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关键词： Bipolar disorder   Prefrontal cortex  

摘要： Bipolar disorder (BD) is highly heritable. Identifying objective biomarkers reflecting pathophysiological processes predisposing to, versus protecting against BD, can help identify BD risk in offspring of BD parents. We recruited 21 BD participants with a first-degree relative with BD, 25 offspring of BD parents, 27 offspring of comparison parents with non-BD psychiatric disorders, and 32 healthy offspring of healthy parents. In at-risk groups, 23 had non-BD diagnoses and 29, no Axis-I diagnoses(healthy). Five at-risk offspring who developed BD post scan(Converters) were included. Diffusion imaging(dMRI) analysis with tract segmentation identified between-group differences in the microstructure of prefrontal tracts supporting emotional regulation relevant to BD: forceps minor, anterior thalamic radiation(ATR), cingulum bundle(CB), and uncinate fasciculus(UF). BD participants showed lower fractional anisotropy (FA) in the right CB (anterior portion) than other groups (q < 0.05);and in bilateral ATR (posterior portion) versus at-risk groups (q < 0.001). Healthy, but not non-BD, at-risk participants showed significantly higher FA in bilateral ATR clusters than healthy controls (qs < 0.05). At-risk groups showed higher FA in these clusters than BD participants (qs < 0.05). Non-BD versus healthy at-risk participants, and Converters versus offspring of BD parents, showed lower FA in the right ATR cluster (qs < 0.05). Low anterior right CB FA in BD participants versus other groups might result from having BD. High bilateral ATR FA in at-risk groups, and in healthy at-risk participants, versus healthy controls might protect against BD/other psychiatric disorders. Absence of elevated right ATR FA in non-BD versus healthy at-risk participants, and in Converters versus non-converter offspring of BD parents, might lower protection against BD in at-risk groups.

关键词： adenomyoepithelioma   biphasic   heterogeneity   malignant potential   skin  

摘要： Some skin adnexal tumors display both epithelial and myoepithelial cell populations and can be broadly categorized as biphasic tumors. These include apocrine hidrocystoma, mixed tumor, adenomyoepithelioma (AME), and adenoid cystic carcinoma (ACC). Myoepithelioma is the myoepithelial cell-predominant type in this category. Cutaneous AME is exceedingly rare and usually has a benign prognosis, but it is considered to have the potential for local recurrence and metastasis. We report the case of a 57-year-old man with a 1-year history of an ulcerated nodule on his scalp. Microscopically, it was a defined cutaneous nodule with a focal lobulated architecture, composed of epithelial cells forming ducts and myoepithelial cells distributed around the ducts. In addition to these findings of typical AME, the present case focally revealed atypical features, such as increased mitotic activity (7/10 high power fields), invasive growth, and necrosis. However, cytological atypia was not significant. We conclusively diagnosed cutaneous AME with atypical features, suggesting malignant potential. Moreover, areas showing appearances similar to apocrine hidrocystoma, mixed tumor, myoepithelioma, and ACC were focally observed. We present a unique case of cutaneous AME exhibiting histopathological heterogeneity. The recognition of morphological variation could be helpful in appropriately diagnosing and treating AME of the skin.

关键词： Rectal cancer   histogram analysis   magnetic resonance imaging   pathological staging  

摘要： Objective: To analyze the correlation between histogram parameters of ADC and pathological staging of rectal cancer and CD31, CD240, S-100, and to explore its predictive value. Materials and Methods: MRI findings of 60 patients with surgically and pathologically proved rectal cancer were analyzed retrospectively. Patients were divided into pT1-2, pT3-4, pN0, pN1-2, G1-2 and G3 groups according to TNM staging of UICC tumors (2019) and WHO classification of digestive system tumors (2019). Cases were divided into CD31 (+) and CD31 (-), CD2-40 (+) and CD4-20 (-), S-100 (+) and S-100 (-) groups according to the expression of immunohistochemical markers. The ROI was delineated layer by layer on the ADC images by Firevoxel software, and the histogram parameters were extracted. The histogram parameters (ADC mean, ADC minimum, ADC maximum, ADC mode, ADC quartile), skewness, kurtosis and entropy were compared between each group. The bivariate logistic regression model was used to predict the tumor staging and immunohistochemical results. Results: 1. ADC10th, ADC mean and Entropy were higher than pT3-4, ADC mean was higher than pT1-2, Entropy was lower than pT1-2, ADC10th, ADC25th, ADC50th, ADC mean and ADC mode were lower than pT3-40 (-) in CD2-40 (+) group, and the difference was statistically significant (p < 0.05);2. The lower area of the curve (AUC) of rectal cancer pT, pN and CD2-40 (+) is 0.952 (0.892-1.000), 0.882 (0.791-0.972), 0.913 (0.840-0.985);3. In the logistic regression model, higher ADC, Ropy and higher pN stages are independent predictors of tumor pT stages (OR =1.156, 1.144,111.528);p = 0.045, 0.048, 0.002);higher Ropy and lower pT stages are independent predictors of tumor pN stages in the model (OR = 73.939, 0.024;p = 0.019, 0.001);higher ADC and lower differentiation are independent predictors of tumor CD2-40 stages in the model (ADC =1.17, 0.048, 0.011);and higher Ropy and lower pT stages are independent predictors of tumor CD2-40 stages in the model (AD

