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1.
Angiol Sosud Khir ; 26(4): 17-22, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33332302

RESUMO

The number of patients with diabetes mellitus has steadily been increasing. This disease is associated with the risk for the development of micro- and macroangiopathies. One of the variants of macroangiopathy is Mönkeberg's sclerosis characterized by the presence of calcification of the media of the arterial wall. This article is a literature review reflecting the role of calcification in arterial lesions in patients with diabetes mellitus, also covering the historical aspect of studying Mönkeberg's sclerosis. Special attention is paid to its morphological forms, aetiopathogenetic mechanisms of development, taking into account contemporary studies, demonstrating mechanisms of the effect of medial arterial calcification on haemodynamics and the risk for the development of cardiovascular complications. Also presented herein are the main non-invasive and invasive methods of its diagnosis.


Assuntos
Arteriosclerose , Calcinose , Diabetes Mellitus , Calcificação Vascular , Artérias/patologia , Calcinose/diagnóstico , Calcinose/etiologia , Humanos , Fatores de Risco , Esclerose/patologia , Calcificação Vascular/diagnóstico , Calcificação Vascular/etiologia , Calcificação Vascular/patologia
2.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5781-5784, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019288

RESUMO

Chronic Kidney Disease has become a worldwide public health problem which demands careful assessments by pathologists. In this paper, we propose a novel architecture for fine-grained classification of glomerular lesions in renal pathology images sampling from patients with IgA nephropathy. The adversarial correlation loss is innovatively presented to guide a parallel convolutional neural network. In this well- designed loss function, bias between the prediction and the label was take into account while the relationship among different categories is well-aligned. Glomerular lesions in this study are divided into five subcategories, Neg (Negative samples such as tubule and artery), SS (sclerosis involving a portion of the glomerular tuft), GS (sclerosis involving 100% of the tuft), C (build-up of more than two layers of cells within Bowman's space, often with fibrin and collagen deposition) and NOA (none of above). Our model with 93.0% accuracy and 92.9% Fl-score for these five categories has proved superior to other models through experimental results.


Assuntos
Glomerulonefrite por IGA , Insuficiência Renal Crônica , Glomerulonefrite por IGA/patologia , Humanos , Rim/patologia , Glomérulos Renais/patologia , Insuficiência Renal Crônica/patologia , Esclerose/patologia
4.
BMC Neurol ; 20(1): 241, 2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32532251

RESUMO

BACKGROUND: Increasing evidence supports the role of soluble inflammatory mediators in the pathogenesis of refractory temporal lobe epilepsy (TLE). Hippocampal sclerosis (HS) is a well-described pathohistological abnormality in TLE. The association of proinflammatory cytokines with epileptic disease profiles is well established; however, the potential significance of circulating interleukin 10 (IL-10), particularly in TLE-associated HS, is still poorly understood. Therefore, taking into consideration the neuroprotective and anticonvulsive effects of IL-10, we performed this study to examine the role of the plasma levels of IL-10 in patients with TLE with HS (TLE + HS), TLE without HS (TLE-HS) and with other types of epilepsy. METHODS: This study included 270 patients with refractory epilepsy who were classified into four groups: i) 34 patients with TLE + HS, ii) 105 patients with TLE-HS, iii) 95 patients with extra-TLE (XLE) and iv) 36 patients with idiopathic generalized epilepsy (IGE). The plasma IL-10 levels were quantified using a commercially available enzyme-linked immunosorbent assay (ELISA). RESULTS: IL-10 levels were significantly lower in TLE + HS than in TLE-HS (p = 0.013). In a subgroup of TLE-HS patients who had seizures 1 month before sampling, patients with seizures had significantly higher IL-10 levels than patients who were seizure-free (p = 0.039). Among a small group (n = 15) of non-refractory TLE-HS patients, IL-10 levels showed a moderate negative correlation with the duration of epilepsy (r = - 0.585, p = 0.023). CONCLUSIONS: This study demonstrated that chronically reduced levels of plasma IL-10 were associated with HS in TLE patients, suggesting that there was an inadequate systemic anti-inflammatory immune response. These results could provide new biological insights into the pathophysiology of HS in TLE. We also found that the production of IL-10 could be affected by the seizure frequency and declined concomitantly with increased disease durations. Therefore, the measurement of plasma IL-10 may have diagnostic value as a biomarker for stratifying TLE + HS from other epilepsy types or as a marker of disease progression towards a progressive form of epilepsy.


