Histopathological findings in lung biopsies with usual interstitial pneumonia: Definition of a new classification score for histological fibrotic stages.

The objective of this article is to describe and classify usual interstitial pneumonia (UIP) changes according to their relevance in the pathology of the idiopathic pulmonary fibrosis (IPF) process. In a cohort of 50 patients (25♀, 25♂) with UIP findings, the percentage ratio between fibrotic and preserved parts of the lungs was quantified. Three quantitative stages of fibrotic involvement of the lung parenchyma and concomitant changes were defined. These are initial (≤20%), advanced (21-40%), and diffuse (≥41%) fibrosis of the lungs. Histologically, temporal heterogeneity is predominant with thickened alveolar septa, interstitial fibrosis, and the presence of fibroblastic foci up to mature diffuse fibrosis with honeycomb changes. The finding is accompanied by variably mature lymphocytic inflammation, presence of macrophages, emphysema, bronchioloectasia of the alveoli, bronchiectasis, bronchial muscle wall hypertrophy, hypertrophy of the vessel walls, alveolar mucosa, focal haemorrhage, and hyalinization of the lungs. Pneumocyte hyperplasia, occasionally atypical in appearance with hobnail changes, as well as squamous metaplasia are observed. In the methodically quantified stages of fibrous involvement, 14 subjects were classified (6♀, 8♂) into the stage of initial fibrosis, 21 subjects (11♀; 10♂) into the stage of advanced fibrosis, and 15 subjects (8♀; 7♂) into the stage of diffuse fibrosis.

Suicides and their preventive interventions possibilities: are there some relationships between mechanisms and different mental disorders?

Suicides are one of the topics discussed around the world. This problem receives large space in scientific and professional literature, in order to eliminate its occurrence. Mechanisms of suicides are determined by whole spectrum of reasons determined by/depending on physical and psychological health. The objective of this work is to document the differences in mechanisms and realization of suicides by mentally sick people. Ten cases of suicides are reported in the article: three of which in people with a history of depression of the victim noted by family members, one with treated depression, three with anxiety-depressive disorder and three schizophrenic patients cases. There are five men and five women. Four of these women overdosed themselves by medicaments and one jumped out of a window. Two men shot themselves, two hanged themselves and one jumped out of a window. Persons without anamnestically proven psychiatric diseases end their lives mostly because of inconclusive situation or as a result of balancing their whole life (usually with good plan and preparation of the act). Persons with treatment of depression or anxiety-depressive disorder kill themselves mostly after several "unsuccessful" attempts. In case of victims with schizophrenia suicides follow a hardly predictable sequence of actions which sometimes do not seem to have any logic. Differences have been found between victims with and without mental disorders in ways of realization of suicides. Psychological predispositions in mood changes, long-term sadness and threatening suicide should be recognized by family members. Prevention of suicides in cases of people with a history of mental disorders is based on medical treatment and cooperation between the client and family members and a psychiatrist (Ref. 30). Keywords: forensic medicine, mental disorders, prevention, psychiatry, risk factors, suicides.

Echogenicity of Brain Structures in Huntington's Disease Patients Evaluated by Transcranial Sonography - Magnetic Resonance Fusion Imaging using Virtual Navigator and Digital Image Analysis.

PURPOSE: Transcranial sonography (TCS) magnetic resonance (MR) fusion imaging and digital image analysis are useful tools for the evaluation of various brain pathologies. This study aimed to compare the echogenicity of predefined brain structures in Huntington's disease (HD) patients and healthy controls by TCS-MR fusion imaging using Virtual Navigator and digitized image analysis. MATERIALS AND METHODS: The echogenicity of the caudate nucleus (CN), substantia nigra (SN), lentiform nucleus (LN), insula, and brainstem raphe (BR) evaluated by TCS-MR fusion imaging using digitized image analysis was compared between 21 HD patients and 23 healthy controls. The cutoff values of echogenicity indices for the CN, LN, insula, and BR with optimal sensitivity and specificity were calculated using receiver operating characteristic analysis. RESULTS: The mean echogenicity indices for the CN (67.0±22.6 vs. 37.9±7.6, p<0.0001), LN (110.7±23.6 vs. 59.7±11.1, p<0.0001), and insula (121.7±39.1 vs. 70.8±23.0, p<0.0001) were significantly higher in HD patients than in healthy controls. In contrast, BR echogenicity (24.8±5.3 vs. 30.1±5.3, p<0.001) was lower in HD patients than in healthy controls. The area under the curve was 90.9%, 95.5%, 84.1%, and 81.8% for the CN, LN, insula, and BR, respectively. The sensitivity and specificity were 86% and 96%, respectively, for the CN and 90% and 100%, respectively, for the LN. CONCLUSION: Increased CN, LN, and insula echogenicity and decreased BR echogenicity are typical findings in HD patients. The high sensitivity and specificity of the CN and LN hyperechogenicity in TCS-MR fusion imaging make them promising diagnostic markers for HD.