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Sample records for case-matched lesion approach

  1. SEX-RELATED FUNCTIONAL ASYMMETRY OF THE AMGDALA: PRELIMINARY EVIDENCE USING A CASE-MATCHED LESION APPROACH

    PubMed Central

    Tranel, Daniel; Bechara, Antoine

    2008-01-01

    We have reported previously that there appears to be an intriguing sex-related functional asymmetry of the prefrontal cortices, especially the ventromedial sector, in regard to social conduct, emotional processing, and decision-making, whereby the right-sided sector is important in men but not women and the left-sided sector is important in women but not men. The amygdala is another structure that has been widely implicated in emotion processing and social decision-making, and the question arises as to whether the amygdala, in a manner akin to what has been observed for the prefrontal cortex, might have sex-related functional asymmetry in regard to social and emotional functions. A preliminary test of this question was carried out in the current study, where we used a case-matched lesion approach and contrasted a pair of men cases and a pair of women cases, where in each pair one patient had left amygdala damage and the other had right amygdala damage. We investigated the domains of social conduct, emotional processing and personality, and decision-making. The results provide support for the notion that there is sex-related functional asymmetry of the amygdala in regard to these functions— in the men pair, the patient with right-sided amygdala damage was impaired in these functions, and the patient with left-sided amygdala damage was not, whereas in the women pair, the opposite pattern obtained, with the left-sided woman being impaired and the right-sided woman being unimpaired. These data provide preliminary support for the notion that sex-related functional asymmetry of the amygdala may entail functions such as social conduct, emotional processing, and decision-making, a finding that in turn could reflect (as either a cause or effect) differences in the manner in which men and women apprehend, process, and execute emotion-related information. PMID:19308794

  2. Posterior versus standard approach in pancreatoduodenectomy: a case-match study

    PubMed Central

    Dumitrascu, Traian; David, Leonard

    2009-01-01

    Background and aims Posterior approach pancreatoduodenectomy (paPD) technique is one of the many modifications of the standard Whipple procedure (sPD). The most important modification of the technique is first approach of the superior mesenteric artery, thus enabling a complete dissection of the right side of this artery and of the portal vein, as well as a complete excision of the retroportal pancreatic lamina. The present study is a case-match one, comparing the paPD to sPD. Materials and methods The present study includes two groups of patients. A first group of 21 patients with PD by posterior approach (group 1, reference group, paPD) and a second group including 21 matched patients with PD by standard approach (group 2, control group, sPD). Demographic characteristics (sex, age), intraoperative data (approach type, operative time, blood loss, intraoperative complications, need for vascular resections and type of reconstruction, type of resection upon remnant tissue), histological diagnosis and pathology data (tumor location, TNM staging, tumor grading, tumor vascular invasion), patient outcomes (postoperative length of stay, in-hospital postoperative mortality and morbidity, survival time) were analyzed in both groups of patients and compared. Results There were no significant differences in the two groups regarding early morbidity and mortality rates, length of hospitalization, overall survival, and survival according to tumor type. However, it was noticed that there was a significant lesser mean blood loss in the pa PD group vs SPD group (P = 0.0314) and a shorter operative time in the paPD group vs sPD group (P = 0.0002). Conclusion The paPD offers an early selection of patients during the operation (in terms of local resectability, by assessing the SMA infiltration), allows an optimal exposure of arterial abnormalities (a replaced right hepatic artery from the SMA), and better detection of venous invasion. In cases with PV/SMV invasion, paPD is

  3. Bone marrow lesions: A systematic diagnostic approach

    PubMed Central

    Grande, Filippo Del; Farahani, Sahar J; Carrino, John A; Chhabra, Avneesh

    2014-01-01

    Bone marrow lesions on magnetic resonance (MR) imaging are common and may be seen with various pathologies. The authors outline a systematic diagnostic approach with proposed categorization of various etiologies of bone marrow lesions. Utilization of typical imaging features on conventional MR imaging techniques and other problem-solving techniques, such as chemical shift imaging and diffusion-weighted imaging (DWI), to achieve accurate final diagnosis has been highlighted. PMID:25114392

  4. Treatment of complex neurovascular lesions: an interdisciplinary angio suite approach

    PubMed Central

    Breyer, Tobias; Wrede, Karsten H.; Stein, Klaus-Peter; Wanke, Isabel; Grams, Astrid E.; Gizewski, Elke R.; Schlamann, Marc; Forsting, Michael; Sandalcioglu, I. Erol; Sure, Ulrich

    2014-01-01

    Objective: The objective of this study was to analyse our initial experience using an interdisciplinary angio suite approach to neurosurgical treatment of complex neurovascular lesions and expound technical feasibility and possible applications. Subjects: Six out of 451 patients with cranial or spinal neurovascular lesions were surgically treated in the angio suite (biplane angiographic system) during a 28-month observation period. Clinical baseline data, radiological and intraoperative findings as well as clinical and radiological outcome were assessed. Results: A ventral spinal perimedullary arteriovenous malformation, a ventral spinal perimedullary fistula, two diffuse frontal dural arteriovenous fistulas, a multifocal temporal arteriovenous malformation and a partially embolized fronto-temporo-basal dural arteriovenous fistula were successfully treated with angiographically confirmed complete occlusion and unimpaired neurological condition of the patients at the 12-month follow up. Conclusion: This study demonstrates the feasibility of this approach and points out possible indications, namely ventrally located spinal lesions and diffuse, deep seated cranial lesions. PMID:24409203

  5. Arthroscopic management of talar dome lesions using a transmalleolar approach.

    PubMed

    Grady, John; Hughes, David

    2006-01-01

    Surgical treatment of posteromedial talar dome lesions is frequently necessary for Berndt and Harty grade IV osteochondral defects and nondisplaced osteochondral fragments resistant to conservative modalities. When operative intervention is indicated, the approach and management can be complicated by the location and extent of the injury. The operative technique we advocate allows direct exposure of the lesion and minimizes damage to healthy articular cartilage and surrounding soft tissue. Use of a drill guide assists the surgeon in precisely placing a transmalleolar portal through the tibia for subchondral drilling of osteochondral defects when the lesions are inaccessible through traditional arthroscopic portals. PMID:16707640

  6. Focal Cortical Dysplasia (FCD) lesion analysis with complex diffusion approach.

    PubMed

    Rajan, Jeny; Kannan, K; Kesavadas, C; Thomas, Bejoy

    2009-10-01

    Identification of Focal Cortical Dysplasia (FCD) can be difficult due to the subtle MRI changes. Though sequences like FLAIR (fluid attenuated inversion recovery) can detect a large majority of these lesions, there are smaller lesions without signal changes that can easily go unnoticed by the naked eye. The aim of this study is to improve the visibility of focal cortical dysplasia lesions in the T1 weighted brain MRI images. In the proposed method, we used a complex diffusion based approach for calculating the FCD affected areas. Based on the diffused image and thickness map, a complex map is created. From this complex map; FCD areas can be easily identified. MRI brains of 48 subjects selected by neuroradiologists were given to computer scientists who developed the complex map for identifying the cortical dysplasia. The scientists were blinded to the MRI interpretation result of the neuroradiologist. The FCD could be identified in all the patients in whom surgery was done, however three patients had false positive lesions. More lesions were identified in patients in whom surgery was not performed and lesions were seen in few of the controls. These were considered as false positive. This computer aided detection technique using complex diffusion approach can help detect focal cortical dysplasia in patients with epilepsy. PMID:19560319

  7. [Hybrid revascularization: a combined approach to multivessel coronary artery lesions].

    PubMed

    Repossini, A; Roĭtberg, G E; Kotelnikov, I; Sokolov, D V

    2013-01-01

    Analysis of effectiveness and feasibility of hybrid approach to multivessel coronary artery disease and problems of interaction between cardiac surgeons and interventional cardiologists in deciding on the choice of revascularization method is performed in the article. Hybrid approach to multivessel disease defined as sternal sparing, off-pump, minimally invasive, hand sewn left internal mammary - left anterior descending (LAD) arteries by-pass graft with percutaneous coronary revascularization of non-LAD lesions to achieve functionally complete revascularization is described in detail. Data of multicenter studies and clinical recommendations for myocardial revascularization is discussed. PMID:24090389

  8. A conservative approach to esthetically treat stained arrested caries lesions.

    PubMed

    Al-Angari, Sarah S; Hara, Anderson T

    2016-01-01

    Esthetic treatment of stained arrested caries lesions (ACLs) has mostly been done using invasive restorative techniques. The aim of this paper was to propose and report the efficacy of a conservative approach based on dental bleaching to esthetically treat these lesions, both experimentally (extracted teeth) and clinically. In a laboratory experiment, ten extracted human teeth with stained ACLs in either pit and fissure or smooth surface were selected and treated with 15% carbamide peroxide gel, 4 h per day, for a total of 6 days. The second part of the paper reports a clinical case of pit and fissure-stained ACLs in four posterior teeth, which were treated with 40% hydrogen peroxide in-office bleaching. Digital photographs were taken in both parts to document the efficacy of the treatment. The lesions showed noticeable increase in color lightness indicating the efficacy and suitability of the proposed approach. By using the conservative clinical technique presented, the esthetics of most stained ACLs could be improved, eliminating the need for invasive restorative treatments. PMID:27092359

  9. Middle fossa approach: Applications in temporal bone lesions.

    PubMed

    Domenech Juan, Iván; Cruz Toro, Paula; Callejo Castillo, Ángela; Moya, Rafael; Merán Gil, Jorge L; Bartel, Ricardo

    2016-01-01

    The middle fossa approach is a surgical technique that is very useful for lateral skull base surgery. However, it is true that it has limited surgical indications and implementation due to its technical complexity. We present our experience in 10 patients in whom the middle fossa approach was the treatment of choice because of the extent of the injury and complexity of the lesion or process. Despite the complexity of the cases, there was no mortality associated with surgery. Postoperative complications were found in 2 patients who presented an epidural hematoma and a cortico-subcortical hematoma. Hearing function was preserved in 5 patients out of the 7 who had adequate hearing at the time of surgery. House/Brackmann I-II facial nerve function was achieved in 8 patients; the remaining 2 had no deterioration of the nerve function. In 9 out of 10 patients, the surgery achieved complete solution of the lesion. The middle fossa approach is a safe and reliable surgical technique. It gives us great control and exposure of different skull base processes. We consider its knowledge of great importance, because it may be the only viable surgical alternative in some specific patients. That is the reason why it is important to learn this approach and know about it in our specialty. PMID:26452620

  10. Focal liver lesions: Practical magnetic resonance imaging approach

    PubMed Central

    Matos, António P; Velloni, Fernanda; Ramalho, Miguel; AlObaidy, Mamdoh; Rajapaksha, Aruna; Semelka, Richard C

    2015-01-01

    With the widespread of cross-sectional imaging, a growth of incidentally detected focal liver lesions (FLL) has been observed. A reliable detection and characterization of FLL is critical for optimal patient management. Maximizing accuracy of imaging in the context of FLL is paramount in avoiding unnecessary biopsies, which may result in post-procedural complications. A tremendous development of new imaging techniques has taken place during these last years. Nowadays, Magnetic resonance imaging (MRI) plays a key role in management of liver lesions, using a radiation-free technique and a safe contrast agent profile. MRI plays a key role in the non-invasive correct characterization of FLL. MRI is capable of providing comprehensive and highly accurate diagnostic information, with the additional advantage of lack of harmful ionizing radiation. These properties make MRI the mainstay for the noninvasive evaluation of focal liver lesions. In this paper we review the state-of-the-art MRI liver protocol, briefly discussing different sequence types, the unique characteristics of imaging non-cooperative patients and discuss the role of hepatocyte-specific contrast agents. A review of the imaging features of the most common benign and malignant FLL is presented, supplemented by a schematic representation of a simplistic practical approach on MRI. PMID:26261689

  11. Focal liver lesions: Practical magnetic resonance imaging approach.

    PubMed

    Matos, António P; Velloni, Fernanda; Ramalho, Miguel; AlObaidy, Mamdoh; Rajapaksha, Aruna; Semelka, Richard C

    2015-08-01

    With the widespread of cross-sectional imaging, a growth of incidentally detected focal liver lesions (FLL) has been observed. A reliable detection and characterization of FLL is critical for optimal patient management. Maximizing accuracy of imaging in the context of FLL is paramount in avoiding unnecessary biopsies, which may result in post-procedural complications. A tremendous development of new imaging techniques has taken place during these last years. Nowadays, Magnetic resonance imaging (MRI) plays a key role in management of liver lesions, using a radiation-free technique and a safe contrast agent profile. MRI plays a key role in the non-invasive correct characterization of FLL. MRI is capable of providing comprehensive and highly accurate diagnostic information, with the additional advantage of lack of harmful ionizing radiation. These properties make MRI the mainstay for the noninvasive evaluation of focal liver lesions. In this paper we review the state-of-the-art MRI liver protocol, briefly discussing different sequence types, the unique characteristics of imaging non-cooperative patients and discuss the role of hepatocyte-specific contrast agents. A review of the imaging features of the most common benign and malignant FLL is presented, supplemented by a schematic representation of a simplistic practical approach on MRI. PMID:26261689

  12. Nonoperative biological treatment approach for partial Achilles tendon lesion.

    PubMed

    Filardo, Giuseppe; Presti, Mirco Lo; Kon, Elizaveta; Marcacci, Maurilio

    2010-02-01

    Tendon injuries, especially those of the Achilles tendon, are major concerns in sports medicine. The clinical presentation can be acute or chronic and the pathologic findings can range from peritendonitis to full-thickness tendon rupture. Nonsurgical treatment is not always successful; in particular, significant partial ruptures seem to respond poorly to conservative measures and do not improve with time. Surgery is most often considered the favored treatment option for this kind of lesion to obtain pain relief and full functionality with long-standing effects.This article describes a case of a partial tear of the Achilles tendon in a 34-year-old competitive athlete where surgical treatment was avoided in favor of a new biological approach. We applied autologous platelet growth factors through multiple platelet-rich plasma injections; approximately 6.5 billion platelets were injected into the lesion 3 times, 7 days apart. The treatment with platelet-rich plasma and a progressive rehabilitation program allowed the patient to play for 20 minutes in a basketball game 64 days after the trauma and in a full game 75 days after the trauma. To date, 18 months later, he has participated regularly in all the season's games and received no further treatment for his tendon.The fast tissue repair, confirmed by magnetic resonance and ultrasound imaging, allowed a swift return to full functionality and competitive sports activity, suggesting a possible role of platelet growth factors in promoting rapid tendon healing with high-quality tissue. This biological approach may represent a less-invasive therapeutic option even in cases where severe tendon lesions are candidates for surgical treatment. PMID:20192152

  13. New approach to gallbladder ultrasonic images analysis and lesions recognition.

    PubMed

    Bodzioch, Sławomir; Ogiela, Marek R

    2009-03-01

    This paper presents a new approach to gallbladder ultrasonic image processing and analysis towards detection of disease symptoms on processed images. First, in this paper, there is presented a new method of filtering gallbladder contours from USG images. A major stage in this filtration is to segment and section off areas occupied by the said organ. In most cases this procedure is based on filtration that plays a key role in the process of diagnosing pathological changes. Unfortunately ultrasound images present among the most troublesome methods of analysis owing to the echogenic inconsistency of structures under observation. This paper provides for an inventive algorithm for the holistic extraction of gallbladder image contours. The algorithm is based on rank filtration, as well as on the analysis of histogram sections on tested organs. The second part concerns detecting lesion symptoms of the gallbladder. Automating a process of diagnosis always comes down to developing algorithms used to analyze the object of such diagnosis and verify the occurrence of symptoms related to given affection. Usually the final stage is to make a diagnosis based on the detected symptoms. This last stage can be carried out through either dedicated expert systems or more classic pattern analysis approach like using rules to determine illness basing on detected symptoms. This paper discusses the pattern analysis algorithms for gallbladder image interpretation towards classification of the most frequent illness symptoms of this organ. PMID:19124224

  14. Approach to the endoscopic resection of duodenal lesions

    PubMed Central

    Gaspar, Jonathan P; Stelow, Edward B; Wang, Andrew Y

    2016-01-01

    Duodenal polyps or lesions are uncommonly found on upper endoscopy. Duodenal lesions can be categorized as subepithelial or mucosally-based, and the type of lesion often dictates the work-up and possible therapeutic options. Subepithelial lesions that can arise in the duodenum include lipomas, gastrointestinal stromal tumors, and carcinoids. Endoscopic ultrasonography with fine needle aspiration is useful in the characterization and diagnosis of subepithelial lesions. Duodenal gastrointestinal stromal tumors and large or multifocal carcinoids are best managed by surgical resection. Brunner’s gland tumors, solitary Peutz-Jeghers polyps, and non-ampullary and ampullary adenomas are mucosally-based duodenal lesions, which can require removal and are typically amenable to endoscopic resection. Several anatomic characteristics of the duodenum make endoscopic resection of duodenal lesions challenging. However, advanced endoscopic techniques exist that enable the resection of large mucosally-based duodenal lesions. Endoscopic papillectomy is not without risk, but this procedure can effectively resect ampullary adenomas and allows patients to avoid surgery, which typically involves pancreaticoduodenectomy. Endoscopic mucosal resection and its variations (such as cap-assisted, cap-band-assisted, and underwater techniques) enable the safe and effective resection of most duodenal adenomas. Endoscopic submucosal dissection is possible but very difficult to safely perform in the duodenum. PMID:26811610

  15. A general approach to liver lesion segmentation in CT images

    NASA Astrophysics Data System (ADS)

    Cao, Li; Udupa, Jayaram K.; Odhner, Dewey; Huang, Lidong; Tong, Yubing; Torigian, Drew A.

    2016-03-01

    Lesion segmentation has remained a challenge in different body regions. Generalizability is lacking in published methods as variability in results is common, even for a given organ and modality, such that it becomes difficult to establish standardized methods of disease quantification and reporting. This paper makes an attempt at a generalizable method based on classifying lesions along with their background into groups using clinically used visual attributes. Using an Iterative Relative Fuzzy Connectedness (IRFC) delineation engine, the ideas are implemented for the task of liver lesion segmentation in computed tomography (CT) images. For lesion groups with the same background properties, a few subjects are chosen as the training set to obtain the optimal IRFC parameters for the background tissue components. For lesion groups with similar foreground properties, optimal foreground parameters for IRFC are set as the median intensity value of the training lesion subset. To segment liver lesions belonging to a certain group, the devised method requires manual loading of the corresponding parameters, and correct setting of the foreground and background seeds. The segmentation is then completed in seconds. Segmentation accuracy and repeatability with respect to seed specification are evaluated. Accuracy is assessed by the assignment of a delineation quality score (DQS) to each case. Inter-operator repeatability is assessed by the difference between segmentations carried out independently by two operators. Experiments on 80 liver lesion cases show that the proposed method achieves a mean DQS score of 4.03 and inter-operator repeatability of 92.3%.

  16. A Contemporary Approach to Classify Ghost Cells Comprising Oral Lesions

    PubMed Central

    Yadav, Sumit Kumar; Narwal, Anjali; Devi, Anju

    2015-01-01

    Ghost cells are swollen eosinophilic epithelial cells that have lost their nuclei but retain the cellular and nuclear outline. Pathologic ghost cell formation could be the process of aberrant keratinization or the result of coagulative necrosis. Ghost cells have been described in several odontogenic lesions, which include calcifying epithelial odontogenic cysts or tumours like odontomas, ameloblastic fibro-odontomas, and ameloblastomas. This article present a view on the formation of ghost cells with proposal/introduction of a classification for ghost cell lesions of the oral cavity in an attempt to organize these lesions for the better understanding and academic purpose. PMID:26501039

  17. Diagnostic approaches in unsuspected oral lesions of syphilis.

    PubMed

    Siqueira, C S; Saturno, J L; de Sousa, S C O M; da Silveira, F R X

    2014-12-01

    Awareness of the increased prevalence of syphilis is essential for early diagnosis and treatment, and to prevent the spread of the disease. Although serological studies are the primary tool used to confirm the diagnosis of secondary syphilis, biopsy of unsuspected oral lesions is not uncommon in the routine oral pathology laboratory. In these cases, histopathological characteristics are likely to indicate the possibility of syphilis, and an immunohistochemical reaction can confirm it. The aim of the present study was to highlight the histological features and test the efficacy of immunohistochemistry in the detection of Treponema pallidum in oral lesions biopsied with the assumption of a non-syphilitic disease. Thirty-nine tissue samples from patients for whom the possibility of syphilis was suggested on the basis of histopathological findings, were retrieved from the surgical oral pathology service files and submitted to immunohistochemical staining for T. pallidum. The study was approved by the institutional ethics committee. Eighteen of the tissue samples were positive for T. pallidum. Following this, the contributing clinicians were contacted to check whether they had asked for serological examinations when the diagnostic report was received; for all 18 positive cases, the clinicians confirmed that the patients had tested positive at that time. This study shows the importance of clinical-pathological correlation and the value of immunohistochemistry in the diagnosis of unsuspected syphilis. PMID:25305698

  18. Neurological Disorders Associated with Striatal Lesions: Classification and Diagnostic Approach.

    PubMed

    Tonduti, Davide; Chiapparini, Luisa; Moroni, Isabella; Ardissone, Anna; Zorzi, Giovanna; Zibordi, Federica; Raspante, Sergio; Panteghini, Celeste; Garavaglia, Barbara; Nardocci, Nardo

    2016-06-01

    Neostriatal abnormalities can be observed in a very large number of neurological conditions clinically dominated by the presence of movement disorders. The neuroradiological picture in some cases has been described as "bilateral striatal necrosis" (BSN). BSN represents a condition histo-pathologically defined by the involvement of the neostriata and characterized by initial swelling of putamina and caudates followed by degeneration and cellular necrosis. After the first description in 1975, numerous acquired and hereditary conditions have been associated with the presence of BSN. At the same time, a large number of disorders involving neostriata have been described as BSN, in some cases irrespective of the presence of signs of cavitation on MRI. As a consequence, the etiological spectrum and the nosographic boundaries of the syndrome have progressively become less clear. In this study, we review the clinical and radiological features of the conditions associated with MRI evidence of bilateral striatal lesions. Based on MRI findings, we have distinguished two groups of disorders: BSN and other neostriatal lesions (SL). This distinction is extremely helpful in narrowing the differential diagnosis to a small group of known conditions. The clinical picture and complementary exams will finally lead to the diagnosis. We provide an update on the etiological spectrum of BSN and propose a diagnostic flowchart for clinicians. PMID:27074771

  19. Various approaches for CT-guided percutaneous biopsy of deep pelvic lesions: anatomic and technical considerations.

    PubMed

    Gupta, Sanjay; Nguyen, Huan Luong; Morello, Frank A; Ahrar, Kamran; Wallace, Michael J; Madoff, David C; Murthy, Ravi; Hicks, Marshall E

    2004-01-01

    Access route planning for computed tomography-guided biopsy of deep pelvic masses remains challenging because vital structures often obstruct the projected needle path. The classical approach through the lower anterior abdominal wall allows access to lesions located anterior, superior, or lateral to the urinary bladder. However, this approach has limitations: Deep masses are difficult to reach because of intervening structures, the bowel or bladder may be unavoidably traversed, and peritoneal transgression is often painful. A transgluteal approach is useful for biopsy of presacral and perirectal lesions and lesions located posterolateral to the bladder. An anterolateral approach through the iliopsoas muscle allows safe extraperitoneal access to external and internal iliac nodes, masses located along the lateral pelvic sidewall, and adnexal lesions. A transosseous (transsacral or transiliac) approach can occasionally be used for otherwise inaccessible lesions. Use of a curved needle, change in patient position, or injection of saline solution to displace intervening structures may also be helpful. Familiarity with normal cross-sectional pelvic anatomy facilitates planning of a safe access route and helps avoid injury to adjacent structures. A thorough understanding of the advantages and disadvantages of each approach allows the clinician to choose the most appropriate approach in a given situation. PMID:14730045

  20. Zygomatic Anterior Subtemporal Approach for Lesions in the Interpeduncular Cistern

    PubMed Central

    Deda, Haluk; Ugur, Hasan Çaglar

    2001-01-01

    The interpeduncular cistern is a difficult region to approach through conventional methods due to its deep location and important adjacent neurovascular structures. Therefore, it is usually difficult to expose the region sufficiently. Technical problems associated with various surgical approaches have led to emergence of combined approaches and their modifications (i.e., the removal of the zygomatic arch). In addition, a frontotemporal craniotomy is reported to provide a wide exposure of the anterior temporal base, thus allowing oblique access to the interpeduncular cistern with minimal brain retraction. This study describes clinicians' experience and the surgical results of 24 patients who underwent a zygomatic anterior subtemporal approach. ImagesFigure 1Figure 2 PMID:17167628

  1. A systematic approach to magnetic resonance imaging evaluation of epiphyseal lesions.

    PubMed

    Thawait, Shrey K; Thawait, Gaurav K; Frassica, Frank J; Andreisek, Gustav; Carrino, John A; Chhabra, Avneesh

    2013-04-01

    Magnetic Resonance Imaging (MRI) is the preferred modality of choice to image epiphyseal lesions. It provides excellent soft tissue resolution and extent of disease. A wide spectrum of tumor and tumor like lesions can involve the epiphysis. Early and accurate diagnosis as well as appropriate management of epiphyseal lesions is critical as these conditions may lead to disabling complications such as, limb length discrepancy, angular or joint surface deformities and secondary osteoarthritis. In this article, we discuss the role of conventional sequences, such as T1W, fluid sensitive T2W and intravenous (IV) Gadolinium enhanced sequences as well as the additional value of problem solving MRI sequences such as, chemical shift and diffusion weighted imaging. Based on the imaging findings on various MRI sequences and lesion characteristics, a systematic approach directed to the diagnoses of epiphyseal lesions is presented and discussed. MRI features of clinically and biopsy proven examples of the epiphyseal lesions, such as osteomyelitis, intra-osseous abscess, infiltrative malignancy, metastases, transient osteoporosis, subchondral insufficiency fracture, avascular necrosis, osteochondral fracture, osteochondritis dissecans, eosinophilic granuloma and geode are demonstrated. Using this systematic approach, the reader will be able to better characterize epiphyseal lesions with a potential to positively affect patient management. PMID:23102949

  2. Caries infiltration of noncavitated white spot lesions: A novel approach for immediate esthetic improvement

    PubMed Central

    Gugnani, Neeraj; Pandit, Inder K.; Gupta, Monika; Josan, Rohini

    2012-01-01

    The earliest evidence of demineralization on the smooth enamel surface of a crown is a white spot lesion. The conventional treatment of these white spot lesions includes topical fluoride application, iamproving the oral hygiene, and use of remineralizing agents. The following article illustrates the use of a novel approach to treat smooth surface noncavitated white spot lesions microinvasively based on infiltration of enamel caries with low-viscosity light curing resins called infiltrants. This treatment aims upon both the prevention of caries progression and improving esthetics, by diminishing the opacity. PMID:23230363

  3. A radiological approach to benign and malignant lesions of the mandible.

    PubMed

    Harmon, M; Arrigan, M; Toner, M; O'Keeffe, S A

    2015-04-01

    There is a wide range of pathological conditions that affect the mandible. Although some lesions demonstrate characteristic imaging features, many of the pathological processes encountered in the mandible often exhibit similar imaging appearances resulting in uncertainty for the reporting radiologist. Many mandibular lesions remain impossible to distinguish without histological analysis. Therefore, this review aims to reassure the radiologist that although imaging findings may not always lead to a specific diagnosis, they narrow the differential diagnosis and guide further work-up. In this regard, we aim to provide a clinically useful framework and approach for radiologists to use when they encounter lesions within the mandible. PMID:25559378

  4. CT-Guided Needle Biopsy of Deep Pelvic Lesions by Extraperitoneal Approach Through Iliopsoas Muscle

    SciTech Connect

    Gupta, Sanjay; Madoff, David C.; Ahrar, Kamran; Morello, Frank A.; Wallace, Michael J.; Murthy, Ravi; Hicks, Marshall E.

    2003-11-15

    We report our experience with computed tomography (CT)-guided coaxial needle biopsy of deep pelvic lesions by an extraperitoneal approach through the iliopsoas muscle, using a curved needle for difficult-to-reach lesions. We reviewed the records of all patients with pelvic masses who underwent CT-guided percutaneous biopsy via iliopsoas muscle between January 1999 and December 2001. Direct anterior or posterior approach to the lesion was obstructed by bowel, bladder, vessels, or bones in all patients. An 18-gauge guide needle was advanced through the iliopsoas muscle and a 22-gauge Chiba needle was used to perform the biopsy. A custom-tailored curved 22-g needle was used in 17 procedures when the location of the iliac vessels and the slope of the iliac wing obstructed a straight path to the lesion. Fifty-three patients underwent 57 CT-guided needle biopsies during the study period. The lesions comprised obturator (n = 25), internal iliac (n = 11), anterior external iliac (n = 4), and common iliac nodes (n = 4); soft tissue masses along pelvic side-wall (n = 6); adnexal lesions (n = 5); a loculated fluid collection, and a perirectal node. All lesions were safely accessed, and major vessels and viscera were avoided in all cases. Of the 57 biopsies, 53 (93%) yielded diagnostic specimens. No major complications were encountered. CT-guided coaxial needle biopsy by an anterolateral approach through the iliopsoas muscle, with the use of a curved needle in selected cases is safe and effective for obtaining samples from deep pelvic lesions.

  5. Treatment of Large Periapical Cyst Like Lesion: A Noninvasive Approach: A Report of Two Cases

    PubMed Central

    Maheshwari, Neha; Gothi, Rajat; Sood, Niti

    2015-01-01

    ABSTRACT Periapical lesions develop as sequelae to pulp disease. Periapical radiolucent areas are generally diagnosed either during routine dental radiographic examination or following acute toothache. Various methods can be used in the nonsurgical management of periapical lesions: the conservative root canal treatment, decompression technique, active nonsurgical decompression technique, aspiration-irrigation technique, method using calcium hydroxide, lesion sterilization and repair therapy and the apexum procedure. Monitoring the healing of periapical lesions is essential through periodic follow-up examinations. The ultimate goal of endodontic therapy should be to return the involved teeth to a state of health and function without surgical intervention. All inflammatory periapical lesions should be initially treated with conservative nonsurgical procedures. Surgical intervention is recommended only after nonsurgical techniques have failed. Besides, surgery has many drawbacks, which limit its use in the management of periapical lesions. How to cite this article: Sood N, Maheshwari N, Gothi R, Sood N. Treatment of Large Periapical Cyst Like Lesion: A Noninvasive Approach: A Report of Two Cases. Int J Clin Pediatr Dent 2015;8(2):133-137. PMID:26379382

  6. Treatment of Large Periapical Cyst Like Lesion: A Noninvasive Approach: A Report of Two Cases.

    PubMed

    Sood, Nikhil; Maheshwari, Neha; Gothi, Rajat; Sood, Niti

    2015-01-01

    Periapical lesions develop as sequelae to pulp disease. Periapical radiolucent areas are generally diagnosed either during routine dental radiographic examination or following acute toothache. Various methods can be used in the nonsurgical management of periapical lesions: the conservative root canal treatment, decompression technique, active nonsurgical decompression technique, aspiration-irrigation technique, method using calcium hydroxide, lesion sterilization and repair therapy and the apexum procedure. Monitoring the healing of periapical lesions is essential through periodic follow-up examinations. The ultimate goal of endodontic therapy should be to return the involved teeth to a state of health and function without surgical intervention. All inflammatory periapical lesions should be initially treated with conservative nonsurgical procedures. Surgical intervention is recommended only after nonsurgical techniques have failed. Besides, surgery has many drawbacks, which limit its use in the management of periapical lesions. How to cite this article: Sood N, Maheshwari N, Gothi R, Sood N. Treatment of Large Periapical Cyst Like Lesion: A Noninvasive Approach: A Report of Two Cases. Int J Clin Pediatr Dent 2015;8(2):133-137. PMID:26379382

  7. Frontolateral Approach Applied to Sellar Region Lesions: A Retrospective Study in 79 Patients

    PubMed Central

    Liu, Hao-Cheng; Wu, Zhen; Wang, Liang; Xiao, Xin-Ru; Li, Da; Jia, Wang; Zhang, Li-Wei; Zhang, Jun-Ting

    2016-01-01

    Background: Various surgical approaches for the removal of sellar region lesions have previously been described. This study aimed to evaluate the reliability and safety of the frontolateral approach (FLA) to remove sellar region lesions. Methods: We presented a retrospective study of 79 patients with sellar region lesions who were admitted and operated by the FLA approach from August 2011 to August 2015 in Department of Neurosurgery of Beijing Tian Tan Hospital. We classified FLA into three types, compared the FLA types to the areas of lesion invasion, and analyzed operation bleeding volume, gross total resection (GTR) rate, visual outcome, and mortality. Results: Seventy-nine patients were followed up from 2.9 to 50.3 months with a mean follow-up of 20.5 months. There were 42 cases of meningiomas, 25 cases of craniopharyngiomas, and 12 cases of pituitary adenomas. The mean follow-up Karnofsky Performance Scale was 90.4. GTR was achieved in 75 patients (94.9%). Two patients (2.5%) had tumor recurrence. No patients died perioperatively or during short-term follow-up. Three patients (3.8%) with craniopharyngioma died 10, 12, and 23 months, respectively, after surgery. The operative bleeding volume of this study was no more than that of the other approaches in the sellar region (P = 0.783). In this study, 35 patients (44.3%) had visual improvement after surgery, 38 patients (48.1%) remained unchanged, and three patients’ visual outcome (3.8%) worsened. Conclusions: FLA was an effective approach in the treatment of sellar region lesions with good preservation of visual function. FLA classification enabled tailored craniotomies for each patient according to the anatomic site of tumor invasion. This study found that FLA had similar outcomes to other surgical approaches of sellar region lesions. PMID:27364792

  8. Monitoring of enamel lesion remineralization by optical coherence tomography: an alternative approach towards signal analysis

    NASA Astrophysics Data System (ADS)

    Sadr, Alireza; Mandurah, Mona; Nakashima, Syozi; Shimada, Yasushi; Kitasako, Yuichi; Tagami, Junji; Sumi, Yasunori

    Early detection, monitoring and remineralization repair of enamel lesions are top research priorities in the modern dentistry focusing on minimal intervention concept for caries management. We investigate the use of swept-source optical coherence tomography system (SS-OCT) without polarization-sensing at 1319 nm wavelength developed for clinical dentistry (Dental OCT System Prototype 2, Panasonic Healthcare Co., Ltd., Japan) in quantitative assessment of artificial enamel lesions and their remineralization. Bovine enamel blocks were subjected to demineralization to create subsurface lesions approximately 130 μm in depth over 2 weeks, and subjected to remineralization in solution containing bioavailable calcium and 1ppm fluoride at pH 6.5 for 2 weeks. Cross-sectional images of sound, demineralized and remineralized specimens were captured under hydrated conditions by the OCT. Finally, the specimens were cut into sections for nanoindentation to measure hardness through the lesion under 2mN load. Reflectivity had increased with demineralization. OCT images of lesions showed a boundary closely suggesting the lesion depth that gradually progressed with demineralization time. After remineralization, the boundary depth gradually decreased and nanoindentation showed over 60% average hardness recovery rate. A significant negative correlation was found between the slope power-law regression as a measure of attenuation and overall nanohardness for a range of data covering sound, demineralized and remineralized areas. In conclusion, OCT could provide clear images of early enamel lesion extent and signal attenuation could indicate its severity and recovery. Clinical data of natural lesions obtained using Dental OCT and analyzed by this approach will also be presented. Study supported by GCOE IRCMSTBD and NCGG.

  9. Current endoscopic ultrasound-guided approach to incidental subepithelial lesions: optimal or optional?

    PubMed Central

    Eckardt, Alexander J.; Jenssen, Christian

    2015-01-01

    Subepithelial lesions (SEL) are identified during endoscopic procedures on a regular basis. They can occur anywhere in the gastrointestinal (GI) tract and are located beneath the normal epithelial layer, which explains why a tissue diagnosis is difficult to obtain with routine biopsies. Endoscopic ultrasound (EUS) is used to further characterize these lesions. EUS can distinguish intramural lesion from extramural compression. Furthermore, it allows allocation of intramural lesions to a specific layer of the GI wall and offers additional information as to whether a lesion could be benign or malignant. EUS also assists in choosing the optimal means of tissue acquisition. The choice of tissue acquisition is based on a number of factors, such as tumor size, EUS features, and location within the GI tract or within a specific layer of the GI wall. Furthermore, local expertise and patient factors should be considered when deciding whether tissue acquisition, surgical intervention or follow up is recommended. In this review we offer an EUS-guided approach to the evaluation of incidental SEL based on current evidence and point out areas of uncertainty, which explain why the proposed algorithmic approach may be optional rather than optimal. PMID:25830949

  10. MS lesion segmentation using a multi-channel patch-based approach with spatial consistency

    NASA Astrophysics Data System (ADS)

    Mechrez, Roey; Goldberger, Jacob; Greenspan, Hayit

    2015-03-01

    This paper presents an automatic method for segmentation of Multiple Sclerosis (MS) in Magnetic Resonance Images (MRI) of the brain. The approach is based on similarities between multi-channel patches (T1, T2 and FLAIR). An MS lesion patch database is built using training images for which the label maps are known. For each patch in the testing image, k similar patches are retrieved from the database. The matching labels for these k patches are then combined to produce an initial segmentation map for the test case. Finally a novel iterative patch-based label refinement process based on the initial segmentation map is performed to ensure spatial consistency of the detected lesions. A leave-one-out evaluation is done for each testing image in the MS lesion segmentation challenge of MICCAI 2008. Results are shown to compete with the state-of-the-art methods on the MICCAI 2008 challenge.

  11. Update on nonsurgical, ultraconservative approaches to treat effectively non-cavitated caries lesions in permanent teeth.

    PubMed

    Borges, Boniek Castillo Dutra; de Souza Borges, Juliane; de Araujo, Larissa Sgarbosa Napoleao; Machado, Claudia Tavares; Dos Santos, Alex Jose Souza; de Assunçao Pinheiro, Isauremi Vieira

    2011-04-01

    Dental caries on tooth surfaces is still a problem in many industrialized countries. For many years, dentistry was influenced by a mechanical approach characterized by the use of high-speed rotary cutting instruments, and dentists predominantly used surgical methods to address caries. This included radical removal of diseased portions of the tooth, along with material-driven geometric extensions to areas that were assumed to be caries-resistant. This concept of extension for prevention was introduced by G. V. Black and influenced dentists for more than 120 years. Recently, a new paradigm of operative conservatism, sometimes referred to as "minimally invasive dentistry," has gained popularity. This paradigm is designed to promote maximum preservation of healthy dental structures over a lifetime. The aim of this review is to discuss the efficacy of current nonsurgical treatments for non-cavitated caries lesions in permanent teeth. Based on results obtained from clinical trials, this review evaluates treatments such as consumption of CPP-ACP added gums, resin infiltration and fissure sealing. Although in a few cases an invasive approach is needed to arrest caries progression, the non-surgical approach generally provides potential benefits that include conserving structure by delaying intervention or minimizing the operative procedure. All current non-invasive methods are effective in treating non-cavitated caries lesions. The adoption of non-invasive approaches in the management of these lesions can preserve dental tissues, thus increasing tooth longevity. PMID:21494394

  12. A white matter lesion-filling approach to improve brain tissue volume measurements

    PubMed Central

    Valverde, Sergi; Oliver, Arnau; Lladó, Xavier

    2014-01-01

    Multiple sclerosis white matter (WM) lesions can affect brain tissue volume measurements of voxel-wise segmentation methods if these lesions are included in the segmentation process. Several authors have presented different techniques to improve brain tissue volume estimations by filling WM lesions before segmentation with intensities similar to those of WM. Here, we propose a new method to refill WM lesions, where contrary to similar approaches, lesion voxel intensities are replaced by random values of a normal distribution generated from the mean WM signal intensity of each two-dimensional slice. We test the performance of our method by estimating the deviation in tissue volume between a set of 30 T1-w 1.5 T and 30 T1-w 3 T images of healthy subjects and the same images where: WM lesions have been previously registered and afterwards replaced their voxel intensities to those between gray matter (GM) and WM tissue. Tissue volume is computed independently using FAST and SPM8. When compared with the state-of-the-art methods, on 1.5 T data our method yields the lowest deviation in WM between original and filled images, independently of the segmentation method used. It also performs the lowest differences in GM when FAST is used and equals to the best method when SPM8 is employed. On 3 T data, our method also outperforms the state-of-the-art methods when FAST is used while performs similar to the best method when SPM8 is used. The proposed technique is currently available to researchers as a stand-alone program and as an SPM extension. PMID:25379419

  13. A white matter lesion-filling approach to improve brain tissue volume measurements.

    PubMed

    Valverde, Sergi; Oliver, Arnau; Lladó, Xavier

    2014-01-01

    Multiple sclerosis white matter (WM) lesions can affect brain tissue volume measurements of voxel-wise segmentation methods if these lesions are included in the segmentation process. Several authors have presented different techniques to improve brain tissue volume estimations by filling WM lesions before segmentation with intensities similar to those of WM. Here, we propose a new method to refill WM lesions, where contrary to similar approaches, lesion voxel intensities are replaced by random values of a normal distribution generated from the mean WM signal intensity of each two-dimensional slice. We test the performance of our method by estimating the deviation in tissue volume between a set of 30 T1-w 1.5 T and 30 T1-w 3 T images of healthy subjects and the same images where: WM lesions have been previously registered and afterwards replaced their voxel intensities to those between gray matter (GM) and WM tissue. Tissue volume is computed independently using FAST and SPM8. When compared with the state-of-the-art methods, on 1.5 T data our method yields the lowest deviation in WM between original and filled images, independently of the segmentation method used. It also performs the lowest differences in GM when FAST is used and equals to the best method when SPM8 is employed. On 3 T data, our method also outperforms the state-of-the-art methods when FAST is used while performs similar to the best method when SPM8 is used. The proposed technique is currently available to researchers as a stand-alone program and as an SPM extension. PMID:25379419

  14. Minimally invasive clinical approach in indirect pulp therapy and healing of deep carious lesions.

    PubMed

    Opal, S; Garg, S; Dhindsa, A; Taluja, T

    2014-01-01

    Indirect pulp treatment is a conservative vital pulp procedure performed in deep carious lesion approximating the pulp, but without signs or symptoms of pulp degeneration. Removing the carious biomass along with sealing the residual caries from extrinsic substrate and oral bacteria makes residual caries after the first excavation less active. This allows time for pulpo dentinal complex to form tertiary dentine so that at the second excavation, there is less likelihood of pulpal exposure. It has also been suggested that by changing the cavity environment from an active lesion into a more slowly progressing lesion, will be accompanied by more regular tubular tertiary dentin formation. The success of this approach has been demonstrated by various randomized controlled studies comparing conventional treatment of such lesions with stepwise excavation. These results are echoed at clinical, radiographic, macroscopic, microscopic and ultrastructural level during follow up visits. This study reviews promising concepts and rationale of minimally invasive indirect pulp therapy technique where conventional wisdom of caries removal is challenged PMID:25095310

  15. Endonasal Endoscopic Transsphenoidal Approach to Lesions of the Sellar Region in Pediatric Patients

    PubMed Central

    Zhan, Rucai; Xin, Tao; Li, Xueen; Li, Weiguo; Li, Xingang

    2015-01-01

    Objective: Endoscopic endonasal (transnasal) transsphenoidal approach (EETA) for management of sellar lesions has gained popularity as a reliable and atraumatic method. Most reported studies of EETA have focused on surgical outcome in adult patients; and there are few reports to describe outcome in pediatric patients. The authors report our early experience of 11 patients aged 14 to 18 years managed with EETA to evaluate the safety and effectiveness of EETA in the pediatric. Methods: Retrospective review of hospital records of 11 pediatric patients who underwent endonasal endoscopic transsphenoidal approach for resection of sellar region lesion over 2 years. Age, sex, symptoms, tumor size, extent of tumor resection, clinical outcome, and surgical complications were reviewed. Results: Total resection was achieved in 9 (81.8%) patients, subtotal resection in 2 (18.2%), and no patient had partial or insufficient resection. All (100%) patients achieved visual remission, 7 (87.5%) of 8 patients with hyperhormone preoperative had endocrinological remission. Two (18.2%) patients incurred temporary diabetes insipidus (DI) postoperatively. One (9.1%) patient incurred postoperative cerebrospinal fluid (CSF) leakage which resolved following lumbar drainage. Three (27.3%) patients developed hypopituitarism needed hormone replacement therapy. There were no cases of meningitis, intracranial hematoma, or death. Conclusions: Endoscopic endonasal (transnasal) transsphenoidal approach (EETA) provides a safe and effective surgical option with low morbidity and mortality in pediatric patients. PMID:26352366

  16. Evaluation of Screening Strategies for Pre-malignant Lesions using a Biomathematical Approach

    PubMed Central

    Jeon, Jihyoun; Meza, Rafael; Moolgavkar, Suresh H.; Georg Luebeck, E.

    2008-01-01

    We derive mathematical expressions for the size distribution of screen-detectable pre-malignant lesions, both conditional and unconditional on no prior detection of cancer in the tissue of interest, based on a general multistage clonal expansion model of carcinogenesis. We apply these expressions to simulate the natural history of colorectal cancer and to evaluate the effect of a screen for adenomatous polyps and concomitant intervention on cancer risk. Our approach allows the efficient simulation of multiple screens and interventions and determination of the optimal timing of the screens. We further demonstrate the utility of our approach by computing the benefits of up to two colonoscopies on the lifetime risk of colorectal cancer. PMID:18374369

  17. Step by step approach to rare breast lesions containing spindle cells.

    PubMed

    Ünal, Betül; Erdoğan, Gülgün; Karaveli, Fatma Şeyda

    2015-01-01

    Differential diagnosis of spindle cell lesions of breast is challenging for certain reasons. The most important reason is the presence of cytological atypia and mitosis in all three conditions: reactive, benign, and malignant. Patients diagnosed with benign and malignant tumor/tumor-like lesions that had spindle cell components following the histopathological examination were included in the study. The patients' medical records were accessed to obtain the clinical history, follow-up notes, and radiological findings. Following histopathological, immunohistochemical, and clinical evaluations, the patients were diagnosed as follows: pseudoangiomatous stromal hyperplasia (PASH), bilateral desmoid-type fibromatosis (FM), adenomyoepithelioma (AME), myofibroblastoma (MFB), malignant phyllodes tumor (MF), high-grade AS, post-chemotherapy osteosarcoma (OS) + Paget's disease, and metaplastic carcinoma (MC). An algorithmic approach should be used in the diagnosis; cellular structure, presence and grade of atypia, growth pattern, mitotic activity, immunohistochemical staining, and clinical and radiological features should be evaluated together. Detection of some molecular changes can be useful in differential diagnosis. PMID:26558181

  18. An approach to the diagnosis of spindle cell lesions of the breast.

    PubMed

    Rakha, Emad A; Aleskandarany, Mohammed A; Lee, Andrew H S; Ellis, Ian O

    2016-01-01

    Although most breast spindle cell lesions (BSCLs) are rare, they constitute a wide spectrum of diseases, ranging from reactive processes to aggressive malignant tumours. Despite their varied histogenesis and behaviour, some lesions show an overlap of morphological features, making accurate diagnosis a challenging task, particularly in needle core biopsies. Clinical history and immunohistochemistry can help in making a correct diagnosis in morphologically challenging cases. To make an accurate diagnosis, it is important to maintain a wide differential diagnosis and be familiar with the diverse morphological appearances of these different entities. BSCLs can generally be classified into bland-looking and malignant-looking categories. In the former, the commonest diagnosis is scarring. However, it is important to distinguish low-grade spindle cell metaplastic breast carcinoma from other benign entities, as the management is clearly different. In the malignant category, it is important to differentiate metaplastic carcinoma from other malignant primary and metastatic malignant spindle cell tumours of the breast, such as malignant phyllodes tumour, angiosarcoma, and melanoma. This review focuses on the classification and histological and molecular diagnosis of various BSCLs, with an emphasis on the diagnostic approach, including in core biopsies. PMID:26768028

  19. Evaluation of orofacial lesions relating child abuse, Esfahan, Iran: A quantitative approach

    PubMed Central

    Nilchian, Firoozeh; Sadri, Leyli; Jabbarifar, Seyed Ebrahim; Saeidi, Alireza; Arbab, Leila

    2012-01-01

    Background: Family violence, including child abuse, neglect, and domestic violence, is a public health problem. The aim of this study was to provide data on prevalence and factors of Orofacial lesions relating child abuse in Iran to lend evidence to support preventing child abuse. Materials and Methods: The overall approach was a case-note review of children having child abuse note, recording by personnel of social services. Research ethical approval was sought from the Central social service organization. This study was conducted in Isfahan, Iran (2011). Result: The mean age of children, when abuse had been occurred was 8 years (SD = 1.68), and there were approximately an equal number of boys and girls. Children had a high physical experience (66.1%).Of these children, at least 60% sustained trauma to the face and mouth. Emotional abuse was 77.1%, neglect was 64.1%, and lower experience of sexual abuse which was 4.1%. There was a strong relationship between gender and abuser which shows girls have been affected by stepfathers (P = 0.001). Conclusion: Preliminary data suggest that there are strong evidence regarding the incidence of child abuse relating orofacial lesions which dentists should be aware of them. Future trials may draw on these useful baseline data to help their study design. PMID:23559953

  20. Minimally invasive removal of lumbar intradural extramedullary lesions using the interlaminar approach.

    PubMed

    Zhu, Yong-Jian; Ying, Guang-Yu; Chen, Ai-Qin; Wang, Lin-Lin; Yu, Dan-Feng; Zhu, Liang-Liang; Ren, Yu-Cheng; Wang, Chen; Wu, Peng-Cheng; Yao, Ying; Shen, Fang; Zhang, Jian-Min

    2015-08-01

    OBJECT Posterior midline laminectomy or hemilaminectomy has been successfully applied as the standard microsurgical technique for the treatment of spinal intradural pathologies. However, the associated risks of postoperative spinal instability increase the need for subsequent fusion surgery to prevent potential long-term spinal deformity. Continuous efforts have been made to minimize injuries to the surrounding tissue resulting from surgical manipulations. The authors report here their experiences with a novel minimally invasive surgical approach, namely the interlaminar approach, for the treatment of lumbar intraspinal tumors. METHODS A retrospective review was conducted of patients at the Second Affiliated Hospital of Zhejiang University School of Medicine who underwent minimally invasive resection of lumbar intradural-extramedullary tumors. By using an operative microscope, in addition to an endoscope when necessary, the authors were able to treat all patients with a unilateral, paramedian, bone-sparing interlaminar technique. Data including preoperative neurological status, tumor location, size, pathological diagnosis, extension of resections, intraoperative blood loss, length of hospital stay, and clinical outcomes were obtained through clinical and radiological examinations. RESULTS Eighteen patients diagnosed with lumbar intradural-extramedullary tumors were treated from October 2013 to March 2015 by this interlaminar technique. A microscope was used in 15 cases, and the remaining 3 cases were treated using a microscope as well as an endoscope. There were 14 schwannomas, 2 ependymomas, 1 epidermoid cyst, and 1 enterogenous cyst. Postoperative radiological follow-up revealed complete removal of all the lesions and no signs of bone defects in the lamina. At clinical follow-up, 14 of the 18 patients had less pain, and patients' motor/sensory functions improved or remained normal in all cases except 1. CONClUSIONS When meeting certain selection criteria

  1. Universal and language-specific sublexical cues in speech perception: a novel electroencephalography-lesion approach.

    PubMed

    Obrig, Hellmuth; Mentzel, Julia; Rossi, Sonja

    2016-06-01

    SEE CAPPA DOI101093/BRAIN/AWW090 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE  : The phonological structure of speech supports the highly automatic mapping of sound to meaning. While it is uncontroversial that phonotactic knowledge acts upon lexical access, it is unclear at what stage these combinatorial rules, governing phonological well-formedness in a given language, shape speech comprehension. Moreover few studies have investigated the neuronal network affording this important step in speech comprehension. Therefore we asked 70 participants-half of whom suffered from a chronic left hemispheric lesion-to listen to 252 different monosyllabic pseudowords. The material models universal preferences of phonotactic well-formedness by including naturally spoken pseudowords and digitally reversed exemplars. The latter partially violate phonological structure of all human speech and are rich in universally dispreferred phoneme sequences while preserving basic auditory parameters. Language-specific constraints were modelled in that half of the naturally spoken pseudowords complied with the phonotactics of the native language of the monolingual participants (German) while the other half did not. To ensure universal well-formedness and naturalness, the latter stimuli comply with Slovak phonotactics and all stimuli were produced by an early bilingual speaker. To maximally attenuate lexico-semantic influences, transparent pseudowords were avoided and participants had to detect immediate repetitions, a task orthogonal to the contrasts of interest. The results show that phonological 'well-formedness' modulates implicit processing of speech at different levels: universally dispreferred phonological structure elicits early, medium and late latency differences in the evoked potential. On the contrary, the language-specific phonotactic contrast selectively modulates a medium latency component of the event-related potentials around 400 ms. Using a novel event-related potential-lesion

  2. Automated segmentation of MS lesions in FLAIR, DIR and T2-w MR images via an information theoretic approach

    NASA Astrophysics Data System (ADS)

    Hill, Jason E.; Matlock, Kevin; Pal, Ranadip; Nutter, Brian; Mitra, Sunanda

    2016-03-01

    Magnetic Resonance Imaging (MRI) is a vital tool in the diagnosis and characterization of multiple sclerosis (MS). MS lesions can be imaged with relatively high contrast using either Fluid Attenuated Inversion Recovery (FLAIR) or Double Inversion Recovery (DIR). Automated segmentation and accurate tracking of MS lesions from MRI remains a challenging problem. Here, an information theoretic approach to cluster the voxels in pseudo-colorized multispectral MR data (FLAIR, DIR, T2-weighted) is utilized to automatically segment MS lesions of various sizes and noise levels. The Improved Jump Method (IJM) clustering, assisted by edge suppression, is applied to the segmentation of white matter (WM), gray matter (GM), cerebrospinal fluid (CSF) and MS lesions, if present, into a subset of slices determined to be the best MS lesion candidates via Otsu's method. From this preliminary clustering, the modal data values for the tissues can be determined. A Euclidean distance is then used to estimate the fuzzy memberships of each brain voxel for all tissue types and their 50/50 partial volumes. From these estimates, binary discrete and fuzzy MS lesion masks are constructed. Validation is provided by using three synthetic MS lesions brains (mild, moderate and severe) with labeled ground truths. The MS lesions of mild, moderate and severe designations were detected with a sensitivity of 83.2%, and 88.5%, and 94.5%, and with the corresponding Dice similarity coefficient (DSC) of 0.7098, 0.8739, and 0.8266, respectively. The effect of MRI noise is also examined by simulated noise and the application of a bilateral filter in preprocessing.

