Morphometry

形态计量学
  • 文章类型: Journal Article
    对据称广泛分布的潮间带虫螨Alismobates的加勒比海种群进行的分子遗传分析揭示了一种隐秘物种的存在。新物种,alismobatespiratussp.n.,显示了相当大的COI和18SrRNA基因序列差异,尽管形态计量学分析表明分类单元之间存在相当大的差异,无法检测到明显的形态学特征。建议极端的潮间带环境是观察到的这两个物种的形态停滞的原因,而代际则是它们的物种形成的原因。alismobatespiratussp.n.在伊斯帕尼奥拉被发现,瓜德罗普岛,巴巴多斯和库拉索岛表明大安的列斯群岛和小安的列斯群岛的主要分布,而A.inexectatus的发生主要限于中美洲,加勒比海北部和大安的列斯群岛。单倍型网络分析表明,在AntilleanA.piratussp.之间存在明显的地理结构和最近的基因流动。n.人口。中美洲和安的列斯的A.inexectatus种群显示出相似的模式,但百慕大和巴哈马的种群具有共同的起源和随后的扩张特征。遗传景观分析表明,广阔的海洋,比如加勒比海盆地和西大西洋,作为相当有效的障碍,而中美洲和北美洲的连续大陆海岸线可能会促进扩散。遗传数据还表明,湾流在潮间带虫螨的生物地理学中起着重要作用,因为它可能是中美洲和北美种群之间的紧密联系以及百慕大定殖的原因。
    在线版本包含补充材料,可在10.1007/s13127-023-00624-9获得。
    Molecular genetic analyses of Caribbean populations of the supposedly widespread intertidal oribatid mite Alismobates inexpectatus revealed the existence of a cryptic species. The new species, Alismobates piratus sp. n., shows considerable COI and 18S rRNA gene sequence divergences and although morphometric analyses indicate considerable variation between the taxa, no distinguishing morphological feature could be detected. The extreme intertidal environment is suggested to be responsible for the observed morphological stasis of the two species and vicariance is supposed to be responsible for their speciation. Alismobates piratus sp. n. was found on Hispaniola, Guadeloupe, Barbados and Curaçao indicating a predominant distribution on the Greater and Lesser Antilles, whereas the occurrence of A. inexpectatus is primarily restricted to Central America, the northern Caribbean and the Greater Antilles. Haplotype network analyses indicate distinct geographic structuring and the absence of recent gene flow among the Antillean A. piratus sp. n. populations. Central American and Antillean populations of A. inexpectatus show similar patterns but populations from Bermuda and the Bahamas are characterized by a common origin and subsequent expansion. Genetic landscape analysis demonstrates that vast stretches of open ocean, like the Caribbean Basin and the Western Atlantic, act as rather effective barriers, whereas the continuous continental coastline of Central and North America may facilitate dispersal. Genetic data also indicates that the Gulf Stream plays an important role for the biogeography of intertidal oribatid mites as it may be responsible for the strong link between Central and North American populations as well as for the colonization of Bermuda.
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s13127-023-00624-9.
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  • 文章类型: Case Reports
    锁定综合征(LiS)被定义为由于脑桥腹侧病变而导致的认知能力得到保留的大多数自愿肌肉运动的丧失。然而,一些患者还可能有严重的意识障碍[锁定+综合征(LiPS)].在这里,我们旨在探讨血管病因的LiS和LiPS患者之间的结构差异,重点关注病变模式和位置,以更好地描绘LiS和LiPS的临床谱。在这项回顾性病例系列研究中,我们报告了9名患者(2名女性),年龄29-74岁(中位数50),在2007年至2021年间诊断为LiS和LiPS。临床参数,MRI检查结果包括病变结构,并为每个患者提供形状特征计算。病变结构由高级神经放射学家确定。9例患者中有2例完全保留了意识(LiS),7例表现出不同程度的意识障碍(LiPS)。LiS患者的病变是圆形的,局限于脑桥,而LiPS患者的病变更细长并到达邻近区域,例如中脑,丘脑或上行网状激活系统。累及中脑和丘脑的病变是LiPS的有力指标,而对于局限于脑桥的病变,背侧延伸和对上行网状激活系统的相关损害对于区分LiS和LiPS至关重要。认识到使用临床和放射学发现的LiPS是重要的,因为这些患者可能需要不同的治疗和护理,最重要的是,不应该被误认为是反应迟钝的觉醒综合症。
    The locked-in syndrome (LiS) is defined as the loss of most voluntary muscle movements with preserved cognitive abilities due to a ventral pontine lesion. However, some patients may also have severe impairment of consciousness [locked-in plus syndrome (LiPS)]. Here we aimed to explore structural differences between LiS and LiPS patients of vascular aetiology, focusing on lesion patterns and locations to better delineate the clinical spectrum of LiS and LiPS. In this retrospective case series study, we report nine patients (two women), ages 29-74 years (median 50) with LiS and LiPS who were diagnosed between 2007 and 2021. Clinical parameters, MRI findings including the lesioned structures, and a