Manifestations In Early Stage Research Articles

A micro-hyperspectral image classification method of gallbladder cancer based on multi-scale fusion attention mechanism

A micro-hyperspectral image classification method of gallbladder cancer based on multi-scale fusion attention mechanism

A new principle for the diagnosis morphea in the onset of the disease

BACKGROUND: Because of the low specificity morphea clinical manifestations in early stages, the differential diagnosis is difficult.
 AIMS: The purpose of the research is to propose a new diagnostic method for early stages of localized scleroderma.
 MATERIALS AND METHODS: During 20112020, 77 patients with clinical manifestations of morphea and 127 controls were examined and included in the study at the LenOblCenter. All participants were conducted a transcutaneous oximetry with the TCM-400 Radiometer apparatus. The tissue oxygen perfusion (tcpO2) level from 40 to 50 mm Hg was considered as a reversible decrease, from 30 to 40 mm hg was a borderline decline and the value below 30 mm hg was critical. The following diagnostic skin biopsy was conducted in all 77 patients
 RESULTS: Skin biopsy allowed to form 4 research groups: 40 patients with morphea, 12 patients with granuloma annulare, 15 patients with small plaque parapsoriasis and 10 individuals with large plaque parapsoriasis. 7 (17.5%) patients with morphea had normal tcpO2 values, 9 (22.5%) patients had significant decrease of tcpO2, 24 patients (60%) showed a reversible decrease of tcpO2. 3/12 (25%) patients with granuloma annulare and 1 patient (10%) with large plaque parapsoriasis had minor oxygen level decrease. Measurement on the healthy skin showed tcpO2 decrease in patients with comorbidities ― 3/77 (3.9%) in research group and 28/127 (22%) in controls.
 CONCLUSIONS: Transcutaneous oximetry is a new perspective direction in the diagnostic algorithm of the morphea based on the pathogenesis and morphological features of the disease.

Creutzfeldt-Jakob Disease: A single center experience and systemic analysis of cases in Turkey.

We aimed to analyze the clinical, laboratory and neuroimaging findings in patients with sporadic Creutzfeldt-Jakob disease (CJD) in a single center as well as to review other published cases in Turkey. Between January 1st, 2014 and June 31st, 2017, all CJD cases were evaluated based on clinical findings, differential diagnosis, the previous misdiagnosis, electroencephalography (EEG), cerebrospinal fluid and cranial magnetic resonance imaging (MRI) findings in our center. All published cases in Turkey between 2005-2018 were also reviewed. In a total of 13 patients, progressive cognitive decline was the most common presenting symptom. Two patients had a diagnosis of Heidenhain variant, 1 patient had a diagnosis of Oppenheimer-Brownell variant. Seven patients (53.3%) had been misdiagnosed with depression, vascular dementia, normal pressure hydrocephalus or encephalitis. Eleven patients (87%) had typical MRI findings but only 5 of these were present at baseline. Asymmetrical high signal abnormalities on MRI were observed in 4 patients. Five patients (45.4%) had periodic spike wave complexes on EEG, all appeared during the follow-up. There were 74 published cases in Turkey bet-ween 2005 and 2018, with various clinical presentations. CJD has a variety of clinical features in our patient series as well as in cases reported in Turkey. Although progressive cognitive decline is the most common presenting symptom, unusual manifestations in early stages of the disease might cause misdiagnosis. Variant forms should be kept in mind in patients with isolated visual or cerebellar symptoms. MRI and EEG should be repeated during follow-up period if the clinical suspicion still exists.

Contribution of the GABAergic System to Non-Motor Manifestations in Premotor and Early Stages of Parkinson's Disease.

Non-motor symptoms are common in Parkinson’s disease (PD) and they represent a major source of disease burden. Several non-motor manifestations, such as rapid eye movement sleep behavior disorder, olfactory loss, gastrointestinal abnormalities, visual alterations, cognitive and mood disorders, are known to precede the onset of motor signs. Nonetheless, the mechanisms mediating these alterations are poorly understood and probably involve several neurotransmitter systems. The dysregulation of GABAergic system has received little attention in PD, although the spectrum of non-motor symptoms might be linked to this pathway. This Mini Review aims to provide up-to-date information about the involvement of the GABAergic system for explaining non-motor manifestations in early stages of PD. Therefore, special attention is paid to the clinical data derived from patients with isolated REM sleep behavior disorder or drug-naïve patients with PD, as they represent prodromal and early stages of the disease, respectively. This, in combination with animal studies, might help us to understand how the disturbance of the GABAergic system is related to non-motor manifestations of PD.