  3. A combined approach to non-carious cervical lesions associated with gingival recession

    PubMed Central

    Lee, HyeJin; Jin, Sung-Ho

    2016-01-01

    Non-carious cervical lesions (NCCLs) with gingival recession require specific consideration on both aspects of hard and soft tissue lesion. In the restorative aspect, careful finishing and polishing of the restorations prior to mucogingival surgery is the critical factor contributing to success. Regarding surgery, assessment of the configuration of the lesion and the choice of surgical technique are important factors. The precise diagnosis and the choice of the proper treatment procedure should be made on the basis of both restorative and surgical considerations to ensure the successful treatment of NCCLs. PMID:27508164

  4. Differential diagnosis of heavily pigmented melanocytic lesions: challenges and diagnostic approach.

    PubMed

    Aung, Phyu P; Mutyambizi, Kudakwashe K; Danialan, Richard; Ivan, Doina; Prieto, Victor G

    2015-12-01

    The differential diagnosis of heavily pigmented melanocytic neoplasms includes melanoma (especially animal type), melanosis of partially or completely regressed melanoma, blue naevus (BN), pigmented Spitzoid lesions, recurrent naevus, combined naevus, pigmented spindle cell naevus, epithelioid blue naevus of the Carney complex/pigmented epithelioid melanocytoma, deep penetrating naevus, hyperpigmented scar after surgery of melanoma in which there are also melanophages and hyperpigmentation due to the minocycline, a tattoo or a hyperpigmented scar. Pathologists face challenges when evaluating a pigmented lesion, especially in a small superficial biopsy, because it is difficult to access important histopathological features to differentiate benign versus malignant melanocytic lesions. The histological features that favour a diagnosis of melanoma include dimension (>6 mm), asymmetry, poor circumscription, irregular confluent nests, confluent lentiginous junctional melanocytic proliferation, lack of maturation with descent in the dermis, suprabasal pagetoid melanocytes, asymmetrical distribution of melanin pigment, cytological atypia, dermal mitotic figures, asymmetrical dermal lymphocytic infiltrate and necrosis. PMID:26602414

  5. Effects of amygdala lesions on overexpectation phenomena in food cup approach and autoshaping procedures.

    PubMed

    Holland, Peter C

    2016-08-01

    Prediction error (PE) plays a critical role in most modern theories of associative learning, by determining the effectiveness of conditioned stimuli (CS) or unconditioned stimuli (US). Here, we examined the effects of lesions of central (CeA) or basolateral (BLA) amygdala on performance in overexpectation tasks. In 2 experiments, after 2 CSs were separately paired with the US, they were combined and followed by the same US. In a subsequent test, we observed losses in strength of both CSs, as expected if the negative PE generated on reinforced compound trials encouraged inhibitory learning. CeA lesions, known to interfere with PE-induced enhancements in CS effectiveness, reduced those losses, suggesting that normally the negative PE also enhances cue associability in this task. BLA lesions had no effect. When a novel cue accompanied the reinforced compound, it acquired net conditioned inhibition, despite its consistent pairings with the US, consonant with US effectiveness models. That acquisition was unaffected by either CeA or BLA lesions, suggesting different rules for assignment of credit of changes in cue strength and cue associability. Finally, we examined a puzzling autoshaping phenomenon previously attributed to overexpectation effects. When a previously food-paired auditory cue was combined with the insertion of a lever and paired with the same food US, the auditory cue not only failed to block conditioning to the lever, but also lost strength, as in an overexpectation experiment. This effect was abolished by BLA lesions but unaffected by CeA lesions, suggesting it was unrelated to other overexpectation effects. (PsycINFO Database Record PMID:27176564

  6. A unified approach to combine temperature estimation and elastography for thermal lesion determination in focused ultrasound thermal therapy.

    PubMed

    Liu, Hao-Li; Li, Meng-Lin; Tsui, Po-Hsiang; Lin, Ming-Shi; Huang, Sheng-Min; Bai, Jing

    2011-01-01

    Sonogram-based temperature estimation and elastography have both shown promise as methods of monitoring focused ultrasound (FUS) treatments to induce thermal ablation in tissue. However, each method has important limitations. Temperature estimates based on echo delays become invalid when the relationship between sound speed and temperature is nonlinear, and are further complicated by thermal expansion and other changes in tissue. Elastography can track thermal lesion formation over a wider range of elasticity, but with low specificity and high noise. Furthermore, this method is poor at small lesion detection. This study proposes integrating the two estimates to improve the quality of monitoring FUS-induced thermal lesions. Our unified computational kernel is tested on three types of phantoms. Experiments with type I and type II phantoms were conducted to calibrate the thermal mapping and elastography methods, respectively. The optimal settings were then used in experiments with the type III phantom, which contains ex vivo swine liver tissue. Three different spatial-peak temporal-average intensities (I(spta); 35, 133 and 240 W cm(-2)) were delivered with a sonication time of 60 s. The new procedure can closely monitor heating while identifying the dimensions of the thermal lesion, and is significantly better at the latter task than either approach alone. This work may help improve the current clinical practice, which employs sonograms to guide the FUS-induced thermal ablation procedure. PMID:21149945

  7. A unified approach to combine temperature estimation and elastography for thermal lesion determination in focused ultrasound thermal therapy

    NASA Astrophysics Data System (ADS)

    Liu, Hao-Li; Li, Meng-Lin; Tsui, Po-Hsiang; Lin, Ming-Shi; Huang, Sheng-Min; Bai, Jing

    2011-01-01

    Sonogram-based temperature estimation and elastography have both shown promise as methods of monitoring focused ultrasound (FUS) treatments to induce thermal ablation in tissue. However, each method has important limitations. Temperature estimates based on echo delays become invalid when the relationship between sound speed and temperature is nonlinear, and are further complicated by thermal expansion and other changes in tissue. Elastography can track thermal lesion formation over a wider range of elasticity, but with low specificity and high noise. Furthermore, this method is poor at small lesion detection. This study proposes integrating the two estimates to improve the quality of monitoring FUS-induced thermal lesions. Our unified computational kernel is tested on three types of phantoms. Experiments with type I and type II phantoms were conducted to calibrate the thermal mapping and elastography methods, respectively. The optimal settings were then used in experiments with the type III phantom, which contains ex vivo swine liver tissue. Three different spatial-peak temporal-average intensities (Ispta; 35, 133 and 240 W cm-2) were delivered with a sonication time of 60 s. The new procedure can closely monitor heating while identifying the dimensions of the thermal lesion, and is significantly better at the latter task than either approach alone. This work may help improve the current clinical practice, which employs sonograms to guide the FUS-induced thermal ablation procedure.

  8. Stem cell therapy: A novel treatment approach for oral mucosal lesions.

    PubMed

    Suma, G N; Arora, Madhu Pruthi; Lakhanpal, Manisha

    2015-01-01

    Stem cells have enormous potential to alleviate sufferings of many diseases that currently have no effective therapy. The research in this field is growing at an exponential rate. Stem cells are master cells that have specialized capability for self-renewal, potency and capability to differentiate to many cell types. At present, the adult mesenchymal stem cells are being used in the head and neck region for orofacial regeneration (including enamel, dentin, pulp and alveolar bone) in lieu of their proliferative and regenerative properties, their use in the treatment of oral mucosal lesions is still in budding stages. Moreover, there is scanty literature available regarding role of stem cell therapy in the treatment of commonly seen oral mucosal lesions like oral submucous fibrosis, oral lichen planus, oral ulcers and oral mucositis. The present review will focus on the current knowledge about the role of stem cell therapies in oral mucosal lesions and could facilitate new advancements in this area (articles were obtained from electronic media like PubMed, EBSCO, Cochrane and Medline etc., from year 2000 to 2014 to review the role of stem cell therapy in oral mucosal lesions). PMID:25709329

  9. ABA and ABC renewal of conditioned magazine approach are not impaired by dorsal hippocampus inactivation or lesions.

    PubMed

    Campese, Vincent; Delamater, Andrew R

    2013-07-01

    Three experiments investigated the role of the dorsal hippocampus (DH) in renewal of conditioned and then extinguished magazine approach responding in rats. Experiments 1 and 2 found no effect of muscimol inactivation of the DH during testing on ABA and ABC renewal, respectively. However, subjects from these studies were subsequently found to be impaired on a delayed non-matching-to-place task following muscimol but not saline infusions. Experiment 3 found no effects of post-training excitotoxic lesions of the DH on ABA and ABC renewal. Lesioned subjects were, however, impaired on the delayed non-matching-to-place task compared to control subjects. These findings suggest that the DH may not play a similar role in Pavlovian extinction in appetitive learning tasks as has previously been reported in aversive learning. PMID:23583520

  10. Management of failed periodontal surgical intervention for a furcal lesion with a nonsurgical endodontic approach

    PubMed Central

    Asgary, Saeed

    2014-01-01

    As long as the prognosis of teeth remains a matter of concern, the endodontic-periodontal relationship will be considered a challenge for the clinician. Many etiologic factors, including bacteria, fungi, and viruses, plus other contributing factors, such as trauma, root resorptions/perforations, and dental malformations, play a role in the co-occurrence of endodontic and periodontal lesions. Whatever the cause, a correct diagnosis on which to base the treatment plan is the key to successful maintenance of the tooth. This article reports the successful endodontic management of a furcation lesion in a mandibular molar that was nonresponsive to a previous periodontal surgical graft. The case had presented a diagnostic challenge for the clinicians, and this article reviews the key points that can lead to a correct diagnosis and treatment planning. PMID:24790924

  11. Mesenchymal tumors and tumor-like lesions of the breast: a contemporary approach review.

    PubMed

    Stolnicu, Simona; Moldovan, Cosmin; Podoleanu, Cristian; Georgescu, Rares

    2015-01-01

    The classification of the breast tumors has been revised and recently published in 2012 in the WHO blue book. Contrary to the epithelial tumors in the breast, mesenchymal tumors are rare and the classification for benign and malignant tumors is based on the same criteria in both categories, since no other specific diagnostic criteria, which would have an impact on prognosis, exist to date. The present review deals with minor changes mirroring the recent developments in the benign mesenchymal tumors (new additions are nodular fasciitis and atypical vascular lesions, while the haemangiopericytoma is removed) focusing especially on criteria to diagnose sarcomas, which represent a wide spectrum including very difficult lesions. The majority of sarcomas of the breast arise as a component of a malignant phyllodes tumor, while the pure forms are very rare. When a pure primary sarcoma of the breast is diagnosed, pathologists are encouraged to categorize the lesion according to the type of differentiation and to provide to the clinicians all the important prognostic parameters for the best treatment choice. PMID:25533916

  12. Meatoplasty keloid: a rare lesion treated with an unusual surgical approach.

    PubMed

    Shine, N P; Lew, K

    2006-07-01

    Keloid scarring is a benign hyperproliferation of fibrous tissue occurring at a wound healing site. Keloid formation related to the ear is generally the result of ear-piercing, mainly causing cosmetic disfigurement. We present an unusual case of keloid formation at a previous meatoplasty incision scar in a 10-year-old Caucasian with a modified radical mastoid cavity. This lesion prevented the cavity from self-cleaning and obstructed microscopic evaluation of the cavity. Treatment was successfully performed by surgical excision, with closure of the defect using supra-keloid skin flaps, followed by serial steroid injection therapy. PMID:16834807

  13. Novel Approaches for Diagnosing Melanoma Skin Lesions Through Supervised and Deep Learning Algorithms.

    PubMed

    Premaladha, J; Ravichandran, K S

    2016-04-01

    Dermoscopy is a technique used to capture the images of skin, and these images are useful to analyze the different types of skin diseases. Malignant melanoma is a kind of skin cancer whose severity even leads to death. Earlier detection of melanoma prevents death and the clinicians can treat the patients to increase the chances of survival. Only few machine learning algorithms are developed to detect the melanoma using its features. This paper proposes a Computer Aided Diagnosis (CAD) system which equips efficient algorithms to classify and predict the melanoma. Enhancement of the images are done using Contrast Limited Adaptive Histogram Equalization technique (CLAHE) and median filter. A new segmentation algorithm called Normalized Otsu's Segmentation (NOS) is implemented to segment the affected skin lesion from the normal skin, which overcomes the problem of variable illumination. Fifteen features are derived and extracted from the segmented images are fed into the proposed classification techniques like Deep Learning based Neural Networks and Hybrid Adaboost-Support Vector Machine (SVM) algorithms. The proposed system is tested and validated with nearly 992 images (malignant & benign lesions) and it provides a high classification accuracy of 93 %. The proposed CAD system can assist the dermatologists to confirm the decision of the diagnosis and to avoid excisional biopsies. PMID:26872778

  14. Midterm Results of a Combined Biological and Mechanical Approach for the Treatment of a Complex Knee Lesion

    PubMed Central

    Filardo, G.; Di Martino, A.; Delcogliano, M.; Marcacci, M.

    2012-01-01

    Objective: Complex fractures of the tibial plateau are difficult to treat and present a high complication rate. The goal of this report is to describe a combined biological and mechanical approach to restore all morphological and functional knee properties. Methods: We treated a 50-year-old woman, who was affected by a posttraumatic osteochondral lesion and depression of the lateral tibial plateau with knee valgus deviation. The mechanical axis was corrected with a lateral tibial plateau elevation osteotomy, the damaged joint surface was replaced by a recently developed biomimetic osteochondral scaffold, and a hinged dynamic external fixator was applied to protect the graft and at the same time to allow postoperative joint mobilization. Results: A marked clinical improvement was documented at 12 months and further improved up to 5 years, with pain-free full range of motion and return to previous activities. The MRI evaluation at 12 and 24 months showed that the implant remained in site with a hyaline-like signal and restoration of the articular surface. Conclusion: This case report describes a combined surgical approach for complex knee lesions that could represent a treatment option to avoid or at least delay posttraumatic osteoarthritis and more invasive procedures. PMID:26069639

  15. Pleomorphic Adenoma of Base of Tongue: Is Midline Mandibulotomy Necessary for Approaching Benign Base Tongue Lesions?

    PubMed Central

    Bansal, Sandeep; Kalsotra, Gopika; Mohammed, Abdul Wadood; Bahl, Amanjit; Gupta, Ashok K.

    2012-01-01

    Objective. To report a rare presentation of pleomorphic adenoma, at base tongue, excised surgically by a transoral midline glossotomy technique without mandibulotomy. Case Report. Pleomorphic adenoma is a benign tumor of the salivary gland found rarely in the base of tongue. Surgery is the definitive treatment for this tumor, and different approaches have been mentioned in the literature. In our case we surgically excised the tumor by a transoral midline glossotomy technique without mandibulotomy where we combined the cosmetic advantage of transoral technique and the exposure advantage of a glossotomy technique. Discussion. We discuss the different approaches to oropharynx, their advantages and disadvantages. Primary transoral approach provides better cosmesis but less exposure whereas median labiomandibuloglossotomy approach provides more exposure but is cosmetically unacceptable. Conclusion. A transoral midline glossotomy approach without mandibulotomy provides wide exposure with acceptable cosmesis. PMID:22953125

  16. A spectroscopic approach to imaging and quantification of cartilage lesions in human knee joints

    NASA Astrophysics Data System (ADS)

    Johansson, A.; Sundqvist, T.; Kuiper, J.-H.; Öberg, P. Å.

    2011-03-01

    We have previously described a technology based on diffuse reflectance of broadband light for measuring joint articular cartilage thickness, utilizing that optical absorption is different in cartilage and subchondral bone. This study is the first evaluation of the technology in human material. We also investigated the prospects of cartilage lesion imaging, with the specific aim of arthroscopic integration. Cartilage thickness was studied ex vivo in a number of sites (n = 87) on human knee joint condyles, removed from nine patients during total knee replacement surgery. A reflectance spectrum was taken at each site and the cartilage thickness was estimated using the blue, green, red and near-infrared regions of the spectrum, respectively. Estimated values were compared with reference cartilage thickness values (taken after sample slicing) using an exponential model. Two-dimensional Monte Carlo simulations were performed in a theoretical analysis of the experimental results. The reference cartilage thickness of the investigated sites was 1.60 ± 1.30 mm (mean ± SD) in the range 0-4.2 mm. Highest correlation coefficients were seen for the calculations based on the near-infrared region after normalization to the red region (r = 0.86) and for the green region (r = 0.80).

  17. Tumours and inflammatory lesions of the anal canal and perianal skin revisited: an update and practical approach.

    PubMed

    Dawson, Heather; Serra, Stefano

    2015-12-01

    Tumours of the anal and perianal region are relatively rare, and clinically often interpreted as innocuous lesions, leading to frequent delays in diagnosis and adequate treatment. Although squamous cell neoplasia represents the most common entity encountered in this anatomically complex area, many conditions, both neoplastic and inflammatory, may occur. Adding to the challenge of correct diagnosis and patient management, recent years have seen major updates in the terminology of squamous cell neoplasia, created to reflect advances in our understanding of the role of human papilloma virus and unify previous terminologies used for different sites in the anogenital tract. However, squamous cell neoplasia in the anal canal and perianal region may differ in terms of histology, biological behaviour, staging and treatment. The aim of this review is to present an overview of neoplastic and non-neoplastic lesions that may be seen in this area, an update on important developments and terminology, potential pitfalls that may be encountered in routine pathology practice and a practical approach on how to resolve these issues. PMID:26602415

  18. Posterior tibial artery access using transradial techniques: retrograde approach to inaccessible lower extremity lesions.

    PubMed

    Londoño, Juan Carlos; Singh, Vikas; Martinez, Claudia A

    2012-06-01

    Percutaneous intervention of chronic limb ischemia is often limited by vascular access especially in patients with previous surgical interventions. This warrants development of alternative endovascular techniques, particularly for patients in whom traditional ipsilateral antegrade or contralateral retrograde access has failed or is not possible. We describe a novel approach to the posterior tibial artery using retrograde access with transradial techniques including closure devices in two patients with inaccessible antegrade access. PMID:21432983

  19. [Two cases of lateral approach for thoraco-lumbar junctional lesions: experiment of Kaneda's device].

    PubMed

    Nishida, K; Ueda, S; Matsumoto, K; Okada, M

    1992-01-01

    Case 1: a 32-year-old woman was admitted to our hospital with major complaints of gait disturbance and urinary incontinence. The tendon reflex was markedly increased in the bilateral lower extremities, and both Babinski's reflex and clonus were strongly positive. Myelography revealed complete block in the 10th thoracic vertebral level. On April 15, 1989, a tumor in the vertebral region was exposed and excised via a right posterolateral approach. Kaneda's device was used for internal fixation. The tumor was diagnosed as myeloma histologically. The postoperative course was uneventful. Postoperatively, the patient became capable of walking by herself. Case 2: an 18-year-old woman was admitted because of burst fractures of the 1st and 2nd lumbar vertebrae due to a traffic accident in January of 1989. The fractured bones had been manually repositioned and fixed with plaster. However, the patient still had gait disturbance (intermittent claudication). Myelography revealed a complete block in the 2nd lumbar vertebral region. On May 7, the vertebral foramen was opened via a left anterolateral approach, and internal fixation was performed using Kaneda's device. Postoperatively, the patient recovered full ability to walk, and returned to normal social activity. From our experience, it is thought to be useful to employ a right posterolateral approach to the thoracic vertebrae, and a left anterolateral approach to the lumbar vertebrae. We used Kaneda's device for internal fixation, successfully. However, this device has the following disadvantages; (1) there are few plates designed for females, whose vertebrae are small, (2) it is difficult to preserve the arteries of Adamkiewicz and (3) postoperative MRI becomes impossible. PMID:1738429

  20. [New approaches in the study of neuroplasticity process in patients with central nervous system lesion].

    PubMed

    Chernikova, L A; Kremneva, E I; Cherviakov, A V; Saenko, I V; Konovalov, R N; Piramidov, M A; Kozlovskaia, I B

    2013-01-01

    Methods which on one hand can ensure the patient's mobility and on other hand activate afferents inputs are the main in rehabilitation treatment. Recent studies has shown that plasticity is structural base of recovery after central nervous system injury. Reorganization of cortical areas and increase of preserved structures functional effectiveness (intensification afferent input) are an anatomical basis of plasticity. However, sensory correction methods, without accounting of functional condition of patients, can lead to the formation of pathological symptoms: spasticity, hyperreflexia, etc. So the main aim is to study adequate management of the neuroplasticity process. This problem cannot be solving without modern methods of neuroimaging and brain mapping. The new approach for study cortical mechanisms of neuroplasticity, responsible for locomotion, was developed in the present study. This approach is complex use of functional magnetic resonance imaging (fMRI) and navigation transcranial magnetic stimulation (nTMS). It was showed that vast fMRI activation area in the first and the second sensorimotor area emerges with passive sensorimotor paradigm using that imitate backing load during walking. The mechanical stimulator footsteps backing zones "Corvit" uses for create this paradigm, nTMS examination, which used after fMRI, help localize the motor representation of muscles which control locomotion more accurately. We guess that new approach can be used for neuroplasticity process study and assessment of neuroplasticity changes during rehabilitation for restore and correct the walking. PMID:23885553

  1. Comparison of High-Dose Proton Radiotherapy and Brachytherapy in Localized Prostate Cancer: A Case-Matched Analysis

    SciTech Connect

    Coen, John J.; Zietman, Anthony L.; Rossi, Carl J.; Grocela, Joseph A.; Efstathiou, Jason A.; Yan, Yan; Shipley, William U.

    2012-01-01

    Purpose: To report a case-matched analysis comparing high-dose external-beam radiation (EBRT) for prostate cancer delivered on Proton Radiation Oncology Group (PROG) 95-09, a randomized trial, with permanent prostate brachytherapy over the same era. Methods: From 1996 to 1999, 196 patients were accrued to the high-dose arm (79.2 Gray equivalent (GyE) using photons and protons) of PROG 95-09 at the Massachusetts General Hospital and Loma Linda University Medical Center. Entry criteria specified T1-2 and prostate-specific antigen {<=}15 ng/mL. When Gleason score >7 was excluded, 177 men were left for case matching. At Massachusetts General Hospital, 203 similar patients were treated by a single brachytherapist from 1997 to 2002. Minimum follow-up was 3 years. Case matching, based on T stage, Gleason score, prostate-specific antigen, and age resulted in 141 matches (282 patients). Median follow-up was 8.6 and 7.4 years for EBRT and brachytherapy, respectively. The primary endpoint was biochemical failure (BF). Results: Using the Phoenix definition, the 8-year BF rates were 7.7% and 16.1% for EBRT and brachytherapy, respectively (p = 0.42). A stratified analysis was performed by risk group. In the EBRT group, 113 and 28 patients were low and intermediate risk, respectively. In the brachytherapy group, 118 and 23 were. When stratified by risk group, the BF rates were similar by either technique. Conclusions: High-dose EBRT and brachytherapy result in similar BF rates for men with localized prostate cancer. Comparative quality-of-life and cost-effectiveness studies are warranted.

  2. Current management of aortic arch lesions with hybrid procedures: a tailored approach to a progressive disease.

    PubMed

    Plichta, Ryan P; Aftab, Muhammad; Roselli, Eric E

    2016-06-01

    In the current era of cardiac and aortic surgery lines between open and endovascular approaches are becoming blurred. Hybrid techniques emerged with the availability of endovascular devices and the idea that combining open operations with a stent graft might provide a treatment option to those patients deemed too high-risk for conventional surgery. As these procedures evolved, it became clear that they still carried significant risk especially for the "inoperable" or "high-risk" patients, but they also offered new options for treating complex pathologies involving multiple segments of the aorta. Hybrid techniques not only provide the potential for less invasive aortic repair, but must be considered as an important complementary treatment option for patients with aortic disease, allowing for a potentially more effective and complete repair. The objective of this article is to review the current options for hybrid arch repair and the indications for choosing the various techniques based on pathologic presentation. PMID:26939046

  3. Is screen-and-treat approach suited for screening and management of precancerous cervical lesions in Sub-Saharan Africa?

    PubMed

    Fokom-Domgue, Joël; Vassilakos, Pierre; Petignat, Patrick

    2014-08-01

    The World Health Organization guidelines for screening and management of cervical precancerous lesions updated in 2013 made an emphasis on the use of the 'screen-and-treat' approach for cervical cancer prevention. In order to facilitate scaling-up in low income settings, most of these screen-and-treat strategies do not involve confirmatory biopsy. This yields a certain rate of overtreatment. In other words, a majority of people undergoing screen-and-treat intervention who are treated does not necessarily benefit from the treatment. Therefore, the issue of potential short term and long term complications of the recommended treatment procedures (cryotherapy and Loop Electrosurgical Excision Procedure) arises. This question has seldom been studied in resource poor countries, particularly in Sub-Saharan Africa where Human Immunodeficiency Virus infection is rampant in an epidemic fashion and where the procreative capacities are socially rewarding for women. We draw the attention of the scientific community and policy makers to the fact that the lack of evidence supporting the safety of these treatment procedures in African populations may have an impact on the acceptability of these strategies and therefore on the effectiveness of screening programs. PMID:24879892

  4. Case-matched Comparison of Robotic Versus Laparoscopic Proctectomy for Inflammatory Bowel Disease.

    PubMed

    Rencuzogullari, Ahmet; Gorgun, Emre; Costedio, Meagan; Aytac, Erman; Kessler, Hermann; Abbas, Maher A; Remzi, Feza H

    2016-06-01

    The present study reports an early institutional experience with robotic proctectomy (RP) and outcome comparison with laparoscopic proctectomy (LP) in patients with inflammatory bowel disease (IBD). Patients who underwent either RP or LP during proctocolectomy for IBD between January 2010 and June 2014 were matched (1:1) and reviewed. Twenty-one patients undergoing RP fulfilled the study criteria and were matched with an equal number of patients who had LP. Operative time was longer (304 vs. 213 min, P=0.008) and estimated blood loss was higher in the RP group (360 vs. 188 mL, P=0.002). Conversion rates (9.5% vs. 14.3%, P>0.99), time to first bowel movement(2.29±1.53 vs. 2.79±2.26, P=0.620), and hospital length stay(7.85±6.41 vs. 9.19±7.47 d, P=0.390) were similar in both groups. No difference was noted in postoperative complications, ileal pouch to anal canal anastomosis-related outcomes, Cleveland Global Quality of Life, and Short Form-12 health survey outcomes between RP and LP. Our good results with standard laparoscopy are unlikely to be improved with robotics in proctectomy cases. Potential benefits of robotic approach for completion proctectomy warrant further investigation as experience grows with robotics. PMID:27258914

  5. Minimal intervention dentistry II: part 3. Management of non-cavitated (initial) occlusal caries lesions--non-invasive approaches through remineralisation and therapeutic sealants.

    PubMed

    Holmgren, C; Gaucher, C; Decerle, N; Doméjean, S

    2014-03-01

    Epidemiological data on dental caries show that prevention and treatment needs have evolved significantly over the past two decades. In younger patients the distribution of caries lesions is mainly found on the occlusal surfaces. The treatment approaches utilised by dentists must evolve to integrate preventive and treatment solutions tailored to the care needs, which are straightforward to implement in the dental office and whose effectiveness is underpinned by scientific evidence. This article aims to describe the principles of non-invasive management of non-cavitated (initial) occlusal caries lesions, based on evidence from recent studies published in the international literature. PMID:24603245

  6. A comparative approach of four different image registration techniques for quantitative assessment of coronary artery calcium lesions using intravascular ultrasound.

    PubMed

    Araki, Tadashi; Ikeda, Nobutaka; Dey, Nilanjan; Chakraborty, Sayan; Saba, Luca; Kumar, Dinesh; Godia, Elisa Cuadrado; Jiang, Xiaoyi; Gupta, Ajay; Radeva, Petia; Laird, John R; Nicolaides, Andrew; Suri, Jasjit S

    2015-02-01

    In IVUS imaging, constant linear velocity and a constant angular velocity of 1800 rev/min causes displacement of the calcium in subsequent image frames. To overcome this error in intravascular ultrasound video, IVUS image frames must be registered prior to the lesion quantification. This paper presents a comprehensive comparison of four registration methods, namely: Rigid, Affine, B-Splines and Demons on five set of calcium lesion quantification parameters namely: (i) the mean lesion area, (ii) mean lesion arc, (iii) mean lesion span, (iv) mean lesion length, and (v) mean lesion distance from catheter. Using our IRB approved data of 100 patient volumes, our results shows that all four registrations showed a decrease in five calcium lesion parameters as follows: for Rigid registration, the values were: 4.92%, 5.84%, 5.89%, 5.27%, and 4.57%, respectively, for Affine registration the values were: 6.06%, 6.51%, 7.28%, 6.50%, and 5.94%, respectively, for B-Splines registration the values were: 7.35%, 8.03%, 9.54%, 8.18%, and 7.62%, respectively, and for Demons registration the five parameters were 7.32%, 8.02%, 10.11%, 7.94%, and 8.92% respectively. The relative overlap of identified lesions decreased by 5.91% in case of Rigid registration, 6.23% in case of Affine registration, 4.48% for Demons registration, whereas it increased by 3.05% in case of B-Splines registration. Rigid and Affine transformation-based registration took only 0.1936 and 0.2893 s per frame, respectively. Demons and B-Splines framework took only 0.5705 and 0.9405 s per frame, respectively, which were significantly slower than Rigid and Affine transformation based image registration. PMID:25523233

  7. A multidrug cocktail approach attenuates ischemic-type biliary lesions in liver transplantation from non-heart-beating donors.

    PubMed

    Deng, Yilei; Zhao, Longshuan; Lu, Xu

    2016-06-01

    Ischemic-type biliary lesions (ITBL) are the most troublesome biliary complication after liver transplantation (LT) from non-heart-beating donors (NHBD) and frequently result in death or re-transplantation. In transplantation process, warm ischemia (WI) in the donor, cold ischemia and reperfusion injury in the recipient altogether inducing ischemia-reperfusion injury (IRI) is strongly associated with ITBL. This is a cascading injury process, involving in a complex series of inter-connecting events causing variety of cells activation and damage associated with the massive release of inflammatory cytokines and generation of reactive oxygen species (ROS). These damaged cells such as sinusoidal endothelial cells (SECs), Kupffer cells (KCs), hepatocytes and biliary epithelial cells (BECs), coupled with immunological injury and bile salt toxicity altogether contribute to ITBL in NHBD LT. Developed therapeutic strategies to attenuate IRI are essential to improve outcome after LT. Among them, single pharmaceutical interventions blocking a specific pathway of IRI in rodent models play an absolutely dominant role, and show a beneficial effect in some given controlled experiments. But this will likely prove ineffective in complex clinical setting in which more risk parameters are involved. Therefore, we intend to design a multidrug cocktail approach to block different pathways on more than one stage (WI, cold ischemia and reperfusion) of the process of IRI-induced ITBL simultaneously. This multidrug cocktail will include six drugs containing streptokinase, epoprostenol, thiazolidinediones (TZDs), N-Acetylcysteine (NAC), hemin and tauroursodeoxycholic acid (TUDC). These drugs show protective effects by targeting the different key events of IRI, such as anti-inflammatory, anti-fibrosis, anti-oxidation, anti-apoptosis and reduced bile salt toxicity. Ideally, the compounds, dosage, and method of application of drugs included in cocktail should not be definitive. We can consider

  8. Imaging Pediatric Vascular Lesions.

    PubMed

    Nguyen, Tuyet A; Krakowski, Andrew C; Naheedy, John H; Kruk, Peter G; Friedlander, Sheila Fallon

    2015-12-01

    Vascular anomalies are commonly encountered in pediatric and dermatology practices. Most of these lesions are benign and easy to diagnose based on history and clinical exam alone. However, in some cases the diagnosis may not be clear. This may be of particular concern given that vascular anomalies may occasionally be associated with an underlying syndrome, congenital disease, or serious, life-threatening condition. Defining the type of vascular lesion early and correctly is particularly important to determine the optimal approach to management and treatment of each patient. The care of pediatric patients often requires collaboration from a multitude of specialties including pediatrics, dermatology, plastic surgery, radiology, ophthalmology, and neurology. Although early characterization of vascular lesions is important, consensus guidelines regarding the evaluation and imaging of vascular anomalies does not exist to date. Here, the authors provide an overview of pediatric vascular lesions, current classification systems for characterizing these lesions, the various imaging modalities available, and recommendations for appropriate imaging evaluation. PMID:26705446

  9. Imaging Pediatric Vascular Lesions

    PubMed Central

    Nguyen, Tuyet A.; Krakowski, Andrew C.; Naheedy, John H.; Kruk, Peter G.

    2015-01-01

    Vascular anomalies are commonly encountered in pediatric and dermatology practices. Most of these lesions are benign and easy to diagnose based on history and clinical exam alone. However, in some cases the diagnosis may not be clear. This may be of particular concern given that vascular anomalies may occasionally be associated with an underlying syndrome, congenital disease, or serious, life-threatening condition. Defining the type of vascular lesion early and correctly is particularly important to determine the optimal approach to management and treatment of each patient. The care of pediatric patients often requires collaboration from a multitude of specialties including pediatrics, dermatology, plastic surgery, radiology, ophthalmology, and neurology. Although early characterization of vascular lesions is important, consensus guidelines regarding the evaluation and imaging of vascular anomalies does not exist to date. Here, the authors provide an overview of pediatric vascular lesions, current classification systems for characterizing these lesions, the various imaging modalities available, and recommendations for appropriate imaging evaluation. PMID:26705446

  10. Hand-Assisted versus Straight-Laparoscopic versus Open Proctosigmoidectomy for Treatment of Sigmoid and Rectal Cancer: A Case-Matched Study of 100 Patients

    PubMed Central

    Gezen, Fazli C; Aytac, Erman; Costedio, Meagan M; Vogel, Jon D; Gorgun, Emre

    2015-01-01

    Objective: The laparoscopic approach is increasingly used for surgical treatment of colorectal cancer. The aim of this study was to assess the efficacy of laparoscopic proctosigmoidectomy for cancer treatment by comparing postoperative outcomes among three groups: hand-assisted laparoscopic resection, conventional straight-laparoscopic resection, and open resection. Methods: Patients who underwent hand-assisted proctosigmoidectomy because of rectal or sigmoid adenocarcinoma between September 2006 and July 2012 were case-matched to their straight-laparoscopy and open-surgery counterparts. Tumor location, tumor stage, resection type, and year of surgery were the matching criteria. Patients who had an abdominoperineal resection were excluded from the study. Results: Twenty-five patients underwent hand-assisted laparoscopic resection during the study period and were matched to 25 straight-laparoscopic and 50 open-surgery cases. The patients who underwent hand-assisted resection had higher rates of preoperative cardiac disease and hypertension than did the straight-laparoscopy and open-surgery groups (76% vs 64% vs 26%; p < 0.0001 and 72% vs 68% vs 42%; p = 0.02, respectively). A history of previous abdominal operations was highest in the straight-laparoscopy group (p = 0.01). The mean estimated blood loss was lowest in the straight-laparoscopy group (p = 0.01). The straight-laparoscopy group had the shortest median length of postoperative hospital stay (p = 0.04). Disease-free survival and overall survival was similar among the groups. Conclusions: Although both hand-assisted and straight-laparoscopic proctosigmoidectomy appear to be as safe and effective as open surgery in short-term and midterm outcomes, straight-laparoscopic surgery seems to provide faster convalescence compared with open surgery and hand-assisted laparoscopic surgery. PMID:25902342

  11. A case of secondary somatosensory epilepsy with a left deep parietal opercular lesion: successful tumor resection using a transsubcentral gyral approach during awake surgery.

    PubMed

    Maesawa, Satoshi; Fujii, Masazumi; Futamura, Miyako; Hayashi, Yuichiro; Iijima, Kentaro; Wakabayashi, Toshihiko

    2016-03-01

    Few studies have examined the clinical characteristics of patients with lesions in the deep parietal operculum facing the sylvian fissure, the region recognized as the secondary somatosensory area (SII). Moreover, surgical approaches in this region are challenging. In this paper the authors report on a patient presenting with SII epilepsy with a tumor in the left deep parietal operculum. The patient was a 24-year-old man who suffered daily partial seizures with extremely uncomfortable dysesthesia and/or occasional pain on his right side. MRI revealed a tumor in the medial aspect of the anterior transverse parietal gyrus, surrounding the posterior insular point. Long-term video electroencephalography monitoring with scalp electrodes failed to show relevant changes to seizures. Resection with cortical and subcortical mapping under awake conditions was performed. A negative response to stimulation was observed at the subcentral gyrus during language and somatosensory tasks; thus, the transcortical approach (specifically, a transsubcentral gyral approach) was used through this region. Subcortical stimulation at the medial aspect of the anterior parietal gyrus and the posterior insula around the posterior insular point elicited strong dysesthesia and pain in his right side, similar to manifestation of his seizure. The tumor was completely removed and pathologically diagnosed as pleomorphic xanthoastrocytoma. His epilepsy disappeared without neurological deterioration postoperatively. In this case study, 3 points are clinically significant. First, the clinical manifestation of this case was quite rare, although still representative of SII epilepsy. Second, the location of the lesion made surgical removal challenging, and the transsubcentral gyral approach was useful when intraoperative mapping was performed during awake surgery. Third, intraoperative mapping demonstrated that the patient experienced pain with electrical stimulation around the posterior insular point

  12. Cytomorphological Analysis of Keratinocytes in Oral Smears from Tobacco Users and Oral Squamous Cell Carcinoma Lesions — A Histochemical Approach

    PubMed Central

    Khandelwal, Suneet; Solomon, Monica Charlotte

    2010-01-01

    Aim To analyse the cytomorphological features of keratinocytes in smears obtained from the oral mucosa of tobacco users and from oral squamous cell carcinoma lesions. Methodology Oral smears were obtained from clinically, normal appearing mucosa of oral squamous cell carcinoma patients (n=20) and from the mucosa of smokers (n=20), and apparently healthy individuals (n=20) were used as controls. The smears were histochemically stained and cytomorphological assessment of the keratinocytes was carried out. One-way ANOVA (Analysis of Variance) was used for comparing the parameters among multiple groups and Tukey-HSD test was used to compare the mean values between groups. Results The mean nuclear area of keratinocytes from the mucosa of tobacco users was 46 ± 2.57 and that of the oral squamous cell carcinoma lesion was 81.54 ± 4.31. While there was a significant (P=0.001) reduction in the cellular area of keratinocytes from oral squamous cell carcinoma lesion when compared with those from oral smears of tobacco users. Conclusion Cytomorphometric analysis of keratinocytes can serve as a useful adjunct in the early diagnosis of oral squamous cell carcinomas. PMID:20690418

  13. A new approach to the treatment of true-combined endodontic-periodontic lesions by the guided tissue regeneration technique.

    PubMed

    Tseng, C C; Harn, W M; Chen, Y H; Huang, C C; Yuan, K; Huang, P H

    1996-12-01

    Clinicians often have difficulty in the diagnosis and treatment of the combined endodontal and periodontal (endo-perio) lesion. A case of an endo-perio true-combined lesion on a maxillary premolar was first treated with conventional endodontic therapy. Periodontal surgery was then completed, which included scaling and root planing and apical curettage on the tooth. The facial bony defect was then filled with a decalcified freeze-dried bone allograft mixed with tetracycline powder. A non-resorbable Teflon membrane was then used to cover the bone material and the periodontal flap sutured over this. This combined treatment resulted in minimal probing depth (2 mm), maximal clinical attachment gain (8 mm), as well as radiographic evidence of alveolar bone gain. This case report demonstrates that proper diagnosis, followed by removal of etiological factors and utilizing the guided tissue regeneration technique combined with osseous grafting, will restore health and function to a tooth with severe attachment loss caused by an endo-perio lesion. PMID:9220758

  14. Enzyme-labeled Antigen Method: Development and Application of the Novel Approach for Identifying Plasma Cells Locally Producing Disease-specific Antibodies in Inflammatory Lesions

    PubMed Central

    Mizutani, Yasuyoshi; Shiogama, Kazuya; Onouchi, Takanori; Sakurai, Kouhei; Inada, Ken-ichi; Tsutsumi, Yutaka

    2016-01-01

    In chronic inflammatory lesions of autoimmune and infectious diseases, plasma cells are frequently observed. Antigens recognized by antibodies produced by the plasma cells mostly remain unclear. A new technique identifying these corresponding antigens may give us a breakthrough for understanding the disease from a pathophysiological viewpoint, simply because the immunocytes are seen within the lesion. We have developed an enzyme-labeled antigen method for microscopic identification of the antigen recognized by specific antibodies locally produced in plasma cells in inflammatory lesions. Firstly, target biotinylated antigens were constructed by the wheat germ cell-free protein synthesis system or through chemical biotinylation. Next, proteins reactive to antibodies in tissue extracts were screened and antibody titers were evaluated by the AlphaScreen method. Finally, with the enzyme-labeled antigen method using the biotinylated antigens as probes, plasma cells producing specific antibodies were microscopically localized in fixed frozen sections. Our novel approach visualized tissue plasma cells that produced 1) autoantibodies in rheumatoid arthritis, 2) antibodies against major antigens of Porphyromonas gingivalis in periodontitis or radicular cyst, and 3) antibodies against a carbohydrate antigen, Strep A, of Streptococcus pyogenes in recurrent tonsillitis. Evaluation of local specific antibody responses expectedly contributes to clarifying previously unknown processes in inflammatory disorders. PMID:27006517

  15. Treatment of a Coronary Bifurcation Lesion Using One Dedicated Sirolimus Eluting Bifurcation Stent in Combination with a Bioresorbable Vascular Scaffold: A Novel Option for Coronary Bifurcation Approach

    PubMed Central

    Benezet, Javier; Agarrado, Antonio; Oneto, Jesús

    2016-01-01

    We present a complex bifurcation lesion treated with a new two-stent strategy combining a dedicated sirolimus eluting bifurcation stent, BiOSS Lim, with a bioresorbable vascular scaffold (BVS). The advantages of this strategy compared with the conventional two-stent approach are as follows: the dedicated stent protects the carina from being damaged, the large cell at the middle zone of the BiOSS Lim gives possibility to enter easily into the side branch (SB) with any standard size conventional device, and, finally, the additional use of BVS in the SB could have a long-term benefit in terms of restenosis. PMID:27066276

  16. A new approach to assess function after sciatic nerve lesion in the mouse - adaptation of the sciatic static index.

    PubMed

    Baptista, Abrahão Fontes; Gomes, Joyce Rios de Souza; Oliveira, Júlia Teixeria; Santos, Soraia Moreira Garzedim; Vannier-Santos, Marcos André; Martinez, Ana Maria Blanco

    2007-04-15

    Among the numerous ways of assessing regeneration after peripheral nerve lesions, the analysis of gait is one of the most important, because it shows the recovery of function, which is the ultimate goal of the repair machinery. The sciatic function index was introduced as a method to assess reinnervation after an experimental sciatic nerve lesion, and was adapted to the mouse model. The sciatic static index (SSI), is more simple and practical to perform, and is not so influenced by gait's velocity, but this method has not yet been adapted to the mouse model of sciatic lesion. We used 63 male Swiss mice (Mus musculus) to develop a formula to the sciatic static index in mice (SSIm). The animals were divided on three groups (control, transection and crush). They were evaluated at the preoperative and 7th, 14th, 21st, 28th, 35th and 42nd days postoperative by the ink track method (SFI), and by the acquisition of photographs of the plantar aspects of the injured and uninjured hind paws. The parameters evaluated were the 1-5 toe spread (TS), the 2-4 toe spread (ITS) and the distance between the tip of the third toe and the most posterior aspect of the paw (PL), on both methods. After verifying the temporal pattern of function, correlation and reproducibility of the measurements, we performed a multiple regression analysis using SFI values as dependent variable, and the TS, ITS and PL measured with the photo method as independent variables, and found the formula of the SSI for mice (SSIm). The three groups (control, transection and crush) had a characteristic pattern of dysfunction. The parameters measured in the ink and photo method had variable but significant correlations between them (P<0.000), but photo method of measurement showed a better reproducibility. The correlation between SFI and SSIm showed a high correlation coefficient (r=0.892, P<0.000), and demonstrates that SSIm can be used as an alternative method to assess the functional status relative of sciatic

  17. An Improved Approach to External Beam Radiation Therapy for Intra-Abdominal Cavity Lesions for Rural Cancer Centers

    SciTech Connect

    Gearheart, Darren M. Walker, Peggy; Collett, Brad S.; Modur, Raghuram S.

    2007-01-01

    Radiation therapy of abdominal lesions is problematic at best. The proximity of highly critical structures, tumor locations, and necessary margins combine to make prescription dose delivery with conventional 3-dimensional (3D) conformal techniques difficult. Others have tried to overcome these hurdles with newer modalities including intra-operative radiation therapy (IORT), intensity modulated radiation therapy (IMRT), and heavy particle irradiation. These techniques have had moderate success but are not readily available and are therefore limited in application. These factors have lead to the development of a modified, noncoplanar 4-field box technique that demonstrates significant improvement in critical structure sparing, i.e., kidney(s), bowel, and liver doses reduced while simultaneously improving isodose coverage to the target.

  18. Cutaneous metastasis of unknown primary presenting as massive and invasive abdominal lesion: an elective approach with electrochemotherapy.

    PubMed

    Lido, Paolo; Paolino, Giovanni; Feliziani, Andrea; Santurro, Letizia; Montuori, Mauro; Sanctis, Flavio de; Rossi, Piero; Petrella, Giuseppe; Ricciardi, Edoardo; Fusano, Giuseppe; Augusto, Orlandi; Polisca, Patrizio

    2015-01-01

    We describe herein what is to our knowledge the first reported case of an invasive cutaneous metastasis with unknown primary, electively treated solely with electrochemotherapy. We describe a female patient with a large, invasive and painful lesion in her hypogastric region, extending up to the pubic area. The cutaneous biopsy and instrumental and laboratory analyses, all failed to reveal the primary site. A final diagnosis of cutaneous metastasis with unknown primary was made and treatment was performed with electrochemotherapy. Our case highlights the importance of interdisciplinary choices in clinical practice to cope with the lack of a primary site and to improve quality of life, since no standardized therapy exists for these classes of patients. PMID:26734871

  19. Vascular Lesions.

    PubMed

    Jahnke, Marla N

    2016-08-01

    Vascular lesions in childhood are comprised of vascular tumors and vascular malformations. Vascular tumors encompass neoplasms of the vascular system, of which infantile hemangiomas (IHs) are the most common. Vascular malformations, on the other hand, consist of lesions due to anomalous development of the vascular system, including the capillary, venous, arterial, and lymphatic systems. Capillary malformations represent the most frequent type of vascular malformation. IHs and vascular malformations tend to follow relatively predictable growth patterns in that IHs grow then involute during early childhood, whereas vascular malformations tend to exhibit little change. Both vascular tumors and vascular malformations can demonstrate a wide range of severity and potential associated complications necessitating specialist intervention when appropriate. Evaluation and treatment of the most common types of vascular lesions are discussed in this article. [Pediatr Ann. 2016;45(8):e299-e305.]. PMID:27517358

  20. Petrous Apex Lesions

    PubMed Central

    Amedee, Ronald G.; Gianoli, Gerard J.; Mann, Wolf J.

