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关键词： Chronic postoperative inguinal pain   Neuropathy   Laparoscopic hernia repair   Neuralgia  

摘要： Introduction: Preoperative inguinal pain (painful inguinal hernia) is a well-known factor associated with chronic postoperative inguinal pain (CPIP). However, it remains unclear what preventive measures should be taken in such patients. Case presentation: We report two patients with painful inguinal hernia who underwent pragmatic ilioinguinal nerve neurectomy during open anterior repair. The nerve was compressed by bulky spermatic cord lipoma in case 1 and by the hernia sac presenting over a few decades in case 2. Hematoxylin and eosin staining of the resected nerves revealed mucoid degeneration. Toluidine blue staining of resin-embedded nerve sections demonstrated that fully-myelinated axons had significantly decreased in case 1 and almost disappeared in case 2, indicating the development of massive demyelination of the ilioinguinal nerve in both cases. Discussion: In cases where the injured nerve is left in situ, CPIP may occur since demyelinating neuropathy sometimes becomes irreversible. Conclusion: Planned nerve resection via open anterior inguinal hernia repair may be an option to prevent CPIP in patients with painful inguinal hernia.

关键词： 呼吸系统疾病   中医治疗学  

ISBN: (纸本)9787539079264

摘要： 本书共分肺的解剖形态、肺脏生理功能、肺脏病理等三大章节，每个章节内容首先有“经典论述”部分，汇集以《内经》为主的四大经典的相关条文。

关键词： Biopsy   Myocardial necrosis   Pathology  

摘要： Restrictive cardiomyopathy (RCM) is a rare primary myocardial disease, and its pathological features are yet to be determined. Restrictive cardiomyopathy with MHY7 mutation was diagnosed in a 65-year-old Japanese woman. Electron microscopy of a myocardial biopsy revealed electron-dense materials resulting from focal myocyte degeneration and necrosis as well as tubular structures and pseudo-inclusion bodies in some nuclei. These features may be associated with the pathogenesis of RCM.

关键词： biopsy   coronavirus   COVID-19   cutaneous   dermatology   histopathology   mucocutaneous   pathology   SARS-CoV-2   skin   systematic review  

摘要： The mucocutaneous manifestations of Corona Virus Disease 2019 (COVID-19) logically may reflect systemic visceral involvements. These findings are visible and easy to approach like biopsies for exact histopathologic evaluations. This systematic review was conducted to collect the mucocutaneous histopathologic data of COVID-19 patients for future investigations and interpretations. The COVID-19 dermatology resource of the Centre of Evidence-Based Dermatology (CEBD) at the University of Nottingham, PubMed, Scopus, Google Scholar and Medscape was searched for relevant English articles published by June 3, 2020. This review included 31 articles, involving 459 patients. The common primary virus-related mucocutaneous manifestations are easy to approach in the course of COVID-19. The authors of this study supposed dermatopathological findings as the predictors of the nature of potential systemic involvements and outcomes of COVID-19. Scrutinizing these findings can help with adopting more effective therapeutic and management strategies;nevertheless, this review found the severity and time of onset of symptoms not to be associated with the laboratory and histopathological findings. Deterioration of clinical conditions and laboratory tests was also not related to the histopathological findings. It is recommended that meta-analyses be conducted in the future to detail on these data for having more comprehensive and better conclusion.

关键词： Endometrial neoplasm   Large cell carcinoma   Neuroendocrine carcinoma   Pathological process   Small cell carcinoma  

摘要： A previous retrospective study of a neuroendocrine carcinoma of the endometrium including 42 cases employed a central pathologic review to ensure the reliability of the findings. However, the pathological processes were not described in detail. In this study, we further analyzed these processes and the results of pretreatment endometrial cytology of neuroendocrine carcinoma. Of the 65 patients from 18 institutions registered in the study, 42 (64.6%) were diagnosed with neuroendocrine carcinoma of the endometrium based on the central pathological review. Thirteen of the 23 excluded cases conflicted from their original diagnoses: 5 (38.5%) were diagnosed with endometrioid adenocarcinoma, 5 (38.5%) with undifferentiated carcinoma, and 3 (23.1%) with carcinosarcoma. Immunohistochemical staining led to a change in diagnosis for 8 (61.5%) of the 13 cases. Pretreatment endometrial cytology was examined in 38 (90.5%) cases;34 (89.5%) of these 38 cases were found, or suspected, to be positive. To ensure the selection of appropriate therapy and keeping patients correctly informed, it is important to distinguish neuroendocrine carcinoma from other similar histologic types. Endometrial cytology may help in the early detection of this disease.

摘要： Background Lentigo maligna (LM) is a subtype of melanoma in situ with poorly defined margins and a high recurrence rate. The biological behaviour of LM appears to differ widely between cases, from biologically indolent to biologically active variants, with some patients experiencing multiple recurrences. It is not known whether this is secondary to inadequate margins, field cancerization or the innate biology of the lesion itself. Objectives (a) Describe the margins of LM in detail by analysing LM in three zones, that is centre, edge and surround using reflectance confocal microscopy (RCM) and histopathology;(b) ascertain association of histological distance of LM and atypical melanocytic hyperplasia from the surgical margin with multi-recurrent (MR) disease and (c) identify features (clinical, dermoscopy, RCM and histopathology) associated with MR LM. Methods (1) Descriptive observational study comparing the centre, edge and surround of LM on histopathology and RCM;(2) retrospective cohort study comparing parameters associated with MR and non-recurrent (NR) LM. Results 30 patients (median follow-up time 6.2 years) were included. On histopathology, confluent or near confluent lentiginous proliferation, melanocyte density >15 per 0.5 mm and adnexal spread were best for distinguishing surround from edge of LM. On RCM, predominant melanocytes, lentiginous proliferation and pleomorphism distinguished surround from centre/edge. MR patients had a median histological distance of LM from the surgical margin of 2mm (versus NR patients with an average distance of 4mm). MR patients had a greater proportion of more florid features, compared with NR on histopathology at both the centre and the edge but were similar in the surround. Conclusion These data may help pathologists and confocalists better define margins of LM. More florid features in MR patients, despite a similar background of sun-damaged skin, suggest the innate biology of the lesion rather than the field of canceriz

