Case Report: Unusual Clinical Presentation of a Rare Cardiac Inflammatory Myofibroblastic Tumor in Children: The Differential Diagnosis With Pediatric Emergencies

Introduction: There are still no guidelines about pediatric cardiac cancers. The purpose of this work is to provide new scientific data facilitating the differential diagnosis of a rare cardiac tumor with an unusual presentation, such as the cardiac inflammatory myofibroblastic tumor (IMT).Case Presentation: A 3-year-old male child presented with several symptoms including unconsciousness, vomiting, and drowsiness. A clinical and neurological examination revealed a unilateral (right) motor delay and positive unilateral Babinski sign. Electrocardiogram (ECG) was normal.Diagnostic Assessment: The total body computed tomography (CT) scans showed hypodensity in the left temporal–parietal lobe, a large hypodense area in the right frontal lobe, and a second area in the left frontal lobe were found with head CT. A magnetic resonance (MR) also noted cerebral areas of hypointensity. The echocardiographic images revealed an ovoid mass, adherent to the anterolateral papillary muscle. The histological exams, performed with hematoxylin–eosin, Masson's trichrome, Alcian blue PAS, Weigert and Van-Gieson stain, allowed observing the microscopic structure of the neoplastic mass. The immunohistochemical analysis was performed through subsequent antibodies: anti-vimentin, anti-actina, anti-ALK, anti-CD8, anti-CD3, anti-CD20, anti-kappa and lambda chains, and anti CD68 antibodies. The healthcare professionals diagnosed a cardiac IMT with brain embolism.Differential Diagnosis: The ventricular localization, observed through radiological exams, required a differential diagnosis with fibroma and rhabdomyoma, the presence of brain embolism with sarcoma, and its morphology with fibroma. Neurological symptoms might be attributed to encephalitis, primitive cerebral cancer, such as astrocytoma or neuroblastoma, cerebral metastases due to any malignancy, or embolic stroke.Conclusion: New studies are encouraged to better define IMT behavior and draw up guidelines confirming the crucial role of multidisciplinary approach and treatment protocol selected on the basis of the characteristics of the tumors, in the case of this rare type of cancer.

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An explainable Artificial Intelligence approach to study MCI to AD conversion via HD-EEG processing

Clinical EEG and Neuroscience ◽

10.1177/15500594211063662 ◽

2021 ◽

pp. 155005942110636

Author(s):

Francesco Carlo Morabito ◽

Cosimo Ieracitano ◽

Nadia Mammone

Keyword(s):

Artificial Intelligence ◽

Frontal Lobe ◽

Parietal Lobe ◽

Classification Performance ◽

Head Region ◽

Left Frontal Lobe ◽

Performance Accuracy ◽

Power Spectral ◽

Explainable Artificial Intelligence

An explainable Artificial Intelligence (xAI) approach is proposed to longitudinally monitor subjects affected by Mild Cognitive Impairment (MCI) by using high-density electroencephalography (HD-EEG). To this end, a group of MCI patients was enrolled at IRCCS Centro Neurolesi Bonino Pulejo of Messina (Italy) within a follow-up protocol that included two evaluations steps: T0 (first evaluation) and T1 (three months later). At T1, four MCI patients resulted converted to Alzheimer’s Disease (AD) and were included in the analysis as the goal of this work was to use xAI to detect individual changes in EEGs possibly related to the degeneration from MCI to AD. The proposed methodology consists in mapping segments of HD-EEG into channel-frequency maps by means of the power spectral density. Such maps are used as input to a Convolutional Neural Network (CNN), trained to label the maps as “T0” (MCI state) or “T1” (AD state). Experimental results reported high intra-subject classification performance (accuracy rate up to 98.97% (95% confidence interval: 98.68–99.26)). Subsequently, the explainability of the proposed CNN is explored via a Grad-CAM approach. The procedure allowed to detect which EEG-channels (i.e., head region) and range of frequencies (i.e., sub-bands) resulted more active in the progression to AD. The xAI analysis showed that the main information is included in the delta sub-band and that, limited to the analyzed dataset, the highest relevant areas are: the left-temporal and central-frontal lobe for Sb01, the parietal lobe for Sb02, the left-frontal lobe for Sb03 and the left-frontotemporal region for Sb04.

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Post-Stimulation Effect of Electroacupuncture at Yintang (EX-HN3) and GV20 on cerebral functional regions in healthy volunteers: A resting functional MRI study

Acupuncture in Medicine ◽

10.1136/acupmed-2011-010123 ◽

2012 ◽

Vol 30 (4) ◽

pp. 307-315 ◽

Cited By ~ 8

Author(s):

Yu Zheng ◽

Shanshan Qu ◽

Na Wang ◽

Limin Liu ◽

Guanzhong Zhang ◽

...

