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1.
Cytopathology ; 27(5): 313-6, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27650598

RESUMO

Currently there is a major challenge to train sufficient cytopathologists and cytotechnicians in developing countries that have poor medical and pathology infrastructure. Cytology requires well trained pathologists and laboratory staff but it needs only minimal laboratory resources. Cytology can provide the material for rapid, accurate and inexpensive diagnoses of infections such as tuberculosis and of benign and malignant palpable and impalpable lesions. Cytology can achieve this in the developing world by utilizing fine needle aspiration biopsy cytology, general fluids cytology and cervical cytology, in the same manner as is currently done in the developed world where cytology specimens are used to make cytomorphological diagnoses and increasingly to provide material for the full range of ancillary testing including molecular pathology. There are a number of ways to develop sustainable training in cytology in developing countries, especially in fine needle aspiration biopsy cytology, and these are presented and discussed.


Assuntos
Citodiagnóstico/tendências , Patologia Molecular/educação , Patologia/educação , Biópsia por Agulha Fina , Citodiagnóstico/métodos , Humanos , Patologia Molecular/tendências
2.
AJNR Am J Neuroradiol ; 44(4): 417-423, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36927761

RESUMO

BACKGROUND AND PURPOSE: Incidental findings are discovered in neuroimaging research, ranging from trivial to life-threatening. We describe the prevalence and characteristics of incidental findings from 16,400 research brain MRIs, comparing spontaneous detection by nonradiology scanning staff versus formal neuroradiologist interpretation. MATERIALS AND METHODS: We prospectively collected 16,400 brain MRIs (7782 males, 8618 females; younger than 1 to 94 years of age; median age, 38 years) under an institutional review board directive intended to identify clinically relevant incidental findings. The study population included 13,150 presumed healthy volunteers and 3250 individuals with known neurologic diagnoses. Scanning staff were asked to flag concerning imaging findings seen during the scan session, and neuroradiologists produced structured reports after reviewing every scan. RESULTS: Neuroradiologists reported 13,593/16,400 (83%) scans as having normal findings, 2193/16,400 (13.3%) with abnormal findings without follow-up recommended, and 614/16,400 (3.7%) with "abnormal findings with follow-up recommended." The most common abnormalities prompting follow-up were vascular (263/614, 43%), neoplastic (130/614, 21%), and congenital (92/614, 15%). Volunteers older than 65 years of age were significantly more likely to have scans with abnormal findings (P < .001); however, among all volunteers with incidental findings, those younger than 65 years of age were more likely to be recommended for follow-up. Nonradiologists flagged <1% of MRIs containing at least 1 abnormality reported by the neuroradiologists to be concerning enough to warrant further evaluation. CONCLUSIONS: Four percent of individuals who undergo research brain MRIs have an incidental, potentially clinically significant finding. Routine neuroradiologist review of all scans yields a much higher rate of significant lesion detection than selective referral from nonradiologists who perform the examinations. Workflow and scan review processes need to be carefully considered when designing research protocols.


Assuntos
Encefalopatias , Encéfalo , Masculino , Feminino , Humanos , Adulto , Encéfalo/patologia , Encefalopatias/diagnóstico por imagem , Encefalopatias/epidemiologia , Achados Incidentais , Imageamento por Ressonância Magnética , Neuroimagem , Voluntários
3.
Transpl Infect Dis ; 14(2): 169-76, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22385431

RESUMO

Microsporidia are obligate intracellular parasites, more closely related to fungi than protozoa on molecular phylogenetic analysis, and are known to be a rare cause of opportunistic infection in immune compromised patients including human immunodeficiency virus-positive patients and solid organ transplant recipients. We report the first case to our knowledge of microsporidial myositis in a lung transplant recipient. He was 49 years old and had received a lung transplant in 2000 for cystic fibrosis. He presented in 2009 with fevers, chronic diarrhea, myalgia, and pancytopenia, and developed progressive weakness and neurological symptoms before his death 35 days after hospital admission. Multiple investigations, including stool culture, rectal biopsy, colonoscopy, cerebrospinal fluid examination, bone marrow biopsy, lung biopsy, and bronchoalveolar lavage, failed to reveal a definite cause for the patient's deterioration. The diagnosis of microsporidial infection was made on post-mortem light microscopic examination of tissue sections of the tongue and deltoid muscle. Light microscopy diagnosed a microsporidial myositis, confirmed by transmission electron microscopy, which suggested that the organism was Brachiola species. The identity of the organism was confirmed by polymerase chain reaction as Brachiola algerae (recently renamed Anncaliia algerae). The case highlights the need to consider protozoal organisms in the differential diagnosis of myalgia and multisystemic infections in immune compromised patients.


