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The American Journal of Surgical... Nov 2023The latest World Health Organization classification of breast tumors recommends diagnosing malignant phyllodes tumors (MPTs) when all 5 morphologic features are present:...
The latest World Health Organization classification of breast tumors recommends diagnosing malignant phyllodes tumors (MPTs) when all 5 morphologic features are present: permeative borders, marked stromal cellularity, marked stromal cytologic atypia, ≥10 mitoses per 10 high-power fields (HPF), and stromal overgrowth. We assessed the performance of this recommendation to capture MPTs and features predictive of distant metastasis in a multi-institutional retrospective study. Of 65 MPTs, most cases had at least focally permeative borders (58, 89%), with marked stromal cellularity in 40 (61.5%), marked atypia in 38 (58.5%), ≥10 mitoses per 10 HPF in 50 (77%), and stromal overgrowth in 56 (86%). Distant metastases were observed in 20 (31%) patients (median follow-up 24.5 mo, 1 to 204). Only 13 of 65 (20%) cases had all 5 morphologic features, while only 7 of 20 (35%) cases with distant metastases had all 5 features. In univariate analysis, only marked stromal atypia ( P =0.004) and cellularity ( P =0.017) were associated with decreased distant metastasis-free survival. In multivariate Cox regression, the combination of stromal overgrowth, marked stromal cellularity, and atypia (C-index 0.721, 95% CI: 0.578, 0.863) was associated with decreased distant metastasis-free survival. The current World Health Organization recommendation will miss a significant number of MPTs with distant metastases. We propose refined diagnostic criteria for MPTs: (1) stromal overgrowth combined with ≥1 feature(s) (marked cellularity, marked atypia, or ≥10 mitoses per 10 HPF), or (2) in the absence of stromal overgrowth, marked cellularity combined with ≥1 feature(s) (permeative borders, marked atypia, or ≥10 mitoses per 10 HPF).
PubMed: 37694517
DOI: 10.1097/PAS.0000000000002109 -
Annals of Combinatorics 2022In this paper, we expand on the notion of , first introduced explicitly by Aguiar and Mahajan in 2010 but already present in the literature in some other points of view....
In this paper, we expand on the notion of , first introduced explicitly by Aguiar and Mahajan in 2010 but already present in the literature in some other points of view. We do this by adapting the algebraic framework of species to the study of substructures in combinatorics. Afterwards, we consider functions that count the number of patterns of objects and endow the linear span of these functions with a product and a coproduct. In this way, any well-behaved family of combinatorial objects that admits a notion of substructure generates a Hopf algebra, and this association is functorial. For example, the Hopf algebra on permutations studied by Vargas in 2014 and the Hopf algebra on symmetric functions are particular cases of this construction. A specific family of pattern Hopf algebras of interest are the ones arising from . This includes the presheaves on graphs, posets and generalized permutahedra. Here, we show that all the pattern Hopf algebras corresponding to commutative presheaves are free. We also study a remarkable non-commutative presheaf structure on marked permutations, permutations with a marked element. These objects have a natural product called inflation, which is an operation motivated by factorization theorems for permutations. In this paper, we find new factorization theorems for marked permutations. We use these theorems to show that the pattern Hopf algebra for marked permutations is also free, using Lyndon words techniques.
PubMed: 35782409
DOI: 10.1007/s00026-022-00578-3 -
Frontiers in Physiology 2022The recognition of tooth-marked tongues has important value for clinical diagnosis of traditional Chinese medicine. Tooth-marked tongue is often related to spleen...
