Spindle-cell tumours and hypoglycaemia.

The light microscopy and clinical features of two patients with extrapancreatic tumours and hypoglycaemic episodes are described-together with the electron microscopy findings in one patient. The primary tumour of one patient arose within the skull and later metastasized to the liver, while the other patient had a locally recurrent intrathoracic tumour. Neither the intracranial origin nor the ultrastructural features support the concept of a mesothelial origin for these tumours, and they should be referred to as spindle-cell tumours associated with hypoglycaemia. There are ultrastructural similarities between these neoplasms and those of the pancreatic beta cells.     

Actinomycosis and nocardiosis. A morphologic study of 17 cases

Actinomycosis and nocardiosis are bacterial infectious diseases with distinct morphologic features, that can be diagnosed in tissue sections. The clinico-pathologic features of 17 cases are reported with emphasis on their histopathologic diagnosis by using a simple combination of common tissue stains. Actinomycosis was frequently observed as a secondary and localized infection often with lung involvement, especially in residual cavities or bronchiectasis; in these cases numerous actinomycotic granules and only occasionally individual bacterial filaments within the suppurative foci and/or granulomas with suppurative centers were identified. Nocardiosis was observed as an opportunistic infection in the three cases studied; in these, isolated filaments of acid-fast and Gram-positive bacteria were observed. The morphologic features and the differential diagnosis in tissue sections of both infections are discussed with emphasis on their identification by the general pathologist in the routine material.     

Acoustic features of rhesus vocalizations and their representation in the ventrolateral prefrontal cortex

Communication is one of the fundamental components of both human and nonhuman animal behavior. Auditory communication signals (i.e., vocalizations) are especially important in the socioecology of several species of nonhuman primates such as rhesus monkeys. In rhesus, the ventrolateral prefrontal cortex (vPFC) is thought to be part of a circuit involved in representing vocalizations and other auditory objects. To further our understanding of the role of the vPFC in processing vocalizations, we characterized the spectrotemporal features of rhesus vocalizations, compared these features with other classes of natural stimuli, and then related the rhesus-vocalization acoustic features to neural activity. We found that the range of these spectrotemporal features was similar to that found in other ensembles of natural stimuli, including human speech, and identified the subspace of these features that would be particularly informative to discriminate between different vocalizations. In a first neural study, however, we found that the tuning properties of vPFC neurons did not emphasize these particularly informative spectrotemporal features. In a second neural study, we found that a first-order linear model (the spectrotemporal receptive field) is not a good predictor of vPFC activity. The results of these two neural studies are consistent with the hypothesis that the vPFC is not involved in coding the first-order acoustic properties of a stimulus but is involved in processing the higher-order information needed to form representations of auditory objects.     

Effect of chemotherapy on tear drop poikilocytes and other peripheral blood findings in myelofibrosis

A leukoerythroblastic blood picture and tear drop shaped red cells are two characteristic features of myelofibrosis (MF). Following our earlier observation of an increase in the hemoglobin level with chemotherapy, we have now reviewed the pre- and post-treatment peripheral blood smears from 14 patients with MF to assess the effect of treatment on the above mentioned peripheral blood features. Our results suggest that these features are reversible with effective chemotherapy.     

The oro-facial-digital syndrome

Two patients, a mother and her daughter, are presented who manifest the clinical features of the oro-facial-digital syndrome (OFD I). Many of these features are shared with Mohr's syndrome (OFD II). Confusion arises when a patient presents with features common to both syndromes. The features which are always or sometimes associated with these syndromes are tabulated. The Tables also show which abnormalities are common to both syndromes and to our cases. Additional clinical and radiological features which have not been considered part of these syndromes are described. We present these cases to suggest that these syndromes should be "lumped" together as one syndrome. We propose expanding this syndrome to include ear and renal abnormalities. Our cases follow an X-linked dominant inheritance pattern and, therefore, do not help determine the genetic controversy of these two syndromes.     

