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Asian Journal of Neurosurgery Jun 2023Intramedullary tumors represent the major cause of spinal cord injuries, and its symptoms include pain and weakness. Progressive weakness may concomitantly occur in the... (Review)
Review
Intramedullary tumors represent the major cause of spinal cord injuries, and its symptoms include pain and weakness. Progressive weakness may concomitantly occur in the upper and lower limbs, along with lack of balance, spine tenderness, sensory loss, trophic changes of extremity, hyperreflexia, and clonus. The study protocol was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic search of the MEDLINE electronic database was performed to identify the studies reporting the clinical features of children and adults who presented with an intramedullary lymphoma. Twenty-one studies were included, reporting 25 cases. Manuscripts were excluded if the full-text article was not available, original data were not reported (e.g., review articles), or if the main disease was not intramedullary lymphoma. A structured data extraction form was employed to standardize the identification and retrieval of data from manuscripts. To enlighten the discussion, a case is also presented. An 82-year-old woman with Fitzpatrick skin type II, diagnosed and treated for non-Hodgkin's lymphoma 7 years ago, was admitted with mental confusion and memory loss for the past 2 months-evolving with recurring falls from her own height. One day before admission, she displayed Brown-Séquard syndrome. An expansive lesion from C2 to C4 in the cervical spinal cord was found and a hypersignal spinal cord adjacent was described at the bulb medullary transition to the C6-C7 level. A primary spinal cord tumor was considered, as well as a melanoma metastasis, due to the lesion's flame pattern. The patient presented a partial recovery of symptoms and a reduction of the spinal cord edema after being empirically treated with corticosteroids, but the lesion maintained its extent. Subsequently, a large diffuse B-cell lymphoma with nongerminal center was found in open body biopsy, infiltrating neural tissue. The main objective of the present study is to report a surgical case treated for a large diffuse B-cell lymphoma, in addition to presenting the results of a systematic review of primary intramedullary spinal cord lymphoma.
PubMed: 37397032
DOI: 10.1055/s-0043-1768574 -
Annals of Burns and Fire Disasters Dec 2016During a judicial inquiry, the forensic doctor is frequently required to examine the hospitalized fire victim. He has to produce a certificate on the burns, defining...
During a judicial inquiry, the forensic doctor is frequently required to examine the hospitalized fire victim. He has to produce a certificate on the burns, defining their origin, seriousness and prognosis. The expert assessment of serious burn victims consists in an overall evaluation of functional and psychological sequelae, and can be conducted only after the long period of treatment needed for them to heal. The expert must know the forensic rules concerning the specific features of sequelae that follow a cutaneous burn injury. The forensic doctor can intervene where a body is discovered, and the aim of the autopsy is to check if burns were the cause of death. The most common lesions observed are serious thermal burns and they are frequently associated with inhalation of fumes. Often the body is carbonized to conceal a homicide therefore it is crucial that postmortem results are compared with the police investigation data. Due to modifications to the body brought about by fire and charring, a specific protocol for identification is required, especially in the event of a disaster.
PubMed: 28289365
DOI: No ID Found -
Neurology(R) Neuroimmunology &... Oct 2016Relapses and progression contribute to multiple sclerosis (MS) disease course, but neither the relationship between them nor the spectrum of clinical heterogeneity has... (Review)
Review
Relapses and progression contribute to multiple sclerosis (MS) disease course, but neither the relationship between them nor the spectrum of clinical heterogeneity has been fully characterized. A hypothesis-driven, biologically informed model could build on the clinical phenotypes to encompass the dynamic admixture of factors underlying MS disease course. In this medical hypothesis, we put forth a dynamic model of MS disease course that incorporates localization and other drivers of disability to propose a clinical manifestation framework that visualizes MS in a clinically individualized way. The topographical model encapsulates 5 factors (localization of relapses and causative lesions; relapse frequency, severity, and recovery; and progression rate), visualized utilizing dynamic 3-dimensional renderings. The central hypothesis is that, like symptom recrudescence in Uhthoff phenomenon and pseudoexacerbations, progression clinically recapitulates prior relapse symptoms and unmasks previously silent lesions, incrementally revealing underlying lesion topography. The model uses real-time simulation software to depict disease course archetypes and illuminate several well-described but poorly reconciled phenomena including the clinical/MRI paradox and prognostic significance of lesion location and burden on disease outcomes. Utilization of this model could allow for earlier and more clinically precise identification of progressive MS and predictive implications can be empirically tested.
