Early cancer in congenital choledochal cyst

We report a case of 35-yr-old woman with early cancer in congenital choledochal cyst. She had a five-year history of intermittent right upper abdominal pain and intermittent jaundice. In this period she had a few abdominal ultrasonographies, but the cholelithiasis had not been found. Now, she was admitted to our hospital because she felt right upper abdominal pain with slight jaundice and subfebrile temperature four weeks ago. Abdominal ultrasonography showed enormous dilatation of the common bile duct, which was suspected as choledochal cyst. Computed tomography and endoscopic retrograde cholangiopancreatography revealed cystic dilatation of extrahepatic bile duct. An anomalous pancreaticobiliary junction was not found. The patient with congenital choledochal cyst was operated on. The excision of choledochal cyst was done with hepaticojejunostomy Roux-en-Y. There were no lymph nodes metastases. On the central part of choledochal cysts mucosa, it was shown a white plain area of thickness 0.3 cm and 0.8 cm in diameter. Histologically it was well-differentiated tubular adenocarcinoma, which was limited to the mucosa and which did not penetrate to other parts of the bile duct wall. From our knowledge, only small number cases of early cholangiocarcinoma in choledochal cyst were until now reported. Nearly eight years after the operation the patient feels very well, and has optimal working ability (Karnofsky 100%).     

抑郁症患者的脑CT灌注成像特征与认知功能的相关性

摘要 目的：探讨抑郁症患者的脑CT灌注成像特征与认知功能的相关性。方法：选取我院2020年1月到2023年1月收治的90例抑郁症患者作为研究对象,将其分为观察组,另选取同期来我院体检的90名健康志愿者作为对照组。收集所有受检者脑CT灌注成像检查数据,分析抑郁症患者的脑CT灌注成像特征,并建立受试者工作特征（ROC）曲线分析脑CT灌注成像对抑郁症的诊断效能。随后对观察组和对照组受检者均进行认知功能评估,其中包括连线检测（TMT）、视觉再生测验（VRT）、言语流畅性测验（VF）、数字广度测验（DST）以及数字符号测验（SDMT）,并分析脑CT灌注成像与抑郁症认知功能的相关性。结果：观察组与对照组受检者rCBV、rCBF、MTT、TIP、右枕叶、左枕叶、右颞叶、左颞叶、右顶叶、左顶叶CT值对比无明显差异（P＞0.05）,观察组与对照组受检者右额叶、左额叶CT值对比差异显著,观察组明显低于对照组（P＜0.05）;90例抑郁症患者经过汉密尔顿抑郁量表（HAMD）评估后分数均＞20分,确定存在抑郁症状,脑CT灌注成像与HAMD评分诊断抑郁症的准确性、灵敏度、特异性、阳性预测值和阴性预测值对比无明显差异（P＞0.05）,脑CT灌注成像的曲线下面积为83.89,最佳诊断着色界限值为82.53%,HAMD评分的曲线下面积为84.26,最佳诊断着色界限值为87.57%;观察组与对照组受检者连线提笔数、连线错误数、视觉再生检测结果对比无明显差异（P＞0.05）,观察组与对照组受检者连线、言语流畅性、数字广度、数字符号检测结果对比差异显著（P＜0.05）;Spearman相关分析结果表明：连线提笔数、连线错误数、视觉再生与脑CT灌注参数均无明显相关性（P＞0.05）,连线、言语流畅性、数字广度、数字符号与rCBV、rCBF、MTT、TIP、右枕叶、左枕叶、右颞叶、左颞叶、右顶叶、左顶叶CT值无明显相关性（P＞0.05）,连线与右额叶、左额叶CT值呈负相关（P＜0.05）,言语流畅性、数字广度、数字符号与右额叶、左额叶CT值呈正相关（P＜0.05）。结论：抑郁症患者的脑CT灌注成像与健康群体呈现差异,其中右额叶、左额叶差异情况最为显著,提示抑郁症患者可能存在大脑额叶功能改变,另外,抑郁症患者的大脑额叶功能与认知功能变化具有明显相关性。     

Ventricular Tachycardia Caused by Mesothelial Cyst

A 27 year-old- lady was evaluated due to recurrent ventricular tachycardia. After performing echocardiography and cardiac MRI, she was found to have large pericardial cyst. Pathologic examination confirmed it as mesothelial pericardial cyst. Up to our knowledge it is the first presentation of simple pericardial cyst as ventricular a tachycardia.     