Assuntos
Transplante de Pulmão/efeitos adversos , Microsporídios/isolamento & purificação , Microsporidiose/microbiologia , Miosite/microbiologia , Evolução Fatal , Humanos , Masculino , Microscopia Eletrônica de Transmissão , Microsporidiose/complicações , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase
4.
Mult Scler ; 17(6): 743-54, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21372112

RESUMO

BACKGROUND: Probiotic treatment strategy based on the hygiene hypothesis, such as administration of ova from the non-pathogenic helminth, Trichuris suis, (TSO) has proven safe and effective in autoimmune inflammatory bowel disease. OBJECTIVE: To study the safety and effects of TSO in a second autoimmune disease, multiple sclerosis (MS), we conducted the phase 1 Helminth-induced Immunomodulatory Therapy (HINT 1) study. METHODS: Five subjects with newly diagnosed, treatment-naive relapsing-remitting multiple sclerosis (RRMS) were given 2500 TSO orally every 2 weeks for 3 months in a baseline versus treatment control exploratory trial. RESULTS: The mean number of new gadolinium-enhancing magnetic resonance imaging (MRI) lesions (n-Gd+) fell from 6.6 at baseline to 2.0 at the end of TSO administration, and 2 months after TSO was discontinued, the mean number of n-Gd+ rose to 5.8. No significant adverse effects were observed. In preliminary immunological investigations, increases in the serum level of the cytokines IL-4 and IL-10 were noted in four of the five subjects. CONCLUSION: TSO was well tolerated in the first human study of this novel probiotic in RRMS, and favorable trends were observed in exploratory MRI and immunological assessments. Further investigations will be required to fully explore the safety, effects, and mechanism of action of this immunomodulatory treatment.


Assuntos
Esclerose Múltipla Recidivante-Remitente/terapia , Probióticos , Trichuris , Administração Oral , Adulto , Animais , Anticorpos Anti-Helmínticos/sangue , Biomarcadores/sangue , Encéfalo/patologia , Proteína C-Reativa/metabolismo , Feminino , Humanos , Interleucina-10/sangue , Interleucina-4/sangue , Imageamento por Ressonância Magnética , Masculino , Esclerose Múltipla Recidivante-Remitente/diagnóstico , Esclerose Múltipla Recidivante-Remitente/imunologia , Projetos Piloto , Probióticos/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Trichuris/imunologia , Regulação para Cima , Wisconsin , Adulto Jovem
5.
Neuroimage ; 51(3): 987-94, 2010 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-20298794

RESUMO

Systemic levels of proinflammatory cytokines such as interleukin-6 (IL-6) increase in old age and may contribute to neural atrophy in humans. We investigated IL-6 associations with age in T1-weighted segments and microstructural diffusion indices using MRI in aged rhesus monkeys (Macaca mulatta). Further, we determined if long-term 30% calorie restriction (CR) reduced IL-6 and attenuated its association with lower tissue volume and density. Voxel-based morphometry (VBM) and diffusion-weighted voxelwise analyses were conducted. IL-6 was associated with less global gray and white matter (GM and WM), as well as smaller parietal and temporal GM volumes. Lower fractional anisotropy (FA) was associated with higher IL-6 levels along the corpus callosum and various cortical and subcortical tracts. Higher IL-6 concentrations across subjects were also associated with increased mean diffusivity (MD) throughout many brain regions, particularly in corpus callosum, cingulum, and parietal, frontal, and prefrontal areas. CR monkeys had significantly lower IL-6 and less associated atrophy. An IL-6xCR interaction across modalities also indicated that CR mitigated IL-6 related changes in several brain regions compared to controls. Peripheral IL-6 levels were correlated with atrophy in regions sensitive to aging, and this relationship was decreased by CR.


