gross

  • 文章类型: Journal Article
    诸如肝细胞癌(HCC)的肿瘤的宏观外观可以被定义为其表型,其事实上由其基因型决定。因此,HCC的宏观特征不太可能是随机的,而是反映癌症的基因组特征,可能是一个有价值的信息来源,可以检索和利用来推断预后。这篇综述旨在提供有关HCC宏观表征预后价值的可用数据的全面概述。总共确定了57项符合合格标准的研究,包括接受肝切除术的患者(LR;47项研究,83%)或肝移植(LT;9项研究,16%)。研究了以下宏观变量:肿瘤大小(n=42项研究),结节数量(n=28),血管浸润(n=24),胆管侵犯(n=6),生长模式(n=15),切除边缘(n=11),肿瘤位置(n=6),胶囊(n=2)和卫星(n=1)。尽管选定的研究提供了具有显著预后表现的有见地数据,报告和总体调查结果分析指出,缺乏标准化和巨大差距。这个话题仍然没有完全覆盖。虽然现有研究强调了宏观变量在HCC预后中的价值,还观察到了重要的缺失。HCC的宏观表征可能是预后因素的未充分利用来源,必须通过未来的多学科研究来积极探索。
    The macroscopic appearance of a tumor such as hepatocellular carcinoma (HCC) may be defined as its phenotype which is de facto dictated by its genotype. Therefore, macroscopic characteristics of HCC are unlikely random but rather reflect genomic traits of cancer, presumably acting as a valuable source of information that can be retrieved and exploited to infer prognosis. This review aims to provide a comprehensive overview of the available data on the prognostic value of macroscopic characterization in HCC. A total of 57 studies meeting eligible criteria were identified, including patients undergoing liver resection (LR; 47 studies, 83%) or liver transplant (LT; 9 studies, 16%). The following macroscopic variables were investigated: tumor size (n = 42 studies), number of nodules (n = 28), vascular invasion (n = 24), bile duct invasion (n = 6), growth pattern (n = 15), resection margin (n = 11), tumor location (n = 6), capsule (n = 2) and satellite (n = 1). Although the selected studies provided insightful data with notable prognostic performances, a lack of standardization and substantial gaps were noted in the report and the analysis of gross findings. This topic remains incompletely covered. While the available studies underscored the value of macroscopic variables in HCC prognostication, important lacks were also observed. Macroscopic characterization of HCC is likely an underexploited source of prognostic factors that must be actively explored by future multidisciplinary research.
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  • 文章类型: Journal Article
    背景:准确、及时地评估儿童的发育状况对于早期诊断和干预至关重要。由于缺乏训练有素的医疗保健提供者和不精确的父母报告,更准确和自动化的发展评估至关重要。在发展的各个领域,众所周知,幼儿的粗大运动发育可以预测随后的童年发展。
    目的:这项研究的目的是开发一种模型来评估粗大运动行为,并将结果整合以确定幼儿的整体粗大运动状态。这项研究还旨在确定在评估总体总体运动技能方面很重要的行为,并检测关键时刻和重要的身体部位,以评估每种行为。
    方法:我们使用了18-35个月幼儿的行为视频。为了评估电机总体发展,我们选择了4种行为(爬楼梯,走下楼梯,扔球,并站在1英尺上),已通过韩国婴儿和儿童发育筛查测试进行了验证。在儿童行为视频中,我们将每个孩子的位置估计为边界框,并在框内提取人类关键点。在第一阶段,使用基于图形卷积网络(GCN)的算法分别评估具有每种行为的提取的人类关键点的视频。在第一阶段模型中获得的每个标签的概率值用作第二阶段模型的输入,极端梯度提升(XGBoost)算法,预测总体运动状态。为了可解释性,我们使用梯度加权类激活映射(Grad-CAM)来识别运动过程中的重要时刻和相关身体部位。Shapley加性解释方法用于评估变量重要性,以确定对整体发展评估贡献最大的运动。
    结果:从147名儿童中收集了4种粗大运动技能的行为视频,共产生2395个视频。评估每种行为的阶段1GCN模型的接受者工作特征曲线下面积(AUROC)为0.79至0.90。关键点映射Grad-CAM可视化识别了每个行为中的重要时刻以及重要身体部位的差异。评估总体粗大运动状态的阶段2XGBoost模型的AUROC为0.90。在这四种行为中,“下楼梯”对整体发展评估的贡献最大。
    结论:使用18-35个月幼儿的运动视频,我们开发了客观和自动化的模型来评估每个行为和评估每个孩子的整体粗大运动表现。我们确定了评估总体电机性能的重要行为,并开发了在评估总体电机性能时识别重要力矩和身体部位的方法。
    BACKGROUND: Accurate and timely assessment of children\'s developmental status is crucial for early diagnosis and intervention. More accurate and automated developmental assessments are essential due to the lack of trained health care providers and imprecise parental reporting. In various areas of development, gross motor development in toddlers is known to be predictive of subsequent childhood developments.