shape feature calculation are presented for every patient. The lesioned structures were determined by a senior neuroradiologist. Two of nine patients had fully retained consciousness (LiS) and seven showed various degrees of impaired consciousness (LiPS). Lesions of LiS patients are round and confined to the pons, whereas lesions of LiPS patients are more elongated and reach neighbouring areas such as the mesencephalon, thalamus or ascending reticular activating system. Lesions involving the mesencephalon and the thalamus are strong indicators of LiPS, whereas for lesions restricted to the pons, the dorsal extension and the associated damage to the ascending reticular activating system are crucial to differentiate LiS from LiPS. Recognizing LiPS using clinical and radiological findings is important as these patients may need different therapies and care and, most importantly, should not be mistaken as unresponsive wakefulness syndrome.
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  • 文章类型: Journal Article
    使用Casearia属,我们评估了嵌套单体的状态:单个标本对应于可接受的物种,但在分子树中出现嵌套在密切相关物种的进化枝中。通常,这种情况将悬而未决,而另一方面,需要及时的分类学决策。我们认为形态学上,脉络膜,生态数据可以提供信息来阐明物种形成的模式。它们的使用可以提供在物种水平上测试分类单元概念的第一步。我们重点研究了Casearia属树木中的5例嵌套单例。我们采用PCA和聚类分析来评估表型分化。使用地理坐标,我们基于19个生物环境变量计算了生态位空间分化,通过PCA和生态位等效性和相似性测试,并生成了点图。我们发现五个病例中的两个(Caseariaselloana和C.manausensis)在形态上是独特的,在另外两种情况下相对不同(C.zizyphoides和C.maritquensis),在最后一种情况下部分重叠(C.grandiflora)。对于两种情况(C.大麻和C.selloana),生态位空间广泛重叠,在两种情况下,它被发现是广泛嵌套的(C.花兰和花兰),在一种情况下,窄嵌套(C.manausensis),但在任何情况下都没有观察到生态位分化。利基重叠,相似性和等效性显示出相应的模式。鉴于这些数据,人们会将C.selloana和C.manausensis解释为很好的分类群,他们狭窄的分布范围表明最近出现的血统。其他三种情况不清楚。形态学数据将特别表明C.grandiflora与C.arborea,但是分布的差异很有趣。我们的方法将在五个案例中的至少两个案例中拒绝基于嵌套系统发生位置的潜在同义词的概念。另一种情况也显示出没有完全缺乏支持同义词的区分。
    Using the genus Casearia, we assessed the status of nested singletons: individual specimens corresponding to accepted species but in molecular trees appearing nested within clades of closely related species. Normally, such cases would be left undecided, while on the other hand, timely taxonomic decisions are required. We argue that morphological, chorological, and ecological data can be informative to illuminate patterns of speciation. Their use can provide a first step in testing taxon concepts at species level. We focused on five cases of nested singletons in trees of the genus Casearia. We employed PCA and cluster analysis to assess phenotypic differentiation. Using geocoordinates, we calculated niche space differentiation based on 19 bioclim variables, by means of PCA and niche equivalency and similarity tests and generated dot maps. We found that the singletons were morphologically distinctive in two of the five cases (Casearia selloana and C. manausensis), relatively distinctive in two other cases (C. zizyphoides and C. mariquitensis), and partially overlapping in the last case (C. grandiflora). For two cases (C. mariquitensis and C. selloana), ecological niche space was broadly overlapping, in two cases it was found broadly nested (C. grandiflora and C. zizyphoides), and in one case narrowly nested (C. manausensis), but in no case niche differentiation was observed. Niche overlap, similarity and equivalency showed corresponding patterns. Given these data, one would interpret C. selloana and C. manausensis as presumably well-distinguished taxa, their narrow distribution ranges suggesting recently emerging lineages. The other three cases are not clearcut. Morphological data would suggest particularly C. grandiflora conspecific with C. arborea, but differences in the distribution are intriguing. Our approach would reject the notion of potential synonymy based on nested phylogenetic placement for at least two of the five cases. The other case also shows no complete lack of differentiation which would support synonymy.