Keyword(s):

Frontal Lobe ◽

Temporal Lobe ◽

Parietal Lobe ◽

Occipital Lobe ◽

Cingulate Gyrus ◽

Left Frontal Lobe ◽

Posterior Cingulate Gyrus ◽

Functional Regions ◽

Limbic Lobe ◽

The Right

Objective The aim of the present work was to observe the activation/deactivation of cerebral functional regions after electroacupuncture (EA) at Yintang (EX-HN3) and GV20 by functional MRI (fMRI). Design A total of 12 healthy volunteers were stimulated by EA at Yintang and GV20 for 30 min. Resting-state fMRI scans were performed before EA, and at 5 and 15 min after needle removal. Statistical parametric mapping was used to preprocess initial data, and regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) were analysed. Results ReHo at 5 min post stimulation showed increases in the left temporal lobe and cerebellum and decreases in the left parietal lobe, occipital lobe and right precuneus. At 15 min post stimulation, ReHo showed increases in the left fusiform gyrus; lingual gyrus; middle temporal gyrus; postcentral gyrus; limbic lobe; cingulate gyrus; paracentral lobule; cerebellum, posterior lobe, declive; right cuneus and cerebellum, anterior lobe, culmen. It also showed decreases in the left frontal lobe, parietal lobe, right temporal lobe, frontal lobe, parietal lobe and right cingulate gyrus. ALFF at 5 min post stimulation showed increases in the right temporal lobe, but decreases in the right limbic lobe and posterior cingulate gyrus. At 15 min post stimulation ALFF showed increases in the left frontal lobe, parietal lobe, occipital lobe, right temporal lobe, parietal lobe, occipital lobe and cerebellum, but decreases in the left frontal lobe, anterior cingulate gyrus, right frontal lobe and posterior cingulate gyrus. Conclusions After EA stimulation at Yintang and GV20, which are associated with psychiatric disorder treatments, changes were localised in the frontal lobe, cingulate gyrus and cerebellum. Changes were higher in number and intensity at 15 min than at 5 min after needle removal, demonstrating lasting and strong after-effects of EA on cerebral functional regions.

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Correlations Between Diffusion Parameters and Neurometabolic Status in the Left Frontal Lobe in UHR Subjects

10.26226/morressier.5a7070e6d462b80290b57a0c ◽

2018 ◽

Author(s):

Petr Menshchikov

Keyword(s):

Frontal Lobe ◽

Left Frontal Lobe ◽

Diffusion Parameters

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CORRELATIONS BETWEEN DIFFUSION PARAMETERS AND NEUROMETABOLIC STATUS IN THE LEFT FRONTAL LOBE IN UHR SUBJECTS.

10.26226/morressier.5d1a037357558b317a1403e0 ◽

2019 ◽

Author(s):

Maxim Ublinskiy

Keyword(s):

Frontal Lobe ◽

Left Frontal Lobe ◽

Diffusion Parameters

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Different Brain Network Activations Induced by Modulation and Nonmodulation Laser Acupuncture

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2011/951258 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8 ◽

Cited By ~ 17

Author(s):

Chang-Wei Hsieh ◽

Jih-Huah Wu ◽

Chao-Hsien Hsieh ◽

Qwa-Fun Wang ◽

Jyh-Horng Chen

Keyword(s):

Primary Motor Cortex ◽

Parietal Lobe ◽

Random Effect ◽

Sensory Information ◽

Brain Network ◽

Laser Acupuncture ◽

Middle Temporal Gyrus ◽

Left Frontal Lobe ◽

External Stimulation ◽

Acupuncture Stimulation

The aim of this study is to compare the distinct cerebral activation with continued wave (CW) and 10 Hz-modulated wave (MW) stimulation during low-level laser acupuncture. Functional magnetic resonance imaging (fMRI) studies were performed to investigate the possible mechanism during laser acupuncture stimulation at the left foot's yongquan (K1) acupoint. There are 12 healthy right-handed volunteers for each type of laser stimulation (10-Hz-Modulated wave: 8 males and 4 females; continued wave: 9 males and 3 females). The analysis of multisubjects in this experiment was applied by random-effect (RFX) analysis. In CW groups, significant activations were found within the inferior parietal lobule, the primary somatosensory cortex, and the precuneus of left parietal lobe. Medial and superior frontal gyrus of left frontal lobe were also aroused. In MW groups, significant activations were found within the primary motor cortex and middle temporal gyrus of left hemisphere and bilateral cuneus. Placebo stimulation did not show any activation. Most activation areas were involved in the functions of memory, attention, and self-consciousness. The results showed the cerebral hemodynamic responses of two laser acupuncture stimulation modes and implied that its mechanism was not only based upon afferent sensory information processing, but that it also had the hemodynamic property altered during external stimulation.

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Decision-Feedback Stages Revealed by Hidden Markov Modeling of EEG

International Journal of Neural Systems ◽

10.1142/s0129065721500313 ◽

2021 ◽

pp. 2150031

Author(s):

Qin Tao ◽

Yajing Si ◽

Fali Li ◽

Peiyang Li ◽

Yuqin Li ◽

...

