Posterior parahippocampal gyrus pathology in Alzheimer's disease

The posterior parahippocampal gyrus (PPHG) of the non-human primate brain has a distinct dual role in cortical neural systems. On the one hand, it is a critical link in providing the entorhinal cortex and hippocampal formation with cortical input, while on the other hand it receives output from these structures and projects widely by disseminating the medial temporal lobe output to the cortex. Layer III of TF and TH areas largely mediate the former (input) while layer V mediates the latter (output). We have examined areas TF and TH in the normal human brain and in Alzheimer's disease (AD) using pathological stains (Nissl, Thioflavin S) and phenotype specific stains non-phosphorylated neurofilament protein (SMI32) and parvalbumin (PV). Seven clinically and pathologically confirmed AD cases have been studied along with six age-compatible normal cases. Our observations reveal that neurofibrillary tangles (NFTs) heavily invest the area TF and TH neurons that form layers III and V. In both cortical areas, the large pyramids that form layer V contain a greater number of NFTs. These changes, and possibly, pyramidal cell loss, greatly alter the cytoarchitectural picture and diminish SMI32 staining patterns. Layer III of area TH loses the majority of SMI32 immunoreactivity, whereas this change is more conspicuous in layer V of area TF. PV-staining in both areas is largely unaffected. Normal cases contained no evidence of pathology or altered cytoarchitecture. These observations reveal a further disruption of memory-related temporal neural systems in AD where pathology selectively alters both the input to the hippocampal formation and its output to the cortex.     

Leiomyoma of scrotum

Leiomyoma is a benign tumor of smooth muscles. Leiomyoma originating from the scrotum is a rare entity. We report here a case of 50-year-old male who presented with a 4-cm lump in the left side of scrotum. Clinically, it was provisionally diagnosed as sebaceous cyst and was excised. The histopathology showed findings consistent with leiomyoma. There was no cytological atypia or mitosis. The final diagnosis of solitary leiomyoma of scrotum was given. The patient was followed up regularly and is doing fine for last 4 months.     

Spindle cell lipoma breast

Spindle cell lipoma, which usually arises in the soft tissues, is rare in breast and is difficult to differentiate from primary mammary spindle cell tumor. Here, we present the case of a 48-year-old woman with a 3-cm, solitary, well-circumscribed and nontethered mass lying deep within the tissue of left breast, incidentally detected on routine mammography. The spindle cells proved to be immunoreactive to CD 34, but nonreactive to desmin and smooth muscle actin.     

A novel iris transillumination grading scale allowing flexible assessment with quantitative image analysis and visual matching

Purpose: To develop a sensitive scale of iris transillumination suitable for clinical and research use, with the capability of either quantitative analysis or visual matching of images.

Methods: Iris transillumination photographic images were used from 70 study subjects with ocular or oculocutaneous albinism. Subjects represented a broad range of ocular pigmentation. A subset of images was subjected to image analysis and ranking by both expert and nonexpert reviewers. Quantitative ordering of images was compared with ordering by visual inspection. Images were binned to establish an 8-point scale. Ranking consistency was evaluated using the Kendall rank correlation coefficient (Kendall’s tau). Visual ranking results were assessed using Kendall’s coefficient of concordance (Kendall’s W) analysis.

Results: There was a high degree of correlation among the image analysis, expert-based and non-expert-based image rankings. Pairwise comparisons of the quantitative ranking with each reviewer generated an average Kendall’s tau of 0.83 ± 0.04 (SD). Inter-rater correlation was also high with Kendall’s W of 0.96, 0.95, and 0.95 for nonexpert, expert, and all reviewers, respectively.

Conclusions: The current standard for assessing iris transillumination is expert assessment of clinical exam findings. We adapted an image-analysis technique to generate quantitative transillumination values. Quantitative ranking was shown to be highly similar to a ranking produced by both expert and nonexpert reviewers. This finding suggests that the image characteristics used to quantify iris transillumination do not require expert interpretation. Inter-rater rankings were also highly similar, suggesting that varied methods of transillumination ranking are robust in terms of producing reproducible results.     

Recurrent group G Streptococcus bacteremia: A case report and literature review

Streptococci group G is an important opportunistic pathogen and causes a wide variety of infections, including pharyngitis, skin and soft tissue infections, bacteremia, endocarditis, septic arthritis, intra‐abdominal infections, meningitis, and streptococcal toxic shock‐like syndrome. As a result, we discuss an interesting case of recurrent group G streptococcal bacteremia in a 68‐year‐old man presenting with altered mental status. We also discuss the risk factors, etiology, pathophysiology, diagnosis, and treatment of group G streptococcal bacteremia.     

‘Tu Souffres,Cela Suffit’: Louis Pasteur's (1822–1895) inspirational motto for Sydney's St George Hospital

In the fiscal year of 1960–1961, board members of Sydney's St George Hospital elected to adopt a new motto for the organisation: ‘Tu souffres, cela suffit’ – French for ‘You are suffering, that is enough’. Today these words are all too familiar to staff members and visitors to St George Hospital, but few are aware of their actual historical significance. Accessible histories of the hospital attribute the motto to the distinguished French microbiologist Louis Pasteur (1822–1895), but the original context of Pasteur's remark is not commonly stated. We set out to record the exact source and history of the hospital's motto alongside its logo, referencing in passing, Louis Pasteur's outstanding legacy to Australian medicine in this bicentenary year of his birth.