The recognition of tooth-marked tongues has important value for clinical diagnosis of traditional Chinese medicine. Tooth-marked tongue is often related to spleen deficiency, cold dampness, sputum, effusion, and blood stasis. The clinical manifestations of patients with tooth-marked tongue include loss of appetite, borborygmus, gastric distention, and loose stool. Traditional clinical tooth-marked tongue recognition is conducted subjectively based on the doctor's visual observation, and its performance is affected by the doctor's subjectivity, experience, and environmental lighting changes. In addition, the tooth marks typically have various shapes and colors on the tongue, which make it very challenging for doctors to identify tooth marks. The existing methods based on deep learning have made great progress for tooth-marked tongue recognition, but there are still shortcomings such as requiring a large amount of manual labeling of tooth marks, inability to detect and locate the tooth marks, and not conducive to clinical diagnosis and interpretation. In this study, we propose an end-to-end deep neural network for tooth-marked tongue recognition based on weakly supervised learning. Note that the deep neural network only requires image-level annotations of tooth-marked or non-tooth marked tongues. In this method, a deep neural network is trained to classify tooth-marked tongues with the image-level annotations. Then, a weakly supervised tooth-mark detection network (WSTDN) as an architecture variant of the pre-trained deep neural network is proposed for the tooth-marked region detection. Finally, the WSTDN is re-trained and fine-tuned using only the image-level annotations to simultaneously realize the classification of the tooth-marked tongue and the positioning of the tooth-marked region. Experimental results of clinical tongue images demonstrate the superiority of the proposed method compared with previously reported deep learning methods for tooth-marked tongue recognition. The proposed tooth-marked tongue recognition model may provide important syndrome diagnosis and efficacy evaluation methods, and contribute to the understanding of ethnopharmacological mechanisms.
PubMed: 35492602
DOI: 10.3389/fphys.2022.847267 -
Clinical Radiology Nov 2022To improve the accuracy of diagnosis of Rosai-Dorfman disease (RDD) by summarising the computed tomography (CT) and magnetic resonance imaging (MRI) characteristics. (Review)
Review
AIM
To improve the accuracy of diagnosis of Rosai-Dorfman disease (RDD) by summarising the computed tomography (CT) and magnetic resonance imaging (MRI) characteristics.
MATERIALS AND METHODS
The clinical manifestations, imaging findings, and pathological characteristics of 14 patients with histopathologically confirmed RDD were analysed retrospectively and a literature review was undertaken.
RESULTS
Of the 14 patients, nine had multiple lesions and five had single lesions. Eight patients had extranodal lesions, while six had mixed-type lesions. In patients with head and neck lesions, plain CT/MRI revealed irregularly shaped, well-defined, homogeneous, and mainly progressive lesions, with marked homogeneous enhancement on multiphasic contrast-enhanced imaging. One patient had dural lesions, one of which iso-intense to grey matter, with patchy hypo-intensity on T2-weighted imaging, meningeal tail signs, and characteristic crabfoot-like enhancement. Three patients with skeletal system involvement exhibited osteolytic bone destruction without sclerosis at the edges, associated soft-tissue masses, or periosteal reactions. Two patients had well-defined subcutaneous lesions, inhomogeneous density, and progressive parenchymal enhancement on contrast-enhanced CT. One patient had multiple intestinal lesions with inhomogeneous nodular thickening of the blind ascending colon and ileum, with marked and progressive enhancement.
CONCLUSION
RDD involvement is mainly multifocal, primarily in the head and neck regions. Plain CT/MRI revealed well-defined, irregularly shaped lesions with homogeneous density/signal, with marked and progressive enhancement on multiphasic contrast-enhanced imaging; however, histopathology is still required to confirm the diagnosis of RDD.
Topics: Head; Histiocytosis, Sinus; Humans; Magnetic Resonance Imaging; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 36038400
DOI: 10.1016/j.crad.2022.07.008 -
Animal Cognition Sep 2023Mirror self-recognition has been examined primarily in vertebrate species, largely through the use of a mirror mark test. Recently, however, there has been growing...
Mirror self-recognition has been examined primarily in vertebrate species, largely through the use of a mirror mark test. Recently, however, there has been growing interest in the notion that all animals likely need some form of self-representation to successfully interact with their environment (Kohda et al. in Plos Biol https://doi.org/10.1371/journal.pbio.3001529 , 2022; de Waal in Plos Biol https://doi.org/10.1371/journal.pbio.3000112 , 2019). Our knowledge of this trait in invertebrate species is particularly limited, while there are several species potentially well suited for mirror mark tests. To better understand this trait and its distribution, the current research examines mirror self-recognition in ghost crab (Ocypode quadrata) using a visual mirror mark test. In an initial phase, animals were exposed to a flat oriented mirror for an extended period. In a subsequent testing phase, subjects were either (1) marked (green sticker) or sham marked (clear sticker) and exposed to a mirror, (2) marked and placed in a tank without a mirror, or (3) marked and shown video of a marked conspecific. Results showed that marked, relative to sham marked, animals were significantly more likely to remove marks when exposed to mirrors. Findings also suggests this behavior was not driven by the perception of mirror images as conspecifics, or issues related to mark placement. These data are interpreted in support of a rudimentary form of self-awareness in this species. Discussions highlight potential cognitive mechanisms that facilitate this type of self-representation and the need for additional research that informs about more sophisticated forms of self-awareness.
