomy of defects that caused amendments as misidentifications, specimen defects, misinterpretations, and report defects. During the introduction of a LEAN process improvement approach-the Henry Ford Productions System-we followed trends in amendment rates and defect fractions to (a) evaluate specific interventions, (b) sort case-by-case root causes of misidentifications, specimen defects, and misinterpretations, and (c) audit the ongoing accuracy of the classification of changed reports. LEAN is the management and production system of the Toyota Motor Corporation that promotes continuous improvement; it considers wasted resources expended for purposes other than creating value for end customers and targets such expenditures for elimination. : Introduction of real-time editing of amendments saw annual amendment rates increase from 4.8/1000 to 10.1/1000 and then decrease in an incremental manner to 5.6/1000 as Henry Ford Productions System-specific interventions were introduced. Before introduction of HFPS interventions, about a fifth of the amendments were due to misidentifications, a 10th were due to specimen defects, a quarter due to misinterpretation, and almost half were due to report defects. During the period of the initial application of HFPS, the fraction of amendments due to misidentifications decreased as those due to report defects increased, in a statistically linked manner. As HFPS interventions took hold, misidentifications fell from 16% to 9%, specimen defect rates remained variable, ranging between 2% and 11%, and misinterpretations fell from 18% to 3%. Reciprocally, report defects rose from 64% to 83% of all amendment-causing defects. A case-by-case study of misidentifications, specimen defects, and misinterpretations found that (a) intervention at the specimen collection level had disappointingly little effect on patient misidentifications; (b) standardization of specimen accession and gross examination reduced only specimen defects surrounding ancillary testing; but (c) a double review of breast and prostate cases was associated with drastically reduced misinterpretation defects. Finally, audit of both amendments and addenda demonstrated that 10% of the so-called addenda actually qualified as amendments. : Monitored by the consistent taxonomy, rates of amended reports first rose, then fell. Examining specific defect categories provided information for evaluating specific LEAN interventions. Tracking the downward trend of amendment rates seemed to document the overall success of surgical pathology quality improvement efforts. Process improvements modestly decreased fractions of misidentifications and markedly decreased misinterpretation fractions. Classification integrity requires real time, independent editing of both amendments (changed reports) and addenda (addition to reports).

Sleep Paralysis Among Egyptian College Students: Association With Anxiety Symptoms (PTSD, Trait Anxiety, Pathological Worry).

PubMed

Jalal, Baland; Hinton, Devon E

2015-11-01

Among Egyptian college students in Cairo (n = 100), this study examined the relationship between sleep paralysis (SP) and anxiety symptoms, viz., posttraumatic stress disorder (PTSD), trait anxiety, and pathological worry. SP rates were high; 43% of participants reported at least one lifetime episode of SP, and 24% of those who reported at least one lifetime episode had experienced four or more episodes during the previous year. Fourteen percent of men had experienced SP as compared to 86% of women. As hypothesized, relative to non-SP experiencers, participants who had SP reported higher symptoms of PTSD, trait anxiety, and pathological worry. Also, as hypothesized, the experiencing of hypnogogic/hypnopompic hallucinations during SP, even after controlling for negative affect, was highly correlated with symptoms of PTSD and trait anxiety. The study also investigated possible mechanisms by examining the relationship of hallucinations to anxiety variables.

Testing Two Alternative Pathological Personality Measures in the Assessment of Psychopathy: An Examination of the Snap and DAPP-BQ.

PubMed

Pryor, Lauren R; Miller, Joshua D; Gaughan, Eric T

2009-02-01

The current study examined the interrelations between two measures of pathological personality, the Schedule for Nonadaptive and Adaptive Personality (SNAP; Clark, 1993) and the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ; Livesley, 1990), and their respective relations with psychopathy. Two hundred and twenty-nine undergraduate students completed the SNAP, DAPP-BQ, and two self-report psychopathy inventories, the Levenson Self-Report Psychopathy Scale (LSRP; Levenson, Kiehl, & Fitzpatrick, 1995) and the Psychopathic Personality Inventory-Revised (PPI-R; Lilienfeld & Widows, 2005). Results revealed good convergence between conceptually related SNAP and DAPP-BQ subscales. Both the SNAP and DAPP-BQ accounted for a substantial amount of variance in psychopathy scores although the DAPP-BQ accounted for a larger percentage of the variance and demonstrated greater incremental validity. Results suggest that both measures can be successfully used to assess traits associated with psychopathy.

The relationship between parental bonding, social problem solving and eating pathology in an anorexic inpatient sample.

PubMed

Swanson, Helen; Power, Kevin; Collin, Paula; Deas, Suzanne; Paterson, Gillian; Grierson, David; Yellowlees, Alex; Park, Katy; Taylor, Louise

2010-01-01

Parental relationships and maladaptive problem solving have been associated with anorexic symptomatology. This study investigates the relationship between perceived parental bonding, social problem solving and eating psychopathology. Forty three female inpatients with anorexia nervosa and 76 student controls were assessed using the Parental Bonding Instrument, the Social Problem Solving Inventory and the Eating Disorders Examination or the Eating Disorders Examination-Questionnaire. The anorexic group reported significantly lower levels of parental care than the student control group and used more negative and avoidance style coping. In the anorexic group, disordered eating was significantly correlated with low maternal care and high control. Maternal bonding was found to mediate the relationship between avoidance style coping and eating pathology. Findings suggest a relationship between maternal bonding, the use of maladaptive problem solving techniques and eating disorder pathology in inpatients with anorexia nervosa.

Image processing and 3D visualization in forensic pathologic examination

NASA Astrophysics Data System (ADS)

Oliver, William R.; Altschuler, Bruce R.

1996-02-01

The use of image processing is becoming increasingly important in the evaluation of violent crime. While much work has been done in the use of these techniques for forensic purposes outside of forensic pathology, its use in the pathologic examination of wounding has been limited. We are investigating the use of image processing and three-dimensional visualization in the analysis of patterned injuries and tissue damage. While image processing will never replace classical understanding and interpretation of how injuries develop and evolve, it can be a useful tool in helping an observer notice features in an image, may help provide correlation of surface to deep tissue injury, and provide a mechanism for the development of a metric for analyzing how likely it may be that a given object may have caused a given wound. We are also exploring methods of acquiring three-dimensional data for such measurements, which is the subject of a second paper.

The cause of death in smallpox: an examination of the pathology record.

PubMed

Martin, David Barrett

2002-07-01

Because the cause of death in smallpox remains controversial, the human pathology record was examined. The surviving case series of smallpox pathology in humans as well as other review articles from English language journals written during the last 200 years were reviewed. The skin lesions in smallpox developed as a result of viral damage and inflammation. Secondary bacterial infection did not occur until the scabs started shedding. During the papular stage of skin eruption, a secondary viremia caused focal lesions in the pharynx, larynx, tongue, trachea, and esophagus in descending frequency. The virus also caused potentially lethal interstitial pneumonitis as well as tubulointerstitial nephritis. The cytopathic effects of smallpox cause death. The data did not support previously promulgated theories attributing death to a bacterial sepsis syndrome seeded from the pustules or immune complex deposition. In a future outbreak, antibiotic therapy would minimally influence mortality.

CO2 surgical laser in the treatment of some types of pathology of pets

NASA Astrophysics Data System (ADS)

Serra, Christian; Pinna, Stefania; Venturini, Antonio; Rossi, Giacomo; Fortuna, Damiano

2002-10-01

We have treated with CO2 laser surgery 40 cases which contemplated: stomatitis and other oral pathologies, anorectal, cutaneous, subcutaneous lesions, and other ophthalmic ones. The parameters employed to evaluate surgical treatment success were: histological analyses, time of healing process and incidence (per cent) of relapses. During the T/3 period (45 days) all cases of feline stomatitis relapsed. The 83% of pets that suffered of anorectal pathologies healed up to 21 days and no relapse was observed in T/4 period (180 days). The cutaneous and subcutaneous nodules vaporization caused lesions that healed during 7 days (T/1) and no relapse was observed after laser treatment. In cutaneous chronic ulcers and in reptilian abscesses we had the lesions reparation by second intention healing in T/3. A case of feline oral squamocellular carcinoma relapsed in T/3 after laser treatment. The results showed three different level of utility: indispensable, useful but unnecessary, inefficacious. The CO2 laser application resulted the best treatment for anorectal pathologies, cutaneous ulcerations and reptilian abscesses. The laser surgery was only useful but unnecessary in treatment of cutaneous and subcutaneous neoformations and also in oral and peri-ophthalmic pathologies. Finally, the laser application appeared inefficacious in squamocellular carcinoma and in chronic phlogosis of feline oral cavity.

Audit of practice in sudden unexpected death in epilepsy (SUDEP) post mortems and neuropathological findings

PubMed Central

Michalak, Zuzanna; Wright, Gabriella; Dawson, Timothy; Hilton, David; Joshi, Abhijit; Diehl, Beate; Koepp, Matthias; Lhatoo, Samden; Sander, Josemir W.; Sisodiya, Sanjay M.

2015-01-01

Aims Sudden unexpected death in epilepsy (SUDEP) is one of the leading causes of death in people with epilepsy. For classification of definite SUDEP, a post mortem (PM), including anatomical and toxicological examination, is mandatory to exclude other causes of death. We audited PM practice as well as the value of brain examination in SUDEP. Methods We reviewed 145 PM reports in SUDEP cases from four UK neuropathology centres. Data were extracted for clinical epilepsy details, circumstances of death and neuropathological findings. Results Macroscopic brain abnormalities were identified in 52% of cases. Mild brain swelling was present in 28%, and microscopic pathologies relevant to cause or effect of seizures were seen in 89%. Examination based on whole fixed brains (76.6% of all PMs), and systematic regional sampling was associated with higher detection rates of underlying pathology (P < 0.01). Information was more frequently recorded regarding circumstances of death and body position/location than clinical epilepsy history and investigations. Conclusion Our findings support the contribution of examination of the whole fixed brain in SUDEP, with high rates of detection of relevant pathology. Availability of full clinical epilepsy‐related information at the time of PM could potentially further improve detection through targeted tissue sampling. Apart from confirmation of SUDEP, complete neuropathological examination contributes to evaluation of risk factors as well as helping to direct future research into underlying causes. PMID:26300477

Parasites and associated pathology observed in pinnipeds stranded along the Oregon coast.

