[Quantification of brain developmental trajectories based on histogram parameters at slice of the anterior and posterior horns of the lateral ventricles on routine brain MRI in normal children aged 0 to 5 years].

Objective: To investigate the value of histogram parameters in quantifying brain development trajectory at slice of anterior and posterior horns of lateral ventricles on conventional brain MRI in normal children aged 0-5 years. Methods: Routine brain MRI data [apparent diffusion coefficient (ADC) map, T1-weighted imaging (T1WI), and T2-weighted imaging (T2WI)] were retrospectively collected from 300 children aged 0-5 years who underwent MRI at Children 's Hospital of Nanjing Medical University from April 2014 to November 2021, 154 males and 146 females, aged [M (Q1, Q3) ] 35.57(17.98,50.66)months. According to the random sampling method, they were divided into training set (n=240) and validation set (n=60) in a ratio of 8∶2. The training set was divided into 6 groups according to age:≤0.5 years, 24 persons; >0.5-≤1 years,21 persons; >1-≤2 years,31 persons; >2-≤3 years,44 persons; >3-≤4 years,42 persons; >4-≤5 years,78 persons. MRIcron software was used to delineate the whole brain at the level of the anterior and posterior horns of the lateral ventricles of the three MRI data as the region of interest. Then gray histograms and their parameters [including mean, maximum, minimum, skewness, kurtosis, mode, variance, and percentiles at 5% intervals from 10% to 95%(10th-95th) ]were obtained. Intra-class correlation coefficients (ICC) were used to assess consistency of intra-observer and inter-observer measurement. Representative parameters were selected by Spearman correlation analysis and curve fitting. The linear regression coefficient ß represented development rates at different ages. The selected curve regression models were applied to the validation set, and the reliability of the model was evaluated with accuracy. Results: Intra-observer and inter-observer histogram measurement parameters were generally in good consistency (ICC>0.800, all P<0.001). Histogram parameters ADC 10th-65th, T1WI 55th-80th and T2WI 10th-45th were highly correlated with age (∣r∣≥0.700, 0.600 and 0.600 respectively; all P<0.001). ADC 30th and T2WI 10th had the greatest goodness of fit (R²=0.871, 0.873; both P<0.001). Map of brain development trends showed that ADC 30th and T2WI 10th decreased with age. ADC 30th changed rapidly before the age of 2 years, most significantly within 6 months, and the rate of decrease slowed down after 2 years old. T2WI 10th decreased rapidly within 1 year, and moderately after 1 year old. The curve regression models of ADC 30th and T2WI 10th had higher accuracy in validation set [93% (56/60) and 95% (57/60), respectively]. Conclusion: Histogram parameters can quantify brain developmental trajectories at slice of anterior and posterior horns of lateral ventricles on conventional MRI in normal children aged 0-5 years, and obtain the brain development curves reflecting this slice of this age group.

Loneliness interacts with family relationship in relation to cognitive function in Chinese older adults.

ABSTRACTObjectives:Loneliness and social networks have been extensively studied in relation to cognitive impairments, but how they interact with each other in relation to cognition is still unclear. This study aimed at exploring the interaction of loneliness and various types of social networks in relation to cognition in older adults. DESIGN: a cross-sectional study. SETTING: face-to-face interview. PARTICIPANTS: 497 older adults with normal global cognition were interviewed. MEASUREMENTS: Loneliness was assessed with Chinese 6-item De Jong Gierverg's Loneliness Scale. Confiding network was defined as people who could share inner feelings with, whereas non-confiding network was computed by subtracting the confiding network from the total network size. Cognitive performance was expressed as a global composite z-score of Cantonese version of mini mental state examination (CMMSE), Categorical verbal fluency test (CVFT) and delayed recall. Linear regression was used to test the main effects of loneliness and the size of various networks, and their interaction on cognitive performance with the adjustment of sociodemographic, physical and psychological confounders. RESULTS: Significant interaction was found between loneliness and non-confiding network on cognitive performance (B = .002, ß = .092, t = 2.099, p = .036). Further analysis showed a significant interaction between loneliness and the number of family members in non-confiding network on cognition (B = .021, ß = .119, t = 2.775, p = .006). CONCLUSIONS: Results suggested that a non-confiding relationship with family members might put lonely older adults at risk of cognitive impairment. Our study might have implications on designing psychosocial intervention for those who are vulnerable to loneliness as an early prevention of neurocognitive impairments.