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  • 文章类型: Journal Article
    背景:可导致三叉神经神经血管冲突和新的孤立性脑桥病变的形态学差异与三叉神经痛(TN)的发病机理有关。在这项病例对照研究中,我们旨在通过研究可能影响三叉神经形态参数的解剖结构,为目前有关TN发病机制的讨论做出贡献.
    方法:本研究纳入了25例因疼痛而随访的TN患者,医学院,和25个年龄和性别匹配的对照。我们进行了形态测量,包括三叉神经的长度和体积,小脑桥脑池,pons,和这些个体的磁共振成像后颅窝。对TN患者患侧和未患侧的平均值进行了比较分析,左,和对照组的两侧。
    结果:在TN患者中,在受影响的一侧,三叉神经的长度和体积以及桥小脑池体积均小于对照组(p<0.05)。与对照组相比,TN患者的脑桥体积更高(p<0.05)。受影响神经的长度与脑桥前池长度和小脑池体积显着相关(p<0.05)。
    结论:桥小脑池体积对三叉神经的形态特征有显著影响。尤其是,脑桥体积的增加是否会导致脑桥小脑池体积的减少,应进一步研究。
    BACKGROUND: Morphological differences that can lead the trigeminal nerve to neurovascular conflict and a new solitary pontine lesion are associated with the pathogenesis of trigeminal neuralgia (TN). In this case-control study, we aimed to contribute to the current discussions about the pathogenesis of TN by investigating the anatomical structures that may have an effect on the morphometric parameters of the trigeminal nerve.
    METHODS: This study included 25 patients with TN followed up for pain in the Department of Algology, Faculty of Medicine, and 25 age- and gender-matched controls. We performed morphometric measurements including the length and volume of the trigeminal nerve, cerebellopontine cistern, pons, and posterior fossa in the MRIs of these individuals. Comparative analyses were performed for the mean of the affected and unaffected sides of the TN patients and the right, left, and both sides of the control group.
    RESULTS: In patients with TN, on the affected side, length and volume of the trigeminal nerve and cerebellopontine cistern volume were found smaller than controls (p < 0.05). Pons volume was higher in patients with TN compared to controls (p < 0.05). The length of the affected nerve was significantly related to prepontine cistern length and cerebellopontine cistern volume (p < 0.05).
    CONCLUSIONS: The cerebellopontine cistern volume has a significant impact on the morphometric characteristics of the trigeminal nerve. Especially, whether the increase in the volume of pons causes a decrease in the volume of cerebellopontine cistern should be clarified with further research.
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  • 文章类型: Journal Article
    UNASSIGNED:关于复发性腰椎间盘突出症(rLDH)的危险因素存在矛盾的数据。到目前为止,大多数确定的rLDH预测因子都是疝程度的获得性危险因素或放射学因素。整个腰椎(WLS)形态测量尚未被评估为rLDH的可能预测指标。
    UNASSIGNED:我们旨在评估术前脊柱形态测量是否可以预测需要进行翻修手术的rLDH的发生。
    UNASSIGNED:这项针对250例患者的回顾性病例对照研究包括45例接受rLDH手术的患者,180名没有rLDH的对照组以前曾接受过微椎间盘切除术治疗单级腰椎间盘突出症,和25名患者的保留验证集。除了先前确定的rLDH预测因子外,还记录了与WLS相关的形态测量变量。进行Logistic回归(LR)分析以确定rLDH的独立预测因子。
    未经评估:LR产生了四个预测因子,其中两个是WLS形态测量变量。虽然年龄增长和吸烟对rLDH有积极的预测,增加WLS界面距离和WLS硬膜囊围对rLDH有负预测。LR模型具有统计学意义,χ2(4)=15.98,P=0.003,正确分类的病例占80.3%。在验证时,该模型在预测rLDH方面具有相当的准确性(准确度:0.80,AUC:0.70).
    未经证实:较大的平均腰椎骨管和硬膜囊可防止症状性rLDH的发生。这些WLS形态学变量应包括在未来的腰椎间盘疾病风险分层算法中。除了先前公认的风险因素外,我们的研究指出了rLDH的潜在发育倾向。
    UNASSIGNED: There is conflicting data on the risk factors for recurrent lumbar disc herniation (rLDH). Most of the predictors for rLDH identified so far are acquired risk factors or radiological factors at the level of the herniation. Whole lumbar spine (WLS) morphometry has not been evaluated as a possible predictor of rLDH.