Dynamic changes of ocular surface tissue of diabetic dry eye in mice

Objective To explore the occurring and developing characteristics of dry eye syndrome in type 1 diabetic mouse model induced with streptozotocin (STZ)-intraperitoneal injection. Methods Completely randomized design method was performed.Sixty SPF degree male C57BL/6 mice (6-8 weeks old) was randomly divided into diabetic group and control group, which were intraperitoneally injected with citrate buffer and STZ-citrate buffer (50 mg/kg per day), respectively.The average weight, blood glucose level and lacrimal gland weight were examined before injection and 1 month, 2 months, 4 months after the last injection; meanwhile, phenol cotton thread and rose bengal staining methods were used to check tear formation and ocular surface condition; corneal perception meter was used to test corneal sensitivity; periodic acid-schiff (PAS) staining method was used to test the density of conjunctival goblet cells; histopathological staining and Masson staining methods were used to test the tissue changes of lacrimal gland. Results Compared with before injections, the body weight and lacrimal gland weight in diabetic group were not significantly changed 1 month, 2 months and 4 months after injection (all at P>0.05), but these measurements in diabetic group 1 month, 2 months and 4 months after injection were significantly lower than those in control group at corresponding time points (all at P<0.05). Compared with before injections and control group at corresponding time points, the blood glucose level were dramatically higher and the tear formation were significantly decreased in diabetic group at 1 month, 2 months, 4 months after injection (all at P<0.05). The ocular surface of diabetic model mice showed positive rose bengal staining 2 months after STZ injections.The corneal sensitivities were significantly lower in diabetic model mice 2 months and 4 months after injection than those before injection and in control group at corresponding time points (all at P<0.05). The density of conjunctival goblet cells in diabetic group 4 months after injection was significantly decreased than those before injection in diabetic group and 4 months after injection in control group (all at P<0.05). The apparent collagen fibrosis and inflammatory cell infiltration were observed at lacrimal gland in diabetic model mice 4 months after injection. Conclusions The major early stage manifestations of STZ induced type 1 diabetes mice include retarded growth of lacrimal gland and decreased tear secretion volume, which gradually develop along the course of diabetes; in the later stage, the manifestations include decreased corneal sensitivity, ocular structural damage, structural changes of lacrimal gland and decreased conjunctival goblet cell density. Key words: Diabetes mellitus; Dry eye; Tear formation; Lacrimal gland; Corneal sensitivity

Analysis of clinical characteristics and treatment outcome of atypical early stage malignant laryngeal tumor

Objective:To observe the clinical characteristics of 22 cases of malignant laryngeal tumor manifested as smooth mass, and explore the diagnosis, pathological types and treatment of the disease.Method:Manifested as smooth mass, 22 cases diagnosed as malignant or borderline tumor by biopsy were collected to summarize the characteristics of pathology, treatment and prognosis. Result:The sex ratio was 13∶9. Eleven cases were diagnosed as malignant tumors of epithelial or mesenchymal origin, 7 cases of tumors of lymphoid hematopoietic system, 4 cases of borderline tumor.Thirteen patients received surgical treatment, and recurrence was not found in postoperative follow-up.Nine patients received radiotherapy and/or chemotherapy, 7 of them were in remission while 2 cases presented progression and metastasis of cervical lymph nodes. Conclusion:Because of lacking typical clinical manifestations in early stage,smooth mass of larynx often easily lead to misdiagnosis.If found and operated early,the prognosis can be satisfied,but the treatment outcome of lymphoma is poor.