PubMed: 27648465
DOI: 10.1212/NXI.0000000000000279 -
Radiologia Brasileira 2016Hyperechoic lesions are not a frequent finding at breasts ultrasonography, and most of times are associated with benign pathologies that do not require further... (Review)
Review
Hyperechoic lesions are not a frequent finding at breasts ultrasonography, and most of times are associated with benign pathologies that do not require further evaluation. However, some neoplasms such as invasive breast carcinomas and metastases may present with hyperechogenicity. Thus, the knowledge about differential diagnoses and identification of signs of lesion aggressiveness are of great relevance to avoid unnecessary procedures or underdiagnosis, and to support the correct clinical/surgical approach. On the basis of such concepts, the present essay describes and illustrates the main features of hyperechoic lesions at breast ultrasonography in different cases, with anatomopathological correlation.
PubMed: 26929460
DOI: 10.1590/0100-3984.2014.0032 -
Breeding Science Dec 2021In the absence of pathogen attack, lesion mimic mutants (LMMs) in plants undergo spontaneous cell death and develop necrosis or apoptosis-like lesions on the leaves or...
In the absence of pathogen attack, lesion mimic mutants (LMMs) in plants undergo spontaneous cell death and develop necrosis or apoptosis-like lesions on the leaves or sheath, resembling symptoms of hypersensitive response. In-depth research has been conducted on LMMs, especially regarding the molecular mechanisms underlying programmed cell death and disease resistance. In this study, the () mutant was identified as a typical LMM, showing lesions on both the leaf blade and leaf sheath. The formation of lesions was found to be caused by cell death accompanied by accumulation of hydrogen peroxide and degradation of chloroplasts. Compared with wild-type, the main agronomic traits such as plant height, effective panicle number, panicle length, grain per panicle, seed setting rate, and 1000-grain weight of were significantly reduced. The defence and pathogenesis-related genes , , , and , were transcriptionally activated in mutant without pathogen attack. Genetic analysis showed that the mutant phenotype was controlled by the gene , which was mapped to an interval of 260 kb at the end of the long arm on chromosome 11. Pathogen inoculation analysis showed that has enhanced resistance to sheath blight, rice blast, and bacterial blight.
PubMed: 35087315
DOI: 10.1270/jsbbs.20160 -
Journal of Animal Science Oct 2022Infrared thermography (IRT) can measure a temperature change on the surface of objects, and is widely used as an inflammation or fever detection tool. The objective of...
Integrated infrared thermography and accelerometer-based behavior logger as a hoof lesion identification tool in dairy cows with various foot diseases under subtropical climates.