    UNASSIGNED: We aimed to evaluate if preoperative spinal morphometry can predict the occurrence of rLDH requiring revision surgery.
    UNASSIGNED: This retrospective case-control study on 250 patients included 45 patients operated for rLDH, 180 controls without rLDH who had previously undergone microdiscectomy for a single level lumbar disc prolapse, and a holdout validation set of 25 patients. Morphometric variables related to the WLS were recorded in addition to previously identified predictors of rLDH. Logistic regression (LR) analysis was performed to identify independent predictors of rLDH.
    UNASSIGNED: LR yielded four predictors of which two were WLS morphometric variables. While increasing age and smoking positively predicted rLDH, increasing WLS interfacet distance and WLS dural-sac circumference negatively predicted rLDH. The LR model was statistically significant, χ2 (4) =15.98, P = 0.003, and correctly classified 80.3% of cases. On validation, the model demonstrated a fair accuracy in predicting rLDH (accuracy: 0.80, AUC: 0.70).
    UNASSIGNED: Larger mean lumbar bony canals and dural sacs protect from the occurrence of symptomatic rLDH. These WLS morphometric variables should be included in future risk stratification algorithms for lumbar disc disease. In addition to the previously recognized risk factors, our study points to an underlying developmental predisposition for rLDH.
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  • 文章类型: Journal Article
    背景:来自评估血管尺寸及其与颅内动脉瘤(IA)形成的最小功(PMW)原理产生的值的偏差的研究的结论仍然没有定论。我们的研究旨在对包含动脉瘤的脑动脉分叉进行形态学分析。
    方法:本研究包括147例基底动脉(BA)和大脑中动脉(MCA)动脉瘤患者和106例患者作为对照组。评估了以下形态参数:形成分叉的血管半径,结指数,分叉角的值(Φ1和Φ2在父血管干轴和较大或较小的分支之间的角度,分别为α角,总分叉角)以及预测的最佳分支角和观察到的分支角之间的差。
    结果:分析的颈内动脉(ICA)分叉参数在各组之间没有显著差异。有动脉瘤的母体MCA和BA血管的MCA和BA分叉角和半径明显高于对照组。与对照组相比,具有动脉瘤的BA和MCA分叉的预测最佳分支角度与观察到的分支角度之间的差异明显更高。Willis圆中分叉的平均结指数(即,ICA和BA分叉,分别)和带有动脉瘤的MCA分叉显着低于理论最佳值,并且各组之间没有显着差异。在多水平多元逻辑回归分析中,分支角度和至母血管的半径是IA存在的重要独立预测因子.ROC分析表明,α角是区分动脉瘤和非动脉瘤分叉的最佳表现。
    结论:形成Willis环的动脉尺寸不符合PMW。偏离Willis圆以外的分叉的能量最佳几何形状(特别是,父动脉的半径更大,总分叉角更宽)可能导致IAs的形成。需要进一步的研究来研究血管尺寸和分叉角对动脉分叉壁中剪切应力大小的重要性。
    BACKGROUND: Conclusions from studies evaluating vessel dimensions and their deviations from values resulting from the principle of minimum work (PMW) on the formation of intracranial aneurysms (IAs) are still inconclusive. Our study aimed to perform a morphometric analysis of cerebral arterial bifurcations harbouring aneurysms.
    METHODS: The study comprised 147 patients with basilar artery (BA) and middle cerebral artery (MCA) aneurysms and 106 patients constituting the control group. The following morphometric parameters were evaluated: the radii of vessels forming the bifurcation, the junction exponent, the values of the bifurcation angles (Φ1 and Φ2 angles between the parent vessel trunk axis and the larger or smaller branches, respectively; α angle, the total bifurcation angle) and the difference between the predicted optimal and observed branch angles.
    RESULTS: The analysed parameters for internal carotid artery (ICA) bifurcations were not significantly different among the groups. The MCA and BA bifurcation angles and the radii of the parent MCA and BA vessels with aneurysms were significantly higher than those of the control group. The differences between the predicted optimal and observed branch angles were significantly higher for BA and MCA bifurcations with aneurysms compared to the control group. The mean junction exponent for bifurcations in the circle of Willis (i.e., ICA and BA bifurcations, respectively) and MCA bifurcations with aneurysms was significantly lower than the theoretical optimum and did not significantly differ among the groups. In a multilevel multivariate logistic regression analysis, the branch angles and the radius from the parent vessel were significant independent predictors of the presence of an IA. The ROC analysis indicated that the α angle was the best performer in discriminating between aneurysmal and nonaneurysmal bifurcations.
