Assuntos
Condrossarcoma , Cordoma , Doenças do Sistema Nervoso , Neoplasias da Base do Crânio , Humanos , Pessoa de Meia-Idade , Osso Petroso/diagnóstico por imagem , Osso Petroso/patologia , Epistaxe/patologia , Neoplasias da Base do Crânio/complicações , Neoplasias da Base do Crânio/diagnóstico por imagem , Condrossarcoma/complicações , Condrossarcoma/diagnóstico por imagem , Cefaleia/diagnóstico por imagem , Cefaleia/etiologiaRESUMO
Hippocampal sclerosis (HS) is often associated with gray-white matter blurring (GMB) of the anterior temporal lobe. In this study, twenty patients with unilateral temporal lobe epilepsy and HS were studied with 3 T MRI including T1 MP2RAGE and DTI/DMI sequences. Anterior temporal lobe white matter T1 relaxation times and diffusion measures were analyzed on the HS side, on the contralateral side, and in 10 normal controls. Resected brain tissue of three patients without GMB and four patients with GMB was evaluated ultrastructurally regarding axon density and diameter, the relation of the axon diameter to the total fiber diameter (G-ratio), and the thickness of the myelin sheath. Hippocampal sclerosis GMB of the anterior temporal lobe was related to prolonged T1 relaxation and axonal loss. A less pronounced reduction in axonal fraction was also found on imaging in GMB-negative temporal poles compared with normal controls. Contralateral values did not differ significantly between patients and normal controls. Reduced axonal density and axonal diameter were histopathologically confirmed in the temporopolar white matter with GMB compared to temporal poles without. These results confirm that GMB can be considered an imaging correlate for disturbed axonal maturation that can be quantified with advanced diffusion imaging.
Assuntos
Epilepsia do Lobo Temporal , Doenças Neurodegenerativas , Substância Branca , Epilepsia do Lobo Temporal/patologia , Hipocampo/diagnóstico por imagem , Hipocampo/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Esclerose/complicações , Esclerose/patologia , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/patologia , Substância Branca/diagnóstico por imagem , Substância Branca/patologiaAssuntos
Paralisia Facial , Tumor Rabdoide , Teratoma , Criança , Paralisia Facial/diagnóstico por imagem , Feminino , Humanos , Neuropatologia , Vômito/etiologiaAssuntos
Ependimoma/diagnóstico por imagem , Hidrocefalia/diagnóstico por imagem , Neoplasias Infratentoriais/diagnóstico por imagem , Astrocitoma/diagnóstico por imagem , Diagnóstico Diferencial , Ependimoma/patologia , Humanos , Hidrocefalia/cirurgia , Lactente , Neoplasias Infratentoriais/patologia , Neoplasias Infratentoriais/cirurgia , Imageamento por Ressonância Magnética , Masculino , Meduloblastoma/diagnóstico por imagem , Tumor Rabdoide/diagnóstico por imagem , Teratoma/diagnóstico por imagemRESUMO
BACKGROUND AND PURPOSE: Therapeutic hypothermia represents a promising neuroprotective treatment in acute ischemic stroke. Selective cerebral hypothermia applied early, prior to and during endovascular mechanical recanalization therapy, may be beneficial in the critical phase of reperfusion. We aimed to assess the feasibility of a new intracarotid cooling catheter in an animal model. MATERIALS AND METHODS: Nine adult sheep were included. Temperature probes were introduced into the frontal and temporal brain cortices bilaterally. The cooling catheter system was introduced into a common carotid artery. Selective blood cooling was applied for 180 minutes. Systemic and local brain temperatures were measured during cooling and rewarming. Common carotid artery diameters and flow were measured angiographically and by Doppler sonography. RESULTS: The common carotid artery diameter was between 6.7 and 7.3 mm. Common carotid artery blood flow velocities increased moderately during cooling and after catheter removal. Maximum cerebral cooling in the ipsilateral temporal cortex was -4.7°C (95% CI, -5.1 to -4.0°C). Ipsilateral brain temperatures dropped significantly faster and became lower compared with the contralateral cortex with maximum temperature difference of -1.3°C (95% CI, -1.5 to -1.0°C; P < .0001) and compared with systemic temperature (-1.4°C; 95% CI, -1.7 to -1.0°C; P < .0001). CONCLUSIONS: Sheep proved a feasible animal model for the intracarotid cooling catheter. Fast induction of selective mild hypothermia was achieved within the cooled cerebral hemisphere, with stable temperature gradients in the contralateral brain and systemic blood. Further studies are required to demonstrate any therapeutic benefit of selective cerebral cooling in a stroke model.