PubMed

Stroud, R K

1978-07-01

Forty-two seals and sea lions found dead along the Oregon Coast were examined for parasites and associated pathology. Nematode infections of the lung and/or gastrointestinal tract were the primary cause of death in 5 of 42 animals examined. New distribution records were established for Pricetrema zalophi and Zalophotrema hepaticum. New host records include Z. hepaticum and Diphyllobothrium cordatum in the Steller's sea lion (Eumetopias jubatus); Nanophyetus salmincola in the California sea lion (Zalophus californianus); P. zalophi in the harbor seal (Phoca vitulina); and P. zalophi, Trigonocotyle sp. and Otostrongylus circumlitus in the northern elephant seal (Mirounga angustirostris).

[Extemporaneous examination in lung pathology: the pathologist's view].

PubMed

Molinié, V; Duchatelle, V; Abbey-Tobby, A; Balaton, A

2012-06-01

Extemporaneous examination of a thoracopulmonary lesion has an unquestionable interest when pre-surgical diagnostic workup has not allowed determining its exact nature. This examination, the sole objective of which is to guide the surgical approach, is especially important in lung pathology, due to the limited non-surgical access to thoracic lesions and the morbidity and mortality of repeated surgery. Its yield as a decision-making procedure is of utmost importance in many clinical situations, and a close collaboration between thoracic surgeons and pathologists is required to ensure its quality, in a context of mutual confidence that requires time and experience. After a presentation of the indications and practical modalities of extemporaneous examination, we will underline its limitations and insist on difficult situations for the pathologist and inadequate indications. Copyright © 2012 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Multimodal PET Imaging of Amyloid and Tau Pathology in Alzheimer Disease and Non-Alzheimer Disease Dementias.

PubMed

Xia, Chenjie; Dickerson, Bradford C

2017-07-01

Biomarkers of the molecular pathology underpinning dementia syndromes are increasingly recognized as crucial for diagnosis and development of disease-modifying treatments. Amyloid PET imaging is an integral part of the diagnostic assessment of Alzheimer disease. Its use has also deepened understanding of the role of amyloid pathology in Lewy body disorders and aging. Tau PET imaging is an imaging biomarker that will likely play an important role in the diagnosis, monitoring, and treatment in dementias. Using tau PET imaging to examine how tau pathology relates to amyloid and other markers of neurodegeneration will serve to better understand the pathophysiologic cascade that leads to dementia. Copyright © 2017 Elsevier Inc. All rights reserved.

At the centre of neuronal, synaptic and axonal pathology in murine prion disease: degeneration of neuroanatomically linked thalamic and brainstem nuclei

PubMed Central

Reis, Renata; Hennessy, Edel; Murray, Caoimhe; Griffin, Éadaoin W.

2015-01-01

Aims The processes by which neurons degenerate in chronic neurodegenerative diseases remain unclear. Synaptic loss and axonal pathology frequently precede neuronal loss and protein aggregation demonstrably spreads along neuroanatomical pathways in many neurodegenerative diseases. The spread of neuronal pathology is less studied. Methods We previously demonstrated severe neurodegeneration in the posterior thalamus of multiple prion disease strains. Here we used the ME7 model of prion disease to examine the nature of this degeneration in the posterior thalamus and the major brainstem projections into this region. Results We objectively quantified neurological decline between 16 and 18 weeks post‐inoculation and observed thalamic subregion‐selective neuronal, synaptic and axonal pathology while demonstrating relatively uniform protease‐resistant prion protein (PrP) aggregation and microgliosis across the posterior thalamus. Novel amyloid precursor protein (APP) pathology was particularly prominent in the thalamic posterior (PO) and ventroposterior lateral (VPL) nuclei. The brainstem nuclei forming the major projections to these thalamic nuclei were examined. Massive neuronal loss in the PO was not matched by significant neuronal loss in the interpolaris (Sp5I), while massive synaptic loss in the ventral posteromedial nucleus (VPM) did correspond with significant neuronal loss in the principal trigeminal nucleus. Likewise, significant VPL synaptic loss was matched by significant neuronal loss in the gracile and cuneate nuclei. Conclusion These findings demonstrate significant spread of neuronal pathology from the thalamus to the brainstem in prion disease. The divergent neuropathological features in adjacent neuronal populations demonstrates that there are discrete pathways to neurodegeneration in different neuronal populations. PMID:25727649

Late-life depression is not associated with dementia-related pathology.

PubMed

Wilson, Robert S; Boyle, Patricia A; Capuano, Ana W; Shah, Raj C; Hoganson, George M; Nag, Sukriti; Bennett, David A

2016-02-01

To test the hypothesis that late-life depression is associated with dementia-related pathology. Older participants (n = 1,965) in 3 longitudinal clinical-pathologic cohort studies who had no cognitive impairment at baseline underwent annual clinical evaluations for a mean of 8.0 years (SD = 5.0). The authors defined depression diagnostically, as major depression during the study period, and psychometrically, as elevated depressive symptoms during the study period, and established their relation to cognitive outcomes (incident dementia, rate of cognitive decline). A total of 657 participants died and underwent a uniform neuropathologic examination. The authors estimated the association of depression with 6 dementia-related markers (tau tangles, beta-amyloid plaques, Lewy bodies, hippocampal sclerosis, gross and microscopic infarcts) in logistic regression models. In the full cohort, 9.4% were diagnosed with major depression and 8.6% had chronically elevated depressive symptoms, both of which were related to adverse cognitive outcomes. In the 657 persons who died and had a neuropathologic examination, higher beta-amyloid plaque burden was associated with higher likelihood of major depression (present in 11.0%; OR = 1.392, 95% CI = 1.088, 1.780) but not with elevated depressive symptoms (present in 11.3%; OR = 0.919, 95% CI = 0.726, 1.165). None of the other pathologic markers was related to either of the depression measures. Neither dementia nor antidepressant medication modified the relation of pathology to depression. The results do not support the hypothesis that major depression is associated with dementia-related pathology. PsycINFO Database Record (c) 2016 APA, all rights reserved.

Late-Life Depression is Not Associated with Dementia Related Pathology

PubMed Central

Wilson, Robert S.; Boyle, Patricia A.; Capuano, Ana W.; Shah, Raj C.; Hoganson, George M.; Nag, Sukriti; Bennett, David A.

2015-01-01

Objective To test the hypothesis that late-life depression is associated with dementia related pathology. Method Older participants (n=1,965) in 3 longitudinal clinical-pathologic cohort studies who had no cognitive impairment at baseline underwent annual clinical evaluations for a mean of 8.0 years (SD = 5.0). We defined depression diagnostically, as major depression during the study period, and psychometrically, as elevated depressive symptoms during the study period, and established their relation to cognitive outcomes (incident dementia, rate of cognitive decline). A total of 657 participants died and underwent a uniform neuropathologic examination. We estimated the association of depression with 6 dementia related markers (tau tangles, beta-amyloid plaques, Lewy bodies, hippocampal sclerosis, gross and microscopic infarcts) in logistic regression models. Results In the full cohort, 9.4% were diagnosed with major depression and 8.6% had chronically elevated depressive symptoms, both of which were related to adverse cognitive outcomes. In the 657 persons who died and had a neuropathologic examination, higher beta-amyloid plaque burden was associated with higher likelihood of major depression (present in 11.0%; odds ratio = 1.392, 95% confidence interval = 1.088, 1.780) but not with elevated depressive symptoms (present in 11.3%; odds ratio = 0.919, 95% confidence interval = 0.726, 1.165). None of the other pathologic markers was related to either of the depression measures. Neither dementia nor antidepressant medication modified the relation of pathology to depression. Conclusion The results do not support the hypothesis that major depression is associated with dementia related pathology. PMID:26237627

Analysis of Radiation Effects in Digital Subtraction Angiography of Intracranial Artery Stenosis.

PubMed

Guo, Chaoqun; Shi, Xiaolei; Ding, Xianhui; Zhou, Zhiming

2018-04-21

Intracranial artery stenosis (IAS) is the most common cause for acute cerebral accidents. Digital subtraction angiography (DSA) is the gold standard to detect IAS and usually brings excess radiation exposure to examinees and examiners. The artery pathology might influence the interventional procedure, causing prolonged radiation effects. However, no studies on the association between IAS pathology and operational parameters are available. A retrospective analysis was conducted on 93 patients with first-ever stroke/transient ischemic attack, who received DSA examination within 3 months from onset in this single center. Comparison of baseline characteristics was determined by 2-tailed Student's t-test or the chi-square test between subjects with and without IAS. A binary logistic regression analysis was performed to determine the association between IAS pathology and the items with a P value <0.05 in Student's t-test or chi-square test. There were 93 candidates (42 with IAS and 51 without IAS) in this study. The 2 groups shared no significance of the baseline characteristics (P > 0.05). We found a significantly higher total time, higher kerma area product, greater total dose, and greater DSA dose in the IAS group than in those without IAS (P < 0.05). A binary logistic regression analysis indicated the significant association between total time and IAS pathology (P < 0.05) but no significance in kerma area product, radiation dose, and DSA dose (P > 0.05). IAS pathology would indicate a prolonged total time of DSA procedure in clinical practice. However, the radiation effects would not change with pathologic changes. Copyright © 2018 Elsevier Inc. All rights reserved.