Topics: Animals; Visual Perception; Brachyura; Behavior, Animal; Recognition, Psychology
PubMed: 37314594
DOI: 10.1007/s10071-023-01800-2 -
International Journal of Pharmaceutical... 2020Safe, inexpensive, and convenient psoriasis therapy is desirable. Two recent case reports suggested that low-dose naltrexone is effective. Cases from our practice are...
Safe, inexpensive, and convenient psoriasis therapy is desirable. Two recent case reports suggested that low-dose naltrexone is effective. Cases from our practice are presented in order to further the evidence of efficacy and safety of low-dose naltrexone in the treatment of psoriasis. Patients included 13 females, 2 males; mean age 57 years; mean psoriasis duration 16 years. Of the patients, 8 had psoriatic arthritis. In the past, 5 had completely failed and 10 had partially responded to =1 topical therapies. Patients used a self-assessed Likert scale on the effect of low-dose naltrexone on their psoriasis: 1 - worse; 2 - unchanged; 3 - slightly improved; 4 - somewhat improved; 5 - marked improvement. The response to 4.5 mg of oral naltrexone was as follows: 8/15 marked improvement; 2/15 somewhat improved; and 5/15 unchanged. Three adverse events included insomnia, diarrhea, and self-limited headache. Marked improvement was seen by 53% of the 15 patients. Low-dose naltrexone regulates lymphocyte responses, reduces cytokine production, and likely reduces mast cell activity. Low-dose naltrexone is safe, inexpensive, and appears be effective in this open-label study.
Topics: Female; Humans; Male; Middle Aged; Naltrexone; Psoriasis; Treatment Outcome
PubMed: 32196470
DOI: No ID Found -
Frontiers in Genetics 2021Visceral fat is related to important metabolic processes, including insulin sensitivity and lipid mobilization. The goal of this study was to identify individual genes,...
Visceral fat is related to important metabolic processes, including insulin sensitivity and lipid mobilization. The goal of this study was to identify individual genes, pathways, and molecular processes implicated in visceral fat deposition in dairy cows. Data from 172 genotyped Holstein cows classified at slaughterhouse as having low ( = 77; omental fold 5 mm in thickness and minimum fat deposition in omentum) or high ( = 95; omental fold 20 mm in thickness and marked fat deposition in omentum) omental fat were analyzed. The identification of regions with significant additive and non-additive genetic effects was performed using a two-step mixed model-based approach. Genomic scans were followed by gene-set analyses in order to reveal the genetic mechanisms controlling abdominal obesity. The association mapping revealed four regions located on BTA19, BTA20 and BTA24 with significant additive effects. These regions harbor genes, such as , , and the HOXB family, that are implicated in lipolysis and insulin tolerance. Three regions located on BTA1, BTA13, and BTA24 showed marked non-additive effects. These regions harbor genes , and that are directly implicated in adipocyte differentiation, lipid metabolism, and insulin sensitivity. The gene-set analysis revealed functional terms related to cell arrangement, cell metabolism, cell proliferation, cell signaling, immune response, lipid metabolism, and membrane permeability, among other functions. We further evaluated the genetic link between visceral fat and two metabolic disorders, ketosis, and displaced abomasum. For this, we analyzed 28k records of incidence of metabolic disorders from 14k cows across lactations using a single-step genomic BLUP approach. Notably, the region on BTA20 significantly associated with visceral fat deposition was also associated with the incidence of displaced abomasum. Overall, our findings suggest that visceral fat deposition in dairy cows is controlled by both additive and non-additive effects. We detected at least one region with marked pleiotropic effects affecting both visceral fat accumulation and displaced abomasum.