Rainbow pattern in Kaposi's sarcoma under polarized dermoscopy: a dermoscopic pathological study.

BACKGROUND: We found previously that the features of Kaposi's sarcoma (KS) under polarized dermoscopy are characterized by a bluish-reddish coloration, a scaly surface, small brown globules and, most distinctively, the multicoloured 'rainbow pattern'. OBJECTIVES: To evaluate the significance of the rainbow pattern on dermoscopy as a diagnostic feature in KS, and to demonstrate that it is associated with the unique vascular structure of the tumour. METHODS: More than 100 lesions from seven patients with histologically proven KS were examined with polarized light dermoscopy. Sixty-three patients with various other cutaneous vascular and nonvascular tumours were also examined. KS lesions exhibiting the rainbow pattern and KS lesions lacking the rainbow pattern on dermoscopy were excised, and dermoscopic features were compared with histopathological structures. The dermoscopic patterns of other vascular tumours were also compared with histological features. In addition, the changes in dermoscopic features and histological structures were assessed before and after surgical therapy in one patient with KS. RESULTS: On the basis of evaluations with polarized dermoscopy, the rainbow pattern was found to be a highly specific dermoscopic feature for KS. Histology of KS lesions showing the rainbow pattern under polarized light dermoscopy demonstrated a vascular lumen-rich pattern of closely arranged 'back-to-back' vascular structures, whereas histology of KS lesions without the rainbow pattern showed a vascular lumen-poor pattern with vascular lumina separated further apart by intervening stromal and cellular tissue. Other vascular tumours did not exhibit the rainbow pattern and were characterized histologically by variably sized vascular structures separated by substantial amounts of stromal and cellular tissue. In one patient with KS, disappearance of the rainbow pattern was associated with obliteration of the vascular structure following surgical ablation therapy. CONCLUSIONS: The rainbow pattern in KS is associated with the vascular lumen-rich histological subtype, is not manifest in the vascular lumen-poor subtype and disappears following total tumour removal. Therefore, the underlying structural arrangement of the vessels in KS may determine whether or not the rainbow pattern can be seen on polarized dermoscopy.

Dermoscopy of Kaposi's sarcoma: areas exhibiting the multicoloured 'rainbow pattern'.

BACKGROUND: Kaposi's sarcoma is a vascular tumour characterized by a proliferation of spindle cells and endothelial cells to form closely arranged slit-like vascular spaces. Currently, the definitive diagnosis of Kaposi's sarcoma relies on histology. The dermoscopic features of Kaposi's sarcoma are not clearly defined in the scientific literature. OBJECTIVES: We seek to evaluate the dermoscopic features of Kaposi's sarcoma and compare them with other vascular tumours. METHODS: One hundred forty-one lesions from seven patients with histologically proven Kaposi's sarcoma were evaluated using polarized light dermoscopy for the presence of various dermoscopic features. Twenty patients with other vascular tumours were also examined. RESULTS: Dermoscopic examination revealed bluish-reddish coloration (84% of lesions), multicoloured areas showing various colours of the rainbow spectrum (36%), scaly surface (29%), and small brown globules (15%). The 'rainbow pattern' was found in six out of seven patients with Kaposi's sarcoma and was not observed in other vascular tumours. In addition, there was an absence of dermoscopic features specific for other vascular and non-vascular skin tumours, such as well-defined lacunae or structured vascular pattern, in most of the Kaposi's sarcoma lesions. CONCLUSIONS: The most frequent dermoscopic patterns in Kaposi's sarcoma were found to be bluish-reddish coloration, the 'rainbow pattern', and scaly surface. The rainbow pattern is a dermoscopic feature which has not been previously described. We propose that dermoscopy, as an adjunct to clinical examination, may enhance accuracy in the preoperative diagnosis of Kaposi's sarcoma.

Patient absconding behaviour in a public general hospital: retrospective study.