关键词： Preschool   Psychopathology   Threat   Externalizing   Violence   Face processing  

摘要： Childhood exposure to traumatic violence may shape how children respond to threatening faces and increase risk for psychopathology. Maltreated children may exhibit altered processing of threatening faces;however, the effects of witnessing intimate partner violence (IPV) on children's discrimination of facial expressions is under-studied. Emotional face processing differentially relates to psychopathology, with some evidence suggesting improved detection of angry faces in children with fear-related anxiety symptoms, whereas externalizing symptoms are associated with poorer detection of fearful faces and perhaps emotional faces broadly. In this cross-sectional study, we examined discrimination of threatening emotional faces (angry, fearful) in relation to experiences of probable abuse and witnessing of physical IPV, as well as psychopathology. Children (N = 137, mean age = 5.01 years, SD = 0.81) completed a "face in the crowd task" designed to examine discrimination of angry and fearful faces. Children either searched for an angry face among fearful distractor faces or a fearful face among angry distractors. Probable child abuse, witnessed IPV, and symptoms were assessed in semi-structured maternal interviews. Children who witnessed violence showed poorer accuracy when fearful faces were the target;however, effects for probable abuse were non-significant. Greater fear-related anxiety symptoms were associated with poorer accuracy for fearful faces. Externalizing symptoms were associated with poorer overall accuracy. Findings suggest that IPV and fear-related anxiety symptoms were associated with difficulty detecting fearful faces when angry distractors were present, consistent with prior research. Implications of violence- and symptom-associated deficits in emotional face processing are discussed.

关键词： alopecia   cicatricial alopecia   dermoscopy   folliculitis decalvans   histology   horizontal sections   scarring alopecia   transverse sections   trichoscopy   tufted folliculitis   vertical sections  

摘要： Background: Folliculitis decalvans (FD) is a form of inflamed primary cicatricial alopecia (PCA). FD is classified as a neutrophilic PCA;however, only a few previous studies have described its histopathology, including the assessment of systematically evaluated and quantified follicular changes in horizontally sectioned biopsy specimens with clinical and dermoscopic findings of the early and advanced stages. Objective: We aimed to clarify the histopathologic and dermoscopic features of early and advanced active stage FD. Methods: We conducted a case series study of 42 patients with FD by dermoscopy and both horizontally and vertically sectioned biopsy specimens. Results: The histopathologic findings of the early-stage lesions included loss of sebaceous glands;interfollicular acanthosis;and fibrosis with depressed, fused follicular infundibula showing thickened interfollicular keloid-like areas with tufted hairs on dermoscopy. Active lesions showed a greater number of hair clusters, clefting, and fused infundibula with dense inflammation predominantly in the upper follicles. Neutrophil-predominant infiltrates were observed in fewer than half of the patients, including those with early-stage lesions. Limitations: This was a retrospective study. Conclusion: FD has the features of mixed-cell PCA. The features of early-stage FD are thickened interfollicular keloid-like areas with tufted hairs and loss of sebaceous glands. ( J Am Acad Dermatol 2021;85:1185-93.)

ISBN: (纸本)9787030667601

关键词： liver transplantation   donor-specific antibody   histology   HLA   antibody-mediated rejection  

摘要： Antibody-mediated rejection after liver transplantation is an under-recognised cause of allograft injury. While definitions of acute and chronic antibody-mediated rejection have increased clinical awareness, timely identification and management of antibody-mediated rejection remain difficult because of complexities in diagnosis and histopathology, lack of treatment protocols, and unclear long-term outcomes. While recent cohort studies assessing the importance of donor-specific antibodies have aided in its diagnosis, literature on the treatment of antibody-mediated rejection in liver transplantation remain limited to case reports and small series. Further increasing the awareness and timely recognition of antibody-mediated rejection post-liver transplantation is crucial in order to stimulate future research and the development of protocols for its diagnosis and treatment. This review will summarise recent advances in the clinical diagnosis and treatment of antibody-mediated rejection in liver transplantation, as well as some of the histopathologic features (on liver biopsy tissue) of acute and chronic antibody-mediated rejection. (C) 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

关键词： simulation   stuttering   speech-language pathology students   student learning  