Assuntos
Encéfalo/irrigação sanguínea , Artéria Carótida Primitiva/fisiopatologia , Artéria Carótida Primitiva/cirurgia , Hipotermia Induzida/instrumentação , Animais , Catéteres , Modelos Animais de Doenças , Estudos de Viabilidade , Masculino , OvinosAssuntos
Imagem de Difusão por Ressonância Magnética , Ependimoma/patologia , Lobo Frontal/patologia , Imageamento por Ressonância Magnética , Neoplasias Supratentoriais/patologia , Biomarcadores Tumorais/análise , Proliferação de Células , Diagnóstico Diferencial , Ependimoma/cirurgia , Feminino , Lobo Frontal/cirurgia , Humanos , Hidrocefalia/cirurgia , Lactente , Gradação de Tumores , Complicações Pós-Operatórias/cirurgia , Reoperação , Neoplasias Supratentoriais/cirurgiaAssuntos
Granuloma/diagnóstico , Interpretação de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Doenças da Hipófise/diagnóstico , Neoplasias Hipofisárias/diagnóstico , Sela Túrcica , Xantomatose/diagnóstico , Meios de Contraste/administração & dosagem , Diagnóstico Diferencial , Feminino , Granuloma/patologia , Granuloma/cirurgia , Humanos , Aumento da Imagem , Pessoa de Meia-Idade , Doenças da Hipófise/patologia , Doenças da Hipófise/cirurgia , Neoplasias Hipofisárias/patologia , Neoplasias Hipofisárias/cirurgia , Complicações Pós-Operatórias/diagnóstico , Sela Túrcica/patologia , Sela Túrcica/cirurgia , Xantomatose/patologia , Xantomatose/cirurgiaAssuntos
Fossa Craniana Posterior/cirurgia , Ganglioglioma/cirurgia , Neoplasias da Base do Crânio/cirurgia , Adolescente , Fossa Craniana Posterior/patologia , Ganglioglioma/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias da Base do Crânio/patologia , Resultado do TratamentoRESUMO
Whole-genome sequencing in an isolated population with few founders directly ascertains variants from the population bottleneck that may be rare elsewhere. In such populations, shared haplotypes allow imputation of variants in unsequenced samples without resorting to complex statistical methods as in studies of outbred cohorts. We focus on an isolated population cohort from the Pacific Island of Kosrae, Micronesia, where we previously collected SNP array and rich phenotype data for the majority of the population. We report identification of long regions with haplotypes co-inherited between pairs of individuals and methodology to leverage such shared genetic content for imputation. Our estimates show that sequencing as few as 40 personal genomes allows for inference in up to 60% of the 3000-person cohort at the average locus. We ascertained a pilot data set of whole-genome sequences from seven Kosraean individuals, with average 5× coverage. This assay identified 5,735,306 unique sites of which 1,212,831 were previously unknown. Additionally, these variants are unusually enriched for alleles that are rare in other populations when compared to geographic neighbors (published Korean genome SJK). We used the presence of shared haplotypes between the seven Kosraen individuals to estimate expected imputation accuracy of known and novel homozygous variants at 99.6% and 97.3%, respectively. This study presents whole-genome analysis of a homogenous isolate population with emphasis on optimal rare variant inference.
Assuntos
Genoma Humano , Estudo de Associação Genômica Ampla , Polimorfismo de Nucleotídeo Único , Grupos Populacionais/genética , Algoritmos , Alelos , Estudos de Coortes , Efeito Fundador , Frequência do Gene , Genótipo , Humanos , Ilhas do Pacífico , Reprodutibilidade dos TestesRESUMO
Adult granulosa cell tumor (GCT) of the ovary is the most common malignancy amongst the sex cord stromal tumors. Clinical stage, age, tumor size, residual disease and several histologic factors have been reported to be of prognostic significance. There were 839 ovarian malignancies at our institute during the period from 1998 to 2002. Out of 54 granulosa cell tumors, 40 cases were evaluable which includes 37 cases of adult GCT and 3 cases of juvenile GCT. They were studied retrospectively. Majority of patients presented with abdominal symptoms and FIGO stage I. All patients were treated surgically and 62.1% of adult GCTs were given post-operative chemotherapy. Clinical stage, presence of residual disease and tumor volume were the most important prognostic factors. Age of patient, menstrual status, post-operative chemotherapy, mitosis or histological patterns were of little significance in our study.