[Pathologic conditions in pregnancy. Preliminary evaluation of the effectiveness of magnetic resonance].

PubMed

Beomonte Zobel, B; Tella, S; Innacoli, M; D'Archivio, C; Cardone, G; Masciocchi, C; Gallucci, M; Cappa, F; Passariello, R

1991-03-01

Some authors suggested that MR imaging could represent an effective diagnostic alternative in the study of pathologic conditions of mother and fetus during pregnancy. To verify the actual role of MR imaging, we examined 20 patients in the 2nd and 3rd trimester of gestation, after a preliminary US examination. Fifteen patients presented fetal or placental pathologies; in 4 patients the onset of the pathologic condition occurred during pregnancy; in 1 case of US diagnosis of fetal ascites, MR findings were normal and the newborn was healthy. As for placental pathologies, our series included a case of placental cyst, two hematomas between placenta and uterine wall, and two cases of partial placenta previa. As for fetal malformations, we evaluated a case of omphalocele, one of Prune-Belly syndrome, a case of femoral asymmetry, one of thanatophoric dwarfism, a case of thoracopagus twins with cardiovascular abnormalities, two fetal hydrocephali, and three cases of pyelo-ureteral stenosis. As for maternal pathologies during pregnancy, we observed a case of subserous uterine fibromyoma, one of right hydronephrosis, one of protrusion of lumbar intervertebral disk, and a large ovarian cyst. In our experience, MR imaging exhibited high sensitivity and a large field of view, which were both useful in the investigation of the different conditions occurring during pregnancy. In the evaluation of fetal and placental abnormalities, especially during the 3rd trimester, the diagnostic yield of MR imaging suggested it as a complementary technique to US for the evaluation of fetal malformations and of intrauterine growth retardation.

Rumination mediates the relationship between peer alienation and eating pathology in young adolescent girls.

PubMed

Hilt, Lori M; Roberto, Christina A; Nolen-Hoeksema, Susan

2013-09-01

This study examined whether rumination, the tendency to passively and repeatedly dwell on negative events, mediated the relationship between peer alienation and eating disorder symptoms among adolescent girls. Participants included 101 girls (ages 10-14; 47% Hispanic, 24% African American) who completed questionnaires regarding peer relationships, symptoms of eating pathology, rumination, and depressive symptoms. Girls who reported experiencing more peer alienation reported a higher degree of pathological eating symptoms. The relationship between peer alienation and eating pathology was mediated by rumination, even after controlling for depressive symptoms. This study extends previous work indicating that rumination is a cognitive mechanism that may contribute to the development and/or maintenance of eating pathology. The findings suggest that adolescents who feel alienated by their peers might be particularly susceptible to engaging in ruminative thinking that can lead to or exacerbate eating problems.

Lipids, adiposity and tendinopathy: is there a mechanistic link? Critical review

PubMed Central

Scott, Alex; Zwerver, Johannes; Grewal, Navi; de Sa, Agnetha; Alktebi, Thuraya; Granville, David J; Hart, David A

2015-01-01

Being overweight or obese is associated with an elevated risk of tendon pathology. However, for sportspeople the epidemiological data linking weight or adiposity on one hand, and risk of tendon pathology on the other, are less consistent. Indeed, the mechanistic links between diet, adiposity and tendon pathology remain largely unexamined. Recent studies have begun to examine the effects of dietary interventions on outcomes such as tendon biomechanics or pain. Oxidised low-density lipoprotein has been shown to (A) accumulate in the tendon tissues of mice that eat a fatty diet and (B) induce a pathological phenotype in human tendon cells. This paper addresses the current debate: is excessive body mass index (causing increased load and strain on tendon tissue) per se the underlying mechanism? Or do local or systemic influences of fat on tendons predispose to tendon pathology? This narrative review argues that excessive blood lipids may be an important avenue for clinical investigations. PMID:25488953

The incidence of pathological gambling among Native Americans treated for alcohol dependence.

PubMed

Elia, C; Jacobs, D F

1993-05-01

The prevalence rate of potential and pathological gambling was examined among Native American and Caucasian patients (n = 85) being treated for alcohol dependence. Previous studies with alcohol-dependent (mainly Caucasian) populations revealed 10-15% to have gambling problems. This study, the first to measure pathological gambling among a Native American population, utilized the South Oaks Gambling Screen and was administered in a group setting, between 1/91 and 4/91 on the alcohol treatment ward of the Ft. Meade Veterans Administration Hospital. Results showed that 22% of the Native Americans studied (compared to 7.3% Caucasian), scored in a range indicating a probable pathological gambling addiction. Furthermore, 41% of the Native Americans studied (compared to 21.3% Caucasian) admitted to some difficulty with gambling. Education and treatment is encouraged to help stem projected radical increases in pathological gambling and related problems among this cultural group as Native American gambling becomes widespread.

Pathological narcissism and maladaptive self-regulatory behaviours in a nationally representative sample of Canadian men.

PubMed

Kealy, David; Ogrodniczuk, John S; Rice, Simon M; Oliffe, John L

2017-10-01

Clinical observation has linked externalizing coping strategies such as substance overuse and aggressive behaviours with narcissistic personality dysfunction. This study examined the relationship between pathological narcissism and maladaptive self-regulatory behaviours among Canadian men. An online survey was distributed among a stratified, nationally representative sample of 1000 men from across Canada. The survey included brief self-report measures of pathological narcissism, maladaptive externalizing coping behaviours, and general psychological distress. After controlling for the effects of age and general psychological distress, pathological narcissism was found to be significantly associated with alcohol overuse and aggressive behaviour. Significant though modest interaction effects were found between pathological narcissism and age - with regards to drug use - and distress - with regards to risk-taking behaviour. The findings point to the need for attention to narcissistic dysfunction as a clinical and public health issue among men. Copyright © 2017 Elsevier B.V. All rights reserved.

10-Minute Delayed Recall from the Modified Mini-Mental State Test Predicts Alzheimer’s Disease Pathology

PubMed Central

Lyness, Scott A.; Lee, Ae Young; Zarow, Chris; Teng, Evelyn L.; Chui, Helena C.

2014-01-01

We compared the sensitivity and specificity of two delayed recall scores from the Modified Mini-Mental State (3MS) test with consensus clinical diagnosis to differentiate cognitive impairment due to Alzheimer’s disease (AD) versus non-AD pathologies. At a memory disorders clinic, 117 cognitively impaired patients were administered a baseline 3MS test and received a contemporaneous consensus clinical diagnosis. Their brains were examined after death about 5 years later. Using logistic regression with forward selection to predict pathologically defined AD versus non-AD, 10-min delayed recall entered first (p = 0.001), followed by clinical diagnosis (p = 0.02); 1-min delayed recall did not enter. 10-min delayed recall scores ≤4 (score range = 0–9) were 87% sensitive and 47% specific in predicting AD pathology; consensus clinical diagnosis was 82% sensitive and 45% specific. For the 57 patients whose initial Mini-Mental State Examination scores were ≥19 (the median), 3MS 10-min delayed recall scores ≤4 showed some loss of sensitivity (80%) but a substantial gain in specificity (77%). In conclusion, 10-min delayed recall score on the brief 3MS test distinguished between AD versus non-AD pathology about 5 years before death at least as well as consensus clinical diagnosis that requires much more comprehensive information and complex deliberation. PMID:24240637

Interinstitutional review of slides for forensic pathology: types of inconsistencies.

PubMed

Ersoy, Gokhan; Akyildiz, Elif Ulker; Korkmaz, Gulay; Albek, Emre

2010-09-01

Because of the specific structure of forensic medicine in Turkey, reexamination of histopathologic specimens is a frequent practice. The aim of the present study is the assessment of microscopic diagnostic consistency in forensic pathology between different laboratories. Reports of the Council of Forensic Medicine between 2001 and 2004 were examined, and 150 cases with second pathologic examination were found. Results of histopathologic reports from peripheral laboratories were compared with those made by the Council pathologists with regard to diagnostic consistency. Consistency was assessed in 3 groups and 1 subgroup. Group 1, consistent and minor inconsistency; includes a major consistency subgroup. Group 2, major inconsistency, is the second diagnosis which is lethal; group 3, major inconsistency, is the first diagnosis which is lethal. The lung was found to be the organ with the highest frequency of diagnostic major inconsistency (group 2 and 3) and major consistency. Bronchopneumonia was the most common diagnosis. The brain had the highest frequency of intercenter diagnostic overall consistency (90.2%, group 1). Myocardial infarction was the diagnosis most frequently rejected on reevaluation (group 3). In conclusion, forensic pathology requires different experience than surgical ones. In cases of discrepancy between the anamnesis of the lethal event and pathologic findings, reevaluation of specimen is mandatory to avoid any diagnostic errors. Quality assurance systems with all include internal and external control mechanisms will improve the diagnostic reliability.

10-minute delayed recall from the modified mini-mental state test predicts Alzheimer's disease pathology.