OBJECTIVE: To identify characteristics of patients who abscond from general hospital wards, and to determine patient outcomes. DESIGN: Retrospective study. SETTING: In-patient wards of a public general hospital, Hong Kong. SUBJECTS AND METHODS: Incident reports of 116 absconding episodes over a 20-month period from 1 November 1998 to 30 June 2000 were reviewed. Clinical characteristics, time and reason for absconding, destination of patient, outcomes, and adverse events were recorded. RESULTS: The majority of patients who absconded were middle-aged males admitted through the Accident and Emergency Department to the specialty of general medicine. Most incidences occurred within 24 hours of admission while in the emergency admission wards. Twelve percent of incidents were repeated episodes of absconding. The most common clinical diagnoses given to this patient group were drug overdose, intoxication, and soft tissue injury. Known drug addicts (29.3%) formed a substantial proportion of the patient group. Forty- seven patients returned to the ward within a few hours, while a further nine (7.8%) re-attended the Accident and Emergency Department of the hospital within 4 days. Several adverse outcomes were recorded: one patient died following a fall from height and two patients committed criminal offences. CONCLUSION: Patient absconding incidents are an important issue in hospital risk management. They can delay the delivery of appropriate medical treatment and may lead to other adverse patient outcomes, in addition to potential medicolegal consequences.

Psychological determinants of idolatry in adolescents.

The self-esteem and fear of negative evaluation of 77 fan-club members age 16 or below and 128 age-equivalent secondary school students who had never joined a fan club were investigated. Consistent with common observations, fan-club respondents were mostly females. Significant differences were found between the two samples. Logistic regression analysis showed that being a fan-club member was associated with poor self-esteem and strong fear of negative evaluation, while the bias toward females in the fan-club sample could be attributed to the effects of these two variables.

Perception of classroom environment in Hong Kong: differences between students in junior and senior forms.

In Hong Kong secondary schools, students in the senior forms take competitive examinations to proceed to the next level, whereas those in the junior forms have to attend school regardless of their ability and motivation. It was hypothesized that this produces different classroom climates. To test this hypothesis, 602 Chinese secondary school students were administered the short version of the Classroom Environment Scale. Significant differences were found, varying by type of school, on the dimensions of Involvement, Task Orientation, Teacher Support, Competition, Order and Organization, Affiliation, Innovation, Rule Clarity, and Teacher Control. These findings are discussed.

Cavernous sinus syndrome and hepatoma metastasis.

A 46-year-old man presented with left cavernous sinus syndrome and subsequent right leg pain proved clear cell type hepatocellular carcinoma metastasis. An initial liver function test was normal and alpha-fetoprotein was only 15 ng/ml but they increased rapidly and he progressed to hepatic failure 2 weeks later. Therefore, a subclinical hepatoma with metastasis should be differentiated in cavernous sinus syndrome, even in cases of normal hepatic enzymes, because hepatoma is prevalent in Taiwan.

Inverted follicular keratosis.

Inverted follicular keratosis (IFK) is a benign skin lesion that typically presents as an asymptomatic, solitary nodule on the face of middle-aged and older individuals. IFK may mimic malignant lesions, especially squamous cell carcinoma (SCC), both clinically and pathologically. We report a 35-year-old male patient who had an exophytic nodule with papillary surface on his right nasal ala of 3 months' duration. The nodule was solitary, flesh colored, 5 mm in diameter and tended to bleed. The patient received shave excision with cautery under the clinical impression of pyogenic granuloma. Pathologically, diagnostic confusion existed between IFK and SCC. Squamous eddy formation and lack of epithelial dysplasia were suggestive of IFK. The tissue was investigated for the presence of human papillomavirus (HPV) DNA sequences by polymerase chain reaction (PCR) and negative result was obtained. This patient healed satisfactorily after removal of the lesion and no visible recurrence occurred during the following 10 months. The possibility of histologically confusing IFK with SCC, leading to unwarranted disfiguring treatments of a benign lesion, is emphasized.

Epidemic genital retraction syndrome: environmental and personal risk factors in southern China.

