The paper is to study the structural changes in cortex and cerebellum of autopsies of subjects with schizophrenia.In the Pathology Department of the Psychiatric Hospital"Fray Bernardino,Avarez",there are 410...The paper is to study the structural changes in cortex and cerebellum of autopsies of subjects with schizophrenia.In the Pathology Department of the Psychiatric Hospital"Fray Bernardino,Avarez",there are 410 autopsy cases with diagnosis of mental disease,from which 52 match schizophrenia.The aim of this work is to describe structural changes in the autopsy material and make markers in order to confirm neurodevelopment alterations.The tissues were preserved in formol,paraffin-embedded;cut into 5-7μm slices;stained with H-E(Hematoxilin and Eosin),Bielschowsky,crystal fast of violet.The observed changes were brain asymmetry,cortical dysplasia,neuronal distortion,axon bifurcation,neuronophagia and generalized demyelination.Schizophrenia is the result of several happenings,it is important to devise new treatment strategies for prevention and genetic counseling for population.展开更多
The current World Health Organization classification system of primary brain tumors is solely based on morphologic criteria. However, there is accumulating evidence that tumors with similar histology have distinct mol...The current World Health Organization classification system of primary brain tumors is solely based on morphologic criteria. However, there is accumulating evidence that tumors with similar histology have distinct molecular signatures that significantly impact treatment response and survival. Recent practice-changing clinical trials have defined a role for routine assessment of O-6-methylguanine-DNA methyltransferase(MGMT) promoter methylation in glioblastoma patients, especially in the elderly, and 1p and 19q codeletions in patients with anaplastic glial tumors. Recently discovered molecular alterations including mutations in IDH-1/2, epidermal growth factor receptor(EGFR), and BRAF also have the potential to become targets for future drug development. This article aims to summarize current knowledge on the molecular biology of high-grade gliomas relevant to daily practice.展开更多
Objective:We aimed to summarize the clinicopathological characteristics and prognostic features of various molecular subtypes of diffuse gliomas(DGs)in the Chinese population.Methods:In total,1,418 patients diagnosed ...Objective:We aimed to summarize the clinicopathological characteristics and prognostic features of various molecular subtypes of diffuse gliomas(DGs)in the Chinese population.Methods:In total,1,418 patients diagnosed with DG between 2011 and 2017 were classified into 5 molecular subtypes according to the 2016 WHO classification of central nervous system tumors.The IDH mutation status was determined by immunohistochemistry and/or DNA sequencing,and 1p/19q codeletion was detected with fluorescence in situ hybridization.The median clinical follow-up time was 1,076 days.T-tests and chi-square tests were used to compare clinicopathological characteristics.Kaplan‒Meier and Cox regression methods were used to evaluate prognostic factors.Results:Our cohort included 15.5%lower-grade gliomas,IDH-mutant and 1p/19q-codeleted(LGG-IDHm-1p/19q);18.1%lowergrade gliomas,IDH-mutant(LGG-IDHm);13.1%lower-grade gliomas,IDH-wildtype(LGG-IDHwt);36.1%glioblastoma,IDHwildtype(GBM-IDHwt);and 17.2%glioblastoma,IDH-mutant(GBM-IDHm).Approximately 63.3%of the enrolled primary gliomas,and the median overall survival times for LGG-IDHm,LGG-IDHwt,GBM-IDHwt,and GBM-IDHm subtypes were 75.97,34.47,11.57,and 15.17 months,respectively.The 5-year survival rate of LGG-IDHm-1p/19q was 76.54%.We observed a significant association between high resection rate and favorable survival outcomes across all subtypes of primary tumors.We also observed a significant role of chemotherapy in prolonging overall survival for GBM-IDHwt and GBM-IDHm,and in prolonging post-relapse survival for the 2 recurrent GBM subtypes.Conclusions:By controlling for molecular subtypes,we found that resection rate and chemotherapy were 2 prognostic factors associated with survival outcomes in a Chinese cohort with DG.展开更多
Machine learning represents a growing subfield of artificial intelligence with much promise in the diagnosis,treatment,and tracking of complex conditions,including neurodegenerative disorders such as Alzheimer’s and ...Machine learning represents a growing subfield of artificial intelligence with much promise in the diagnosis,treatment,and tracking of complex conditions,including neurodegenerative disorders such as Alzheimer’s and Parkinson’s diseases.While no definitive methods of diagnosis or treatment exist for either disease,researchers have implemented machine learning algorithms with neuroimaging and motion-tracking technology to analyze pathologically relevant symptoms and biomarkers.Deep learning algorithms such as neural networks and complex combined architectures have proven capable of tracking disease-linked changes in brain structure and physiology as well as patient motor and cognitive symptoms and responses to treatment.However,such techniques require further development aimed at improving transparency,adaptability,and reproducibility.In this review,we provide an overview of existing neuroimaging technologies and supervised and unsupervised machine learning techniques with their current applications in the context of Alzheimer’s and Parkinson’s diseases.展开更多
Hirschsprung＇s disease （HD） is a disorder associated with congenital malformation of the enteric nervous system with segmental aganglionosis. Prevailing therapy includes a resection of the affected part of the bowe...Hirschsprung＇s disease （HD） is a disorder associated with congenital malformation of the enteric nervous system with segmental aganglionosis. Prevailing therapy includes a resection of the affected part of the bowel, However, patients often do not obtain complete functional improvement after surgical treatment. We present the case of a 25-year-old woman who had surgical treatment of lid in early childhood. After that procedure she had clinical features of constipation for years in the end, passing of stool once a week, requiring laxatives and enemas. We diagnosed an incomplete resection of the aganglionic bowel via rectal biopsy and resected the remaining aganglionic segment. Two months after surgery the patient＇s bowel function improved to a frequency of 1-4 stools per day. We conclude that regular follow-up is required to identify lid patients with persistent alterations of bowel function after surgery. In patients presenting with constipation, recognition of a remaining aganglionic segment or other alterations of the enteric nervous system should be aimed at in an early stage. 2005 The WJG Press and Elsevier Inc. All rights reserved展开更多