    1994-01-01

    The purpose of this article is to detail our experience in treating 69 patients over the past 6 years with pathologic processes involving the petrous apex. These included 25 (36%) primary petrous apex lesions, 40 (58%) lesions that involved the petrous apex by direct invasion from an adjacent region, and four (6%) lesions that were the result of metastatic spread from a distant site. Although lesions of the petrous apex are uncommon, they may present significant morbidity to the patient. The symptoms elicited by these lesions are usually vague and nonlocalizing in the early stages but may progress to include multiple cranial neuropathies. Successful results are contingent on early diagnosis, which requires a high index of suspicion and use of appropriate imaging modalities. Thorough preoperative assessment with use of computed tomography, magnetic resonance imaging, and carotid arteriography is essential to plan the surgical approach. We present this collection of patients in order to aid in the further preoperative characterization of the differences in primary and secondary lesions of the petrous apex. PMID:17170919

  1. Dual-Port 2D and 3D Endoscopy: Expanding the Limits of the Endonasal Approaches to Midline Skull Base Lesions with Lateral Extension

    PubMed Central

    Beer-Furlan, Andre; Evins, Alexander I.; Rigante, Luigi; Anichini, Giulio; Stieg, Philip E.; Bernardo, Antonio

    2014-01-01

    Objective To investigate a novel dual-port endonasal and subtemporal endoscopic approach targeting midline lesions with lateral extension beyond the intracavernous carotid artery anteriorly and the Dorello canal posteriorly. Methods Ten dual-port approaches were performed on five cadaveric heads. All specimens underwent an endoscopic endonasal approach from the sella to middle clivus. The endonasal port was combined with an anterior or posterior endoscopic extradural subtemporal approach. The anterior subtemporal port was placed directly above the middle third of the zygomatic arch, and the posterior port was placed at its posterior root. The extradural space was explored using two-dimensional and three-dimensional endoscopes. Results The anterior subtemporal port complemented the endonasal port with direct access to the Meckel cave, lateral sphenoid sinus, superior orbital fissure, and lateral and posterosuperior compartments of the cavernous sinus; the posterior subtemporal port enhanced access to the petrous apex. Endoscopic dissection and instrument maneuverability were feasible and performed without difficulty in both the anterior and posterior subtemporal ports. Conclusion The anterior and posterior subtemporal ports enhanced exposure and control of the region lateral to the carotid artery and Dorello canal. Dual-port neuroendoscopy is still minimally invasive yet dramatically increases surgical maneuverability while enhancing visualization and control of anatomical structures. PMID:25072012

  2. [Foot lesions].

    PubMed

    Stelzner, C; Schellong, S; Wollina, U; Machetanz, J; Unger, L

    2013-11-01

    The foot is the target organ of a variety of internal diseases. Of upmost importance is the diabetic foot syndrome (DFS). Its complex pathophysiology is driven by the diabetic neuropathy, a vastly worsening effect is contributed by infection and ischemia. Seemingly localised lesions have the potential for phlegmone and septicaemia if not diagnosed and drained early. The acral lesions of peripheral artery occlusive disease (PAOD) have unique features as well. However, their life-threatening potential is lower than that of DFS even if the limb is critical. Notably, isolated foot lesions with a mere venous cause may arise from insufficient perforator veins; the accompanying areas of haemosiderosis will lead the diagnostic path. Cholesterol embolization (blue toe syndrome, trash foot) elicits a unique clinical picture and will become more frequent with increasing numbers of catheter-based procedures. Finally, descriptions are given of podagra and of foot mycosis as disease entities not linked to perfusion. The present review focuses on the depiction of disease and its diagnosis, leaving therapeutic considerations untouched. PMID:24114468

  3. Stress-induced cervical lesions.

    PubMed

    Braem, M; Lambrechts, P; Vanherle, G

    1992-05-01

    The increasing occurrence of dental lesions at the cervical surfaces requires more knowledge of the causes of the process. Acidic and abrasive mechanisms have clearly been documented as causes but the stress theory by Lee and Eakle is still controversial. This report describes several incidences of possible stress-induced lesions according to the characteristics described by Lee and Eakle. The occurrences of subgingival lesions lend credence to the stress-induction theory by exclusion of other superimposing etiologic factors. With the current concepts, a perceptive approach to the treatment of cervical lesions can be executed. PMID:1527763

  4. [Active forms of oxygen: cytotoxic effects and methodological approaches to laboratory control of liver lesions (literature review)].

    PubMed

    Matiushin, B N; Loginov, A S

    1996-01-01

    The injurious effects of active oxygen forms (AOF) on the cell caused by destruction of its membranous structures and impairment of their functional characteristics are discussed. Disorders of the processes of formation and inactivation of AOF in hepatocytes may be the metabolic mechanisms mediating the status and development of the pathological process in the liver. The problem of prospective approaches to assessing chronic diseases of the liver at the level of "free-radical pathology" is discussed. PMID:8963562

  5. Minimally invasive approach for adrenal lesions: Systematic review of laparoscopic versus retroperitoneoscopic adrenalectomy and assessment of risk factors for complications.

    PubMed

    Conzo, G; Tartaglia, E; Gambardella, C; Esposito, D; Sciascia, V; Mauriello, C; Nunziata, A; Siciliano, G; Izzo, G; Cavallo, F; Thomas, G; Musella, M; Santini, L

    2016-04-01

    In the last decades, minimally invasive transperitoneal laparoscopic adrenalectomy has become the standard of care for surgical resection of the adrenal gland tumors. Recently, however, adrenalectomy by a mininvasive retroperitoneal approach has reached increasingly popularity as alternative technique. Short hospitalization, lower postoperative pain and decrease of complications and a better cosmetic resolution are the main advantages of these innovative techniques. In order to determine the better surgical management of adrenal neoplasms, the Authors analyzed and compared the feasibility and the postoperative complications of minimally invasive adrenalectomy approaches. A systematic research of the English literature, including major meta-analysis articles, clinical randomized trials, retrospective studies and systematic reviews was performed, comparing laparoscopic transperitoneal adrenalectomy versus retroperitoneoscopic adrenalectomy. Many studies support that posterior retroperitoneal adrenalectomy is superior or at least comparable to laparoscopic transperitoneal adrenalectomy in operation time, pain score, blood loss, hospitalization, complications rates and return to normal activity. However, laparoscopic transperitoneal adrenalectomy is up to now a safe and standardized procedure with a shorter learning curve and a similar low morbidity rate, even for tumors larger than 6 cm. Nevertheless, further studies are needed to objectively evaluate these techniques, excluding selection bias and bias related to differences in surgeons' experiences with this approaches. PMID:26708860

  6. Pineal lesions: a multidisciplinary challenge.

    PubMed

    Westphal, Manfred; Emami, Pedram

    2015-01-01

    The pineal region is a complex anatomical compartment, harbouring the pineal gland surrounded by the quadrigeminal plate and the confluents of the internal cerebral veins to form the vein of Galen. The complexity of lesions in that region, however, goes far beyond the pineal parenchyma proper. Originating in the pineal gland, there are not only benign cysts but also numerous different tumour types. In addition, lesions such as tectal gliomas, tentorial meningiomas and choroid plexus papillomas arise from the surrounding structures, occupying that regions. Furthermore, the area has an affinity for metastatic lesions. Vascular lesions complete the spectrum mainly as small tectal arteriovenous malformations or cavernous haemangiomas.Taken together, there is a wide spectrum of lesions, many unique to that region, which call for a multidisciplinary approach. The limited access and anatomical complexity have generated a spectrum of anatomical approaches and raised the interest for neuroendoscopic approaches. Equally complex is the spectrum of treatment modalities such as microsurgery as the main option but stereotactic radiosurgery as an alternative or adjuvant to surgery for selected cases, radiation as for germinoma (see below) and or combinatorial chemotherapy, which may need to precede any other ablative technique as constituents.In this context, we review the current literature and our own series to obtain a snapshot sentiment of how to approach pineal lesions, how to interrelate alternative/competing concepts and review the recent technological advances. PMID:25411146

  7. GeneYenta: a phenotype-based rare disease case matching tool based on online dating algorithms for the acceleration of exome interpretation.

    PubMed

    Gottlieb, Michael M; Arenillas, David J; Maithripala, Savanie; Maurer, Zachary D; Tarailo Graovac, Maja; Armstrong, Linlea; Patel, Millan; van Karnebeek, Clara; Wasserman, Wyeth W

    2015-04-01

    Advances in next-generation sequencing (NGS) technologies have helped reveal causal variants for genetic diseases. In order to establish causality, it is often necessary to compare genomes of unrelated individuals with similar disease phenotypes to identify common disrupted genes. When working with cases of rare genetic disorders, finding similar individuals can be extremely difficult. We introduce a web tool, GeneYenta, which facilitates the matchmaking process, allowing clinicians to coordinate detailed comparisons for phenotypically similar cases. Importantly, the system is focused on phenotype annotation, with explicit limitations on highly confidential data that create barriers to participation. The procedure for matching of patient phenotypes, inspired by online dating services, uses an ontology-based semantic case matching algorithm with attribute weighting. We evaluate the capacity of the system using a curated reference data set and 19 clinician entered cases comparing four matching algorithms. We find that the inclusion of clinician weights can augment phenotype matching. PMID:25703386

  8. Case-Matched comparison of contemporary radiation therapy to surgery in patients with locally advanced prostate cancer

    SciTech Connect

    Fletcher, Sophie G.; Mills, Stacey E.; Smolkin, Mark E.; Theodorescu, Dan . E-mail: dt9d@virginia.edu

    2006-11-15

    Purpose: Few studies critically compare current radiotherapy techniques to surgery for patients with locally advanced prostate cancer, despite an urgent need to determine which approach offers superior cancer control. Our objective was to compare rates of biochemical relapse-free survival (BFS) and surrogates of disease specific survival among men with high risk adenocarcinoma of the prostate as a function of treatment modality. Methods and Materials: Retrospective data from 409 men with prostate-specific antigen (PSA) {>=}10 or Gleason 7-10 or Stage {>=}T2b cancer treated uniformly at one university between March 1988 and December 2000 were analyzed. Patients had undergone radical prostatectomy (RP), brachytherapy implant alone (BTM), or external beam radiotherapy with brachytherapy boost with short-term neoadjuvant and adjuvant androgen deprivation therapy (BTC). From the total study population a 1:1 matched-cohort analysis (208 patients matched via prostate-specific antigen, Gleason score) comparing RP with BTC was performed as well. Results: Estimated 4-year BFS rates were superior for patients treated with BTC (BTC 72%, BTM 25%, RP 53%; p < 0.001). Matched analysis of BTC vs. RP confirmed these results (BTC 73%, BTM 55%; p = 0.010). Relative risk (RR) of biochemical relapse for BTM and BTC compared with RP were 2.92 (1.95-4.36) and 0.56 (0.36-0.87) (p < 0.001, p = 0.010). RR for BTC from the matched cohort analysis was 0.44 (0.26-0.74; p = 0.002). Conclusions: High-risk prostate cancer patients receiving multimodality radiation therapy (BTC) display apparently superior BFS compared with those receiving surgery (RP) or brachytherapy alone (BTM)

  9. Novel lesion detection aids.

    PubMed

    Neuhaus, K W; Longbottom, C; Ellwood, R; Lussi, A

    2009-01-01

    Several non-invasive and novel aids for the detection of (and in some cases monitoring of) caries lesions have been introduced in the field of 'caries diagnostics' over the last 15 years. This chapter focusses on those available to dentists at the time of writing; continuing research is bound to lead to further developments in the coming years. Laser fluorescence is based on measurements of back-scattered fluorescence of a 655-nm light source. It enhances occlusal and (potentially) approximal lesion detection and enables semi-quantitative caries monitoring. Systematic reviews have identified false-positive results as a limitation. Quantitative light-induced fluorescence is another sensitive method to quantitatively detect and measure mineral loss both in enamel and some dentine lesions; again, the trade-offs with lower specificity when compared with clinical visual detection must be considered. Subtraction radiography is based on the principle of digitally superimposing two radiographs with exactly the same projection geometry. This method is applicable for approximal surfaces and occlusal caries involving dentine but is not yet widely available. Electrical caries measurements gather either site-specific or surface-specific information of teeth and tooth structure. Fixed-frequency devices perform best for occlusal dentine caries but the method has also shown promise for lesions in enamel and other tooth surfaces with multi-frequency approaches. All methods require further research and further validation in well-designed clinical trials. In the future, they could have useful applications in clinical practice as part of a personalized, comprehensive caries management system. PMID:19494675

  10. Simulation of spiculated breast lesions

    NASA Astrophysics Data System (ADS)

    Elangovan, Premkumar; Alrehily, Faisal; Pinto, R. Ferrari; Rashidnasab, Alaleh; Dance, David R.; Young, Kenneth C.; Wells, Kevin

    2016-03-01

    Virtual clinical trials are a promising new approach increasingly used for the evaluation and comparison of breast imaging modalities. A key component in such an assessment paradigm is the use of simulated pathology, in particular, simulation of lesions. Breast mass lesions can be generally classified into two categories based on their appearance; nonspiculated masses and spiculated masses. In our previous work, we have successfully simulated non-spiculated masses using a fractal growth process known as diffusion limited aggregation. In this new work, we have extended the DLA model to simulate spiculated lesions by using features extracted from patient DBT images containing spiculated lesions. The features extracted included spicule length, width, curvature and distribution. This information was used to simulate realistic looking spicules which were attached to the surface of a DLA mass to produce a spiculated mass. A batch of simulated spiculated masses was inserted into normal patient images and presented to an experienced radiologist for review. The study yielded promising results with the radiologist rating 60% of simulated lesions in 2D and 50% of simulated lesions in DBT as realistic.

  11. DNA lesions: A thermodynamic perspective

    SciTech Connect

    Plum, G.E.; Breslauer, K.J.

    1994-12-31

    The studies described in this paper are part of an overall program project entitled {open_quotes}The Chemistry and Biology of Exocyclic DNA Adducts and Oxidative DNA Damage.{close_quotes}. Initially, all the project leaders discuss and agree on biologically interesting lesions to target for study. Then begins the process of developing the chemistry required to synthesize modified nucleosides that either correspond to or model the damage sites of interest. Such modified nucleotides then are incorporated into oligonucleotides that are hybridized to their complements, thereby forming lesion-containing duplex structures. In any given duplex, the identity of the lesion-opposing nucleoside on the complementary strand is systematically altered, thereby allowing us to evaluate the impact on duplex properties of the identity of the base opposite the lesion. For comparative purposes, the undamaged parent Watson-Crick duplex also is synthesized. Such families of DNA duplexes are then sent for independent physiochemical characterizations. Armed with an extensive body of biophysical data, one then searches for correlations between the physiochemical influences of the lesions on duplex properties and the biological consequences of each lesion. At this stage, our approach is highly empirical. Ultimately, we hope that our studies will reveal correlations between physiochemical properties and biological consequences such that we will develop predictive powers and gain insight into the mechanisms of recognition, repair, and mutagenesis.

  12. Dosimetric advantages of intensity-modulated proton therapy for oropharyngeal cancer compared with intensity-modulated radiation: A case-matched control analysis.

    PubMed

    Holliday, Emma B; Kocak-Uzel, Esengul; Feng, Lei; Thaker, Nikhil G; Blanchard, Pierre; Rosenthal, David I; Gunn, G Brandon; Garden, Adam S; Frank, Steven J

    2016-01-01

    A potential advantage of intensity-modulated proton therapy (IMPT) over intensity-modulated (photon) radiation therapy (IMRT) in the treatment of oropharyngeal carcinoma (OPC) is lower radiation dose to several critical structures involved in the development of nausea and vomiting, mucositis, and dysphagia. The purpose of this study was to quantify doses to critical structures for patients with OPC treated with IMPT and compare those with doses on IMRT plans generated for the same patients and with a matched cohort of patients actually treated with IMRT. In this study, 25 patients newly diagnosed with OPC were treated with IMPT between 2011 and 2012. Comparison IMRT plans were generated for these patients and for additional IMRT-treated controls extracted from a database of patients with OPC treated between 2000 and 2009. Cases were matched based on the following criteria, in order: unilateral vs bilateral therapy, tonsil vs base of tongue primary, T-category, N-category, concurrent chemotherapy, induction chemotherapy, smoking status, sex, and age. Results showed that the mean doses to the anterior and posterior oral cavity, hard palate, larynx, mandible, and esophagus were significantly lower with IMPT than with IMRT comparison plans generated for the same cohort, as were doses to several central nervous system structures involved in the nausea and vomiting response. Similar differences were found when comparing dose to organs at risks (OARs) between the IMPT cohort and the case-matched IMRT cohort. In conclusion, these findings suggest that patients with OPC treated with IMPT may experience fewer and less severe side effects during therapy. This may be the result of decreased beam path toxicities with IMPT due to lower doses to several dysphagia, odynophagia, and nausea and vomiting-associated OARs. Further study is needed to evaluate differences in long-term disease control and chronic toxicity between patients with OPC treated with IMPT in comparison to those

  13. Effect of Urate-Lowering Therapy on All-Cause and Cardiovascular Mortality in Hyperuricemic Patients without Gout: A Case-Matched Cohort Study

    PubMed Central

    Chen, Jiunn-Horng; Lan, Joung-Liang; Cheng, Chi-Fung; Liang, Wen-Miin; Lin, Hsiao-Yi; Tsay, Gregory J; Yeh, Wen-Ting; Pan, Wen-Harn

    2015-01-01

    Objectives An increased risk of mortality in patients with hyperuricemia has been reported. We examined (1) the risk of all-cause and cardiovascular disease (CVD) mortality in untreated hyperuricemic patients who did not receive urate-lowering therapy (ULT), and (2) the impact of ULT on mortality risk in patients with hyperuricemia. Methods In this retrospective case-matched cohort study during a mean follow-up of 6.4 years, 40,118 Taiwanese individuals aged ≥17 years who had never used ULT and who had never had gout were examined. The mortality rate was compared between 3,088 hyperuricemic patients who did not receive ULT and reference subjects (no hyperuricemia, no gout, no ULT) matched for age and sex (1:3 hyperuricemic patients/reference subjects), and between 1,024 hyperuricemic patients who received ULT and 1,024 hyperuricemic patients who did not receive ULT (matched 1:1 based on their propensity score and the index date of ULT prescription). Cox proportional hazard modeling was used to estimate the respective risk of all-cause and CVD (ICD-9 code 390–459) mortality. Results After adjustment, hyperuricemic patients who did not receive ULT had increased risks of all-cause (hazard ratio, 1.24; 95% confidence interval, 0.97–1.59) and CVD (2.13; 1.34–3.39) mortality relative to the matched reference subjects. Hyperuricemic patients treated with ULT had a lower risk of all-cause death (0.60; 0.41–0.88) relative to hyperuricemic patients who did not receive ULT. Conclusion Under-treatment of hyperuricemia has serious negative consequences. Hyperuricemic patients who received ULT had potentially better survival than patients who did not. PMID:26683302

  14. The potential cost-effectiveness of the Diamondback 360® Coronary Orbital Atherectomy System for treating de novo, severely calcified coronary lesions: an economic modeling approach

    PubMed Central

    Chambers, Jeffrey; Généreux, Philippe; Lee, Arthur; Lewin, Jack; Young, Christopher; Crittendon, Janna; Mann, Marita; Garrison, Louis P.

    2015-01-01

    Background: Patients who undergo percutaneous coronary intervention (PCI) for severely calcified coronary lesions have long been known to have worse clinical and economic outcomes than patients with no or mildly calcified lesions. We sought to assess the likely cost-effectiveness of using the Diamondback 360® Orbital Atherectomy System (OAS) in the treatment of de novo, severely calcified lesions from a health-system perspective. Methods and results: In the absence of a head-to-head trial and long-term follow up, cost-effectiveness was based on a modeled synthesis of clinical and economic data. A cost-effectiveness model was used to project the likely economic impact. To estimate the net cost impact, the cost of using the OAS technology in elderly (⩾ 65 years) Medicare patients with de novo severely calcified lesions was compared with cost offsets. Elderly OAS patients from the ORBIT II trial (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) [ClinicalTrials.gov identifier: NCT01092426] were indirectly compared with similar patients using observational data. For the index procedure, the comparison was with Medicare data, and for both revascularization and cardiac death in the following year, the comparison was with a pooled analysis of the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI)/Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trials. After adjusting for differences in age, gender, and comorbidities, the ORBIT II mean index procedure costs were 17% (p < 0.001) lower, approximately US$2700. Estimated mean revascularization costs were lower by US$1240 in the base case. These cost offsets in the first year, on average, fully cover the cost of the device with an additional 1.2% cost savings. Even in the low-value scenario, the use of the OAS is cost-effective with a cost per life-year gained of US$11,895. Conclusions: Based on economic modeling

  15. Example based lesion segmentation

    NASA Astrophysics Data System (ADS)

    Roy, Snehashis; He, Qing; Carass, Aaron; Jog, Amod; Cuzzocreo, Jennifer L.; Reich, Daniel S.; Prince, Jerry; Pham, Dzung

    2014-03-01

    Automatic and accurate detection of white matter lesions is a significant step toward understanding the progression of many diseases, like Alzheimer's disease or multiple sclerosis. Multi-modal MR images are often used to segment T2 white matter lesions that can represent regions of demyelination or ischemia. Some automated lesion segmentation methods describe the lesion intensities using generative models, and then classify the lesions with some combination of heuristics and cost minimization. In contrast, we propose a patch-based method, in which lesions are found using examples from an atlas containing multi-modal MR images and corresponding manual delineations of lesions. Patches from subject MR images are matched to patches from the atlas and lesion memberships are found based on patch similarity weights. We experiment on 43 subjects with MS, whose scans show various levels of lesion-load. We demonstrate significant improvement in Dice coefficient and total lesion volume compared to a state of the art model-based lesion segmentation method, indicating more accurate delineation of lesions.

  16. Does flat epithelial atypia have rounder nuclei than columnar cell change/hyperplasia? A morphometric approach to columnar cell lesions of the breast.

    PubMed

    Yamashita, Yoshiko; Ichihara, Shu; Moritani, Suzuko; Yoon, Han-Seung; Yamaguchi, Masahiro

    2016-06-01

    Columnar cell lesions of the breast encompass columnar cell change/hyperplasia (CCC/CCH) and flat epithelial atypia (FEA). These have attracted researchers because emerging data suggest that FEA may represent the earliest histologically detectable non-obligate precursor of breast cancer. However, it is occasionally difficult to distinguish FEA from CCC/CCH because of similar histology. Although the nuclei of FEA are frequently described as relatively round compared with those of CCC/CCH, there are few morphometric studies to support this statement. The aim of this study was to provide objective data as to the nuclear shape in columnar cell lesions. As a shape descriptor, we adopted ellipticity that is defined by the formula 2b/2a, where a is the length of the long axis of the ellipse and b is the length of the short axis. Contrary to circularity, ellipticity reflects the overall configuration of an ellipse irrespective of surface irregularity. Our image analysis included generating whole slide images, extracting glandular cell nuclei, measuring nuclear ellipticity, and superimposing graded colors based on execution of results on the captured images. A total of 7917 nuclei extracted from 22 FEA images and 5010 nuclei extracted from 13 CCC/CCH images were analyzed. There was a significant difference in nuclear roundness between FEA and CCC/CCH with mean ellipticity values of 0.723 and 0.679, respectively (p < 0.001, Welch's t test). Furthermore, FEA with malignancy had significantly rounder nuclei than FEA without malignancy (p < 0.001). Our preliminary results suggest that nuclear ellipticity is a key parameter in reproducibly classifying columnar cell lesions of the breast. PMID:27026270

  17. Preclinical efficacy of a gastro-sparing novel thiazolidin-4-one in alleviating secondary lesions of polyarthritis: A multi-parametric approach.

    PubMed

    Mudgal, Jayesh; Gowdra, Vasantharaju S; Mudgal, Piya P; Nayak, Pawan G; Kumar, Nitesh; Attari, Zenab; Rao, C Mallikarjuna; Nampurath, Gopalan K

    2016-08-25

    The promising role of thiazolidin-4-ones (TZOs) against inflammatory conditions has been reported. From our lab, one of the TZO derivatives, compound 4C, exerted anti-inflammatory potential via inhibition of locally released cytokines and prostaglandin. In continuance, a detailed study was undertaken for the preclinical profiling of this promising TZO derivative against polyarthritis in rats, along with assessment of risk associated with the treatment. Male Sprague-Dawley rats were used for the adjuvant-induced arthritis (AIA) model. Based on the development of secondary lesion, the animals were randomized into different treatment groups. To establish the efficacy of the test compound, parameters such as inflammation, pain, disease progression, cytokines and prostaglandin (PG)-E2 levels and complete blood cell profile were recorded along with radiological and histological examinations of joints. The study also focused on evaluating the side effect of test compound on gastric, liver, renal, blood and cardiovascular components. Compound 4C exerted promising therapeutic effect against secondary lesions in polyarthritis in rats. It limited the progression of chronic inflammation and associated pain in rats. Modulation of cytokine signalling and arachidonate metabolism by 4C was evident from inhibition of interleukin (IL)-6, tumor necrosis factor (TNF)-α and PGE2 generation in AIA rats. Comparatively, compound 4C was safer than diclofenac to cause gastric, liver, renal, blood and cardiovascular toxicities. These finding supports the efficacy and safety profile of 4C, a TZO derivative in limiting the progression of arthritis when administered orally. PMID:27283483

  18. Differential diagnosis of primary petrous apex lesions.

    PubMed

    Arriaga, M A; Brackmann, D E

    1991-11-01

    Accurate preoperative diagnosis of petrous apex lesions is critical because the surgical approaches used for this region are different depending upon the specific disease process involved. While CT and MRI have each improved the accuracy of preoperative diagnosis of petrous apex pathology, these imaging studies are most helpful when used in conjunction with one another. When systematically applied, the combination of CT with contrast and MRI (with and without gadolinium) permits accurate differential diagnosis of primary petrous apex lesions. This review presents the imaging approach employed at the House Ear Clinic for the differential diagnosis of primary lesions of the petrous apex. PMID:1805645

  19. Combined periodontal and restorative approach to the treatment of gingival recessions with noncarious cervical lesions: a case treated with acellular dermal matrix allograft and compomer restorations.

    PubMed

    Efeoğlu, Ahmet; Hanzade, Mete; Sari, Esra; Alpay, Hande; Karakaş, Ozan; Koray, Fatma

    2012-08-01

    Treatment of gingival recessions has become one of the most challenging procedures in periodontal plastic surgery. Various surgical options with predictable outcomes are available, but in cases with cervical lesions or restorations, optimal functional and esthetic results may require the combination of periodontal and restorative procedures. In this case report, one patient treated with acellular dermal matrix allograft and a coronally positioned flap in combination with compomer cervical restorations is presented. Clinical parameters were recorded immediately prior to surgery and after 12 months. Postoperatively, significant root coverage, reductions in probing depths, and gains in clinical attachment were observed. The final clinical results, esthetics, color match, and tissue contours were acceptable to both the patient and clinicians. PMID:22577650

  20. Ghost cell lesions

    PubMed Central

    Rajesh, E.; Jimson, Sudha; Masthan, K. M. K.; Balachander, N.

    2015-01-01

    Ghost cells have been a controversy for a long time. Ghost cell is a swollen/enlarged epithelial cell with eosnophilic cytoplasm, but without a nucleus. In routine H and E staining these cells give a shadowy appearance. Hence these cells are also called as shadow cells or translucent cells. The appearance of these cells varies from lesion to lesion involving odontogenic and nonodontogenic lesions. This article review about the origin, nature and significance of ghost cells in different neoplasms. PMID:26015694

  1. [Surprising white lesions].

    PubMed

    Nolte, J W; van der Waal, I

    2011-09-01

    A 46-year-old man appeared with white lesions of the oral cavity. A previously taken biopsy revealed no classifying diagnosis and treatment with mouth rinse produced no improvement. A new biopsy was taken, on which the pathologist performed additional tests. This resulted in the diagnosis 'syphilis'. The patient was treated with benzylpenicillin and the oral white lesions disappeared. Although nowadays syphilis is rare, special attention is required when noticing these kinds of lesions of the oral cavity. PMID:21957637

  2. A Population Approach to Characterize Interferon Beta-1b Effect on Contrast Enhancing Lesions in Patients With Relapsing Remitting Multiple Sclerosis

    PubMed Central

    Gulati, A; Bagnato, F; Villoslada, P; Velez de Mendizabal, N

    2015-01-01

    In patients with relapsing-remitting multiple sclerosis (RRMS), interferon beta-1b (IFNβ-1b) reduces the occurrence of contrast enhancing lesions (CELs) on magnetic resonance imaging (MRI). Questions remain on the stability of IFNβ-1b effect over time and its action beyond the reduction of CELs. In this study, we described the IFNβ-1b effect by a mixed effects model, quantifying the interpatient variability associated with its parameters. Using a negative binomial distribution model as a natural history model, the effect of IFNβ-1b was evaluated using different mathematical functions of time. IFNβ-1b produced a decrease in the expected CEL numbers, inhibiting the formation of new CELs but did not promote the resolution of the already-formed ones. Based on the final selected model, simulations were carried out to optimize the combined IFNβ-1b-corticosteroid therapy as a proof-of-concept. In summary, we provide evidence on the dynamics of CELs under IFNβ-1b treatment that can be used to monitor the effects of therapies in MS. PMID:26225255

  3. A Population Approach to Characterize Interferon Beta-1b Effect on Contrast Enhancing Lesions in Patients With Relapsing Remitting Multiple Sclerosis.

    PubMed

    Gulati, A; Bagnato, F; Villoslada, P; Velez de Mendizabal, N

    2015-05-01

    In patients with relapsing-remitting multiple sclerosis (RRMS), interferon beta-1b (IFNβ-1b) reduces the occurrence of contrast enhancing lesions (CELs) on magnetic resonance imaging (MRI). Questions remain on the stability of IFNβ-1b effect over time and its action beyond the reduction of CELs. In this study, we described the IFNβ-1b effect by a mixed effects model, quantifying the interpatient variability associated with its parameters. Using a negative binomial distribution model as a natural history model, the effect of IFNβ-1b was evaluated using different mathematical functions of time. IFNβ-1b produced a decrease in the expected CEL numbers, inhibiting the formation of new CELs but did not promote the resolution of the already-formed ones. Based on the final selected model, simulations were carried out to optimize the combined IFNβ-1b-corticosteroid therapy as a proof-of-concept. In summary, we provide evidence on the dynamics of CELs under IFNβ-1b treatment that can be used to monitor the effects of therapies in MS. PMID:26225255

  4. Retrograde crossing for chronic total occlusion lesions: the Japanese way.

    PubMed

    Takano, Masamichi; Mizuno, Kyoichi

    2008-01-01

    Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions remains one of the major challenges in the field of interventional cardiology. Crossing guidewires through the CTO lesions has been conventionally performed from the proximal arteries to the lesions as an antegrade approach. To date, a retrograde approach, to penetrate PCI devices including guidewires and balloons into the distal end of CTO lesions via collateral vessels or coronary artery bypass grafts, has been attempted in order to achieve procedural success. With introduction of the retrograde approach for treatments of CTO lesions, several kinds of devices, techniques, and strategies have been developed. Although the techniques and strategies for the retrograde approach have not been worldwide accepted to interventional cardiologists, we introduce a way to obtain recanalization of the CTO lesions using the retrograde approach in this article. PMID:19276488

  5. Preinvasive lesions

    Cancer.gov

    This definition is for allocation of lesions with preinvasive/borderline properties. It is currently aimed at newly identified neoplasms, which may be similar to those described in humans. In mouse pathology, many adenomas may be preinvasive/borderline lesions. However, their inclusion in the preinvasive category can be justified only upon development of better diagnostic criteria.

  6. Noninfectious penile lesions.

    PubMed

    Teichman, Joel M H; Sea, Jason; Thompson, Ian M; Elston, Dirk M

    2010-01-15

    Family physicians commonly diagnose and manage penile cutaneous lesions. Noninfectious lesions may be classified as inflammatory and papulosquamous (e.g., psoriasis, lichen sclerosus, angiokeratomas, lichen nitidus, lichen planus), or as neoplastic (e.g., carcinoma in situ, invasive squamous cell carcinoma). The clinical presentation and appearance of the lesions guide the diagnosis. Psoriasis presents as red or salmon-colored plaques with overlying scales, often with systemic lesions. Lichen sclerosus presents as a phimotic, hypopigmented prepuce or glans penis with a cellophane-like texture. Angiokeratomas are typically asymptomatic, well-circumscribed, red or blue papules, whereas lichen nitidus usually produces asymptomatic pinhead-sized, hypopigmented papules. The lesions of lichen planus are pruritic, violaceous, polygonal papules that are typically systemic. Carcinoma in situ should be suspected if the patient has velvety red or keratotic plaques of the glans penis or prepuce, whereas invasive squamous cell carcinoma presents as a painless lump, ulcer, or fungating irregular mass. Some benign lesions, such as psoriasis and lichen planus, can mimic carcinoma in situ or squamous cell carcinoma. Biopsy is indicated if the diagnosis is in doubt or neoplasm cannot be excluded. The management of benign penile lesions usually involves observation or topical corticosteroids; however, neoplastic lesions generally require surgery. PMID:20082512

  7. Extragastric Dieulafoy's lesion

    PubMed Central

    Gauci, James; Galea, Samuel; Galea, Joseph; Schembri, Mark

    2014-01-01

    A 74-year-old man on warfarin for aortic valve replacement presented with recurrent episodes of melaena. An initial oesophagogastroduodenoscopy (OGD) was normal, as were red cell scanning and colonoscopy. It was a third OGD that revealed the cause of the melaena—a vascular lesion in the duodenum, at the junction between D1 and D2. An extragastric Dieulafoy's lesion was diagnosed, and the lesion was injected with epinephrine and tattooed. Over the following months, episodes of bleeding recurred despite further attempts at injection. Percutaneous radiologically assisted embolisation of the gastroduodenal artery, and eventually duodenotomy and oversuturing of the lesion were performed to no avail. The patient has undergone over 10 endoscopies, and has received over 70 units of packed red cells to date, since his initial presentation 6 years ago. Attempts to stop the bleeding permanently have been difficult, highlighting the complexity of managing such a lesion. PMID:25216921

  8. [Liver ultrasound: focal lesions and diffuse diseases].

    PubMed

    Segura Grau, A; Valero López, I; Díaz Rodríguez, N; Segura Cabral, J M

    2016-01-01

    Liver ultrasound is frequently used as a first-line technique for the detection and characterization of the most common liver lesions, especially those incidentally found focal liver lesions, and for monitoring of chronic liver diseases. Ultrasound is not only used in the Bmode, but also with Doppler and, more recently, contrast-enhanced ultrasound. It is mainly used in the diagnosis of diffuse liver diseases, such as steatosis or cirrhosis. This article presents a practical approach for diagnosis workup, in which the different characteristics of the main focal liver lesions and diffuse liver diseases are reviewed. PMID:25523277

  9. Oral Lesions in Neonates

    PubMed Central

    Rao, Roopa S; Majumdar, Barnali; Jafer, Mohammed; Maralingannavar, Mahesh; Sukumaran, Anil

    2016-01-01

    ABSTRACT Oral lesions in neonates represent a wide range of diseases often creating apprehension and anxiety among parents. Early examination and prompt diagnosis can aid in prudent management and serve as baseline against the future course of the disease. The present review aims to enlist and describe the diagnostic features of commonly encountered oral lesions in neonates. How to cite this article: Patil S, Rao RS, Majumdar B, Jafer M, Maralingannavar M, Sukumaran A. Oral Lesions in Neonates. Int J Clin Pediatr Dent 2016;9(2):131-138. PMID:27365934

  10. Oral Lesions in Neonates.

    PubMed

    Patil, Shankargouda; Rao, Roopa S; Majumdar, Barnali; Jafer, Mohammed; Maralingannavar, Mahesh; Sukumaran, Anil

    2016-01-01

    Oral lesions in neonates represent a wide range of diseases often creating apprehension and anxiety among parents. Early examination and prompt diagnosis can aid in prudent management and serve as baseline against the future course of the disease. The present review aims to enlist and describe the diagnostic features of commonly encountered oral lesions in neonates. How to cite this article: Patil S, Rao RS, Majumdar B, Jafer M, Maralingannavar M, Sukumaran A. Oral Lesions in Neonates. Int J Clin Pediatr Dent 2016;9(2):131-138. PMID:27365934

  11. Retinal lesions in septicemia.

    PubMed

    Neudorfer, M; Barnea, Y; Geyer, O; Siegman-Igra, Y

    1993-12-15

    We explored the association between septicemia and specific retinal lesions in a prospective controlled study. Hemorrhages, cotton-wool spots, or Roth's spots were found in 24 of 101 septicemic patients (24%), compared to four of 99 age- and gender-matched control patients (4%) (P = .0002). There was no significant association between types of organisms or focus of infection and the presence of specific lesions. Histologic examination of affected eyes disclosed cytoid bodies in the nerve fiber layer without inflammation. A definite association between septicemia and retinal lesions was found and indicates the need for routine ophthalmoscopy in septicemic patients. PMID:8250076

  12. Successful Revascularization of an LCx CTO Lesion by Retrograde Approach From an Acute Thrombotic SVG Without Protection Device in an ACS Patient.

    PubMed

    Lin, Mei Mei; Wang, Ji Hung

    2016-05-25

    We describe a patient who underwent coronary artery bypass grafting (CABG) surgery with the presentation of acute coronary syndrome (ACS). The diagnostic coronary angiogram showed acute thrombotic and occluded saphenous vein graft (SVG) and proximal right coronary artery (RCA) drug eluting stent (DES) instent restenosis (ISR) with chronic total occlusion (CTO). Our strategy was to recanalize the native left circumflex coronary artery (LCx) CTO instead of SVG or RCA instent CTO. After heparinization for 5 days, the LCx antegrade approach and the retrograde approach from left anterior descending coronary artery (LAD) septal branches were first attempted but failed, and the LCx CTO was successfully revascularized retrogradely via the acute thrombotic SVG without an embolic protection device (EPD). PMID:27170471

  13. Talar Dome Lesion

    MedlinePlus

    ... be helpful in reducing the pain and inflammation. Physical therapy . Range-of-motion and strengthening exercises are beneficial once the lesion is adequately healed. Physical therapy may also include techniques to reduce pain and ...

  14. Hypervascular liver lesions.

    PubMed

    Kamaya, Aya; Maturen, Katherine E; Tye, Grace A; Liu, Yueyi I; Parti, Naveen N; Desser, Terry S

    2009-10-01

    Hypervascular hepatocellular lesions include both benign and malignant etiologies. In the benign category, focal nodular hyperplasia and adenoma are typically hypervascular. In addition, some regenerative nodules in cirrhosis may be hypervascular. Malignant hypervascular primary hepatocellular lesions include hepatocellular carcinoma, fibrolamellar carcinoma, and peripheral cholangiocarcinoma. Vascular liver lesions often appear hypervascular because they tend to follow the enhancement of the blood pool; these include hemangiomas, arteriovenous malformations, angiosarcomas, and peliosis. While most gastrointestinal malignancies that metastasize to the liver will appear hypovascular on arterial and portal-venous phase imaging, certain cancers such as metastatic neuroendocrine tumors (including pancreatic neuroendocrine tumors, carcinoid, and gastrointestinal stromal tumors) tend to produce hypervascular metastases due to the greater recruitment of arterial blood supply. Finally, rare hepatic lesions such as glomus tumor and inflammatory pseudotumor may have a hypervascular appearance. PMID:19842564

  15. Uterine Vascular Lesions

    PubMed Central

    Vijayakumar, Abhishek; Srinivas, Amruthashree; Chandrashekar, Babitha Moogali; Vijayakumar, Avinash

    2013-01-01

    Vascular lesions of the uterus are rare; most reported in the literature are arteriovenous malformations (AVMs). Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, cesarean delivery, and curettage. It can be seen from these reports that there is confusion concerning the terminology of uterine vascular lesions. There is also a lack of diagnostic criteria and management guidelines, which has led to an increased number of unnecessary invasive procedures (eg, angiography, uterine artery embolization, hysterectomy for abnormal vaginal bleeding). This article familiarizes readers with various vascular lesions of the uterus and their management. PMID:24340126

  16. Evaluation of Parotid Lesions.

    PubMed

    Kuan, Edward C; Mallen-St Clair, Jon; St John, Maie A

    2016-04-01

    The differential diagnosis of a parotid lesion is broad, and the otolaryngologist must consider inflammatory, neoplastic, autoimmune, traumatic, infectious, or congenital causes. A comprehensive history and physical examination, in conjunction with judicious use of radiographic imaging (MRI, computed tomography, ultrasonography, nuclear medicine studies), laboratory studies, and pathologic analysis (fine-needle aspiration, core biopsy, incisional biopsy), facilitates making an accurate diagnosis. This article reviews the key history and physical elements and adjunctive diagnostic tools available for working up parotid lesions. PMID:26902978

  17. Multiple Osteolytic Lesions

    PubMed Central

    Vinayachandran, Divya; Sankarapandian, Sathasivasubramanian

    2013-01-01

    Several systemic diseases initially present with various oral manifestations. Investigation of these oral symptoms may at times lead to the diagnosis of grave underlying life-threatening conditions. We present one such case, where the patient manifested with gross enlargement of the mandible, along with lesions in the lower limbs. These lesions were the initial manifestation and on further investigations the patient was diagnosed with multiple myeloma. PMID:24516769

  18. Colorectal Subepithelial Lesions

    PubMed Central

    2015-01-01

    Most of subepithelial lesion (SEL) being identified was accidentally discovered as small bulging lesion covered with normal mucosa from endoscopic screening. The type of treatment and prognosis vary depending on the type of tumor, it would be crucial to perform an accurate differential diagnosis. Since the differentiation of SEL relied on the indirect findings observed from the mucosal surface using an endoscopy only in the past, it was able to confirm the presence of lesion only but difficult to identify complex detailed nature of the lesion. However, after the endoscopic ultrasonography (EUS) was introduced, it became possible to identify extrinsic compression, and size of intramural tumors, internal properties and contour so that it gets possible to have differential diagnosis of lesions and prediction on the lesion whether it is malignant or benign. In addition, the use of EUS-guided fine needle aspiration and EUS-guided core biopsy made it possible to make histological differential diagnosis. This study intended to investigate endoscopic and EUS findings, histological diagnosis, treatment regimen and impression of colorectal SELs. PMID:26240803

  19. Imaging of skull base lesions.

    PubMed

    Kelly, Hillary R; Curtin, Hugh D

    2016-01-01

    Skull base imaging requires a thorough knowledge of the complex anatomy of this region, including the numerous fissures and foramina and the major neurovascular structures that traverse them. Computed tomography (CT) and magnetic resonance imaging (MRI) play complementary roles in imaging of the skull base. MR is the preferred modality for evaluation of the soft tissues, the cranial nerves, and the medullary spaces of bone, while CT is preferred for demonstrating thin cortical bone structure. The anatomic location and origin of a lesion as well as the specific CT and MR findings can often narrow the differential diagnosis to a short list of possibilities. However, the primary role of the imaging specialist in evaluating the skull base is usually to define the extent of the lesion and determine its relationship to vital neurovascular structures. Technologic advances in imaging and radiation therapy, as well as surgical technique, have allowed for more aggressive approaches and improved outcomes, further emphasizing the importance of precise preoperative mapping of skull base lesions via imaging. Tumors arising from and affecting the cranial nerves at the skull base are considered here. PMID:27432686

  20. Characterizing lesions in corals from American Samoa

    USGS Publications Warehouse

    Work, Thierry M.; Rameyer, R.A.

    2005-01-01

    The study of coral disease has suffered from an absence of systematic approaches that are commonly used to determine causes of diseases in animals. There is a critical need to develop a standardized and portable nomenclature for coral lesions in the field and to incorporate more commonly available biomedical tools in coral disease surveys to determine the potential causes of lesions in corals. We characterized lesions in corals from American Samoa based on gross and microscopic morphology and classified them as discoloration, growth anomalies, or tissue loss. The most common microscopic finding in corals manifesting discoloration was the depletion of zooxanthellae, followed by necrosis, sometimes associated with invasive algae or fungi. The most common microscopic lesion in corals manifesting tissue loss was cell necrosis often associated with algae, fungi, or protozoa. Corals with growth anomaly had microscopic evidence of hyperplasia of gastrovascular canals, followed by necrosis associated with algae or metazoa (polychaete worms). Several species of apparently normal corals also had microscopic changes, including the presence of bacterial aggregates or crustacea in tissues. A single type of gross lesion (e.g., discoloration) could have different microscopic manifestations. This phenomenon underlines the importance of using microscopy to provide a more systematic description of coral lesions and to detect potential pathogens associated with these lesions.

  1. CASE-MATCHING ANALYSIS OF HEAD AND NECK SQUAMOUS CELL CARCINOMA IN RACIAL AND ETHNIC MINORITIES IN THE UNITED STATES—POSSIBLE ROLE FOR HUMAN PAPILLOMAVIRUS IN SURVIVAL DISPARITIES

    PubMed Central

    Schrank, Travis P.; Han, Yimei; Weiss, Heidi

    2010-01-01

    Background Several studies have documented disparities in head and neck cancer outcomes for black patients in the United States. Recent studies have found that differences in oropharyngeal tumor human papillomavirus (HPV) status may be a cause of this disparity. Methods In all, 76,817 cases of head and neck squamous cell carcinoma (HNSCC) recorded in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program were analyzed. Racial/ethnic groups were studied, for disease-specific survival in both case-matched and non-matched cohorts. Calculation of expected disparity magnitudes based on HPV status was performed using data reported in the literature. Results A disease-specific survival disparity was demonstrated for Hispanic patients. However, case matching eliminated this disparity. Conversely, the disparity for black patients persisted in matched cohorts. The oropharyngeal subsite was found to be the dominant contributor to this disparity. Conclusions The survival disparity for Hispanic patients in SEER with HNSCC is explained by differences in presentation and treatment. Also, HPV tumor status is likely a key determinant of the disparity for black patients. PMID:20848419

  2. Sampling probability distributions of lesions in mammograms

    NASA Astrophysics Data System (ADS)

    Looney, P.; Warren, L. M.; Dance, D. R.; Young, K. C.

    2015-03-01

    One approach to image perception studies in mammography using virtual clinical trials involves the insertion of simulated lesions into normal mammograms. To facilitate this, a method has been developed that allows for sampling of lesion positions across the cranio-caudal and medio-lateral radiographic projections in accordance with measured distributions of real lesion locations. 6825 mammograms from our mammography image database were segmented to find the breast outline. The outlines were averaged and smoothed to produce an average outline for each laterality and radiographic projection. Lesions in 3304 mammograms with malignant findings were mapped on to a standardised breast image corresponding to the average breast outline using piecewise affine transforms. A four dimensional probability distribution function was found from the lesion locations in the cranio-caudal and medio-lateral radiographic projections for calcification and noncalcification lesions. Lesion locations sampled from this probability distribution function were mapped on to individual mammograms using a piecewise affine transform which transforms the average outline to the outline of the breast in the mammogram. The four dimensional probability distribution function was validated by comparing it to the two dimensional distributions found by considering each radiographic projection and laterality independently. The correlation of the location of the lesions sampled from the four dimensional probability distribution function across radiographic projections was shown to match the correlation of the locations of the original mapped lesion locations. The current system has been implemented as a web-service on a server using the Python Django framework. The server performs the sampling, performs the mapping and returns the results in a javascript object notation format.

  3. What affects detectability of lesion-deficit relationships in lesion studies?

    PubMed

    Inoue, Kayo; Madhyastha, Tara; Rudrauf, David; Mehta, Sonya; Grabowski, Thomas

    2014-01-01

    Elucidating the brain basis for psychological processes and behavior is a fundamental aim of cognitive neuroscience. The lesion method, using voxel-based statistical analysis, is an important approach to this goal, identifying neural structures that are necessary for the support of specific mental operations, and complementing the strengths of functional imaging techniques. Lesion coverage in a population is by nature spatially heterogeneous and biased, systematically affecting the ability of lesion-deficit correlation methods to detect and localize functional associations. We have developed a simulator that allows investigators to model parameters in a lesion-deficit study and characterize the statistical bias in lesion deficit detection coverage that will result from specific assumptions. We used the simulator to assess the signal detection properties and localization accuracy of standard lesion-deficit correlation methods, under a simple truth model - that a critical region of interest (CR), when damaged, gives rise to a deficit. We considered voxel-based lesion-symptom mapping (VLSM) and proportional MAP-3 (PM3). Using regression analysis, we examined if the pattern of outcome statistics can be explained by simulation parameters, factors that are inherent to anatomic parcels, and lesion coverage of the population, which consisted of a representative sample of 351 subjects drawn from the Iowa Patient Registry. We examined the effect of using nonparametric versus parametric statistics to obtain thresholded maps and the effect of correcting for multiple comparisons using false discovery rate or cluster-based correction. Our results, which are derived from samples of realistic lesions, indicate that even a simple truth model yields localization errors that are systematic and pervasive, averaging 2 cm in the standard anatomic space, and tending to be directed towards areas of greater anatomic coverage. This displacement positions the center of mass of the detected

  4. Meniscal Ramp Lesions

    PubMed Central

    Chahla, Jorge; Dean, Chase S.; Moatshe, Gilbert; Mitchell, Justin J.; Cram, Tyler R.; Yacuzzi, Carlos; LaPrade, Robert F.

    2016-01-01

    Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and consequently, ramp lesions often go undiagnosed. Therefore, to rule out a ramp lesion, an arthroscopic evaluation with probing of the posterior horn of the medial meniscus should be performed. Several treatment options have been reported, including nonsurgical management, inside-out meniscal repair, or all-inside meniscal repair. In cases of isolated ramp lesions, a standard meniscal repair rehabilitation protocol should be followed. However, when a concomitant ACL reconstruction (ACLR) is performed, the rehabilitation should follow the designated ACLR postoperative protocol. The purpose of this article was to review the current literature regarding meniscal ramp lesions and summarize the pertinent anatomy, biomechanics, diagnostic strategies, recommended treatment options, and postoperative protocol. PMID:27504467

  5. [Minimally Invasive Thoracoscopic Surgery for Mediastinal Lesions].

