PAX8 Distinguishes Diffuse Large B-Cell Lymphoma Mimicking Sarcoma

PAX8 is important for embryogenesis of the thyroid, Müllerian system, and upper urinary/renal tract, and expression of PAX8 has been described in carcinomas from each of these sites. The sensitivity and specificity of the polyclonal PAX8 antibody in a large cohort of epithelial tumors as well as lymphomas have been previously determined, the latter because polyclonal PAX8 is known to be immunoreactive in nonneoplastic B-cell lymphocytes which are often used as the positive internal control for immunohistochemistry. In this case report, PAX8 was a diagnostic clue for revising a previous diagnosis of unclassified high grade sarcoma to diffuse large B-cell lymphoma. This case report demonstrates a pitfall for PAX8 immunoreactivity and acts as a reminder that lymphoma should be included in the differential diagnosis of a PAX8 positive, epithelial cell marker negative tumor of unknown primary origin.

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Changes in resting-state directed connectivity in cortico-subcortical networks correlate with cognitive function in Parkinson’s disease

Publication date: July 2017
Source:Clinical Neurophysiology, Volume 128, Issue 7
Author(s): Lennard I. Boon, Arjan Hillebrand, Kim T.E. Olde Dubbelink, Cornelis J. Stam, Henk W. Berendse
ObjectiveThe pathophysiological mechanisms underlying Parkinson's disease (PD)-related cognitive decline and conversion to PD dementia are poorly understood. In the healthy human brain, stable patterns of posterior-to-anterior cortical information flow have recently been demonstrated in the higher frequency bands using magnetoencephalography (MEG). In this study we estimated PD-related changes in information flow patterns, as well as the contribution of subcortical regions.MethodsResting-state MEG recordings were acquired in moderately advanced PD patients (n=34; mean Hoehn and Yahr-stage 2.5) and healthy controls (n=12). MEG signals were projected to both cortical and subcortical brain regions, following which we estimated the balance between incoming and outgoing information flow per region.ResultsIn PD patients, compared to controls, preferential beta band information outflow was significantly higher for the basal ganglia and frontotemporal cortical regions, and significantly lower for parieto-occipital regions. In addition, in patients, low preferential information outflow from occipital regions correlated with poor global cognitive performance.ConclusionIn the PD brain, a shift in balance towards more anterior-to-posterior beta band information flow takes place and is associated with poorer cognitive performance.SignificanceOur results indicate that a reversal of the physiological posterior-to-anterior information flow may be an important mechanism in PD-related cognitive decline.



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Heart rate changes according to the complexity of motor events in REM sleep behavior disorder

Publication date: July 2017
Source:Clinical Neurophysiology, Volume 128, Issue 7
Author(s): Paulo Bugalho, Marcelo Mendonça




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Flexion synergy overshadows flexor spasticity during reaching in chronic moderate to severe hemiparetic stroke

Publication date: July 2017
Source:Clinical Neurophysiology, Volume 128, Issue 7
Author(s): Michael D. Ellis, Ingrid Schut, Julius P.A. Dewald
ObjectivePharmaceutical intervention targets arm flexor spasticity with an often-unsuccessful goal of improving function. Flexion synergy is a related motor impairment that may be inadvertently neglected. Here, flexor spasticity and flexion synergy are disentangled to determine their contributions to reaching dysfunction.MethodsTwenty-six individuals participated. A robotic device systematically modulated shoulder abduction loading during ballistic reaching. Elbow muscle electromyography data were partitioned into windows delineated by elbow joint velocity allowing for the separation of synergy- and spasticity-related activation.ResultsReaching velocity decreased with abduction loading (p<0.001) such that velocity was 30% slower when lifting the arm at 50% of abduction strength compared to when arm weight was supported. Abnormal flexion synergy increased with abduction loading (p<0.001) such that normalized activation ranged from a median (interquartile range) of 0.07 (0.03–0.12) when arm weight was supported to 0.19 (0.12–0.40) when actively lifting (large effect size, d=0.59). Flexor spasticity was detected during reaching (p=0.016) but only when arm weight was supported (intermediate effect size, d=0.33).ConclusionFlexion synergy is the predominant contributor to reaching dysfunction while flexor spasticity appears only relevant during unnaturally occurring passively supported movement.SignificanceInterventions targeting flexion synergy should be leveraged in future stroke recovery trials.



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Macrodactylia lipomatosa with fibrolipomatous hamartomas: Macroscopic and ultrasound clues

Publication date: July 2017
Source:Clinical Neurophysiology, Volume 128, Issue 7
Author(s): Daniel Weiss, Brigitte Zrenner, Stefan Wolking, Tobias Freilinger, Alexander Grimm




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Acute otitis media in children: a vaccine‐preventable disease?

Marco Aurélio Palazzi Sáfadi, Daniel Jarovsky
Braz J Otorhinolaryngol 2017;83:241-2

Texto Completo - PDF

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Diagnostic value of repeated Dix‐Hallpike and roll maneuvers in benign paroxysmal positional vertigo

Cenk Evren, Nevzat Demirbilek, Mustafa Suphi Elbistanlı, Füruzan Köktürk, Mustafa Çelik
Braz J Otorhinolaryngol 2017;83:243-8

Resumo - Texto Completo - PDF

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