Assuntos
Epilepsia do Lobo Temporal/sangue , Epilepsia do Lobo Temporal/patologia , Hipocampo/patologia , Interleucina-10/sangue , Adulto , Epilepsia Resistente a Medicamentos/sangue , Epilepsia Resistente a Medicamentos/imunologia , Epilepsia Resistente a Medicamentos/patologia , Epilepsia do Lobo Temporal/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose/sangue , Esclerose/complicações , Esclerose/patologia
5.
Sci Rep ; 10(1): 8580, 2020 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-32444668

RESUMO

Anti-Thy1.1 transgenic mice develop glomerular lesions that mimic collapsing focal segmental glomerulosclerosis (FSGS) in humans with collapse of the glomerular tuft and marked hyperplasia of the parietal epithelial cells (PECs). Immunostaining of phosphor-S6 ribosomal protein (pS6RP) revealed high mTOR activity in PECs of the FSGS lesions of these mice. In this study we questioned whether the mTOR inhibitor rapamycin (sirolimus) could attenuate the development and progression of glomerulosclerotic lesions in the anti-Thy1.1 transgenic mice. We observed reduced mTOR signalling and proliferation in human parietal epithelial cells after rapamycin treatment. Experiments with anti-Thy1.1. mice showed that early treatment with sirolimus reduced the development of glomerular lesions and glomerular cell proliferation at day 4. Levels of albuminuria, podocyte injury and podocyte number were similar in the sirolimus and vehicle treated groups. The initial beneficial effects of sirolimus treatment were not observed at day 7. Late sirolimus treatment did not reduce albuminuria or the progression of glomerulosclerosis. Taken together, rapamycin attenuated PEC proliferation and the formation of early FSGS lesions in experimental FSGS and reduced human PEC proliferation in vitro. However, the initial inhibition of PEC proliferation did not translate into a decline of albuminuria nor in a sustained reduction in sclerotic lesions.


Assuntos
Albuminúria/patologia , Glomerulosclerose Segmentar e Focal/patologia , Esclerose/patologia , Sirolimo/farmacologia , Serina-Treonina Quinases TOR/antagonistas & inibidores , Albuminúria/tratamento farmacológico , Albuminúria/metabolismo , Animais , Proliferação de Células , Glomerulosclerose Segmentar e Focal/tratamento farmacológico , Glomerulosclerose Segmentar e Focal/metabolismo , Humanos , Imunossupressores/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Esclerose/tratamento farmacológico , Esclerose/metabolismo , Transdução de Sinais , Serina-Treonina Quinases TOR/genética , Serina-Treonina Quinases TOR/metabolismo , Antígenos Thy-1/fisiologia
6.
Epilepsia ; 61(4): 787-797, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32243580

RESUMO

OBJECTIVE: The "adenosine hypothesis of SUDEP" (sudden unexpected death in epilepsy) predicts that a seizure-induced adenosine surge combined with impaired metabolic clearance can foster lethal apnea or cardiac arrest. Changes in adenosine receptor density and adenosine kinase (ADK) occur in surgical epilepsy patients. Our aim was to correlate the distribution of ADK and adenosine A2A and A1 receptors (A2A R and A1 R) in surgical tissue from patients with temporal lobe epilepsy and hippocampal sclerosis (TLE/HS) with SUDEP risk factors. METHODS: In 75 cases, patients were stratified into high-risk (n = 16), medium-risk (n = 11) and low-risk (n = 48) categories according to the frequency of generalized seizures before surgery. Using whole-slide scanning Definiens image analysis we quantified the labeling index (LI) for ADK, A2A R, and A1 R in seven regions of interest: temporal cortex, temporal lobe white matter, CA1, CA4, dentate gyrus, subiculum, and amygdala and relative to glial and neuronal densities with glial fibrillary acidic protein (GFAP) and neuronal nuclear antigen (NeuN). RESULTS: A1 R showed predominant neuronal, A2A R astroglial, and ADK nuclear labeling in all regions but with significant variation. Compared with the low-risk group, the high-risk group had significantly lower A2A R LI in the temporal cortex. In HS cases with severe neuronal cell loss and gliosis predominantly in the CA1 and CA4 regions, significantly higher A1 R was present in the amygdala in high-risk than in low-risk cases. There was no significant difference in neuronal loss or gliosis between the risk groups or differences for ADK labeling. SIGNIFICANCE: Reduced cortical A2A R suggests glial dysfunction and impaired adenosine modulation in response to seizures in patients at higher risk for SUDEP. Increased neuronal A1 R in the high-risk group could contribute to periictal amygdala dysfunction in SUDEP.