Diagnostik und Therapie der frühen Psoriasis-Arthritis

Early diagnosis of psoriatic arthritis is of importance because an erosive disease is already detectable after a 2-year duration of symptoms. Often psoriatic arthritis cannot easily be detected because of the diversity of disease manifestations in early stages. As up to 30% of psoriasis patients develop psoriatic arthritis an interdisciplinary dermatologic/rheumatologic approach to diagnose findings and treatment decisions would be desirable. Screening tools, such as validated questionnaires allow an early detection and selection of patients with a high probability of psoriatic arthritis even in dermatological care or on a house physician basis. The implementation of the CASPAR criteria as a classification tool for psoriatic arthritis has also improved the diagnosis finding in patients with a recent onset of active musculoskeletal disease. Data from early psoriatic arthritis cohorts illustrate that drug-free remission is rare. An adequate treatment is of importance. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) has developed treatment recommendations based on the available evidence for different treatment modalities.

Correlation of aberrant expression of p53, Rad50, and cyclin-E proteins with microsatellite instability in gallbladder adenocarcinomas

Gallbladder carcinoma is an uncommon, but highly malignant tumor, with poor prognostic, and diagnostic manifestations in early stages. The Indian Council of Medical Research reported increased incidence of gallbladder carcinoma in the surviving population of the Bhopal gas tragedy that involved exposure of more than 500,000 people to methyl isocyanate gas. The severity of exposure, and increased multi-systemic morbidity in the survivors stimulated us to examine the molecular changes leading to gallbladder carcinoma. Surgically resected samples (N = 40) of gallbladder carcinoma were studied for the p53, Rad50, and cyclin-E expression by immunohistofluorescence bioimaging. Among the 40 samples, 23, 11, and 10 showed p53, Rad50, and cyclin-E expression, respectively, in moderately differentiated adenocarcinomas, demonstrating the prevalence and invasiveness of this disease in the methyl isocyanate-exposed population (P = 0.0009). Nevertheless, co-expression of Rad50, and cyclin-E with p53 was absent in adenomas with dysplasia, demonstrating their independent roles. We conclude that there was altered expression of p53, Rad50, and cyclin-E in the malignant transformation of gallbladder carcinoma in this methyl isocyanate gas-exposed cohort. Hence, these proteins may be useful as markers to identify premalignant lesions that are likely to progress into malignant adenocarcinoma.

The mechanisms controlling NK cell autoreactivity in TAP2-deficient patients

AbstractThe killing of natural killer (NK) cells is regulated by activating and inhibitory NK receptors that recognize mainly class I major histocompatibility complex (MHC) proteins. In transporter associated with antigen processing (TAP2)–deficient patients, killing of autologous cells by NK cells is therefore expected. However, none of the TAP2-deficient patients studied so far have suffered from immediate NK-mediated autoimmune manifestations. We have previously demonstrated the existence of a novel class I MHC–independent inhibitory mechanism of NK cell cytotoxicity mediated by the homophilic carcinoembryonic antigen–related cell adhesion molecule 1 (CEACAM1) interactions. Here, we identified 3 new siblings suffering from TAP2 deficiency. NK cells derived from these patients express unusually high levels of the various killer cell inhibitory receptors (KIRs) and the CEACAM1 protein. Importantly, the patients' NK cells use the CEACAM1 protein to inhibit the killing of tumor and autologous cells. Finally, we show that the function of the main NK lysis receptor, NKp46, is impaired in these patients. These results indicate that NK cells in TAP2-deficient patients have developed unique mechanisms to reduce NK killing activity and to compensate for the lack of class I MHC–mediated inhibition. These mechanisms prevent the attack of self-cells by the autologous NK cells and explain why TAP2-deficient patients do not suffer from autoimmune manifestations in early stages of life.

Ultrastructural Renal Changes in Juvenile Diabetics

Electron microscopic examination of percutaneous renal biopsy specimens from 12 normotensive patients ranging in age from 13 to 23 years with diabetes of juvenile onset revealed that glomerular alteration is not an invariable manifestation of early stages of diabetes and that changes in glomerular basement membrane most likely result from rather than precede those of the mesangium. Arteriolar hyalinosis was the most frequent alteration observed in these patients, occurring in 75% (9) of the specimens. This abnormally high prevalence of arteriolar hyalinosis is in accord with the recognized tendency of vascular disease to develop in patients with diabetes. The ultrastructural appearance of the renal arteriolar hyalinosis in our patients was indistinguishable from that in patients with essential and renal hyptertension and that in some normotensive older adults. These observations provide some information unifying the triad of hypertension, aging, and diabetes mellitus.