PubMed: 35058972
DOI: 10.3389/fgene.2021.803216 -
Current Topics in Developmental Biology 2023A signature feature of the animal kingdom is the presence of epithelia: sheets of polarized cells that both insulate the organism from its environment and mediate...
A signature feature of the animal kingdom is the presence of epithelia: sheets of polarized cells that both insulate the organism from its environment and mediate interactions with it. Epithelial cells display a marked apico-basal polarity, which is highly conserved across the animal kingdom, both in terms of morphology and of molecular regulators. How did this architecture first evolve? Although the last eukaryotic common ancestor almost certainly possessed a simple form of apico-basal polarity (marked by the presence of one or several flagella at a single cellular pole), comparative genomics and evolutionary cell biology reveal that the polarity regulators of animal epithelial cells have a surprisingly complex and stepwise evolutionary history. Here, we retrace their evolutionary assembly. We suggest that the "polarity network" that polarized animal epithelial cells evolved by integration of initially independent cellular modules that evolved at distinct steps of our evolutionary ancestry. The first module dates back to the last common ancestor of animals and amoebozoans and involved Par1, extracellular matrix proteins, and the integrin-mediated adhesion complex. Other regulators, such as Cdc42, Dlg, Par6 and cadherins evolved in ancient unicellular opisthokonts, and might have first been involved in F-actin remodeling and filopodial dynamics. Finally, the bulk of "polarity proteins" as well as specialized adhesion complexes evolved in the metazoan stem-line, in concert with the newly evolved intercellular junctional belts. Thus, the polarized architecture of epithelia can be understood as a palimpsest of components of distinct histories and ancestral functions, which have become tightly integrated in animal tissues.
Topics: Animals; Cell Polarity; Epithelium; Epithelial Cells; Cadherins; Actins
PubMed: 37100515
DOI: 10.1016/bs.ctdb.2023.03.001 -
Frontiers in Neurology 2022Inclusion body myositis (IBM) is a progressive muscle disease affecting patients over the age of 40, with distinctive clinical and histopathological features. The... (Review)
Review
Inclusion body myositis (IBM) is a progressive muscle disease affecting patients over the age of 40, with distinctive clinical and histopathological features. The typical clinical phenotype is characterized by prominent involvement of deep finger flexors and quadriceps muscles. Less common presentations include isolated dysphagia, asymptomatic hyper-CKemia, and axial or limb weakness beyond the typical pattern. IBM is associated with marked morbidity as majority of patients eventually become wheelchair dependent with limited use of their hands and marked dysphagia. Furthermore, IBM mildly affects longevity with aspiration pneumonia and respiratory complications being the most common cause of death. On muscle biopsy, IBM is characterized by a peculiar combination of endomysial inflammation, rimmed vacuoles, and protein aggregation. These histopathological features are reflective of the complexity of underlying disease mechanisms. No pharmacological treatment is yet available for IBM. Monitoring for swallowing and respiratory complications, exercise, and addressing mobility issues are the mainstay of management. Further research is needed to better understand disease pathogenesis and identify novel therapeutic targets.
PubMed: 36237625
DOI: 10.3389/fneur.2022.1020113 -
Maedica Dec 2022Patients with sarcoidosis are known to have peripheral blood eosinophilia (PBE). However, most of them had PBE slightly above the upper limit of the normal range. Few...
Patients with sarcoidosis are known to have peripheral blood eosinophilia (PBE). However, most of them had PBE slightly above the upper limit of the normal range. Few patients had increased eosinophils in the bronchoalveolar lavage fluid (BALF), and eosinophilia in BALF enough to be diagnosed as eosinophilic pneumonia (EP) was extremely rare. We present herein a sarcoidosis case with PBE. There were fluctuations in peripheral eosinophils consistent with sarcoidosis disease activity, and peripheral blood eosinophils increased up to 50%, 12500/mm3, although the patient was affected by cough variant asthma and multimodal therapies for breast cancer. Some case reports showed EP in patients with sarcoidosis. To our best knowledge, however, no sarcoidosis patient presented with such a high level of PBE. In this report, we would like to emphasize that there might be patients with sarcoidosis who have a marked increase in peripheral blood eosinophils.
PubMed: 36818266
DOI: 10.26574/maedica.2022.17.4.990