Assuntos
Adenosina Quinase/metabolismo , Epilepsia do Lobo Temporal/metabolismo , Receptor A1 de Adenosina/metabolismo , Receptor A2A de Adenosina/metabolismo , Morte Súbita Inesperada na Epilepsia , Adulto , Epilepsia do Lobo Temporal/patologia , Epilepsia do Lobo Temporal/fisiopatologia , Feminino , Hipocampo/patologia , Humanos , Masculino , Fatores de Risco , Esclerose/patologia , Morte Súbita Inesperada na Epilepsia/etiologia , Morte Súbita Inesperada na Epilepsia/patologia
7.
AJNR Am J Neuroradiol ; 41(4): 591-597, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32217554

RESUMO

BACKGROUND AND PURPOSE: NeuroQuant is an FDA-approved software that performs automated MR imaging quantitative volumetric analysis. This study aimed to compare the accuracy of NeuroQuant analysis with visual MR imaging analysis by neuroradiologists with expertise in epilepsy in identifying hippocampal sclerosis. MATERIALS AND METHODS: We reviewed 144 adult patients who underwent presurgical evaluation for temporal lobe epilepsy. The reference standard for hippocampal sclerosis was defined by having hippocampal sclerosis on pathology (n = 61) or not having hippocampal sclerosis on pathology (n = 83). Sensitivities, specificities, positive predictive values, and negative predictive values were compared between NeuroQuant analysis and visual MR imaging analysis by using a McNemar paired test of proportions and the Bayes theorem. RESULTS: NeuroQuant analysis had a similar specificity to neuroradiologist visual MR imaging analysis (90.4% versus 91.6%; P = .99) but a lower sensitivity (69.0% versus 93.0%, P < .001). The positive predictive value of NeuroQuant analysis was comparable with visual MR imaging analysis (84.0% versus 89.1%), whereas the negative predictive value was not comparable (79.8% versus 95.0%). CONCLUSIONS: Visual MR imaging analysis by a neuroradiologist with expertise in epilepsy had a higher sensitivity than did NeuroQuant analysis, likely due to the inability of NeuroQuant to evaluate changes in hippocampal T2 signal or architecture. Given that there was no significant difference in specificity between NeuroQuant analysis and visual MR imaging analysis, NeuroQuant can be a valuable tool when the results are positive, particularly in centers that lack neuroradiologists with expertise in epilepsy, to help identify and refer candidates for temporal lobe epilepsy resection. In contrast, a negative test could justify a case referral for further evaluation to ensure that false-negatives are detected.


Assuntos
Epilepsia do Lobo Temporal/diagnóstico por imagem , Hipocampo/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/métodos , Imagem por Ressonância Magnética/métodos , Neuroimagem/métodos , Software , Adulto , Teorema de Bayes , Epilepsia do Lobo Temporal/patologia , Feminino , Hipocampo/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Radiologistas , Esclerose/diagnóstico por imagem , Esclerose/patologia , Sensibilidade e Especificidade
8.
World Neurosurg ; 138: e160-e168, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32081816