关键词： environmental parameters   histopathology   microbiology   tilapia farming  

摘要： The present work aimed to use histopathological gill biomarkers in tilapia (Oreochromis sp.) and physicochemical and microbiological analyses of water in the evaluation of impacts to fish farms located in Sao Jose de Ribamar and Paco do Lumiar, state of Maranhao, northeastern Brazil. Histopathological analyses performed on gills indicated morphological alterations in all tissues analysed. The lesions found were as follows: epithelial lifting, lamellar epithelium hyperplasia, blood vessel congestion, lamellar fusion, blood sinus dilation and lamellar aneurysm. Temperature, D.O., salinity and nitrite values obtained were considered within recommended standards. The pH verified in a pisciculture located in Paco do Lumiar is considered potentially stressful to fish and, therefore, predisposing to pathologies. Ammonia in a fish farm in Sao Jose de Ribamar is considered sublethal. In all fish farms evaluated, the presence of high counts of total coliforms for fish farms of Sao Jose de Ribamar was verified. Escherichia coli was verified in a cultivation in Sao Jose de Ribamar indicating faecal contamination of the nursery water by the flow of some source of domestic effluent. The integration of studies with physical, chemical and biological variables generates important data to evaluate the quality of fish production.

关键词： atypical teratoid rhabdoid tumor   intracranial germ cell tumor   methylation analysis   SMARCA4  

摘要： SMARCA4 pathogenic variants are rarely detected in pediatric brain tumors other than atypical teratoid rhabdoid tumors (AT/RTs) without INI1 deficiency or in some cases of medulloblastoma. Here, we report an atypical intracranial immature teratoma that recurred as a yolk sac tumor with metastatic spinal and lung lesions. Sequencing of the tumor revealed two SMARCA4 variants, including a splice-site variant and a non-synonymous variant of uncertain significance. Additionally, the methylation signature of the tumor was close to that of AT/RTs. Our case might be a yet-unrecognized subtype of pediatric tumors in which inactivation of SMARCA4 contributes to the pathogenesis.

关键词： Gentoo penguin (Pygoscelis papua)   Ocular exfoliative cytology   Pyogranulomatous inflammation   Putative novel bacteria   Inflammatory mediators   Immunohistochemistry  

摘要： In this study, it was aimed to present the results of microbiological, cytological, histopathological, and immunohistochemical analyses of ocular samples from an Antarctic (Ardley Island, King George Island) Gentoo penguin chick (Pygoscelis papua) with a pyogranulomatous lesion in the right eye. Samples were taken from both the healthy left eye and the lesion in the right eye. Conventional culture methods and phenotypic and molecular tests were used for bacterial isolation and identification, respectively. None of the isolates could be identified phenotypically. As a result, four of the five isolates obtained from the right eye were considered to belong to putative novel bacterial species and taxa as their similarity to GenBank data was below 98.75%. The isolates were considered to be Pasteurellaceae bacterium, Corynebacterium ciconiae, Cardiobacteriaceae bacterium, Actinomyces sp., and Dermabacteraceae bacterium. The only isolate from the left eye was identified as Psychrobacter pygoscelis. The cytological analysis demonstrated cell infiltrates composed mostly of degenerate heterophils, reactive macrophages, plasma cells, lymphocytes, and eosinophils. Based on histopathological findings, the lesion was defined as a typical pyogranulomatous lesion. Immunohistochemistry demonstrated that the granuloma was positive for TNF-alpha, IL-4, MMP-9, IL-1 beta, and IL-6. This is the first documented report of the unilateral pyogranulomatous ocular lesion in a Gentoo penguin chick, living in its natural habitat in Antarctica. This report also describes the isolation of four bacteria from the infected eye, which are considered to belong to novel Genus, species, or taxa. The primary bacterial pathogen that caused the ocular lesion was not able to be detected and remains unclear.

关键词： pandemic   speech-language pathology   survey   telehealth  

摘要： Background: The coronavirus disease2019 (COVID-19) pandemic has led to important challenges in health and education service delivery. Aims: The present study aimed to document: ( i) changes in the use of telepractice by speech-language pathology (SLP) professionals in Quebec since the start of the COVID-19 outbreak;(ii) perceptions of the feasibility of telepractice by SLPs;(iii) barriers to the use of telepractice;and (iv) the perceptions of SLP professionals regarding the main issues of telepractice. Methods & Procedures: An online survey with closed and open, Likert scale and demographic questions was completed by 83 SLPs in Quebec in June and July 2020. Outcomes & Results: The survey responses showed that within the cohort responding, telepractice use has increased significantly as a response to the COVID-19 pandemic. Most respondents planned to continue using telepractice after the pandemic ends. In addition, the respondents considered telepractice to be adequate for many clinical practices but less so for others (e.g., swallowing disorders, hearing impairment). Most of the reported barriers to the use of telepractice concerned technological problems and a lack of clinical materials for online use. Confidentiality and privacy issues were also raised. Conclusions& Implications: SLP professionals rapidly took advantage of existing technologies in their clinical settings to cope with the pandemic's effects on service delivery. The discrepancy between their perceptions and the evidence in the literature for some practices and populations strengthens the need for more information and education on telepractice.