    OBJECTIVE: The purpose of this study was to develop a model to assess gross motor behavior and integrate the results to determine the overall gross motor status of toddlers. This study also aimed to identify behaviors that are important in the assessment of overall gross motor skills and detect critical moments and important body parts for the assessment of each behavior.
    METHODS: We used behavioral videos of toddlers aged 18-35 months. To assess gross motor development, we selected 4 behaviors (climb up the stairs, go down the stairs, throw the ball, and stand on 1 foot) that have been validated with the Korean Developmental Screening Test for Infants and Children. In the child behavior videos, we estimated each child\'s position as a bounding box and extracted human keypoints within the box. In the first stage, the videos with the extracted human keypoints of each behavior were evaluated separately using a graph convolutional networks (GCN)-based algorithm. The probability values obtained for each label in the first-stage model were used as input for the second-stage model, the extreme gradient boosting (XGBoost) algorithm, to predict the overall gross motor status. For interpretability, we used gradient-weighted class activation mapping (Grad-CAM) to identify important moments and relevant body parts during the movements. The Shapley additive explanations method was used for the assessment of variable importance, to determine the movements that contributed the most to the overall developmental assessment.
    RESULTS: Behavioral videos of 4 gross motor skills were collected from 147 children, resulting in a total of 2395 videos. The stage-1 GCN model to evaluate each behavior had an area under the receiver operating characteristic curve (AUROC) of 0.79 to 0.90. Keypoint-mapping Grad-CAM visualization identified important moments in each behavior and differences in important body parts. The stage-2 XGBoost model to assess the overall gross motor status had an AUROC of 0.90. Among the 4 behaviors, \"go down the stairs\" contributed the most to the overall developmental assessment.
    CONCLUSIONS: Using movement videos of toddlers aged 18-35 months, we developed objective and automated models to evaluate each behavior and assess each child\'s overall gross motor performance. We identified the important behaviors for assessing gross motor performance and developed methods to recognize important moments and body parts while evaluating gross motor performance.
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  • 文章类型: Journal Article
    细针抽吸细胞学(FNAC)是一种简单的程序,被广泛接受为一线研究。理想情况下,应在患者附近进行显微镜评估,以评估抽吸物的充分性。因为这并不总是可能的,一个有价值的替代品是评估所获得材料的总体外观。这项研究的目的是确定这种替代方法的价值,床边方法。
    这项研究是在三级保健医院进行的,为期1年,其中包括在门诊部(OPD)接受FNAC的50例患者。对常见病变的未染色涂片进行拍照,并由三名独立观察者进行评估。把他们分成四个等级,viz.1级:不可能含有诊断材料。2级:可能包含诊断材料。3级:可能包含诊断材料。4级:暗示特定诊断的材料。随后将结果与染色涂片的显微镜发现进行比较。
    在1、2、3和4年级之间的50例病例的分布分别为5、6、17和22。
    FNA涂片的总体外观有助于预测样品的充分性,有时有助于最终的显微镜诊断。可以通过检查来测量样品的细胞性,并且有时可以做出可能的诊断。一些病变表现出典型的肉眼容易被有经验的眼睛发现,因此在显微镜检查之前可以预测可能的诊断。然而,FNA标本的近患者显微镜评估,用于快速现场评估,如果可用,应该是首选模式。
    UNASSIGNED: Fine needle aspiration cytology (FNAC) is a simple procedure that is widely accepted as a first-line investigation. It should ideally be performed near the patient with microscopic assessment for evaluation of adequacy of aspirate. Since this is not always possible, a worthwhile substitute is to assess the gross appearance of the material obtained. This study was aimed to determine the value of this alternative rapid, bed-side approach.