PubMed

Lyness, Scott A; Lee, Ae Young; Zarow, Chris; Teng, Evelyn L; Chui, Helena C

2014-01-01

We compared the sensitivity and specificity of two delayed recall scores from the Modified Mini-Mental State (3MS) test with consensus clinical diagnosis to differentiate cognitive impairment due to Alzheimer's disease (AD) versus non-AD pathologies. At a memory disorders clinic, 117 cognitively impaired patients were administered a baseline 3MS test and received a contemporaneous consensus clinical diagnosis. Their brains were examined after death about 5 years later. Using logistic regression with forward selection to predict pathologically defined AD versus non-AD, 10-min delayed recall entered first (p = 0.001), followed by clinical diagnosis (p = 0.02); 1-min delayed recall did not enter. 10-min delayed recall scores ≤4 (score range = 0-9) were 87% sensitive and 47% specific in predicting AD pathology; consensus clinical diagnosis was 82% sensitive and 45% specific. For the 57 patients whose initial Mini-Mental State Examination scores were ≥19 (the median), 3MS 10-min delayed recall scores ≤4 showed some loss of sensitivity (80%) but a substantial gain in specificity (77%). In conclusion, 10-min delayed recall score on the brief 3MS test distinguished between AD versus non-AD pathology about 5 years before death at least as well as consensus clinical diagnosis that requires much more comprehensive information and complex deliberation.

Clinicopathological and molecular stability and methylation analyses of gastric papillary adenocarcinoma.

PubMed

Uesugi, Noriyuki; Sugai, Tamotsu; Sugimoto, Ryo; Eizuka, Makoto; Fujita, Yasuko; Sato, Ayaka; Osakabe, Mitsumasa; Ishida, Kazuyuki; Koeda, Keisuke; Sasaki, Akira; Matsumoto, Takayuki

2017-10-01

The molecular alterations and pathological features of gastric papillary adenocarcinoma (GPA) remain unknown. We examined GPA samples and compared their molecular and pathological characteristics with those of gastric tubular adenocarcinoma (GTA). Additionally, we identified pathological and molecular features of GPA that vary with microsatellite stability. In the present study, samples from 63 GPA patients and 47 GTA patients were examined using a combination of polymerase chain reaction (PCR)-microsatellite assays and PCR-pyrosequencing in order to detect microsatellite instability (microsatellite instability, MSI; microsatellite stable, MSS), methylation status (low methylation, intermediate methylation and high methylation level), and chromosomal AI in multiple cancer-related loci. Additionally, the expression levels of TP53 and Her2 were evaluated using immunohistochemistry. GTA and GPA are statistically different in their frequency of pathological features, including mucinous, poorly differentiated and invasive micropapillary components. Clear genetic patterns differentiating GPA and GTA could not be identified with a hierarchical cluster analysis, but microsatellite stability was linked with TP53 and Her2 overexpression. Methylation status in GPA was also associated with the development of high microsatellite instability. However, no pathological differences were associated with microsatellite stability. We suggest that although molecular alterations in a subset of GPAs are closely associated with microsatellite stability, they play a minor role in GPA carcinogenesis. Copyright © 2017 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.

Low Reporting Quality of the Meta-Analyses in Diagnostic Pathology.

PubMed

Liu, Xulei; Kinzler, Michael; Yuan, Jiangfan; He, Guozhong; Zhang, Lanjing

2017-03-01

- Little is known regarding the reporting quality of meta-analyses in diagnostic pathology. - To compare reporting quality of meta-analyses in diagnostic pathology and medicine and to examine factors associated with reporting quality of diagnostic pathology meta-analyses. - Meta-analyses were identified in 12 major diagnostic pathology journals without specifying years and 4 major medicine journals in 2006 and 2011 using PubMed. Reporting quality of meta-analyses was evaluated using the 27-item checklist of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement published in 2009. A higher PRISMA score indicates higher reporting quality. - Forty-one diagnostic pathology meta-analyses and 118 medicine meta-analyses were included. Overall, reporting quality of meta-analyses in diagnostic pathology was lower than that in medicine (median [interquartile range] = 22 [15, 25] versus 27 [23, 28], P < .001). Compared with medicine meta-analyses, diagnostic pathology meta-analyses less likely reported 23 of the 27 items (85.2%) on the PRISMA checklist, but more likely reported the data items. Higher reporting quality of diagnostic pathology meta-analyses was associated with recent publication years (later than 2009 versus 2009 or earlier, P = .002) and non-North American first authors (versus North American, P = .001), but not journal publisher's location (P = .11). Interestingly, reporting quality was not associated with adjusted citation ratio for meta-analyses in either diagnostic pathology or medicine (P = .40 and P = .09, respectively). - Meta-analyses in diagnostic pathology had lower reporting quality than those in medicine. Reporting quality of diagnostic pathology meta-analyses is linked to publication year and first author's location, but not to journal publisher's location or article's adjusted citation ratios. More research and education on meta-analysis methodology may improve the reporting quality of diagnostic pathology meta-analyses.

Ultrasonography of uterine leiomyomas

PubMed Central

Woźniak, Andrzej

2017-01-01

Uterine leiomyomas or uterine fibroids are the most common gynaecological tumours and occur in about 20-50% of women around the world. Ultrasonography (USG) is the first-line imaging examination in suspected fibroids and shows high sensitivity and specificity in diagnosing this condition. Ultrasound scans can be performed transvaginally (transvaginal scan – TVS) or transabdominally (transabdominal scan – TAS); both scans have advantages and limitations, but, in general, transvaginal sonography is superior to transabdominal sonography in most cases of pelvic pathology. Whether a leiomyoma is symptomatic or not depends primarily on its size and location. During ultrasound examination, leiomyomas usually appear as well-defined, solid, concentric, hypoechoic masses that cause a variable amount of acoustic shadowing. During the examination of leiomyomas differential diagnosis is important. Some of the most common misdiagnosed pathologies are adenomyosis, solid tumours of adnexa, and endometrial polyps. Misdiagnosis of a leiomyosarcoma has the most negative consequences, presenting symptoms are very similar to benign leiomyoma, and there is no pelvic imaging technique that can reliably differentiate between those pathologies. Magnetic resonance and computer tomography might be helpful in the diagnostics of uterine leiomyoma; however, ultrasound examination is the basic imaging test confirming the existence of leiomyomas, allowing the differentiation of myomas with adenomyosis, endometrial polyps, ovarian tumours, and pregnant uterus. PMID:29483851

[Physiology and pathology of reproduction in domesticated New World camelids with special emphasis on ultrasonography].

PubMed

Hoops, M; Kauffold, J

2013-01-01

The number of New World camelids in Germany is increasing. Owners and breeders are usually well educated regarding their animals. For practitioners, this means being up-to-date with respect to their veterinary knowledge. This includes the physiology and pathology of reproduction. Specifics of reproduction in domesticated New World camelids are an induced ovulation, the absence of cyclic sexual activity, a relatively long gestation of 336-349 days and a predominantly left-horn gestation. Ultrasonography plays an important role as part of the gynecological examination. Generally, the ultrasonographic examination can be performed transrectally and transcutaneously in the left or right flanks. Transrectal ultrasonography has to be carried out with particular caution to avoid rectal injuries. An accurate pregnancy diagnosis by transrectal scanning is possible starting from day 20 of pregnancy; using transcutaneous scanning, diagnosis is accurate starting on days 50-60 (left flank) or from day 90 (right flank) of pregnancy, respectively. Ultrasonography is also appropriate to examine the non-gravid uterus and the ovaries. Based on 5 years of experience working with farmed New World camelids, the article describes the physiology and pathology of reproduction in domesticated New World camelids. Particular consideration is given to the ultrasonographical examination of the genital organs.

An industry perspective: An update on the adoption of whole slide imaging.

PubMed

Montalto, Michael C

2016-01-01

This manuscript is an adaptation of the closing keynote presentation of the Digital Pathology Association Pathology Visions Conference 2015 in Boston, MA, USA. In this presentation, analogies are drawn between the adoption of whole slide imaging (WSI) and other mainstream digital technologies, including digital music and books. In doing so, it is revealed that the adoption of seemingly similar digital technologies does not follow the same adoption profiles and that understanding the unique aspects of value for each customer segment is critical. Finally, a call to action is given to academia and industry to study the value that WSI brings to the global healthcare community.

[Effect of tobacco smoking on skin and mucosa appearance, ageing and pathological conditions].

PubMed

Czogała, Jan; Goniewicz, Maciej Ł; Czubek, Agnieszka; Gołabek, Karolina; Sobczak, Andrzej

2008-01-01

Tobacco smoking is considered to be one of the main factors that negatively affect the skin, mucous membranes and teeth, i.e. the body parts that decide on the so called 'healthy look' and 'attraction'. This paper is a review of literature on the subject of harmful and pathological influence of tobacco smoking on the skin and the immunological system. Furthermore, the paper described such smoking results as wrinkle development, skin elasticity and thickness loss, as well as a decreased ability of tissues to regenerate. Finally, the authors discussed various diseases connected with tobacco use: changes in the skin, teeth and mucous membranes, and cancerous lesions.

Illuminating Neural Circuits: From Molecules to MRI.

PubMed

Lee, Jin Hyung; Kreitzer, Anatol C; Singer, Annabelle C; Schiff, Nicholas D

2017-11-08

Neurological disease drives symptoms through pathological changes to circuit functions. Therefore, understanding circuit mechanisms that drive behavioral dysfunction is of critical importance for quantitative diagnosis and systematic treatment of neurological disease. Here, we describe key technologies that enable measurement and manipulation of neural activity and neural circuits. Applying these approaches led to the discovery of circuit mechanisms underlying pathological motor behavior, arousal regulation, and protein accumulation. Finally, we discuss how optogenetic functional magnetic resonance imaging reveals global scale circuit mechanisms, and how circuit manipulations could lead to new treatments of neurological diseases. Copyright © 2017 the authors 0270-6474/17/3710817-09$15.00/0.

[Corneal manifestations in systemic diseases].