PIP: Koro is the term used to define the fear that one's sex organ is retracting into the body and that the complete retraction of the organ will result in death. While koro is found mainly among the Chinese and other Asian societies near China, the condition is most prevalent in southern China, where repeated epidemics have occurred. In that region, koro is found only among the Hans, the dominant ethnic group, and is over-represented among people under age 24 years. Koro provokes considerable anxiety in the individual in question and his/her family and neighbors, and is more prevalent among males than females. Men try to pull the penis out from the body or to prevent it from shrinking further by tying a string around the penis or securing it with a clamping device. Some Asian women have reported shrinking breasts, nipples, or labia. Relatives and neighbors of the same sex often help to rescue the organ in question, especially in applying anchoring devices. Others may also believe a person has koro and attempt to rescue their organ without the individual's consent. Injury to the sex organ, including bruises, bleeding, and infection, is common and sometimes results in permanent damage. In general, however, koro attacks are acute, brief, and tend not to recur. The 1984-85 koro epidemic in Hainan Island and Leizhou Peninsula is reviewed to shed light upon prevailing cultural attitudes and beliefs, news and rumors about koro, and anxiety in neighborhoods which may be causative environmental risk factors for koro. Education, age, and marital status are considered as individual risk factors. Koro in China is best described as a social sickness supported by cultural myths which tend to affect young people who are deprived of proper sex information to explain their physical development.^ieng

Sex, competitiveness, and intimacy in same-sex friendship in Hong Kong adolescents.

One of the alleged reasons that males report lower intimacy in same-sex friendships than females is that males tend to be more competitive than females, but this assumption has not been empirically tested. In the current study, 121 Hong Kong adolescents filled out Chinese versions of the Intimate Friendship Scale and the Competitiveness Index. As predicted, females reported having more intimate same-sex relationships than males, and they scored lower on competitiveness than males. However, the correlations between scores on the Competitiveness Index and the Intimate Friendship subscales were small and nonsignificant, suggesting that the sex difference in intimacy was not a function of competitiveness.

Health beliefs and optimism as predictors of preventive health decisions in Hong Kong Chinese.

The effects of components of the Health Belief Model and optimism on preventive intention were examined in 144 Hong Kong Chinese. Two variables related to the Health Belief Model, susceptibility and severity, were experimentally manipulated for an imaginary flu outbreak and a hypothetical vaccine. Participants indicated their intention to take the hypothetical vaccine after reading each of the 4 combinations of high versus low susceptibility and severity. Analysis suggested that both higher susceptibility and higher severity were associated with stronger behavioral intention to take the vaccine. Higher optimism scores were significantly associated with lower intention to take preventive action. In addition, a significant interaction was observed for optimism and severity. The effect of optimism was higher when severity was low than when it was high. Implications of these findings for research among Chinese were discussed.

An ecosystem-based understanding and analysis for SENCE toward sustainable development.

There is a need to find a comprehensive approach focusing on the conflicts between economical growth and environmental protection. Chinese scholars advocate a comprehensive ecosystem viewpoint named social-economic-natural complex ecosystem(SENCE). The kernel of the concept lies in the hierarchical structure of SENCE, through which methods from ecological network can be useful to the compound system. The author gives a schema depicting its structure, following a model analysis to help understand the reliance of economy on ecosystem. It is obvious that more actions should be done to strive for sustainable development.

A critical review of Chinese Koro.

Koro is generally considered a culture-bound psychiatric syndrome, the dominant feature of which is anxiety or dissociation. A close examination of koro epidemics in China, where koro cases appear to be more frequent than other parts of the world, shows that koro has a sociocultural component which has not been sufficiently taken into account in previous formulations. This article analyzes koro in the natural environment in which it appears and dispels the notion of koro being individual psychopathology. Koro, at least the way it is manifested in China, is a social malady maintained by cultural beliefs which affect the whole community and not just those diagnosed with it. Further directions for research into the subject are discussed.

The social context of Hong Kong's booming elderly home industry.

Hong Kong experienced a rapid increase in private homes for elderly people in recent years. This paper examines the social background of that development. Private elderly homes thrived in a context of rising demand due to changing demographics, particularly massive emigration secondary to political instability, which created a large potential market of elderly people in need of residential care. However, entrepreneurs would not be attracted unless it is a profitable business, and much of that profit is likely derived from social security payments to elderly people. Because the amount of social security benefits is way below the level required for purchasing good quality service in the private sector, many elderly people are bound to ive in very poor residential settings.