The subgenual cingulate cortex has been found to be different in structure and function in mood and affective disorders compared to healthy individuals. Imaging studies have shown a decrease in function of the subgenu...The subgenual cingulate cortex has been found to be different in structure and function in mood and affective disorders compared to healthy individuals. Imaging studies have shown a decrease in function of the subgenual region in bipolar disorder and depression, with overall glial number shown to be decreased in these disorders. Decreases in subgenual grey matter in SZ have been observed also. In this neuropathological study upon formalin-fixed coronal brain sections we describe the morphological finding of de- creased frequency of subgenual cingulate crown bifurcation (p = 0.02) as compared to control, bipolar and depression cases. This suggests that the cingulate cortex in schizophrenia may be morphologically distinct in utero formation, potentially enabling an early identification of high-risk individuals.展开更多
In the porcine model discussed in this review,the acute subdural hematoma was induced by subdural injection of autologous blood over the left parietal cortex,which led to a transient elevation of the intracerebral pre...In the porcine model discussed in this review,the acute subdural hematoma was induced by subdural injection of autologous blood over the left parietal cortex,which led to a transient elevation of the intracerebral pressure,measured by bilateral neuromonitoring.The hematoma-induced brain injury was associated with albumin extravasation,oxidative stress,reactive astrogliosis and microglial activation in the ipsilateral hemisphere.Further proteins and injury markers were validated to be used for immunohistochemistry of porcine brain tissue.The cerebral expression patterns of oxytocin,oxytocin receptor,cystathionine-γ-lyase and cystathionine-β-synthase were particularly interesting:these four proteins all co-localized at the base of the sulci,where pressure-induced brain injury elicits maximum stress.In this context,the pig is a very relevant translational model in contrast to the rodent brain.The structure of the porcine brain is very similar to the human:the presence of gyri and sulci(gyrencephalic brain),white matter to grey matter proportion and tentorium cerebelli.Thus,pressure-induced injury in the porcine brain,unlike in the rodent brain,is reflective of the human pathophysiology.展开更多
In the published version of Figure 21,an error appeared in Figure 2C on page 1468.In Figure 2C,the Kaplan-Meier estimation of the overall survival of patients with recurrent DG classified according to molecular subtyp...In the published version of Figure 21,an error appeared in Figure 2C on page 1468.In Figure 2C,the Kaplan-Meier estimation of the overall survival of patients with recurrent DG classified according to molecular subtypes was mistakenly covered by the curves of patients with primary DGs during the figure layout process,while the number statistic under the figure is correct.Figure 2C has been updated to correct this mistake.The error does not affect the conclusions of this article.We apologize for the error and for any confusion that it might have caused.展开更多
Cardiovascular diseases in general and atherothrombosis as the most common of its individualdisease entities is the leading cause of death in the developed countries.Therefore,visualizationand characterization of inne...Cardiovascular diseases in general and atherothrombosis as the most common of its individualdisease entities is the leading cause of death in the developed countries.Therefore,visualizationand characterization of inner arterial plaque composition is of vital diagnostic interest,especilly for the early recognition of vulnerable plaques.Established clinical techniques provide valuablemorphological information but cannot deliver information about the chemicai composition ofindividual plaques.Therefore,spectroscopic imaging techniques have recently drawn consider-able attention.Based on the spectroscopic properties of the individual plaque components,as forinstance diferent types of lipids,the composition of atherosclerotic plaques can be analyzedqualitatively as well as quantitatively.Here,we compare the feasibility of multimodal nonlinearimaging combining,two-photon fluorescence(TPF),coherent anti-Stokes Raman scatering(CARS)and second-hamonic generation(SHG)microscopy to contrast composition and mor-phology of lipid deposits against the surrounding matrix of connective tissue with diffractionlimited spatial resolution.In this contribution,the spatial distribution of major constituents of the arterial wall and atherosclerotic plaques like elastin,collagen,triglycerides and cholesterol can be simultaneously visualized by a combination of nonlinear imaging methods,providing a powerful label-free complement to standard histopathological methods with great potential forin vivo application.展开更多
Introduction: Total en bloc spondylectomy (TES) is gaining increasing favour as a treatment of choice for cancers of the spine that are resistant to radiological and chemotherapeautic intervention such as renal cell c...Introduction: Total en bloc spondylectomy (TES) is gaining increasing favour as a treatment of choice for cancers of the spine that are resistant to radiological and chemotherapeautic intervention such as renal cell carcinoma (RCC). Until recently, RCC of the lumbar spine has presented a surgical challenge due to anatomical and vascular constraints. The development of the combined posterior-anterior en bloc spondylectomy offers improved access to the lumbar region. This case report and review of the literature presents a combined posterior-anterior lumbar en bloc spondylectomy for RCC involving L3 vertebra, which we believe is the first reported in Australia. Methods: A 46-year-old male with a seven-year history of renal cell carcinoma resulting in a left nephrectomy presented with a lytic lesion involving the L3 vertebral body, extending to the epidural space and compressing the cauda equina and left L3 and L4 nerve roots on MRI. A literature review revealed ten previous cases of the posterior-anterior TES in the lumbar spine for cancerous lesions but none from Australia. Results: A posterior-anterior TES and L2-L4 fusion was performed to remove a cancerous renal cell carcinoma of L3 with wide margins. Blood loss was the major complication. The patient remains recurrence free at nineteen months post procedure. Conclusion: Despite being an aggressive and invasive procedure, TES is rapidly becoming the treatment of choice for curative and palliative care in select patients with isolated metastatic tumours of the lumbar spine.展开更多
A 17-year-old female patient presented to the neurology department with a 3-month history of left limb numbness and spasm with transient loss of consciousness 3 weeks earlier.A brain MRI revealed a right temporal lobe...A 17-year-old female patient presented to the neurology department with a 3-month history of left limb numbness and spasm with transient loss of consciousness 3 weeks earlier.A brain MRI revealed a right temporal lobe mass(Figure 1a,arrow)with hypointensity on T1WI,hyperintensity on T2WI,and no diffusion restriction on DWI and ADC mapping.展开更多