PubMed

Zarranz Ventura, J; De Nova, E; Moreno-Montañés, J

2008-01-01

Systemic diseases affecting the cornea have a wide range of manifestations. The detailed study of all pathologies that cause corneal alteration is unapproachable, so we have centered our interest in the most prevalent or characteristic of them. In this paper we have divided these pathologies in sections to facilitate their study. Pulmonar and conective tissue (like colagen, rheumatologic and idiopathic inflamatory diseases), dermatologic, cardiovascular, hematologic, digestive and hepatopancreatic diseases with corneal alteration are described. Endocrine and metabolic diseases, malnutrition and carential states are also studied, as well as some otorhinolaryngologic and genetic diseases that affect the cornea. Finally, a brief report of ocular toxicity induced by drugs is referred.

Development and evaluation of an open source software tool for deidentification of pathology reports

PubMed Central

Beckwith, Bruce A; Mahaadevan, Rajeshwarri; Balis, Ulysses J; Kuo, Frank

2006-01-01

Background Electronic medical records, including pathology reports, are often used for research purposes. Currently, there are few programs freely available to remove identifiers while leaving the remainder of the pathology report text intact. Our goal was to produce an open source, Health Insurance Portability and Accountability Act (HIPAA) compliant, deidentification tool tailored for pathology reports. We designed a three-step process for removing potential identifiers. The first step is to look for identifiers known to be associated with the patient, such as name, medical record number, pathology accession number, etc. Next, a series of pattern matches look for predictable patterns likely to represent identifying data; such as dates, accession numbers and addresses as well as patient, institution and physician names. Finally, individual words are compared with a database of proper names and geographic locations. Pathology reports from three institutions were used to design and test the algorithms. The software was improved iteratively on training sets until it exhibited good performance. 1800 new pathology reports were then processed. Each report was reviewed manually before and after deidentification to catalog all identifiers and note those that were not removed. Results 1254 (69.7 %) of 1800 pathology reports contained identifiers in the body of the report. 3439 (98.3%) of 3499 unique identifiers in the test set were removed. Only 19 HIPAA-specified identifiers (mainly consult accession numbers and misspelled names) were missed. Of 41 non-HIPAA identifiers missed, the majority were partial institutional addresses and ages. Outside consultation case reports typically contain numerous identifiers and were the most challenging to deidentify comprehensively. There was variation in performance among reports from the three institutions, highlighting the need for site-specific customization, which is easily accomplished with our tool. Conclusion We have demonstrated that it is possible to create an open-source deidentification program which performs well on free-text pathology reports. PMID:16515714

Policies and Practices regarding Students with Accents in Speech-Language Pathology Training Programs

ERIC Educational Resources Information Center

Levy, Erika S.; Crowley, Catherine J.

2012-01-01

Speech-language pathology (SLP) training programs are the initial gateway for nonnative speakers of English to join the SLP profession. An anonymous web-based survey in New York State examined policies and practices implemented when SLP students have foreign accents in English or in other languages. Responses were elicited from 530 students and 28…

Linking Gambling and Trauma: A Phenomenological Hermeneutic Case Study Using Almaas' Transformation of Narcissism Approach

ERIC Educational Resources Information Center

Nixon, Gary; Solowoniuk, Jason; Boni, Lauren Julia; Kalischuk, Ruth Grant

2013-01-01

The purpose of this article is to examine the phenomenon of pathological gambling and addiction from the perspective of writer and teacher A.H Almaas. By drawing on his Diamond Mind approach we trace the origin of addictive behaviors and pathological gambling to narcissistic wounding, which constitutes the loss of connection with the Essential…

The Parent-Child Relationship as Predictor of Eating Pathology and Weight Gain in Preadolescents

ERIC Educational Resources Information Center

Goossens, Lien; Braet, Caroline; Van Durme, Kim; Decaluwe, Veerle; Bosmans, Guy

2012-01-01

The present study examined the role of attachment toward mother and father as a predictor of eating pathology and weight gain among preadolescent boys and girls. Self-report questionnaires and adjusted body mass index (BMI) were administered from a community sample of 601 preadolescents (8-11 years; 48% female) at baseline and once again 1 year…

Feasibility of intraoperative imaging during Mohs surgery with reflectance confocal microscopy

NASA Astrophysics Data System (ADS)

Flores, Eileen S.; Cordova, Miguel; Kose, Kivanc; Phillips, William; Nehal, Kishwer; Rajadhyaksha, Milind

2014-03-01

Mohs surgery for the removal of non-melanoma skin cancers (NMSCs) is performed in stages, while being guided by the examination for residual tumor with frozen pathology. However, preparation of frozen pathology at each stage is timeconsuming and labor-intensive. Real-time intraoperative reflectance confocal microscopy (RCM) may enable rapid detection of residual tumor directly in surgical wounds on patients. We report initial feasibility on twenty-one patients, using 35% AlCl3 for nuclear contrast. Imaging was performed in quadrants in the wound, to simulate the Mohs surgeon's examination of pathology. Images and videos of the epidermal and dermal margins were found to be of clinically acceptable quality. Bright nuclear morphology was identified at the epidermal margin. The presence of residual BCC/SCC tumor and normal skin features could be detected in the peripheral and deep dermal margins. Nuclear morphology was detectable in residual BCC/SCC tumors. Intraoperative RCM imaging may enable detection of residual tumor, directly on Mohs patients, and may serve as an adjunct for frozen pathology. However, a stronger source of contrast will be necessary, and also a smaller device with an automated approach for imaging in the entire wound in a rapid and controlled manner for clinical utility.

DSM-5 Pathological Personality Traits and Intimate Partner Violence Among Male and Female College Students.

PubMed

Dowgwillo, Emily A; Ménard, Kim S; Krueger, Robert F; Pincus, Aaron L

2016-01-01

The purpose of this study was to examine associations between pathological personality traits identified in the Diagnostic and Statistical Manual of Mental Disorders (5th ed., DSM-5) Section III alternative model of personality disorder (using the Personality Inventory for DSM-5; PID-5) and intimate partner violence (IPV; using the Conflict Tactics Scale [CTS]) in a sample of male (N = 1,106) and female (N = 1,338) college students. In this sample, self and partner perpetration of CTS Relationship Violence and CTS Negotiation tactics loaded onto 2 separate factors. The PID-5 facets and domains were differentially associated with these factors for both men and women. Facets and domains explained 10.1%-16.1% and 5.8%-10.6% of the variance in CTS Relationship Violence tactics, respectively. For both genders, detachment was positively associated with relationship violence. Antagonism was uniquely associated with relationship violence for women, whereas disinhibition was uniquely associated with relationship violence for men. Associations with lower level pathological personality facets were also examined. Overall, results indicate that DSM-5 pathological personality traits are associated with IPV reported by both men and women.

CUBIC pathology: three-dimensional imaging for pathological diagnosis.

PubMed

Nojima, Satoshi; Susaki, Etsuo A; Yoshida, Kyotaro; Takemoto, Hiroyoshi; Tsujimura, Naoto; Iijima, Shohei; Takachi, Ko; Nakahara, Yujiro; Tahara, Shinichiro; Ohshima, Kenji; Kurashige, Masako; Hori, Yumiko; Wada, Naoki; Ikeda, Jun-Ichiro; Kumanogoh, Atsushi; Morii, Eiichi; Ueda, Hiroki R

2017-08-24

The examination of hematoxylin and eosin (H&E)-stained tissues on glass slides by conventional light microscopy is the foundation for histopathological diagnosis. However, this conventional method has some limitations in x-y axes due to its relatively narrow range of observation area and in z-axis due to its two-dimensionality. In this study, we applied a CUBIC pipeline, which is the most powerful tissue-clearing and three-dimensional (3D)-imaging technique, to clinical pathology. CUBIC was applicable to 3D imaging of both normal and abnormal patient-derived, human lung and lymph node tissues. Notably, the combination of deparaffinization and CUBIC enabled 3D imaging of specimens derived from paraffin-embedded tissue blocks, allowing quantitative evaluation of nuclear and structural atypia of an archival malignant lymphoma tissue. Furthermore, to examine whether CUBIC can be applied to practical use in pathological diagnosis, we performed a histopathological screening of a lymph node metastasis based on CUBIC, which successfully improved the sensitivity in detecting minor metastatic carcinoma nodules in lymph nodes. Collectively, our results indicate that CUBIC significantly contributes to retrospective and prospective clinicopathological diagnosis, which might lead to the establishment of a novel field of medical science based on 3D histopathology.

How Does Psychosocial Behavior Contribute to Cognitive Health in Old Age?

PubMed Central

Wilson, Robert S.; Bennett, David A.

2017-01-01

With the aging of the U.S. population, the number of cognitively disabled persons is expected to substantially increase in coming decades, underscoring the urgent need for effective interventions. Here, we review the current evidence linking psychosocial factors to late-life cognitive loss and consider the study design needed to illuminate the biologic bases of the associations. We then examine an ongoing study that includes several of the key design elements, the Rush Memory and Aging Project. In this longitudinal clinical-pathological cohort study, indicators of personality, social connectedness, and psychological well-being were shown to predict late-life cognitive outcomes. Participants who died underwent a uniform neuropathologic examination to quantify common dementia-related pathologies. Some psychosocial indicators were associated with cerebral infarction; some indicators modified the association of neurodegenerative pathologies with cognitive loss; and the association of some indicators with cognitive outcomes appears to be independent of the pathologies traditionally associated with late-life dementia. These findings suggest that psychosocial behavior influences late-life cognitive health through multiple neurobiologic mechanisms. A better understanding of these mechanisms may lead to novel strategies for preserving cognitive health in old age. PMID:28545247

[The impact of technology in Pathological Anatomy and the contribution of this speciality to technological development].