摘要： Background Simulation-based learning can be used in university programmes to provide speech-language pathology students with essential clinical experiences. However, limited research has explored the use of simulation to support students' development of skills in clinical practice with people who stutter. Aims (1) To evaluate students' clinical skills in managing stuttering within a simulation-based learning programme;(2) to develop an assessment tool, the Standardised Patient Interview Rating Scale for Stuttering (SPIRS-Stuttering);and (3) to conduct a preliminary investigation of its validity in measuring students' performance. Methods & Procedures Speech-language pathology students (n = 114) participated in a simulation-based stuttering programme in addition to academic coursework in fluency disorders. Students' clinical skills were assessed over two simulation sessions using the SPIRS-Stuttering tool, adapted from an earlier iteration of the SPIRS tool. Content validity, intra-rater reliability and internal consistency of the SPIRS-Stuttering tool were also explored. Outcomes & Results Students demonstrated a statistically significant improvement in stuttering clinical skills between sessions 1 and 4 of the simulation-based stuttering programme. Good content validity was achieved for the SPIRS-Stuttering tool with a low level of intra-rater reliability and variable internal consistency. Conclusions & Implications This study identified that students' clinical skills in stuttering improved during participation in a simulation-based programme undertaken in conjunction with an academic course on fluency disorders. The results of this study support the inclusion of this learning modality in university programme curricula. Whilst the SPIRS-Stuttering tool enabled assessment of speech-language pathology students' clinical skills in stuttering management, further exploration of reliability is required. What this paper adds What is already known on this subject Within sp

关键词： Surgical Oncology   Oncology   Surgery  

摘要： Background Phyllodes tumors are rare fibroepithelial neoplasms that are classified by tiered histopathologic features. While there are protocols for the reporting of cancer specimens, no standardized reporting protocol exists for phyllodes. Methods We performed an 11-institution contemporary review of phyllodes tumors. Granular histopathologic details were recorded, including the features specifically considered for phyllodes grade classification. Results Of 550 patients, median tumor size was 3.0 cm, 68.9% (n = 379) of tumors were benign, 19.6% (n = 108) were borderline, and 10.5% (n = 58) were malignant. All cases reported the final tumor size and grade classification. Complete pathologic reporting of all histopathologic features was present in 15.3% (n = 84) of cases, while an additional 35.6% (n = 196) were missing only one or two features in the report. Individual details regarding the degree of stromal cellularity was not reported in 53.5% (n = 294) of cases, degree of stromal atypia in 58.0% (n = 319) of cases, presence of stromal overgrowth in 56.2% (n = 309) of cases, stromal cell mitoses in 37.5% (n = 206) of cases, and tumor border in 54.2% (n = 298) of cases. The final margin status (negative vs. positive) was omitted in only 0.9% of cases, and the final negative margin width was specifically reported in 73.8% of cases. Reporting of details was similar across all sites. Conclusion In this academic cohort of phyllodes tumors, one or more histopathologic features were frequently omitted from the pathology report. While all features were considered by the pathologist for grading, this limited reporting reflects a lack of reporting consensus. We recommend that standardized reporting in the form of a synoptic-style cancer protocol be implemented for phyllodes tumors, similar to other rare tumors.

关键词： fennel ethanolic extract   glyphosate   herbicides   inflammation   Oreochromis niloticus  

摘要： Glyphosate, a common herbicide widely used all over the world, can reach the aquatic environment and adversely affect their living organisms. The current study was designed to investigate the possible ameliorating effect of Foeniculum vulgare (Fennel) against glyphosate exposure in Nile tilapia. The fish in this study were assigned into six groups: Control group, Fennel 1 group and Fennel 2 group: fed on 1 and 2 ml/kg diet, respectively, Glyphosate group: exposed to 1.2 +/- 0.05 mg/L glyphosate in water, Glyphosate + Fennel 1 group and Glyphosate + Fennel 2 group: exposed to glyphosate and fed on fennel supplemented diet, all for 30 days. Blood and tissue samples were collected from all groups at the end of the experiment. The biochemical analysis of serum revealed a significant increase in alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) activities after glyphosate exposure. Moreover, a profound state of hepatic oxidative stress was observed in fish exposed to glyphosate as an increase in malondialdehyde and DNA fragmentation and a decrease in antioxidant enzyme activities. The gene expression of hepatic pro-inflammatory cytokines (Tumour necrosis factor-alpha-Interleukin-1 beta) was up-regulated in the glyphosate group. On the other hand, a diet supplemented with fennel extract reversed to a large extent the above-mentioned adverse effects of glyphosate exposure in a dose-dependent manner. Therefore, we could conclude that fennel supplementation provides a natural, safe and economically available method to reverse and protect against the inevitable pesticide exposure in non-target organisms as Nile tilapia.