Background:Microglia and brain macrophages contribute significantly to the tumor microenvironment in highly malignant glioblastoma where they are considered important drivers of tumor progression.A better understandin...Background:Microglia and brain macrophages contribute significantly to the tumor microenvironment in highly malignant glioblastoma where they are considered important drivers of tumor progression.A better understanding of the role of the brain macrophages present in glioblastoma appears crucial for improving therapeutic outcomes,especially in the context of novel immunotherapeutic approaches.Methods:We investigated the regulation of two well-established markers for microglia and brain macrophages,IBA1 and CD163,in relation to glioblastoma tumor necrosis using immunohistochemistry and modality fusion heatmaps of whole slide images obtained from adjacent tissue sections.Results:IBA1 and CD163 showed remarkable differences in relation to glioblastoma tumor necrosis.Generally,IBA1 immunoreactive cells were far less common in necrotic tissue areas than CD163-expressing cells.We also found extensive and frequently diffuse extracellular CD163 deposition,especially in hypocellular necrobiotic tumor regions where IBA1 was typically absent.Conclusions:Resident microglia seem more likely to be important for the diffuse infiltration of glioma cells in hypercellular tissue areas,whereas myeloid macrophages may be the main macrophage population in the wake of tumor necrosis.Since the necrotic niche with its interactions between microglia,brain macrophages,and glioblastoma/glioma stem cells is increasingly recognised as an important factor in tumor progression,further detailed studies of the macrophage populations in glioblastoma are warranted.展开更多
Background:Medulloblastoma(MB)is one of the most common malignant brain tumors that mainly affect children.Various approaches have been used to model MB to facilitate investigating tumorigenesis.This study aims to com...Background:Medulloblastoma(MB)is one of the most common malignant brain tumors that mainly affect children.Various approaches have been used to model MB to facilitate investigating tumorigenesis.This study aims to compare the recapitulation of MB between subcutaneous patient-derived xenograft(sPDX),intracranial patient-derived xenograft(iPDX),and genetically engineered mouse models(GEMM)at the single-cell level.Methods:We obtained primary human sonic hedgehog(SHH)and group 3(G3)MB samples from six patients.For each patient specimen,we developed two sPDX and iPDX models,respectively.Three Patch+/-GEMM models were also included for sequencing.Single-cell RNA sequencing was performed to compare gene expression profiles,cellular composition,and functional pathway enrichment.Bulk RNA-seq deconvolution was performed to compare cellular composition across models and human samples.Results:Our results showed that the sPDX tumor model demonstrated the highest correlation to the overall transcriptomic profiles of primary human tumors at the single-cell level within the SHH and G3 subgroups,followed by the GEMM model and iPDX.The GEMM tumor model was able to recapitulate all subpopulations of tumor microenvironment(TME)cells that can be clustered in human SHH tumors,including a higher proportion of tumor-associated astrocytes and immune cells,and an additional cluster of vascular endothelia when compared to human SHH tumors.Conclusions:This study was the first to compare experimental models for MB at the single-cell level,providing value insights into model selection for different research purposes.sPDX and iPDX are suitable for drug testing and personalized therapy screenings,whereas GEMM models are valuable for investigating the interaction between tumor and TME cells.展开更多
The matrix-degrading metalloproteinases （MMPs）, particularly MMP-9, play important roles in the pathogenesis and development of malignant gliomas. In the present study, the oncogenic role of MMP-9 in malignant gliom...The matrix-degrading metalloproteinases （MMPs）, particularly MMP-9, play important roles in the pathogenesis and development of malignant gliomas. In the present study, the oncogenic role of MMP-9 in malignant glioma cells was investigated via antisense RNA blockade in vitro and in vivo. TJ905 malignant glioma cells were transfected with pcDNA3.0 vector expressing antisense MMP-9 RNA （pcDNA-AS-MMP9）, which significantly decreased MMP-9 expression, and cell proliferation was assessed. For in vivo studies, U251 cells, a human malignant glioma cell line, were implanted subcutaneously into 4-to 6-week-old BALB/c nude mice. The mice bearing well-established U251 gliomas were treated with intratumoral pcDNA-AS-MMP9-Lipofectamine complex （AS-MMP-9-treated group）, subcutaneous injection of endostatin （endostatin-treated group）, or both （combined therapy group）. Mice treated with pcDNA （empty vector）-Lipofectamine served as the control group. Four or eight weeks later, the volume and weight of tumor, MMP-9 expression, microvessel density and proliferative activity were assayed. We demonstrate that pcDNA-AS-MMP9 significantly decreased MMP-9 expression and inhibited glioma cell proliferation. Volume and weight of tumor, MMP-9 expression, microvessel density and proliferative activity in the antisense-MMP-9-treated and therapeutic alliance groups were significantly lower than those in the control group. The results suggest that MMP-9 not only promotes malignant glioma cell invasiveness, but also affects tumor cell proliferation. Blocking the expression of MMP-9 with antisense RNA substantially suppresses the malignant phenotype of glioma cells, and thus can be used as an effective therapeutic strategy for malignant gliomas.展开更多
Idiopathic or primary angiitis of the CNS (PACNS) and cerebral amyloid angiopa thy (CAA) are unusual vasculopathies generally regarded as unrelated disorders. A few case reports have,however, described granulomatous a...Idiopathic or primary angiitis of the CNS (PACNS) and cerebral amyloid angiopa thy (CAA) are unusual vasculopathies generally regarded as unrelated disorders. A few case reports have,however, described granulomatous angiitis in patients wi th sporadic,amyloid βpeptide (Aβ)-related CAA. Here we describe the clinical, neuroradiological and neuropathological features of nine patients with Aβ-rel ated angiitis (ABRA). Combining these with the individual case reports drawn fro m the literature has allowed us to define ABRA as a clinical entity and to compa re its features with those of PACNS. The mean age of presentation of ABRA (67 ye ars) is higher than that of PACNS but lower than that of sporadic non-inflammat ory Aβ-related CAA.Alterations in mental status (59%), headaches (35%), seiz ures and focal neurological deficits (24%) are common. Hallucinations are a pre senting manifestation in 12 %of cases. Most patients have white matter hyperint ensities on MRI but these are of similar appearance to those in PACNS. Cerebrosp inal fluid usually shows modest elevation of protein and pleocytosis.Neuropathol ogy reveals angiodestructive inflammation,often granulomatous, and meningeal lym phocytosis. Aβis consistently present in abundance in affected blood vessels bu t usually scanty within the parenchyma of the cerebral cortex.However, the corte x includes numerous activated microglia,occasionally in a plaque-like distribut ion and containing cytoplasmic Aβ. The cerebral white matter shows patchy glios is and rarefaction, in some cases marked. Our findings (i) help to dissect one s eparate clinicopathological entity from what is likely to be a spectrum of prima ry angiitides of the CNS;(ii) have important therapeutic implications for one ca tegory of patients with amyloid-related vasculopathy; and (iii) may provide val uable insights into the development of amyloid-associated inflammation, of rele vance not only to ABRA but also to Aβ-immunization-related encephalitis and t o Alzheimer’s disease.展开更多