    PubMed

    Maeda, Sumiko

    2016-07-01

    This review article describes minimally invasive thoracoscopic surgery for anterior mediastinal lesions. The operative procedures for anterior mediastinal lesions have been changed in a couple of decades from open surgery under median sternotomy to complete thoracoscopic mediastinal surgery with sternal lifting or carbon dioxide insufflation. Carbon dioxide insufflation of the thoracic cavity or the mediastinum is now prevailing to improve the surgical field and facilitate the operative procedures. Surgical indications for complete thoracoscopic mediastinal surgery include benign cystic lesions generally regardless of their size and non-invasive anterior mediastinal tumors usually less than 50~60 mm in the greatest dimension. There are currently three surgical approaches in the complete thoracoscopic surgery for the anterior mediastinal lesions. One is the unilateral or bilateral transthoracic approach. The second is the combination of the subxiphoid and the transthoracic approach. The last is the subxiphoid approach. The selection of the surgical approach depends on the surgeon's preference and experiences. When carbon dioxide insufflation is applied during the operation, following complications may occur;hypercapnia, gas embolism, subcutaneous emphysema, endotracheal tube dislocation due to the mediastinal sift, and hypotention. Special safety considerations are necessary during the complete thoracoscopic mediastinal surgery with carbon dioxide insufflation. PMID:27440034

  6. Endoscopic management of orbital apex lesions.

    PubMed

    Sethi, D S; Lau, D P

    1997-01-01

    Lesions of the orbital apex often present a diagnostic dilemma. Clinical assessment and imaging studies are helpful but a tissue biopsy is often required. The morbidity associated with transcranial approaches to the orbital apex may outweigh the benefits of obtaining a biopsy by these routes. Fine needle aspiration cytology of orbital apex lesions can be performed but there are disadvantages with this method. We describe a transnasal endoscopic technique to biopsy the orbital apex. The technique was used successfully to obtain a tissue diagnosis in six patients with orbital apex lesions. This enabled commencement of definitive treatment. There were no significant complications. The transnasal approach to the orbital apex using the endoscopes is reliable. Endoscopes provide excellent illumination, magnification, and a panoramic view of the operative field. PMID:9438058

  7. Genital lesions following bestiality.

    PubMed

    Mittal, A; Shenoi, S D; Kumar, K B; Sharma, P V

    2000-01-01

    A 48-year-old man presented with painful genital lesions with history of bestiality and abnor-mal sexual behaviour. Examination revealed multiple irregular tender ulcers and erosions, with phimosis and left sided tender inguinal adenopathy. VDRL, TPHA, HIV-ELISA were negative. He was treated with ciprofloxacin 500mg b.d. along with saline compresses with complete resolution. PMID:20877040

  8. The Pharmacologic Management of Common Lesions of the Oral Cavity.

    PubMed

    Radulescu, Mihai

    2016-04-01

    The oral ulcerations caused by aphtous lesions, herpetic lesions, candidiasis, ulcerative lichen planus, mucous membrane pemphigoid, and pemphigus vulgaris are managed in a step-up approach that can involve topical, intarlesional, and systemic pharmacologic management. This article reviews the common treatment agents, modalities, and dosages. The emphasis is on local pharmacologic therapies, yet systemic conditions that often present with such oral lesions are briefly reviewed, along with the appropriate management. PMID:27040292

  9. Optical discrimination between malignant and benign breast lesions

    NASA Astrophysics Data System (ADS)

    Quarto, Giovanna; Pifferi, Antonio; Cubeddu, Rinaldo; Ieva, Francesca; Paganoni, Anna Maria; Abbate, Francesca; Cassano, Enrico; Taroni, Paola

    2015-07-01

    Time domain multi-wavelength (635 to 1060 nm) optical mammography was performed on 82 subjects with breast lesions (45 malignant and 38 benign lesions). A perturbative approach based on the high-order calculation of the pathlength of photons inside the lesion was applied to estimate differences between lesion and average healthy tissue of the same breast in terms of: i) absorption properties, and ii) concentration of the major tissue constituents (oxy- and deoxy-hemoglobin, water, lipid and collagen). The absorption difference Δμa between lesion and healthy tissue is significantly different for malignant vs. benign lesions at all wavelengths. Logistic regression fitted to the absorption data identifies 975 nm as the key wavelength to discriminate malignant from benign lesions. When the difference in tissue composition between lesion and healthy tissue is considered, malignant lesions are characterized by significantly higher collagen content than benign lesions. Also the best model for the discrimination of malignant lesions obtained applying regression logistic to tissue composition is based only on collagen. Including demographic information into the model improves its specificity.

  10. Demyelinative chiamal lesions.

    PubMed

    Spector, R H; Glaser, J S; Schatz, N J

    1980-12-01

    To clarify the clinical syndrome of demyelinative chiasmal involvement, six case histories were analyzed and the literature was reviewed. This entitity is characterized by especial predilection for women in the third to fifth decades; visual deficites of a chiasmal pattern that may be modest to marked, with a generallly good prognosis for functional recovery; and other signs and symptoms, not necessarily severe, of scattered lesions of the neuraxis. Neuroradiological studies, especially laminography of the sellar area and computerized tomography, must be employed to rule out a suprasellar mass lesion. The efficacy of systemic corticosteroid therapy is moot, but it seems reasonable to use such agents during acute stages, especially where vision is severely reduced on both sides. PMID:7447764

  11. [Remineralizing methods in early caries lesions - review of the literature].

    PubMed

    Berczyński, Paweł; Gmerek, Anna; Buczkowska-Radlińska, Jadwiga

    2015-01-01

    Early diagnosis and treatment of early caries lesions are the basic tenets of minimally invasive dentistry. One of the key elements of a biological approach is the usage of remineralizing agents, which are great alternative to surgical intervention. This article shows a review of the literature concering materials used for the treatment of early caries lesions. PMID:27116859

  12. Adrenal imaging (Part 2): Medullary and secondary adrenal lesions

    PubMed Central

    Dhamija, Ekta; Panda, Ananya; Das, Chandan J.; Gupta, A. K.

    2015-01-01

    Adrenal malignancies can be either primary adrenal tumors or secondary metastases, with metastases representing the most common malignant adrenal lesion. While imaging cannot always clearly differentiate between various adrenal malignancies, presence of certain imaging features, in conjunction with appropriate clinical background and hormonal profile, can suggest the appropriate diagnosis. The second part of the article on adrenal imaging describes adrenal medullary tumors, secondary adrenal lesions, bilateral adrenal lesions, adrenal incidentalomas and provides an algorithmic approach to adrenal lesions based on current imaging recommendations. PMID:25593821

  13. Abfraction lesions: etiology, diagnosis, and treatment options.

    PubMed

    Nascimento, Marcelle M; Dilbone, Deborah A; Pereira, Patricia Nr; Duarte, Wagner R; Geraldeli, Saulo; Delgado, Alex J

    2016-01-01

    Abfraction is a type of noncarious cervical lesion (NCCL) characterized by loss of tooth tissues with different clinical appearances. Evidence supports that abfraction lesions, as any NCCLs, have a multifactorial etiology. Particularly, the cervical wear of abfraction can occur as a result of normal and abnormal tooth function and may also be accompanied by pathological wear, such as abrasion and erosion. The interaction between chemical, biological, and behavioral factors is critical and helps to explain why some individuals exhibit more than one type of cervical wear mechanism than others. In an era of personalized dentistry, patient risk factors for NCCLs must be identified and addressed before any treatment is performed. Marked variations exist in dental practice concerning the diagnosis and management of these lesions. The lack of understanding about the prognosis of these lesions with or without intervention may be a major contributor to variations in dentists' management decisions. This review focuses on the current knowledge and available treatment strategies for abfraction lesions. By recognizing that progressive changes in the cervical area of the tooth are part of a physiologically dynamic process that occurs with aging, premature and unnecessary intervention can be avoided. In cases of asymptomatic teeth, where tooth vitality and function are not compromised, abfraction lesions should be monitored for at least 6 months before any invasive procedure is planned. In cases of abfraction associated with gingival recession, a combined restorative-surgical approach may be performed. Restorative intervention and occlusal adjustment are not indicated as treatment options to prevent further tooth loss or progression of abfraction. The clinical decision to restore abfraction lesions may be based on the need to replace form and function or to relieve hypersensitivity of severely compromised teeth or for esthetic reasons. PMID:27217799

  14. Abfraction lesions: etiology, diagnosis, and treatment options

    PubMed Central

    Nascimento, Marcelle M; Dilbone, Deborah A; Pereira, Patricia NR; Duarte, Wagner R; Geraldeli, Saulo; Delgado, Alex J

    2016-01-01

    Abfraction is a type of noncarious cervical lesion (NCCL) characterized by loss of tooth tissues with different clinical appearances. Evidence supports that abfraction lesions, as any NCCLs, have a multifactorial etiology. Particularly, the cervical wear of abfraction can occur as a result of normal and abnormal tooth function and may also be accompanied by pathological wear, such as abrasion and erosion. The interaction between chemical, biological, and behavioral factors is critical and helps to explain why some individuals exhibit more than one type of cervical wear mechanism than others. In an era of personalized dentistry, patient risk factors for NCCLs must be identified and addressed before any treatment is performed. Marked variations exist in dental practice concerning the diagnosis and management of these lesions. The lack of understanding about the prognosis of these lesions with or without intervention may be a major contributor to variations in dentists’ management decisions. This review focuses on the current knowledge and available treatment strategies for abfraction lesions. By recognizing that progressive changes in the cervical area of the tooth are part of a physiologically dynamic process that occurs with aging, premature and unnecessary intervention can be avoided. In cases of asymptomatic teeth, where tooth vitality and function are not compromised, abfraction lesions should be monitored for at least 6 months before any invasive procedure is planned. In cases of abfraction associated with gingival recession, a combined restorative-surgical approach may be performed. Restorative intervention and occlusal adjustment are not indicated as treatment options to prevent further tooth loss or progression of abfraction. The clinical decision to restore abfraction lesions may be based on the need to replace form and function or to relieve hypersensitivity of severely compromised teeth or for esthetic reasons. PMID:27217799

  15. Improving diagnosis of atraumatic splenic lesions, part I: nonneoplastic lesions.

    PubMed

    Ricci, Zina J; Oh, Sarah K; Chernyak, Victoria; Flusberg, Milana; Rozenblit, Alla M; Kaul, Bindu; Stein, Marjorie W; Mazzariol, Fernanda S

    2016-01-01

    Focal atraumatic splenic lesions often pose a diagnostic challenge on cross-sectional imaging. They can be categorized based on etiology as nonneoplastic (reviewed in Part I), benign neoplastic, and malignant neoplastic lesions. Lesions can also be characterized based on prevalence as common, uncommon, and rare. Familiarity with pertinent clinical parameters, etiology, pathology, prevalence, and ancillary features such as splenomegaly, concomitant hepatic involvement, and extrasplenic findings, in addition to knowledge of imaging spectra of these lesions, can improve diagnostic confidence. Since the nonneoplastic lesions are usually easily recognized, it is critical that the radiologist identifies them avoiding unnecessary work up. PMID:27317223

  16. T2 black lesions on routine knee MRI: differential considerations.

    PubMed

    Wadhwa, Vibhor; Cho, Gina; Moore, Daniel; Pezeshk, Parham; Coyner, Katherine; Chhabra, Avneesh

    2016-07-01

    The majority of abnormal findings or lesions on T2-weighted fast spin-echo (FSE) magnetic resonance imaging (MRI) are hyperintense due to increased perfusion or fluid content, such as infections, tumours or synovitis. Hypointense lesions on T2-weighted images (both fat-suppressed and non-fat-suppressed) are less common and can sometimes be overlooked. Such lesions have limited differential diagnostic possibilities, and include vacuum phenomenon, loose body, tenosynovial giant cell tumour, rheumatoid arthritis, haemochromatosis, gout, amyloid, chondrocalcinosis, hydroxyapetite deposition disease, lipoma arborescens, arthrofibrosis and iatrogenic lesions. These lesions often show characteristic appearances and predilections in the knee. In this article, the authors describe the MRI features of hypointense T2 lesions on routine knee MRI and outline a systematic diagnostic approach towards their evaluation. Key Points • Hypointense lesions on T2 images (T2 Dark Lesions) encompass limited diagnostic possibilities. • T2 Dark lesions often show characteristic appearances and predilections in the knee. • A systematic diagnostic approach will help radiologists make the correct diagnosis. PMID:26420500

  17. Cystic Lesions of the Mediastinum.

    PubMed

    Vargas, Daniel; Suby-Long, Thomas; Restrepo, Carlos S

    2016-06-01

    Cystic lesions are commonly seen in the mediastinum, and they may arise from virtually any organ. The vast majority of these lesions are benign and result in no symptoms. When large, cysts may produce symptoms related to compression of adjacent structures. The most common mediastinal cysts are pericardial and foregut duplication cysts. Both computed tomography and magnetic resonance are routinely used to evaluate these lesions. Although computed tomography offers superior spatial resolution, magnetic resonance is useful in differentiating cysts that contain proteinaceous material from solid lesions. Occasionally, cysts arise from solid lesions, such as thymoma or teratoma. Although cysts are alike in appearance, location helps narrowing the differential diagnoses. PMID:27261346

  18. [Multifocal Vitelliform Retinal Lesion].

    PubMed

    Streicher, T; Špirková, J; Ilavská, M

    2015-06-01

    The authors present retrospective follow up of patient with bilateral multifocal vitelliform retinal lesion during the 18 years period. At this time, spontaneous improvement of objective picture on retina and subjective visual troubles was observed. It is probable, that this case is a part of the same symptom complex as a variant of Best´s hereditary disease. This conclusion was based on initial stadium of phenotypical expressivity and additional evaluations. The course and outcomes of visual functions were different. The hereditary transmission was not confirmed. PMID:26201364

  19. Andersson lesion in ankylosing spondylitis.

    PubMed

    Dhakad, Urmila; Das, Siddharth K

    2013-01-01

    A middle-aged male patient developed acute back pain and a lumbar vertebral lesion following trivial physical trauma. The lesion was considered as tuberculous on vertebral x-rays and MRI. After biopsy of the lesion and spinal fixation, the patient was kept on empirical antituberculous treatment (ATT) to which he did not respond. On re-evaluation he was diagnosed to have an Andersson lesion in ankylosing spondylitis (AS). ATT was stopped and he was successfully managed by rest, steroids, methotrexate and sulfasalazine. A careful look at the patient's plain x-ray spine and awareness about the lesion can avoid misdiagnosis of this characteristic vertebral lesion found in AS. PMID:23559648

  20. Focal lesions in normal liver.

    PubMed

    Semelka, Richard C; Martin, Diego R; Balci, N Cem

    2005-10-01

    A variety of lesions occur in the normal liver. This review will describe the most common benign, malignant, and infectious lesions. Illustration will be made of the magnetic resonance imaging (MRI) appearance of the most common of these. Due to the high accuracy for liver lesion detection and characterization, and the intrinsic safety of the modality, MR should be considered the primary imaging tool to investigate liver diseases. PMID:16174062

  1. Pigmented Lesion of Buccal Mucosa

    PubMed Central

    Bajpai, Manas; Kumar, Malay; Kumar, Manish; Agarwal, Deshant

    2014-01-01

    Pigmented lesions are commonly found in the mouth. Such lesions represent a variety of clinical entities, ranging from physiologic changes to manifestation of systemic illness and malignant neoplasm. Diagnosis of such lesions requires a proper case history, extraoral and intraoral examination, and, in some cases, biopsy, aspiration cytology, and laboratory investigations. Here we present a case of purple lesion on the buccal mucosa of a 34-year-old male patient which was provisionally diagnosed as mucocele but on the basis of histopathological picture it was finally diagnosed as angiofibroma, and we also discuss the clinical and histopathological differential diagnosis. PMID:25161669

  2. Pigmented lesion of buccal mucosa.

    PubMed

    Bajpai, Manas; Kumar, Malay; Kumar, Manish; Agarwal, Deshant

    2014-01-01

    Pigmented lesions are commonly found in the mouth. Such lesions represent a variety of clinical entities, ranging from physiologic changes to manifestation of systemic illness and malignant neoplasm. Diagnosis of such lesions requires a proper case history, extraoral and intraoral examination, and, in some cases, biopsy, aspiration cytology, and laboratory investigations. Here we present a case of purple lesion on the buccal mucosa of a 34-year-old male patient which was provisionally diagnosed as mucocele but on the basis of histopathological picture it was finally diagnosed as angiofibroma, and we also discuss the clinical and histopathological differential diagnosis. PMID:25161669

  3. Nonneoplastic nasal lesions in rats and mice.

    PubMed Central

    Monticello, T M; Morgan, K T; Uraih, L

    1990-01-01

    Rodents are commonly used for inhalation toxicology studies, but until recently the nasal passages have often been overlooked or only superficially examined. The rodent nose is a complex organ in which toxicant-induced lesions may vary, depending on the test compound. A working knowledge of rodent nasal anatomy and histology is essential for the proper evaluation of these responses. Lack of a systematic approach for examining rodent nasal tissue has led to a paucity of information regarding nonneoplastic lesions in the rodent nose. Therefore, slides from the National Toxicology Program (NTP) and the Chemical Industry Institute of Toxicology (CIIT) were examined, and the literature was reviewed to assemble the spectrum of nonneoplastic rodent nasal pathology. Presented are lesions associated with the various types of epithelia lining the rodent nasal cavity plus lesions involving accessory nasal structures. Even though there are anatomic and physiologic differences between the rodent and human nose, both rats and mice provide valuable animal models for the study of nasal epithelial toxicity, following administration of chemical compounds. Images PLATE 1. PLATE 2. PLATE 3. PLATE 4. PLATE 5. PLATE 6. PLATE 7. PLATE 8. PLATE 9. PLATE 10. PLATE 11. PLATE 12. PLATE 13. PLATE 14. PLATE 15. PLATE 16. PLATE 17. PLATE 18. PLATE 19. PLATE 20. PLATE 21. PLATE 22. PLATE 23. PLATE 24. PLATE 25. PLATE 26. PLATE 27. PLATE 28. PLATE 29. PLATE 30. PLATE 31. PLATE 32. PLATE 33. PLATE 34. PLATE 35. PLATE 36. PLATE 37. PLATE 38. PMID:2200665

  4. Skin lesion image segmentation using Delaunay Triangulation for melanoma detection.

    PubMed

    Pennisi, Andrea; Bloisi, Domenico D; Nardi, Daniele; Giampetruzzi, Anna Rita; Mondino, Chiara; Facchiano, Antonio

    2016-09-01

    Developing automatic diagnostic tools for the early detection of skin cancer lesions in dermoscopic images can help to reduce melanoma-induced mortality. Image segmentation is a key step in the automated skin lesion diagnosis pipeline. In this paper, a fast and fully-automatic algorithm for skin lesion segmentation in dermoscopic images is presented. Delaunay Triangulation is used to extract a binary mask of the lesion region, without the need of any training stage. A quantitative experimental evaluation has been conducted on a publicly available database, by taking into account six well-known state-of-the-art segmentation methods for comparison. The results of the experimental analysis demonstrate that the proposed approach is highly accurate when dealing with benign lesions, while the segmentation accuracy significantly decreases when melanoma images are processed. This behavior led us to consider geometrical and color features extracted from the binary masks generated by our algorithm for classification, achieving promising results for melanoma detection. PMID:27215953

  5. Fortuitously discovered liver lesions

    PubMed Central

    Dietrich, Christoph F; Sharma, Malay; Gibson, Robert N; Schreiber-Dietrich, Dagmar; Jenssen, Christian

    2013-01-01

    The fortuitously discovered liver lesion is a common problem. Consensus might be expected in terms of its work-up, and yet there is none. This stems in part from the fact that there is no preventive campaign involving the early detection of liver tumors other than for patients with known liver cirrhosis and oncological patients. The work-up (detection and differential diagnosis) of liver tumors comprises theoretical considerations, history, physical examination, laboratory tests, standard ultrasound, Doppler ultrasound techniques, contrast-enhanced ultrasound (CEUS), computed tomography and magnetic resonance imaging, as well as image-guided biopsy. CEUS techniques have proved to be the most pertinent method; these techniques became part of the clinical routine about 10 years ago in Europe and Asia and are used for a variety of indications in daily clinical practice. CEUS is in many cases the first and also decisive technical intervention for detecting and characterizing liver tumors. This development is reflected in many CEUS guidelines, e.g., in the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) guidelines 2004, 2008 and 2012 as well as the recently published World Federation for Ultrasound in Medicine and Biology-EFSUMB guidelines 2012. This article sets out considerations for making a structured work-up of incidental liver tumors feasible. PMID:23745019

  6. Automated Detection of Lupus White Matter Lesions in MRI.

    PubMed

    Roura, Eloy; Sarbu, Nicolae; Oliver, Arnau; Valverde, Sergi; González-Villà, Sandra; Cervera, Ricard; Bargalló, Núria; Lladó, Xavier

    2016-01-01

    Brain magnetic resonance imaging provides detailed information which can be used to detect and segment white matter lesions (WML). In this work we propose an approach to automatically segment WML in Lupus patients by using T1w and fluid-attenuated inversion recovery (FLAIR) images. Lupus WML appear as small focal abnormal tissue observed as hyperintensities in the FLAIR images. The quantification of these WML is a key factor for the stratification of lupus patients and therefore both lesion detection and segmentation play an important role. In our approach, the T1w image is first used to classify the three main tissues of the brain, white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF), while the FLAIR image is then used to detect focal WML as outliers of its GM intensity distribution. A set of post-processing steps based on lesion size, tissue neighborhood, and location are used to refine the lesion candidates. The proposal is evaluated on 20 patients, presenting qualitative, and quantitative results in terms of precision and sensitivity of lesion detection [True Positive Rate (62%) and Positive Prediction Value (80%), respectively] as well as segmentation accuracy [Dice Similarity Coefficient (72%)]. Obtained results illustrate the validity of the approach to automatically detect and segment lupus lesions. Besides, our approach is publicly available as a SPM8/12 toolbox extension with a simple parameter configuration. PMID:27570507

  7. Automated Detection of Lupus White Matter Lesions in MRI

    PubMed Central

    Roura, Eloy; Sarbu, Nicolae; Oliver, Arnau; Valverde, Sergi; González-Villà, Sandra; Cervera, Ricard; Bargalló, Núria; Lladó, Xavier

    2016-01-01

    Brain magnetic resonance imaging provides detailed information which can be used to detect and segment white matter lesions (WML). In this work we propose an approach to automatically segment WML in Lupus patients by using T1w and fluid-attenuated inversion recovery (FLAIR) images. Lupus WML appear as small focal abnormal tissue observed as hyperintensities in the FLAIR images. The quantification of these WML is a key factor for the stratification of lupus patients and therefore both lesion detection and segmentation play an important role. In our approach, the T1w image is first used to classify the three main tissues of the brain, white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF), while the FLAIR image is then used to detect focal WML as outliers of its GM intensity distribution. A set of post-processing steps based on lesion size, tissue neighborhood, and location are used to refine the lesion candidates. The proposal is evaluated on 20 patients, presenting qualitative, and quantitative results in terms of precision and sensitivity of lesion detection [True Positive Rate (62%) and Positive Prediction Value (80%), respectively] as well as segmentation accuracy [Dice Similarity Coefficient (72%)]. Obtained results illustrate the validity of the approach to automatically detect and segment lupus lesions. Besides, our approach is publicly available as a SPM8/12 toolbox extension with a simple parameter configuration. PMID:27570507

  8. Cystic lesions of the pancreas

    PubMed Central

    Hruban, Ralph H.; Fukushima, Noriyoshi

    2008-01-01

    Summary In contrast to the relatively uniform pathology and the unyielding dismal outcome associated with infiltrating ductal adenocarcinoma of the pancreas, cystic lesions have a broad spectrum of gross and microscopic pathologies, and a range of clinical outcomes. The common cystic lesions of the pancreas are reviewed with emphasis on practical tips for distinguishing between the main entities. PMID:20953247

  9. Hamartomatous tongue lesions in children.

    PubMed

    Kreiger, Portia A; Ernst, Linda M; Elden, Lisa M; Kazahaya, Ken; Alawi, Faizan; Russo, Pierre A

    2007-08-01

    The incidence and spectrum of tongue lesions in children, in particular tongue hamartomas, is relatively unknown. We report a retrospective review of all tongue lesions seen at a major tertiary care children's hospital over an 18-year period with an emphasis on describing tongue hamartomas. A total of 135 tongue lesions were identified. Vascular/lymphatic lesions (36/135) were the most common followed by mucus extravasation phenomenon (22/135). Interestingly, hamartomatous lesions (18/135) were the third most common lesion category identified. Lingual hamartomas were predominantly submucosal in location and were classified histologically by tissue composition as follows: neurovascular (2/18), smooth muscle predominant (5/18), fat predominant (1/18), and smooth muscle and fat containing (10/18). All 5 smooth muscle predominant hamartomas also contained vasculature, and 1 case additionally contained salivary gland tissue. The single fat predominant hamartoma additionally contained vessels and salivary gland. The final 10 hamartomas contained varying amounts of both smooth muscle and fat, and also admixed combinations of vessels, nerves, and salivary glands. Two of these 10 cases additionally contained foci of choristomatous elements, including cutaneous adnexal structures and cartilage. Most patients with hamartomatous lesions were young, 2 years or less. Eight cases were congenital in origin. Females outnumbered males by 2:1. The majority of lesions (16/18) were dorsal in location, and 4 patients had a syndromic association, all oral-facial-digital syndrome. PMID:17667541

  10. Nonsurgical management of periapical lesions

    PubMed Central

    Fernandes, Marina; de Ataide, Ida

    2010-01-01

    Periapical lesions develop as sequelae to pulp disease. They often occur without any episode of acute pain and are discovered on routine radiographic examination. The incidence of cysts within periapical lesions varies between 6 and 55%. The occurrence of periapical granulomas ranges between 9.3 and 87.1%, and of abscesses between 28.7 and 70.07%. It is accepted that all inflammatory periapical lesions should be initially treated with conservative nonsurgical procedures. Studies have reported a success rate of up to 85% after endodontic treatment of teeth with periapical lesions. A review of literature was performed by using electronic and hand searching methods for the nonsurgical management of periapical lesions. Various methods can be used in the nonsurgical management of periapical lesions: the conservative root canal treatment, decompression technique, active nonsurgical decompression technique, aspiration-irrigation technique, method using calcium hydroxide, Lesion Sterilization and Repair Therapy, and the Apexum procedure. Monitoring the healing of periapical lesions is essential through periodic follow-up examinations. PMID:21217952

  11. Impairments in proverb interpretation following focal frontal lobe lesions.

    PubMed

    Murphy, Patrick; Shallice, Tim; Robinson, Gail; MacPherson, Sarah E; Turner, Martha; Woollett, Katherine; Bozzali, Marco; Cipolotti, Lisa

    2013-09-01

    The proverb interpretation task (PIT) is often used in clinical settings to evaluate frontal "executive" dysfunction. However, only a relatively small number of studies have investigated the relationship between frontal lobe lesions and performance on the PIT. We compared 52 patients with unselected focal frontal lobe lesions with 52 closely matched healthy controls on a proverb interpretation task. Participants also completed a battery of neuropsychological tests, including a fluid intelligence task (Raven's Advanced Progressive Matrices). Lesions were firstly analysed according to a standard left/right sub-division. Secondly, a finer-grained analysis compared the performance of patients with medial, left lateral and right lateral lesions with healthy controls. Thirdly, a contrast of specific frontal subgroups compared the performance of patients with medial lesions with patients with lateral frontal lesions. The results showed that patients with left frontal lesions were significantly impaired on the PIT, while in patients with right frontal lesions the impairments approached significance. Medial frontal patients were the only frontal subgroup impaired on the PIT, relative to healthy controls and lateral frontal patients. Interestingly, an error analysis indicated that a significantly higher number of concrete responses were found in the left lateral subgroup compared to healthy controls. We found no correlation between scores on the PIT and on the fluid intelligence task. Overall our results suggest that specific regions of the frontal lobes contribute to the performance on the PIT. PMID:23850600

  12. Rare cystic liver lesions: A diagnostic and managing challenge

    PubMed Central

    Bakoyiannis, Andreas; Delis, Spiros; Triantopoulou, Charina; Dervenis, Christos

    2013-01-01

    Cystic formations within the liver are a frequent finding among populations. Besides the common cystic lesions, like simple liver cysts, rare cystic liver lesions like cystadenocarcinoma should also be considered in the differential diagnosis. Thorough knowledge of each entity’s nature and course are key elements to successful treatment. Detailed search in PubMed, Cochrane Database, and international published literature regarding rare cystic liver lesions was carried out. In our research are included not only primary rare lesions like cystadenoma, hydatid cyst, and polycystic liver disease, but also secondary ones like metastasis from gastrointestinal stromal tumors lesions. Up-to date knowledge regarding diagnosis and management of rare cystic liver lesions is provided. A diagnostic and therapeutic algorithm is also proposed. The need for a multidisciplinary approach by a team including radiologists and surgeons familiar with liver cystic entities, diagnostic tools, and treatment modalities is stressed. Patients with cystic liver lesions must be carefully evaluated by a multidisciplinary team, in order to receive the most appropriate treatment, since many cystic liver lesions have a malignant potential and evolution. PMID:24282350

  13. Rare cystic liver lesions: a diagnostic and managing challenge.

    PubMed

    Bakoyiannis, Andreas; Delis, Spiros; Triantopoulou, Charina; Dervenis, Christos

    2013-11-21

    Cystic formations within the liver are a frequent finding among populations. Besides the common cystic lesions, like simple liver cysts, rare cystic liver lesions like cystadenocarcinoma should also be considered in the differential diagnosis. Thorough knowledge of each entity's nature and course are key elements to successful treatment. Detailed search in PubMed, Cochrane Database, and international published literature regarding rare cystic liver lesions was carried out. In our research are included not only primary rare lesions like cystadenoma, hydatid cyst, and polycystic liver disease, but also secondary ones like metastasis from gastrointestinal stromal tumors lesions. Up-to date knowledge regarding diagnosis and management of rare cystic liver lesions is provided. A diagnostic and therapeutic algorithm is also proposed. The need for a multidisciplinary approach by a team including radiologists and surgeons familiar with liver cystic entities, diagnostic tools, and treatment modalities is stressed. Patients with cystic liver lesions must be carefully evaluated by a multidisciplinary team, in order to receive the most appropriate treatment, since many cystic liver lesions have a malignant potential and evolution. PMID:24282350

  14. Radioguided occult lesion localization (ROLL) of the nonpalpable breast lesions.

    PubMed

    Zgajnar, J; Hocevar, M; Frkovic-Grazio, S; Hertl, K; Schweiger, E; Besic, N

    2004-01-01

    Standard localization techniques of the nonpalpable breast lesions (guide wire, carbon, skin marking) have several disadvantages. Radioguided occult lesion localization (ROLL) was recently proposed as a better alternative resulting in wider surgical margins and lower average specimen weight. The aim of our study was to compare ROLL to our previously published series of the standard guidewire localization, performed at the Institute of Oncology Ljubljana. ROLL was performed in 110 nonpalpable breast lesions. Human serum albumin macroaggregats, marked with 1.8-5.5 MBq 99mTc was injected in the nonpalpable lesion. During surgery the radioactive breast tissue was excised using hand held gamma probe. Nonpalpable breast lesions were excised in all 110 patients. The definitive histology revealed 32 invasive carcinomas, 19 DCIS, 5 LCIS in and 54 benign breast lesions. Mean specimen weight was 40 g which is less in comparison to 53 g of the guidewire series (p=0.002). Surgical margins were clear in 36/51 (70%) invasive breast cancer or DCIS patients and close or involved in 15/51 (30%) patients. Compared to the guidewire series, where 41/92 (44%) margins were clear and 51/92 (56%) were close or involved, the difference was statistically significant (p=0.005). ROLL proved to be superior to guidewire localization in our series, allowing excision of the nonpalpable breast lesion with wider surgical margins despite lower average specimen weight. PMID:15640944

  15. Automatic Classification of Specific Melanocytic Lesions Using Artificial Intelligence

    PubMed Central

    Jaworek-Korjakowska, Joanna; Kłeczek, Paweł

    2016-01-01

    Background. Given its propensity to metastasize, and lack of effective therapies for most patients with advanced disease, early detection of melanoma is a clinical imperative. Different computer-aided diagnosis (CAD) systems have been proposed to increase the specificity and sensitivity of melanoma detection. Although such computer programs are developed for different diagnostic algorithms, to the best of our knowledge, a system to classify different melanocytic lesions has not been proposed yet. Method. In this research we present a new approach to the classification of melanocytic lesions. This work is focused not only on categorization of skin lesions as benign or malignant but also on specifying the exact type of a skin lesion including melanoma, Clark nevus, Spitz/Reed nevus, and blue nevus. The proposed automatic algorithm contains the following steps: image enhancement, lesion segmentation, feature extraction, and selection as well as classification. Results. The algorithm has been tested on 300 dermoscopic images and achieved accuracy of 92% indicating that the proposed approach classified most of the melanocytic lesions correctly. Conclusions. A proposed system can not only help to precisely diagnose the type of the skin mole but also decrease the amount of biopsies and reduce the morbidity related to skin lesion excision. PMID:26885520

  16. Hyperechoic breast lesions: anatomopathological correlation and differential sonographic diagnosis*

    PubMed Central

    Medeiros, Marcelo Menezes; Graziano, Luciana; de Souza, Juliana Alves; Guatelli, Camila Souza; Poli, Miriam Rosalina B.; Yoshitake, Rafael

    2016-01-01

    Hyperechoic lesions are not a frequent finding at breasts ultrasonography, and most of times are associated with benign pathologies that do not require further evaluation. However, some neoplasms such as invasive breast carcinomas and metastases may present with hyperechogenicity. Thus, the knowledge about differential diagnoses and identification of signs of lesion aggressiveness are of great relevance to avoid unnecessary procedures or underdiagnosis, and to support the correct clinical/surgical approach. On the basis of such concepts, the present essay describes and illustrates the main features of hyperechoic lesions at breast ultrasonography in different cases, with anatomopathological correlation. PMID:26929460

  17. Dentition and lesion history.

    PubMed

    Eggertsson, H; Ferreira-Zandona, A

    2009-01-01

    Dental caries is a process that typically keeps recurring throughout life, and the consequences are too often seen as irreversible damage to the dentition. At various stages of life, different parts of the dentition are affected, and the effects continue to be seen in the dentition long after the events took place. They bear witness to previous occurrences of this process throughout the lifetime of an individual. This chapter reviews the linkage between the caries process and the dental caries lesion history of the human dentition. The prevalence and distribution of the caries burden are very variable and closely tied to cultural aspects. In the primary dentition, income and education have been found to be inversely associated with: (1) any early childhood caries and (2) the maxillary incisor caries pattern. A positive association between these caries patterns and minority ethnicity/race status was also identified. These patterns are different from those of the permanent dentition. Well-documented changes in caries prevalence have been observed throughout history, most closely tied to availability and amount of refined sugar consumed. Changes in caries rates are also well documented in the 20th century, mainly with the advent of fluoride in several forms, first as a steep decline and recently as being relatively unchanged. It is likely that there will be dramatic changes in the rates and distribution of dental caries in the future, due to changes in behavioural factors and therapeutic measures. The description drawn is based on the dental caries pattern experienced in modern western societies. PMID:19494678

  18. Spectrum of prostatic lesions

    PubMed Central

    2013-01-01

    Background Prostate gland of male reproductive system is about the size of walnut and surrounds the urethra. Most frequently encountered diseases affecting prostate are Prostatitis, Benign prostatic hyperplasia and Prostatic cancer .Our objective of study was to evaluate the spectrum and correlation of prostatic lesions with presenting complaints of patient. Methods It was a cross-sectional study conducted in Pathology Department of Dow Medical College, Dow University of Health Sciences during the period of 1st January 2010 to December 2012. Pathology department of Dow Medical College collected specimens from both Civil Hospital and Lyari General Hospital Karachi, Pakistan. Specimens were taken through transurethral resection of prostate (TURP), simple prostatectomy and radical prostatectomy. A questionnaire was made and information including name, age, ward name of hospital, laboratory number, clinical diagnosis and symptoms were noted in it. Data was entered and analyzed through SPSS 19. Result During the targeted months, 48 prostatic specimens were received with a mean age of 65.7 + -7.6 years. Common presenting complains were urinary retention in 23(47.9%) patients, followed by dribbling in 12(25%). Out of 48 patients, 42 have Benign Prostatic Hyperplasia and 6 have Prostatic Adenocarcinoma. Both Benign Prostatic Hyperplasia and Prostatic Adenocarcinoma were more prevalent in the age group of 60-70 years. Conclusion Frequency of prostatic cancer is on the rise and measures should be taken for its early detection. Screening protocols and awareness programs need to be introduced. Screening programs should be focused on level of androgens and molecular pathogenesis. PMID:24063260

  19. Lesion insertion in the projection domain: Methods and initial results

    SciTech Connect

    Chen, Baiyu; Leng, Shuai; Yu, Lifeng; Yu, Zhicong; Ma, Chi; McCollough, Cynthia

    2015-12-15

    Purpose: To perform task-based image quality assessment in CT, it is desirable to have a large number of realistic patient images with known diagnostic truth. One effective way of achieving this objective is to create hybrid images that combine patient images with inserted lesions. Because conventional hybrid images generated in the image domain fails to reflect the impact of scan and reconstruction parameters on lesion appearance, this study explored a projection-domain approach. Methods: Lesions were segmented from patient images and forward projected to acquire lesion projections. The forward-projection geometry was designed according to a commercial CT scanner and accommodated both axial and helical modes with various focal spot movement patterns. The energy employed by the commercial CT scanner for beam hardening correction was measured and used for the forward projection. The lesion projections were inserted into patient projections decoded from commercial CT projection data. The combined projections were formatted to match those of commercial CT raw data, loaded onto a commercial CT scanner, and reconstructed to create the hybrid images. Two validations were performed. First, to validate the accuracy of the forward-projection geometry, images were reconstructed from the forward projections of a virtual ACR phantom and compared to physically acquired ACR phantom images in terms of CT number accuracy and high-contrast resolution. Second, to validate the realism of the lesion in hybrid images, liver lesions were segmented from patient images and inserted back into the same patients, each at a new location specified by a radiologist. The inserted lesions were compared to the original lesions and visually assessed for realism by two experienced radiologists in a blinded fashion. Results: For the validation of the forward-projection geometry, the images reconstructed from the forward projections of the virtual ACR phantom were consistent with the images physically

  20. Automated delineation of stroke lesions using brain CT images

    PubMed Central

    Gillebert, Céline R.; Humphreys, Glyn W.; Mantini, Dante

    2014-01-01

    Computed tomographic (CT) images are widely used for the identification of abnormal brain tissue following infarct and hemorrhage in stroke. Manual lesion delineation is currently the standard approach, but is both time-consuming and operator-dependent. To address these issues, we present a method that can automatically delineate infarct and hemorrhage in stroke CT images. The key elements of this method are the accurate normalization of CT images from stroke patients into template space and the subsequent voxelwise comparison with a group of control CT images for defining areas with hypo- or hyper-intense signals. Our validation, using simulated and actual lesions, shows that our approach is effective in reconstructing lesions resulting from both infarct and hemorrhage and yields lesion maps spatially consistent with those produced manually by expert operators. A limitation is that, relative to manual delineation, there is reduced sensitivity of the automated method in regions close to the ventricles and the brain contours. However, the automated method presents a number of benefits in terms of offering significant time savings and the elimination of the inter-operator differences inherent to manual tracing approaches. These factors are relevant for the creation of large-scale lesion databases for neuropsychological research. The automated delineation of stroke lesions from CT scans may also enable longitudinal studies to quantify changes in damaged tissue in an objective and reproducible manner. PMID:24818079

  1. No Carious Cervical Lesions: Abfraction

    PubMed Central

    Shetty, Sumanth M; Shetty, Rashmi G; Mattigatti, Sudha; Managoli, Noopur A; Rairam, Surabhi G; Patil, Ashwini M

    2013-01-01

    Abfraction or Theory of Abfraction is a theory explaining the non-carious cervical lesions (NCCL). It suggests that they are caused by flexural forces, usually from cyclic loading; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating the enamel rods. Clinical aspect importance of these ineart lesions are at most important to be detected for early intervention and treatment modalities as options during the progression of the disease. How to cite this article: Shetty SM, Shetty RG, Mattigatti S, Managoli NA, Rairam SG, Patil AM. No Carious Cervical Lesions: Abfraction. J Int Oral Health 2013; 5(5):142-5. PMID:24324319

  2. Nerve lesioning with direct current

    NASA Astrophysics Data System (ADS)

    Ravid, E. Natalie; Shi Gan, Liu; Todd, Kathryn; Prochazka, Arthur

    2011-02-01

    Spastic hypertonus (muscle over-activity due to exaggerated stretch reflexes) often develops in people with stroke, cerebral palsy, multiple sclerosis and spinal cord injury. Lesioning of nerves, e.g. with phenol or botulinum toxin is widely performed to reduce spastic hypertonus. We have explored the use of direct electrical current (DC) to lesion peripheral nerves. In a series of animal experiments, DC reduced muscle force by controlled amounts and the reduction could last several months. We conclude that in some cases controlled DC lesioning may provide an effective alternative to the less controllable molecular treatments available today.

  3. MRI of Focal Liver Lesions.

    PubMed

    Albiin, Nils

    2012-05-01

    Magnetic resonance imaging, MRI has more advantages than ultrasound, computed tomography, CT, positron emission tomography, PET, or any other imaging modality in diagnosing focal hepatic masses. With a combination of basic T1 and T2 weighted sequences, diffusion weighted imaging, DWI, and hepatobiliary gadolinium contrast agents, that is gadobenate dimeglumine (Gd-BOPTA) and gadoxetic acid (Gd-EOB), most liver lesions can be adequately diagnosed. Benign lesions, as cyst, hemangioma, focal nodular hyperplasia, FNH or adenoma, can be distinguished from malignant lesions. In a non-cirrhotic liver, the most common malignant lesions are metastases which may be hypovascular or hypervascular. In the cirrhotic liver hepatocellular carcinoma, HCC, is of considerable importance. Besides, intrahepatic cholangiocarcinoma and other less common malignancies has to be assessed. In this review, the techniques and typical MRI features are presented as well as the new algorithm issued by American Association for the Study of the Liver Diseases (AASLD). PMID:23049491

  4. Electrocautery for Precancerous Anal Lesions

    Cancer.gov

    Results from a randomized clinical trial conducted in Amsterdam suggest that electrocautery is better than topical imiquimod or fluorouracil at treating potentially precancerous anal lesions in HIV-positive men who have sex with men.

  5. Benign Pediatric Salivary Gland Lesions.

    PubMed

    Carlson, Eric R; Ord, Robert A

    2016-02-01

    Salivary gland lesions are rare in pediatric patients. In addition, the types of salivary gland tumors are different in their distribution in specific sites in the major and minor salivary glands in children compared with adults. This article reviews benign neoplastic and nonneoplastic salivary gland disorders in pediatric patients to help clinicians to develop an orderly differential diagnosis that will lead to expedient treatment of pediatric patients with salivary gland lesions. PMID:26614702

  6. Hearing disorders in brainstem lesions.

    PubMed

    Celesia, Gastone G

    2015-01-01

    Auditory processing can be disrupted by brainstem lesions. It is estimated that approximately 57% of brainstem lesions are associated with auditory disorders. However diseases of the brainstem usually involve many structures, producing a plethora of other neurologic deficits, often relegating "auditory symptoms in the background." Lesions below or within the cochlear nuclei result in ipsilateral auditory-processing abnormalities detected in routine testing; disorders rostral to the cochlear nuclei may result in bilateral abnormalities or may be silent. Lesions in the superior olivary complex and trapezoid body show a mixture of ipsilateral, contralateral, and bilateral abnormalities, whereas lesions of the lateral lemniscus, inferior colliculus, and medial geniculate body do not affect peripheral auditory processing and result in predominantly subtle contralateral abnormalities that may be missed by routine auditory testing. In these cases psychophysical methods developed for the evaluation of central auditory function should be employed (e.g., dichotic listening, interaural time perception, sound localization). The extensive connections of the auditory brainstem nuclei not only are responsible for binaural interaction but also assure redundancy in the system. This redundancy may explain why small brainstem lesions are sometimes clinically silent. Any disorder of the brainstem (e.g., neoplasms, vascular disorders, infections, trauma, demyelinating disorders, neurodegenerative diseases, malformations) that involves the auditory pathways and/or centers may produce hearing abnormalities. PMID:25726288

  7. Unusual lesions of the mediastinum

    PubMed Central

    Shamsuddin, Fatima; Khadilkar, Urmila N; Saha, Debarshi

    2015-01-01

    Objectives: To study unusual lesions in the mediastinum, which do not originate from the thymus, lymph nodes, neural tissues or germ cells, and tissues that normally engender pathologic lesions in the mediastinum. Materials and Methods: Of the 65 cases seen, 12 unusual lesion were encountered in a 5½ year period from 2006 to 2011. Results: Two cases of nodular colloid goiter and one each of the mediastinal cyst, undifferentiated carcinoma, and Langerhans cell histiocytosis (LCH) affected the anterosuperior mediastinum. In the middle mediastinum, one case each of the mesothelioma, malignant gastrointestinal stromal tumor (GIST), squamous cell carcinoma (SCC), solitary fibrous tumor (SFT), and pleomorphic sarcoma (PS) was seen. One case of meningeal melanocytoma (Mme) and primary pleural liposarcoma (PL) involved the posterior mediastinum. Persistent disease was seen in LCH after 2 years. Of all the cases with malignant lesions, only the patient with SCC was alive after 1 year. Conclusion: The cases of primary and SCC, LCH, melanocytoma, liposarcoma and PS, and GIST are unexpected and very rarely have paradigms in the mediastinum. Radiologic impression and knowledge of the compartment where these lesions arose from hardly assisted in arriving at a definitive opinion as the lesions were not typical of this location. A high index of suspicion and the immunohistochemical profile facilitated the final diagnosis. PMID:26664161

  8. Ultrasound elastographic techniques in focal liver lesions

    PubMed Central

    Conti, Clara Benedetta; Cavalcoli, Federica; Fraquelli, Mirella; Conte, Dario; Massironi, Sara

    2016-01-01

    Elastographic techniques are new ultrasound-based imaging techniques developed to estimate tissue deformability/stiffness. Several ultrasound elastographic approaches have been developed, such as static elastography, transient elastography and acoustic radiation force imaging methods, which include point shear wave and shear wave imaging elastography. The application of these methods in clinical practice aims at estimating the mechanical tissues properties. One of the main settings for the application of these tools has been liver stiffness assessment in chronic liver disease, which has been studied mainly using transient elastography. Another field of application for these techniques is the assessment of focal lesions, detected by ultrasound in organs such as pancreas, prostate, breast, thyroid, lymph nodes. Considering the frequency and importance of the detection of focal liver lesions through routine ultrasound, some studies have also aimed to assess the role that elestography can play in studying the stiffness of different types of liver lesions, in order to predict their nature and thus offer valuable non-invasive methods for the diagnosis of liver masses. PMID:26973405

  9. Managing Carious Lesions: Consensus Recommendations on Terminology.

    PubMed

    Innes, N P T; Frencken, J E; Bjørndal, L; Maltz, M; Manton, D J; Ricketts, D; Van Landuyt, K; Banerjee, A; Campus, G; Doméjean, S; Fontana, M; Leal, S; Lo, E; Machiulskiene, V; Schulte, A; Splieth, C; Zandona, A; Schwendicke, F

    2016-05-01

    Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current words used in the literature for caries removal techniques, and 2) agreed terms and definitions, explaining how these were decided.Dental cariesis the name of the disease, and thecarious lesionis the consequence and manifestation of the disease-the signs or symptoms of the disease. The termdental caries managementshould be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereascarious lesion managementcontrols the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions' clinical manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm dentine; 2)stepwise removal-including stage 1,selective removal to soft dentine, and stage 2,selective removal to firm dentine6 to 12 mo later; and 3)nonselective removal to hard dentine-formerly known ascomplete caries removal(technique no longer recommended). Adoption of these terms, around managing dental caries and its sequelae, will facilitate improved understanding and communication among researchers and within dental educators and the wider clinical dentistry community. PMID:27099357

  10. Diode Laser Excision of Oral Benign Lesions

    PubMed Central

    Mathur, Ena; Sareen, Mohit; Dhaka, Payal; Baghla, Pallavi

    2015-01-01

    Introduction: Lasers have made tremendous progress in the field of dentistry and have turned out to be crucial in oral surgery as collateral approach for soft tissue surgery. This rapid progress can be attributed to the fact that lasers allow efficient execution of soft tissue procedures with excellent hemostasis and field visibility. When matched to scalpel, electrocautery or high frequency devices, lasers offer maximum postoperative patient comfort. Methods: Four patients agreed to undergo surgical removal of benign lesions of the oral cavity. 810 nm diode lasers were used in continuous wave mode for excisional biopsy. The specimens were sent for histopathological examination and patients were assessed on intraoperative and postoperative complications. Results: Diode laser surgery was rapid, bloodless and well accepted by patients and led to complete resolution of the lesions. The excised specimen proved adequate for histopathological examination. Hemostasis was achieved immediately after the procedure with minimal postoperative problems, discomfort and scarring. Conclusion: We conclude that diode lasers are rapidly becoming the standard of care in contemporary dental practice and can be employed in procedures requiring excisional biopsy of oral soft tissue lesions with minimal problems in histopathological diagnosis. PMID:26464781

  11. Automatic detection of red lesions in digital color fundus photographs.

    PubMed

    Niemeijer, Meindert; van Ginneken, Bram; Staal, Joes; Suttorp-Schulten, Maria S A; Abràmoff, Michael D

    2005-05-01

    The robust detection of red lesions in digital color fundus photographs is a critical step in the development of automated screening systems for diabetic retinopathy. In this paper, a novel red lesion detection method is presented based on a hybrid approach, combining prior works by Spencer et al. (1996) and Frame et al. (1998) with two important new contributions. The first contribution is a new red lesion candidate detection system based on pixel classification. Using this technique, vasculature and red lesions are separated from the background of the image. After removal of the connected vasculature the remaining objects are considered possible red lesions. Second, an extensive number of new features are added to those proposed by Spencer-Frame. The detected candidate objects are classified using all features and a k-nearest neighbor classifier. An extensive evaluation was performed on a test set composed of images representative of those normally found in a screening set. When determining whether an image contains red lesions the system achieves a sensitivity of 100% at a specificity of 87%. The method is compared with several different automatic systems and is shown to outperform them all. Performance is close to that of a human expert examining the images for the presence of red lesions. PMID:15889546

  12. Management of breast magnetic resonance imaging-detected lesions.

    PubMed

    Seely, Jean M

    2012-08-01

    Breast magnetic resonance imaging (MRI) has become an essential component of breast imaging. Whether it is used as a problem-solving tool or a screening test or for staging patients with breast cancer, it detects many lesions in the breast. The challenge for the radiologist is to distinguish significant from insignificant lesions and to direct their management. A brief summary of the terminology according to the American College of Radiologists lexicon will be provided. This review article will cover the differential diagnosis of enhancing lesions, including masses and nonmass enhancement, from benign and malignant causes. Some of the specific morphologic and kinetic features that help to differentiate benign from malignant lesions will be illustrated, and positive predictive values of these features will be reviewed. The various methods of investigating enhancing lesions of the breast will be discussed, including second-look ultrasound, ultrasound-guided biopsy, stereotactic biopsy, and MRI-guided biopsy. A practical approach to the management of MRI-detected lesions will include timing of follow-up, when to biopsy and when to ignore enhancing lesions in the breast. PMID:21798693

  13. Diagnosis and management of premalignant penile lesions

    PubMed Central

    Shabbir, Majid; Minhas, Suks; Muneer, Asif

    2011-01-01

    Diagnosing premalignant penile lesions from benign penile dermatoses presents a unique challenge. The rarity of these conditions and the low incidence of penile cancer mean that the majority of our knowledge is based on small, non-randomized, retrospective studies. The introduction of specialist penile cancer centres in the UK has resulted in the centralization of expertise and resources, and has furthered our understanding of the biological behaviour and management of this rare malignancy. We review the current trends in the approach to diagnosing and treating various premalignant penile conditions. PMID:21904571

  14. Dissociation between verbal response initiation and suppression after prefrontal lesions.

    PubMed

    Volle, Emmanuelle; de Lacy Costello, Angela; Coates, Laure M; McGuire, Catrin; Towgood, Karren; Gilbert, Sam; Kinkingnehun, Serge; McNeil, Jane E; Greenwood, Richard; Papps, Ben; van den Broeck, Martin; Burgess, Paul W

    2012-10-01

    Some of the most striking symptoms after prefrontal damage are reduction of behavioral initiation and inability to suppress automatic behaviors. However, the relation between these 2 symptoms and the location of the lesions that cause them are not well understood. This study investigates the cerebral correlates of initiation and suppression abilities assessed by the Hayling Sentence Completion Test, using the human lesion approach. Forty-five patients with focal brain lesions and 110 healthy matched controls were examined. We combined a classical group approach with 2 voxel-based lesion methods. The results show several critical prefrontal regions to Hayling Test performance, associated with either common or differential impairment in "initiation" and "suppression" conditions. A crucial role for medial rostral prefrontal cortex (BA 10) in the initiation condition was shown by both group and lesion-mapping methods. A posterior inferolateral lesion provoked both initiation and suppression slowness, although to different degrees. An orbitoventral region was associated with errors in the suppression condition. These findings are important for clinical practice since they indicate that the brain regions required to perform a widely used and sensitive neuropsychological test but also shed light on the regions crucial for distinct components of adaptative behaviors, in particular, rostral prefrontal cortex. PMID:22095216

  15. Dissociation between Verbal Response Initiation and Suppression after Prefrontal Lesions

    PubMed Central

    de Lacy Costello, Angela; Coates, Laure M.; McGuire, Catrin; Towgood, Karren; Gilbert, Sam; Kinkingnehun, Serge; McNeil, Jane E.; Greenwood, Richard; Papps, Ben; van den Broeck, Martin; Burgess, Paul W.