Assuntos
Envelhecimento/metabolismo , Envelhecimento/patologia , Encéfalo/anatomia & histologia , Encéfalo/metabolismo , Restrição Calórica/métodos , Interleucina-6/sangue , Interleucinas/sangue , Animais , Feminino , Macaca mulatta , Imageamento por Ressonância Magnética , Masculino , Tamanho do Órgão
6.
AJNR Am J Neuroradiol ; 38(6): 1103-1110, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28450439

RESUMO

BACKGROUND AND PURPOSE: Synthetic MR imaging enables reconstruction of various image contrasts from 1 scan, reducing scan times and potentially providing novel information. This study is the first large, prospective comparison of synthetic-versus-conventional MR imaging for routine neuroimaging. MATERIALS AND METHODS: A prospective multireader, multicase noninferiority trial of 1526 images read by 7 blinded neuroradiologists was performed with prospectively acquired synthetic and conventional brain MR imaging case-control pairs from 109 subjects (mean, 53.0 ± 18.5 years of age; range, 19-89 years of age) with neuroimaging indications. Each case included conventional T1- and T2-weighted, T1 and T2 FLAIR, and STIR and/or proton density and synthetic reconstructions from multiple-dynamic multiple-echo imaging. Images were randomized and independently assessed for diagnostic quality, morphologic legibility, radiologic findings indicative of diagnosis, and artifacts. RESULTS: Clinical MR imaging studies revealed 46 healthy and 63 pathologic cases. Overall diagnostic quality of synthetic MR images was noninferior to conventional imaging on a 5-level Likert scale (P < .001; mean synthetic-conventional, -0.335 ± 0.352; Δ = 0.5; lower limit of the 95% CI, -0.402). Legibility of synthetic and conventional morphology agreed in >95%, except in the posterior limb of the internal capsule for T1, T1 FLAIR, and proton-density views (all, >80%). Synthetic T2 FLAIR had more pronounced artifacts, including +24.1% of cases with flow artifacts and +17.6% cases with white noise artifacts. CONCLUSIONS: Overall synthetic MR imaging quality was similar to that of conventional proton-density, STIR, and T1- and T2-weighted contrast views across neurologic conditions. While artifacts were more common in synthetic T2 FLAIR, these were readily recognizable and did not mimic pathology but could necessitate additional conventional T2 FLAIR to confirm the diagnosis.


Assuntos
Encéfalo/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Neuroimagem/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
7.
AJNR Am J Neuroradiol ; 27(6): 1258-71, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16775277

RESUMO

BACKGROUND AND PURPOSE: Diffusion tensor imaging (DTI) and white matter tractography (WMT) are promising techniques for estimating the course, extent, and connectivity patterns of the white matter (WM) structures in the human brain. In this study, DTI and WMT were used to evaluate WM tract reorganization after the surgical resection of brain tumors and vascular malformations. METHODS: Pre- and postoperative DTI data were obtained in 6 patients undergoing surgical resection of brain lesions. WMT using a tensor deflection algorithm was used to reconstruct WM tracts adjacent to the lesions. Reconstructed tracts included corticospinal tracts, the corona radiata, superior longitudinal and inferior fronto-occipital fasciculi, cingulum bundles, and the corpus callosum. RESULTS: WMT revealed a series of tract alteration patterns including deviation, deformation, infiltration, and apparent tract interruption. In general, the organization of WM tracts appeared more similar to normal anatomy after resection, with either disappearance or reduction of the deviation, deformation, or infiltration present preoperatively. In patients whose lesions were associated with corticospinal tract involvement, the WMT reconstructions showed that the tract was preserved during surgery and improved in position and appearance, and this finding correlated with improvement or preservation of motor function as determined by clinical assessment. CONCLUSION: WMT is useful for appreciating the complex relationships between specific WM structures and the anatomic distortions created by brain lesions. Further studies with intraoperative correlation are necessary to confirm these initial findings and to determine WMT utility for presurgical planning and evaluation of surgical treatments.


Assuntos
Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Encéfalo/patologia , Imagem de Difusão por Ressonância Magnética , Malformações Arteriovenosas Intracranianas/patologia , Malformações Arteriovenosas Intracranianas/cirurgia , Adolescente , Adulto , Criança , Pré-Escolar , Humanos , Processamento de Imagem Assistida por Computador , Pessoa de Meia-Idade , Tratos Piramidais/patologia
8.
Clin Cancer Res ; 4(4): 847-54, 1998 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9563877