RESUMO

OBJECTIVE: To investigate the association between Modic changes (MCs) and endplate sclerosis; and to investigate the effect of MCs and endplate sclerosis on cage subsidence in oblique lumbar interbody fusion (OLIF) stand-alone. METHODS: We included 78 inpatients who underwent OLIF stand-alone from August 2015 to August 2017. All patients underwent computed tomography (CT) and magnetic resonance imaging. The presence and the types of MCs were assessed. Endplate sclerosis was evaluated from sagittally reconstructed CT images. Cage subsidence was evaluated at the 1-, 3-, 6-, and 12-month follow-up. RESULTS: Of 78 patients, 92 discs underwent OLIF without posterior instrumentation; 32 of 92 (34.8%) had MCs. Type I, II, and III MCs were seen in 10 (10.9%), 19 (20.7%), and 3 (3.2%) endplates, respectively. Among 32 endplates with MCs, 10 (31.3%) showed evidence of sclerosis on CT images, including 2 of 10 endplates (20%) with type I MCs, 5 of 19 (26.3%) with type II, and 3 of 3 (100%) with type III. Among 60 endplates without MCs, 5 (8.3%) showed evidence of sclerosis. Cage subsidence rate in the no-MCs group was higher than that in the MCs group (P <0.01). We found only 1 case of cage subsidence in the MCs group (n = 32), which was classified as MCs type I, whereas 6 cases of cage subsidence were observed in the no-MCs group (n = 60). Hounsfield unit ratios for sclerotic and no-sclerotic endplates were 2.2 ± 0.3 and 1.1 ± 0.1, respectively. No subsidence of cage was found in the sclerotic endplates group (n = 15), whereas 7 cases of cage subsidence were found in the no-sclerotic group (n = 77). CONCLUSION: MCs associated with endplate sclerosis can prevent cage subsidence in OLIF stand-alone.


Assuntos
Vértebras Lombares/patologia , Vértebras Lombares/cirurgia , Complicações Pós-Operatórias/patologia , Próteses e Implantes/efeitos adversos , Fusão Vertebral , Adulto , Idoso , Falha de Equipamento , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Esclerose/diagnóstico por imagem , Esclerose/patologia , Fusão Vertebral/instrumentação , Fusão Vertebral/métodos , Tomografia Computadorizada por Raios X
9.
Indian J Pathol Microbiol ; 63(1): 109-111, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32031136

RESUMO

Sclerosing polycystic adenosis (SPA) is a rare benign salivary gland lesion. Dysgenetic polycystic disease (DPD), which is a histologically similar lesion, may cause a lattice-like gross appearance with bilateral enlargement of the entire salivary glands. In this report, we present a case of SPA in the right parotid and coexistent DPD involving the both parotid.


Assuntos
Cistos/patologia , Glândula Parótida/patologia , Neoplasias Parotídeas/diagnóstico por imagem , Esclerose/patologia , Adulto , Cistos/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Hiperplasia/patologia , Imuno-Histoquímica , Imagem por Ressonância Magnética , Glândula Parótida/diagnóstico por imagem , Neoplasias Parotídeas/patologia , Ultrassonografia
10.
J Cutan Pathol ; 47(3): 291-294, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31606915

RESUMO

Sclerotic fibroma (storiform collagenoma) is a rare benign skin tumor. A solitary tumor, as well as multifocal lesions, are found either sporadically, or associated with Cowden syndrome. The tumor usually presents as clinically asymptomatic, slowly growing papule or nodule on the skin of the head, neck, and upper extremities. Microscopically the lesion is sharply demarcated, composed of hyalinized bands of collagen with low cellularity and a distinctive irregularly whorled or storiform pattern. We describe a case of a unique variant of this tumor in the scalp of a 33-year-old male. The tumor was microscopically composed of concentrically arranged collagen bundles with prevailing type III collagen, which resembled an enlarged Vater-Pacini corpuscle, with low density of CD34-positive and glucose transporter 1-negative spindle shaped cells. The specific microscopic appearance is suggestive of the term "Pacinian collagenoma" for this unique benign tumor.


Assuntos
Fibroma/patologia , Neoplasias de Cabeça e Pescoço/patologia , Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia , Adulto , Humanos , Masculino , Esclerose/patologia
11.
J Cutan Pathol ; 47(3): 286-290, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31605494

RESUMO

Sclerotic lipomas, a lipoma variant, are benign subcutaneous tumors, so-named because of their resemblance to sclerotic fibromas. Previous literature has suggested that these tumors may show a predilection for middle-aged adult males. We report an unusual case of a sclerotic lipoma diagnosed on the scalp of a 66-year-old female. The patient presented to the outpatient clinic with a 3- to 4-year history of an enlarging and irritated 2.6-cm nodule on the anterior crown of the scalp, clinically thought to be a pilar cyst. Histopathological examination from the excisional specimen revealed a well-circumscribed dermal to subcutaneous tumor with ample sclerotic collagen bundles, an increased number of CD34 positive spindled cells, and prominent S-100 positive mature adipocytes comprising greater than 50% of the tumor. We present this case given its atypical clinical and histopathological presentation, review the literature of sclerotic lipomas, and discuss the differential diagnosis to raise awareness of this rare entity.