Purpose: Magnetic resonance imaging (MRI) is the gold standard in visualizing brain tumors and their effects on adjacent structures. However, no reliable information concerning different tumor components and borders b...Purpose: Magnetic resonance imaging (MRI) is the gold standard in visualizing brain tumors and their effects on adjacent structures. However, no reliable information concerning different tumor components and borders between perifocal edema and infiltration areas can be received. The aim of the study was to establish and evaluate a multimodal imaging concept, in order to differentiate different biological tumor components and to determine tumor borders. Materials and Methods: 12 patients with cerebral gliomas (four low and eight high grade) received a “morphological” MRI, a 3D MR spectroscopy and a T2* MR perfusion examination prior to surgery. Data was evaluated by defining different tumor components, which were entitled based upon their multimodal characteristics and histological data. Results: In high grade gliomas different components can be differentiated, which were described as: “true edema”, “cellular proliferation”, “vascular proliferation”, “cellular infiltration”, “tumor” and “necrosis”. In low grade gliomas, four different tumor components were found: “true edema”, “cellular infiltration”, “cellular proliferation” and “tumor”. Conclusion: With the applied multimodal imaging and a novel evaluation concept, it was possible to detect different tumor components, which could be helpful in detecting the optimal sites for tumor biopsy. Especially in morphological “edema appearing” sites, this knowledge could be important for the adaption of tumor resection borders and the planning of radiation therapy. Further studies with more patients and histological correlation are needed.展开更多
Objective:IDH-mutant lower-grade gliomas(LGGs,grade 2 or 3)eventually transform into secondary grade 4 astrocytomas(sAIDHmut/G4).Here,we sought to describe the transformation time,risk factors,and outcomes in malignan...Objective:IDH-mutant lower-grade gliomas(LGGs,grade 2 or 3)eventually transform into secondary grade 4 astrocytomas(sAIDHmut/G4).Here,we sought to describe the transformation time,risk factors,and outcomes in malignant transformation of IDHmutant LGGs.Methods:We screened data for 108 patients with sAIDHmut/G4 in the Chinese Glioma Genome Atlas who had initial IDH-mutant LGGs and underwent reoperation during 2005–2021.We evaluated the transformation time from IDH-mutant LGGs to sAIDHmut/G4,and associated risk factors and outcomes.Malignant transformation was defined as pathological confirmation of grade 4 astrocytoma.Results:The median age of the 108 patients with IDH-mutant LGGs was 35 years(range,19–54);the median age at transformation was 40 years(range,25–62);and the median follow-up time for all patients was 146 months(range,121–171).The average transformation time was 58.8 months for all patients with LGGs(range,5.9–208.1);63.5 and 51.9 months for grade 2 and 3 gliomas,respectively;and 58.4 and 78.1 months for IDH-mutant/1p/19q-non-codeleted astrocytomas and IDH-mutant/1p/19q-codeleted oligodendrogliomas,respectively.Univariate and multivariate analysis indicated that radiotherapy[hazard ratio(HR),0.29;95%confidence interval(CI),0.137–0.595;P=0.001]and non-A blood type(HR,0.37;95%CI,0.203–0.680;P=0.001)were protective factors against delayed malignant transformation.Radiotherapy was associated with improved survival after transformation(HR,0.44;95%CI,0.241–0.803;P=0.008),overall survival(HR,0.50;95%CI,0.265–0.972;P=0.041),and progression-free survival(HR,0.25;95%CI,0.133–0.479;P<0.0001)in patients with IDH-mutant gliomas.Conclusions:Radiotherapy is associated with delayed malignant transformation and improved survival in patients with IDHmutant gliomas.展开更多
Pancreatic cancer(PC)is an aggressive and lethal neoplasm,ranking seventh in the world for cancer deaths,with an overall 5-year survival rate of below 10%.The knowledge about PC pathogenesis is rapidly expanding.New a...Pancreatic cancer(PC)is an aggressive and lethal neoplasm,ranking seventh in the world for cancer deaths,with an overall 5-year survival rate of below 10%.The knowledge about PC pathogenesis is rapidly expanding.New aspects of tumor biology,including its molecular and morphological heterogeneity,have been reported to explain the complicated“cross-talk”that occurs between the cancer cells and the tumor stroma or the nature of pancreatic ductal adenocarcinoma-associated neural remodeling.Nevertheless,currently,there are no specific and sensitive diagnosis options for PC.Vibrational spectroscopy(VS)shows a promising role in the development of early diagnosis technology.In this review,we summarize recent reports about improvements in spectroscopic methodologies,briefly explain and highlight the drawbacks of each of them,and discuss available solutions.The important aspects of spectroscopic data evaluation with multivariate analysis and a convolutional neural network methodology are depicted.We conclude by presenting a study design for systemic verification of the VS-based methods in the diagnosis of PC.展开更多
文摘The paper is to study the structural changes in cortex and cerebellum of autopsies of subjects with schizophrenia.In the Pathology Department of the Psychiatric Hospital"Fray Bernardino,Avarez",there are 410 autopsy cases with diagnosis of mental disease,from which 52 match schizophrenia.The aim of this work is to describe structural changes in the autopsy material and make markers in order to confirm neurodevelopment alterations.The tissues were preserved in formol,paraffin-embedded;cut into 5-7μm slices;stained with H-E(Hematoxilin and Eosin),Bielschowsky,crystal fast of violet.The observed changes were brain asymmetry,cortical dysplasia,neuronal distortion,axon bifurcation,neuronophagia and generalized demyelination.Schizophrenia is the result of several happenings,it is important to devise new treatment strategies for prevention and genetic counseling for population.