    2012-01-01

    Some of the most striking symptoms after prefrontal damage are reduction of behavioral initiation and inability to suppress automatic behaviors. However, the relation between these 2 symptoms and the location of the lesions that cause them are not well understood. This study investigates the cerebral correlates of initiation and suppression abilities assessed by the Hayling Sentence Completion Test, using the human lesion approach. Forty-five patients with focal brain lesions and 110 healthy matched controls were examined. We combined a classical group approach with 2 voxel-based lesion methods. The results show several critical prefrontal regions to Hayling Test performance, associated with either common or differential impairment in “initiation” and “suppression” conditions. A crucial role for medial rostral prefrontal cortex (BA 10) in the initiation condition was shown by both group and lesion-mapping methods. A posterior inferolateral lesion provoked both initiation and suppression slowness, although to different degrees. An orbitoventral region was associated with errors in the suppression condition. These findings are important for clinical practice since they indicate that the brain regions required to perform a widely used and sensitive neuropsychological test but also shed light on the regions crucial for distinct components of adaptative behaviors, in particular, rostral prefrontal cortex. PMID:22095216

  16. Autoimmune control of lesion growth in CNS with minimal damage

    NASA Astrophysics Data System (ADS)

    Mathankumar, R.; Mohan, T. R. Krishna

    2013-07-01

    Lesions in central nervous system (CNS) and their growth leads to debilitating diseases like Multiple Sclerosis (MS), Alzheimer's etc. We developed a model earlier [1, 2] which shows how the lesion growth can be arrested through a beneficial auto-immune mechanism. We compared some of the dynamical patterns in the model with different facets of MS. The success of the approach depends on a set of control parameters and their phase space was shown to have a smooth manifold separating the uncontrolled lesion growth region from the controlled. Here we show that an optimal set of parameter values exist in the model which minimizes system damage while, at once, achieving control of lesion growth.

  17. Oral pigmented lesions: Clinicopathologic features and review of the literature

    PubMed Central

    da Silva-Jorge, Rogério; Jorge, Jacks; Lopes, Márcio A.; Vargas, Pablo A.

    2012-01-01

    Diagnosis of pigmented lesions of the oral cavity and perioral tissues is challenging. Even though epidemiology may be of some help in orientating the clinician and even though some lesions may confidently be diagnosed on clinical grounds alone, the definitive diagnosis usually requires histopathologic evaluation. Oral pigmentation can be physiological or pathological, and exogenous or endogenous. Color, location, distribution, and duration as well as drugs use, family history, and change in pattern are important for the differential diagnosis. Dark or black pigmented lesions can be focal, multifocal or diffuse macules, including entities such as racial pigmentation, melanotic macule, melanocytic nevus, blue nevus, smoker’s melanosis, oral melanoacanthoma, pigmentation by foreign bodies or induced by drugs, Peutz-Jeghers syndrome, Addison´s disease and oral melanoma. The aim of this review is to present the main oral black lesions contributing to better approach of the patients. Key words:Pigmentation, melanin, oral, diagnosis, management. PMID:22549672

  18. Fast semi-automated lesion demarcation in stroke

    PubMed Central

    de Haan, Bianca; Clas, Philipp; Juenger, Hendrik; Wilke, Marko; Karnath, Hans-Otto

    2015-01-01

    Lesion–behaviour mapping analyses require the demarcation of the brain lesion on each (usually transverse) slice of the individual stroke patient's brain image. To date, this is generally thought to be most precise when done manually, which is, however, both time-consuming and potentially observer-dependent. Fully automated lesion demarcation methods have been developed to address these issues, but these are often not practicable in acute stroke research where for each patient only a single image modality is available and the available image modality differs over patients. In the current study, we evaluated a semi-automated lesion demarcation approach, the so-called Clusterize algorithm, in acute stroke patients scanned in a range of common image modalities. Our results suggest that, compared to the standard of manual lesion demarcation, the semi-automated Clusterize algorithm is capable of significantly speeding up lesion demarcation in the most commonly used image modalities, without loss of either lesion demarcation precision or lesion demarcation reproducibility. For the three investigated acute datasets (CT, DWI, T2FLAIR), containing a total of 44 patient images obtained in a regular clinical setting at patient admission, the reduction in processing time was on average 17.8 min per patient and this advantage increased with increasing lesion volume (up to 60 min per patient for the largest lesion volumes in our datasets). Additionally, our results suggest that performance of the Clusterize algorithm in a chronic dataset with 11 T1 images was comparable to its performance in the acute datasets. We thus advocate the use of the Clusterize algorithm, integrated into a simple, freely available SPM toolbox, for the precise, reliable and fast preparation of imaging data for lesion–behaviour mapping analyses. PMID:26413473

  19. [Focal liver lesion, incidental finding].

    PubMed

    Dietrich, C F; Jenssen, C

    2012-10-01

    The differential diagnosis of incidentally found Focal Liver Lesions (FLL) is complex. Screening procedures so far are only defined for patients with liver cirrhosis. Characterization of a FLL begins as soon as it is detected. Taking patients history and thorough clinical examination are essential. An imaging procedure that is used to detect liver masses should also allow the examiner to determine whether the lesion is benign or malignant. Conventional B-mode US and colour Doppler imaging are effective at detecting and characterizing typical liver cysts and calcifications. Laboratory data, computed tomography, magnetic resonance imaging and imaging guided liver biopsy are complementary methods.Contrast Enhanced Ultrasound (CEUS) is a well established diagnostic imaging technique for a variety of indications and applications. One of the most important applications is in the liver where it is frequently a first-line technique for the detection and diagnosis (characterization) of focal liver lesions (FLL). In this setting the accurate differentiation of benign from malignant lesions is critical to ensure the patient undergoes the appropriate therapeutic option. This has been documented in recently published guidelines, in particular in terms of the enhancement patterns of the most common FLL hemangioma, focal nodular hyperplasia hepatocellular adenoma and their differentiation from malignant lesions. In this article the role of CEUS in the characterization of incidentally found FLL is described. PMID:23033169

  20. Skin lesions in returning travellers.

    PubMed

    Korzeniewski, Krzysztof; Juszczak, Dariusz; Jerzemowski, Janusz

    2015-01-01

    Skin lesions, apart from diarrhoeas, fever of unknown origin, and respiratory tract infections belong to the most frequent medical problems in travellers returned from tropical and subtropical destinations, accounting more than 10% of reported cases. Most dermatoses have their clinical onset during travel, although some of them can occur after return. Travel-related dermatological problems can have a wide spectrum of clinical picture, from macular, popular or nodular rash, linear and migratory lesions, to plaques, vesicles, bullae, erosions or ulcers. Skin conditions in returning travellers may be of infectious and non-infectious aetiologies. Infectious lesions may be originally tropical (e.g. dengue, chikungunya, schistosomiasis, leishmaniasis, myiasis, tungiasis, loiasis), although the majority are cosmopolitan (arthropod bites, sunburns, allergic rashes). The evaluation of skin lesions depends on many factors, including immune status of patients, use of medicines, exposure on health hazards (fauna, flora, risky behaviours), as well as the time, duration and location of travel. As the number of travellers to tropical and subtropical destinations has been continuously rising, the number of skin illnesses has also been increasing. This means that specialists in travel medicine need to extend their knowledge of epidemiology, clinical features and diagnosis of travel-related health problems including skin lesions in returning travellers. PMID:26394319

  1. Brain lesions and eating disorders

    PubMed Central

    Uher, R; Treasure, J

    2005-01-01

    Objective: To evaluate the relation between lesions of various brain structures and the development of eating disorders and thus inform the neurobiological research on the aetiology of these mental illnesses. Method: We systematically reviewed 54 previously published case reports of eating disorders with brain damage. Lesion location, presence of typical psychopathology, and evidence suggestive of causal association were recorded. Results: Although simple changes in appetite and eating behaviour occur with hypothalamic and brain stem lesions, more complex syndromes, including characteristic psychopathology of eating disorders, are associated with right frontal and temporal lobe damage. Conclusions: These findings challenge the traditional view that eating disorders are linked to hypothalamic disturbance and suggest a major role of frontotemporal circuits with right hemispheric predominance in the pathogenesis. PMID:15897510

  2. Oral Lesions and Lymphoproliferative Disorders

    PubMed Central

    Castellarin, P.; Pozzato, G.; Tirelli, G.; Di Lenarda, R.; Biasotto, M.

    2010-01-01

    Lymphoproliferative disorders are heterogeneous malignancy characterized by the expansion of a lymphoid clone more or less differentiated. At the level of the oral cavity, the lymphoproliferative disorder can occur in various ways, most commonly as lymphoid lesions with extranodal externalization, but sometimes, oral lesions may represent a localization of a disease spread. With regard to the primary localizations of lymphoproliferative disorders, a careful examination of the head and neck, oral, and oropharyngeal area is necessary in order to identify suspicious lesions, and their early detection results in a better prognosis for the patient. Numerous complications have been described and frequently found at oral level, due to pathology or different therapeutic strategies. These complications require precise diagnosis and measures to oral health care. In all this, oral pathologists, as well as dental practitioners, have a central role in the treatment and long-term monitoring of these patients. PMID:20871659

  3. Renal lesions of nondomestic felids.

    PubMed

    Newkirk, K M; Newman, S J; White, L A; Rohrbach, B W; Ramsay, E C

    2011-05-01

    To comprehensively evaluate the occurrence of renal lesions in a variety of nondomestic felids, necropsy cases from 1978 to 2008 were reviewed from a municipal zoo and a large cat sanctuary for those in which the kidneys were examined histologically. Seventy exotic felids were identified (25 tigers, 18 lions, 6 cougars, 5 leopards, 3 snow leopards, 3 clouded leopards, 3 Canadian lynx, 2 ocelots, 2 bobcats, 2 cheetahs, 1 jaguar), and their histologic renal lesions were evaluated and compared. The most common lesion was tubulointerstitial nephritis (TIN); 36 of 70 (51%) cats were affected to some degree. Lymphocytic interstitial nephritis was the most common lesion in the tigers (9 of 25, 36%) and was rarely seen in other species. Although the renal pelvis was not available for all cats, 28 of 47 (60%) had some degree of lymphocytic pyelitis. There was no significant association between the presence of pyelitis and that of TIN. Only 1 cat had pyelonephritis. Renal papillary necrosis was present in 13 of 70 (19%) cats and was significantly associated with historical nonsteroidal anti-inflammatory drug treatment (odds ratio, 7.1; 95% confidence interval, 1.9 to 26.8). Only 1 cat (lion) had amyloid accumulation, and it was restricted to the corticomedullary junction. Primary glomerular lesions were absent in all cats. Intraepithelial pigment was identified in many of the cats but was not correlated with severity of TIN. Despite several previous reports describing primary glomerular disease or renal amyloidosis in exotic felids, these lesions were rare to absent in this population. PMID:20876911

  4. Can Small Lesions Induce Language Reorganization as Large Lesions Do?

    ERIC Educational Resources Information Center

    Maestu, Fernando; Saldana, Cristobal; Amo, Carlos; Gonzalez-Hidalgo, Mercedes; Fernandez, Alberto; Fernandez, Santiago; Mata, Pedro; Papanicolaou, Andrew; Ortiz, Tomas

    2004-01-01

    Shift of the cortical mechanisms of language from the usually dominant left to the non-dominant right hemisphere has been demonstrated in the presence of large brain lesions. Here, we report a similar phenomenon in a patient with a cavernoma over the anterolateral superior temporal gyrus associated with epilepsy. Language mapping was performed by…

  5. Lesion detectability in digital radiography

    NASA Astrophysics Data System (ADS)

    Gagne, Robert M.; Boswell, Jonathan S.; Myers, Kyle J.; Peter, Guillaume

    2001-06-01

    The usefulness of Fourier-based measures of imaging performance has come into question for the evaluation of digital imaging systems. Figures of merit such as detective quantum efficiency are relevant for linear, shift-invariant systems with stationary noise. However, no digital imaging system is shift invariant, and realistic images do not satisfy the stationarity condition. Our methods for task- based evaluation of imaging systems, based on lesion detectability, do not require such assumptions. We have computed the performance of Hotelling and nonprewhitening matched-filter observers for the task of lesion detection in digital radiography.

  6. Cutaneous lesions of the nose

    PubMed Central

    2010-01-01

    Skin diseases on the nose are seen in a variety of medical disciplines. Dermatologists, otorhinolaryngologists, general practitioners and general plastic and dermatologic surgeons are regularly consulted regarding cutaneous lesions on the nose. This article is the second part of a review series dealing with cutaneous lesions on the head and face, which are frequently seen in daily practice by a dermatologic surgeon. In this review, we focus on those skin diseases on the nose where surgery or laser therapy is considered a possible treatment option or that can be surgically evaluated. PMID:20525327

  7. BLACK LESIONS OF THE SKIN

    PubMed Central

    Becker, S. William

    1958-01-01

    Benign melanocytic lesions include lentigo, ephelid (freckle), pigmented nevus, sacral spot, blue nevus, and combined nevus and blue nevus. Malignant melanocytic lesions are melanomas, which arise from melanocytes at the epidermodermal junction, or, rarely, from blue nevi. They usually originate in brown plaques known as lentigo maligna, in pigmented nevi, or in normal skin. Melanoma is diagnosed clinically in less than 50 per cent of instances. Biopsy is therefore of great importance, since practically all melanoma can be cured by adequate early resection. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6.Figure 7.Figure 8. PMID:13511215

  8. Apraxia in deep cerebral lesions.

    PubMed Central

    Agostoni, E; Coletti, A; Orlando, G; Tredici, G

    1983-01-01

    In a series of 50 patients with cerebrovascular lesions (demonstrated with CT scan), seven patients had lesions located in the basal ganglia and/or thalamus. All these seven patients were apractic. Ideomotor apraxia was present in all patients; five also had constructional apraxia, and one had bucco-facial apraxia. None of the patients had utilisation apraxia. These observations indicated that apraxia is not only a "high cerebral (cortical) function", but may depend also on the integrity of subcortical circuits and structures. PMID:6619888

  9. Localized lesions in secondary syphilis.

    PubMed

    Dar, Nasser Rashid; Raza, Naeem

    2008-05-01

    The clinical manifestations of secondary syphilis are variable and can mimic many skin diseases, mostly being generalized and symmetrical in distribution. Localized lesions of secondary syphilis are rarely seen in dermatology clinics. We report an unusual presentation wherein a patient had localized lesions over face and soles only. There is a need for increased awareness on the part of physicians to recognize new patterns of syphilitic infection, together with a willingness to consider the diagnosis of syphilis in patients with unusual clinical features. PMID:18541087

  10. Management of precancerous lesions prior to conception and during pregnancy: a narrative review of the literature.

    PubMed

    Tseng, J-Y; Bastu, E; Gungor-Ugurlucan, F

    2012-11-01

    Special considerations aiming at preserving reproductive function have to be implemented when treating young patients with precancerous lesions of the lower genital tract. These high-grade lesions may progress into invasive cancer if left untreated. Currently, there are limited data on the impact of vulvar and vaginal precancerous lesions on fertility and its management during pregnancy. However, management and outcomes for cervical lesions have been extensively reported. The main approach for vulvar and vaginal lesions are maintaining anatomical function and cosmetics; whereas, treatment options for cervical precancerous lesions range from observation, cryotherapy or the more aggressive conisation. Gestational age is the most important factor in determining expectant management or surgical intervention. This narrative review draws attention to the relevant aspects of precancerous lesions of the lower genital tract, the potential effects and management prior to conception and during pregnancy. PMID:22966861

  11. Two Cases of the Laryngeal Cystic Lesions

    PubMed Central

    Kusunoki, Takeshi; Wada, Ryo; Homma, Hirotomo; Kidokoro, Yoshinobu; Yanai, Aya; Ikeda, Katsuhisa

    2016-01-01

    We experienced two rare cases with laryngeal cystic lesions (laryngocele and laryngeal cyst). In the first case, the laryngocele case was removed by laryngomicrosurgery using an oral approach under general anesthesia. In the second case, the magnetic resonance imaging demonstrated a dumbbell-type cyst with mucus widely extending from the laryngeal lumen to the neck through the thyroid cartilage. The patient had undergone chemotherapy for renal carcinoma with multiple lung and bone metastases. Therefore, we performed only fine needle aspiration rather than aggressive surgery for extirpation of the cyst using an external approach. This fine needle aspiration could improve the quality of life by decreasing both the left laryngeal swelling and the resulting pain, which were the chief complaints. PMID:27162605

  12. Red lesion detection using background estimation and lesions characteristics in diabetic retinal image

    NASA Astrophysics Data System (ADS)

    Zhang, Dongbo; Peng, Yinghui; Yi, Yao; Shang, Xingyu

    2013-10-01

    Detection of red lesions [hemorrhages (HRs) and microaneurysms (MAs)] is crucial for the diagnosis of early diabetic retinopathy. A method based on background estimation and adapted to specific characteristics of HRs and MAs is proposed. Candidate red lesions are located by background estimation and Mahalanobis distance measure and then some adaptive postprocessing techniques, which include vessel detection, nonvessel exclusion based on shape analysis, and noise points exclusion by double-ring filter (only used for MAs detection), are conducted to remove nonlesion pixels. The method is evaluated on our collected image dataset, and experimental results show that it is better than or approximate to other previous approaches. It is effective to reduce the false-positive and false-negative results that arise from incomplete and inaccurate vessel structure.

  13. Imaging inflammatory acne: lesion detection and tracking

    NASA Astrophysics Data System (ADS)

    Cula, Gabriela O.; Bargo, Paulo R.; Kollias, Nikiforos

    2010-02-01

    It is known that effectiveness of acne treatment increases when the lesions are detected earlier, before they could progress into mature wound-like lesions, which lead to scarring and discoloration. However, little is known about the evolution of acne from early signs until after the lesion heals. In this work we computationally characterize the evolution of inflammatory acne lesions, based on analyzing cross-polarized images that document acne-prone facial skin over time. Taking skin images over time, and being able to follow skin features in these images present serious challenges, due to change in the appearance of skin, difficulty in repositioning the subject, involuntary movement such as breathing. A computational technique for automatic detection of lesions by separating the background normal skin from the acne lesions, based on fitting Gaussian distributions to the intensity histograms, is presented. In order to track and quantify the evolution of lesions, in terms of the degree of progress or regress, we designed a study to capture facial skin images from an acne-prone young individual, followed over the course of 3 different time points. Based on the behavior of the lesions between two consecutive time points, the automatically detected lesions are classified in four categories: new lesions, resolved lesions (i.e. lesions that disappear completely), lesions that are progressing, and lesions that are regressing (i.e. lesions in the process of healing). The classification our methods achieve correlates well with visual inspection of a trained human grader.

  14. Altered serial position learning after frontal lobe lesion.

    PubMed

    Eslinger, P J; Grattan, L M

    1994-06-01

    The serial position function is a powerful and highly reliable feature of human learning, with well-described primacy and recency effects. We tested the hypothesis that frontal lobe lesions in patients would disrupt the serial position function since such patients are known to have disturbed temporal ordering, learning in the presence of interference, encoding and organizational approaches to learning. Performance was compared in patients with focal, acquired lesions of frontal and non-frontal cortices, using a standardized paradigm of verbal list learning. Results indicated a similar pattern of performance on first trial learning for the two groups. However, across learning trials, frontal lesion subjects failed to maintain significant primacy and recency effects. Non-frontal lesion subjects consistently showed the expected U-shaped serial position curve across all trials. Subjective organization in learning was particularly deficient in the dorsolateral frontal lesion subjects. We propose that serial position effects are qualitatively different after frontal lobe lesion, being transitory and prone to alteration by the cumulative effects of disturbed temporal-spatial processing across learning trials. PMID:8084427

  15. Cystic Lesions in Autoimmune Pancreatitis.

    PubMed

    Gompertz, Macarena; Morales, Claudia; Aldana, Hernán; Castillo, Jaime; Berger, Zoltán

    2015-01-01

    Autoimmune pancreatitis (AIP) can be chronic or recurrent, but frequently completely reversible after steroid treatment. A cystic lesion in AIP is a rare finding, and it can mimic a pancreatic cystic neoplasm. Difficulties in an exact diagnosis interfere with treatment, and surgery cannot be avoided in some cases. We report the history of a 63-year-old male presenting with jaundice and pruritus. AIP was confirmed by imaging and elevated IgG4 blood levels, and the patient completely recovered after corticosteroid therapy. One year later, he presented with a recurrent episode of AIP with elevated IgG4 levels, accompanied by the appearance of multiple intrapancreatic cystic lesions. All but 1 of these cysts disappeared after steroid treatment, but the remaining cyst in the pancreatic head was even somewhat larger 1 year later. Pancreatoduodenectomy was finally performed. Histology showed the wall of the cystic lesion to be fibrotic; the surrounding pancreatic tissue presented fibrosis, atrophy and lymphoplasmacytic infiltration by IgG4-positive cells, without malignant elements. Our case illustrates the rare possibility that cystic lesions can be part of AIP. These pseudocysts appear in the pancreatic segments involved in the autoimmune disease and can be a consequence of the local inflammation or related to ductal strictures. Steroid treatment should be initiated, after which these cysts can completely disappear with recovery from AIP. Surgical intervention may be necessary in some exceptional cases. PMID:26675058

  16. Neuromuscular lesions in restrained rabbits.

    PubMed

    Mendlowski, B

    1975-01-01

    Ten of 16 rabbits restrained 6 h daily for 35 days developed focal to diffuse degeneration of the sciatic nerves. Very small necrotic areas also were found in the skeletal muscles of seven of 16 rabbits, but the muscle lesions did not correlate with the nerve changes. PMID:180647

  17. Cystic lesions of the pancreas

    PubMed Central

    Karoumpalis, Ioannis; Christodoulou, Dimitrios K.

    2016-01-01

    Different types of benign or malignant cystic lesions can be observed in the pancreas. Pancreatic cystic lesions are classified under pathology terms into simple retention cysts, pseudocysts and cystic neoplasms. Mucinous cystic neoplasm is a frequent type of cystic neoplasm and has a malignant potential. Serous cystadenoma follows in frequency and is usually benign. Intraductal papillary mucinous neoplasms are the most commonly resected cystic pancreatic neoplasms characterized by dilated segments of the main pancreatic duct and/or side branches, the wall of which is covered by mucus secreting cells. These neoplasms can occupy the pancreatic head or any part of the organ. Solid pseudopapillary tumor is rare, has a low tendency for malignancy, and is usually located in the pancreatic body or tail. Endoscopic ultrasound with the use of fine-needle aspiration and cytology permits discrimination of those lesions. In this review, the main characteristics of those lesions are presented, as well as recommendations regarding their follow up and management according to recent guidelines. PMID:27065727

  18. Cystic lesions of the pancreas.

    PubMed

    Karoumpalis, Ioannis; Christodoulou, Dimitrios K

    2016-01-01

    Different types of benign or malignant cystic lesions can be observed in the pancreas. Pancreatic cystic lesions are classified under pathology terms into simple retention cysts, pseudocysts and cystic neoplasms. Mucinous cystic neoplasm is a frequent type of cystic neoplasm and has a malignant potential. Serous cystadenoma follows in frequency and is usually benign. Intraductal papillary mucinous neoplasms are the most commonly resected cystic pancreatic neoplasms characterized by dilated segments of the main pancreatic duct and/or side branches, the wall of which is covered by mucus secreting cells. These neoplasms can occupy the pancreatic head or any part of the organ. Solid pseudopapillary tumor is rare, has a low tendency for malignancy, and is usually located in the pancreatic body or tail. Endoscopic ultrasound with the use of fine-needle aspiration and cytology permits discrimination of those lesions. In this review, the main characteristics of those lesions are presented, as well as recommendations regarding their follow up and management according to recent guidelines. PMID:27065727

  19. Odontogenic lesions in pediatric patients.

    PubMed

    Fang, Qi-Gen; Shi, Shuang; Sun, Chang-Fu

    2014-05-01

    The purpose was to evaluate our 20-year experience of pediatric odontogenic lesions. Pediatric patients with a diagnosis of odontogenic lesion were identified. Three hundred ten patients were odontogenic; dentigerous cyst was seen in 62.0% of the cases. Most (70.2%) of them occurred in mixed dentition period, and it had a male preponderance. Odontogenic keratocystic tumor occurred in the permanent dentition period. It had an equal site distribution. Odontoma was seen in 20.0% of the cases. Its site of predilection was the mandible. Ameloblastoma was the most common odontogenic tumor. Most of the cases occurred in the permanent dentition period. It affected the male and female equally. Calcifying epithelioma odontogenic tumor was seen in 11.8% of the cases. All the lesions occurred in the primary dentition period. It had no sex or site preponderance. Myxoma was seen in 3.6% of the cases. It was most common in the permanent dentition period, and it was more frequent in the male. Iliac crest bone graft was successfully performed in 28 patients, postoperative infection occurred in 2 patients, and no donor-site dysfunctions were reported. The observed differences in lesion type and distribution in this study compared with previous researches may be attributable to genetic and geographic variation in the populations studied. Iliac crest bone graft was suggested for pediatric mandible reconstruction. PMID:24785745

  20. Molecular imaging of cerebrovascular lesions.

    PubMed

    Chalouhi, Nohra; Jabbour, Pascal; Magnotta, Vincent; Hasan, David

    2014-04-01

    Inflammation is a key component in the pathogenesis of cerebrovascular lesions. Two agents have emerged as promising possibilities for imaging cerebrovascular lesions. These agents are ferumoxytol and myeloperoxidase (MPO)-specific paramagnetic magnetic resonance (MR) contrast agent. Ferumoxytol is an iron oxide nanoparticle coated by a carbohydrate shell that is used in MRI studies as an inflammatory marker as it is cleared by macrophages. Ferumoxytol-enhanced MRI allows noninvasive assessment of the inflammatory status of cerebral aneurysms and arteriovenous malformations and, possibly, may differentiate "unstable" lesions that require early intervention from "stable" lesions that can be safely observed. Several pilot studies have also suggested that MPO-specific paramagnetic MR contrast agent, di-5-hydroxytryptamide of gadopentetate dimeglumine, may allow imaging of inflammation in the wall of saccular aneurysms in animal models. However, studies in human subjects have yet to be performed. In this paper, we review current data regarding ferumoxytol-enhanced MRI and MPO-specific paramagnetic MR contrast agent and discuss current and future applications. PMID:24323714

  1. SLAP lesions: a treatment algorithm.

    PubMed

    Brockmeyer, Matthias; Tompkins, Marc; Kohn, Dieter M; Lorbach, Olaf

    2016-02-01

    Tears of the superior labrum involving the biceps anchor are a common entity, especially in athletes, and may highly impair shoulder function. If conservative treatment fails, successful arthroscopic repair of symptomatic SLAP lesions has been described in the literature particularly for young athletes. However, the results in throwing athletes are less successful with a significant amount of patients who will not regain their pre-injury level of performance. The clinical results of SLAP repairs in middle-aged and older patients are mixed, with worse results and higher revision rates as compared to younger patients. In this population, tenotomy or tenodesis of the biceps tendon is a viable alternative to SLAP repairs in order to improve clinical outcomes. The present article introduces a treatment algorithm for SLAP lesions based upon the recent literature as well as the authors' clinical experience. The type of lesion, age of patient, concomitant lesions, and functional requirements, as well as sport activity level of the patient, need to be considered. Moreover, normal variations and degenerative changes in the SLAP complex have to be distinguished from "true" SLAP lesions in order to improve results and avoid overtreatment. The suggestion for a treatment algorithm includes: type I: conservative treatment or arthroscopic debridement, type II: SLAP repair or biceps tenotomy/tenodesis, type III: resection of the instable bucket-handle tear, type IV: SLAP repair (biceps tenotomy/tenodesis if >50 % of biceps tendon is affected), type V: Bankart repair and SLAP repair, type VI: resection of the flap and SLAP repair, and type VII: refixation of the anterosuperior labrum and SLAP repair. PMID:26818554

  2. [Application of Interventional Bronchoscopy in Pulmonary Peripheral Lesions].

    PubMed

    Wang, Hui; Huang, Linian

    2016-08-20

    Lung cancer is the leading cause of cancer-related mortality worldwide. A low cure rate of lung cancer is not only attributed to intrinsic aggressive biological behavior, but also little attention to lung cancer screening. With lung screening methods continuous progress, peripheral pulmonary lesions detection rate gradually increased. Currently, a transbronchial approach using a bronchoscope or computed tompgraphy (CT) guided transthoracic needle aspiration/biopsy have been the most generally accepted methods for diagnosing peripheral pulmonary lesions. However, conventional bronchoscopy has a poor diagnostic yield and CT-guided approach has high rates of pneumothorax for such peripheral pulmonary lesions. Therefore, clinicians will be challenged with the task of providing the means to provide a safe and minimally invasive method of obtaining accurate tissue diagnostics for the pulmonary peripheral lesions. New bronchoscopic interventional diagnosis technologies have recommended in clinical gradually. They can effectively improve the peripheral pulmonary lesions diagnosis rate, shorten the time of diagnosis, and make the patients get timely and effective treatment. In this paper, we reviewed briefly available technologies to aid clinicians in attempts at minimally invasive techniques. PMID:27561808

  3. Hock lesions and free-stall design.

    PubMed

    Weary, D M; Taszkun, I

    2000-04-01

    We compared the prevalence and severity of skin lesions on the hocks of lactating dairy cows in southern British Columbia, comparing 20 farms using three common bedding surfaces: sawdust, sand, and geotextile mattresses. Skin lesions were scored at five positions on the hock. For each position we noted if the lesion showed inflammatory attributes, and then assigned a severity score. Of the 1752 lactating cows scored, 1267 cows (73%) had at least one hock lesion. Of those cows with lesions, 87% had lesions on both legs, 76% had lesions on more than one location on the hock, and 78% had a lesion of at least moderate severity (i.e., evidence of skin breakage or an area of hair loss >10 cm2). Lesions were most prevalent on farms that used geotextile mattresses (91% of cows) and least common on farms that used sand (24% of cows). Moreover, lesions on cows from farms using mattresses were more numerous and more severe than those on cows from sand-bedded farms. The prevalence and severity of lesions on farms using sawdust was intermediate. Lesions also varied in relation to location on the hock. For farms using geotextile mattresses, lesions were more common and more severe on the lateral surfaces of both the tuber calcis and the tarsal joint. On farms using sawdust, lesions were common on the dorsal surface of the tuber calcis and the lateral surfaces of both the tuber calcis and the tarsal joint. Lesions were rare on all five positions for cows from sand-bedded farms. Among the 10 farms sampled using sawdust, we found a significant negative relationship between the length of the stall and severity of lesions. For cows with lesions, the number and severity of lesions increased with age. PMID:10791785

  4. Granuloma faciale with extrafacial lesions.

    PubMed

    Rossiello, Luigi; Palla, Marco; Aiello, Francesco Saviero; Baroni, Adone; Satriano, Rocco Alfredo

    2007-01-01

    A 35-year-old man presented with a 7-year history of gradually enlarging plaques on his face and trunk. The first lesions had developed on both sides of the forehead and the left cheekbone (Figure 1). Four years later similar lesions appeared on his neck and back. He presented a histologic report of a biopsy specimen from a facial plaque performed 5 years earlier that was diagnostic for granuloma faciale. He had different treatments such as topical steroids and cryotherapy without improvement. The appearance of new lesions on his trunk and the gradual enlarging of the old lesions convinced the patient to seek further treatment. Physical examination revealed dusky, violaceous plaques and papules, 0.5 to 2 cm, well-circumscribed, slightly elevated, and located on the face and trunk, with mild pruritus (Figure 1 and Figure 2). Laboratory investigations, including complete blood cell count, VDRL test, antinuclear antibody test, biochemical parameters, and chest x-ray, did not reveal any abnormalities. A skin biopsy taken from the upper part of the back showed similar features to the facial lesion, detected 5 years before, revealing a dense, polymorphous infiltrate involving mid and deep dermis and displaying a diffuse and perivascular pattern (Figure 3A). A narrow grenz zone of normal collagen was consistently observed between dermal infiltrate and epidermis as well as around the pilosebaceous follicles (Figure 3A). The infiltrate mainly consisted of eosinophils and lymphocytes, but neutrophils (often displaying leukocytoclasis), macrophages, and plasma cells were also present (Figures 3B, 3C). Some mast cells were also identified by staining with toluidine blue (Figure 3D). Perivascular infiltrates were often seen, sometimes penetrating vessel walls and in association with leukocytoclasis. Hyalinization of vessel walls, extravasation of red blood cells around capillaries, and nuclear dust were also noted. The epidermis did not show any remarkable change except for

  5. CT-Guided Percutaneous Biopsy of Intrathoracic Lesions

    PubMed Central

    Lal, Hira; Nath, Alok; Borah, Samudra

    2012-01-01

    Percutaneous CT-guided needle biopsy of mediastinal and pulmonary lesions is a minimally invasive approach for obtaining tissue for histopathological examination. Although it is a widely accepted procedure with relatively few complications, precise planning and detailed knowledge of various aspects of the biopsy procedure is mandatory to avert complications. In this pictorial review, we reviewed important anatomical approaches, technical aspects of the procedure, and its associated complications. PMID:22438689

  6. Dispelling myths concerning pigmented skin lesions.

    PubMed

    Piccolo, V; Russo, T; Giacomel, J; Lallas, A; Alfano, R; Argenziano, G

    2016-06-01

    The history of medicine is replete with examples of debunked myths, and in daily clinical dermatological practice, we must still counter many misconceptions regarding pigmented lesions, both with patients and other medical practitioners. Debunking myths and attempting to explain the reasons for these erroneous beliefs are the purposes of this review. The literature review has been partially guided by the results obtained from an online questionnaire conducted on an Italian website (www.vediamocichiara.it) from February 15, 2015 to March 15, 2015. The remaining discussed were selected on the basis of the existing literature and our personal experience. In order to explore these misconceptions, the following are the seven most salient questions that require investigation: (i) Is it dangerous to excise moles?; (ii) Is it dangerous to traumatize moles?; (iii) Are plantar moles worrisome?; (iv) Is it necessary to selectively apply sunscreen to moles?; (v) Is it inadvisable to partially biopsy a melanoma?; (vi) Do moles turn into melanoma?; and (vii) Is it necessary to perform sentinel lymph node biopsy for thin melanomas and for atypical Spitz naevi? Myths are ubiquitous, being prevalent in dermatological practice, with many of them concerning pigmented skin lesions. By encouraging critical analysis by patients and medical practitioners, the birth and perpetuation of myths can potentially be minimized, for the ultimate benefit of patients. This requires a scientific approach to be rigorously applied to dermatology, with critical questioning of unsubstantiated hypotheses including those emanating from the mass media as well as from respected sources. PMID:26840917

  7. Massive lower gastrointestinal bleeding from a jejunal Dieulafoy lesion

    PubMed Central

    Kozan, Ramazan; Gülen, Merter; Yılmaz, Tonguç Utku; Leventoğlu, Sezai; Yılmaz, Erdal

    2014-01-01

    Dieulafoy lesion should be considered in massive gastrointestinal bleeding that may be difficult to localize. If the endoscopic and angiographic approaches fail, surgery must be considered according to the patient’s clinical condition within an appropriate time. Although mostly seen in the stomach of old male patients with co-morbidities, here we presented a Dieulafoy lesion in the jejunum of a 21-year-old female patient without any significant comorbidity. After endoscopic and angiographic attempts, surgical resection with the help of intraoperative endoscopy was performed. It was shown that perioperative endoscopy may reveal the localization of jejunal bleedings and may guide the definitive treatment. PMID:25931935

  8. Massive lower gastrointestinal bleeding from a jejunal Dieulafoy lesion.

    PubMed

    Kozan, Ramazan; Gülen, Merter; Yılmaz, Tonguç Utku; Leventoğlu, Sezai; Yılmaz, Erdal

    2014-01-01

    Dieulafoy lesion should be considered in massive gastrointestinal bleeding that may be difficult to localize. If the endoscopic and angiographic approaches fail, surgery must be considered according to the patient's clinical condition within an appropriate time. Although mostly seen in the stomach of old male patients with co-morbidities, here we presented a Dieulafoy lesion in the jejunum of a 21-year-old female patient without any significant comorbidity. After endoscopic and angiographic attempts, surgical resection with the help of intraoperative endoscopy was performed. It was shown that perioperative endoscopy may reveal the localization of jejunal bleedings and may guide the definitive treatment. PMID:25931935

  9. Brain lesions affect penile reflexes.

    PubMed

    Monaghan, E P; Arjomand, J; Breedlove, S M

    1993-03-01

    Electrolytic lesions of several potential brain afferents to the spinal nucleus of the bulbocavernosus (SNB) affect the display of penile reflexes. Ablation of the median and pontine raphe areas significantly potentiates the expression of cups and flips. Animals with a bilateral lesion of the paraventricular nucleus of the hypothalamus have a shorter latency to the first erection but otherwise display normal reflex behavior. Although bilateral destruction of the lateral vestibular nucleus (LVN) completely eliminated penile reflex activity, it also caused significant motor impairment thus clouding conclusions concerning the normal role of the LVN in penile reflex behavior. These and other results support the hypothesis that these brain regions which project to the SNB region normally modulate spinal reflex behavior of the rat penis. PMID:8440513

  10. Cytologic diagnosis of pulmonary lesions.

    PubMed

    Rossi, Esther Diana; Mulè, Antonino; Maggiore, Claudia; Miraglia, Antonella; Lauriola, Libero; Vecchio, Fabio Maria; Fadda, Guido

    2004-01-01

    The major types of cytologic preparations used in most laboratories to detect the lesions of the lower respiratory tract (LRT) are examined. These methods include sputum, bronchial washing, bronchial brushing, bronchoalveolar lavage (BAL) and fine-needle aspiration biopsy (FNAB). Sputum represents the simplest and most cost-effective sampling method even though fiberoptic bronchoscopy and radiologic guided FNAB are superseding it as the first diagnostic choice in most cases. There are advantages and disadvantages associated with each technique:bronchial brushing and FNABs tend to preserve both the cellular details and their architectural arrangement whereas sputum and bronchial washing often cause a variable degree of cellular degeneration and fragmentation. As a result, most pulmonary lesions may be detected and correctly diagnosed if multiple techniques are used to acquire diagnostic material. CT-guided FNAB represents the most effective method to achieve a correct diagnosis in pulmonary tumors. PMID:15852720

  11. Are parenchymal AVMs congenital lesions?

    PubMed

    Morales-Valero, Saul F; Bortolotti, Carlo; Sturiale, Carmelo; Sturiale, Carmelo L; Lanzino, Giuseppe

    2014-09-01

    A long-held dogma in neurosurgery is that parenchymal arteriovenous malformations (AVMs) are congenital. However, there is no strong evidence supporting this theory. An increasing number of documented cases of de novo formation of parenchymal AVMs cast doubt on their congenital nature and suggest that indeed the majority of these lesions may form after birth. Further evidence suggesting the postnatal development of parenchymal AVMs comes from the exceedingly rare diagnosis of these lesions in utero despite the widespread availability of high-resolution imaging modalities such as ultrasound and fetal MRI. The exact mechanism of AVM formation has yet to be elucidated, but most likely involves genetic susceptibility and environmental triggering factors. In this review, the authors report 2 cases of de novo AVM formation and analyze the evidence suggesting that they represent an acquired condition. PMID:25175439

  12. Identifying Lesions on Structural Brain Images-Validation of the Method and Application to Neuropsychological Patients

    ERIC Educational Resources Information Center

    Stamatakis, E.A.; Tyler, L.K.

    2005-01-01

    The study of neuropsychological disorders has been greatly facilitated by the localization of brain lesions on MRI scans. Current popular approaches for the assessment of MRI brain scans mostly depend on the successful segmentation of the brain into grey and white matter. These methods cannot be used effectively with large lesions because lesions…

  13. Detection of atherosclerotic lesions and intimal macrophages using CD36-targeted nanovesicles

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Current approaches to the diagnosis and therapy of atherosclerosis cannot target to lesion-determinant cells in the artery wall. Intimal macrophage infiltration promotes atherosclerotic lesion development by facilitating the accumulation of oxidized low-density lipoproteins (oxLDL) and increasing in...

  14. Lymphoproliferative lesions of the skin

    PubMed Central

    Cerroni, L

    2006-01-01

    Diagnosis and differential diagnosis of cutaneous lymphoproliferative disorders is one of the most difficult areas in dermatopathology, and biopsies are often taken to rule out a cutaneous lymphoma in patients with “unclear” or “therapy‐resistant” skin lesions. Histopathological features alone often enable a given case to be classified to a diagnostic group (eg, epidermotropic lymphomas), but seldom allow a definitive diagnosis to be made. Performing several biopsies from morphologically different lesions is suggested, especially in patients with suspicion of mycosis fungoides. Immunohistochemistry is often crucial for proper classification of the cases, but in some instances is not helpful (eg, early lesions of mycosis fungoides). Although molecular techniques provide new, powerful tools for diagnosing cutaneous lymphoproliferative disorders, results of molecular methods should always be interpreted with the clinicopathological features, keeping in mind the possibility of false positivity and false negativity. In many cases, a definitive diagnosis can be made only on careful correlation of the clinical with the histopathological, immunophenotypical and molecular features. PMID:16873563

  15. Eye lesions in pet birds.

    PubMed

    Tsai, S S; Park, J H; Hirai, K; Itakura, C

    1993-03-01

    Amongst eye lesions in birds that died in quarantine, cataracts were the most common disorders (37/241, 15.4%), being prevalent in the annular pads of cockatiels (Nymphicus hollandicus), Amazon parrots (Amazona aestiva aestiva) and budgerigars (Melopsittacus undulatus). The incidence in male birds was more than twice that in females. Deposition of crystals, mostly in the cornea, was the second most frequent lesion (21/293, 8.7%), mainly found in cockatiels, parakeets (Psittacula krameri manillensis), Amazon parrots (Amazona aestiva aestiva), budgerigars and finches (Poephila gouldiae gouldiae). These corneal crystals were negative to PAS and Kossa's stains. Six parakeets (Psittacula krameri manillensis) had calcium salts deposited in the inner plexiform layer of the retina and occasionally in the iris and ciliary body. Neither inflammation nor neo-vascularization was observed when cataracts, corneal crystalline deposition, and retinal and ciliary calcification were present. Intranuclear inclusion bodies typical for papovavirus infection were found in the eyelids of six budgerigars (2.5%). Similar inclusions were simultaneously found in the pars ciliaris retinae (4, 1.7%), inner plexiform of retina (1, 0.4%) and anterior epithelium of the cornea (1, 0.4%). Other lesions such as candidial endophthalmitis, conjunctival cryptosporidiosis, corneal dystrophy, keratitis, corneal perforation and iridocyclitis, were occasional findings. PMID:18671000

  16. [Infected lesions of diabetic foot].

    PubMed

    Vitale, Mario; Zeppa, Pio; Esposito, Isabella; Esposito, Silvano

    2012-01-01

    The diabetic foot lesions are the result of a complex set of factors including peripheral neuropathy, trauma, joint deformities and perfusion abnormalities. The foot becomes vulnerable and insensitive to minor injuries caused by excessive pressure, mechanically or minimum thermal insults that can determine the primum movens of a foot ulcer. Due to the trauma, the subcutaneous tissues are exposed to bacterial colonization. Therefore, the wound can develop an infection. So, the first step in the treatment of the lesion is the evaluation of tissue damage, in order to guide therapy and prognosis. Wagner's classification, used by over 25 years, is still one of the best known systems of lesion classification; however, it is giving way to the most recent Texas's classification. However, in both systems infection have a minority role. Therefore, the Infectious Diseases Society of America has developed a classification system that divides infections in mild, moderate and severe. The purpose of this classification is to recognize the severe patients because they require immediate hospitalization, parenteral antibiotic therapy and specific instrumental examinations. PMID:22982693

  17. Automatic segmentation of psoriasis lesions

    NASA Astrophysics Data System (ADS)

    Ning, Yang; Shi, Chenbo; Wang, Li; Shu, Chang

    2014-10-01

    The automatic segmentation of psoriatic lesions is widely researched these years. It is an important step in Computer-aid methods of calculating PASI for estimation of lesions. Currently those algorithms can only handle single erythema or only deal with scaling segmentation. In practice, scaling and erythema are often mixed together. In order to get the segmentation of lesions area - this paper proposes an algorithm based on Random forests with color and texture features. The algorithm has three steps. The first step, the polarized light is applied based on the skin's Tyndall-effect in the imaging to eliminate the reflection and Lab color space are used for fitting the human perception. The second step, sliding window and its sub windows are used to get textural feature and color feature. In this step, a feature of image roughness has been defined, so that scaling can be easily separated from normal skin. In the end, Random forests will be used to ensure the generalization ability of the algorithm. This algorithm can give reliable segmentation results even the image has different lighting conditions, skin types. In the data set offered by Union Hospital, more than 90% images can be segmented accurately.

  18. [Pigmented lesions of the genital mucosa].

    PubMed

    Hengge, U R; Meurer, M

    2005-06-01

    Pigmented lesions of the genital mucosa are more frequent in women than in men. They represent a spectrum of different benign entities. A biopsy is always recommended when the diagnosis cannot be made with certainty on clinical examination and dermatoscopy. Differential diagnostic considerations include melanocytic nevi, blue nevi and syndromes featuring lentigines. Malignant melanomas of the penis and vulva are uncommon tumors which usually appear in elderly patients. They frequently present as painless palpable nodules at routine examination. The treatment consists of excision with histological control of the margins. An aggressive surgical approach has not been shown to prolong the poor 5-year survival. Cooperation with gynecologists and urologists is essential for the optimal management of such patients. PMID:15905972

  19. [Vesiculobullous lesions of the oral mucosa].

    PubMed

    Spijkervet, F K; Vissink, A; Raghoebar, G M; van der Waal, I

    2001-06-01

    In general practice, the dentist can be confronted with a vesiculobullous lesion of the oral mucosa. In many cases the lesion can be classified as recurrent herpes labialis, but many other causes can induce a vesiculobullous lesion of the oral mucosa and perioral skin as well. This article gives an overview of the various vesiculous and bullous lesions of the oral mucous membranes. Special attention is given to the possible causes and their treatment. PMID:11441714

  20. [Imaging spinal cord cystic lesions in adults].

    PubMed

    Kremer, S; Bierry, G; Abu Eid, M; Bogorin, A; Koob, M; Zöllner, G; Dietemann, J L

    2007-05-01

    Intrarachidian cystic lesions are frequent, with highly varied causes. They can be classified according to their location into intramedullary cystic lesions and extramedullary cystic lesions. In these two categories, they can then be regrouped according to the tissue from which they develop. MRI is the first-choice examination for the study of the intracanal contents and the differential diagnosis between the various lesions. PMID:17541357

  1. Quantification of osteolytic bone lesions in a preclinical rat trial

    NASA Astrophysics Data System (ADS)

    Fränzle, Andrea; Bretschi, Maren; Bäuerle, Tobias; Giske, Kristina; Hillengass, Jens; Bendl, Rolf

    2013-10-01

    In breast cancer, most of the patients who died, have developed bone metastasis as disease progression. Bone metastases in case of breast cancer are mainly bone destructive (osteolytic). To understand pathogenesis and to analyse response to different treatments, animal models, in our case rats, are examined. For assessment of treatment response to bone remodelling therapies exact segmentations of osteolytic lesions are needed. Manual segmentations are not only time-consuming but lack in reproducibility. Computerized segmentation tools are essential. In this paper we present an approach for the computerized quantification of osteolytic lesion volumes using a comparison to a healthy reference model. The presented qualitative and quantitative evaluation of the reconstructed bone volumes show, that the automatically segmented lesion volumes complete missing bone in a reasonable way.