Auditory ERPs to stimulus deviance in an awake chimpanzee (Pan troglodytes): towards hominid cognitive neurosciences

Background

For decades, the chimpanzee, phylogenetically closest to humans, has been analyzed intensively in comparative cognitive studies. Other than the accumulation of behavioral data, the neural basis for cognitive processing in the chimpanzee remains to be clarified. To increase our knowledge on the evolutionary and neural basis of human cognition, comparative neurophysiological studies exploring endogenous neural activities in the awake state are needed. However, to date, such studies have rarely been reported in non-human hominid species, due to the practical difficulties in conducting non-invasive measurements on awake individuals.

Methodology/Principal Findings

We measured auditory event-related potentials (ERPs) of a fully awake chimpanzee, with reference to a well-documented component of human studies, namely mismatch negativity (MMN). In response to infrequent, deviant tones that were delivered in a uniform sound stream, a comparable ERP component could be detected as negative deflections in early latencies.

Conclusions/Significance

The present study reports the MMN-like component in a chimpanzee for the first time. In human studies, various ERP components, including MMN, are well-documented indicators of cognitive and neural processing. The results of the present study validate the use of non-invasive ERP measurements for studies on cognitive and neural processing in chimpanzees, and open the way for future studies comparing endogenous neural activities between humans and chimpanzees. This signifies an essential step in hominid cognitive neurosciences.     

Diffusion tensor and perfusion MRI of non-human primates

This paper reviews recent non-human primate (NHP) neuroimaging literature using MRI in macaque, baboon and chimpanzee. It describes general challenges and limitations for NHP MRI studies, and reviews recent applications of anatomical, diffusion tensor, cerebral blood flow MRI. Applications to NHP stroke is discussed in some detail.     

Visual and auditory conditional position discrimination in chimpanzees (Pan troglodytes)

Chimpanzee cognition has been studied predominantly through the visual modality, and much less through the auditory modality. The aim of this study was to explore possible differences in chimpanzees’ processing of visual and auditory stimuli. We developed a new conditional position discrimination (CPD) task requiring the association between a stimulus (from either the auditory or the visual modality), and a spatial position (left or right). The stimuli consisted of the face and voice of two individuals well known to the subjects (one chimpanzee and one human). Six chimpanzees participated in both the visual and the auditory conditions. We found contrasting results between the two conditions: the subjects acquired the CPD more easily in the visual than in the auditory condition. This supports previous findings on the difficulties encountered by chimpanzees in learning tasks involving auditory stimuli. Our experiments also revealed individual differences: the chimpanzee with the most extensive experience in symbolic visual matching tasks showed good performance in both conditions. In contrast, the chimpanzee expert in an auditory-visual intermodal matching task showed no sign of learning in either condition. Future work should focus on finding the most appropriate procedure for exploring chimpanzees’ auditory-visual cognitive skills.     

Identification of vocalizers by pant hoots,pant grunts and screams in a chimpanzee

Identification of vocalizers was examined using an auditory-visual matching-to-sample task with a female chimpanzee. She succeeded in selecting the picture of the vocalizer in response to various types of vocalizations: pant hoots, pant grunts, and screams. When pant hoots by two chimpanzees were presented as a "duet", she could identify both of the vocalizers. These results suggest that researchers have underestimated the capability of vocalizer identification in chimpanzees. The chimpanzee correctly chose her own pictures in response to her vocalizations only by exclusion, and she did not show vocal self-recognition. The effect of acoustical modification (pitch shift and filtration) on the performance suggested that pitch is an important cue for the vocalizer identification.     

A comprehensive atlas of white matter tracts in the chimpanzee

Chimpanzees (Pan troglodytes) are, along with bonobos, humans’ closest living relatives. The advent of diffusion MRI tractography in recent years has allowed a resurgence of comparative neuroanatomical studies in humans and other primate species. Here we offer, in comparative perspective, the first chimpanzee white matter atlas, constructed from in vivo chimpanzee diffusion-weighted scans. Comparative white matter atlases provide a useful tool for identifying neuroanatomical differences and similarities between humans and other primate species. Until now, comprehensive fascicular atlases have been created for humans (Homo sapiens), rhesus macaques (Macaca mulatta), and several other nonhuman primate species, but never in a nonhuman ape. Information on chimpanzee neuroanatomy is essential for understanding the anatomical specializations of white matter organization that are unique to the human lineage.

Diffusion MRI tractography reveals the first complete atlas of white matter of the chimpanzee, with the potential to help understand differences between the organization of human and chimpanzee brains.     