RESUMO

The cell cycle regulatory gene cyclin D1 is a candidate oncogene in breast cancer. It is overexpressed in 30-50% of invasive primary breast cancers and plays a key role in mediating mitogenic responses to steroids and growth factors in breast cancer cells in vitro. Because the role of cyclin D1 in the proliferative and early noninvasive stages of breast cancer is largely unknown, we examined normal breast epithelium (NBE), proliferative disease (PD), ductal carcinoma in situ (DCIS), and invasive carcinoma (IC) to evaluate the timing and possible importance of cyclin D1 expression in the development of breast cancer. Using immunohistochemistry, we examined cyclin D1 protein expression in 471 breast tissue samples. A quantitative scoring system for immunohistochemistry based on percentage of positive cells was developed that correlated with Western blot analysis of antigen concentration in paired samples (r2 = 0.91, P = 0.003). A sample was considered positive if >5% of relevant epithelial cells demonstrated nuclear staining. Cyclin D1 positivity was observed in 11.7% (7 of 60) samples of NBE, 25% (11 of 44) of PD without atypia, 39.4% (13 of 33) of atypical ductal hyperplasia, 43.6% (17 of 39) of low-grade DCIS, 47.9% (23 of 48) of high-grade DCIS, and 48.3% (99 of 205) of IC. Cyclin D1 expression was significantly higher in PD than NBE (P = 0.006) and in DCIS than PD (P = 0.038). There was no significant increase from DCIS to IC (P = 0.52). The increase in cyclin D1 expression in the overall progression from NBE to IC was also highly significant (P = 0.0001). Therefore, cyclin D1 expression was detected at levels significantly greater than in NBE in the earliest proliferative epithelial lesions of the breast with a further significant increase accompanying the progression to any form of cancer. This suggests that overexpression of cyclin D1 protein is important at the earliest stages of breast oncogenesis and continues to have a crucial role throughout the development of malignancy.


Assuntos
Neoplasias da Mama/metabolismo , Carcinoma Intraductal não Infiltrante/metabolismo , Ciclina D1/metabolismo , Proteínas de Neoplasias/metabolismo , Neoplasias da Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Feminino , Humanos , Hiperplasia/metabolismo , Hiperplasia/patologia , Células Tumorais Cultivadas
9.
AJNR Am J Neuroradiol ; 36(3): E12-23, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25655872

RESUMO

The past decade has seen impressive advances in the types of neuroimaging information that can be acquired in patients with traumatic brain injury. However, despite this increase in information, understanding of the contribution of this information to prognostic accuracy and treatment pathways for patients is limited. Available techniques often allow us to infer the presence of microscopic changes indicative of alterations in physiology and function in brain tissue. However, because histologic confirmation is typically lacking, conclusions reached by using these techniques remain solely inferential in almost all cases. Hence, a need exists for validation of these techniques by using data from large population samples that are obtained in a uniform manner, analyzed according to well-accepted procedures, and correlated with closely monitored clinical outcomes. At present, many of these approaches remain confined to population-based research rather than diagnosis at an individual level, particularly with regard to traumatic brain injury that is mild or moderate in degree. A need and a priority exist for patient-centered tools that will allow advanced neuroimaging tools to be brought into clinical settings. One barrier to developing these tools is a lack of an age-, sex-, and comorbidities-stratified, sequence-specific, reference imaging data base that could provide a clear understanding of normal variations across populations. Such a data base would provide researchers and clinicians with the information necessary to develop computational tools for the patient-based interpretation of advanced neuroimaging studies in the clinical setting. The recent "Joint ASNR-ACR HII-ASFNR TBI Workshop: Bringing Advanced Neuroimaging for Traumatic Brain Injury into the Clinic" on May 23, 2014, in Montreal, Quebec, Canada, brought together neuroradiologists, neurologists, psychiatrists, neuropsychologists, neuroimaging scientists, members of the National Institute of Neurologic Disorders and Stroke, industry representatives, and other traumatic brain injury stakeholders to attempt to reach consensus on issues related to and develop consensus recommendations in terms of creating both a well-characterized normative data base of comprehensive imaging and ancillary data to serve as a reference for tools that will allow interpretation of advanced neuroimaging tests at an individual level of a patient with traumatic brain injury. The workshop involved discussions concerning the following: 1) designation of the policies and infrastructure needed for a normative data base, 2) principles for characterizing normal control subjects, and 3) standardizing research neuroimaging protocols for traumatic brain injury. The present article summarizes these recommendations and examines practical steps to achieve them.