Infrared thermography (IRT) can measure a temperature change on the surface of objects, and is widely used as an inflammation or fever detection tool. The objective of this longitudinal study was to investigate the feasibility of detecting hoof lesion cattle using IRT under subtropical climate conditions. The experiment was conducted in two free-stall commercial dairy farms and 502 dairy cows participated between August 2020 and March 2022. Before hoof trimming, the portable IRT was used to measure the maximum temperature of each hoof from three shooting directions, including anterior (hoof coronary band), lateral (hoof lateral coronary band), and posterior (skin between heel and bulbs). In order to evaluate the effect of hoof lesions on the behavior of dairy cows, we also collected behavior data by automated accelerometers. The results indicated that the temperature of hooves with lesions was significantly higher than that of sound hooves in hot environments regardless of the shooting directions (P < 0.0001). In all of three shooting directions, the maximum temperature of feet with severe lesion was significantly higher than those of feet with mild lesion and sound feet (P < 0.05). Cows with lesion feet had lower daily activity and feeding time than sound cows before clinical diagnosis (P < 0.05). Furthermore, we used thresholds of both anterior hoof temperature at 32.05 °C and average daily activity at 410.5 (arbitrary unit/d) as a lame cow detecting tool. The agreement of this integrated tool reached 75% with clinical diagnosis, indicating that this integrated approach may be feasible for practice in dairy farm. In conclusion, IRT has the potential to be used as a hoof lesion detecting tool under subtropical climate conditions when using sound hoof temperature as reference points, and detection precision can be improved when IRT integrated with automated accelerometers as a lame cow detecting tool.
Topics: Female; Cattle; Animals; Hoof and Claw; Thermography; Longitudinal Studies; Cattle Diseases; Foot Diseases; Accelerometry
PubMed: 35985291
DOI: 10.1093/jas/skac271 -
Journal of Neurology, Neurosurgery, and... Jun 1978Anosognosia (denial of weakness) and "anosognosic phenomena" (other abnormal attitudes to a weak limb) were studied in 100 acute hemiplegics. Both conditions were...
Anosognosia (denial of weakness) and "anosognosic phenomena" (other abnormal attitudes to a weak limb) were studied in 100 acute hemiplegics. Both conditions were associated with lesions of either hemisphere. Apathy, visual field defect, and impaired picture identification were particularly prominent in anosognosia. A failure to integrate information from one side of the body was regarded as fundamental to the condition; explanations in terms of "unilateral neglect" and "agnosia" are discussed.
Topics: Aged; Aphasia; Attention; Attitude; Cerebrovascular Disorders; Denial, Psychological; Female; Functional Laterality; Hemiplegia; Humans; Kinesthesis; Male; Middle Aged; Orientation; Visual Perception
PubMed: 671066
DOI: 10.1136/jnnp.41.6.548 -
Brazilian Journal of Medical and... Jun 2009This review provides examples of the fact that different procedures for the measurement of atherosclerosis in mice may lead to interpretation of the extent of... (Review)
Review
This review provides examples of the fact that different procedures for the measurement of atherosclerosis in mice may lead to interpretation of the extent of atherosclerosis having markedly different biological and clinical significance for humans: 1) aortic cholesterol measurement is highly sensitive for the detection of early and advanced atherosclerosis lesions, but misses the identification of the location and complexity of these lesions that are so critical for humans; 2) the histological analysis of the aortic root lesions in simvastatin-treated and control mice reveals similar lesion morphology in spite of the remarkable simvastatin-induced reduction of the aortic cholesteryl ester content; 3) in histological analyses, chemical fixation and inclusion may extract the tissue fat and also shrink and distort tissue structures. Thus, the method may be less sensitive for the detection of slight differences among the experimental groups, unless a more suitable procedure employing physical fixation with histological sample freezing using optimal cutting temperature and liquid nitrogen is employed. Thus, when measuring experimental atherosclerosis in mice, investigators should be aware of several previously unreported pitfalls regarding the extent, location and complexity of the arterial lesion that may not be suitable for extrapolation to human pathology.
Topics: Animals; Anticholesteremic Agents; Aorta; Arteriosclerosis; Cholesterol; Disease Models, Animal; Humans; Mice; Simvastatin; Tunica Intima
PubMed: 19448893
DOI: 10.1590/s0100-879x2009000600001 -
American Journal of Ophthalmology Nov 2021To validate a custom algorithm for automated identification and quantification of clinically relevant inflammatory choriocapillaris (CC) lesions from en face... (Observational Study)
Observational Study
PURPOSE
To validate a custom algorithm for automated identification and quantification of clinically relevant inflammatory choriocapillaris (CC) lesions from en face swept-source optical coherence tomography (SS-OCTA) images.