    UNASSIGNED: This study was carried out in a tertiary care hospital for a duration of 1 year, where 50 cases undergoing FNAC in the out-patient department (OPD) were included. Unstained smears of commonly encountered lesions were photographed and assessed by three independent observers, who graded them into four grades, viz. Grade 1: unlikely to contain diagnostic material. Grade 2: possibly contains diagnostic material. Grade 3: probably contains diagnostic material. Grade 4: material suggesting a specific diagnosis. Results were subsequently compared with the microscopic findings of stained smears.
    UNASSIGNED: Distribution of the 50 cases between grades 1, 2, 3, and 4 were 5, 6, 17, and 22, respectively.
    UNASSIGNED: Gross appearances of FNA smears are helpful in predicting the adequacy of the sample and sometimes the final microscopic diagnosis. The cellularity of a sample can be gauged by inspection and sometimes a likely diagnosis can be made. Some lesions show typical gross appearance easily detected by the experienced eye so a likely diagnosis can be predicted prior to microscopic examination. However, near-patient microscopic assessment of FNA specimens for rapid onsite evaluation, if available, should be the preferred mode.
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  • 文章类型: Journal Article
    目的:静脉浸润(VI)是结直肠癌(CRC)的一个强有力但报道不足的预后因素。改善其检测的努力主要集中在组织学评估上,对组织采样策略的关注较少。这项研究旨在前瞻性地确定在CRC切除中优化VI检测所需的肿瘤块的数量。此外,研究了线性棘突(LS)与壁外静脉侵犯(EMVI)之间的关系。
    结果:制定了标准化的组织采样方案,并前瞻性地应用于217例CRC切除[AJCC第8版,1期(n=32);2期(n=84);3期(n=87);4期(n=14);和新辅助治疗后(n=46)]。对所有肿瘤块进行弹性蛋白染色。在55%的病例中发现了VI(EMVI=37%;仅IMVI=18%)。VI检测的灵敏度随着提交的肿瘤块数量的增加而增加[一个块(35%),三个街区(66%),五个街区(84%),六个街区(95%)和七个街区(97%)]。对EMVI观察到类似的发现[一个区块(35%),三个街区(73%),五个街区(89%),六个街区(96%)和七个街区(96%)]。在22%的标本中宏观鉴定了LS。在没有给予新辅助治疗的情况下,EMVI与LS显著相关(LS+病例为71%,LS-病例为29%;P<0.001)。此外,与不靶向LS的肿瘤阻滞相比,靶向LS的肿瘤阻滞的EMVI发生率高5倍(P<0.001).
    结论:我们的研究结果证明了组织采样和大体检查质量对VI检测的影响,并可能为将来的CRC方案提供指导。
    OBJECTIVE: Venous invasion (VI) is a powerful yet under-reported prognostic factor in colorectal cancer (CRC). Efforts to improve its detection have largely focused upon histological assessment, with less attention paid to tissue-sampling strategies. This study aimed to prospectively determine the number of tumour blocks required to optimise VI detection in CRC resections. In addition, the relationship between linear spiculation (LS) and extramural venous invasion (EMVI) was investigated.
    RESULTS: A standardised tissue sampling protocol was developed and applied prospectively to 217 CRC resections [AJCC 8th edition, stage 1 (n = 32); stage 2 (n = 84); stage 3 (n = 87); stage 4 (n = 14); and post-neoadjuvant therapy (n = 46)]. Elastin stains were performed on all tumour blocks. VI was identified in 55% of cases (EMVI = 37%; IMVI alone = 18%). The sensitivity of VI detection increased with increasing numbers of tumour blocks submitted [one block (35%), three blocks (66%), five blocks (84%), six blocks (95%) and seven blocks (97%)]. Similar findings were observed for EMVI [one block (35%), three blocks (73%), five blocks (89%), six blocks (96%) and seven blocks (96%)]. LS was identified macroscopically in 22% of specimens. In cases where no neoadjuvant therapy had been given, EMVI was significantly associated with LS (71% in LS+ cases versus 29% in LS- cases; P < 0.001). In addition, tumour blocks targeting LS were associated with a fivefold higher rate of EMVI compared with blocks that did not (P < 0.001).
    CONCLUSIONS: Our findings demonstrate the impact of tissue sampling and quality of gross examination on VI detection and may inform practices in future CRC protocols.