The characteristic physiognomy and tissue specific karyotype distribution in the Pallister-Killian syndrome

We report a child with clinical features remarkably similar to those of our patient reported as tetrasomy 21 in 1982. Improved banding in this, and the previous case, together with gene dosage studies, and subsequent reports in the literature lead us to conclude that these patients are in fact tetrasomic for 12p. The clinical features of these children are most distinctive and the importance of their recognition lies in the fact that the abnormal cell line is virtually confined to fibroblast studies.     

Clinical developmental,neuropsychological, and social–emotional features of Turner syndrome

Individuals with Turner syndrome (TS) are at risk for a constellation of neurocognitive and psychosocial differences, although there is significant individual variability in these features. TS is associated with an increased risk for difficulties with visual–spatial reasoning, visual–spatial memory, attention, executive functioning, motor, and math skills. Additionally, increased rates of social difficulties, anxiety, and depression are observed. There can be significant interplay between all of these factors contributing to the behavioral phenotype. Neuropsychological features and previous research are reviewed. Clinical considerations and recommendations for evaluation and treatment of psychological and behavioral difficulties are provided, including consideration of medical features in TS, as well as therapies, educational supports, and medication treatment. Future research is needed to evaluate effectiveness of different treatments for neuropsychological and psychosocial features of TS, including modification and validation of existing evidence‐based treatments and new approaches to care.     

Odor maps in the mammalian olfactory bulb: domain organization and odorant structural features

Psychophysical studies indicate that structural features of odorants differentially influence their perceived odor. In the olfactory bulb (OB), odorants are represented by ensembles of activated glomeruli. Here we used optical imaging of intrinsic signals to examine how these structural features are represented spatially in the sensory map of the rat OB. We found that the dorsal OB contained two topographically fixed domains; constituent glomeruli in each domain could be activated by odorants with particular functional groups. Within each domain, other structural features such as carbon chain length and branching were represented by local differences in patterns. These results suggest that structural features are categorized into two classes, primary features (functional groups) that characterize each domain, and secondary features that are represented by local positions within each domain. Such hierarchical representations of different structural features correlate well with psychophysical structure-odor relationships.     

Atypical melanocytic lesions of the thigh with spitzoid and dysplastic features: a clinicopathologic study of 29 cases

Melanocytic nevi in certain anatomic locations can display unusual histopathologic features potentially creating diagnostic uncertainty. Benign melanocytic nevi in sites such as acral, genital, and flexural areas may show unusual architecture and cytologic atypia, which can mimic dysplastic nevi and, sometimes, melanoma. Twenty-nine benign melanocytic skin lesions were identified in the thigh of 26 women and 3 men who showed atypical histologic features, including both dysplastic and spitzoid features. All lesions measured less than 1 cm in diameter. Eighteen cases showed features of compound nevi, and 11 were junctional. In all cases, the lesions displayed spitzoid features including large epithelioid and/or spindle cells, some melanocytes with ganglion-like cytomorphology, and focal suprabasilar upward migration. All cases showed dysplastic features. Clinical follow-up was available in 26 patients; no recurrences or metastases were observed. The demographic features and the anatomical sites of these melanocytic nevi appear to be reproducible, and in the assessment of histologically difficult cases, these data are helpful. It is our opinion that the malignant potential of these lesions with hybrid patterns (spitzoid/dysplastic) has yet to be determined, and although we favor these lesions to be benign, longer follow-up may yield a more complete understanding of their biologic potential.     

Visual features of intermediate complexity and their use in classification

The human visual system analyzes shapes and objects in a series of stages in which stimulus features of increasing complexity are extracted and analyzed. The first stages use simple local features, and the image is subsequently represented in terms of larger and more complex features. These include features of intermediate complexity and partial object views. The nature and use of these higher-order representations remains an open question in the study of visual processing by the primate cortex. Here we show that intermediate complexity (IC) features are optimal for the basic visual task of classification. Moderately complex features are more informative for classification than very simple or very complex ones, and so they emerge naturally by the simple coding principle of information maximization with respect to a class of images. Our findings suggest a specific role for IC features in visual processing and a principle for their extraction.     