    CONCLUSIONS: The dimensions of the arteries forming the circle of Willis do not follow the PMW. Deviation from the energetically optimum geometry for bifurcations beyond the circle of Willis (particularly, a larger radius of the parent artery and a wider total bifurcation angle) may lead to the formation of IAs. Further studies are warranted to investigate the significance of vessel dimensions and the bifurcation angle on the magnitude of shear stress in the walls of arterial bifurcations.
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  • 文章类型: Journal Article
    描述了四种吸食人类血液的placobdellacostata事件。人类血液被成年和幼年的P.costata标本吸走。介绍了父母照料下青少年的喂养策略。提供了有关青少年标本\'身体形态的新数据。考虑了有关哺乳动物在水蛭P.costata的分散和栖息地偏好中的潜在作用的信息。
    Four events of Placobdella costata sucking human blood are described.Human blood was sucked by both adult and juvenile specimens of P. costata.The feeding strategies of juveniles under parental care are presented.New data on juvenile specimens\' body form are presented.Information on the potential role of mammals in dispersion and habitat preferences of leeches P. costata is considered.
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  • 文章类型: Journal Article
    背景:阿片类药物流行具有严重的医疗和社会后果。阿片类药物通常用于慢性疼痛患者,是鸦片流行的主要原因。长期使用阿片类药物的不良反应主要在依赖性/成瘾性疾病中进行了研究,但不是慢性疼痛。这里,我们检查了额外的医源性效应,心理学,长期使用阿片类药物的慢性疼痛患者和不使用阿片类药物的大脑形态(病例对照设计)。
    方法:我们比较了社会心理,功能,以及在有或没有阿片类药物的情况下处理疼痛的慢性背痛(CBP)患者之间的心理措施,从而控制疼痛对这些结果的影响。此外,我们调查了与长期使用阿片类药物相关的大脑形态差异.我们招募了58名CBP患者,其中29人长期服用阿片类药物,29人没有使用阿片类药物,在年龄方面是匹配的,性别,疼痛强度,和疼痛持续时间。问卷调查用于评估疼痛质量,疼痛心理学,消极和积极的情绪,物理,认知,感官,和电机功能,生活质量,和人格特质。
    结果:服用阿片类药物的CBP患者表现出更多的负面情绪,较差的身体机能,和更多的疼痛干扰(p<0.001),而认知和运动功能以及人格特质没有统计学差异。使用结构性脑成像数据的基于体素的形态计量学确定阿片类药物患者的背侧旁皮层的灰质密度降低(家庭误差校正p<0.05),与负性情绪相关(p=0.03)。最后,一项对海马亚区的体积分析发现,阿片类药物患者的左前下丘体积较低(p<0.001).
    结论:长期使用阿片类药物治疗慢性疼痛与不良负面情绪和残疾有关,以及特定大脑区域的灰质体积减少。
    BACKGROUND: The opiate epidemic has severe medical and social consequences. Opioids are commonly prescribed in patients with chronic pain, and are a main contributor to the opiate epidemic. The adverse effects of long-term opioid usage have been studied primarily in dependence/addiction disorders, but not in chronic pain. Here, we examine the added iatrogenic effects, psychology, and brain morphology of long-term opioid use in matched patients with chronic pain with and without opioid use (case-controlled design).
    METHODS: We compared psychosocial, functional, and psychological measures between patients with chronic back pain (CBP) who were managing their pain with or without opioids, thereby controlling for the effect of pain on these outcomes. In addition, we investigated brain morphological differences associated with long-term opioid usage. We recruited 58 patients with CBP, 29 of them on long-term opioids and 29 who did not use opioids, and who were matched in terms of age, sex, pain intensity, and pain duration. Questionnaires were used to assess pain quality, pain psychology, negative and positive emotions, physical, cognitive, sensory, and motor functions, quality of life, and personality traits.
    RESULTS: Patients with CBP on opioids displayed more negative emotion, poorer physical function, and more pain interference (p < 0.001), whereas there were no statistical differences in cognitive and motor functions and personality traits. Voxel-based morphometry using structural brain imaging data identified decreased gray matter density of the dorsal paracingulate cortex (family-wise error-corrected p < 0.05) in patients with opioids, which was associated with negative emotion (p = 0.03). Finally, a volumetric analysis of hippocampal subfields identified lower volume of the left presubiculum in patients on opioids (p < 0.001).