PubMed

Puras-Gil, A M; López-Cousillas, A

1999-01-01

It is obvious that technology has contributed throughout history to the development of the different sciences. In this article, we define the concept of Pathology as a medical speciality, and we explain its influence in a hospital, considering very different fields such as education, research, quality control, hospital information, and patient care. This speciality has undergone a considerable evolution, to which technological innovation has undoubtedly contributed. As a basic discipline, it is of great importance in pre and post-graduate training, in the medical education at the hospital or outside it, and in the fields previously mentioned. Its relation with other disciplines such us Chemistry, (fixation and dyeing), Physics (mechanical devices), Mathematics (algorithms, morphometry, statistics...) and Telecommunications (telepathology, image analysis...) is examined and their contribution to Pathology is evaluated. We are also aware of contributions made by Pathology to technological innovation in the evaluation of different diagnostic methods or in the recent therapeutic technologies based on Radiotherapy, Hyperthermia, laser, prothesis, etc.; where histological examination provides accurate information about the therapeutic capacity or side-effects, or the rejection reactions caused, aiding the research to obtain adequate results.

Panning artifacts in digital pathology images

NASA Astrophysics Data System (ADS)

Avanaki, Ali R. N.; Lanciault, Christian; Espig, Kathryn S.; Xthona, Albert; Kimpe, Tom R. L.

2017-03-01

In making a pathologic diagnosis, a pathologist uses cognitive processes: perception, attention, memory, and search (Pena and Andrade-Filho, 2009). Typically, this involves focus while panning from one region of a slide to another, using either a microscope in a traditional workflow or software program and display in a digital pathology workflow (DICOM Standard Committee, 2010). We theorize that during panning operation, the pathologist receives information important to diagnosis efficiency and/or correctness. As compared to an optical microscope, panning in a digital pathology image involves some visual artifacts due to the following: (i) the frame rate is finite; (ii) time varying visual signals are reconstructed using imperfect zero-order hold. Specifically, after pixel's digital drive is changed, it takes time for a pixel to emit the expected amount of light. Previous work suggests that 49% of navigation is conducted in low-power/overview with digital pathology (Molin et al., 2015), but the influence of display factors has not been measured. We conducted a reader study to establish a relationship between display frame rate, panel response time, and threshold panning speed (above which the artifacts become noticeable). Our results suggest visual tasks that involve tissue structure are more impacted by the simulated panning artifacts than those that only involve color (e.g., staining intensity estimation), and that the panning artifacts versus normalized panning speed has a peak behavior which is surprising and may change for a diagnostic task. This is work in progress and our final findings should be considered in designing future digital pathology systems.

Constant-Murley Score: systematic review and standardized evaluation in different shoulder pathologies.

PubMed

Vrotsou, Kalliopi; Ávila, Mónica; Machón, Mónica; Mateo-Abad, Maider; Pardo, Yolanda; Garin, Olatz; Zaror, Carlos; González, Nerea; Escobar, Antonio; Cuéllar, Ricardo

2018-05-10

The objective of this study was to evaluate the psychometric properties of the Constant-Murley Score (CMS) in various shoulder pathologies, based on a systematic review and expert standardized evaluations. A systematic review was performed in MEDLINE and EMBASE databases. Titles and abstracts were reviewed and finally the included articles were grouped according to patients' pathologies. Two expert evaluators independently assessed the CMS properties of reliability, validity, responsiveness to change, interpretability and burden score in each group, using the EMPRO (Evaluating Measures of Patient Reported Outcomes) tool. The CMS properties were assessed per attribute and overall for each considered group. Only the concept and measurement model was assessed globally. Five individual pathologies (i.e. subacromial, fractures, arthritis, instability and frozen shoulder) and two additional groups (i.e. various pathologies and healthy subjects) were considered. Overall EMPRO scores ranged from 58.6 for subacromial to 30.6 points for instability. Responsiveness to change was the only quality to obtain at least 50 points across all groups, but for frozen shoulder. Insufficient information was obtained in relation to the concept and measurement model and great variability was seen in the other evaluated attributes. The current evidence does not support the CMS as a gold standard in shoulder evaluation. Its use is advisable for subacromial pathology; but data are inconclusive for other shoulder conditions. Prospective studies exploring the psychometric properties of the scale, particularly for fractures, arthritis, instability and frozen shoulder are needed. Systematic review.

North American veterinary pathology residency training programs: an overview of where they are today and where they were five years ago, with an analysis of trends.

PubMed

Fitzgerald, Scott D; Reed, Willie M; Kaneene, John B

2007-01-01

An e-mail/telephone survey of all active North American residency training programs in veterinary pathology was conducted in September 2005. The purpose of this survey was to determine current numbers of trainees, their program length and type, and salaries; to compare current numbers to five years earlier; and, finally, to gauge interest in expanding current programs. All 41 training institutions contacted responded to the survey. Briefly, the survey found that there are currently 235 veterinary pathology residents, for a mean of 5.7 residents per training program. The number of residents currently in training programs and the number of applicants for these programs has increased compared to five years earlier. There is widespread interest in further expanding capacity in these programs, and the coalition of the American College of Veterinary Pathologists and the Society of Toxicologic Pathology is a well-known source of possible funding for additional residents. This survey report further documents the numbers of combined residency/PhD programs, average starting salaries for new residents, outside sponsorship effects on pathology training programs, and some of the common concerns regarding veterinary pathology training programs voiced by the respondents. While residency training capacity has expanded in the last five years, and there is widespread desire to further expand these training programs, a shortage of veterinary pathologists for future market needs will need to be addressed by increased funding from as yet unspecified sources.

Does the choice of display system influence perception and visibility of clinically relevant features in digital pathology images?

NASA Astrophysics Data System (ADS)

Kimpe, Tom; Rostang, Johan; Avanaki, Ali; Espig, Kathryn; Xthona, Albert; Cocuranu, Ioan; Parwani, Anil V.; Pantanowitz, Liron

2014-03-01

Digital pathology systems typically consist of a slide scanner, processing software, visualization software, and finally a workstation with display for visualization of the digital slide images. This paper studies whether digital pathology images can look different when presenting them on different display systems, and whether these visual differences can result in different perceived contrast of clinically relevant features. By analyzing a set of four digital pathology images of different subspecialties on three different display systems, it was concluded that pathology images look different when visualized on different display systems. The importance of these visual differences is elucidated when they are located in areas of the digital slide that contain clinically relevant features. Based on a calculation of dE2000 differences between background and clinically relevant features, it was clear that perceived contrast of clinically relevant features is influenced by the choice of display system. Furthermore, it seems that the specific calibration target chosen for the display system has an important effect on the perceived contrast of clinically relevant features. Preliminary results suggest that calibrating to DICOM GSDF calibration performed slightly worse than sRGB, while a new experimental calibration target CSDF performed better than both DICOM GSDF and sRGB. This result is promising as it suggests that further research work could lead to better definition of an optimized calibration target for digital pathology images resulting in a positive effect on clinical performance.

Cognitive distortions, anxiety, and depression among regular and pathological gambling online poker players.

PubMed

Barrault, Servane; Varescon, Isabelle

2013-03-01

The aims were to assess cognitive distortions and psychological distress (anxiety and depression) among online poker players of different levels of gambling intensity (non-pathological gamblers [NPG], problem gamblers [PbG], and pathological gamblers [PG]), and to examine the relationship between these variables and gambling pathology. Overall, 245 regular online poker players recruited on an Internet forum completed online self-report scales assessing pathological gambling (South Oaks Gambling Screen [SOGS]), psychological distress (Hospital Anxiety and Depression Scale [HADS]) and cognitive distortions (Gambling-Related Cognition Scale). Based on their SOGS scores, poker players were ranked into three groups: NPG (n=146), PbG (n=55), and PG (n=44). All poker players appeared to be more anxious than depressive. PG exhibited higher levels of depression and anxiety than did PbG and NPG. Cognitive distortions also significantly discriminated PG from PbG and NPG. A regression model showed that the perceived inability to stop gambling, the illusion of control, depression (HADS D), and anxiety were good predictors for pathological gambling among poker players. Our results suggest that cognitive distortions play an important role in the development and maintenance of gambling pathology. This study also underlines the role of anxiety and depression in pathological gambling among poker players. It seems relevant to take these elements into account in the research, prevention, and treatment of pathological gambling poker players.

Otoscopic examinations reveal high prevalence of outer and middle ear pathologies in paediatrics in Limpopo, South Africa.

PubMed

Phanguphangu, Mukovhe Chad

2017-04-01

To determine the prevalence of outer and middle ear pathologies in paediatrics in Limpopo, South Africa. Cross-sectional retrospective review of otoscopy results obtained during a school health screening campaign conducted between March and June 2015. Descriptive statistics through percentages and frequency tables were used to analyse the data. Logistic regression was used to determine associations between age, gender and pathologies observed. Medical folders of 1089 pupils. Forty-nine percent had normal otoscopy results. A significant 36% (n = 392) had impacted cerumen. Furthermore, 45% of those with impacted cerumen were bilaterally impacted. Additionally, 4% presented with foreign bodies and a further 8% had otitis externa and otitis media. The remaining 3% had tympanic membrane perforations. The odds of developing outer and middle ear pathologies were higher in pupils below 6 years of age (p = 0.046). This study highlights a high prevalence of outer and middle ear pathologies in paediatrics in Limpopo and therefore recommends comprehensive baseline and periodic screenings; to identify children with outer and middle ear pathologies and need further management, and consequently prevent the complications of these pathologies. Additionally, this report highlights a rising need for large-scale research to provide comprehensive analysis of these pathologies.

[Records of the invisible: Visa reperta in 18th- and 19th-century forensic medicine and their role as promoters of pathological-anatomical knowledge].