Assuntos
Neoplasias de Cabeça e Pescoço/patologia , Lipoma/patologia , Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia , Idoso , Feminino , Humanos , Esclerose/patologia
12.
Neuroradiology ; 62(2): 185-195, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31673749

RESUMO

PURPOSE: The aim of this study is to investigate the changes in the volume of individual thalamic nuclei in patients with temporal lobe epilepsy (TLE) and hippocampal sclerosis (HS). METHODS: We enrolled 80 TLE patients with HS and 40 healthy controls. All of the subjects underwent 3D T1-weighted imaging. The hippocampus subfields and thalamic nuclei were segmented using the FreeSurfer program. We investigated volume changes in thalamic nuclei according to the HS side involved, and types or antiepileptic drug (AED) response compared with healthy controls. RESULTS: Compared with healthy controls, patients with HS showed atrophy of thalamic nuclei involving right and left parafascicular nuclei. In the right HS, the atrophy of the right thalamic nucleus was more prominent than that of the left thalamic nucleus, whereas the reduction in the volume of left thalamic nuclei was more prominent in patients with left HS. The reduction in thalamic nuclear volumes was more prominent in HS type 1 (atrophy of both CA1 and CA4 regions) than in other HS types. The suprageniculate nuclear volumes were significantly increased in patients with drug-controlled epilepsy. CONCLUSIONS: Our study demonstrates thalamic nuclear atrophy in TLE patients with HS. In addition, the atrophy of individual thalamic nuclei varied according to the HS side, the HS types, and the AED response. These findings suggest that the role of thalamic nuclei varied in TLE with HS subtypes and displayed varying degrees of vulnerability in the pathology networks associated with the hippocampus.


Assuntos
Epilepsia do Lobo Temporal/diagnóstico por imagem , Hipocampo/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Esclerose/diagnóstico por imagem , Núcleos Talâmicos/diagnóstico por imagem , Adulto , Atrofia/diagnóstico por imagem , Atrofia/patologia , Estudos de Casos e Controles , Epilepsia do Lobo Temporal/patologia , Feminino , Hipocampo/patologia , Humanos , Interpretação de Imagem Assistida por Computador , Imageamento Tridimensional , Masculino , Estudos Retrospectivos , Esclerose/patologia , Núcleos Talâmicos/patologia
13.
J Cell Physiol ; 235(2): 1674-1688, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31432509

RESUMO

Renal interstitial fibrosis is a key factor in the development of chronic renal diseases, possibly leading to uremia. The present study conducted aimed to assess the hypothesis whether keratin 1 (KRT1) silencing could suppress kidney interstitial fibrosis and glomerular sclerosis via the Notch pathway to alleviate uremic symptoms. Differentially expressed genes associated with uremia were identified using the gene expression omnibus (GEO) database. Uremic rat models were established, in which short hairpin-RNA against KRT1, activators, and inhibitors of the Notch pathway were transfected. To further validate the mechanism of KRT1 in uremia, KRT1 expression, cell apoptosis, glomerular area (GA), and glomerular capillary volume (GV), the score of glomerular sclerosis, and tubulointerstitial injury were assayed and investigated. GEO database revealed that KRT1 was upregulated in uremia and regulated the Notch pathway. GA, GV, cell apoptosis, glomerular sclerosis, and tubulointerstitial injury were typically located in more elevated levels of uremia in rats. KRT1 silencing and Notch pathway inhibition decreased the expression of Jagged1, Notch1, NICD1, Hey1, Hes1, α-SMA, and FN, which further resulted in decreased cell apoptosis, GA, GV, the score of glomerular sclerosis, and tubulointerstitial injury. Subsequently, the effect of KRT1 silencing on uremia was no longer evident once the Notch pathway was activated. The co-localization of high expression KRT1 and Notch1 was found in uremia. In summary, the results identified KRT1 as a key regulator in uremia progression, and KRT1 silencing can suppress glomerular sclerosis and tubulointerstitial injury via inactivation of the Notch pathway in uremic rats.