Assuntos
Lesões Encefálicas , Bases de Dados Factuais , Neuroimagem , Lesões Encefálicas/patologia , Feminino , Humanos , Masculino
10.
AJNR Am J Neuroradiol ; 21(8): 1388-96, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11003269

RESUMO

BACKGROUND AND PURPOSE: Movements of the participant during blood oxygen level-dependent (BOLD) functional MR imaging cerebral activation studies are known to produce occasionally regions of false activation, especially when these movements are relatively large (>3 mm) and highly correlated with the stimulus. We investigated whether minimal (<1 mm), weakly correlated movements in a controlled functional MR imaging model could produce false activation artifacts that could potentially mimic regions of true activation in size, location, and statistical significance. METHODS: A life-size brain phantom was constructed by embedding vials of a dilute carboxylic acid solution within a gadolinium-doped gelatin mold. Imaging was performed at 1.5 T using a 2D spiral sequence (3,000/5 [TR/TE]; flip angle, 88 degrees; matrix, 64 x 64; field of view, 24 cm; section thickness, 5 mm). Controlled, in-plane, submillimeter movements of the phantom were generated using a pneumatic system and were made to correlate with a hypothetical "boxcar" stimulus over the range 0.31 < r < 0.96. Regions of false activation were sought using standard statistical methods (SPM96) that excluded phantom edges and accounted for spatial extent (regions tested at P < .05, corrected for multiple comparisons). A similar experiment was performed on a resting volunteer. RESULTS: The pneumatic system provided motion control with average in-plane displacements and rotations of 0.74 mm and 0.47 degrees, respectively, in the 18 data sets analyzed. No areas of false activation in the phantom were identified for poorly correlated motions (r < 0.52). Above this level, false activations occurred with increasing frequency, scaling in size and number with the degree of motion correlation. For motions with r > 0.67, areas of false activation were seen in every experiment. For a statistical threshold of P = .001, the median number of falsely activated regions was 3.5, with a mean size of 71.7 voxels (approximately 5 cc). Areas of possibly false activation of average size 72.5 voxels resulting from passive motion of the resting human participant were observed in two of four experiments. CONCLUSION: Participant movements of 1 mm or less that are only modestly correlated with a blocked stimulus paradigm can produce appreciable false activation artifacts on BOLD functional MR imaging studies, even when strict image realignment methods are used to prevent them.


Assuntos
Encéfalo/fisiologia , Imageamento por Ressonância Magnética , Oxigênio/sangue , Artefatos , Reações Falso-Positivas , Movimento (Física) , Imagens de Fantasmas
11.
Pathology ; 33(3): 278-82, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11523924

RESUMO

The arrival of Herceptin (Trastuzumab), an antibody against the HER-2 oncogene found in a proportion of breast carcinomas and other carcinomas, has emphasised the need for a standardised technique for demonstrating overexpression of HER-2. We compared the Dako A485 antibody and Dako HercepTest kit (HT) on a series of 122 breast carcinomas. Fluorescence in situ hybridisation (FISH) (Vysis) was performed on all cases with positive or equivocal immunohistochemical results. The Dako A485 showed HER-2 overexpression in 53% of carcinomas, while the HT showed 21% positive (HT 2+ 8%, HT 3+ 13%) and 79% negative (HT 0 67%, HT 1+ 12%). FISH for HER-2 gene amplification on all the HT 1+ and HT 2+ cases was negative, whereas FISH analysis of all HT 3+ cases was positive, with the exception of one case which could not be analysed for technical reasons. When histological subtype was analysed, only grade 3 infiltrating duct carcinomas were FISH-positive, suggesting that histological grading and subtyping may be able to triage carcinomas suitable for HER-2 testing. We suggest that the HT or a similar standardised immunohistochemical study for HER-2 can be used to screen breast carcinomas. We then recommend FISH where the carcinoma is HT 2+. FISH may also be appropriate in high grade, HT 1+ carcinomas where there are doubts regarding optimal tissue fixation or block storage conditions.


Assuntos
Neoplasias da Mama/química , DNA de Neoplasias/análise , Receptor ErbB-2/análise , Receptor ErbB-2/genética , Anticorpos Monoclonais , Anticorpos Monoclonais Humanizados , Neoplasias da Mama/patologia , Centrômero , Cromossomos Humanos Par 17 , Feminino , Genes erbB-2/genética , Humanos , Técnicas Imunoenzimáticas , Hibridização in Situ Fluorescente , Invasividade Neoplásica , Estadiamento de Neoplasias , Trastuzumab
12.
Folia Parasitol (Praha) ; 40(4): 261-6, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-7516907