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  • 文章类型: Journal Article
    众所周知,跟腱是体内最强的肌腱。它的解剖组成是独特的,允许极端负荷的吸收。历史上,长期以来,人们一直认为跟腱断裂发生在缺血的“分水岭”区域内。然而,实验数据表明,整个肌腱的血流动力学均匀,挑战了这一广泛的概念。
    The Achilles tendon is well known as the strongest tendon within the body. Its anatomic composition is unique to allow absorption of extreme loads. Historically, there has been a longstanding belief that rupture of the Achilles tendon occurs within a \"watershed\" region of ischemia. However, experimental data have demonstrated uniform hemodynamic flow throughout the tendon to challenge this widespread notion.
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  • 文章类型: Journal Article
    结节性皮肤病(LSD)是埃及繁殖群中仍然造成巨大经济损失的主要病毒性疾病之一。本研究旨在将光线聚焦于非皮肤病变(患病率,强度,和影响)在尸检的LSD感染的牛中。我们选择了位于3个省(Sharkia,Dakahlia,和卡卢比亚)在尼罗河三角洲,埃及,在2019年1月至2020年1月期间进行我们的调查研究。农场的病史宣布以前没有接受过检查的农场的疫苗接种。临床症状,发病率,并记录死亡率。平均发病率和死亡率分别为22.28%和6.59%,分别。肝脏标本的PCR,肾脏,心,肺,睾丸,udder,气管,和淋巴结表明存在分子量大小为192bp的扩增子辣椒病毒基因产物。记录尸检和紧急屠宰的死后病变。感染动物中主要可检测的组织病理学病变是睾丸炎(75%),未成熟乳房和哺乳期乳房炎(66.66%),和坏死性肝炎(77.77%),播散性血管炎(61.11),肾小球肾炎(55.55),心肌变性(50%),冠状动脉脂肪浆液性萎缩(38.88%),淋巴结炎(88.88%),脾坏死和淋巴组织衰竭(38.88%),坏死性肌炎(77.77%),支气管炎(16.66%),和肺炎(间质性支气管肺炎)(44.44%),除了皮肤中的细胞质内包涵体(33.33%)。可以得出结论,LSD的死亡率较高可能是由于感染动物的全身性感染,这对繁殖群中的经济损失产生了很大影响。
    Lumpy skin disease (LSD) is one of the major viral diseases still causing great economic losses among breeding flocks of Egypt. This study was designed to focus light on non-cutaneous lesions (prevalence, intensity, and impacts) among necropsied LSD infected cattle. We selected some dairy and beef flocks (Frisian breed) located in 3 governorates (Sharkia, Dakahlia, and Kaloubia) in Nile delta, Egypt, in the period from January 2019 to January 2020 for our survey study. The case history of farms declared no previous vaccination of examined farms. The clinical signs, morbidity, and mortality rates were recorded. Average morbidity and mortality percentage were 22.28% and 6.59%, respectively. PCR for specimens from liver, kidneys, heart, lungs, testis, udder, trachea, and lymph node indicates presence of amplicon capripoxvirus gene product at molecular weight size 192 bp. Postmortem lesions of necropsied and emergency slaughtered were recorded. The main detectable histopathology lesions among the infected animals were orchitis (75%), mastitis in immature and lactating udder (66.66%), and necrotic hepatitis (77.77%), disseminated vasculitis (61.11), glomerulonephritis (55.55), myocardial degeneration (50%), and serous atrophy of coronary fats (38.88%), lymphadenitis (88.88%), necrosis and depleted lymphoid tissue of spleen (38.88%), necrotic myositis (77.77%), tracheitis (16.66%), and pneumonia (interstitial bronchopneumonia) (44.44%) besides intra-cytoplasmic inclusions bodies in skin (33.33%). It could be concluded that higher mortalities of LSD may be due to systemic infection of infected animals which had great impact on economic losses among breeding flocks.