文摘The current World Health Organization classification system of primary brain tumors is solely based on morphologic criteria. However, there is accumulating evidence that tumors with similar histology have distinct molecular signatures that significantly impact treatment response and survival. Recent practice-changing clinical trials have defined a role for routine assessment of O-6-methylguanine-DNA methyltransferase(MGMT) promoter methylation in glioblastoma patients, especially in the elderly, and 1p and 19q codeletions in patients with anaplastic glial tumors. Recently discovered molecular alterations including mutations in IDH-1/2, epidermal growth factor receptor(EGFR), and BRAF also have the potential to become targets for future drug development. This article aims to summarize current knowledge on the molecular biology of high-grade gliomas relevant to daily practice.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.81903078,82002647,82103623,and 81761168038)the RGC(Grant Nos.26102719 and 16101021)+2 种基金the ITC(Grant Nos.MHP/004/19 and ITCPD/17-9)the Beijing Nova Program(Grant No.Z201100006820118)MOST(Grant No.2019YFE0109400).
文摘Objective:We aimed to summarize the clinicopathological characteristics and prognostic features of various molecular subtypes of diffuse gliomas(DGs)in the Chinese population.Methods:In total,1,418 patients diagnosed with DG between 2011 and 2017 were classified into 5 molecular subtypes according to the 2016 WHO classification of central nervous system tumors.The IDH mutation status was determined by immunohistochemistry and/or DNA sequencing,and 1p/19q codeletion was detected with fluorescence in situ hybridization.The median clinical follow-up time was 1,076 days.T-tests and chi-square tests were used to compare clinicopathological characteristics.Kaplan‒Meier and Cox regression methods were used to evaluate prognostic factors.Results:Our cohort included 15.5%lower-grade gliomas,IDH-mutant and 1p/19q-codeleted(LGG-IDHm-1p/19q);18.1%lowergrade gliomas,IDH-mutant(LGG-IDHm);13.1%lower-grade gliomas,IDH-wildtype(LGG-IDHwt);36.1%glioblastoma,IDHwildtype(GBM-IDHwt);and 17.2%glioblastoma,IDH-mutant(GBM-IDHm).Approximately 63.3%of the enrolled primary gliomas,and the median overall survival times for LGG-IDHm,LGG-IDHwt,GBM-IDHwt,and GBM-IDHm subtypes were 75.97,34.47,11.57,and 15.17 months,respectively.The 5-year survival rate of LGG-IDHm-1p/19q was 76.54%.We observed a significant association between high resection rate and favorable survival outcomes across all subtypes of primary tumors.We also observed a significant role of chemotherapy in prolonging overall survival for GBM-IDHwt and GBM-IDHm,and in prolonging post-relapse survival for the 2 recurrent GBM subtypes.Conclusions:By controlling for molecular subtypes,we found that resection rate and chemotherapy were 2 prognostic factors associated with survival outcomes in a Chinese cohort with DG.
文摘Machine learning represents a growing subfield of artificial intelligence with much promise in the diagnosis,treatment,and tracking of complex conditions,including neurodegenerative disorders such as Alzheimer’s and Parkinson’s diseases.While no definitive methods of diagnosis or treatment exist for either disease,researchers have implemented machine learning algorithms with neuroimaging and motion-tracking technology to analyze pathologically relevant symptoms and biomarkers.Deep learning algorithms such as neural networks and complex combined architectures have proven capable of tracking disease-linked changes in brain structure and physiology as well as patient motor and cognitive symptoms and responses to treatment.However,such techniques require further development aimed at improving transparency,adaptability,and reproducibility.In this review,we provide an overview of existing neuroimaging technologies and supervised and unsupervised machine learning techniques with their current applications in the context of Alzheimer’s and Parkinson’s diseases.
文摘Hirschsprung＇s disease （HD） is a disorder associated with congenital malformation of the enteric nervous system with segmental aganglionosis. Prevailing therapy includes a resection of the affected part of the bowel, However, patients often do not obtain complete functional improvement after surgical treatment. We present the case of a 25-year-old woman who had surgical treatment of lid in early childhood. After that procedure she had clinical features of constipation for years in the end, passing of stool once a week, requiring laxatives and enemas. We diagnosed an incomplete resection of the aganglionic bowel via rectal biopsy and resected the remaining aganglionic segment. Two months after surgery the patient＇s bowel function improved to a frequency of 1-4 stools per day. We conclude that regular follow-up is required to identify lid patients with persistent alterations of bowel function after surgery. In patients presenting with constipation, recognition of a remaining aganglionic segment or other alterations of the enteric nervous system should be aimed at in an early stage. 2005 The WJG Press and Elsevier Inc. All rights reserved
文摘The subgenual cingulate cortex has been found to be different in structure and function in mood and affective disorders compared to healthy individuals. Imaging studies have shown a decrease in function of the subgenual region in bipolar disorder and depression, with overall glial number shown to be decreased in these disorders. Decreases in subgenual grey matter in SZ have been observed also. In this neuropathological study upon formalin-fixed coronal brain sections we describe the morphological finding of de- creased frequency of subgenual cingulate crown bifurcation (p = 0.02) as compared to control, bipolar and depression cases. This suggests that the cingulate cortex in schizophrenia may be morphologically distinct in utero formation, potentially enabling an early identification of high-risk individuals.