Merkel cell carcinoma in a malignant pleural effusion: case report

BACKGROUND: Merkel cell (neuroendocrine) carcinoma is a small round blue cell malignant neoplasm that primarily presents in the skin. The diagnosis of Merkel cell carcinoma in a pleural fluid is challenging because of the morphological similarity to many other malignant neoplasms. Immunohistochemical stains can be essential to establish the diagnosis of Merkel cell carcinoma. CASE PRESENTATION: A 77 year-old woman presented with a mass in her right buttock thought clinically to be a boil or sebaceous cyst. Upon histopathologic review including immunohistochemical analysis, a diagnosis of Merkel cell carcinoma was rendered. Wide-excision and sentinel lymph node biopsy revealed negative margins and no evidence of metastasis. Ten months later she complained of bone pain and a bone scan revealed multiple lesions. An abdominal CT scan revealed a T4 vertebral mass and local radiotherapy was administered. Two months later the patient presented with shortness of breath. A chest radiograph showed an effusion and thoracentesis was performed. The fluid was confirmed to contain metastatic Merkel cell carcinoma by cytology and immunohistochemical analysis. CONCLUSIONS: Merkel cell carcinoma is an aggressive neoplasm that can, despite careful surgical management, occasionally present as a malignant pleural effusion in a relatively short time period. Immunohistochemical analysis can aid in confirming this rare outcome.     

Repeated hypoglycemia and cognitive decline. A case report

OBJECTIVE: Diabetes mellitus has a high incidence in general population and goes by high morbidity by specific micro vascular pathology in the retina, renal glomerul and peripheral nerves. In type 1 DM, intensive therapy can prevent or delay the development of long-term complications associated with DM but hypoglycaemia especially severe hypoglycaemia defined, as a low blood glucose resulting in stupor, seizure, or unconsciousness that precludes self-treatment is a serious threat. Hypoglycaemia that may preferentially harm neurons in the medial temporal region, specifically the hippocampus, is a potential danger for the brain cognitive function which several studies failed to detect any significant effects, whereas others indicated an influence on it. A young diabetic case presented here with severe cognitive defect. Great number of severe hypoglycaemic or hyperglycaemic attacks and convulsion episodes were described in his medical history. RESULTS and CONCLUSION: Neuroradiologic findings on CT and MRI, pointed that global cerebral atrophy that is incompatible with his age. Brain perfusion studies (SPECT, (99m)Tc-labeled HMPAO) also showed that there were severe perfusion defects at superior temporal region and less perfusion defects at gyrus cingulum in frontal region. These regions are related with memory processing. Severe cognitive defect in this patient seems to be closely related these changes and no another reason was found to explain except the repeated severe hypoglycaemic episodes.     

The perception of self-agency in chimpanzees (Pan troglodytes)

The ability to distinguish actions and effects caused by oneself from events occurring in the external environment is a fundamental aspect of human cognition. Underlying such distinctions, self-monitoring processes are often assumed, in which predicted events accompanied by one's own volitional action are compared with actual events observed in the external environment. Although many studies have examined the absence or presence of a certain type of self-recognition (i.e. mirror self-recognition) in non-human animals, the underlying cognitive mechanisms remain unclear. Here, we provide, to our knowledge, the first behavioural evidence that chimpanzees can perform self/other distinction for external events on the basis of self-monitoring processes. Three chimpanzees were presented with two cursors on a computer display. One cursor was manipulated by a chimpanzee using a trackball, while the other displayed motion that had been produced previously by the same chimpanzee. Chimpanzees successfully identified which cursor they were able to control. A follow-up experiment revealed that their performance could not be explained by simple associative responses. A further experiment with one chimpanzee showed that the monitoring process occurred in both temporal and spatial dimensions. These findings indicate that chimpanzees and humans share the fundamental cognitive processes underlying the sense of being an independent agent.     

Evaluation of Resting State Networks in Patients with Gliomas: Connectivity Changes in the Unaffected Side and Its Relation to Cognitive Function