RESUMO

A protocol for the handling of small intestinal biopsies from HIV-infected patients is presented. This protocol includes the Warthin-Starry stain for the detection of microsporidia. This stain has proved a reliable and sensitive diagnostic technique for microsporidial infections as it stains both Enterocytozoon bieneusi and Septata intestinalis in duodenal enterocytes. Because the stain demonstrates Septata intestinalis in lamina propria macrophages as well as enterocytes, it allows for the practical differentiation of these two microsporidial infections. The Warthin-Starry stain has also demonstrated Septata intestinalis in nasal and colonic biopsies in some of these patients. Since the completion of an earlier study, a further 40 cases of Enterocytozoon bieneusi and three cases of Septata intestinalis have been diagnosed in just over 240 consecutive duodenal biopsies from HIV positive patients presenting with diarrhoea and other gastrointestinal complaints. Other opportunistic infections include cytomegalovirus in four cases, mycobacteria in eight cases, cryptosporidia in nine cases, giardia in four cases and Isospora belli in one case. Since the ratio of these opportunistic infections has remained much the same as in the previous study of 180 consecutive duodenal biopsies, we suggest that these rates may reflect the actual prevalence of microsporidial infections in AIDS patients in Sydney, Australia.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Duodeno/parasitologia , Microsporidiose/diagnóstico , Coloração e Rotulagem/métodos , Animais , Biópsia , Duodeno/citologia , Encephalitozoon/citologia , Humanos
13.
Diagn Cytopathol ; 40(3): 273-81, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21309011

RESUMO

Cytology is able to deliver rapid accurate diagnoses with minimal equipment and laboratory infrastructure at minimal cost, and this is especially so for fine needle biopsy (FNB), which is a powerful diagnostic tool in medically resource-poor environments, where histopathology laboratories are small in number and poorly supported financially. The crucial element in the development of cytology services is to train a sufficient number of well trained cytopathologists and cytotechnologists to create a 'critical mass' of personnel who not only provide routine diagnostic services, but also can train an ever expanding number of pathologists, cytotechnologists, and health workers. A review of practical programs to train cytopathologists and cytotechnologists in their own countries will be presented, including a recent series of FNB and cytology tutorials run in sub Saharan Africa. The need for local cytopathology programs and the potential for both local and visiting cytopathologists to provide a faculty will be discussed, as well as a range of possible programs which can bring African pathologists and trainee pathologists to Western institutions for periods of their training. Ideally, the regional Societies of Cytology, including the recently formed West African Society of Cytology, will establish their own diagnostic protocols, training programs, syllabuses, examinations and accreditation and career pathways for both cytopathologists and cytotechnologists, and organize tutorials where they will invite overseas faculty to contribute. Crucially, these new societies will empower cytopathologists and cytotechnologists to approach health services and governments to state the need for cytology services as a cost-effective accurate diagnostic service that enhances patient care.


Assuntos
Biópsia por Agulha Fina/estatística & dados numéricos , Biologia Celular/educação , Patologia Clínica/educação , África Subsaariana , Países em Desenvolvimento , Humanos
14.
Neurobiol Aging ; 32(12): 2319.e1-11, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20541839

RESUMO

Rhesus macaques on a calorie restricted diet (CR) develop less age-related disease, have virtually no indication of diabetes, are protected against sarcopenia, and potentially live longer. Beneficial effects of caloric restriction likely include reductions in age-related inflammation and oxidative damage. Oligodendrocytes are particularly susceptible to inflammation and oxidative stress, therefore, we hypothesized that CR would have a beneficial effect on brain white matter and would attenuate age-related decline in this tissue. CR monkeys and controls underwent diffusion tensor imaging (DTI). A beneficial effect of CR indexed by DTI was observed in superior longitudinal fasciculus, fronto-occipital fasciculus, external capsule, and brainstem. Aging effects were observed in several regions, although CR appeared to attenuate age-related alterations in superior longitudinal fasciculus, frontal white matter, external capsule, right parahippocampal white matter, and dorsal occipital bundle. The results, however, were regionally specific and also suggested that CR is not salutary across all white matter. Further evaluation of this unique cohort of elderly primates to mortality will shed light on the ultimate benefits of an adult-onset, moderate CR diet for deferring brain aging.


Assuntos
Envelhecimento/metabolismo , Restrição Calórica/métodos , Fibras Nervosas Mielinizadas/metabolismo , Envelhecimento/patologia , Animais , Encéfalo/metabolismo , Encéfalo/patologia , Estudos de Coortes , Imagem de Tensor de Difusão/métodos , Feminino , Estudos Longitudinais , Macaca mulatta , Masculino , Fibras Nervosas Mielinizadas/patologia
15.
AJNR Am J Neuroradiol ; 32(8): 1420-5, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21885713