Keyword(s):

Frontal Lobe ◽

Visual Information ◽

Hidden Markov ◽

Decision Feedback ◽

Markov Modeling ◽

Feedback Process ◽

Feedback Systems ◽

Left Frontal Lobe ◽

Hidden Markov Modeling ◽

Independent Decision

Decision response and feedback in gambling are interrelated. Different decisions lead to different ranges of feedback, which in turn influences subsequent decisions. However, the mechanism underlying the continuous decision-feedback process is still left unveiled. To fulfill this gap, we applied the hidden Markov model (HMM) to the gambling electroencephalogram (EEG) data to characterize the dynamics of this process. Furthermore, we explored the differences between distinct decision responses (i.e. choose large or small bets) or distinct feedback (i.e. win or loss outcomes) in corresponding phases. We demonstrated that the processing stages in decision-feedback process including strategy adjustment and visual information processing can be characterized by distinct brain networks. Moreover, time-varying networks showed, after decision response, large bet recruited more resources from right frontal and right center cortices while small bet was more related to the activation of the left frontal lobe. Concerning feedback, networks of win feedback showed a strong right frontal and right center pattern, while an information flow originating from the left frontal lobe to the middle frontal lobe was observed in loss feedback. Taken together, these findings shed light on general principles of natural decision-feedback and may contribute to the design of biologically inspired, participant-independent decision-feedback systems.

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Use of immunohistochemical analysis of CK5/6, CK14, and CK34betaE12 in the differential diagnosis of solid papillary carcinoma in situ from intraductal papilloma with usual ductal hyperplasia of the breast

SAGE Open Medicine ◽

10.1177/2050312118811542 ◽

2018 ◽

Vol 6 ◽

pp. 205031211881154 ◽

Cited By ~ 3

Author(s):

Ichiro Maeda ◽

Shinya Tajima ◽

Yoshihide Kanemaki ◽

Koichiro Tsugawa ◽

Masayuki Takagi

Keyword(s):

Differential Diagnosis ◽

Papillary Carcinoma ◽

Carcinoma In Situ ◽

Immunohistochemical Staining ◽

Immunohistochemical Analysis ◽

Intraductal Papilloma ◽

Solid Papillary Carcinoma ◽

Usual Ductal Hyperplasia ◽

Ductal Hyperplasia

Objectives: The aim of this study was to use immunohistochemistry to differentiate solid papillary carcinoma in situ from intraductal papilloma with usual ductal hyperplasia (IPUDH). Three types of high-molecular-weight cytokeratins (CKs) – CK5/6, CK14, and CK34betaE12 – were targeted. Methods: We studied 17 patients with solid papillary carcinoma in situ and 18 patients with IPUDH diagnosed by at least two pathologists. Immunohistochemical analyses used antibodies to CK5/6, CK14, and CK34betaE12 to make the differential diagnosis of solid papillary carcinoma in situ versus IPUDH. Immunohistochemical staining was scored as 0–5 using Allred score. Results: Immunohistochemistry with CK5/6 and CK14 antibodies produced scores of 0–3 in all patients with solid papillary carcinoma in situ and 2–5 in all patients with IPUDH. Immunohistochemical staining with CK34betaE12 antibody produced scores of 1–3 in all patients with solid papillary carcinoma and 3–5 in all patients with IPUDH. In tissues from patients with IPUDH, significantly more cells were stained with CK34betaE12 than CK5/6 ( p < 0.05) or CK14 ( p < 0.05). Conclusion: The immunoreactivity of CK5/6, CK14, and CK34betaE12 antibodies was useful to differentiate solid papillary carcinoma in situ from IPUDH. CK34betaE12 is especially useful for distinguishing solid papillary carcinoma from IPUDH.

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Semantic monitoring of words with emotional connotation during fMRI: Contribution of anterior left frontal cortex

Journal of the International Neuropsychological Society ◽

10.1017/s1355617702801394 ◽

2002 ◽

Vol 8 (5) ◽

pp. 607-622 ◽

Cited By ~ 32

Author(s):

Bruce Crosson ◽

M. Allison Cato ◽

Joseph R. Sadek ◽

Didem Gökçay ◽

Russell M. Bauer ◽

...

Keyword(s):

Frontal Cortex ◽

Frontal Lobe ◽

Semantic Processing ◽

Normal Subjects ◽

Neural Substrates ◽

Significant Activity ◽

Left Frontal Lobe ◽

Temporal Lobes ◽

Semantic Attribute ◽

Animal Names

AbstractPrevious studies showed that cortex in the anterior portions of the left frontal and temporal lobes participates in generating words with emotional connotations and processing pictures with emotional content. If these cortices process the semantic attribute of emotional connotation, they should be active whenever processing emotional connotation, without respect to modality of input or mode of output. Thus, we hypothesized that they would activate during monitoring of words with emotional connotations. Sixteen normal subjects performed semantic monitoring of words with emotional connotations, animal names, and implement names during fMRI. Cortex in the anterior left frontal lobe demonstrated significant activity for monitoring words with emotional connotations compared to monitoring tone sequences, animal names, or implement names. Together, the current and previous results implicate cortex in the anterior left frontal lobe in semantic processing of emotional connotation, consistent with connections of this cortex to paralimbic association areas. Current findings also indicate that neural substrates for processing emotional connotation are independent of substrates for processing the categories of living and nonliving things.

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