基金This work was supported by a grant from the Deutsche Bundeswehr and the Deutsche Forschungsgemeinschaft(DFG,German Research Foundation)-Projektnummer 251293561-SFB 1149(to PR)a grant from the Deutsche Forschungsgemeinschaft(DFG,German Research Foundation)-Projektnummer 251293561-SFB 1149 and Ulm University-Baustein-Programm(to TM).
文摘In the porcine model discussed in this review,the acute subdural hematoma was induced by subdural injection of autologous blood over the left parietal cortex,which led to a transient elevation of the intracerebral pressure,measured by bilateral neuromonitoring.The hematoma-induced brain injury was associated with albumin extravasation,oxidative stress,reactive astrogliosis and microglial activation in the ipsilateral hemisphere.Further proteins and injury markers were validated to be used for immunohistochemistry of porcine brain tissue.The cerebral expression patterns of oxytocin,oxytocin receptor,cystathionine-γ-lyase and cystathionine-β-synthase were particularly interesting:these four proteins all co-localized at the base of the sulci,where pressure-induced brain injury elicits maximum stress.In this context,the pig is a very relevant translational model in contrast to the rodent brain.The structure of the porcine brain is very similar to the human:the presence of gyri and sulci(gyrencephalic brain),white matter to grey matter proportion and tentorium cerebelli.Thus,pressure-induced injury in the porcine brain,unlike in the rodent brain,is reflective of the human pathophysiology.
文摘In the published version of Figure 21,an error appeared in Figure 2C on page 1468.In Figure 2C,the Kaplan-Meier estimation of the overall survival of patients with recurrent DG classified according to molecular subtypes was mistakenly covered by the curves of patients with primary DGs during the figure layout process,while the number statistic under the figure is correct.Figure 2C has been updated to correct this mistake.The error does not affect the conclusions of this article.We apologize for the error and for any confusion that it might have caused.
基金Financial support from the European Union via the Europaischer Fonds für Regionale Entwicklung(EFRE)and the"Thiringer Ministerium fir Bildung Wissenschaft und Kultur(TMBWK)"(Projects:B714-07037,B578-06001,14.90 HWP)via the European network of excellence P4L(Photonics4Life)financial support,by the German Ministry for Science and Education(BMBF)MediCARS(FKZ:13N10774)is highly acknowledged.
文摘Cardiovascular diseases in general and atherothrombosis as the most common of its individualdisease entities is the leading cause of death in the developed countries.Therefore,visualizationand characterization of inner arterial plaque composition is of vital diagnostic interest,especilly for the early recognition of vulnerable plaques.Established clinical techniques provide valuablemorphological information but cannot deliver information about the chemicai composition ofindividual plaques.Therefore,spectroscopic imaging techniques have recently drawn consider-able attention.Based on the spectroscopic properties of the individual plaque components,as forinstance diferent types of lipids,the composition of atherosclerotic plaques can be analyzedqualitatively as well as quantitatively.Here,we compare the feasibility of multimodal nonlinearimaging combining,two-photon fluorescence(TPF),coherent anti-Stokes Raman scatering(CARS)and second-hamonic generation(SHG)microscopy to contrast composition and mor-phology of lipid deposits against the surrounding matrix of connective tissue with diffractionlimited spatial resolution.In this contribution,the spatial distribution of major constituents of the arterial wall and atherosclerotic plaques like elastin,collagen,triglycerides and cholesterol can be simultaneously visualized by a combination of nonlinear imaging methods,providing a powerful label-free complement to standard histopathological methods with great potential forin vivo application.
文摘Introduction: Total en bloc spondylectomy (TES) is gaining increasing favour as a treatment of choice for cancers of the spine that are resistant to radiological and chemotherapeautic intervention such as renal cell carcinoma (RCC). Until recently, RCC of the lumbar spine has presented a surgical challenge due to anatomical and vascular constraints. The development of the combined posterior-anterior en bloc spondylectomy offers improved access to the lumbar region. This case report and review of the literature presents a combined posterior-anterior lumbar en bloc spondylectomy for RCC involving L3 vertebra, which we believe is the first reported in Australia. Methods: A 46-year-old male with a seven-year history of renal cell carcinoma resulting in a left nephrectomy presented with a lytic lesion involving the L3 vertebral body, extending to the epidural space and compressing the cauda equina and left L3 and L4 nerve roots on MRI. A literature review revealed ten previous cases of the posterior-anterior TES in the lumbar spine for cancerous lesions but none from Australia. Results: A posterior-anterior TES and L2-L4 fusion was performed to remove a cancerous renal cell carcinoma of L3 with wide margins. Blood loss was the major complication. The patient remains recurrence free at nineteen months post procedure. Conclusion: Despite being an aggressive and invasive procedure, TES is rapidly becoming the treatment of choice for curative and palliative care in select patients with isolated metastatic tumours of the lumbar spine.
文摘A 17-year-old female patient presented to the neurology department with a 3-month history of left limb numbness and spasm with transient loss of consciousness 3 weeks earlier.A brain MRI revealed a right temporal lobe mass(Figure 1a,arrow)with hypointensity on T1WI,hyperintensity on T2WI,and no diffusion restriction on DWI and ADC mapping.
基金funding but aspects of this work(computer analysis)were supported by an Australian Research Council(ARC)grant,DP150104472(MBG)The Australian Genomics and Outcomes of Glioma project was funded by a Cancer Council NSW Strategic Research Partnership Grant.