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  • 文章类型: Journal Article
    The thyroid cancer is the most prevalent oncologic disease of endocrine organs, characterized by multi factorial risk of development. The purpose of the study was to analyze dynamics of indices of thyroid cancer morbidity of population of the Russian Federation, considering gender and age differences in 2008-2018. The increase of \"rough\" indicator of thyroid cancer morbidity of male population made up to 56.6%, and of female population - 48.3%. The dynamics of standardized indicator in gender contingents was characterized by increasing up to 48.7% in males and up to 43.9% in females. There is an increasing of thyroid cancer morbidity with age and prevalence of the morbidity in females as compared with males in all age categories. The highest morbidity was established in male population aged 65-69 years (8.3 per 100,000 population) and in females aged 55-64 years (27.3 per 100,000 population). In the territories of the Russian Federation, in the gender aspect, variations in thyroid cancer morbidity were established. both in male and female populations, maximal thyroid cancer morbidity was established in the North Western and Siberian Federal Okrugs, and morbidity below national level was registered in the Privolzhskiy and North Caucasian Federal Okrugs. It is necessary to take into account differentiation of the territories of the Russian Federation in terms of the thyroid cancer morbidity in different gender and age groups for development of rational measures of early identification of risk factors, diagnosis and treatment of patients.
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  • 文章类型: Journal Article
    To determine diagnostic, workflow, and economic implications of instituting a gross-only policy at our institution.
    Retrospective (2017) key word searches were performed to identify \"gross-only\" cases for which microscopic evaluation could potentially be omitted, but was performed, and those who underwent gross evaluation per surgeon request. Cases were evaluated for type(s), part(s), block volume, turnaround time, demographics, and diagnosis. Laboratory costs and reimbursement were evaluated.
    In total, 448 potential gross-only cases with 472 specimens consisted of atherosclerotic plaques (33.5%), bariatric stomach/bowel (32.6%), hernia (15.7%), heart valves (12.7%), and other (5.9%). Four (2.6%) bariatric surgery cases had Helicobacter pylori infection; these were the only cases with \"significant\" histologic findings. Cost analysis revealed that converting all potential gross-only specimens to gross only would result in overall losses based on average reimbursements, most influenced by bariatric specimens (Current Procedural Terminology code 88307), comprising 65.2% of estimated loss.
    Establishing a gross-only policy should be guided by established recommendations but institutionally individualized and data driven. It was reasonable for us to establish a gross-only policy for most evaluated specimens, while excluding bariatric stomach specimens in which microscopic pathology could be missed, given the lack of H pylori screening at our institution.
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  • 文章类型: Journal Article
    Thirty-five years old female and 12 years old male wild elephant were found dead at Seviyodu and Cherangode of Cherambadi range at Nilgiris district, Tamil Nadu state. On post mortem examination, maggots were recovered from palate of oral cavity and gastric mucosa of the stomach and identified as Chrysomyia bezziana and Cobbaldia elephantis, respectively. Histopathology of oral tissue specimen revealed myonecrosis of soft palate due to myiasis and cross section of encysted larvae surrounded by fibrous capsule and inflammatory cells. This study reports the mixed infection of wound and gastric myiasis due to C. bezziana and C. elephantis and its histopathological lesions in wild elephants.
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  • 文章类型: Journal Article
    Equine intervertebral disc degeneration is thought to be rare and of limited clinical relevance, although research is lacking. To objectively assess pathological changes of the equine intervertebral disc and their clinical relevance, description of the normal morphology and a practical, biologically credible grading scheme are needed. The objectives of this study are to describe the gross and histological appearance of the equine intervertebral discs and to propose a grading scheme for macroscopic degeneration. Spinal units from 33 warmblood horses were grossly analyzed and scored. Of the 286 intervertebral discs analyzed, 107 (37%) were assigned grade 1 and grade 2 (considered normal) and were analyzed histologically. A nucleus pulposus and an annulus fibrosus could be identified macroscopically and histologically. Histologically, the nucleus pulposus was composed of a cartilaginous matrix and the annulus fibrosus of parallel collagenous bands. A transition zone was also histologically visible. Intra- and inter-observer reliability scores were high for all observers. Higher grades were associated with greater age. Gross changes associated with equine intervertebral disc degeneration (grades 3-5)-that is, yellow discoloration, cleft formation (tearing), and changes in consistency of the nucleus pulposus-were largely similar to those in humans and dogs and were most prevalent in the caudal cervical spine. Equine intervertebral disc degeneration was not associated with osteophyte formation. Changes of the vertebral bone were most common in the thoracolumbar spine but were not correlated with higher grades of intervertebral disc degeneration. Thus, changes of the vertebral bone should be excluded from grading for equine intervertebral disc degeneration.
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