RESUMO

BACKGROUND AND PURPOSE: fMRI is increasingly used in neurosurgery to preoperatively identify areas of eloquent cortex. Our study evaluated the efficacy of clinical fMRI by analyzing the relationship between the distance from the tumor border to the area of functional activation (LAD) and patient pre- and postoperative morbidity and mortality. MATERIALS AND METHODS: The study included patients with diagnosis of primary or metastatic brain tumor who underwent preoperative fMRI-based motor mapping (n=74) and/or language mapping (n=77). The impact of LAD and other variables collected from patient records was analyzed with respect to functional deficits in terms of morbidity (paresis and aphasia) and mortality. RESULTS: Significant relationships were found between motor and language LAD and the existence of either pre- or postoperative motor (P < .001) and language deficits (P=.009). Increasing age was associated with motor and language deficits (P=.02 and P=.04 respectively). Right-handedness was related to language deficits (P=.05). Survival analysis revealed that pre- and postoperative deficits, grade, tumor location, and LAD predicted mortality. Motor deficits increased linearly as the distance from the tumor to the primary sensorimotor cortex decreased. Language deficits increased exponentially as the distance from the tumor to the language areas decreased below 1 cm. Postoperative mortality analysis showed an interaction effect between motor or language LAD and mortality predictors (grade and tumor location, respectively). CONCLUSIONS: These findings indicate that tumors may affect language and motor function differently depending on tumor LAD. Overall, the data support the use of fMRI as a tool to evaluate patient prognosis and are directly applicable to neurosurgical planning.


Assuntos
Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/cirurgia , Imageamento por Ressonância Magnética , Complicações Pós-Operatórias/epidemiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Complicações Pós-Operatórias/mortalidade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida
16.
AJNR Am J Neuroradiol ; 31(3): 448-53, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19875474

RESUMO

BACKGROUND AND PURPOSE: Fetal origin of the PCA is a common anatomic variation of the circle of Willis. On perfusion imaging, patients with unilateral fetal-type PCA may demonstrate left-right asymmetry that could mimic cerebrovascular disease. The aim of this study was to characterize the relationship between a fetal-type PCA and asymmetry of hemodynamic parameters derived from MR perfusion imaging. MATERIALS AND METHODS: We retrospectively reviewed MR perfusion studies of 36 patients to determine the relationship between hemodynamic and vascular asymmetries in the PCA territory. Perfusion asymmetry indices for the PCA territory were computed from maps of rCBF, rCBV, MTT, T(max), and FMT. Vascular asymmetry indices were derived from calibers of the PCA-P1 segments relative to the posterior communicating arteries. RESULTS: Asymmetrically smaller values of FMT and T(max) were observed with unilateral fetal-type PCA, and these were strongly correlated with the degree of vascular asymmetry (Spearman's rho = 0.76 and 0.74, respectively, P < 1 x 10(-6)). Asymmetries of rCBF, MTT, and rCBV were neither significant nor related to vascular asymmetry. CONCLUSIONS: Faster perfusion transit times are seen for parameters sensitive to macrovascular transit effects (eg, FMT and T(max)) ipsilateral to fetal origin of the PCA in proportion to the degree of arterial asymmetry. Knowledge of this normal variation is critical in the interpretation of perfusion studies because asymmetry could mimic cerebrovascular pathology.


Assuntos
Circulação Cerebrovascular , Círculo Arterial do Cérebro/anatomia & histologia , Lateralidade Funcional , Imageamento por Ressonância Magnética/métodos , Artéria Cerebral Posterior/anatomia & histologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Encéfalo/irrigação sanguínea , Mapeamento Encefálico , Feminino , Humanos , Imageamento por Ressonância Magnética/normas , Masculino , Pessoa de Meia-Idade , Valores de Referência , Estudos Retrospectivos , Adulto Jovem
17.
Brain Topogr ; 3(4): 407-23, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-1742157

RESUMO

We describe a substantive application of the trilinear topographic components/parallel factors model (TC/PARAFAC, due to Möcks/Harshman) to the decomposition of multichannel evoked potentials (MEP's). We provide practical guidelines and procedures for applying PARAFAC methodology to MEP decomposition. Specifically, we apply techniques of data preprocessing, orthogonality constraints, and validation of solutions in a complete TC analysis, for the first time using actual MEP data. The TC model is shown to be superior to the traditional bilinear principal components model in terms of data reduction, confirming the advantage of the TC model's added assumptions. The model is then shown to provide a unique spatiotemporal decomposition that is reproducible in different subject groups. The components are shown to be consistent with spatial/temporal features evident in the data, except for an artificial component resulting from latency jitter. Subject scores on this component are shown to reflect peak latencies in the data, suggesting a new aspect to statistical analyses based on subject scores. In general, the results support the conclusion that the TC model is a promising alternative to principal components for data reduction and analysis of MEP's.