In this study, we investigated changes in resting state networks (RSNs) in patients with gliomas located in the left hemisphere and its relation to cognitive function. We hypothesized that long distance connection, especially between hemispheres, would be affected by the presence of the tumor. We further hypothesized that these changes would correlate with, or reflect cognitive changes observed in patients with gliomas. Resting state functional MRI datasets from 12 patients and 12 healthy controls were used in the analysis. The tumor’s effect on three well-known RSNs including the default mode network (DMN), executive control network (ECN), and salience network (SN) identified using independent component analysis were investigated using dual regression analysis. Scores of neuropsychometric testing (WAIS-III and WMS-R) were also compared. Compared to the healthy control group, the patient group showed significant decrease in functional connectivity in the right angular gyrus/inferior parietal lobe of the ventral DMN and in the dorsolateral prefrontal cortex of the left ECN, whereas a significant increase in connectivity in the right ECN was observed in the right parietal lobe. Changes in connectivity in the right ECN correlated with spatial memory, while that on the left ECN correlated with attention. Connectivity changes in the ventral DMN correlated with attention, working memory, full IQ, and verbal IQ measures. Although the tumors were localized in the left side of the brain, changes in connectivity were observed in the contralateral side. Moreover, these changes correlated with some aspects of cognitive function indicating that patients with gliomas may undergo cognitive changes even in the absence of or before the onset of major symptoms. Evaluation of resting state networks could be helpful in advancing our hodological understanding of brain function in glioma cases.     

Capacity-speed relationships in prefrontal cortex

Working memory (WM) capacity and WM processing speed are simple cognitive measures that underlie human performance in complex processes such as reasoning and language comprehension. These cognitive measures have shown to be interrelated in behavioral studies, yet the neural mechanism behind this interdependence has not been elucidated. We have carried out two functional MRI studies to separately identify brain regions involved in capacity and speed. Experiment 1, using a block-design WM verbal task, identified increased WM capacity with increased activity in right prefrontal regions, and Experiment 2, using a single-trial WM verbal task, identified increased WM processing speed with increased activity in similar regions. Our results suggest that right prefrontal areas may be a common region interlinking these two cognitive measures. Moreover, an overlap analysis with regions associated with binding or chunking suggest that this strategic memory consolidation process may be the mechanism interlinking WM capacity and WM speed.     

Measurement of 150 kDa protein of Taenia solium metacestodes by antibody-sandwich ELISA in cerebrospinal fluid of neurocysticercosis patients.

An antigenic protein in cystic fluid of Taenia solium metacestodes (CF) of 150 kDa was measured by antibody-sandwich ELISA in serum and cerebrospinal fluid (CSF) of neurocysticercosis patients. Capture antibodies were rabbit antisera against CF (RACF) and a monoclonal antibody (MAb) against 150 kDa protein in CF. Lower limit of antibody-sandwich ELISA was 8 ng/ml of the protein. Except CF, no tested helminths extracts reacted. Levels of the protein in 351 sera from 255 patients (55 surgery confirmed and 202 antibody and CT/MRI confirmed) were below sensitivity of the assay. Of 276 CSF from 212 patients, 31 samples (11.2%) showed positive findings. This assay, therefore, was not sensitive enough to be a diagnostic. Instead, the 150 kDa protein appeared in CSF in such situations as in 2 days after praziquantel treatment, or as in a patient infected with a racemose cysticercus with degenerated cyst wall. Of cases whose follow-up CSF were assayed, 2 cases showed that the protein appeared intermittently. These results suggest strongly that appearance of free 150 kDa protein is associated with cyst wall rupture. In CSF which contained the 150 kDa protein over 61 ng/ml, the protein was recognized in SDS-PAGE before and after immunoprecipitation.     

Human cognitive ecology: an instructive framework for comparative primatology

In this review, research on human cognitive ecology is compared with studies of the cognitive ecologies of apes-especially the common chimpanzee. The objective was to assess the feasibility of extending an activity-theory framework developed in studies of humans to an integrated approach for studying the cognitive accomplishments and skills of other primates living in the wild. Six generalizations were abstracted from studies of humans: 1) Social and material environments are arranged to facilitate production. 2) Human activity is shaped by conceptual and cultural principles that provide underlying logic for working knowledge and practice. 3) Schemata (multimodal, mental representations of procedures, strategies, and techniques) govern performance in a domain. 4) Working knowledge, skills, and social identities are co-constructed in communities of practice. 5) Rehearsal improves skilled performances, from which reputations as well as material products are derived. 6) Planning and emergence are in productive tension in human practices. These generalizations are applied to findings in the literature regarding the behavior of chimpanzees and other apes in the wild to assess the potential utility of a situated-activity approach for comparative studies of primate cognition. It is argued in the Discussion that schemata constitute a common core of higher primate intelligence. Planning, emergence, and alterations of the environment to facilitate production further characterize human and chimpanzee or gorilla behaviors to varying degrees. Less apparent in the nonhuman-primate literature is evidence of governing principles, rehearsal, and skill-based reputations or identities entailing theories of mind. Nonetheless, recent observations in the wild suggest that further research is warranted to explore the rudiments of each of these components to enhance our understanding of the ecology of primate cognition and its evolutionary history.     