Assuntos
Queratina-1/metabolismo , Nefropatias/metabolismo , Receptores Notch/metabolismo , Transdução de Sinais/fisiologia , Uremia/metabolismo , Animais , Fibrose/metabolismo , Fibrose/patologia , Nefropatias/patologia , Glomérulos Renais/metabolismo , Glomérulos Renais/patologia , Masculino , Ratos , Ratos Wistar , Esclerose/metabolismo , Esclerose/patologia
14.
Histopathology ; 76(2): 244-250, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31373020

RESUMO

AIMS: Despite increasing interest in the recently established immunoglobulin 4-related disease (IgG4-RD), its pathogenesis and aetiology remain largely unclear. Characteristic histopathological features are one of the key elements of diagnosis, including 'storiform' fibrosis, obliterative phlebitis, increased lymphoplasmacytic infiltration and increased levels of IgG4 in serum and tissue. Histopathological features of IgG4-RD are striking but not specific, and can pose a pitfall for surgical pathologists. This paper aims to determine the actual amount of IgG4+ plasma cells in nodular-sclerosing Hodgkin lymphoma (NSHL) and its potential to be misdiagnosed in routine clinical practice. METHODS AND RESULTS: IgG4+ plasma cells per high-power field (HPF) and the ratio of IgG4+ versus IgG+ plasma cells (IgG4/IgG ratio) in lymph node biopsies of 24 patients with nodular-sclerosing Hodgkin lymphoma (NSHL) were determined using immunohistochemistry and consensus scoring criteria as used for IgG4-RD. Ten lymph node biopsies with reactive follicular hyperplasia were assessed for comparison. Higher numbers of IgG4+ plasma cells (P < 0.001) were observed in NSHL versus follicular hyperplasia (mean 34 versus 8 per HPF) with a mean IgG4/IgG ratio of 0.38 versus 0.18. Five cases (21%) fulfilled the consensus criteria of IgG4-RD, with >50 IgG4+ plasma cells per HPF and an IgG4/IgG ratio of >0.4. The mean count of IgG4+ plasma cells per HPF in NSHL varied greatly (3-88) with increased numbers of IgG4+ plasma cells seen near areas of fibrosclerosis. CONCLUSIONS: Significantly higher levels of IgG4+ plasma cells are common in NSHL, emphasising the need to exclude Reed-Sternberg cells by morphology and immunohistochemistry in biopsies where IgG4-RD is suspected.


Assuntos
Doença de Hodgkin/diagnóstico , Doença Relacionada a Imunoglobulina G4/diagnóstico , Imunoglobulina G/análise , Esclerose/diagnóstico , Adolescente , Adulto , Idoso , Biópsia , Criança , Estudos de Coortes , Erros de Diagnóstico , Feminino , Alemanha , Doença de Hodgkin/imunologia , Doença de Hodgkin/patologia , Humanos , Doença Relacionada a Imunoglobulina G4/imunologia , Doença Relacionada a Imunoglobulina G4/patologia , Imuno-Histoquímica , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Plasmócitos/imunologia , Plasmócitos/patologia , Esclerose/imunologia , Esclerose/patologia , Adulto Jovem
16.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(12): 1499-1503, 2020 Dec 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33473009