DESIGN
Observational case series.
METHODS
Twenty eyes of 14 patients with posterior uveitis were imaged. The machine-generated en face OCTA CC slabs were exported to a computing platform, where a custom algorithm performed unsupervised lesion boundary delineation and area quantification. Lesions identified by the algorithm (AG) were compared to those identified by 2 masked human graders (HG1 and HG2), using the Sørensen-Dice coefficient (DSC) and intraclass correlation coefficient (ICC). Intragrader and intravisit reliability were determined by coefficient of variation (CV) and DSC.
RESULTS
The AG demonstrated excellent agreement with both HGs in determination of lesion area (HG1 vs AG ICC 0.92, 95% CI 0.81-0.97, HG2 vs AG ICC 0.91, 95% CI 0.78-0.97). The AG demonstrated good spatial overlap (DSC ≥0.70) with both HGs in 14 of 20 (70%) eyes and at least 1 HG in 16 of 20 (80%) eyes. Poor spatial overlap (DSC between 0.31 and 0.69) was associated with the presence of a choroidal neovascular membrane and low-contrast lesion boundaries. Intravisit repeatability for the AG was superior to both HGs (CV 2.6% vs >5%).
CONCLUSION
This custom algorithm demonstrated a high degree of agreement with HGs in identification of inflammatory CC lesions and outperformed HGs in reproducibility. Automated CC lesion delineation will support the development of objective and quantitative biomarker of disease activity in patients with posterior uveitis.
Topics: Choroid; Fluorescein Angiography; Humans; Reproducibility of Results; Tomography, Optical Coherence; Uveitis, Posterior
PubMed: 34107308
DOI: 10.1016/j.ajo.2021.06.004 -
Endoscopic submucosal dissection and endoscopic mucosal resection for early stage esophageal cancer.Annals of Cardiothoracic Surgery Mar 2017Mortality from esophageal cancer remains high despite advances in medical therapy. Although the incidence of squamous cell carcinoma of the esophagus remains unchanged,... (Review)
Review
Mortality from esophageal cancer remains high despite advances in medical therapy. Although the incidence of squamous cell carcinoma of the esophagus remains unchanged, the incidence of the esophageal adenocarcinoma has increased over time. Gastroesophageal reflux disease (GERD and obesity are contributing factors to the development of Barrett's esophagus and subsequent development of adenocarcinoma. Early recognition of the disease can lead to resection of esophageal cancer prior to the development of lymphovascular invasion. Various modalities have been implemented to aid identification of precancerous lesions and early esophageal cancer. Chromoendoscopy, narrowband imaging and endoscopic ultrasound examination are typically used for evaluating early esophageal lesions. Recently, confocal laser endomicroscopy (CLE) and volumetric laser scanning were implemented with promising results. Endoscopic management of early esophageal cancer may be done using endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). Both techniques allow resection of the mucosa (and possibly a portion of the submucosa) containing the early tumor without interruption of deeper layers. A submucosal injection creating a cushion coupled with snare resection or cap assisted mucosal suction followed by ligation and snare resection are the most common techniques of EMR. EMR can remove lesions less than 2 cm in size en bloc. Larger lesions may require resection in piecemeal fashion. This may limit assessment of the margins of the lesion and orienting the lesion's border. ESD offers en bloc dissection of the lesion regardless of its size. ESD is performed with specialized needle knives, which allow incision followed by careful dissection of the lesion within the submucosal layer. Tumor recurrence after ESD is rare but the technique is labor intensive and has an increased risk of perforation. Esophageal stenosis remains a concern after extensive EMR or ESD. Dilation with balloon or stent placement is usually sufficient to treat post-resection stenosis.
PubMed: 28446997
DOI: 10.21037/acs.2017.03.15