Assuntos
Tumor de Células da Granulosa/patologia , Neoplasias Ovarianas/patologia , Adulto , Idoso , Feminino , Tumor de Células da Granulosa/mortalidade , Tumor de Células da Granulosa/terapia , Humanos , Índia/epidemiologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/terapia , Prognóstico , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
Metastasis of mesothelioma of the pleura, to the skin and subcutis is an extremely rare occurrence. A 25 year old woman, who had undergone chemotherapy, partial excision of tumor followed by radiotherapy of sarcomatoid mesothelioma of the pleura, presented three months later with painless widespread subcutaneous nodules. FNAC of these nodules reveled pleomorphic malignant spindle shaped cell with epithelioid morphology. The subcutis is a particularly rare site of metastatic sarcomatoid mesothelioma. It is essential to differentiate neoplasm metastatic to the skin and subcutis from primary and benign lesions of the same region. FNAC is accurate and efficient, in conjugation with clinical history, and it also prevents surgical biopsy in the diagnosis of metastatic subcutaneous lesion. To our knowledge, this is the first case, reported till date, in which the sarcomatoid mesothelioma metastasized to the subcutaneous tissue and was diagnosed by fine needle aspiration cytology (FNAC).
Assuntos
Mesotelioma/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Adulto , Biópsia por Agulha Fina , Diagnóstico Diferencial , Feminino , Humanos , Mesotelioma/secundário , Neoplasias Pleurais , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/secundário , Neoplasias de Tecidos Moles/secundário , Tela SubcutâneaRESUMO
Hepatoblastoma (HBL) is the most common primary malignant hepatic tumor in children. The aim of the present study is to describe cytological findings of HBL, to subclassify it, and to discuss differential diagnoses. Twenty cases were taken from records of Cytopathology department, Gujarat Cancer and Research Institute, Ahmedabad. The aspiration smears were stained with Papanicolaou stain andlor Giemsa stain. Cytological and architectural criteria were applied to aspiration smears. Fifteen cases (75%) of HBL were diagnosed in the patients below the age of two years. The commonest presentation was found to be lump in abdomen. On the basis of cytoarchitectural features, HBL was classified in two groups undifferentiated and differentiated. Morphologically, the tumor cells were commonly arranged in acinar pattern, papillary pattern, or in sheets. FNA cytology alone had some limitations in the diagnosis of HBL. Hence, cytoarchitecture in combination with clinicalfeatures, imaging techniques and serum a-fetoprotein levels were helpful for specific diagnosis of HBL and to rule out various others differential diagnosis of small round cell tumor. The cytological differential diagnosis between differentiated HBL and Hepatocellular carcinoma (HCC) was found to be very difficult.
Assuntos
Hepatoblastoma , Neoplasias Hepáticas , Adolescente , Biópsia por Agulha Fina , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/patologia , Criança , Pré-Escolar , Citodiagnóstico , Diagnóstico Diferencial , Feminino , Hepatoblastoma/diagnóstico , Hepatoblastoma/patologia , Humanos , Lactente , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patologia , MasculinoRESUMO
A 12-year-old girl, with incessant atypical idiopathic left ventricular tachycardia, underwent successful radiofrequency ablation of ventricular tachycardia focus originating from a subepicardial site adjacent to the left coronary cusp. Ventricular tachycardia was successfully eliminated by targeting an endocardial site concordant to the epicardial site of early activation. Epicardial mapping was useful in locating an effective ablation site, and aortic root angiography was used to avoid potential injury to important structures, such as the left main coronary artery and left coronary cusp.
Assuntos
Ablação por Cateter , Taquicardia Ventricular/terapia , Ablação por Cateter/métodos , Criança , Angiografia Coronária , Eletrocardiografia , Fluoroscopia , Humanos , Pericárdio , Taquicardia Ventricular/diagnóstico por imagemRESUMO
We report a case of a child with familial long QT syndrome (Jervell Lange-Nielsen) who had multiple electrical storms in the presence of b blocker and implantable cardioverter device (ICD) therapy. Discontinuation of ICD therapy and addition of oral amiodarone to b blockade therapy resulted in freedom from electrical storms.
Assuntos
Desfibriladores Implantáveis , Síndrome de Jervell-Lange Nielsen/fisiopatologia , Antagonistas Adrenérgicos beta/uso terapêutico , Amiodarona/uso terapêutico , Antiarrítmicos/uso terapêutico , Pré-Escolar , Humanos , Síndrome de Jervell-Lange Nielsen/terapia , MasculinoRESUMO
100 Cases of invasive breast cancer were studied for Tumor type, Tumor site, Nodal Status, Mitotic counts, Nuclear pleomorphism, Tubule formation and Nottingham modification of Bloom Richardson Grading. The follow up of the 82 patients treated with surgery and adjuvant treatment was available. Mitotic activity index (MAI) counted with strict criteria of elston CW, emerged as one of the most significant prognostic parameter followed by overall grade in predicting Tumor free survival (TFS) for the patients. Mitotic count also correlated well with overall Grade and lymph node status in predicting the TFS. This parameter is very useful where advanced studies like flowcytometry and immunohistochemical studies of the cell proliferation marker are not available.