  2. Visualization of Epicardial Cryoablation Lesions using Endogenous Tissue Fluorescence

    PubMed Central

    Swift, Luther; Gil, Daniel A.B.; Jaimes, Rafael; Kay, Matthew; Mercader, Marco; Sarvazyan, Narine

    2014-01-01

    Background Percutaneous cryoballoon ablation is a commonly used procedure to treat atrial fibrillation. One of the major limitations of the procedure is the inability to directly visualize tissue damage and functional gaps between the lesions. We seek to develop an approach that will enable real-time visualization of tissue necrosis during cryo- or radiofrequency ablation procedures. Methods and Results Cryoablation of either blood-perfused or saline-perfused hearts was associated with a marked decrease in NADH fluorescence leading to a 60-70% loss of signal intensity at the lesion site. The total lesion area observed on the NADH channel exhibited a strong correlation with the area identified by triphenyl tetrazolium staining (r=0.89, p<0.001). At physiological temperatures, loss of NADH became visually apparent within 26±8 sec after detachment of the cryoprobe from the epicardial surface and plateaued within minutes after which the boundaries of the lesions remained stable for several hours. The loss of electrical activity within the cryoablation site exhibited a close spatial correlation with the loss of NADH (r=0.84±0.06, p<0.001). Cryoablation led to a decrease in diffuse reflectance across the entire visible spectrum which was in stark contrast to radiofrequency ablation that markedly increased the intensity of reflected light at the lesion sites. Conclusions We confirmed the feasibility of using endogenous NADH fluorescence for the real-time visualization of cryoablation lesions in blood-perfused cardiac muscle preparations and revealed similarities and differences between imaging cryo- and radiofrequency ablation lesions when using ultraviolet and visible light illumination. PMID:25141861

  3. Diagnosis and management of neoplastic lesions of the submandibular triangle.

    PubMed

    Munir, Nazia; Bradley, Patrick J

    2008-03-01

    Review of submandibular triangle neoplasms (benign and malignant) treated at a tertiary referral centre in the United Kingdom (1986-2004). One hundred and seven cases identified via computerised search of histopathology records over the 18 year review period. Retrospective review clinical notes and collation with data maintained prospectively by the senior author. Forty nine benign and 58 malignant neoplasms of the submandibular triangle were reviewed. Definitive diagnosis was by excision and pathological examination. Pleomorphic adenoma (n=37) were the most common benign neoplasms. For malignant lesions (n=58), 48 were primary malignancies and 10 metastatic lesions. The most frequent primary lesions were malignant non-Hodgkin lymphoma (n=22), adenoid cystic carcinoma (n=9) and mucoepidermoid carcinoma (n=9). The mainstay treatment for both benign and malignant lesions was surgical either by extracapsular excision of the gland/lesion or selective levels I, IIa and III neck dissection. The main post-operative complication was temporary weakness of the marginal mandibular nerve (13%). Submandibular triangle neoplasms are rare and pose many diagnostic and therapeutic challenges. There is a relatively high incidence of malignant neoplasms in this region (54%). Benign tumours manifest a mild course of disease and have an excellent prognosis following adequate excision. Malignant tumours have a poor symptomatology that can result in late (often post-operative) diagnosis. The adequacy of primary surgery is crucial and would support the approach of a more radical excision primarily with a selective levels I, IIa and III neck dissection; ensuring a definitive operation for benign lesions, avoiding the risks of tumour spillage associated with a more limited excision; and removing the primary echelon of lymph nodes at risk of metastasis if the pathology in fact turns out to be malignant; without a significantly higher morbidity in comparison with an extracapsular gland/lesion

  4. A Model of Population and Subject (MOPS) Intensities with Application to Multiple Sclerosis Lesion Segmentation

    PubMed Central

    Tomas-Fernandez, Xavier; Warfield, Simon K.

    2015-01-01

    White matter (WM) lesions are thought to play an important role in multiple sclerosis (MS) disease burden. Recent work in the automated segmentation of white matter lesions from MRI has utilized a model in which lesions are outliers in the distribution of tissue signal intensities across the entire brain of each patient. However, the sensitivity and specificity of lesion detection and segmentation with these approaches have been inadequate. In our analysis, we determined this is due to the substantial overlap between the whole brain signal intensity distribution of lesions and normal tissue. Inspired by the ability of experts to detect lesions based on their local signal intensity characteristics, we propose a new algorithm that achieves lesion and brain tissue segmentation through simultaneous estimation of a spatially global within-the-subject intensity distribution and a spatially local intensity distribution derived from a healthy reference population. We demonstrate that MS lesions can be segmented as outliers from this intensity model of population and subject (MOPS). We carried out extensive experiments with both synthetic and clinical data, and compared the performance of our new algorithm to those of state-of-the art techniques. We found this new approach leads to a substantial improvement in the sensitivity and specificity of lesion detection and segmentation. PMID:25616008

  5. Photoacoustic discrimination of vascular and pigmented lesions using classical and Bayesian methods

    NASA Astrophysics Data System (ADS)

    Swearingen, Jennifer A.; Holan, Scott H.; Feldman, Mary M.; Viator, John A.

    2010-01-01

    Discrimination of pigmented and vascular lesions in skin can be difficult due to factors such as size, subungual location, and the nature of lesions containing both melanin and vascularity. Misdiagnosis may lead to precancerous or cancerous lesions not receiving proper medical care. To aid in the rapid and accurate diagnosis of such pathologies, we develop a photoacoustic system to determine the nature of skin lesions in vivo. By irradiating skin with two laser wavelengths, 422 and 530 nm, we induce photoacoustic responses, and the relative response at these two wavelengths indicates whether the lesion is pigmented or vascular. This response is due to the distinct absorption spectrum of melanin and hemoglobin. In particular, pigmented lesions have ratios of photoacoustic amplitudes of approximately 1.4 to 1 at the two wavelengths, while vascular lesions have ratios of about 4.0 to 1. Furthermore, we consider two statistical methods for conducting classification of lesions: standard multivariate analysis classification techniques and a Bayesian-model-based approach. We study 15 human subjects with eight vascular and seven pigmented lesions. Using the classical method, we achieve a perfect classification rate, while the Bayesian approach has an error rate of 20%.

  6. Automatic colonic lesion detection and tracking in endoscopic videos

    NASA Astrophysics Data System (ADS)

    Li, Wenjing; Gustafsson, Ulf; A-Rahim, Yoursif

    2011-03-01

    The biology of colorectal cancer offers an opportunity for both early detection and prevention. Compared with other imaging modalities, optical colonoscopy is the procedure of choice for simultaneous detection and removal of colonic polyps. Computer assisted screening makes it possible to assist physicians and potentially improve the accuracy of the diagnostic decision during the exam. This paper presents an unsupervised method to detect and track colonic lesions in endoscopic videos. The aim of the lesion screening and tracking is to facilitate detection of polyps and abnormal mucosa in real time as the physician is performing the procedure. For colonic lesion detection, the conventional marker controlled watershed based segmentation is used to segment the colonic lesions, followed by an adaptive ellipse fitting strategy to further validate the shape. For colonic lesion tracking, a mean shift tracker with background modeling is used to track the target region from the detection phase. The approach has been tested on colonoscopy videos acquired during regular colonoscopic procedures and demonstrated promising results.

  7. Pathologic Heterogeneity Persists in Early Active Multiple Sclerosis Lesions

    PubMed Central

    Metz, Imke; Weigand, Stephen D; Popescu, Bogdan F G; Frischer, Josa M; Parisi, Joseph E; Guo, Yong; Lassmann, Hans; Brück, Wolfgang; Lucchinetti, Claudia F.

    2014-01-01

    Objective Multiple sclerosis (MS) lesions demonstrate immunopathological heterogeneity in patterns of demyelination. Previous cross-sectional studies reported immunopatterns of demyelination were identical among multiple active demyelinating lesions from the same individual, but differed between individuals, leading to the hypothesis of intraindividual pathological homogeneity and interindividual heterogeneity. Other groups suggested a time-dependent heterogeneity of lesions. The objective of our present study was to analyze tissue samples collected longitudinally to determine whether patterns of demyelination persist over time within a given patient. Methods Archival tissue samples derived from patients with pathologically confirmed CNS inflammatory demyelinating disease who had undergone either diagnostic serial biopsy or biopsy followed by autopsy, were analyzed immunohistochemically. Inclusion criteria was the presence of early active demyelinating lesions - required for immunopattern classification - obtained from the same patient at two or more time points. Results Among 1321 surgical biopsies consistent with MS, 22 cases met study inclusion criteria. Twenty-one patients (95%) showed a persistence of immunopathological patterns in tissue sampled from different time points. This persistence was demonstrated for all major patterns of demyelination. A single patient showed features suggestive of both pattern II and pattern III on biopsy, but only pattern II among all active lesions examined at autopsy. Interpretation These findings continue to support the concept of patient-dependent immunopathological heterogeneity in early MS and suggest that the mechanisms and targets of tissue injury may differ among patient subgroups. These observations have potentially significant implications for individualized therapeutic approaches. PMID:24771535

  8. Advanced MRI and staging of multiple sclerosis lesions.

    PubMed

    Absinta, Martina; Sati, Pascal; Reich, Daniel S

    2016-06-01

    Over the past few decades, MRI-based visualization of demyelinated CNS lesions has become pivotal to the diagnosis and monitoring of multiple sclerosis (MS). In this Review, we outline current efforts to correlate imaging findings with the pathology of lesion development in MS, and the pitfalls that are being encountered in this research. Multimodal imaging at high and ultra-high magnetic field strengths is yielding biologically relevant insights into the pathophysiology of blood-brain barrier dynamics and both active and chronic inflammation, as well as mechanisms of lesion healing and remyelination. Here, we parallel the results in humans with advances in imaging of a primate model of MS - experimental autoimmune encephalomyelitis (EAE) in the common marmoset - in which demyelinated lesions resemble their human counterparts far more closely than do EAE lesions in the rodent. This approach holds promise for the identification of innovative biological markers, and for next-generation clinical trials that will focus more on tissue protection and repair. PMID:27125632

  9. Skin lesions: mirror images of oral lesion infections.

    PubMed

    Phanuphak, N

    2006-01-01

    Skin lesions can be the presenting signs for HIV disease and are among the most prevalent manifestations throughout the course of HIV disease. Correlation of skin diseases and HIV disease staging has long been recognized and used to guide medical management in resource-limited settings. The purpose of this paper is to give a review of common skin infections presented in HIV-infected patients. Common skin infections presenting in HIV-infected patients include viral, fungal, mycobacterial, and bacterial infections, along with skin infestation. Key diagnostic points correlate with certain HIV disease staging for many skin diseases. These can help facilitate appropriate diagnosis and referral by health care personnel when treating HIV-infected patients who have skin lesions. Knowledge of common skin manifestations found in HIV-infected patients is essential for all health care personnel who work in the HIV field. Most skin infections presenting in HIV-infected patients can be treated effectively if the correct diagnosis and appropriate referral are made promptly. PMID:16672553

  10. Efficacy of endoport-guided endoscopic resection for deep-seated brain lesions.

    PubMed

    Jo, Kwang-Wook; Shin, Hyung Jin; Nam, Do-Hyun; Lee, Jung-Il; Park, Kwan; Kim, Jong Hyun; Kong, Doo-Sik

    2011-10-01

    Surgery for deep-seated brain lesions without causing significant trauma to the overlying cortex is difficult because brain retraction is required to approach these lesions. The aim of this study was to determine the efficacy of endoport-guided endoscopic or microscopic removal for deep-seated lesions using the neuronavigation system. Between October 2008 and December 2009, 21 patients (17 men and 4 women; average age, 40.8 years) underwent endoport-guided endoscopic tumor removal. We adapted the transparent tubular conduit, so-called "endoport," to target the lesions under the guidance of neuronavigation. We then determined the efficacy and limitations of this technique with fully endoscopic removal, compared with standard approaches using a spatula retractor. Gross total resection of the lesions was achieved in 14 of 21 patients (66%), and partial removal occurred in four (19%) patients. However, there was failure to remove the lesion through the endoport in three patients (14.3%), requiring the use of blade spatula retractors. In reviewing the seven cases with either failure or partial removal, it was found that a large tumor size (≥ 3 cm) and calcified lesions were the major factors limiting the application of this technique. Endoport-guided endoscopic surgery facilitated an accurate and minimally invasive technique for removal of these deep-seated brain lesions. This procedure required a protracted learning curve although, when successful, this approach can minimize brain retraction and provide satisfactory visualization. PMID:21614427

  11. Hyperspectral imaging of melanocytic lesions.

    PubMed

    Gaudi, Sudeep; Meyer, Rebecca; Ranka, Jayshree; Granahan, James C; Israel, Steven A; Yachik, Theodore R; Jukic, Drazen M

    2014-02-01

    Hyperspectral imaging (HSI) allows the identification of objects through the analysis of their unique spectral signatures. Although first developed many years ago for use in terrestrial remote sensing, this technology has more recently been studied for application in the medical field. With preliminary data favoring a role for HSI in distinguishing normal and lesional skin tissues, we sought to investigate the potential use of HSI as a diagnostic aid in the classification of atypical Spitzoid neoplasms, a group of lesions that often leave dermatopathologists bewildered. One hundred and two hematoxylin and eosin-stained tissue samples were divided into 1 of 4 diagnostic categories (Spitz nevus, Spitz nevus with unusual features, atypical Spitzoid neoplasm, and Spitzoid malignant melanoma) and 1 of 2 control groups (benign melanocytic nevus and malignant melanoma). A region of interest was selected from the dermal component of each sample, thereby maximizing the examination of melanocytes. Tissue samples were examined at ×400 magnification using a spectroscopy system interfaced with a light microscope. The absorbance patterns of wavelengths from 385 to 880 nm were measured and then analyzed within and among groups. All tissue groups demonstrated 3 common absorbance spectra at 496, 533, and 838 nm. Each sample group contained at least one absorption point that was unique to that group. The Spitzoid malignant melanoma category had the highest number of total and unique absorption points for any sample group. The data were then clustered into 12 representative spectral classes. Although each of the sample groups contained all 12 spectral vectors, they did so in differing proportions. These preliminary results reveal differences in the spectral signatures of the Spitzoid lesions examined in this study. Further investigation into a role for HSI in classifying atypical Spitzoid neoplasms is encouraged. PMID:24247577

  12. Association between lesion location and language function in adult glioma using voxel-based lesion-symptom mapping

    PubMed Central

    Banerjee, Pia; Leu, Kevin; Harris, Robert J.; Cloughesy, Timothy F.; Lai, Albert; Nghiemphu, Phioanh L.; Pope, Whitney B.; Bookheimer, Susan Y.; Ellingson, Benjamin M.

    2015-01-01

    Background Management of language difficulties is an important aspect of clinical care for glioma patients, and accurately identifying the possible language deficits in patients based on lesion location would be beneficial to clinicians. To that end, we examined the relationship between lesion presence and language performance on tests of receptive language and expressive language using a highly specific voxel-based lesion–symptom mapping (VLSM) approach in glioma patients. Methods 98 adults with primary glioma, who were pre-surgical candidates, were administered seven neurocognitive tests within the domains of receptive language and expressive language. The association between language performance and lesion presence was examined using VLSM. Statistical parametric maps were created for each test, and composite maps for both receptive language and expressive language were created to display the significant voxels common to all tests within these language domains. Results We identified clusters of voxels with a significant relationship between lesion presence and language performance. All tasks were associated with several white matter pathways. The receptive language tasks were additionally all associated with regions primarily within the lateral temporal lobe and medial temporal lobe. In contrast, the expressive language tasks shared little overlap, despite each task being independently associated with large anatomic areas. Conclusions Our findings identify the key anatomic structures involved in language functioning in adult glioma patients using an innovative lesion analysis technique and suggest that expressive language abilities may be more task-dependent and distributed than receptive language abilities. PMID:26740915

  13. Multiple lesion track structure model

    NASA Technical Reports Server (NTRS)

    Wilson, John W.; Cucinotta, Francis A.; Shinn, Judy L.

    1992-01-01

    A multilesion cell kinetic model is derived, and radiation kinetic coefficients are related to the Katz track structure model. The repair-related coefficients are determined from the delayed plating experiments of Yang et al. for the C3H10T1/2 cell system. The model agrees well with the x ray and heavy ion experiments of Yang et al. for the immediate plating, delaying plating, and fractionated exposure protocols employed by Yang. A study is made of the effects of target fragments in energetic proton exposures and of the repair-deficient target-fragment-induced lesions.

  14. Pancreatic Lesion: Malignancy or Abscess?

    PubMed

    Shulik, Oleg; Cavanagh, Yana; Grossman, Matthew

    2016-01-01

    BACKGROUND Pancreatic abscesses are rare. They may be seen in patients with pancreatic inflammation or pancreatitis. Patients with pancreatic abscesses may have abdominal pain, fever, chills, and nausea/vomiting or an inability to eat. Presentation with alternate symptomatology is extremely unusual. CASE REPORT A 67-year-old Asian male presented with painless, afebrile obstructive jaundice and a CA 19-9 of 1732 IU. He was found to have a 3.1×2.4 cm low-density lesion in the head of the pancreas and the right lobe of the liver, suggesting malignancy. Surgical management was considered, however additional diagnostic workup, including an endoscopic retrograde cholangiopancreatography (ERCP), was performed to complete staging of the presumed mass. A smooth, 3-cm-long, tapering stricture was found it the common bile duct. It was stented from the common hepatic duct to the duodenum. Subsequent endoscopic ultrasound (EUS) evaluation of the pancreatic head lesion revealed a drainable fluid collection that was aspirated and found to contain pyogenic material on pathology. The patient's symptoms resolved, and he was subsequently managed conservatively. A repeat ERCP confirmed complete resolution of the previously visualized cystic lesion. Interestingly, laboratory values showed concomitant normalization of CA 19-9 to 40 IU. CONCLUSIONS EUS-guided biopsy is not widely regarded as a required step before surgery, in the management of patients with pancreatic masses. It is generally reserved for determination of resectability or staging, and only utilized when clinically indicated. However, this practice may be associated with an inherently significant risk of misdiagnosis and subsequent unnecessary surgery, as illustrated by this case. Malignancy was initially suspected in our patient and surgical resection was recommended. Endoscopic measures were only pursued to complete staging. We propose that EUS-guided biopsy may be a crucial diagnostic step in the management algorithm

  15. Pancreatic Lesion: Malignancy or Abscess?

    PubMed Central

    Shulik, Oleg; Cavanagh, Yana; Grossman, Matthew

    2016-01-01

    Patient: Male, 67 Final Diagnosis: Pancreatic abscess Symptoms: Jaundice • fatigue • anorexia • subjective weight loss Medication: — Clinical Procedure: Therapeutic endoscopic ultrasound guided fine needle aspiration • biliary stenting • endoscopic cholangiopancreatography Specialty: Gastroenterology and Hepatology Objective: Rare coexistance of disease or pathology Background: Pancreatic abscesses are rare. They may be seen in patients with pancreatic inflammation or pancreatitis. Patients with pancreatic abscesses may have abdominal pain, fever, chills, and nausea/vomiting or an inability to eat. Presentation with alternate symptomatology is extremely unusual. Case Report: A 67-year-old Asian male presented with painless, afebrile obstructive jaundice and a CA 19-9 of 1732 IU. He was found to have a 3.1×2.4 cm low-density lesion in the head of the pancreas and the right lobe of the liver, suggesting malignancy. Surgical management was considered, however additional diagnostic workup, including an endoscopic retrograde cholangiopancreatography (ERCP), was performed to complete staging of the presumed mass. A smooth, 3-cm-long, tapering stricture was found it the common bile duct. It was stented from the common hepatic duct to the duodenum. Subsequent endoscopic ultrasound (EUS) evaluation of the pancreatic head lesion revealed a drainable fluid collection that was aspirated and found to contain pyogenic material on pathology. The patient’s symptoms resolved, and he was subsequently managed conservatively. A repeat ERCP confirmed complete resolution of the previously visualized cystic lesion. Interestingly, laboratory values showed concomitant normalization of CA 19-9 to 40 IU. Conclusions: EUS-guided biopsy is not widely regarded as a required step before surgery, in the management of patients with pancreatic masses. It is generally reserved for determination of resectability or staging, and only utilized when clinically indicated. However, this

  16. Breast ultrasound lesions classification: a performance evaluation between manual delineation and computer segmentation

    NASA Astrophysics Data System (ADS)

    Yap, Moi Hoon; Yap, Chuin Hong

    2016-03-01

    Breast cancer is a threat to women worldwide. Manual delineation on breast ultrasound lesions is time-consuming and operator dependent. Computer segmentation of ultrasound breast lesions can be a challenging task due to the ill-defined lesions boundaries and issues related to the speckle noise in ultrasound images. The main contribution of this paper is to compare the performance of the computer classifier on the manual delineation and computer segmentation in malignant and benign lesions classification. This paper we implement computer segmentation using multifractal approach on a database consists of 120 images (50 malignant lesions and 70 benign lesions). The computer segmentation result is compared with the manual delineation using Jaccard Similarity Index (JSI). The result shows that the average JSI of 0.5010 (+/-0.2088) for malignant lesions and the average JSI of 0.6787 (+/-0.1290) for benign lesions. These results indicate lower agreement in malignant lesions due to the irregular shape while the higher agreement in benign lesions with regular shape. Further, we extract the shape descriptors for the lesions. By using logistic regression with 10 fold cross validation, the classification rates of manual delineation and computer segmentation are computed. The computer segmentation produced results with sensitivity 0.780 and specificity 0.871. However, the manual delineation produced sensitivity of 0.520 and specificity of 0.800. The results show that there are no clear differences between the delineation in MD and CS in benign lesions but the computer segmentation on malignant lesions shows better accuracy for computer classifier.

  17. Health Effects of Lesion Localization in Multiple Sclerosis: Spatial Registration and Confounding Adjustment

    PubMed Central

    Eloyan, Ani; Shou, Haochang; Shinohara, Russell T.; Sweeney, Elizabeth M.; Nebel, Mary Beth; Cuzzocreo, Jennifer L.; Calabresi, Peter A.; Reich, Daniel S.; Lindquist, Martin A.; Crainiceanu, Ciprian M.

    2014-01-01

    Brain lesion localization in multiple sclerosis (MS) is thought to be associated with the type and severity of adverse health effects. However, several factors hinder statistical analyses of such associations using large MRI datasets: 1) spatial registration algorithms developed for healthy individuals may be less effective on diseased brains and lead to different spatial distributions of lesions; 2) interpretation of results requires the careful selection of confounders; and 3) most approaches have focused on voxel-wise regression approaches. In this paper, we evaluated the performance of five registration algorithms and observed that conclusions regarding lesion localization can vary substantially with the choice of registration algorithm. Methods for dealing with confounding factors due to differences in disease duration and local lesion volume are introduced. Voxel-wise regression is then extended by the introduction of a metric that measures the distance between a patient-specific lesion mask and the population prevalence map. PMID:25233361

  18. Computer-aided tracking of MS lesions

    NASA Astrophysics Data System (ADS)

    Sturm, Deborah; Gurwitz Kletenik, Devorah; Koshy, Philip

    2011-03-01

    Multiple Sclerosis (MS) lesions are known to change over time. The location, size and shape characteristics of lesions are often used to diagnose and to track disease progression. We have improved our lesion-browsing tool that allows users to automatically locate successive significant lesions in a MRI stack. In addition, an automatic alignment feature was implemented to facilitate comparisons across stacks. A lesion stack is formed that can be browsed independently or in tandem with the image windows. Lesions of interest can then be measured, rendered and rotated. Multiple windows allow the viewer to compare the size and shape of lesions from the MRI images of the same patient taken at different time intervals.

  19. Convolutional neural networks for mammography mass lesion classification.

    PubMed

    Arevalo, John; Gonzalez, Fabio A; Ramos-Pollan, Raul; Oliveira, Jose L; Guevara Lopez, Miguel Angel

    2015-08-01

    Feature extraction is a fundamental step when mammography image analysis is addressed using learning based approaches. Traditionally, problem dependent handcrafted features are used to represent the content of images. An alternative approach successfully applied in other domains is the use of neural networks to automatically discover good features. This work presents an evaluation of convolutional neural networks to learn features for mammography mass lesions before feeding them to a classification stage. Experimental results showed that this approach is a suitable strategy outperforming the state-of-the-art representation from 79.9% to 86% in terms of area under the ROC curve. PMID:26736382

  20. An SPM12 extension for multiple sclerosis lesion segmentation

    NASA Astrophysics Data System (ADS)

    Roura, Eloy; Oliver, Arnau; Cabezas, Mariano; Valverde, Sergi; Pareto, Deborah; Vilanova, Joan C.; Ramió-Torrentà, Lluís.; Rovira, Àlex; Lladó, Xavier

    2016-03-01

    Purpose: Magnetic resonance imaging is nowadays the hallmark to diagnose multiple sclerosis (MS), characterized by white matter lesions. Several approaches have been recently presented to tackle the lesion segmentation problem, but none of them have been accepted as a standard tool in the daily clinical practice. In this work we present yet another tool able to automatically segment white matter lesions outperforming the current-state-of-the-art approaches. Methods: This work is an extension of Roura et al. [1], where external and platform dependent pre-processing libraries (brain extraction, noise reduction and intensity normalization) were required to achieve an optimal performance. Here we have updated and included all these required pre-processing steps into a single framework (SPM software). Therefore, there is no need of external tools to achieve the desired segmentation results. Besides, we have changed the working space from T1w to FLAIR, reducing interpolation errors produced in the registration process from FLAIR to T1w space. Finally a post-processing constraint based on shape and location has been added to reduce false positive detections. Results: The evaluation of the tool has been done on 24 MS patients. Qualitative and quantitative results are shown with both approaches in terms of lesion detection and segmentation. Conclusion: We have simplified both installation and implementation of the approach, providing a multiplatform tool1 integrated into the SPM software, which relies only on using T1w and FLAIR images. We have reduced with this new version the computation time of the previous approach while maintaining the performance.

  1. Assessment and Management of Challenging BI-RADS Category 3 Mammographic Lesions.

    PubMed

    Michaels, Aya Y; Birdwell, Robyn L; Chung, Chris SungWon; Frost, Elisabeth P; Giess, Catherine S

    2016-01-01

    Breast Imaging Reporting and Data System (BI-RADS) category 3 lesions are probably benign by definition and are recommended for short-interval follow-up after a diagnostic workup has been completed. Although the original lexicon-derived BI-RADS category 3 definition applied to lesions without prior imaging studies (when stability could not be determined), in clinical practice, many lesions with prior images may be assigned to BI-RADS category 3. Although the BI-RADS fifth edition specifically delineates lesions that are appropriate for categorization as probably benign, it also specifies that the interpreting radiologist may use his or her discretion and experience to justify a "watchful waiting" approach for lesions that do not meet established criteria. Examples of such lesions include evolving masses or calcifications suggestive of prior trauma and instances when stability cannot be ascertained because of image quality. Although interval change is an important feature of malignancy, many benign lesions also change over time; thus, use of prior imaging studies and ongoing imaging surveillance to demonstrate the evolution of a probably benign lesion is justified. Some examples of common pitfalls associated with inappropriate BI-RADS category 3 assessment include failure to use proper BI-RADS descriptors, failure to perform a complete diagnostic workup, and overreliance on negative ultrasonographic findings. When appropriately used, short-interval follow-up saves many patients from undergoing biopsy of benign lesions, without decreasing the rate of cancer detection. (©)RSNA, 2016. PMID:27541437

  2. Spinal focal lesion detection in multiple myeloma using multimodal image features

    NASA Astrophysics Data System (ADS)

    Fränzle, Andrea; Hillengass, Jens; Bendl, Rolf

    2015-03-01

    Multiple myeloma is a tumor disease in the bone marrow that affects the skeleton systemically, i.e. multiple lesions can occur in different sites in the skeleton. To quantify overall tumor mass for determining degree of disease and for analysis of therapy response, volumetry of all lesions is needed. Since the large amount of lesions in one patient impedes manual segmentation of all lesions, quantification of overall tumor volume is not possible until now. Therefore development of automatic lesion detection and segmentation methods is necessary. Since focal tumors in multiple myeloma show different characteristics in different modalities (changes in bone structure in CT images, hypointensity in T1 weighted MR images and hyperintensity in T2 weighted MR images), multimodal image analysis is necessary for the detection of focal tumors. In this paper a pattern recognition approach is presented that identifies focal lesions in lumbar vertebrae based on features from T1 and T2 weighted MR images. Image voxels within bone are classified using random forests based on plain intensities and intensity value derived features (maximum, minimum, mean, median) in a 5 x 5 neighborhood around a voxel from both T1 and T2 weighted MR images. A test data sample of lesions in 8 lumbar vertebrae from 4 multiple myeloma patients can be classified at an accuracy of 95% (using a leave-one-patient-out test). The approach provides a reasonable delineation of the example lesions. This is an important step towards automatic tumor volume quantification in multiple myeloma.

  3. Lesion insertion in projection domain for computed tomography image quality assessment

    NASA Astrophysics Data System (ADS)

    Chen, Baiyu; Ma, Chi; Yu, Zhicong; Leng, Shuai; Yu, Lifeng; McCollough, Cynthia

    2015-03-01

    To perform task-based image quality assessment in CT, it is desirable to have a large number of realistic patient images with known diagnostic truth. One effective way to achieve this objective is to create hybrid images that combine patient images with simulated lesions. Because conventional hybrid images generated in the image-domain fails to reflect the impact of scan and reconstruction parameters on lesion appearance, this study explored a projection-domain approach. Liver lesion models were forward projected according to the geometry of a commercial CT scanner to acquire lesion projections. The lesion projections were then inserted into patient projections (decoded from commercial CT raw data with the assistance of the vendor) and reconstructed to acquire hybrid images. To validate the accuracy of the forward projection geometry, simulated images reconstructed from the forward projections of a digital ACR phantom were compared to physically acquired ACR phantom images. To validate the hybrid images, lesion models were inserted into patient images and visually assessed. Results showed that the simulated phantom images and the physically acquired phantom images had great similarity in terms of HU accuracy and high-contrast resolution. The lesions in the hybrid image had a realistic appearance and merged naturally into the liver background. In addition, the inserted lesion demonstrated reconstruction-parameter-dependent appearance. Compared to conventional image-domain approach, our method enables more realistic hybrid images for image quality assessment.

  4. Dental infection simulating skin lesion.

    PubMed

    Abuabara, Allan; Schramm, Celso Alfredo; Zielak, João César; Baratto-Filho, Flares

    2012-01-01

    Orocutaneous fistulas or cutaneous sinus, a tract of dental origin, is an uncommon but well-documented condition that usually requires emergency treatment. Such condition may be misdiagnosed by physicians and dentists and may sometimes be confused with bone and skin tumor, osteomyelitis, congenital fistula, salivary gland fistula, pyogenic granuloma, infected cyst, deep mycotic infection, and other pathologies. A case of facial sinus tract that was initially misdiagnosed by a physician as a nonodontogenic lesion is presented. Nonsurgical endodontic therapy was the treatment of choice for this case. Facial cutaneous sinus tracts must be considered of dental origin. Early diagnosis and prompt treatment minimize patient discomfort and esthetic problems, reducing the possibility of further complications such as sepsis and osteomyelitis. PMID:22892779

  5. Trigeminal Neuralgia and Radiofrequency Lesioning

    PubMed Central

    Eugene, Andy R.

    2016-01-01

    Trigeminal Neuralgia is a disorder that is characterized with electrical-type shocking pain in the face and jaw. This pain may either present as sharp unbearable pain unilateral or bilaterally. There is no definite etiology for this condition. There are various treatment methods that are currently being used to relieve the pain. One of the pharmacological treatments is Carbamazepine and the most prevalent surgical treatments include Gamma Knife Surgery (GKS), Microvascular Decompression (MVD) and Radiofrequency Lesioning (RFL). Although, MVD is the most used surgical method it is not an option for all the patients due to the intensity of the procedure. RFL is used when MVD is not suitable. In this paper we present the various options in the treatment of Trigeminal Neuralgia. PMID:26770820

  6. Cutaneous lesions in new born.

    PubMed

    Sachdeva, Meenakshi; Kaur, Surjeet; Nagpal, Madhu; Dewan, S P

    2002-01-01

    Five hundred unselected newborn babies delivered in the Department of Obstetrics and Gynaecology, Unit II of SGBT Hospital attached to Government Medical College, Amritsar during April 2000 to October 2000 were examined for cutaneous lesions daily for the first five days after birth. Different cutaneous lesions were seen in 474(94.8%) newborns. The physiological skin changes observed in order of frequency were Epstein pearls in 305(61%), Mongolian spot in 301(60.2%), superficial cutaneous desquamation in 200(40%), icterus in 128(25.6%), milia in 119(23.8%), sebaceous gland hyperplasia in 107(21.4%), occipital alopecia in 94(18.8%), lanugo in 72(14.4%), peripheral cyanosis in 47(9.4%), breast hypertrophy in 29(5.8%) and miniature puberty in 28(5.6%) newborns. Of the transient non-infective skin diseases, erythema toxicum neonatorum was observed most commonly in 105(21%), followed by miliaria rubra in 103(20.6%) and acne neonatorum in 27(5.4%) newborns. The naevi and other developmental defects in the descending order were salmon patch in 69(13.8%), congenital melanocytic noevi in 10(2%), accessory tragi in 3(0.6%), spina bifida in 2(0.4%), hydrocephalus in 1(0.2%) and poliosis in 1(0.2%) newborns. Cradle cap was the only dermatitis observed in 50(10%) newborns. One (0.2%) case each of Harlequin ichthyosis and labial cyst was seen. PMID:17656992

  7. [Vascular lesions of the small intestine].

    PubMed

    Yano, Tomonori; Yamamoto, Hironori

    2008-07-01

    Small-intestinal vascular lesions accounted for the bleeding source in a large percentage of the patients with mid-GI-bleeding. The progress of enteroscopy has been changing the diagnostic and therapeutic algorithm for them. There are 3 pathological conditions of vascular lesions. Angioectasia is characterized by venous/capillary lesions, Dieulafoy' s lesion is characterized by arterial lesions, and AVM is a condition in which arteries and veins are directly connected without capillary beds. We classified vascular lesions with consideration of the presence or absence of pulsatility. The presence or absence of arterial components provides important information in understanding the pathological conditions. This classification will be useful for selecting hemostatic procedure and outcome studies. PMID:18616125

  8. Malignancy and the benign lymphoepithelial lesion.

    PubMed

    Batsakis, J G; Bernacki, E G; Rice, D H; Stebler, M E

    1975-02-01

    The benign lymphoepithelial lesion of salivary glands is now considered the histological hallmark of a variety of clinical and pathological disorders affecting salivary tissues. Malignancy arising in the lesion is uncommon, but may take origin in either the epithelial or lymphoreticular components. Lymphomas and pseudolymphomas associated with salivary gland lymphoepithelial lesions have been predominately extra-salivary and strongly correlated with Sjögren's syndrome. Epithelial malignancy has not been associated with autoimmunity and with few exceptions has been of the anaplastic type. This report presents two patients with intra-salivary lymphomas arising in a benign lymphoepithelial lesion of salivary glands and a patient with anaplastic carcinoma arising in the epithelial islands of the lesion. The fourth patient manifested pseudolymphomatous lymphoreticular hyperplasia in lung and submandibular gland and illustrates the possible multiple organ involvement that may occur in patients with benign lymphoepithelial lesion, even without clinical evidence of concommitant autoimmune disorders. PMID:1172885

  9. Calcified Cystic Lesion of the Pancreas.

    PubMed

    Li, Tao; Chen, Zhi-Qiang; Meng, Zhi-Xin; Hong, Jian-Guo; Zhi, Xu-Ting

    2016-06-01

    Pancreatic cystic lesion is a relatively uncommon condition with an estimated prevalence of 2 % in the general population. In the past two decades, there has been a dramatic increase in the prevalence of pancreatic cystic lesions because of the widespread use of high-resolution imaging, as well as the aging of the population. Pancreatic cystic lesions cover a wide spectrum of pathology and can range from obviously benign to borderline malignant potential lesions to overt malignancy. Though the presence of mural nodules, septa-like structures, or calcification on imaging examination contributes to the differential diagnosis, preoperatively determining the biological nature of these cystic lesions is sometimes challenging. In this paper, we report a rare case of pancreatic cystic lesion with an egg-shell like calcification. Complete resection was performed and histological examination confirmed the diagnosis of calcified pancreatic pseudocyst. PMID:26992398

  10. Nasal diagrams: a tool for recording the distribution of nasal lesions in rats and mice.

    PubMed

    Mery, S; Gross, E A; Joyner, D R; Godo, M; Morgan, K T

    1994-01-01

    Knowledge of patterns of lesion distribution can provide insight into the relative roles played by regional tissue dose and local tissue susceptibility in toxic responses to xenobiotics in the nose and assist assessment of potential human risk. A consistent approach is needed for recording lesion distribution patterns in the complex nasal airways of rats and mice. The present work provides a series of diagrams of the nasal passages of the Fischer-344 rat and B6C3F1 mouse, designed for mapping nasal lesions. The diagrams present each of the major cross-sectional airway profiles, provide adequate space for nasal mucosal lesion recording, and are suitable for duplication in a commercial photocopier. Sagittal diagrams are also provided to permit transfer of lesion location data observed in transverse sections onto the long axis of the nose. The distribution of lesions induced by a selected range of xenobiotics is presented. Approaches to application of the diagrams and interpretation of results obtained are discussed in relation to factors responsible for lesion distribution in the nose and their relevance to interspecies extrapolation. A modified approach to anatomical classification of the ethmoturbinates of the rodent is also presented. PMID:7817125

  11. Metatranscriptomics reveals overall active bacterial composition in caries lesions

    PubMed Central

    Simón-Soro, Aurea; Guillen-Navarro, Miriam; Mira, Alex

    2014-01-01

    Background Identifying the microbial species in caries lesions is instrumental to determine the etiology of dental caries. However, a significant proportion of bacteria in carious lesions have not been cultured, and the use of molecular methods has been limited to DNA-based approaches, which detect both active and inactive or dead microorganisms. Objective To identify the RNA-based, metabolically active bacterial composition of caries lesions at different stages of disease progression in order to provide a list of potential etiological agents of tooth decay. Design Non-cavitated enamel caries lesions (n=15) and dentin caries lesions samples (n=12) were collected from 13 individuals. RNA was extracted and cDNA was constructed, which was used to amplify the 16S rRNA gene. The resulting 780 bp polymerase chain reaction products were pyrosequenced using Titanium-plus chemistry, and the sequences obtained were used to determine the bacterial composition. Results A mean of 4,900 sequences of the 16S rRNA gene with an average read length of 661 bp was obtained per sample, giving a comprehensive view of the active bacterial communities in caries lesions. Estimates of bacterial diversity indicate that the microbiota of cavities is highly complex, each sample containing between 70 and 400 metabolically active species. The composition of these bacterial consortia varied among individuals and between caries lesions of the same individuals. In addition, enamel and dentin lesions had a different bacterial makeup. Lactobacilli were found almost exclusively in dentin cavities. Streptococci accounted for 40% of the total active community in enamel caries, and 20% in dentin caries. However, Streptococcus mutans represented only 0.02–0.73% of the total bacterial community. Conclusions The data indicate that the etiology of dental caries is tissue dependent and that the disease has a clear polymicrobial origin. The low proportion of mutans streptococci detected confirms that they

  12. [Tumor-like lesions of bone].

    PubMed

    Erlemann, R; Jundt, G

    2016-06-01

    Historically, tumor-like lesions of bone were defined as non-neoplastic bone lesions. Today, however, some of them are considered real neoplasms. They are among the most frequent bone lesions. They usually grow slowly, but occasionally they grow rapidly. Many of them can be diagnosed by plain films alone; in others, CT and MRI yield additional features for a correct diagnosis. Some lesions do not need treatment; others should be resected, and some may even recur. Non-ossifying fibroma, juvenile and aneurysmal bone cysts, fibrous and osteofibrous dysplasia and eosinophilic granuloma are presented. PMID:27216410

  13. Spectral lesion characterization on a photon-counting mammography system

    NASA Astrophysics Data System (ADS)

    Erhard, Klaus; Fredenberg, Erik; Homann, Hanno; Roessl, Ewald

    2014-03-01

    Spectral X-ray imaging allows to differentiate between two given tissue types, provided their spectral absorption characteristics differ measurably. In mammography, this method is used clinically to determine a decomposition of the breast into adipose and glandular tissue compartments, from which the glandular tissue fraction and, hence, the volumetric breast density (VBD) can be computed. Another potential application of this technique is the characterization of lesions by spectral mammography. In particular, round lesions are relatively easily detected by experienced radiologists, but are often difficult to characterize. Here, a method is described that aims at discriminating cystic from solid lesions directly on a spectral mammogram, obtained with a calibrated spectral mammography system and using a hypothesis-testing algorithm based on a maximum likelihood approach. The method includes a parametric model describing the lesion shape, compression height variations and breast composition. With the maximum likelihood algorithm, the model parameters are estimated separately under the cyst and solid hypothesis. The resulting ratio of the maximum likelihood values is used for the final tissue characterization. Initial results using simulations and phantom measurements are presented.

  14. Tractographic Analysis of Historical Lesion Surgery for Depression

    PubMed Central

    Schoene-Bake, Jan-Christoph; Parpaley, Yaroslav; Weber, Bernd; Panksepp, Jaak; Hurwitz, Trevor A; Coenen, Volker A

    2010-01-01

    Various surgical brain ablation procedures for the treatment of refractory depression were developed in the twentieth century. Most notably, key target sites were (i) the anterior cingulum, (ii) the anterior limb of the internal capsule, and (iii) the subcaudate white matter, which were regarded as effective targets. Long-term symptom remissions were better following lesions of the anterior internal capsule and subcaudate white matter than of the cingulum. It is possible that the observed clinical improvements of these various surgical procedures may reflect shared influences on presently unspecified brain affect-regulating networks. Such possibilities can now be analyzed using modern brain connectivity procedures such as diffusion tensor imaging (DTI) tractography. We determined whether the shared connectivities of the above lesion sites in healthy volunteers might explain the therapeutic effects of the various surgical approaches. Accordingly, modestly sized historical lesions, especially of the anatomical overlap areas, were ‘implanted' in brain-MRI scans of 53 healthy subjects. These were entered as seed regions for probabilistic DTI connectivity reconstructions. We analyzed for the shared connectivities of bilateral anterior capsulotomy, anterior cingulotomy, subcaudate tractotomy, and stereotactic limbic leucotomy (a combination of the last two lesion sites). Shared connectivities between the four surgical approaches mapped onto the most mediobasal aspects of bilateral frontal lobe fibers, including the forceps minor and the anterior thalamic radiations that contacted subgenual cingulate regions. Anatomically, convergence of these shared connectivities may derive from the superolateral branch of the medial forebrain bundle (MFB), a structure that connects these frontal areas to the origin of the mesolimbic dopaminergic ‘reward' system in the midbrain ventral tegmental area. Thus, all four surgical anti-depressant approaches may be promoting positive

  15. Precancerous lesions of oral mucosa

    PubMed Central

    Yardimci, Gurkan; Kutlubay, Zekayi; Engin, Burhan; Tuzun, Yalcin

    2014-01-01

    Precancerous lesions of oral mucosa, known as potentially malignant disorders in recent years, are consists of a group of diseases, which should be diagnosed in the early stage. Oral leukoplakia, oral submucous fibrosis, and oral erythroplakia are the most common oral mucosal diseases that have a very high malignant transformation rate. Oral lichen planus is one of the potentially malignant disorders that may be seen in six different subtypes including papular, reticular, plaque-like, atrophic, erosive, and bullous type, clinically. Atrophic and erosive subtypes have the greater increased malignant transformation risk compared to another subtypes. Although there are various etiological studies, the etiology of almost all these diseases is not fully understood. Geographically, etiologic factors may vary. The most frequently reported possible factors are tobacco use, alcohol drinking, chewing of betel quid containing areca nut, and solar rays. Early diagnosis is very important and can be lifesaving, because in late stages, they may be progressed to severe dysplasia and even carcinoma in situ and/or squamous cell carcinoma. For most diseases, treatment results are not satisfactory in spite of miscellaneous therapies. While at the forefront of surgical intervention, topical and systemic treatment alternatives such as corticosteroids, calcineurin inhibitors, and retinoids are widely used. PMID:25516862

  16. Focal liver lesions found incidentally

    PubMed Central

    Algarni, Abdullah A; Alshuhri, Abdullah H; Alonazi, Majed M; Mourad, Moustafa Mabrouk; Bramhall, Simon R

    2016-01-01

    Incidentally found focal liver lesions are a common finding and a reason for referral to hepatobiliary service. They are often discovered in patients with history of liver cirrhosis, colorectal cancer, incidentally during work up for abdominal pain or in a trauma setting. Specific points should considered during history taking such as risk factors of liver cirrhosis; hepatitis, alcohol consumption, substance exposure or use of oral contraceptive pills and metabolic syndromes. Full blood count, liver function test and tumor markers can act as a guide to minimize the differential diagnosis and to categorize the degree of liver disease. Imaging should start with B-mode ultrasound. If available, contrast enhanced ultrasound is a feasible, safe, cost effective option and increases the ability to reach a diagnosis. Contrast enhanced computed tomography should be considered next. It is more accurate in diagnosis and better to study anatomy for possible operation. Contrast enhanced magnetic resonance is the gold standard with the highest sensitivity. If doubt still remains, the options are biopsy or surgical excision. PMID:27028805

  17. Evaluation of hepatic cystic lesions.

    PubMed

    Lantinga, Marten A; Gevers, Tom J G; Drenth, Joost P H

    2013-06-21

    Hepatic cysts are increasingly found as a mere coincidence on abdominal imaging techniques, such as ultrasonography (USG), computed tomography (CT) and magnetic resonance imaging (MRI). These cysts often present a diagnostic challenge. Therefore, we performed a review of the recent literature and developed an evidence-based diagnostic algorithm to guide clinicians in characterising these lesions. Simple cysts are the most common cystic liver disease, and diagnosis is based on typical USG characteristics. Serodiagnostic tests and microbubble contrast-enhanced ultrasound (CEUS) are invaluable in differentiating complicated cysts, echinococcosis and cystadenoma/cystadenocarcinoma when USG, CT and MRI show ambiguous findings. Therefore, serodiagnostic tests and CEUS reduce the need for invasive procedures. Polycystic liver disease (PLD) is arbitrarily defined as the presence of > 20 liver cysts and can present as two distinct genetic disorders: autosomal dominant polycystic kidney disease (ADPKD) and autosomal dominant polycystic liver disease (PCLD). Although genetic testing for ADPKD and PCLD is possible, it is rarely performed because it does not affect the therapeutic management of PLD. USG screening of the liver and both kidneys combined with extensive family history taking are the cornerstone of diagnostic decision making in PLD. In conclusion, an amalgamation of these recent advances results in a diagnostic algorithm that facilitates evidence-based clinical decision making. PMID:23801855

  18. [Mandibular lesions in multiple myeloma].