Assuntos
Potenciais Evocados , Mapeamento Encefálico , Análise Fatorial , Humanos , Modelos Neurológicos , Terminologia como Assunto
18.
Bioelectromagnetics ; 14(6): 503-20, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-8297395

RESUMO

The effects of pulsed microwaves (2.45 GHz, 10 microseconds, 100 pps, SAR: 81.5 kW/kg peak, 81.5 W/kg average) on membrane input resistance and action potential (AP) interval statistics were studied in spontaneously active ganglion neurons of land snails (Helix aspersa), at strictly constant temperature (20.8 +/- .07 degrees C worst case). Statistical comparison with sham-irradiated neurons revealed a significant increase in the mean input resistance of neurons exposed to pulsed microwaves (P < or = .05). Pulsed microwaves had no visible effect on mean AP firing rate; this observation was confirmed by analysis of interspike intervals (ISIs). Using an integrator model for spontaneously active neurons, we found the net input current to be more variable in neurons exposed to pulsed microwaves. The mean input current was not affected. The standard deviation of ISIs and the autocorrelation of the input current were marginally affected, but these changes were not consistent across neurons. Although the observed effects were less obvious than those reported in other studies, they represent evidence of a direct interaction between neurons and pulsed microwaves, in the absence of macroscopic temperature changes. The data do not suggest a single, specific mechanism for such interaction.


Assuntos
Caracois Helix/fisiologia , Micro-Ondas , Neurônios/efeitos da radiação , Animais , Eletricidade
19.
Proc Natl Acad Sci U S A ; 80(5): 1251-5, 1983 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-6572384

RESUMO

We have synthesized RNA from cloned adenovirus 2 late promoter DNA in an in vitro transcription extract under UTP-limiting conditions. Under these circumstances, almost all of the alpha-amanitin-sensitive RNA produced is shorter than 20 nucleotides; most of these short transcripts are present in four species, 6, 7, 13, and 17 nucleotides. These short RNAs are initiated at the adenovirus 2 promoter, as judged by partial sequence analysis and by the abolition of their synthesis upon cleavage of the template DNA at sites which also abolish the production of full-length transcripts. All of the short transcripts can be chased, with excess UTP, into 197-base run-off transcripts; thus, these RNAs are precursors of full-length transcripts and not synthetic "dead ends." Significantly, none of these short RNAs is capped or 2'-O-methylated. However, 79-base run-off transcripts synthesized from this promoter with nonlimiting NTP levels are fully capped.


Assuntos
RNA Polimerases Dirigidas por DNA/metabolismo , Capuzes de RNA/análise , RNA Polimerase II/metabolismo , Transcrição Gênica , Sequência de Bases , Eletroforese em Gel de Poliacrilamida , Células HeLa , Humanos
20.
J Bacteriol ; 153(1): 253-8, 1983 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-6401278

RESUMO

The rate of degradation of aspartate transcarbamylase in exponentially growing Bacillus subtilis cells was determined by measurement of enzyme activity after the addition of uridine to repress further enzyme synthesis and by specific immunoprecipitation of the enzyme from cells grown in the presence of [3H]leucine. Aspartate transcarbamylase was degraded with a half-life of about 1.5 h in cells growing on a glucose-salts medium with NH4+ ions as the sole source of nitrogen. Replacement of NH4+ in this medium with a combination of the amino acids aspartate, glutamate, isoleucine, proline, and threonine reduced the degradation rate to an undetectable level. Various other amino acids and amino acid mixtures had smaller effects on the rate of degradation. The carbon source also influenced the degradation rate, but to a smaller extent than the nitrogen source. The effects of these nutritional variables on the rate of bulk protein turnover in growing cells were generally similar to their effects on degradation of aspartate transcarbamylase. Since the degradation of aspartate transcarbamylase has been shown to be 10 to 20 times faster than bulk protein turnover, the results suggest that a substantial portion of protein turnover in growing cells represents regulable, rapid degradation of a number of normal proteins, of which aspartate transcarbamylase is an example.


Assuntos
Aminoácidos/farmacologia , Aspartato Carbamoiltransferase/metabolismo , Bacillus subtilis/metabolismo , Proteínas de Bactérias/metabolismo , Bacillus subtilis/crescimento & desenvolvimento , Meios de Cultura , Cinética , Compostos de Amônio Quaternário/farmacologia
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