文摘Background:Microglia and brain macrophages contribute significantly to the tumor microenvironment in highly malignant glioblastoma where they are considered important drivers of tumor progression.A better understanding of the role of the brain macrophages present in glioblastoma appears crucial for improving therapeutic outcomes,especially in the context of novel immunotherapeutic approaches.Methods:We investigated the regulation of two well-established markers for microglia and brain macrophages,IBA1 and CD163,in relation to glioblastoma tumor necrosis using immunohistochemistry and modality fusion heatmaps of whole slide images obtained from adjacent tissue sections.Results:IBA1 and CD163 showed remarkable differences in relation to glioblastoma tumor necrosis.Generally,IBA1 immunoreactive cells were far less common in necrotic tissue areas than CD163-expressing cells.We also found extensive and frequently diffuse extracellular CD163 deposition,especially in hypocellular necrobiotic tumor regions where IBA1 was typically absent.Conclusions:Resident microglia seem more likely to be important for the diffuse infiltration of glioma cells in hypercellular tissue areas,whereas myeloid macrophages may be the main macrophage population in the wake of tumor necrosis.Since the necrotic niche with its interactions between microglia,brain macrophages,and glioblastoma/glioma stem cells is increasingly recognised as an important factor in tumor progression,further detailed studies of the macrophage populations in glioblastoma are warranted.
基金National Key Research and Development Program of China,Grant/Award Number:2022ZD0210100Beijing Nova Star Program,Grant/Award Number:2022002+2 种基金Natural Science Foundation of Beijing and Haidian Collaboration Foundation,Grant/Award Number:L232079National Natural Science Foundation of China,Grant/Award Number:82172608,82273343,81902975 and 82101356Capital Medical University Fund for Excellent Young Scholars,Grant/Award Number:KCB2304。
文摘Background:Medulloblastoma(MB)is one of the most common malignant brain tumors that mainly affect children.Various approaches have been used to model MB to facilitate investigating tumorigenesis.This study aims to compare the recapitulation of MB between subcutaneous patient-derived xenograft(sPDX),intracranial patient-derived xenograft(iPDX),and genetically engineered mouse models(GEMM)at the single-cell level.Methods:We obtained primary human sonic hedgehog(SHH)and group 3(G3)MB samples from six patients.For each patient specimen,we developed two sPDX and iPDX models,respectively.Three Patch+/-GEMM models were also included for sequencing.Single-cell RNA sequencing was performed to compare gene expression profiles,cellular composition,and functional pathway enrichment.Bulk RNA-seq deconvolution was performed to compare cellular composition across models and human samples.Results:Our results showed that the sPDX tumor model demonstrated the highest correlation to the overall transcriptomic profiles of primary human tumors at the single-cell level within the SHH and G3 subgroups,followed by the GEMM model and iPDX.The GEMM tumor model was able to recapitulate all subpopulations of tumor microenvironment(TME)cells that can be clustered in human SHH tumors,including a higher proportion of tumor-associated astrocytes and immune cells,and an additional cluster of vascular endothelia when compared to human SHH tumors.Conclusions:This study was the first to compare experimental models for MB at the single-cell level,providing value insights into model selection for different research purposes.sPDX and iPDX are suitable for drug testing and personalized therapy screenings,whereas GEMM models are valuable for investigating the interaction between tumor and TME cells.
基金supported by the National Natural Science Foundation of China(30770827,31170864and81100887)National Basic Research Development Program of China(973Program,2010CB529405)+5 种基金Key Laboratory Project of Tianjin Municipality for Science and Technology(10SYSYJC28800)Major Program of Research on Applied Fundamentals and Frontier Technologies(10JCZDJC19400)Key Program of Higher Education of Tianjin Municipality for Science and Technology(2004ZD06,20060202)Program for New Century Excellent Talents in University of China(NCET-11-1067)Key Project of Natural Science Foundation of Tianjin Municipality,China(12JCZDJC24200)Key Project for Science and Technology of Ministry of Education,China(212005)
文摘The matrix-degrading metalloproteinases （MMPs）, particularly MMP-9, play important roles in the pathogenesis and development of malignant gliomas. In the present study, the oncogenic role of MMP-9 in malignant glioma cells was investigated via antisense RNA blockade in vitro and in vivo. TJ905 malignant glioma cells were transfected with pcDNA3.0 vector expressing antisense MMP-9 RNA （pcDNA-AS-MMP9）, which significantly decreased MMP-9 expression, and cell proliferation was assessed. For in vivo studies, U251 cells, a human malignant glioma cell line, were implanted subcutaneously into 4-to 6-week-old BALB/c nude mice. The mice bearing well-established U251 gliomas were treated with intratumoral pcDNA-AS-MMP9-Lipofectamine complex （AS-MMP-9-treated group）, subcutaneous injection of endostatin （endostatin-treated group）, or both （combined therapy group）. Mice treated with pcDNA （empty vector）-Lipofectamine served as the control group. Four or eight weeks later, the volume and weight of tumor, MMP-9 expression, microvessel density and proliferative activity were assayed. We demonstrate that pcDNA-AS-MMP9 significantly decreased MMP-9 expression and inhibited glioma cell proliferation. Volume and weight of tumor, MMP-9 expression, microvessel density and proliferative activity in the antisense-MMP-9-treated and therapeutic alliance groups were significantly lower than those in the control group. The results suggest that MMP-9 not only promotes malignant glioma cell invasiveness, but also affects tumor cell proliferation. Blocking the expression of MMP-9 with antisense RNA substantially suppresses the malignant phenotype of glioma cells, and thus can be used as an effective therapeutic strategy for malignant gliomas.