    PubMed

    Scutellari, P N; Orzincolo, C

    1992-03-01

    A review was made of 237 cases of multiple myeloma seen at the Institute of Radiology and Hematology of the Ferrara University from 1984 through 1990. The results showed skeletal involvement of the mandible to be present in 25 patients (10.54%). The diagnosis of multiple myeloma was based on the following criteria: 1) increased number of abnormal, atypical or immature plasma cells in the bone marrow; 2) the presence of a monoclonal protein in the serum or urine; 3) bone lesions consistent with those of myeloma. Symptoms include pain and swelling of the oral cavity, tooth mobility and loss, numbness along the inferior dental nerve, and paresthesia of the lower lip. The typical radiographic appearance is a well-defined "punched-out" lytic defect, solitary or multiple; sometimes, the defect enlarges and appears "bubbly" or septated. Permeative lytic areas, with blurred outlines, are a rare pattern, which is radiologically indistinguishable from skeletal metastases. The involvement of the oral cavity and jaw in multiple myeloma has been often reported in literature: nevertheless, if radiographs of the jaws had been systematically taken in all the cases, its incidence would probably have been much higher than previously suspected. PMID:1579669

  19. Diagnostic evaluation of papillary lesions of the breast on core biopsy.

    PubMed

    Pathmanathan, Nirmala; Albertini, Ann-Flore; Provan, Pamela J; Milliken, Jane S; Salisbury, Elizabeth L; Bilous, A Michael; Byth, Karen; Balleine, Rosemary L

    2010-07-01

    The management of asymptomatic intraductal papillary lesions of the breast diagnosed on core biopsy poses a challenge for patients and clinicians, as the distinction between common benign lesions and atypical or malignant varieties may be difficult without formal excision. The aim of this study was to determine whether a combination of histopathologic and biomarker features could be used to accurately identify benign papillary lesions on core biopsy. An inclusive group of 127 excised papillary lesions was characterized by detailed histopathologic review and immunohistochemical staining for the basal markers cytokeratin 5/6 (CK5/6) and P63 and the proliferation marker Ki67. Comparison of benign, atypical, and malignant lesions revealed that the combination of broad, sclerotic fibrovascular cores, and epithelial CK5/6 staining was most commonly seen in benign papillomas. Ki67 staining revealed striking intralesional heterogeneity, but there was no difference between the high scores of benign, atypical, or malignant lesions (P=0.173). In a non-overlapping set of 42 cases, a binary classifier specifying benign lesions on the basis of thick fibrovascular cores and epithelial CK5/6 staining on core biopsy gave an overall misclassification rate of 4/42 (10%) when compared with the final excision diagnosis. Misclassified cases included 2/27 lesions ultimately diagnosed as benign and 2/2 atypical papillomas. All malignant lesions (n=13) were correctly assigned. The combined assessment of fibrovascular core thickness and CK5/6 staining on core biopsy distinguished benign from malignant papillary lesions, but did not separate benign from atypical cases. This approach may form a useful addition to the clinicopathologic evaluation of papillary lesions of the breast. PMID:20473278

  20. Cathepsin Protease Inhibition Reduces Endometriosis Lesion Establishment.

    PubMed

    Porter, Kristi M; Wieser, Friedrich A; Wilder, Catera L; Sidell, Neil; Platt, Manu O

    2016-05-01

    Endometriosis is a gynecologic disease characterized by the ectopic presence of endometrial tissue on organs within the peritoneal cavity, causing debilitating abdominal pain and infertility. Current treatments alleviate moderate pain symptoms associated with the disorder but exhibit limited ability to prevent new or recurring lesion establishment and growth. Retrograde menstruation has been implicated for introducing endometrial tissue into the peritoneal cavity, but molecular mechanisms underlying attachment and invasion are not fully understood. We hypothesize that cysteine cathepsins, a group of powerful extracellular matrix proteases, facilitate endometrial tissue invasion and endometriosis lesion establishment in the peritoneal wall and inhibiting this activity would decrease endometriosis lesion implantation. To test this, we used an immunocompetent endometriosis mouse model and found that endometriotic lesions exhibited a greater than 5-fold increase in active cathepsins compared to tissue from peritoneal wall or eutopic endometrium, with cathepsins L and K specifically implicated. Human endometriosis lesions also exhibited greater cathepsin activity than adjacent peritoneum tissue, supporting the mouse results. Finally, we tested the hypothesis that inhibiting cathepsin activity could block endometriosis lesion attachment and implantation in vivo. Intraperitoneal injection of the broad cysteine cathepsin inhibitor, E-64, significantly reduced the number of attached endometriosis lesions in our murine model compared to vehicle-treated controls demonstrating that cathepsin proteases contribute to endometriosis lesion establishment, and their inhibition may provide a novel, nonhormonal therapy for endometriosis. PMID:26482207

  1. Sentinel lesions of primary CNS lymphoma.

    PubMed Central

    Alderson, L; Fetell, M R; Sisti, M; Hochberg, F; Cohen, M; Louis, D N

    1996-01-01

    Some patients ultimately diagnosed with primary CNS lymphoma (PCNSL) have transient symptomatic contrast enhancing lesions. These "sentinel lesions" of PCNSL recede spontaneously or with corticosteroid treatment and present an important diagnostic dilemma because they show variable, but non-diagnostic histopathological features. Four previously healthy, immunocompetent patients aged 49 to 58 years had contrast enhancing intraparenchymal brain lesions. Before biopsy, three of the four were treated with corticosteroids. Initial biopsies showed demyelination with axonal sparing in two, non-specific inflammation in one, and normal brain in one. Infiltrating lymphocytes predominantly expressed T cell markers with rare B cells. All four patients recovered within two to four weeks after the initial biopsy and imaging studies showed resolution of the lesions. The CSF was normal in three of the four patients tested; oligoclonal bands were absent in both of the two tested. After seven to 11 months, each patient developed new symptomatic lesions in a different region of the brain, biopsy of which showed a B cell PCNSL. The mechanism of spontaneous involution of sentinel lesions is not understood, but may represent host immunity against the tumour. Sentinel lesions of PCNSL should be considered in patients with contrast enhancing focal parenchymal lesions that show non-specific or demyelinative histopathological changes. Close clinical and radiographic follow up is essential if PCNSL is to be diagnosed early in such patients. Images PMID:8558135

  2. Intraorbital Cystic Lesions: An Imaging Spectrum.

    PubMed

    Pahwa, Shivani; Sharma, Sanjay; Das, Chandan J; Dhamija, Ekta; Agrawal, Saurabh

    2015-01-01

    Presence of a cyst or a cystic component in an intraorbital mass often narrows the list of differential diagnoses to specific entities. Such a lesion in the orbit may arise from structures within the orbit, globe, and lacrimal system or from neighboring paranasal sinuses or meninges. Common congenital and developmental lesions encountered within the orbit include dermoids and epidermoids, and infrequently coloboma. Parasitic cysts (cysticercus), orbital abscess, mucocele, and vascular lesions are the most common acquired pathologies giving rise to fluid-containing lesions within the orbit. The role of a radiologist is crucial in expediting the diagnosis of orbital lesions with the help of characteristic imaging features on ultrasound, computed tomography, or magnetic resonance imaging. It also helps in identifying complications in others where formulation of an early and effective management strategy is vital for preserving vision. PMID:25908230

  3. Radiological evaluation of post-tracheostomy lesions

    PubMed Central

    Macmillan, Alexander S.; James, A. Everette; Stitik, Frederick P.; Grillo, Hermes C.

    1971-01-01

    Post-tracheostomy lesions are becoming more commonplace and surgical techniques for definitive repair of these abnormalities are being developed. These lesions, in general, occur at two sites, the proximal lesions at the tracheostomy incision and the distal lesions 1·5 to 2·5 cm inferior in the area of the tracheostomy balloon cuff. Granuloma formation, stenosis, tracheomalacia, and perforation of the tracheal wall have been encountered in our experience. Clinical symptoms depend upon the type and location of the lesion as well as on the patient's awareness and physical activity. Radiological evaluation offers an accurate method to depict the anatomical and physiological alterations. This radiological assessment should begin with routine postero-anterior and lateral chest radiographs followed by fluoroscopy. Laminograms and special oblique views are often helpful. Contrast tracheograms using powdered tantalum allow good mucosal detail as well as excellent delineation of structural and physiological abnormalities. Images PMID:5144647

  4. Diagnosing breast lesions by fine needle aspiration cytology or core biopsy: which is better?

    PubMed

    Tse, Gary M; Tan, Puay-Hoon

    2010-08-01

    Fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) are widely used in diagnosing breast lesions, with both achieving high sensitivity and specificity. Whether FNAC or CNB is better remains highly controversial. In this review, the advantages and disadvantages of each of these methods are discussed, especially in relation to specific problematic groups of breast lesions. In general, CNB has a slight advantage with lower inadequate and suspicious rates, allowing easier grade assessment and ancillary testings (hormome receptors, HER2) in cases of cancers. FNAC cannot reliably predict invasion in a malignant aspirate, whereas CNB, although useful in confirming invasion in carcinomas, has a much lower efficacy in predicting invasion when only in situ carcinoma is detected. The other problematic areas are papillary breast lesions and fibroepithelial lesions, notably phyllodes tumors. In papillary lesions, FNAC diagnosis is inaccurate, but with CNB, one can confidently diagnose papillary lesion, although there is still significant false positive and false negative rates, even with immunohistochemistry. For fibroepithelial lesions, using either FNAC or CNB to differentiate between a phyllodes tumor from fibroadenoma is also inaccurate. As management of breast diseases necessitates the triple approach (clinical, imaging and pathological), an awareness of the limitations of these very useful diagnostic modalities by all specialists is prudent, especially when dealing with these specific groups of breast lesions. PMID:20526738

  5. The structure of an authentic spore photoproduct lesion in DNA suggests a basis for recognition.

    PubMed

    Singh, Isha; Jian, Yajun; Lian, Yajun; Li, Lei; Georgiadis, Millie M

    2014-03-01

    The spore photoproduct lesion (SP; 5-thymine-5,6-dihydrothymine) is the dominant photoproduct found in UV-irradiated spores of some bacteria such as Bacillus subtilis. Upon spore germination, this lesion is repaired in a light-independent manner by a specific repair enzyme: the spore photoproduct lyase (SP lyase). In this work, a host-guest approach in which the N-terminal fragment of Moloney murine leukemia virus reverse transcriptase (MMLV RT) serves as the host and DNA as the guest was used to determine the crystal structures of complexes including 16 bp oligonucleotides with and without the SP lesion at 2.14 and 1.72 Å resolution, respectively. In contrast to other types of thymine-thymine lesions, the SP lesion retains normal Watson-Crick hydrogen bonding to the adenine bases of the complementary strand, with shorter hydrogen bonds than found in the structure of the undamaged DNA. However, the lesion induces structural changes in the local conformation of what is otherwise B-form DNA. The region surrounding the lesion differs significantly in helical form from B-DNA, and the minor groove is widened by almost 3 Å compared with that of the undamaged DNA. Thus, these unusual structural features associated with SP lesions may provide a basis for recognition by the SP lyase. PMID:24598744

  6. An interdisciplinary approach for the management of noncarious lesions

    PubMed Central

    Purushotham, Sahana; Manjunath, Nandini; D’Souza, Melba Lisa; Shetty, Roshan

    2016-01-01

    Miller's class III gingival recession is a common entity observed in individuals, posing a difficult situation for the clinicians to treat. Large fenestration defects with cervical abrasion compromise the esthetics resulting in poor prognosis. Obtaining predictable and esthetic root coverage has become an integral part of periodontal therapy. The present case report describes a situation where class III gingival recession with cervical abrasion was seen in the lower central incisors. The patient was successfully treated with a combination of restorations (Filtek Z350® composite resin) to fill the defect, followed by fenestration procedure to increase the vestibular depth and subsequently with grafting procedure (soft tissue autograft with bovine-derived xenograft collagen [Bio-oss]). Though the results were not tangible esthetically, it was functionally successful as evidenced during the follow-up period. PMID:27143838

  7. The mechanism of the keyhole lesion reassessed: An experimental approach.

    PubMed

    Delannoy, Yann; Colard, Thomas; Le Garff, Erwan; Humez, Sarah; Gosset, Didier; Hedouin, Valéry

    2016-01-01

    The initial description of the keyhole defect was detailed as a peculiar gunshot entrance wound in the cranial vault due to firearm discharge in a tangential path. This injury may be described in two parts: a rounded section with inner table beveling and a triangular section with outer table beveling. We report a case of a gunshot skull wound "keyhole" shaped, appeared to have been made perpendicularly to the bone. Performing an experimental study on cranial bones with shots made perpendicularly to the skull approved this hypothesis, and bone injuries were then architecturally characterised using high-resolution micro computed tomography. The singular link between the tangential gunshot path and the keyhole pattern has been refuted several times, and some authors have hypothesised that there is an important role for concentric fractures that occur far away from the initial impact point of the bullet. Micro computed tomography analysis of the bone showed these keyhole defect features with a particular high description. Then, the whole pattern has a spider-web effect, and these concentric fractures could explain the keyhole pattern even in a perpendicular gunshot path. PMID:26497111

  8. Hearing results in surgery for primary petrous apex lesions.

    PubMed

    Gianoli, G J; Amedee, R G

    1994-09-01

    Hearing preservation is a frequently mentioned phrase in the growing field of skull base surgery. Many authors have attempted to identify prognostic factors for successful hearing preservation, and many have suggested alternative procedures for preserving serviceable hearing. Few have mentioned hearing improvement with skull base surgical procedures. In this article we present the hearing results of 25 surgical procedures for primary petrous apex lesions. These include 13 cholesterol granulomas, 5 cholesteatomas, 4 mucoceles, and 3 eosinophilic granulomas. Surgical approaches included 14 transmastoid/infralabyrinthine, 6 transphenoid, 3 suboccipital, and 2 transmastoid/translabyrinthine. Hearing was maintained in 14 patients (56%), improved in 9 patients (36%), and worse in 1 patient with nonserviceable hearing before surgery (4%); 1 patient had profound hearing loss before surgery (4%). Results of this review should have significant implications on the choice of surgical approach for petrous apex lesions. Additionally, the standard method of determining salvageable hearing for most skull base procedures may not apply for this specific group of lesions. Implications for future treatment plans will be discussed in detail. PMID:8084633

  9. detecting multiple sclerosis lesions with a fully bioinspired visual attention model

    NASA Astrophysics Data System (ADS)

    Villalon-Reina, Julio; Gutierrez-Carvajal, Ricardo; Thompson, Paul M.; Romero-Castro, Eduardo

    2013-11-01

    The detection, segmentation and quantification of multiple sclerosis (MS) lesions on magnetic resonance images (MRI) has been a very active field for the last two decades because of the urge to correlate these measures with the effectiveness of pharmacological treatment. A myriad of methods has been developed and most of these are non specific for the type of lesions and segment the lesions in their acute and chronic phases together. On the other hand, radiologists are able to distinguish between several stages of the disease on different types of MRI images. The main motivation of the work presented here is to computationally emulate the visual perception of the radiologist by using modeling principles of the neuronal centers along the visual system. By using this approach we are able to detect the lesions in the majority of the images in our population sample. This type of approach also allows us to study and improve the analysis of brain networks by introducing a priori information.

  10. Optical configuration of pigmented lesion detection by frequency analysis of skin speckle patterns

    PubMed Central

    Bishitz, Yael; Ozana, Nisan; Schwarz, Ariel; Beiderman, Yevgeny; Garcia, Javier; Zalevsky, Zeev

    2016-01-01

    In this paper we present a novel approach of realizing a safe, simple, and inexpensive sensor applicable to pigmented lesions detection. The approach is based on temporal tracking of back-reflected secondary speckle patterns generated while illuminating the affected area with a laser and applying periodic pressure to the surface via a controlled vibration source. When applied to pigmented lesions, the technique is superior to visual examination in avoiding many false positives and resultant unnecessary biopsies. Applying a series of different vibration frequencies at the examined tissue and analyzing the 2-D time varying speckle patterns in response to the applied periodic pressure creates a unique signature for each and different pigmented lesion. Analyzing these signatures is the first step toward detection of malignant melanoma. In this paper we present preliminary experiments that show the validity of the developed sensor for the classification of pigmented lesions. PMID:27231603

  11. Optical configuration of pigmented lesion detection by frequency analysis of skin speckle patterns.

    PubMed

    Bishitz, Yael; Ozana, Nisan; Schwarz, Ariel; Beiderman, Yevgeny; Garcia, Javier; Zalevsky, Zeev

    2016-03-01

    In this paper we present a novel approach of realizing a safe, simple, and inexpensive sensor applicable to pigmented lesions detection. The approach is based on temporal tracking of back-reflected secondary speckle patterns generated while illuminating the affected area with a laser and applying periodic pressure to the surface via a controlled vibration source. When applied to pigmented lesions, the technique is superior to visual examination in avoiding many false positives and resultant unnecessary biopsies. Applying a series of different vibration frequencies at the examined tissue and analyzing the 2-D time varying speckle patterns in response to the applied periodic pressure creates a unique signature for each and different pigmented lesion. Analyzing these signatures is the first step toward detection of malignant melanoma. In this paper we present preliminary experiments that show the validity of the developed sensor for the classification of pigmented lesions. PMID:27231603

  12. ACG clinical guideline: the diagnosis and management of focal liver lesions.

    PubMed

    Marrero, Jorge A; Ahn, Joseph; Rajender Reddy, K

    2014-09-01

    Focal liver lesions (FLL) have been a common reason for consultation faced by gastroenterologists and hepatologists. The increasing and widespread use of imaging studies has led to an increase in detection of incidental FLL. It is important to consider not only malignant liver lesions, but also benign solid and cystic liver lesions such as hemangioma, focal nodular hyperplasia, hepatocellular adenoma, and hepatic cysts, in the differential diagnosis. In this ACG practice guideline, the authors provide an evidence-based approach to the diagnosis and management of FLL. PMID:25135008

  13. Two Cases of Ileal Dieulafoy Lesion with Massive Hematochezia Treated by Single Balloon Enteroscopy

    PubMed Central

    Choi, Young Chul; Park, Sang Hyun; Kwon, Kye Sook; Kim, Hyung Gil; Shin, Yong Woon

    2012-01-01

    Ileal Dieulafoy lesion is an unusual vascular abnormality that can cause gastrointestinal bleeding. It can be associated with massive, life-threatening hemorrhage and requires urgent angiographic intervention or surgery. Ileal Dieulafoy lesion is hard to recognize due to inaccessibility and normal-appearing mucosa. With advances in endoscopy, aggressive diagnostic and therapeutic approaches including enteroscopy have recently been performed for small bowel bleeding. We report two cases of massive ileal Dieulafoy lesion bleeding diagnosed and treated successfully by single balloon enteroscopy with a review of the literature. PMID:23251897

  14. Noncontact monitoring of vascular lesion phototherapy efficiency by RGB multispectral imaging.

    PubMed

    Jakovels, Dainis; Kuzmina, Ilona; Berzina, Anna; Valeine, Lauma; Spigulis, Janis

    2013-12-01

    A prototype low-cost RGB imaging system consisting of a commercial RGB CMOS sensor, RGB light-emitting diode ring light illuminator, and a set of polarizers was designed and tested for mapping the skin erythema index, in order to monitor skin recovery after phototherapy of vascular lesions, such as hemangiomas and telangiectasias. The contrast of erythema index (CEI) was proposed as a parameter for quantitative characterization of vascular lesions. Skin recovery was characterized as a decrease of the CEI value relative to the value before the treatment. This approach was clinically validated by examining 31 vascular lesions before and after phototherapy. PMID:24362928

  15. Tumefactive fibroinflammatory lesion of the head and neck treated with steroids: a case report.

    PubMed

    Hostalet, F; Hellin, D; Ruiz, J A

    2003-04-01

    Tumefactive fibroinflammatory lesion is an idiopathic fibrosclerosing disorder of the head and neck region that clinically simulates a malignant process, but is histologically benign. This lesion is believed to be part of a broader fibrosclerotic syndrome that includes idiopathic mediastinal and retroperitoneal fibrosis, sclerosing cholangitis and Riedel's thyroiditis. The tumefactive fibroinflammatory lesion differs from other fibrosing conditions encountered in the head and neck region: fibromatoses, nodular fasciitis and fibrosarcomas. Although there is no optimum treatment, steroid therapy is suggested as the first line of management. Our patient was treated with corticosteroids and had a favourable response, supporting this approach as the initial treatment. PMID:12709810

  16. Treatment of a Periodontic-Endodontic Lesion in a Patient with Aggressive Periodontitis

    PubMed Central

    2016-01-01

    Case Description. This case report describes the successful management of a left mandibular first molar with a combined periodontic-endodontic lesion in a 35-year-old Caucasian woman with aggressive periodontitis using a concerted approach including endodontic treatment, periodontal therapy, and a periodontal regenerative procedure using an enamel matrix derivate. In spite of anticipated poor prognosis, the tooth lesion healed. This case report also discusses the rationale behind different treatment interventions. Practical Implication. Periodontic-endodontic lesions can be successfully treated if dental professionals follow a concerted treatment protocol that integrates endodontic and periodontic specialties. General dentists can be the gatekeepers in managing these cases. PMID:27418983

  17. Treatment of lesions of the rotator cuff.

    PubMed

    Saggini, R; Cavezza, T; Di Pancrazio, L; Pisciella, V; Saladino, G; Zuccaro, M C; Bellomo, R G

    2010-01-01

    The impingement syndrome and tendinopathy of the rotator cuff are the most common causes (complaints) of pain and disability of the shoulder. The aim of this study is to evaluate the efficacy of a specific rehabilitative protocol, integrated with the administration of a nutritional supplement, in the conservative rehabilitative treatment, as well as in post-surgery, of patients with lesions of the rotator cuff. Two groups with syndrome of the rotator cuff were formed to follow different therapeutic courses, in relation to the choice of each subject to undergo the conservative treatment (Arm A) or the surgical one (Arm B). In Arm A the study included the association of therapy with ESWT (shock waves) with the proprioceptive Multi Joint System, for rehabilitating joint movement and muscle strength of the shoulder, and a specific nutritional supplement to reduce the pain and conserve the cartilage tissue. Between February 2009 and June 2009, we enrolled 30 subjects (randomized into three homogenous groups A1, A2, A3), average age 45±10 years, with rotator cuff syndrome with calcification of the shoulder, diagnosed through clinical examination and investigative instruments (X-ray, echography or NMR). In Arm B, from September 2009 to January 2010, we enrolled 50 patients (randomized into two groups, B1 and B2), 24 male (average age 58.4: min 28 and max 78) and 26 females (average age 59.5: min 30 and max 80), who had undergone rotator cuff operations and acromionplasty for non-massive lesions without important gleno-humeral instability, with either open or arthroscopic procedures. The analysis of the results of Arm A highlights that in terms of reducing pain the main benefits were found in Group A1 where the supplement was given. From the analysis of the data of Arm B, in both groups an improvement of the first 4 items evaluated was evident. In Group B1, 84 percent of the patients declared to be satisfied and improved and 16 percent were dissatisfied; in Group B2

  18. Multiparametric MRI for Localized Prostate Cancer: Lesion Detection and Staging

    PubMed Central

    Margolis, Daniel J. A.

    2014-01-01

    Multiparametric MRI of the prostate combines high-resolution anatomic imaging with functional imaging of alterations in normal tissue caused by neoplastic transformation for the identification and characterization of in situ prostate cancer. Lesion detection relies on a systematic approach to the analysis of both anatomic and functional imaging using established criteria for the delineation of suspicious areas. Staging includes visual and functional analysis of the prostate “capsule” to determine if in situ disease is, in fact, organ-confined, as well as the evaluation of pelvic structures including lymph nodes and bones for the detection of metastasis. Although intertwined, the protocol can be optimized depending on whether lesion detection or staging is of the highest priority. PMID:25525600

  19. Evaluation of thermal and cryo lesions by diffusion-weighted MRI

    NASA Astrophysics Data System (ADS)

    Chen, Jing; Daniel, Bruce; Bouley, Donna; Sommer, Graham; Butts Pauly, Kim

    2007-02-01

    The purpose of this study is to further investigate the approach of DWI to estimate the cell viability immediately after treatment. In this work, we reported the result from 12 canine prostate experiments underwent cryoablation or hyperthermic therapy. The lesion detected by diffusion-weighted imaging was evaluated through apparent diffusion coefficient (ADC) value, image contrast, and lesion contour compared to contrast enhanced imaging and histology.

  20. Classifiers for Ischemic Stroke Lesion Segmentation: A Comparison Study

    PubMed Central

    Maier, Oskar; Schröder, Christoph; Forkert, Nils Daniel; Martinetz, Thomas; Handels, Heinz

    2015-01-01

    Motivation Ischemic stroke, triggered by an obstruction in the cerebral blood supply, leads to infarction of the affected brain tissue. An accurate and reproducible automatic segmentation is of high interest, since the lesion volume is an important end-point for clinical trials. However, various factors, such as the high variance in lesion shape, location and appearance, render it a difficult task. Methods In this article, nine classification methods (e.g. Generalized Linear Models, Random Decision Forests and Convolutional Neural Networks) are evaluated and compared with each other using 37 multiparametric MRI datasets of ischemic stroke patients in the sub-acute phase in terms of their accuracy and reliability for ischemic stroke lesion segmentation. Within this context, a multi-spectral classification approach is compared against mono-spectral classification performance using only FLAIR MRI datasets and two sets of expert segmentations are used for inter-observer agreement evaluation. Results and Conclusion The results of this study reveal that high-level machine learning methods lead to significantly better segmentation results compared to the rather simple classification methods, pointing towards a difficult non-linear problem. The overall best segmentation results were achieved by a Random Decision Forest and a Convolutional Neural Networks classification approach, even outperforming all previously published results. However, none of the methods tested in this work are capable of achieving results in the range of the human observer agreement and the automatic ischemic stroke lesion segmentation remains a complicated problem that needs to be explored in more detail to improve the segmentation results. PMID:26672989

  1. Colon Preneoplastic Lesions in Animal Models

    PubMed Central

    Suzui, Masumi; Morioka, Takamitsu; Yoshimi, Naoki

    2013-01-01

    The animal model is a powerful and fundamental tool in the field of biochemical research including toxicology, carcinogenesis, cancer therapeutics and prevention. In the carcinogenesis animal model system, numerous examples of preneoplastic lesions have been isolated and investigated from various perspectives. This may indicate that several options of endpoints to evaluate carcinogenesis effect or therapeutic outcome are presently available; however, classification of preneoplastic lesions has become complicated. For instance, these lesions include aberrant crypt foci (ACF), dysplastic ACF, flat ACF, β-catenin accumulated crypts, and mucin-depleted foci. These lesions have been induced by commonly used chemical carcinogens such as azoxymethane (AOM), 1,2-dimethylhydrazine (DMH), methylnitrosourea (MUN), or 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP). Investigators can choose any procedures or methods to examine colonic preneoplastic lesions according to their interests and the objectives of their experiments. Based on topographical, histopathological, and biological features of colon cancer preneoplastic lesions in the animal model, we summarize and discuss the character and implications of these lesions. PMID:24526805

  2. Hepatic lesions segmentation in ultrasound nonlinear imaging

    NASA Astrophysics Data System (ADS)

    Kissi, Adelaide A.; Cormier, Stephane; Pourcelot, Leandre; Tranquart, Francois

    2005-04-01

    Doppler has been used for many years for cardiovascular exploration in order to visualize the vessels walls and anatomical or functional diseases. The use of ultrasound contrast agents makes it possible to improve ultrasonic information. Nonlinear ultrasound imaging highlights the detection of these agents within an organ and hence is a powerful technique to image perfusion of an organ in real-time. The visualization of flow and perfusion provides important information for the diagnosis of various diseases as well as for the detection of tumors. However, the images are buried in noise, the speckle, inherent in the image formation. Furthermore at portal phase, there is often an absence of clear contrast between lesions and surrounding tissues because the organ is filled with agents. In this context, we propose a new method of automatic liver lesions segmentation in nonlinear imaging sequences for the quantification of perfusion. Our method of segmentation is divided into two stages. Initially, we developed an anisotropic diffusion step which raised the structural characteristics to eliminate the speckle. Then, a fuzzy competitive clustering process allowed us to delineate liver lesions. This method has been used to detect focal hepatic lesions (metastasis, nodular hyperplasia, adenoma). Compared to medical expert"s report obtained on 15 varied lesions, the automatic segmentation allows us to identify and delineate focal liver lesions during the portal phase which high accuracy. Our results show that this method improves markedly the recognition of focal hepatic lesions and opens the way for future precise quantification of contrast enhancement.

  3. Association of Malassezia species with psoriatic lesions.

    PubMed

    Rudramurthy, Shivaprakash M; Honnavar, Prasanna; Chakrabarti, Arunaloke; Dogra, Sunil; Singh, Pankaj; Handa, Sanjeev

    2014-08-01

    The aetiology of psoriasis remains elusive. Among multiple factors hypothesised, association of Malassezia spp. is supported by response to topical antifungals. The objective of this study was to evaluate the association of Malassezia spp. with psoriatic lesion. The subjects included 50 consecutive patients with psoriasis, and 50 age- and sex-matched healthy controls. Samples were collected using scotch tape over one square inch area from the lesional and non-lesional sites. The isolated Malassezia spp. were identified by phenotypic methods and confirmed by ITS2 PCR-RFLP and sequencing of D1/D2 region of 26S rDNA. Psoriatic lesions were seen commonly on scalp (28%, 14), chest (22%, 11) and arms (16%, 8). Majority of cases presented with chronic plaque form (76%, 38; P < 0.05). From psoriatic lesions, most frequently isolated Malassezia species was M. furfur (70.6%, 24), followed by M. japonica (11.8%, 4) and M. globosa (8.8%, 3). From healthy individuals M. furfur, M. sympodialis, mixture of M. furfur and M. globosa was isolated in 73.3%, 10% and 16.7% (22, 3 and 5) of cases respectively. The average number of colonies isolated from scalp lesions of the patients was significantly higher (P = 0.03) than healthy areas. Although no strong association of Malassezia species was formed with psoriatic lesion in general, the fungi may play a role in exacerbation of scalp psoriasis. PMID:24655111

  4. Pediatric soft tissue oral lesions.

    PubMed

    Pinto, Andres; Haberland, Christel M; Baker, Suher

    2014-04-01

    This article provides an overview of common color changes and soft tissue oral nodular abnormalities in children and adolescents. The clinical presentation and treatment options to address these conditions are presented in a concise approach, highlighting key features relevant to the oral health care professional. PMID:24655531

  5. Neurovestibular Compensation following Ototoxic Lesion and Labyrinthectomy.

    PubMed

    Yazdanshenas, Hamed; Ashouri, Anousheh; Kaufman, Galen

    2016-04-01

    Introduction Unilateral labyrinthectomy and intra-tympanic gentamycin have been employed in the treatment of Ménière's disease, but the efficacy of these techniques has not been well established. Objective The objective of this study is to measure the time course of recovery from a unilateral labyrinthectomy either after ipsilateral topical treatment with gentamicin to the inner ear or without the previous insult. Methods Twenty-nine adult Mongolian gerbils were randomized into two experimental groups. Group 1 (n = 17) received a right ear gentamicin drug-induced lesion by unilateral labyrinthectomy (UL). Group 2 (n = 12) only received a right unilateral labyrinthectomy lesion. We measured the horizontal vestibulo-ocular responses in gerbils before and after the lesion. The gerbils received an angular acceleration stimulus and their eye movements were recorded. Results The gentamicin lesion resulted in a quicker recovery. Experimental groups underwent a similar time course of recovery. Statistical analysis showed no significant difference between the two groups. Both groups displayed adaptation to the lesion by day 21, but long-term compensation did not completely revert to the original pre-lesion state. Conclusions In a lesion requiring both static and dynamic compensation as in UL, the need for a static compensation may alter pre-existing compensation from a previous dynamic insult and require a new compensation. A previous lesion and adaptation is not preserved for a second lesion and the subject has to re-compensate. Therefore, surgical treatment in Meniere's disease such as UL can be considered without prior gentamicin treatment. Static and dynamic compensations do not appear to be as independent as previous studies have suggested. PMID:27096015

  6. Neurovestibular Compensation following Ototoxic Lesion and Labyrinthectomy

    PubMed Central

    Yazdanshenas, Hamed; Ashouri, Anousheh; Kaufman, Galen

    2016-01-01

    Introduction Unilateral labyrinthectomy and intra-tympanic gentamycin have been employed in the treatment of Ménière's disease, but the efficacy of these techniques has not been well established. Objective The objective of this study is to measure the time course of recovery from a unilateral labyrinthectomy either after ipsilateral topical treatment with gentamicin to the inner ear or without the previous insult. Methods Twenty-nine adult Mongolian gerbils were randomized into two experimental groups. Group 1 (n = 17) received a right ear gentamicin drug-induced lesion by unilateral labyrinthectomy (UL). Group 2 (n = 12) only received a right unilateral labyrinthectomy lesion. We measured the horizontal vestibulo-ocular responses in gerbils before and after the lesion. The gerbils received an angular acceleration stimulus and their eye movements were recorded. Results The gentamicin lesion resulted in a quicker recovery. Experimental groups underwent a similar time course of recovery. Statistical analysis showed no significant difference between the two groups. Both groups displayed adaptation to the lesion by day 21, but long-term compensation did not completely revert to the original pre-lesion state. Conclusions In a lesion requiring both static and dynamic compensation as in UL, the need for a static compensation may alter pre-existing compensation from a previous dynamic insult and require a new compensation. A previous lesion and adaptation is not preserved for a second lesion and the subject has to re-compensate. Therefore, surgical treatment in Meniere's disease such as UL can be considered without prior gentamicin treatment. Static and dynamic compensations do not appear to be as independent as previous studies have suggested. PMID:27096015

  7. Coping strategies in patients with acquired brain injury: relationships between coping, apathy, depression and lesion location.

    PubMed

    Finset, A; Andersson, S

    2000-10-01

    Coping strategies in individuals suffering severe traumatic brain injury (TBI), cerebrovascular accidents (CVA), or hypoxic brain injury (HBI) were investigated in relation to apathy, depression, and lesion location. Seventy patients (27 with TBI, 30 with CVA, and 13 with HBI) filled in a coping questionnaire (COPE) and were evaluated with respect to apathy and depression. A comparison sample of 71 students also filled in COPE. Patients coping strategies were similar to the comparison group, but patients tended to display less differentiated coping styles. A factor analysis indicated two dimensions of coping in the patient sample; approach oriented and avoidance oriented coping. Approach and avoidance coping sum scores, based on subscales from the two factors, were positively correlated in the patient sample, but not in the comparison group. Lack of active approach oriented coping was associated with apathy, whereas avoidant coping was associated with depression. Coping styles were not related to lesion location. Apathy was related to subcortical and right hemisphere lesions. In bivariate analyses, depression was unrelated to lesion location, but, in a MANCOVA, avoidant coping, apathy and lesion location (left hemisphere lesions) contributed to the variance in positive depressive symptoms. The consistent relationships between coping strategies and neuropsychiatric symptoms were interpreted as two dimensions of adaptational behaviour: an active vs. passive dimension and a depression--distress-avoidance dimension. PMID:11076135

  8. Multiple sclerosis with caudate lesions on MRI.

    PubMed

    Hashiguchi, S; Ogasawara, N; Mine, H; Kawachi, Y

    2001-04-01

    A 31-year-old woman displayed sleepiness and impairment of recent memory. T2-weighted MRI revealed high signal intensity lesions in the bilateral basal ganglia, thalamus, and brainstem. Although remission was achieved with corticosteroid therapy, she again displayed memory dysfunction and emotional disturbance one year later, at which time MRI disclosed new lesions in the right caudate nucleus and left frontal white matter. Corticosteroid therapy lead to improvement, and she suffered no recurrence on maintenance steroid therapy. These findings suggest that caudate lesions do occur in multiple sclerosis, the manifestations of which can be abulia and memory dysfunction, as in the present case. PMID:11334400

  9. The Horizon for Treating Cutaneous Vascular Lesions

    PubMed Central

    Patel, Amit M.; Chou, Elizabeth L.; Findeiss, Laura; Kelly, Kristen M.

    2013-01-01

    Dermatologists encounter a wide range of cutaneous vascular lesions, including infantile hemangiomas, port-wine stain birthmarks, arteriovenous malformations, venous malformations, Kaposi sarcomas, angiosarcomas, and angiofibromas. Current treatment modalities to reduce these lesions include topical and/or intralesional steroids, laser therapy, surgical resection, and endovascular therapy. However, each method has limitations owing to recurrence, comorbidities, toxicity, or lesion location. Photodynamic therapy, antiangiogenic therapy, and evolving methods of sclerotherapy are promising areas of development that may mitigate limitations of current treatments and offer exciting options for patients and their physicians. PMID:22640429

  10. Lesion segmentation from multimodal MRI using random forest following ischemic stroke.

    PubMed

    Mitra, Jhimli; Bourgeat, Pierrick; Fripp, Jurgen; Ghose, Soumya; Rose, Stephen; Salvado, Olivier; Connelly, Alan; Campbell, Bruce; Palmer, Susan; Sharma, Gagan; Christensen, Soren; Carey, Leeanne

    2014-09-01

    Understanding structure-function relationships in the brain after stroke is reliant not only on the accurate anatomical delineation of the focal ischemic lesion, but also on previous infarcts, remote changes and the presence of white matter hyperintensities. The robust definition of primary stroke boundaries and secondary brain lesions will have significant impact on investigation of brain-behavior relationships and lesion volume correlations with clinical measures after stroke. Here we present an automated approach to identify chronic ischemic infarcts in addition to other white matter pathologies, that may be used to aid the development of post-stroke management strategies. Our approach uses Bayesian-Markov Random Field (MRF) classification to segment probable lesion volumes present on fluid attenuated inversion recovery (FLAIR) MRI. Thereafter, a random forest classification of the information from multimodal (T1-weighted, T2-weighted, FLAIR, and apparent diffusion coefficient (ADC)) MRI images and other context-aware features (within the probable lesion areas) was used to extract areas with high likelihood of being classified as lesions. The final segmentation of the lesion was obtained by thresholding the random forest probabilistic maps. The accuracy of the automated lesion delineation method was assessed in a total of 36 patients (24 male, 12 female, mean age: 64.57±14.23yrs) at 3months after stroke onset and compared with manually segmented lesion volumes by an expert. Accuracy assessment of the automated lesion identification method was performed using the commonly used evaluation metrics. The mean sensitivity of segmentation was measured to be 0.53±0.13 with a mean positive predictive value of 0.75±0.18. The mean lesion volume difference was observed to be 32.32%±21.643% with a high Pearson's correlation of r=0.76 (p<0.0001). The lesion overlap accuracy was measured in terms of Dice similarity coefficient with a mean of 0.60±0.12, while the contour

  11. Long term motor function after neonatal stroke: Lesion localization above all.

    PubMed

    Dinomais, Mickael; Hertz-Pannier, Lucie; Groeschel, Samuel; Chabrier, Stéphane; Delion, Matthieu; Husson, Béatrice; Kossorotoff, Manoelle; Renaud, Cyrille; Nguyen The Tich, Sylvie

    2015-12-01

    Motor outcome is variable following neonatal arterial ischemic stroke (NAIS). We analyzed the relationship between lesion characteristics on brain MRI and motor function in children who had suffered from NAIS. Thirty eight full term born children with unilateral NAIS were investigated at the age of seven. 3D T1- and 3D FLAIR-weighted MR images were acquired on a 3T MRI scanner. Lesion characteristics were compared between patients with and without cerebral palsy (CP) using the following approaches: lesion localization either using a category-based analysis, lesion mapping as well as voxel-based lesion-symptom mapping (VLSM). Using diffusion-weighted imaging the microstructure of the cortico-spinal tract (CST) was related to the status of CP by measuring DTI parameters. Whereas children with lesions sparing the primary motor system did not develop CP, CP was always present when extensive lesions damaged at least two brain structures involving the motor system. The VLSM approach provided a statistical map that confirmed the cortical lesions in the primary motor system and revealed that CP was highly correlated with lesions in close proximity to the CST. In children with CP, diffusion parameters indicated microstructural changes in the CST at the level of internal capsule and the centrum semiovale. White matter damage of the CST in centrum semiovale was a highly reproducible marker of CP. This is the first description of the implication of this latter region in motor impairment after NAIS. In conclusion, CP in childhood was closely linked to the location of the infarct in the motor system. PMID:26512551

  12. Skin Lesions on Common Bottlenose Dolphins (Tursiops truncatus) from Three Sites in the Northwest Atlantic, USA

    PubMed Central

    Hart, Leslie Burdett; Rotstein, Dave S.; Wells, Randall S.; Allen, Jason; Barleycorn, Aaron; Balmer, Brian C.; Lane, Suzanne M.; Speakman, Todd; Zolman, Eric S.; Stolen, Megan; McFee, Wayne; Goldstein, Tracey; Rowles, Teri K.; Schwacke, Lori H.

    2012-01-01

    Skin disease occurs frequently in many cetacean species across the globe; methods to categorize lesions have relied on photo-identification (photo-id), stranding, and by-catch data. The current study used photo-id data from four sampling months during 2009 to estimate skin lesion prevalence and type occurring on bottlenose dolphins (Tursiops truncatus) from three sites along the southeast United States coast [Sarasota Bay, FL (SSB); near Brunswick and Sapelo Island, GA (BSG); and near Charleston, SC (CHS)]. The prevalence of lesions was highest among BSG dolphins (P = 0.587) and lowest in SSB (P = 0.380), and the overall prevalence was significantly different among all sites (p<0.0167). Logistic regression modeling revealed a significant reduction in the odds of lesion occurrence for increasing water temperatures (OR = 0.92; 95%CI:0.906–0.938) and a significantly increased odds of lesion occurrence for BSG dolphins (OR = 1.39; 95%CI:1.203–1.614). Approximately one-third of the lesioned dolphins from each site presented with multiple types, and population differences in lesion type occurrence were observed (p<0.05). Lesions on stranded dolphins were sampled to determine the etiology of different lesion types, which included three visually distinct samples positive for herpesvirus. Although generally considered non-fatal, skin disease may be indicative of animal health or exposure to anthropogenic or environmental threats, and photo-id data provide an efficient and cost-effective approach to document the occurrence of skin lesions in free-ranging populations. PMID:22427955

  13. Skin lesions on common bottlenose dolphins (Tursiops truncatus) from three sites in the Northwest Atlantic, USA.

    PubMed

    Hart, Leslie Burdett; Rotstein, Dave S; Wells, Randall S; Allen, Jason; Barleycorn, Aaron; Balmer, Brian C; Lane, Suzanne M; Speakman, Todd; Zolman, Eric S; Stolen, Megan; McFee, Wayne; Goldstein, Tracey; Rowles, Teri K; Schwacke, Lori H

    2012-01-01

    Skin disease occurs frequently in many cetacean species across the globe; methods to categorize lesions have relied on photo-identification (photo-id), stranding, and by-catch data. The current study used photo-id data from four sampling months during 2009 to estimate skin lesion prevalence and type occurring on bottlenose dolphins (Tursiops truncatus) from three sites along the southeast United States coast [Sarasota Bay, FL (SSB); near Brunswick and Sapelo Island, GA (BSG); and near Charleston, SC (CHS)]. The prevalence of lesions was highest among BSG dolphins (P = 0.587) and lowest in SSB (P = 0.380), and the overall prevalence was significantly different among all sites (p<0.0167). Logistic regression modeling revealed a significant reduction in the odds of lesion occurrence for increasing water temperatures (OR = 0.92; 95%CI:0.906-0.938) and a significantly increased odds of lesion occurrence for BSG dolphins (OR = 1.39; 95%CI:1.203-1.614). Approximately one-third of the lesioned dolphins from each site presented with multiple types, and population differences in lesion type occurrence were observed (p<0.05). Lesions on stranded dolphins were sampled to determine the etiology of different lesion types, which included three visually distinct samples positive for herpesvirus. Although generally considered non-fatal, skin disease may be indicative of animal health or exposure to anthropogenic or environmental threats, and photo-id data provide an efficient and cost-effective approach to document the occurrence of skin lesions in free-ranging populations. PMID:22427955

  14. Lesion Expansion in Experimental Demyelination Animal Models and Multiple Sclerosis Lesions.

    PubMed

    Große-Veldmann, René; Becker, Birte; Amor, Sandra; van der Valk, Paul; Beyer, Cordian; Kipp, Markus

    2016-09-01

    Gray matter pathology is an important aspect of multiple sclerosis (MS) pathogenesis and disease progression. In a recent study, we were able to demonstrate that the higher myelin content in the white matter parts of the brain is an important variable in the neuroinflammatory response during demyelinating events. Whether higher white matter myelination contributes to lesion development and progression is not known. Here, we compared lesion size of intra-cortical vs. white matter MS lesions. Furthermore, dynamics of lesion development was compared in the cuprizone and lysophosphatidylcholine models. We provide clear evidence that in the human brain, white matter lesions are significantly increased in size as compared to intra-cortical gray matter lesions. In addition, studies using the cuprizone mouse model revealed that the autonomous progression of white matter lesions is more severe compared to that in the gray matter. Focal demyelination revealed that the application of equal amounts of lysophosphatidylcholine results in more severe demyelination in the white compared to the gray matter. In summary, lesion progression is most intense in myelin-rich white matter regions, irrespective of the initial lesion trigger mechanism. A better understanding of myelin debris-triggered lesion expansion will pave the way for the development of new protective strategies in the future. PMID:26363796

  15. Keloidal granuloma faciale with extrafacial lesions.

    PubMed

    Verma, Rajesh; Das, A L; Vaishampayan, S S; Vaidya, Sachin

    2005-01-01

    Granuloma faciale (GF) is a rare cutaneous disorder characterized by one to several soft, erythematous to livid papules, plaques or nodules, usually occurring on the face. Extrafacial lesions are uncommon. A 52-year-old lady with multiple asymptomatic, variously sized brownish-black colored, firm, sharply circumscribed plaques resembling keloids on both cheeks and extrafacial lesions on the right arm and the right breast is presented for its unusual keloidal appearance and typical histopathological findings. She failed to respond to oral dapsone 100 mg daily administered for 3 months. Local infiltration of triamcinolone combined with cryotherapy led to only partial flattening of the lesions. All the skin lesions were excised surgically followed by flap transfer grafting on both cheeks. The cosmetic outcome was highly satisfactory. PMID:16394461

  16. Atherectomy in complex infrainguinal lesions: a review.

    PubMed

    Engelberger, S; van den Berg, J C

    2015-02-01

    In the femoropopliteal segment, endovascular revascularization techniques have gained the role as a first line treatment strategy. Nitinol stent placement has improved the short- and mid-term primary patency rates in most lesion types and is therefore widely applied. Stenting has several shortcomings as in-stent restenosis, stent fractures and foreign material being left behind in the vessel. The concept of atherectomy is plaque debulking. This results in a potential reduction of inflation pressure requirements in angioplasty. Stent placement and consecutive in-stent restenosis may be avoided. In this non systematic literature review, the performance of different atherectomy techniques, such as direct atherectomy, orbital atherectomy, laser debulking and rotational atherectomy in the treatment of complex femoropopliteal lesions, including long lesions, moderately to heavily calcified lesions as well as occlusions and in-stent restenosis, has been analyzed. PMID:25399550

  17. New Fully Automated Method for Segmentation of Breast Lesions on Ultrasound Based on Texture Analysis.

    PubMed

    Gómez-Flores, Wilfrido; Ruiz-Ortega, Bedert Abel

    2016-07-01

    The study described here explored a fully automatic segmentation approach based on texture analysis for breast lesions on ultrasound images. The proposed method involves two main stages: (i) In lesion region detection, the original gray-scale image is transformed into a texture domain based on log-Gabor filters. Local texture patterns are then extracted from overlapping lattices that are further classified by a linear discriminant analysis classifier to distinguish between the "normal tissue" and "breast lesion" classes. Next, an incremental method based on the average radial derivative function reveals the region with the highest probability of being a lesion. (ii) In lesion delineation, using the detected region and the pre-processed ultrasound image, an iterative thresholding procedure based on the average radial derivative function is performed to determine the final lesion contour. The experiments are carried out on a data set of 544 breast ultrasound images (including cysts, benign solid masses and malignant lesions) acquired with three distinct ultrasound machines. In terms of the area under the receiver operating characteristic curve, the one-way analysis of variance test (α=0.05) indicates that the proposed approach significantly outperforms two published fully automatic methods (p<0.001), for which the areas under the curve are 0.91, 0.82 and 0.63, respectively. Hence, these results suggest that the log-Gabor domain improves the discrimination power of texture features to accurately segment breast lesions. In addition, the proposed approach can potentially be used for automated computer diagnosis purposes to assist physicians in detection and classification of breast masses. PMID:27095150

  18. DIAGNOSTIC CRITERIA FOR PROLIFERATIVE THYROID LESIONS IN BONY FISHES

    EPA Science Inventory

    Thyroid proliferative lesions are rather common in bony fishes but disagreement exists in the fish pathology community concerning diagnostic criteria for hyperplastic versus neoplastic lesions. To simplify the diagnosis of proliferative thyroid lesions and to reduce confusion reg...

  19. 21 CFR 882.4725 - Radiofrequency lesion probe.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    .... (a) Identification. A radiofrequency lesion probe is a device connected to a radiofrequency (RF) lesion generator to deliver the RF energy to the site within the nervous system where a lesion is...

  20. 21 CFR 882.4725 - Radiofrequency lesion probe.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... (a) Identification. A radiofrequency lesion probe is a device connected to a radiofrequency (RF) lesion generator to deliver the RF energy to the site within the nervous system where a lesion is...

  1. 21 CFR 882.4725 - Radiofrequency lesion probe.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    .... (a) Identification. A radiofrequency lesion probe is a device connected to a radiofrequency (RF) lesion generator to deliver the RF energy to the site within the nervous system where a lesion is...

  2. 21 CFR 882.4725 - Radiofrequency lesion probe.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .... (a) Identification. A radiofrequency lesion probe is a device connected to a radiofrequency (RF) lesion generator to deliver the RF energy to the site within the nervous system where a lesion is...

  3. Diffuse peritoneal deciduosis mimicking metastatic lesions

    PubMed Central

    Baroni Cruz, Dennis; Dhamer, Thricy; da Rocha, Vívian Wünderlich; Dupont, Roberta Finkler

    2014-01-01

    A 32-year-old woman with an uneventful antenatal period underwent a caesarean section for breech presentation. At laparotomy, there were multiple yellowish elastic nodules distributed along the parietal peritoneal surface, totalling over 30 lesions and worrying the surgical team. The conclusive diagnosis of peritoneal deciduosis was supported by pathological analysis (histology and immunohistochemistry). The present case reports an uncommon presentation of diffuse peritoneal deciduosis mimicking metastatic lesions. PMID:24526201

  4. [Surgery of benign vocal fold lesions].