    CONCLUSIONS: Long-term opioid use in chronic pain is associated with adverse negative emotion and disabilities, as well as decreased gray matter volumes of specific brain regions.
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  • 文章类型: Journal Article
    目的:I型Chiari畸形(CMI)是后脑和后颅窝(PCF)的放射学定义的结构畸形。CMI的传统放射学鉴定依赖于小脑扁桃体相对于大孔的测量,有无相关的神经轴异常。这项回顾性研究的主要目的是全面评估一组女性CMI患者和正常对照组中McRea线以上的形态参数。
    方法:对成年女性CMI患者(n=162)和健康对照(n=140)的302个中矢状MR图像进行了29次形态学测量。所有MR图像均由CMI受试者通过在线数据库自愿提供,而对照参与者图像则通过HumanConnectome项目和当地医院系统获得。
    结果:对成年女性MR图像的完整数据集和229名年龄相等的参与者的受限数据集进行了分析,种族,和体重指数。在我们分为三个簇的PCF区域中确定了18组差异;PCF结构高度,clivus成角,齿状突过程不规则。在将我们的CMI和对照组的人口统计学特征等同后,仍然存在14个组间差异。
    结论:与健康对照相比,成年女性CMI患者的PCF结构存在可靠差异。这些差异反映了斜坡骨和软组织结构的结构异常,齿状突,还有小脑.讨论了临床和病理生理意义。
    OBJECTIVE: Type I Chiari malformation (CMI) is a radiologically-defined structural dysmorphism of the hindbrain and posterior cranial fossa (PCF). Traditional radiographic identification of CMI relies on the measurement of the cerebellar tonsils in relation to the foramen magnum with or without associated abnormalities of the neuraxis. The primary goal of this retrospective study was to comprehensively assess morphometric parameters above the McRea line in a group of female CMI patients and normal controls.
    METHODS: Twenty-nine morphological measurements were taken on 302 mid-sagittal MR images of adult female CMI patients (n=162) and healthy controls (n=140). All MR images were voluntarily provided by CMI subjects through an online database and control participant images were obtained through the Human Connectome Project and a local hospital system.
    RESULTS: Analyses were performed on the full dataset of adult female MR images and a restricted dataset of 229 participants that were equated for age, race, and body mass index. Eighteen group differences were identified in the PCF area that we grouped into three clusters; PCF structures heights, clivus angulation, and odontoid process irregularity. Fourteen group differences persisted after equating our CMI and control groups on demographic characteristics.
    CONCLUSIONS: PCF structures reliably differ in adult female CMI patients relative to healthy controls. These differences reflect structural abnormalities in the osseous and soft tissue structures of the clivus, odontoid process, and cerebellum. Clinical and pathophysiological implications are discussed.
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  • 文章类型: Comparative Study
    BACKGROUND: The diagnosis of idiopathic atrophoderma of Pasini and Pierini (IAPP) relies on typical clinical features, particularly distinctive pigmented ovular/round depressed plaques. Histologic examination often reveals no obvious changes, but patterns of collagen distribution, using multiphoton imaging and second harmonic generation can help track hidden details of tissue organization contributing to atrophy.
    OBJECTIVE: To identify histologic features that distinguish IAPP from unaffected skin.
    METHODS: Eleven patients were included for conventional analyses. Masson trichrome- and Unna-Tanzer orcein-stained sections were evaluated using automated morphometry. Hematoxylin-eosin-stained sections were analyzed by multiphoton imaging using 2-photon excited fluorescence and second harmonic generation.
    RESULTS: No abnormalities were found under light microscopy or by automated quantification. Multiphoton imaging revealed no difference in optical density of either collagen or elastic fibers in lesioned and unaffected skin; however, horizontal collagen fiber organization in lesion specimens increased toward the lower dermis, whereas elastic fibers featured greater disorganization within the upper dermis.
    CONCLUSIONS: The low number of patients evaluated.
    CONCLUSIONS: The atrophic appearance of IAPP lesions reflects changes in organization, but not in collagen and elastic tissue content. Minute organizational differences that are imperceptible to the experienced pathologist and undetectable by automated analyses were revealed by multiphoton analyses, particularly second harmonic generation, in association with texture analyses.
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