Endoscopic ultrasound-guided fine-needle aspiration findings of gastrointestinal leiomyomas and gastrointestinal stromal tumors

True leiomyomas of the gastrointestinal system are rare but remain the most common mesenchymal tumors of the esophagus. It has become important to distinguish these tumors from gastrointestinal stromal tumors (GISTs) because the neoplasms have different prognoses and treatment options. We describe and compare clinical findings and the following fine-needle aspiration (FNA) features of 9 gastrointestinal leiomyomas and 19 GISTs sampled with endoscopic ultrasound: overall cellularity, cell group features, cell shape and cytoplasmic features, nuclear characteristics, background, cell block features, and immunohistochemical results. Gastrointestinal leiomyomas and GISTs have different clinical and cytologic features that help pathologists distinguish these tumors, and the immunohistochemical findings that help define these lesions can be derived readily from cell block material obtained by endoscopic ultrasound-guided FNA.     

Recurrent hepatitis C and acute allograft rejection: clinicopathologic features with emphasis on the differential diagnosis between these entities

Chronic hepatitis C virus infection is the leading etiology for liver transplantation in the United States. Recurrent hepatitis C occurs nearly universally in these patients and represents a serious posttransplantation complication. Despite the detailed characterization of the histologic features of both recurrent hepatitis C and acute cellular rejection (ACR) over the last decades, the pathologic distinction between these 2 conditions remains one of the greatest diagnostic challenges in liver pathology. An accurate diagnosis, nevertheless, plays an essential role in patient management, as different therapeutic strategies are used for these conditions. In this review, the clinicopathologic features of posttransplantation recurrent hepatitis C and ACR are discussed, with emphasis on distinguishing histopathologic features, morphologic variants, ancillary techniques, and diagnostic pitfalls.     

Vulvar apocrine adenocarcinoma: a case with nodal metastasis and intranodal mucinous differentiation

Primary vulvar adenocarcinomas are rare tumors, and their histogenesis is not fully understood. They are classified into extramammary Paget's disease, sweat gland carcinomas, and "breast-like" adenocarcinomas of the vulva. The latter resemble adenocarcinomas arising in the breast morphologically and immunophenotypically. Rare cases of adenocarcinoma with apocrine features have been reported, and whether these neoplasms originate from the "native apocrine" sweat glands or from "anogenital mammary-like" glands are still debatable. The presence of normal mammary-like glands in the vicinity of the tumor, the transitional malignant morphological features from normal mammary-like glands and the tumor, the breast-like histological features of the tumor, and the expression of estrogen and progesterone receptors generally suggest an origin from anogenital mammary-like glands. Absence of these features points toward native apocrine sweat glands as the source of these neoplasms. In this report, we present a patient who was initially diagnosed with Paget's disease of the right vulva, which was treated by hemi-vulvectomy, and who later presented with primary vulvar apocrine adenocarcinoma with metastasis to the inguinal lymph nodes and intranodal mucinous/colloidal differentiation: a feature, to the best of our knowledge, not reported before. We also reviewed the histogenesis of the vulvar adenocarcinomas, with emphasis on the morphological features that separate the tumors arising from the anogenital mammary-like glands in the vulva from those arising from the native vulvar sweat glands.     

The Role of Ultrastructural Pathology in the Diagnosis of Epithelial and Unusual Renal Tumors

The electron microscopic and immunohistochemical features of epithelial and unusual renal tumors are reviewed. Ultra-structural and immunohistochemical features of diagnostic value are highlighted. An attempt is made to address histoge-nesis/differentiation issues that would help in understanding morphologic findings, with an emphasis placed on the role that ultrastructural evaluation has played in demonstrating these.     

Cities and health: history, approaches, and key questions.