PubMed

Müller, Irmgard; Fangerau, Heiner

2010-01-01

Case reports in medicine serve as a tool to collect and to transfer knowledge. A special kind of case report in forensic medicine during the 18th and 19th centuries was the so-called Visum repertum. This format of note-taking and of rendering an expert opinion without presuppositions has rarely investigated in the history of medicine. Analyzing Visa reperta the authors argue that due to their special structure and mode of representation Visa reperta not only shaped the practice of forensic medicine but also the standardized examination and documentation in pathological anatomy. Based on previous studies on medical case reports, medical expert witnesses in court and traditions in pathological anatomy the authors examine two examples from the 18th and 19th centuries in order to show how semiological, classifying methods of presenting forensic examinations were replaced by the material aspect of the observation of examination results itself. The examples are a forensic case report by Michael Alberti (1682-1757) from 1728 and a Visum repertum by Joseph Bernt (1770-1842) from 1827. The authors argue that Visa reperta transcended their original forensic purpose and served as a guideline for pathology leading to an understanding of the origin of diseases in organs. They served as a promoter of scientific medicine, and their persuasiveness was backed by factors such as (a) the extreme conditions of forensic practice, (b) the claim to act as a tool for the sound and precise recording of facts and c) the awareness that they documented objects that were destroyed during the process of documentation.

Mechanical disruption of the blood-brain barrier following experimental concussion.

PubMed

Johnson, Victoria E; Weber, Maura T; Xiao, Rui; Cullen, D Kacy; Meaney, David F; Stewart, William; Smith, Douglas H

2018-05-01

Although concussion is now recognized as a major health issue, its non-lethal nature has limited characterization of the underlying pathophysiology. In particular, potential neuropathological changes have typically been inferred from non-invasive techniques or post-mortem examinations of severe traumatic brain injury (TBI). Here, we used a swine model of head rotational acceleration based on human concussion to examine blood-brain barrier (BBB) integrity after injury in association with diffuse axonal injury and glial responses. We then determined the potential clinical relevance of the swine concussion findings through comparisons with pathological changes in human severe TBI, where post-mortem examinations are possible. At 6-72 h post-injury in swine, we observed multifocal disruption of the BBB, demonstrated by extravasation of serum proteins, fibrinogen and immunoglobulin-G, in the absence of hemorrhage or other focal pathology. BBB disruption was observed in a stereotyped distribution consistent with biomechanical insult. Specifically, extravasated serum proteins were frequently observed at interfaces between regions of tissue with differing material properties, including the gray-white boundary, periventricular and subpial regions. In addition, there was substantial overlap of BBB disruption with regions of axonal pathology in the white matter. Acute perivascular cellular uptake of blood-borne proteins was observed to be prominent in astrocytes (GFAP-positive) and neurons (MAP-2-positive), but not microglia (IBA1-positive). Parallel examination of human severe TBI revealed similar patterns of serum extravasation and glial uptake of serum proteins, but to a much greater extent than in the swine model, attributed to the higher injury severity. These data suggest that BBB disruption represents a new and important pathological feature of concussion.

Functional vision loss: a diagnosis of exclusion.

PubMed

Villegas, Rex B; Ilsen, Pauline F

2007-10-01

Most cases of visual acuity or visual field loss can be attributed to ocular pathology or ocular manifestations of systemic pathology. They can also occasionally be attributed to nonpathologic processes or malingering. Functional vision loss is any decrease in vision the origin of which cannot be attributed to a pathologic or structural abnormality. Two cases of functional vision loss are described. In the first, a 58-year-old man presented for a baseline eye examination for enrollment in a vision rehabilitation program. He reported bilateral blindness since a motor vehicle accident with head trauma 4 years prior. Entering visual acuity was "no light perception" in each eye. Ocular health examination was normal and the patient made frequent eye contact with the examiners. He was referred for neuroimaging and electrophysiologic testing. The second case was a 49-year-old man who presented with a long history of intermittent monocular diplopia. His medical history was significant for psycho-medical evaluations and a diagnosis of factitious disorder. Entering uncorrected visual acuities were 20/20 in each eye, but visual field testing found constriction. No abnormalities were found that could account for the monocular diplopia or visual field deficit. A diagnosis of functional vision loss secondary to factitious disorder was made. Functional vision loss is a diagnosis of exclusion. In the event of reduced vision in the context of a normal ocular health examination, all other pathology must be ruled out before making the diagnosis of functional vision loss. Evaluation must include auxiliary ophthalmologic testing, neuroimaging of the visual pathway, review of the medical history and lifestyle, and psychiatric evaluation. Comanagement with a psychiatrist is essential for patients with functional vision loss.

Dual Pathology of Mandible

PubMed Central

Rajurkar, Suday G.; Deshpande, Mohan D.; Kazi, Noaman; Jadhav, Dhanashree; Ranadive, Pallavi; Ingole, Snehal

2017-01-01

Aneurysmal Bone cyst (ABC)is a rare benign lesion of the bone which is infrequent in craniofacial region (12%). Rapid growth pattern causing bone expansion and facial asymmetry is a characteristic feature of ABC. Giant cell lesion is another distinct pathological entity. Here we present to you a rare case of dual pathology in an 11 year old female patient who presented with a large expansile lesion in the left hemimandible. All radiographic investigations were suggestive of ABC, aspiration of the lesion resulted in blood aspirate. However only after a histologic examination the dual nature of the lesion was revealed. PMID:29264307

Dual Pathology of Mandible.

PubMed

Rajurkar, Suday G; Deshpande, Mohan D; Kazi, Noaman; Jadhav, Dhanashree; Ranadive, Pallavi; Ingole, Snehal

2017-01-01

Aneurysmal Bone cyst (ABC)is a rare benign lesion of the bone which is infrequent in craniofacial region (12%). Rapid growth pattern causing bone expansion and facial asymmetry is a characteristic feature of ABC. Giant cell lesion is another distinct pathological entity. Here we present to you a rare case of dual pathology in an 11 year old female patient who presented with a large expansile lesion in the left hemimandible. All radiographic investigations were suggestive of ABC, aspiration of the lesion resulted in blood aspirate. However only after a histologic examination the dual nature of the lesion was revealed.

Pathological grief and the activation of latent self-images.

PubMed

Horowitz, M J; Wilner, N; Marmar, C; Krupnick, J

1980-10-01

The authors studied the case material for patients treated with either psychoanalysis or brief therapy to examine the basis for the various states of pathological grief after berevavement. They view these states as intensifications or unusual prolongations of states found in normal grief and describe them in terms of the reemergence of self-images and role relationship models that had been held in check by the existence ofthe deceased person. This conclusion concerning preexisting mental schemata leads to an elaboration and partial revision of theories of regression, ambivalence, and introjection as causes of pathological grief.

The Effect of Vascular Neuropathology on Late-life Cognition: Results from the SMART Project.

PubMed

Kryscio, R J; Abner, E L; Nelson, P T; Bennett, D; Schneider, J; Yu, L; Hemmy, L S; Lim, K O; Masaki, K; Cairns, N; Xiong, C; Woltjer, R; Dodge, H H; Tyas, S; Fardo, D W; Lou, W; Wan, L; Schmitt, F A

2016-06-01

Cerebral vascular pathology may contribute to cognitive decline experienced by some elderly near death. Given evidence for mixed neuropathologies in advanced age, preventing or reducing cerebrovascular burden in late life may be beneficial. To correlate measures of cerebral vascular pathology with cognitive trajectories. Observational study. A cohort of 2,274 individuals who came to autopsy at a mean age of 89.3 years and 82 percent of whom had at least two cognitive assessments within the last six years of life was compiled from six centers conducting longitudinal studies. For each cognitive domain: immediate and delayed memory, language, and naming, three trajectories were examined: good, intermediate, and poor cognition. The probability of a participant belonging to each trajectory was associated with measures of cerebral vascular pathology after adjustment for demographics, APOE, and Alzheimer neuropathology. A large proportion of the cohort (72-94%) experienced good or intermediate cognition in the four domains examined. The presence of arteriolosclerosis and the presence of lacunar infarcts doubled the odds of belonging to the poor cognitive trajectory for language when compared to the good trajectory. The presence of lacunar infarcts increased the odds of an intermediate or poor trajectory for immediate and delayed recall while the presence of large artery infarcts increased the odds of poor trajectories for all four cognitive domains examined. Microinfarcts and cerebral amyloid angiopathy had little effect on the trajectories. Indicators of cerebral vascular pathology act differently on late life cognition.

The Effect of Vascular Neuropathology on Late-life Cognition: Results from the SMART Project

PubMed Central

Kryscio, R.J.; Abner, E.L.; Nelson, P.T.; Bennett, D.; Schneider, J.; Yu, L.; Hemmy, L.S.; Lim, K.O.; Masaki, K.; Cairns, N.; Xiong, C.; Woltjer, R.; Dodge, H.H.; Tyas, S.; Fardo, D.W.; Lou, W.; Wan, L.; Schmitt, F.A.

2016-01-01

Background Cerebral vascular pathology may contribute to cognitive decline experienced by some elderly near death. Given evidence for mixed neuropathologies in advanced age, preventing or reducing cerebrovascular burden in late life may be beneficial. Objective To correlate measures of cerebral vascular pathology with cognitive trajectories. Setting Observational study. Participants A cohort of 2,274 individuals who came to autopsy at a mean age of 89.3 years and 82 percent of whom had at least two cognitive assessments within the last six years of life was compiled from six centers conducting longitudinal studies. Measurements For each cognitive domain: immediate and delayed memory, language, and naming, three trajectories were examined: good, intermediate, and poor cognition. The probability of a participant belonging to each trajectory was associated with measures of cerebral vascular pathology after adjustment for demographics, APOE, and Alzheimer neuropathology. Results A large proportion of the cohort (72-94%) experienced good or intermediate cognition in the four domains examined. The presence of arteriolosclerosis and the presence of lacunar infarcts doubled the odds of belonging to the poor cognitive trajectory for language when compared to the good trajectory. The presence of lacunar infarcts increased the odds of an intermediate or poor trajectory for immediate and delayed recall while the presence of large artery infarcts increased the odds of poor trajectories for all four cognitive domains examined. Microinfarcts and cerebral amyloid angiopathy had little effect on the trajectories. Conclusion Indicators of cerebral vascular pathology act differently on late life cognition. PMID:27709107

Using Factor Mixture Models to Evaluate the Type A/B Classification of Alcohol Use Disorders in a Heterogeneous Treatment Sample

PubMed Central

Hildebrandt, Tom; Epstein, Elizabeth E.; Sysko, Robyn; Bux, Donald A.