文摘Idiopathic or primary angiitis of the CNS (PACNS) and cerebral amyloid angiopa thy (CAA) are unusual vasculopathies generally regarded as unrelated disorders. A few case reports have,however, described granulomatous angiitis in patients wi th sporadic,amyloid βpeptide (Aβ)-related CAA. Here we describe the clinical, neuroradiological and neuropathological features of nine patients with Aβ-rel ated angiitis (ABRA). Combining these with the individual case reports drawn fro m the literature has allowed us to define ABRA as a clinical entity and to compa re its features with those of PACNS. The mean age of presentation of ABRA (67 ye ars) is higher than that of PACNS but lower than that of sporadic non-inflammat ory Aβ-related CAA.Alterations in mental status (59%), headaches (35%), seiz ures and focal neurological deficits (24%) are common. Hallucinations are a pre senting manifestation in 12 %of cases. Most patients have white matter hyperint ensities on MRI but these are of similar appearance to those in PACNS. Cerebrosp inal fluid usually shows modest elevation of protein and pleocytosis.Neuropathol ogy reveals angiodestructive inflammation,often granulomatous, and meningeal lym phocytosis. Aβis consistently present in abundance in affected blood vessels bu t usually scanty within the parenchyma of the cerebral cortex.However, the corte x includes numerous activated microglia,occasionally in a plaque-like distribut ion and containing cytoplasmic Aβ. The cerebral white matter shows patchy glios is and rarefaction, in some cases marked. Our findings (i) help to dissect one s eparate clinicopathological entity from what is likely to be a spectrum of prima ry angiitides of the CNS;(ii) have important therapeutic implications for one ca tegory of patients with amyloid-related vasculopathy; and (iii) may provide val uable insights into the development of amyloid-associated inflammation, of rele vance not only to ABRA but also to Aβ-immunization-related encephalitis and t o Alzheimer’s disease.
文摘Purpose: Magnetic resonance imaging (MRI) is the gold standard in visualizing brain tumors and their effects on adjacent structures. However, no reliable information concerning different tumor components and borders between perifocal edema and infiltration areas can be received. The aim of the study was to establish and evaluate a multimodal imaging concept, in order to differentiate different biological tumor components and to determine tumor borders. Materials and Methods: 12 patients with cerebral gliomas (four low and eight high grade) received a “morphological” MRI, a 3D MR spectroscopy and a T2* MR perfusion examination prior to surgery. Data was evaluated by defining different tumor components, which were entitled based upon their multimodal characteristics and histological data. Results: In high grade gliomas different components can be differentiated, which were described as: “true edema”, “cellular proliferation”, “vascular proliferation”, “cellular infiltration”, “tumor” and “necrosis”. In low grade gliomas, four different tumor components were found: “true edema”, “cellular infiltration”, “cellular proliferation” and “tumor”. Conclusion: With the applied multimodal imaging and a novel evaluation concept, it was possible to detect different tumor components, which could be helpful in detecting the optimal sites for tumor biopsy. Especially in morphological “edema appearing” sites, this knowledge could be important for the adaption of tumor resection borders and the planning of radiation therapy. Further studies with more patients and histological correlation are needed.
基金supported bygrants from the Beijing Hospitals Authority Youth Programme(Grant No.QML20190506)the Capital Health Development Research Project(Grant No.2020-2-1072).
文摘Objective:IDH-mutant lower-grade gliomas(LGGs,grade 2 or 3)eventually transform into secondary grade 4 astrocytomas(sAIDHmut/G4).Here,we sought to describe the transformation time,risk factors,and outcomes in malignant transformation of IDHmutant LGGs.Methods:We screened data for 108 patients with sAIDHmut/G4 in the Chinese Glioma Genome Atlas who had initial IDH-mutant LGGs and underwent reoperation during 2005–2021.We evaluated the transformation time from IDH-mutant LGGs to sAIDHmut/G4,and associated risk factors and outcomes.Malignant transformation was defined as pathological confirmation of grade 4 astrocytoma.Results:The median age of the 108 patients with IDH-mutant LGGs was 35 years(range,19–54);the median age at transformation was 40 years(range,25–62);and the median follow-up time for all patients was 146 months(range,121–171).The average transformation time was 58.8 months for all patients with LGGs(range,5.9–208.1);63.5 and 51.9 months for grade 2 and 3 gliomas,respectively;and 58.4 and 78.1 months for IDH-mutant/1p/19q-non-codeleted astrocytomas and IDH-mutant/1p/19q-codeleted oligodendrogliomas,respectively.Univariate and multivariate analysis indicated that radiotherapy[hazard ratio(HR),0.29;95%confidence interval(CI),0.137–0.595;P=0.001]and non-A blood type(HR,0.37;95%CI,0.203–0.680;P=0.001)were protective factors against delayed malignant transformation.Radiotherapy was associated with improved survival after transformation(HR,0.44;95%CI,0.241–0.803;P=0.008),overall survival(HR,0.50;95%CI,0.265–0.972;P=0.041),and progression-free survival(HR,0.25;95%CI,0.133–0.479;P<0.0001)in patients with IDH-mutant gliomas.Conclusions:Radiotherapy is associated with delayed malignant transformation and improved survival in patients with IDHmutant gliomas.
基金The National Science Centre,Poland Under The“OPUS 19”Project,No.UMO-2020/37/B/ST4/02990.
文摘Pancreatic cancer(PC)is an aggressive and lethal neoplasm,ranking seventh in the world for cancer deaths,with an overall 5-year survival rate of below 10%.The knowledge about PC pathogenesis is rapidly expanding.New aspects of tumor biology,including its molecular and morphological heterogeneity,have been reported to explain the complicated“cross-talk”that occurs between the cancer cells and the tumor stroma or the nature of pancreatic ductal adenocarcinoma-associated neural remodeling.Nevertheless,currently,there are no specific and sensitive diagnosis options for PC.Vibrational spectroscopy(VS)shows a promising role in the development of early diagnosis technology.In this review,we summarize recent reports about improvements in spectroscopic methodologies,briefly explain and highlight the drawbacks of each of them,and discuss available solutions.The important aspects of spectroscopic data evaluation with multivariate analysis and a convolutional neural network methodology are depicted.We conclude by presenting a study design for systemic verification of the VS-based methods in the diagnosis of PC.