RESUMO

Encapsulating peritoneal sclerosis (EPS) is a rare but severe complication of peritoneal dialysis. A total of 50% of the patients died within 12 months after being diagnosed. There are no obvious clinical symptoms in the early stage of EPS, which is easy to be missed. And there are few case reports of EPS in early stage. On December 22, 2018, a 70-year-old male patient undergoing peritoneal dialysis for 17 months, who was diagnosed as EPS, was admitted to the Department of Nephrology, the Third Xiangya Hospital, Central South University. The patient's peritoneal dialysis catheter was obstructed after peritonitis. The peritoneal dialysis fluid couldn't be drain in and out of the abdominal cavity. Therefore, the laparoscopy was performed to repair the catheter. The operation in progress showed that the peritoneum was slightly thickened and the ileocecal intestinal tube was closely adhered to the parietal peritoneum where the catheter was wrapped, indicating the early stage of EPS. Peritoneal relaxation was performed. The patient's catheter was normal after adhesiolysis. He underwent hemodialysis, nutritional supporting as well as peritoneal dialysis transition, etc. The peritonitis was controlled after 10 days and the peritoneal dialysis was resumed. After discharge from hospital, the patient took moxifloxacin for 2 more weeks. We followed up the patient for 6 months. The automated peritoneal dialysis is maintained, and everything remains normal. Clinicians need to improve understanding of EPS. Early diagnosis and laparoscopic adhesiolysis is helpful to continue peritoneal dialysis treatment.


Assuntos
Diálise Peritoneal , Fibrose Peritoneal , Peritonite , Idoso , Diagnóstico Precoce , Humanos , Masculino , Diálise Peritoneal/efeitos adversos , Fibrose Peritoneal/etiologia , Fibrose Peritoneal/patologia , Peritônio , Peritonite/etiologia , Peritonite/patologia , Esclerose/patologia
17.
Neuroimage Clin ; 24: 102024, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31670154

RESUMO

OBJECTIVE: To investigate the agreement between manually and automatically generated tracts from diffusion tensor imaging (DTI) in patients with temporal lobe epilepsy (TLE). Whole and along-the-tract diffusivity metrics and correlations with patient clinical characteristics were analyzed with respect to tractography approach. METHODS: We recruited 40 healthy controls and 24 patients with TLE who underwent conventional T1-weighted imaging and 60-direction DTI. An automated (Automated Fiber Quantification, AFQ) and manual (TrackVis) deterministic tractography approach was used to identify the uncinate fasciculus (UF) and parahippocampal white matter bundle (PHWM). Tract diffusion scalar metrics were analyzed with respect to agreement across automated and manual approaches (Dice Coefficient and Spearman correlations), to side of onset of epilepsy and patient clinical characteristics, including duration of epilepsy, age of onset and presence of hippocampal sclerosis. RESULTS: Across approaches the analysis of tract morphology similarity revealed Dice coefficients at moderate to good agreement (0.54 - 0.6) and significant correlations between diffusion values (Spearman's Rho=0.4-0.9). However, within bilateral PHWM, AFQ yielded significantly lower FA (left: Z = 4.4, p<0.001; right: Z = 5.1, p<0.001) and higher MD values (left: Z=-4.7, p<0.001; right: Z=-3.7, p<0.001) compared to the manual approach. Whole tract DTI metrics determined using AFQ were significantly correlated with patient characteristics, including age of epilepsy onset in FA (R = 0.6, p = 0.02) and MD of the ipsilateral PHWM (R=-0.6, p = 0.02), while duration of epilepsy corrected for age correlated with MD in ipsilateral PHWM (R = 0.7, p<0.01). Correlations between clinical metrics and diffusion values extracted using the manual whole tract technique did not survive correction for multiple comparisons. Both manual and automated along-the-tract analyses demonstrated significant correlations with patient clinical characteristics such as age of onset and epilepsy duration. The strongest and most widespread localized ipsi- and contralateral diffusivity alterations were observed in patients with left TLE and patients with HS compared to controls, while patients with right TLE and patients without HS did not show these strong effects. CONCLUSIONS: Manual and AFQ tractography approaches revealed significant correlations in the reconstruction of tract morphology and extracted whole and along-tract diffusivity values. However, as non-identical methods they differed in the respective yield of significant results across clinical correlations and group-wise statistics. Given the absence of excellent agreement between manual and AFQ techniques as demonstrated in the present study, caution should be considered when using AFQ particularly when used without reference to benchmark manual measures.