2017-01-01

Background The type A/B classification model for alcohol use disorders (AUDs) has received considerable empirical support. However, few studies examine the underlying latent structure of this subtyping model, which has been challenged as a dichotomization of a single drinking severity dimension. Type B, relative to type A, alcoholics represent those with early age of onset, greater familial risk, and worse outcomes from alcohol use. Method We examined the latent structure of the type A/B model using categorical, dimensional, and factor mixture models in a mixed gender community treatment-seeking sample of adults with an AUD. Results Factor analytic models identified 2-factors (drinking severity/externalizing psychopathology and internalizing psychopathology) underlying the type A/B indicators. A factor mixture model with 2-dimensions and 3-classes emerged as the best overall fitting model. The classes reflected a type A class and two type B classes (B1 and B2) that differed on the respective level of drinking severity/externalizing pathology and internalizing pathology. Type B1 had a greater prevalence of women and more internalizing pathology and B2 had a greater prevalence of men and more drinking severity/externalizing pathology. The 2-factor, 3-class model also exhibited predictive validity by explaining significant variance in 12-month drinking and drug use outcomes. Conclusions The model identified in the current study may provide a basis for examining different sources of heterogeneity in the course and outcome of AUDs. PMID:28247423

Disrupted sensory gating in pathological gambling.

PubMed

Stojanov, Wendy; Karayanidis, Frini; Johnston, Patrick; Bailey, Andrew; Carr, Vaughan; Schall, Ulrich

2003-08-15

Some neurochemical evidence as well as recent studies on molecular genetics suggest that pathologic gambling may be related to dysregulated dopamine neurotransmission. The current study examined sensory (motor) gating in pathologic gamblers as a putative measure of endogenous brain dopamine activity with prepulse inhibition of the acoustic startle eye-blink response and the auditory P300 event-related potential. Seventeen pathologic gamblers and 21 age- and gender-matched healthy control subjects were assessed. Both prepulse inhibition measures were recorded under passive listening and two-tone prepulse discrimination conditions. Compared to the control group, pathologic gamblers exhibited disrupted sensory (motor) gating on all measures of prepulse inhibition. Sensory motor gating deficits of eye-blink responses were most profound at 120-millisecond prepulse lead intervals in the passive listening task and at 240-millisecond prepulse lead intervals in the two-tone prepulse discrimination task. Sensory gating of P300 was also impaired in pathologic gamblers, particularly at 500-millisecond lead intervals, when performing the discrimination task on the prepulse. In the context of preclinical studies on the disruptive effects of dopamine agonists on prepulse inhibition, our findings suggest increased endogenous brain dopamine activity in pathologic gambling in line with previous neurobiological findings.

Altered resting-state functional activity in isolated pontine infarction patients with pathological laughing and crying.

PubMed

Liu, Tao; Li, Jianjun; Huang, Shixiong; Li, Changqinq; Zhao, Zhongyan; Wen, Guoqiang; Chen, Feng

2017-10-13

We used resting-state functional magnetic resonance imaging to investigate the global spontaneous neural activity involved in pathological laughing and crying after stroke. Twelve pathological laughing and crying patients with isolated pontine infarction were included, along with 12 age- and gender-matched acute isolated pontine infarction patients without pathological laughing and crying, and 12 age- and gender-matched healthy controls. We examined both the amplitude of low-frequency fluctuation and the regional homogeneity in order to comprehensively evaluate the intrinsic activity in patients with post-stroke pathological laughing and crying. In the post-stroke pathological laughing and crying group, changes in these measures were observed mainly in components of the default mode network (medial prefrontal cortex/anterior cingulate cortex, middle temporal gyrus, inferior temporal gyrus, superior frontal gyrus, middle frontal gyrus and inferior parietal lobule), sensorimotor network (supplementary motor area, precentral gyrus and paracentral lobule), affective network (medial prefrontal cortex/anterior cingulate cortex, parahippocampal gyrus, middle temporal gyrus and inferior temporal gyrus) and cerebellar lobes (cerebellum posterior lobe). We therefore speculate that when disinhibition of the volitional system is lost, increased activation of the emotional system causes pathological laughing and crying.

Non-malignant pathological results on transthoracic CT guided core-needle biopsy: when is benign really benign?

PubMed

Rui, Y; Han, M; Zhou, W; He, Q; Li, H; Li, P; Zhang, F; Shi, Y; Su, X

2018-06-06

To determine true negatives and characterise the variables associated with false-negative results when interpreting non-malignant results of computed tomography (CT)-guided lung biopsy. Nine hundred and fifty patients with initial non-malignant findings on their first transthoracic CT-guided core-needle biopsy (TTNB) were included in the study. Initial biopsy results were compared to definitive diagnoses established later. The negative predictive value (NPV) of non-malignant diseases upon initial TTNB was 83.6%. When the biopsy results indicated specific infection or benign tumour (n=225, 26.1%), they all were confirmed true negative for malignancy later. Only one inconclusive "granuloma" diagnosis was false negative. All 141 patients (141/861, 16.4%) who were false negative for malignancy were from the "infection not otherwise specified (NOS)", "inflammatory diseases", or "inconclusive" groups. Age (p=0.002), cancer history (p<0.001), target size (p=0.003), and pneumothorax during lung biopsy (p=0.003) were found to be significant predictors of false-negative results; 47.6% (410/861) of patients underwent additional invasive examinations to reach a final diagnosis. Ultimately, 52.7% (216/410) were successfully diagnosed. Specific infection, benign tumour, and granulomatous inflammation of first TTNBs were mostly true negative. Older age, history of cancer, larger target size, and pneumothorax were highly predictive of false-negative results for malignancies. In such cases, additional invasive examinations were frequently necessary to obtain final diagnoses. Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Enhancing preclinical year pathology exposure: the Angevine approach.

PubMed

Brooks, Erin G; Paus, Amanda M; Corliss, Robert F; Ranheim, Erik A

2016-07-01

Less than 2% of graduating US medical seniors select pathology residencies. One major obstacle to attracting prospective residents is the relative "invisibility" of pathology; medical students lacking positive preclinical exposure to pathology are unlikely to later select pathology clerkships or residencies. The Angevine Fellowship is a 10-week competitive pathology internship medical students may apply for the summer following their first year of preclinical training at our institution. We sought to determine whether it was an effective pathology recruitment tool and how it compared with the postsophomore pathology fellowship (PSF). Angevine fellow and PSF data from 2000 to 2014 were retrospectively analyzed. Specialty choices of former fellows already matched into residency programs were tabulated. Data regarding annual percentage of graduating seniors at our institution who matched into pathology during the years former fellow cohorts matched were also examined. Our results showed that of the former Angevine fellow cohorts already matched into residency programs, 40% (8/20) matched in pathology and 20% (4/20) at our own institution. Angevine fellows comprised a disproportionately high number of the graduating seniors matching in pathology at our medical school (26.7%). PSFs comprised 6.67%. Although we have endowment funding for 2 Angevine fellows annually, the level of interest among applicants has increased to the point that our department has consistently contributed funding for 1-2 additional fellowship spots since 2011. We conclude that the Angevine Fellowship offers an effective alternative to the postsophomore fellowship. It has proven successful at our institution and could be implemented at others to potentially improve pathology recruitment trends nationwide. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Diagnostic accuracy of scapular physical examination tests for shoulder disorders: a systematic review.

PubMed

Wright, Alexis A; Wassinger, Craig A; Frank, Mason; Michener, Lori A; Hegedus, Eric J

2013-09-01

To systematically review and critique the evidence regarding the diagnostic accuracy of physical examination tests for the scapula in patients with shoulder disorders. A systematic, computerised literature search of PubMED, EMBASE, CINAHL and the Cochrane Library databases (from database inception through January 2012) using keywords related to diagnostic accuracy of physical examination tests of the scapula. The Quality Assessment of Diagnostic Accuracy Studies tool was used to critique the quality of each paper. Eight articles met the inclusion criteria; three were considered to be of high quality. Of the three high-quality studies, two were in reference to a 'diagnosis' of shoulder pain. Only one high-quality article referenced specific shoulder pathology of acromioclavicular dislocation with reported sensitivity of 71% and 41% for the scapular dyskinesis and SICK scapula test, respectively. Overall, no physical examination test of the scapula was found to be useful in differentially diagnosing pathologies of the shoulder.

[Anatomy of the skull base and the cranial nerves in slice imaging].

PubMed

Bink, A; Berkefeld, J; Zanella, F

2009-07-01

Computed tomography (CT) and magnetic resonance imaging (MRI) are suitable methods for examination of the skull base. Whereas CT is used to evaluate mainly bone destruction e.g. for planning surgical therapy, MRI is used to show pathologies in the soft tissue and bone invasion. High resolution and thin slice thickness are indispensible for both modalities of skull base imaging. Detailed anatomical knowledge is necessary even for correct planning of the examination procedures. This knowledge is a requirement to be able to recognize and interpret pathologies. MRI is the method of choice for examining the cranial nerves. The total path of a cranial nerve can be visualized by choosing different sequences taking into account the tissue surrounding this cranial nerve. This article summarizes examination methods of the skull base in CT and MRI, gives a detailed description of the anatomy and illustrates it with image examples.