Muscle architecture of the common chimpanzee (Pan troglodytes): perspectives for investigating chimpanzee behavior

Thorpe et al. (Am J Phys Anthropol 110:179–199, 1999) quantified chimpanzee (Pan troglodytes) muscle architecture and joint moment arms to determine whether they functionally compensated for structural differences between chimpanzees and humans. They observed enough distinction to conclude that musculoskeletal properties were not compensatory and suggested that chimpanzees and humans do not exhibit dynamically similar movements. These investigators based their assessment on unilateral limb musculatures from three male chimpanzees, of which they called one non-adult representative. Factors such as age, sex, and behavioral lateralization may be responsible for variation in chimpanzee muscle architecture, but this is presently unknown. While the full extent of variation in chimpanzee muscle architecture due to such factors cannot be evaluated with data presently available, the present study expands the chimpanzee dataset and provides a preliminary glimpse of the potential relevance of these factors. Thirty-seven forelimb and 36 hind limb muscles were assessed in two chimpanzee cadavers: one unilaterally (right limbs), and one bilaterally. Mass, fiber length, and physiological cross-sectional area (PCSA) are reported for individual muscles and muscle groups. The musculature of an adult female is more similar in architectural patterns to a young male chimpanzee than to humans, particularly when comparing muscle groups. Age- and sex-related intraspecific differences do not obscure chimpanzee-human interspecific differences. Side asymmetry in one chimpanzee, despite consistent forelimb directional asymmetry, also does not exceed the magnitude of chimpanzee-human differences. Left forelimb muscles, on average, usually had higher masses and longer fiber lengths than right, while right forelimb muscles, on average, usually had greater PCSAs than left. Most muscle groups from the left forelimb exhibited greater masses than right groups, but group asymmetry was significant only for the manual digital muscles. The hind limb exhibited less asymmetry than the forelimb in most comparisons. Examination of additional chimpanzees would clarify the full range of inter- and intra-individual variation.     

Default-Mode Network Changes in Huntington’s Disease: An Integrated MRI Study of Functional Connectivity and Morphometry

Previous MRI studies of functional connectivity in pre-symptomatic mutation carriers of Huntington’s disease (HD) have shown dysfunction of the Default-Mode Network (DMN). No data however are currently available on the DMN alterations in the symptomatic stages of the disease, which are characterized by cortical atrophy involving several DMN nodes. We assessed DMN integrity and its possible correlations with motor and cognitive symptoms in 26 symptomatic HD patients as compared to 22 normal volunteers, by analyzing resting state functional MRI data, using the Precuneal Cortex/Posterior Cingulate Cortices (PC/PCC) as seed, controlling at voxel level for the effect of atrophy by co-varying for gray matter volume. Direct correlation with PC/PCC was decreased, without correlation with atrophy, in the ventral medial prefrontal cortex (including anterior cingulate and subgenual cortex), right dorso-medial prefrontal cortex, and in the right inferior parietal cortex (mainly involving the angular gyrus). Negative correlations with PC/PCC were decreased bilaterally in the inferior parietal cortices, while a cluster in the right middle occipital gyrus presented increased correlation with PC/PCC. DMN changes in the ventral medial prefrontal cortex significantly correlated with the performance at the Stroop test (p = .0002). Widespread DMN changes, not correlating with the atrophy of the involved nodes, are present in symptomatic HD patients, and correlate with cognitive disturbances.     

Rex Shunt Preoperative Imaging: Diagnostic Capability of Imaging Modalities

The purpose of this study was to evaluate the diagnostic capability of imaging modalities used for preoperative mesenteric-left portal bypass (“Rex shunt”) planning. Twenty patients with extrahepatic portal vein thrombosis underwent 57 preoperative planning abdominal imaging studies. Two readers retrospectively reviewed these studies for an ability to confidently determine left portal vein (PV) patency, superior mesenteric vein (SMV) patency, and intrahepatic left and right PV contiguity. In this study, computed tomographic arterial portography allowed for confident characterization of left PV patency, SMV patency and left and right PV continuity in 100% of the examinations. Single phase contrast-enhanced CT, multi-phase contrast-enhanced CT, multiphase contrast-enhanced MRI, and transarterial portography answered all key diagnostic questions in 33%, 30%, 0% and 8% of the examinations, respectively. In conclusion, of the variety of imaging modalities that have been employed for Rex shunt preoperative planning, computed tomographic arterial portography most reliably allows for assessment of left PV patency, SMV patency, and left and right PV contiguity in a single study.