Assuntos
Imagem de Tensor de Difusão/métodos , Epilepsia do Lobo Temporal/diagnóstico por imagem , Fibras Nervosas/patologia , Adolescente , Adulto , Automação , Mapeamento Encefálico , Contagem de Células , Eletroencefalografia , Epilepsia do Lobo Temporal/patologia , Feminino , Lateralidade Funcional , Hipocampo/patologia , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Esclerose/patologia , Substância Branca/diagnóstico por imagem , Substância Branca/patologia , Adulto Jovem
19.
J Neurol ; 266(12): 3150-3159, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31549200

RESUMO

Temporal lobe epilepsy has been usually associated with progressive brain atrophy due to neuronal cell loss. However, recent animal models demonstrated a dual effect of epileptic seizures with initial enhancement of hippocampal neurogenesis followed by abnormal astrocyte proliferation and neurogenesis depletion in the chronic stage. Our aim was to test for the hypothesized bidirectional pattern of epilepsy-associated brain remodeling in the context of the presence and absence of mesial temporal lobe sclerosis. We acquired MRIs from a large cohort of mesial temporal lobe epilepsy patients with or without hippocampus sclerosis on radiological examination. The statistical analysis tested explicitly for common and differential brain patterns between the two patients' cohorts and healthy controls within the computational anatomy framework of voxel-based morphometry. The main effect of disease was associated with continuous hippocampus volume loss ipsilateral to the seizure onset zone in both temporal lobe epilepsy cohorts. The post hoc simple effects tests demonstrated bilateral hippocampus volume increase in the early epilepsy stages in patients without hippocampus sclerosis. Early age of onset and longer disease duration correlated with volume decrease in the ipsilateral hippocampus. Our findings of seizure-induced hippocampal remodeling are associated with specific patterns of mesial temporal lobe atrophy that are modulated by individual clinical phenotype features. Directionality of hippocampus volume changes strongly depends on the chronicity of disease. Specific anatomy differences represent a snapshot within a progressive continuum of seizure-induced structural remodeling.


Assuntos
Progressão da Doença , Epilepsia do Lobo Temporal/patologia , Hipocampo/patologia , Adulto , Idade de Início , Atrofia/patologia , Doença Crônica , Estudos Transversais , Epilepsia do Lobo Temporal/diagnóstico por imagem , Epilepsia do Lobo Temporal/fisiopatologia , Feminino , Hipocampo/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Esclerose/patologia , Fatores de Tempo , Adulto Jovem
20.
Forensic Sci Int ; 303: 109952, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31546166

RESUMO

BACKGROUND: Dating the traumatic event is usually done on subdural hematoma (SDH). After infant deaths due to Abusive head trauma (AHT) without SDH available, the magistrates still ask experts to date the traumatic event. To do so, the expert only has tools based on adult series of AHT. We aimed to develop a subarachnoid hemorrhage (SAH) and retinal hemorrhage (RH) dating system applicable to infants aged under 3 years. METHODS AND RESULTS: We studied a retrospective multicenter collection of 235 infants who died between the ages of 0 and 36 months, diagnosed with SAH and/or RH by forensic pathological examination and with known posttraumatic interval (PTI). Two pathologists assessed blindly and independently 12histomorphological features in 83 infants (35 girls, 48 boys) whose median age was 3.8 months. For SAH, histopathological changes were significantly correlated with PTI for the appearance of red blood cells, of fibrino-plaquetted organization, the quantity of lymphocytes and macrophages and the presence or absence of siderophages, collagen and fibroblast formation and presence or absence of neovascularization. For RH, histopathological changes were significantly correlated with PTI for the appearance of red blood cells, the presence or absence of siderophages and sclerosis of the retina. CONCLUSION: Our HAS dating system improves the precision and reliability of forensic pathological expert examination of AHT, when SDH are not available, for age estimation in infants. The study of RH histomorphological changes does not allow for reliable dating.


Assuntos
Mudanças Depois da Morte , Hemorragia Retiniana/patologia , Hemorragia Subaracnóidea/patologia , Plaquetas/patologia , Maus-Tratos Infantis , Pré-Escolar , Colágeno/metabolismo , Eritrócitos/patologia , Feminino , Fibrina/metabolismo , Fibroblastos/patologia , Patologia Legal , Humanos , Lactente , Recém-Nascido , Linfócitos/patologia , Macrófagos/patologia , Masculino , Neovascularização Fisiológica , Retina/patologia , Estudos Retrospectivos , Esclerose/patologia
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