The majority of the world's population will live in cities in the next few years, and the pace of urbanization worldwide will continue to accelerate over the coming decades. Such a dramatic demographic shift can be expected to have an impact on population health. Although there has been historic interest in how city living is associated with health, this interest has waxed and waned and a cogent framework has yet to evolve that encompasses key issues in urban health. In this article, the authors discuss three alternate approaches to the study of urban health today; these include considering urban health from the perspective of a presumed urban health penalty, from an urban sprawl perspective, and more comprehensively, considering how urban living conditions may be associated with health. The authors also propose three key questions that may help guide the study and practice of urban health in coming decades. These include considering what specific features of cities are causally related to health, the extent to which these features are unique to a particular city or are different between cities, and ultimately, to what extent these features of cities are modifiable in order to allow interventions that can improve the health of urban populations.     

Human papillomavirus in oral verrucal-papillary lesions. A comparative histological, clinical and immunohistochemical study.

The purpose of this study was to determine the presence of Human Papillomavirus (HPV) virions in the verrucal-papillary (OVP) lesions by clinical, histological and immunohistochemical [peroxidase-antiperoxidase (PAP) features]. Thirty seven positive cases were compared with 47 negative cases. Considerable overlapping of clinical and histological features can be seen among all these lesions. The study provides evidence that there are no clinical or histologic features with taken alone are strongly correlated with the presence of virions in oral lesions.     

Therapist features in sexual offender treatment: their reliable identification and influence on behaviour change

In the first of the two studies reported here, we established that trained judges could reliably identify 18 therapist features that occurred with reasonable frequency. In the second study 17 of these features were examined to determine how well they related to changes in sexual offenders with treatment. Five videotapes from each of five different prison programs were rated for the presence of these 17 features and correlational analyses examined their relationship with changes in 44 measures of treatment targets. The primary findings indicated that empathy and warmth displayed by the therapists and their directive and rewarding behaviours, were the features that most strongly predicted therapeutic benefits. The results are discussed in terms of their clinical and research implications. Copyright © 2002 John Wiley & Sons, Ltd.     

The effect of time course and context on the facilitation of semantic features in the cerebral hemispheres.

Two divided visual field priming experiments were designed to determine the nature of lexical retrieval in the cerebral hemispheres by studying the facilitation of semantic features of unambiguous nouns. Unambiguous nouns have a single meaning, yet semantic features associated with these nouns may vary in the degree to which they are compatible with this single meaning (e.g., LAMB-WOOL as compared with LAMB-CHOPS). Results suggest that the left hemisphere selects both strongly and weakly associated semantic features that are compatible with the dominant representation of the noun. Dominance compatibility, rather than association strength, seems to be the more important factor for deciding what features are maintained in the left hemisphere. In contrast, the right hemisphere maintains more varied information, including features that are less compatible with the dominant representation (Experiment 1) and context information (Experiment 2).     

Neuroblastoma in adults. Pathologic findings and clinical outcome

Neuroblastoma in adults is uncommon. Previous reports have suggested that adult patients with neuroblastoma have a better prognosis than children with these tumors. We have examined the clinical features of eight adults with neuroblastoma and related these data to tumor histopathology and immunohistochemistry using an antibody to neuron-specific enolase. The results show that when children and adults with neuroblastoma are compared by stage, adults do not have a better prognosis. Adults tend to have a different anatomic distribution of primary tumor sites, with more frequent extra-abdominal sites than are seen in children. Neuroblastomas arising in adults are similar to those seen in children by containing neuron-specific enolase, an enzyme associated with cells of neuroectodermal origin. These findings show that adult neuroblastomas are similar to their childhood counterparts in clinical behavior and pathologic features.     

Normal growth and development in a child with Baller-Gerold syndrome (craniosynostosis and radial aplasia).

The cardinal features of the Baller-Gerold syndrome (MIM *21860) are craniosynostosis and radial aplasia. Only 12 cases have been published and these are roughly divisible into two groups: cases without any additional abnormalities and cases with a broad range of additional features. We describe a boy with craniosynostosis and radial aplasia alone and highlight genetic counselling difficulties presented by a sporadic case of this rare syndrome.