    PubMed

    Olthoff, A

    2016-09-01

    Surgical treatment of benign vocal fold lesions can be indicated for clinical or functional reasons. The principles of phonosurgery have to be maintained in either case. The appropriate phonosurgical technique depends on the type of vocal fold lesion. Depending on the findings, phonosurgery aims to maintain or improve voice quality. The evaluation of clinical and functional results includes indirect laryngoscopy, videostroboscopy, and voice analysis. PMID:27552826

  5. Evolution of early lesions in leprosy.

    PubMed

    Mishra, B; Mukherjee, A; Girdhar, A; Husain, S; Malaviya, G N; Girdhar, B K

    1993-09-01

    We observed 29 patients presenting with vague peripheral neurological symptoms for 6 months or more. During this period, 16 developed clinical leprosy, 3 developed borderline tuberculoid leprosy and the other 13 developed neuritic leprosy. Of these 13 cases 11 subsequently developed skin lesions similar to those seen in indeterminate and in borderline tuberculoid leprosy. Based on the above observations, an attempt has been made to explain the evolution of early lesions of leprosy. PMID:8231606

  6. Dark-without-pressure fundus lesions.

    PubMed Central

    Nagpal, K C; Goldberg, M F; Asdourian, G; Goldbaum, M; Huamonte, F

    1975-01-01

    Seven black patients had dark brown homogeneous geographical areas of the fundus. Six cases were associated with sickle cell haemoglobinopathies and one was associated with systemic hypertension. These flat lesions were uniform in colour and occurred in the posterior pole or in the midperiphery. They appeared to be transient and often disappeared leaving no residue. The cause is unknown. By analogy with white-without-pressure fundus lesions, we have called these areas dark-without-pressure. Images PMID:1203232

  7. Lesions of the Neovagina--A Review.

    PubMed

    Heller, Debra S

    2015-07-01

    Creation of a neovagina is uncommon, but it may be performed for congenital absence or anomaly, after exenterative cancer surgery, or in male-to-female transsexuals. A variety of tissues may be used to create the neovagina. Lesions of the neovagina are uncommon and probably not well known to most practitioners. A review of these lesions will be helpful if such a patient presents. PMID:26111041

  8. Common Adult Skin and Soft Tissue Lesions.

    PubMed

    Trost, Jeffrey G; Applebaum, Danielle S; Orengo, Ida

    2016-08-01

    A strong foundational knowledge of dermatologic disease is crucial for a successful practice in plastic surgery. A plastic surgeon should be able to identify and appreciate common dermatologic diseases that may require medical and/or surgical evaluation and management. In this article, the authors describe epidermal/dermal, infectious, pigmented, and malignant cutaneous lesions that are commonly encountered in practice. Descriptions include the epidemiology, pathogenesis, clinical course, and management options for each type of lesion. PMID:27478418

  9. Differential diagnosis of bovine teat lesions.

    PubMed

    Sieber, R L; Farnsworth, R J

    1984-07-01

    Teat lesions affect the dairyman by interfering with the milking process or by increasing the likelihood of intramammary infection. Lesions where the skin is broken are frequently infected. The viral, chemical, environmental, and equipment-induced lesions that lead to ulceration, hemorrhage, and scabbing are all associated with increased intramammary infection; however, this association does not necessarily hold true with the less severe conditions. The dry and flakey skin seen with certain teat dips, lime, or sunburn, the common teat-end callous condition, and the mild, temporary congestion or edema sometimes seen after machine milking usually do not lead to increased intramammary infection. When investigating a problem of increased intramammary infection, other factors should be discussed with the dairyman before suggesting that these conditions are the cause of the problem. Before making a diagnosis of machine-induced lesions, the milking equipment should be carefully inspected and tested. Although the equipment can and frequently does cause lesions, it rarely does so if it is properly set or maintained. Maintenance of inflations, pulsators, vacuum regulators, and vacuum pumps will frequently reveal the source of the problem. In most cases, an equipment malfunction must be quite severe to result in teat injury. Many teat-lesion problems are seasonal in occurrence. The problem will frequently subside in the spring only to reoccur in mid fall. In the midwestern United States, most teat-lesion problems occur from November to April. When investigating a teat-lesion complaint, a large proportion of the herd should be examined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6089400

  10. Isolated plexiform neurofibroma mimicking a vascular lesion.

    PubMed

    Stefano, Paola Cecilia; Apa, Sebastian Nicolas; Lanoël, Agustina Maria; María, Josefina Sala; Sierre, Sergio; Pierini, Adrián Martin

    2016-04-01

    Plexiform neurofibromas are benign tumors originating from peripheral nerve sheaths, generally associated with Neurofibromatosis Type 1 (NF1). They are diffuse, painful and sometimes locally invasive, generating cosmetic problems. This report discusses an adolescent patient who presented with an isolated, giant plexiform neurofibroma on her leg that was confused with a vascular lesion due to its clinical aspects. Once the diagnosis was confirmed by surgical biopsy, excision of the lesion was performed with improvement of the symptoms. PMID:27192529

  11. Computerized lesion detection on breast ultrasound.

    PubMed

    Drukker, Karen; Giger, Maryellen L; Horsch, Karla; Kupinski, Matthew A; Vyborny, Carl J; Mendelson, Ellen B

    2002-07-01

    We investigated the use of a radial gradient index (RGI) filtering technique to automatically detect lesions on breast ultrasound. After initial RGI filtering, a sensitivity of 87% at 0.76 false-positive detections per image was obtained on a database of 400 patients (757 images). Next, lesion candidates were segmented from the background by maximizing an average radial gradient (ARD) index for regions grown from the detected points. At an overlap of 0.4 with a radiologist lesion outline, 75% of the lesions were correctly detected. Subsequently, round robin analysis was used to assess the quality of the classification of lesion candidates into actual lesions and false-positives by a Bayesian neural network. The round robin analysis yielded an Az value of 0.84, and an overall performance by case of 94% sensitivity at 0.48 false-positives per image. Use of computerized analysis of breast sonograms may ultimately facilitate the use of sonography in breast cancer screening programs. PMID:12148724

  12. Potentially malignant oral lesions: clinicopathological correlations.

    PubMed

    Maia, Haline Cunha de Medeiros; Pinto, Najara Alcântara Sampaio; Pereira, Joabe Dos Santos; Medeiros, Ana Miryam Costa de; Silveira, Éricka Janine Dantas da; Miguel, Márcia Cristina da Costa

    2016-03-01

    Objective To determine the incidence of potentially malignant oral lesions, and evaluate and correlate their clinical and pathological aspects. Methods The sample consisted of cases clinically diagnosed as oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, and oral lichen planus treated at a diagnostic center, between May 2012 and July 2013. Statistical tests were conducted adopting a significance level of 5% (p≤0.05). Results Out of 340 patients, 106 (31.2%) had potentially malignant oral lesions; and 61 of these (17.9%) were submitted to biopsy. Actinic cheilitis was the most frequent lesion (37.5%) and the lower lip was the most affected site (49.6%). Among 106 patients in the sample, 48 (45.3%) reported nicotine consumption, 35 (33%) reported alcohol intake and 34 (32.1%) sun exposure while working. When clinical and histopathological diagnoses were compared, oral erythroplakia and atypical ulcer were the lesions that exhibited greater compatibility (100% each). Conclusion In most cases, clinical and histopathological diagnoses were compatible. An association between the occurrence of erythroplakia, leukoplakia and erythroleukoplakia with smoking was observed. Similarly, an association between actinic cheilitis and sun exposure was noted. Erythroleukoplakia presented the highest malignancy grade in this study. Finally, dental surgeons should draw special attention to diagnosis of potentially malignant oral lesions, choose the best management, and control the lesions to avoid their malignant transformation. PMID:27074232

  13. Texture feature based liver lesion classification

    NASA Astrophysics Data System (ADS)

    Doron, Yeela; Mayer-Wolf, Nitzan; Diamant, Idit; Greenspan, Hayit

    2014-03-01

    Liver lesion classification is a difficult clinical task. Computerized analysis can support clinical workflow by enabling more objective and reproducible evaluation. In this paper, we evaluate the contribution of several types of texture features for a computer-aided diagnostic (CAD) system which automatically classifies liver lesions from CT images. Based on the assumption that liver lesions of various classes differ in their texture characteristics, a variety of texture features were examined as lesion descriptors. Although texture features are often used for this task, there is currently a lack of detailed research focusing on the comparison across different texture features, or their combinations, on a given dataset. In this work we investigated the performance of Gray Level Co-occurrence Matrix (GLCM), Local Binary Patterns (LBP), Gabor, gray level intensity values and Gabor-based LBP (GLBP), where the features are obtained from a given lesion`s region of interest (ROI). For the classification module, SVM and KNN classifiers were examined. Using a single type of texture feature, best result of 91% accuracy, was obtained with Gabor filtering and SVM classification. Combination of Gabor, LBP and Intensity features improved the results to a final accuracy of 97%.

  14. Renal lesions in cetaceans from Brazil.

    PubMed

    Gonzales-Viera, O; Ruoppolo, V; Marigo, J; Carvalho, V L; Groch, K R; Bertozzi, C P; Takakura, C; Namiyama, G; Vanstreels, R E T; Catão-Dias, J L

    2015-05-01

    This study reports the occurrence of renal lesions in cetaceans from the coast of Brazil subjected to necropsy examination between 1996 and 2011. The animals (n = 192) were by-caught in fishing nets, were found dead on beaches or died despite attempted rehabilitation. Kidney samples were evaluated grossly and microscopically and, depending on the histopathological findings, immunohistochemical and ultrastructural analyses were conducted. Due to autolysis, a diagnosis was reached in only 128 animals, of which 82 (64.1%) had kidney lesions. Cystic renal disease was the most common lesion observed in 34 cases (26.6%) and these were classified as simple cysts in eight cases (6.3%), polycystic kidney disease in one rough-toothed dolphin (Steno bredanensis), secondary glomerulocystic disease in 16 cases (12.5%) and primary glomerulocystic disease in nine cases (7%). Other lesions included membranous glomerulonephritis (28 cases; 21.9%), membranoproliferative glomerulonephritis (20 cases; 15.6%), lymphoplasmacytic interstitial nephritis (21 cases; 16.4%), lipidosis (19 cases; 14.8%), glomerulosclerosis (8 cases; 6.3%) and pyogranulomatous nephritis(five cases; 3.9%); two of the later were associated with the migration of nematode larvae. Additionally, tubular adenoma was identified in a Franciscana (Pontoporia blainvillei). The pathological implications of these lesions are discussed according the cause of death, age or sex of the animals. Furthermore, the lesions were compared with those of other marine and terrestrial mammals, including man. PMID:25824116

  15. Skin conditions: benign nodular skin lesions.

    PubMed

    Nguyen, Tam; Zuniga, Ramiro

    2013-04-01

    Benign subcutaneous lesions are a common reason that patients visit family physicians. Lipomas are the most common of these lesions; they most often occur on the trunk and proximal extremities. Recent data show that as many as half of the fat cells in lipomas are atypical. Ultrasound is used increasingly to confirm lipoma diagnosis, but deep lesions should be evaluated with magnetic resonance imaging study or computed tomography scan to exclude involvement of underlying structures and/or liposarcoma. Small lesions can sometimes be managed with serial injections of midpotency steroids. Larger lesions (larger than 5 cm), those compressing other structures, or those suspicious for malignancy should be excised using standard surgical excision or, when possible, the newer minimal-scar segmental extraction technique. Ganglion cysts are another common lesion, the presence of which often is confirmed with ultrasound if the diagnosis is not clinically apparent. Management includes splinting, aspiration, and/or injection of steroids, with or without hyaluronidase. Epidermal inclusion cysts, also called sebaceous cysts, typically are asymptomatic unless they become infected. Ultrasound can aid in diagnosis. The only definitive management is surgical excision with complete removal of the cyst wall or capsule, using minimal-scar segmental extraction or conventional surgical removal. PMID:23600336

  16. Endoscopic treatment of the isolated sphenoid sinus lesions.

    PubMed

    Castelnuovo, Paolo; Pagella, Fabio; Semino, Lucia; De Bernardi, Francesca; Delù, Giovanni

    2005-02-01

    Presenting symptoms of the isolated sphenoid sinus lesion are often vague and non-specific. Diagnostic nasal endoscopy procedures and imaging techniques are of great value for an early and precise diagnosis. Moreover, endoscopic sinus surgery is a safe and effective technique that allows a direct route to the sphenoid sinus. Because of its close vicinity to important and vulnerable structures of the skull base, delay in diagnosis and treatment can be potentially lethal. Endoscopically controlled procedures for the sphenoid sinus provide the surgeon with an obvious alternative to the traditional approaches. From November 1994 to May 2001 the authors operated on 41 patients with isolated sphenoid lesions. The pathology spectrum was rather wide and included 11 cases of isolated fungal sinusitis, 10 mucoceles, 7 bacterial sinusitis, 7 cerebrospinal fluid leaks, 3 inverted papillomas, 1 chondrosarcoma, 1 ossifying fibroma and 1 foreign body. The sphenoid sinus was the only sinus involved, and lesions arising from adjacent tissues were excluded. In this paper, the authors present clinical symptoms, endoscopic findings and imaging data as well as endoscopic surgical techniques for the treatment of sphenoid sinus disease. PMID:15060830

  17. Superior labral anterior posterior lesions of the shoulder: Current diagnostic and therapeutic standards

    PubMed Central

    Popp, Dominik; Schöffl, Volker

    2015-01-01

    Surgical treatment of superior labral anterior posterior (SLAP) lesion becomes more and more frequent which is the consequence of evolving progress in both, imaging and surgical technique as well as implants. The first classification of SLAP lesions was described in 1990, a subdivision in four types existed. The rising comprehension of pathology and pathophysiology in SLAP lesions contributed to increase the types in SLAP classification to ten. Concerning the causative mechanism of SLAP lesions, acute trauma has to be differed from chronic degeneration. Overhead athletes tend to develop a glenohumeral internal rotation deficit which forms the basis for two controversial discussed potential mechanisms of pathophysiology in SLAP lesions: Internal impingement and peel-back mechanism. Clinical examination often remains unspecific whereas soft tissue imaging such as direct or indirect magnetic resonance arthrography has technically improved and is regarded to be indispensable in detection of SLAP lesions. Concomitant pathologies as Bankart lesions, rotator cuff tears or perilabral cysts should be taken into consideration when planning a personalized therapeutic strategy. In addition, normal variants such as sublabral recess, sublabral hole, Buford complex and other less common variants have to be distinguished. The most frequent SLAP type II needs a sophisticated approach when surgical teatment comes into consideration. While SLAP repair is considered to be the standard operative option, overhead athletes benefit from a biceps tenodesis because improved patient-reported satisfaction and higher rate of return to pre-injury level of sports has been reported. PMID:26495243

  18. Sulfur-oxidizing bacterial populations within cyanobacterial dominated coral disease lesions.

    PubMed

    Bourne, David G; van der Zee, Marc J J; Botté, Emmanuelle S; Sato, Yui

    2013-08-01

    This study investigated the diversity and quantitative shifts of sulfur-oxidizing bacteria (SOB) during the onset of black band disease (BBD) in corals using quantitative PCR (qPCR) and cloning approaches targeting the soxB gene, involved in sulfur oxidation. Four Montipora sp. coral colonies identified with lesions previously termed cyanobacterial patches (CP) (comprising microbial communities different from those of BBD lesions), was monitored in situ as CP developed into BBD. The overall abundance of SOB in both CP and BBD lesions were very low and near the detection limit of the qPCR assay, although consistently indicated that SOB populations decreased as the lesions transitioned from CP to BBD. Phylogenetic assessment of retrieved soxB genes showed that SOB in both CP and BBD lesions were dominated by one sequence type, representing > 70% of all soxB gene sequences and affiliated with members of the Rhodobacteraceae within the α-Proteobacteria. This study represents the first assessment targeting SOB within BBD lesions and clearly shows that SOB are not highly diverse or abundant in this complex microbial mat. The lack of oxidation of reduced sulfur compounds by SOB likely aids the accumulation of high levels of sulfide at the base of the BBD mat, a compound contributing to the pathogenicity of BBD lesions. PMID:23864565

  19. Characterization of radiofrequency ablation lesion development based on simulated and measured intracardiac electrograms.

    PubMed

    Keller, Matthias Walter; Schuler, Steffen; Wilhelms, Mathias; Lenis, Gustavo; Seemann, Gunnar; Schmitt, Claus; Dössel, Olaf; Luik, Armin

    2014-09-01

    Radiofrequency ablation (RFA) therapy is the gold standard in interventional treatment of many cardiac arrhythmias. A major obstacle is nontransmural lesions, leading to recurrence of arrhythmias. Recent clinical studies have suggested intracardiac electrogram (EGM) criteria as a promising marker to evaluate lesion development. Seeking for a deeper understanding of underlying mechanisms, we established a simulation approach for acute RFA lesions. Ablation lesions were modeled by a passive necrotic core surrounded by a borderzone with properties of heated myocardium. Herein, conduction velocity and electrophysiological properties were altered. We simulated EGMs during RFA to study the relation between lesion formation and EGM changes using the bidomain model. Simulations were performed on a three-dimensional setup including a geometrically detailed representation of the catheter with highly conductive electrodes. For validation, EGMs recorded during RFA procedures in five patients were analyzed and compared to simulation results. Clinical data showed major changes in the distal unipolar EGM. During RFA, the negative peak amplitude decreased up to 104% and maximum negative deflection was up to 88% smaller at the end of the ablation sequence. These changes mainly occurred in the first 10 s after ablation onset. Simulated unipolar EGMs reproduced the clinical changes, reaching up to 83% negative peak amplitude reduction and 80% decrease in maximum negative deflection for transmural lesions. In future studies, the established model may enable the development of further EGM criteria for transmural lesions even for complex geometries in order to support clinical therapy. PMID:24816474

  20. Improving diagnosis of atraumatic splenic lesions, part II: benign neoplasms/nonneoplastic mass-like lesions.

    PubMed

    Ricci, Zina J; Mazzariol, Fernanda S; Flusberg, Milana; Chernyak, Victoria; Oh, Sarah K; Kaul, Bindu; Stein, Marjorie W; Rozenblit, Alla M

    2016-01-01

    Focal atraumatic splenic lesions often pose a diagnostic challenge on cross-sectional imaging. They can be categorized based on etiology as nonneoplastic, benign neoplastic (discussed in Part II), and malignant neoplastic lesions or on prevalence as common, uncommon, and rare lesions. Familiarity with pertinent clinical parameters, etiology, pathology, prevalence and ancillary features such as splenomegaly, concomitant hepatic involvement, and extrasplenic findings, in addition to knowledge of imaging spectra of the lesions, can improve diagnostic confidence. Consideration of these factors together can arm the radiologist with the necessary tools to render a more confident diagnosis and, thus, better aid management. PMID:27317213

  1. Oral lesions associated with human immunodeficiency virus disease.

    PubMed

    Patton, Lauren L

    2013-10-01

    Human immunodeficiency virus (HIV)-associated oral disease among people living with HIV infection includes oral candidiasis, oral hairy leukoplakia, Kaposi sarcoma, oral warts, herpes simplex virus ulcers, major aphthous ulcers or ulcers not otherwise specified, HIV salivary gland disease, and atypical gingival and periodontal diseases. Diagnosis of some oral lesions is based on clinical appearance and behavior, whereas others require biopsy, culture, or imaging for definitive diagnosis. Management strategies including pharmacologic and nonpharmacologic approaches are discussed in this article. Dentists also need to be cognizant of the potential oral side effects of HIV antiretroviral medications. PMID:24034072

  2. Cutaneous lesions as presentation form of mantle cell lymphoma

    PubMed Central

    Merino de Paz, Nayra; Rodríguez-Martín, Marina; Contreras Ferrer, Patricia; García-Hernández, Sonia; Hernández-León, Nieves; Martín-Herrera, Antonio; Noda-Cabrera, Antonio

    2011-01-01

    Mantle cell lymphoma is a type of non-Hodgkin lymphoma that affects extranodal areas, especially, bone narrow, digestive tract and Waldeyer ring. Here we report a case of mantle cell lymphoma IV Ann Arbor stage with cutaneous lesions on nasal dorsum and glans penis as the first manifestations. Skin involvement is a very rare manifestation and less than 20 cases have been reported in the literature. The importance of establishing multidisciplinary relationships for a global approach has been shown by this clinical case. PMID:25386303

  3. The microbiological signature of human cutaneous leishmaniasis lesions exhibits restricted bacterial diversity compared to healthy skin.

    PubMed

    Salgado, Vanessa R; Queiroz, Artur Tl de; Sanabani, Sabri S; Oliveira, Camila I de; Carvalho, Edgar M; Costa, Jackson Ml; Barral-Netto, Manoel; Barral, Aldina

    2016-04-01

    Localised cutaneous leishmaniasis (LCL) is the most common form of cutaneous leishmaniasis characterised by single or multiple painless chronic ulcers, which commonly presents with secondary bacterial infection. Previous culture-based studies have found staphylococci, streptococci, and opportunistic pathogenic bacteria in LCL lesions, but there have been no comparisons to normal skin. In addition, this approach has strong bias for determining bacterial composition. The present study tested the hypothesis that bacterial communities in LCL lesions differ from those found on healthy skin (HS). Using a high throughput amplicon sequencing approach, which allows for better populational evaluation due to greater depth coverage and the Quantitative Insights Into Microbial Ecology pipeline, we compared the microbiological signature of LCL lesions with that of contralateral HS from the same individuals.Streptococcus, Staphylococcus,Fusobacterium and other strict or facultative anaerobic bacteria composed the LCL microbiome. Aerobic and facultative anaerobic bacteria found in HS, including environmental bacteria, were significantly decreased in LCL lesions (p < 0.01). This paper presents the first comprehensive microbiome identification from LCL lesions with next generation sequence methodology and shows a marked reduction of bacterial diversity in the lesions. PMID:27074253

  4. The microbiological signature of human cutaneous leishmaniasis lesions exhibits restricted bacterial diversity compared to healthy skin

    PubMed Central

    Salgado, Vanessa R; de Queiroz, Artur TL; Sanabani, Sabri S; de Oliveira, Camila I; Carvalho, Edgar M; Costa, Jackson ML; Barral-Netto, Manoel; Barral, Aldina

    2016-01-01

    Localised cutaneous leishmaniasis (LCL) is the most common form of cutaneous leishmaniasis characterised by single or multiple painless chronic ulcers, which commonly presents with secondary bacterial infection. Previous culture-based studies have found staphylococci, streptococci, and opportunistic pathogenic bacteria in LCL lesions, but there have been no comparisons to normal skin. In addition, this approach has strong bias for determining bacterial composition. The present study tested the hypothesis that bacterial communities in LCL lesions differ from those found on healthy skin (HS). Using a high throughput amplicon sequencing approach, which allows for better populational evaluation due to greater depth coverage and the Quantitative Insights Into Microbial Ecology pipeline, we compared the microbiological signature of LCL lesions with that of contralateral HS from the same individuals.Streptococcus, Staphylococcus,Fusobacterium and other strict or facultative anaerobic bacteria composed the LCL microbiome. Aerobic and facultative anaerobic bacteria found in HS, including environmental bacteria, were significantly decreased in LCL lesions (p < 0.01). This paper presents the first comprehensive microbiome identification from LCL lesions with next generation sequence methodology and shows a marked reduction of bacterial diversity in the lesions. PMID:27074253

  5. Cystic and Cavitary Lung Lesions in Children: Radiologic Findings with Pathologic Correlation

    PubMed Central

    Odev, Kemal; Guler, İbrahim; Altinok, Tamer; Pekcan, Sevgi; Batur, Abdussamed; Ozbiner, Hüseyin

    2013-01-01

    A number of diseases produce focal or multiple thin-walled or thick-walled air- or fluid-containing cysts or cavitary lung lesions in both infants and children. In infants and children, there is a spectrum of focal or multifocal cystic and cavitary lung lesions including congenital lobar emphysema, congenital cystic adenomatoid malformation, pleuropulmonary blastoma, bronchogenic cyst, pulmonary sequestration, Langerhans cell histiocytosis, airway diseases, infectious diseases (bacterial infection, fungal infection, etc.), hydatid cysts, destroid lung, and traumatic pseudocyst. For the evaluation of cystic or cavitary lung lesion in infants and children, imaging plays an important role in accurate early diagnosis and optimal patient management. Therefore, a practical imaging approach based on the most sensitive and least invasive imaging modality in an efficient and cost-effective manner is paramount. We reviewed the conventional radiographs and computed tomography findings of the most common cystic and cavitary lung lesions in infants and children. PMID:24605255

  6. Atlas-based segmentation of pathological MR brain images using a model of lesion growth.

    PubMed

    Cuadra, Meritxell Bach; Pollo, Claudio; Bardera, Anton; Cuisenaire, Olivier; Villemure, Jean-Guy; Thiran, Jean-Philippe

    2004-10-01

    We propose a method for brain atlas deformation in the presence of large space-occupying tumors, based on an a priori model of lesion growth that assumes radial expansion of the lesion from its starting point. Our approach involves three steps. First, an affine registration brings the atlas and the patient into global correspondence. Then, the seeding of a synthetic tumor into the brain atlas provides a template for the lesion. The last step is the deformation of the seeded atlas, combining a method derived from optical flow principles and a model of lesion growth. Results show that a good registration is performed and that the method can be applied to automatic segmentation of structures and substructures in brains with gross deformation, with important medical applications in neurosurgery, radiosurgery, and radiotherapy. PMID:15493697

  7. Automatic iterative segmentation of multiple sclerosis lesions using Student's t mixture models and probabilistic anatomical atlases in FLAIR images.

    PubMed

    Freire, Paulo G L; Ferrari, Ricardo J

    2016-06-01

    Multiple sclerosis (MS) is a demyelinating autoimmune disease that attacks the central nervous system (CNS) and affects more than 2 million people worldwide. The segmentation of MS lesions in magnetic resonance imaging (MRI) is a very important task to assess how a patient is responding to treatment and how the disease is progressing. Computational approaches have been proposed over the years to segment MS lesions and reduce the amount of time spent on manual delineation and inter- and intra-rater variability and bias. However, fully-automatic segmentation of MS lesions still remains an open problem. In this work, we propose an iterative approach using Student's t mixture models and probabilistic anatomical atlases to automatically segment MS lesions in Fluid Attenuated Inversion Recovery (FLAIR) images. Our technique resembles a refinement approach by iteratively segmenting brain tissues into smaller classes until MS lesions are grouped as the most hyperintense one. To validate our technique we used 21 clinical images from the 2015 Longitudinal Multiple Sclerosis Lesion Segmentation Challenge dataset. Evaluation using Dice Similarity Coefficient (DSC), True Positive Ratio (TPR), False Positive Ratio (FPR), Volume Difference (VD) and Pearson's r coefficient shows that our technique has a good spatial and volumetric agreement with raters' manual delineations. Also, a comparison between our proposal and the state-of-the-art shows that our technique is comparable and, in some cases, better than some approaches, thus being a viable alternative for automatic MS lesion segmentation in MRI. PMID:27058437

  8. Fluoride-Releasing Materials to Prevent White Spot Lesions around Orthodontic Brackets: A Systematic Review.

    PubMed

    Nascimento, Patrícia Layane de Menezes Macêdo; Fernandes, Micaelle Tenório Guedes; Figueiredo, Fabricio Eneas Diniz de; Faria-E-Silva, André Luis

    2016-02-01

    The relation between orthodontic fixed appliances use and enamel demineralization is well established. Different preventive approaches have been suggested to this problem, but controversy remains about which is the best. The aim of this study was to perform a systematic review of clinical trials that investigated the effectiveness of materials containing fluorides to lute brackets or cover the bonding interface in order to inhibit the development and progression of white spot lesions. The null hypothesis was that fluoride materials do not affect the incidence of white spot lesions around brackets. A MEDLINE search was conducted for randomized clinical trials evaluating the development of white spot lesions in patients using fixed orthodontic appliances, followed by meta-analysis comparing the results for patients for whom dental materials containing fluorides were used (experimental group) to those for whom these materials were not used (control group). The pooled relative risk of developing white spot lesions for the experimental group was 0.42 (95% confidence interval: 0.25 to 0.72); hence, when fluoride-releasing materials are used, the patient has 58% less risk of white spot lesion development. Regarding white spot lesion extent, the pooled mean difference between the experimental and control groups was not statistically significant (-0.12; 95% confidence interval: -0.29 to 0.04). In conclusion, the results of the present systematic review suggest that fluoride-releasing materials can reduce the risk of white spot lesions around brackets. However, when white spot lesions had already occurred, there is no evidence that fluoride-releasing materials reduce the extent of these lesions. PMID:27007355

  9. Automatic segmentation of lesions for the computer-assisted detection in fluorescence urology

    NASA Astrophysics Data System (ADS)

    Kage, Andreas; Legal, Wolfgang; Kelm, Peter; Simon, Jörg; Bergen, Tobias; Münzenmayer, Christian; Benz, Michaela

    2012-03-01

    Bladder cancer is one of the most common cancers in the western world. The diagnosis in Germany is based on the visual inspection of the bladder. This inspection performed with a cystoscope is a challenging task as some kinds of abnormal tissues do not differ much in their appearance from their surrounding healthy tissue. Fluorescence Cystoscopy has the potential to increase the detection rate. A liquid marker introduced into the bladder in advance of the inspection is concentrated in areas with high metabolism. Thus these areas appear as bright "glowing". Unfortunately, the fluorescence image contains besides the glowing of the suspicious lesions no more further visual information like for example the appearance of the blood vessels. A visual judgment of the lesion as well as a precise treatment has to be done using white light illumination. Thereby, the spatial information of the lesion provided by the fluorescence image has to be guessed by the clinical expert. This leads to a time consuming procedure due to many switches between the modalities and increases the risk of mistreatment. We introduce an automatic approach, which detects and segments any suspicious lesion in the fluorescence image automatically once the image was classified as a fluorescence image. The area of the contour of the detected lesion is transferred to the corresponding white light image and provide the clinical expert the spatial information of the lesion. The advantage of this approach is, that the clinical expert gets the spatial and the visual information of the lesion together in one image. This can save time and decrease the risk of an incomplete removal of a malign lesion.

  10. The arthroscopic anatomy of symptomatic meniscal lesions.

    PubMed

    Dandy, D J

    1990-07-01

    The anatomy of 1000 symptomatic meniscus lesions is described and related to the age of the patients. All symptomatic lesions found during the study period were treated by arthroscopic surgery. Meniscal lesions were commoner in the right knee (56.5%) and 81% of the patients were men. Of the medial meniscus tears, 75% were vertical and 23% horizontal. Vertical tears of the medial meniscus occurred most often in the fourth decade and horizontal tears in the fifth. There were 22% type I, 37% type II and 31% type III vertical tears; 62% of type I tears and 23% of type II tears had locked fragments. Superior flaps were six times more common than inferior flaps. Of all medial meniscus fragments, 6% were inverted; 51% of these were flaps and the rest ruptured bucket-handle fragments. Of the lateral meniscus lesions 54% were vertical tears, 15% oblique, 15% myxoid, 4% were inverted and 5% were lesions of discoid menisci. The commonest pattern of tear in the lateral compartment (27%) was a vertical tear involving half the length and half the width of the meniscus. PMID:2380218

  11. [Pigmented lesions of the oral cavity].

    PubMed

    Brocheriou, C; Kuffer, R; Verola, O

    1985-01-01

    Pigmented lesions of the oral cavity are of multiple origin. They can be subdivided as follows: non tumoral pigmentations, non melanin pigmented tumors or tumor-like lesions, benign melanin pigmented tumors and malignant melanomas. Among non tumoral pigmented lesions, some of them show melanin deposits: they can be associated with a systemic disease (Peutz Jeghers syndrome, Addison's disease) or have a medicamentous origin, or belong to a lichen migricans. Non tumoral and non melanin pigmentations are principally due to a heavy metal accumulation or an accidental tatoo arising after tooth treatment. Peripheral giant cell granuloma, so-called giant cell epulis is the major non pigmented non melanin pseudotumoral lesion; pigmentation is due to hemosiderin deposits. In the oral cavity nevi are principally of the intramucosal type. Blue nevus, the second type in frequency, is usually located on the hard palate. Primary malignant melanomas are rare in the oral cavity, but it is--because its very bad prognosis--the most important lesion. In order to improve the survival it is necessary to do the diagnosis as early as possible. PMID:3833244

  12. Computer detection of stellate lesions in mammograms

    NASA Astrophysics Data System (ADS)

    Kegelmeyer, W. Philip, Jr.

    1992-06-01

    The three primary signs for which radiologists search when screening mammograms for breast cancer are stellate lesions, microcalcifications, and circumscribed lesions. Stellate lesions are of particular importance, as they are almost always associated with a malignancy. Further, they are often indicated only by subtle architectural distortions and so are in general easier to miss than the other signs. We have developed a method for the automatic detection of stellate lesions in digitized mammograms, and have tested them on image data where the presence or absence of malignancies is known. We extract image features from the known images, use them to grow binary decision trees, and use those trees to label each pixel of new mammograms with its probability of being located on an abnormality. The primary feature for the detection of stellate lesions is ALOE, analysis of local oriented edges, which is derived from an analysis of the histogram of edge orientations in local windows. Other features, based on the Laws texture energy measures, have been developed to respond to normal tissue, and so improve the false alarm performance of the entire system.

  13. Phantom experiments to improve parathyroid lesion detection

    SciTech Connect

    Nichols, Kenneth J.; Tronco, Gene G.; Tomas, Maria B.; Kunjummen, Biju D.; Siripun, Lisa; Rini, Josephine N.; Palestro, Christopher J.

    2007-12-15

    This investigation tested the hypothesis that visual analysis of iteratively reconstructed tomograms by ordered subset expectation maximization (OSEM) provides the highest accuracy for localizing parathyroid lesions using {sup 99m}Tc-sestamibi SPECT data. From an Institutional Review Board approved retrospective review of 531 patients evaluated for parathyroid localization, image characteristics were determined for 85 {sup 99m}Tc-sestamibi SPECT studies originally read as equivocal (EQ). Seventy-two plexiglas phantoms using cylindrical simulated lesions were acquired for a clinically realistic range of counts (mean simulated lesion counts of 75{+-}50 counts/pixel) and target-to-background (T:B) ratios (range=2.0 to 8.0) to determine an optimal filter for OSEM. Two experienced nuclear physicians graded simulated lesions, blinded to whether chambers contained radioactivity or plain water, and two observers used the same scale to read all phantom and clinical SPECT studies, blinded to pathology findings and clinical information. For phantom data and all clinical data, T:B analyses were not statistically different for OSEM versus FB, but visual readings were significantly more accurate than T:B (88{+-}6% versus 68{+-}6%, p=0.001) for OSEM processing, and OSEM was significantly more accurate than FB for visual readings (88{+-}6% versus 58{+-}6%, p<0.0001). These data suggest that visual analysis of iteratively reconstructed MIBI tomograms should be incorporated into imaging protocols performed to localize parathyroid lesions.

  14. Producing Uniform Lesion Pattern in HIFU Ablation

    NASA Astrophysics Data System (ADS)

    Zhou, Yufeng; Kargl, Steven G.; Hwang, Joo Ha

    2009-04-01

    High intensity focused ultrasound (HIFU) is emerging as a modality for treatment of solid tumors. The temperature at the focus can reach over 65° C denaturing cellular proteins resulting in coagulative necrosis. Typically, HIFU parameters are the same for each treated spot in most HIFU control systems. Because of thermal diffusion from nearby spots, the size of lesions will gradually become larger as the HIFU therapy progresses, which may cause insufficient treatment of initial spots, and over-treatment of later ones. It is found that the produced lesion pattern also depends on the scanning pathway. From the viewpoint of the physician creating uniform lesions and minimizing energy exposure are preferred in tumor ablation. An algorithm has been developed to adaptively determine the treatment parameters for every spot in a theoretical model in order to maintain similar lesion size throughout the HIFU therapy. In addition, the exposure energy needed using the traditional raster scanning is compared with those of two other scanning pathways, spiral scanning from the center to the outside and from the outside to the center. The theoretical prediction and proposed algorithm were further evaluated using transparent gel phantoms as a target. Digital images of the lesions were obtained, quantified, and then compared with each other. Altogether, dynamically changing treatment parameters can improve the efficacy and safety of HIFU ablation.

  15. Scintigraphic localization of bone lesions during surgery.

    PubMed

    Harcke, H T; Conway, J J; Tachdjian, M O; Dias, L S; Noble, H B; MacEwen, G D; Weiss, S

    1985-01-01

    Nuclear medicine provides several methods for increasing the accuracy of surgical removal of bone lesions with focally increased uptake. In this paper, three intraoperative procedures are discussed: remote control by imaging, intraoperative control by imaging, and intraoperative control by scintillation probe. All techniques require preoperative injection of bone imaging tracer. Remote operative control calls for a gamma camera to mark the skin over the lesion prior to surgery, providing optimal preoperative localization and imaging of the excised lesion to ensure complete removal. Intraoperative control procedures require that a portable camera or a scintillation probe be used in the operating room; these permit direct monitoring of localization and resection. Our experience with 18 procedures performed on 15 patients suggests that these techniques are worthy of continued use. PMID:3158078

  16. COMMON LESIONS OF THE URETHRA IN WOMEN

    PubMed Central

    Burkland, Carl E.

    1952-01-01

    Urethral disease in women and girls often is overlooked. As the urine may seem to be normal as determined by repeated urinalysis, the symptoms—urinary frequency and burning—may be attributed entirely to other pelvic disease or to functional disorder. Since erroneous diagnosis may lead to unnecessary procedures or to neglect of treatment with consequent development of severe disease in the kidneys or ureters, it is important to consider urethral lesions as a possible cause in any case of abdominal discomfort in women. The most common lesions of the urethra in women are urethritis, stricture, caruncle, inflammatory polyps and cysts, prolapse of the urethra, and diverticulum. In some cases diagnosis can be made simply on the basis of inspection and palpation. In others more extensive diagnostic procedures must be carried out in order that treatment may be definitive. The methods of treatment, varying with the nature of the lesion, are outlined herein. PMID:14905285

  17. Cerebriform Cutaneous Lesions in Pemphigus Vegetans.

    PubMed

    Rebello, Meryl Sonia; Ramesh, Bhat M; Sukumar, D; Alapatt, Geethu F

    2016-01-01

    Pemphigus vegetans is an autoimmune bullous disorder characterized by vegetating lesions commonly over the flexures. A 42-year-old female patient came with pemphigus vegetans presenting with interesting cerebriform morphology of the cutaneous lesions over the flexures. Cerebriform tongue, a morphology with typical pattern of sulci and gyri over dorsum of the tongue is a well-known sign seen in pemphigus vegetans. Interestingly, we noticed the typical sulci and gyri pattern in the skin lesions of pemphigus vegetans over the flexures of the body. This clinical sign can be used as a clue in the diagnosis of pemphigus vegetans. Morphology and physical characteristics are important for the diagnosis of the disease. Clinical signs always give a clue to the probable or possible diagnosis in most of the dermatological conditions. PMID:27057025

  18. Morgellons Disease Presenting As an Eyelid Lesion.

    PubMed

    Sandhu, Rasanamar K; Steele, Eric A

    2016-01-01

    Morgellons disease is characterized by complaints of uncomfortable skin sensations and fibers emanating from nonhealing skin lesions. Morgellons disease is well-known in the dermatology and psychiatry literature, where it is typically considered a subtype of delusional parasitosis, but it has not yet been described in the ophthalmology literature. A patient with self-reported Morgellons disease is presented, who was referred for evaluation of left lower eyelid ectropion. She reported that her skin was infested with fibers that were "trying to get down into the eyelid." On examination, she had ectropion of the left lower eyelid, broken cilia, and an ulcerated left upper eyelid lesion concerning for carcinoma. Biopsy of the lesion was consistent with excoriation. Treatment of her ectropion was deferred out of concern for wound dehiscence, given the patient's aggressive excoriation behavior. This case is presented to make the ophthalmologist aware of this disorder and to highlight the appropriate clinical management. PMID:25192328

  19. Imaging of Retrosternal Space Lesions - A Pictorial Review.

    PubMed

    Chandrashekhara, S H; Rahul, Kumar; Handa, Nayha; Panda, Ananya

    2016-01-01

    The retrosternal region (RSS) can be involved by diverse lesions. The RSS is the region behind the sternum and anterior to the ascending aorta. It normally is less than 3 cm deep. Chest X-ray is usually the first imaging modality to raise a suspicion of RSS pathology; however computed tomography is the mainstay to delineate and characterize lesions in this location. Lesions in this location include thyroid, thymic and lymph node lesions; germ cell tumors and vascular lesions. Lesions arising from the sternum, lungs as well as the pleura can also involve this space. The pictorial review depicts the diverse spectrum of lesions in this location. PMID:27504144

  20. Imaging of Retrosternal Space Lesions – A Pictorial Review

    PubMed Central

    Chandrashekhara, S.H.; Rahul, Kumar; Handa, Nayha; Panda, Ananya

    2016-01-01

    Summary The retrosternal region (RSS) can be involved by diverse lesions. The RSS is the region behind the sternum and anterior to the ascending aorta. It normally is less than 3 cm deep. Chest X-ray is usually the first imaging modality to raise a suspicion of RSS pathology; however computed tomography is the mainstay to delineate and characterize lesions in this location. Lesions in this location include thyroid, thymic and lymph node lesions; germ cell tumors and vascular lesions. Lesions arising from the sternum, lungs as well as the pleura can also involve this space. The pictorial review depicts the diverse spectrum of lesions in this location. PMID:27504144

  1. A soft kinetic data structure for lesion border detection

    PubMed Central

    Kockara, Sinan; Mete, Mutlu; Yip, Vincent; Lee, Brendan; Aydin, Kemal

    2010-01-01

    Motivation: The medical imaging and image processing techniques, ranging from microscopic to macroscopic, has become one of the main components of diagnostic procedures to assist dermatologists in their medical decision-making processes. Computer-aided segmentation and border detection on dermoscopic images is one of the core components of diagnostic procedures and therapeutic interventions for skin cancer. Automated assessment tools for dermoscopic images have become an important research field mainly because of inter- and intra-observer variations in human interpretations. In this study, a novel approach—graph spanner—for automatic border detection in dermoscopic images is proposed. In this approach, a proximity graph representation of dermoscopic images in order to detect regions and borders in skin lesion is presented. Results: Graph spanner approach is examined on a set of 100 dermoscopic images whose manually drawn borders by a dermatologist are used as the ground truth. Error rates, false positives and false negatives along with true positives and true negatives are quantified by digitally comparing results with manually determined borders from a dermatologist. The results show that the highest precision and recall rates obtained to determine lesion boundaries are 100%. However, accuracy of assessment averages out at 97.72% and borders errors' mean is 2.28% for whole dataset. Contact: skockara@uca.edu PMID:20529909

  2. Non-infectious inflammatory genital lesions.

    PubMed

    Andreassi, Lucio; Bilenchi, Roberta

    2014-01-01

    The genitalia may be the site of non-infectious inflammatory lesions that are generally manifested as balanoposthitis and vulvovaginitis. In men, these forms constitute 50% of all balanoposthitis forms, and in women, vulvovaginitis frequency is even higher. They consist of genital locations of general skin diseases, such as psoriasis, lichen planus, lichen sclerosus, and other clinical entities with their own physiognomy, such as Zoon's balanitis-vulvitis. Diagnosis of genital non-infectious inflammatory lesions is usually made on clinical criteria. A biopsy is only necessary for the identification of clinical conditions that may simulate inflammatory form but are actually premalignant processes. PMID:24559568

  3. Chondro-Osseous Lesions of Soft Tissue.

    PubMed

    Cho, Soo-Jin; Horvai, Andrew

    2015-09-01

    Soft tissue lesions can contain bone or cartilage matrix as an incidental, often metaplastic, phenomenon or as a diagnostic feature. The latter category includes a diverse group ranging from self-limited proliferations to benign neoplasms to aggressive malignancies. Correlating imaging findings with pathology is mandatory to confirm that a tumor producing bone or cartilage, in fact, originates from soft tissue rather than from the skeleton. The distinction can have dramatic diagnostic and therapeutic implications. This content focuses on the gross, histologic, radiographic, and clinical features of bone or cartilage-producing soft tissue lesions. Recent discoveries regarding tumor-specific genetics are discussed. PMID:26297064

  4. Treatment of calcified coronary artery lesions.

    PubMed

    Farag, Mohamed; Costopoulos, Charis; Gorog, Diana A; Prasad, Abhiram; Srinivasan, Manivannan

    2016-06-01

    Heavily calcified coronary plaques represent a complex lesion subset and a challenge to the interventional cardiologist, as they are often resistant to simple plaque modification with conventional balloon angioplasty. Inadequate plaque modification can lead to stent underdeployment, which itself predisposes to in-stent restenosis and stent thrombosis. Over the years, a number of mechanical devices ranging from modified angioplasty balloons to atherectomy devices have become available in order to tackle such lesions. Here we review these devices concentrating on the evidence behind their use. PMID:26924773

  5. [Proliferative mucosal lesions in elderly people].

    PubMed

    Ursache, Maria; Grădinaru, Irina; Vlădoiu, Ruxandra

    2004-01-01

    The aim of this study consisted into the identification of the hyperplasic modifications on the oral mucosa related to the etiological factors implicated into the etiopathogenity. We surveyed 228 patients aged between 65-84 years, with partial or total edentation, with removable dentures. The diagnostic was based on a complex clinical examination and complementary tests. The clinical manifestation forms were very different, determined by local factors, especially prosthetic one. The registration of these lesions demonstrates the main role of the dentist on the prophylactic activity of registration of these lesions and reduction of the etiologic factors. PMID:15688766

  6. [Inflammatory odontogenic lesions of the jaws].

    PubMed

    Gallini, G; Merlini, C; Martelossi, L; Benetti, C

    1991-04-15

    The apical granuloma, the periapical abcess and the radicular cyst are the most frequent between the inflammatory odontogenic lesions of the jaws. These three lesions are caused by the necrosis of the pulp but are very different between each other from an histological point of view and they can correspond to different stages of the same pathological process considering the fact that from a granuloma can arise a periapical abcess or a radicular cyst and from a radicular cyst and abcess can originate. About these three pathological processes we discuss in this article the clinical, radiographical, ethiological, microscopical features, we suggest the treatment and the differential diagnosis. PMID:2070926

  7. Malignant hyperechoic breast lesions at ultrasound: A pictorial essay.

    PubMed

    Tiang, Stephen; Metcalf, Cecily; Dissanayake, Deepthi; Wylie, Elizabeth

    2016-08-01

    Malignant breast lesions are typically hypoechoic at sonography. However, a small subgroup of hyperechoic malignant breast lesions is encountered in clinical practice. We present a pictorial essay of a number of different hyperechoic breast malignancies with mammographic, sonographic and histopathologic correlation. Suspicious sonographic features in a hyperechoic lesion include inhomogeneity in echogenic pattern, an irregular margin, posterior acoustic shadowing and internal vascularity. A hyperechoic lesion at ultrasound does not discount the need to undertake histological assessment of a mammographically suspicious lesion. PMID:27216965

  8. Longitudinal Patch-Based Segmentation of Multiple Sclerosis White Matter Lesions

    PubMed Central

    Roy, Snehashis; Carass, Aaron; Prince, Jerry L.; Pham, Dzung L.

    2016-01-01

    Segmenting T2-hyperintense white matter lesions from longitudinal MR images is essential in understanding progression of multiple sclerosis. Most lesion segmentation techniques find lesions independently at each time point, even though there are different noise and image contrast variations at each point in the time series. In this paper, we present a patch based 4D lesion segmentation method that takes advantage of the temporal component of longitudinal data. For each subject with multiple time-points, 4D patches are constructed from the T1-w and FLAIR scans of all time-points. For every 4D patch from a subject, a few relevant matching 4D patches are found from a reference, such that their convex combination reconstructs the subject’s 4D patch. Then corresponding manual segmentation patches of the reference are combined in a similar manner to generate a 4D membership of lesions of the subject patch. We compare our 4D patch-based segmentation with independent 3D voxel-based and patch-based lesion segmentation algorithms. Based on ground truth segmentations from 30 data sets, we show that the mean Dice coefficients between manual and automated segmentations improve after using the 4D approach compared to two state-of-the-art 3D segmentation algorithms.

  9. Fish biomarkers for environmental monitoring: An integrated model supporting enzyme activity and histopathological lesions

    NASA Astrophysics Data System (ADS)

    Neta, Raimunda Nonata Fortes Carvalho; Torres Junior, Audalio Rebelo

    2014-10-01

    We present a mathematical model describing the association between glutathione-S-transferase activity and brachial lesions in the catfish, Sciades herzbergii (Ariidae) from a polluted port. The catfish were sampled from a port known to be contaminated with heavy metals and organic compounds and from a natural reserve in São Marcos Bay, Brazil. Two biomarkers, hepatic glutathione S-transferase (GST) activity and histopathological lesions, in gills tissue were measured. The values for GST activity were modeled with the occurrence of branchial lesions by fitting a third order polynomial. Results from the mathematical model indicate that GST activity has a strong polynomial relationship with the occurrence of branchial lesions in both the wet and the dry seasons, but only at the polluted port site. The model developed in this study indicates that branchial and hepatic lesions are initiated when GST activity reaches 2.15 μmol min-1 mg protein-1. Beyond this limit, GST activity decreased to very low levels and irreversible histopathological lesions occurred. This mathematical model provides a realistic approach to analyze predictive biomarkers of environmental health status.

  10. Characteristics of common solid liver lesions and recommendations for diagnostic workup

    PubMed Central

    Assy, Nimer; Nasser, Gattas; Djibre, Agness; Beniashvili, Zaza; Elias, Saad; Zidan, Jamal

    2009-01-01

    Due to the widespread clinical use of imaging modalities such as ultrasonography, computed tomography and magnetic resonance imaging (MRI), previously unsuspected liver masses are increasingly being found in asymptomatic patients. This review discusses the various characteristics of the most common solid liver lesions and recommends a practical approach for diagnostic workup. Likely diagnoses include hepatocellular carcinoma (the most likely; a solid liver lesion in a cirrhotic liver) and hemangioma (generally presenting as a mass in a non-cirrhotic liver). Focal nodular hyperplasia and hepatic adenoma should be ruled out in young women. In 70% of cases, MRI with gadolinium differentiates between these lesions. Fine needle core biopsy or aspiration, or both, might be required in doubtful cases. If uncertainty persists as to the nature of the lesion, surgical resection is recommended. If the patient is known to have a primary malignancy and the lesion was found at tumor staging or follow up, histology is required only when the nature of the liver lesion is doubtful. PMID:19598296

  11. Evidence for perceptual neglect of environmental features in hippocampal-lesioned pigeons during homing.

    PubMed

    Gagliardo, Anna; Pollonara, Enrica; Coppola, Vincent J; Santos, Carlos D; Wikelski, Martin; Bingman, Verner P

    2014-10-01

    The importance of the vertebrate hippocampus in spatial cognition is often related to its broad role in memory. However, in birds, the hippocampus appears to be more specifically involved in spatial processes. The maturing of GPS-tracking technology has enabled a revolution in navigation research, including the expanded possibility of studying brain mechanisms that guide navigation in the field. By GPS-tracking homing pigeons released from distant, unfamiliar sites prior to and after hippocampal lesion, we observed, as has been reported previously, impaired navigational performance post-lesion over the familiar/memorized space near the home loft, where topographic features constitute an important source of navigational information. The GPS-tracking revealed that many of the lost pigeons, when lesioned, approached the home area, but nevertheless failed to locate their loft. Unexpectedly, when they were hippocampal-lesioned, the pigeons showed a notable change in their behaviour when navigating over the unfamiliar space distant from home; they actually flew straighter homeward-directed paths than they did pre-lesion. The data are consistent with the hypothesis that, following hippocampal lesion, homing pigeons respond less to unfamiliar visual, topographic features encountered during homing, and, as such, offer the first evidence for an unforeseen, perceptual neglect of environmental features following hippocampal damage. PMID:25039270

  12. Computer-Aided Diagnosis of Different Rotator Cuff Lesions Using Shoulder Musculoskeletal Ultrasound.

    PubMed

    Chang, Ruey-Feng; Lee, Chung-Chien; Lo, Chung-Ming

    2016-09-01

    The lifetime prevalence of shoulder pain approaches 70%, which is mostly attributable to rotator cuff lesions such as inflammation, calcific tendinitis and tears. On clinical examination, shoulder ultrasound is recommended for the detection of lesions. However, there exists inter-operator variability in diagnostic accuracy because of differences in the experience and expertise of operators. In this study, a computer-aided diagnosis (CAD) system was developed to assist ultrasound operators in diagnosing rotator cuff lesions and to improve the practicality of ultrasound examination. The collected cases included 43 cases of inflammation, 30 cases of calcific tendinitis and 26 tears. For each case, the lesion area and texture features were extracted from the entire lesions and combined in a multinomial logistic regression classifier for lesion classification. The proposed CAD achieved an accuracy of 87.9%. The individual accuracy of this CAD system was 88.4% for inflammation, 83.3% for calcific tendinitis and 92.3% for tears. Cohen's k was 0.798. On the basis of its diagnostic performance, clinical use of this CAD technique has promise. PMID:27381057

  13. Breast-lesion Segmentation Combining B-Mode and Elastography Ultrasound.

    PubMed

    Pons, Gerard; Martí, Joan; Martí, Robert; Ganau, Sergi; Noble, J Alison

    2016-05-01

    Breast ultrasound (BUS) imaging has become a crucial modality, especially for providing a complementary view when other modalities (i.e., mammography) are not conclusive in the task of assessing lesions. The specificity in cancer detection using BUS imaging is low. These false-positive findings often lead to an increase of unnecessary biopsies. In addition, increasing sensitivity is also challenging given that the presence of artifacts in the B-mode ultrasound (US) images can interfere with lesion detection. To deal with these problems and improve diagnosis accuracy, ultrasound elastography was introduced. This paper validates a novel lesion segmentation framework that takes intensity (B-mode) and strain information into account using a Markov Random Field (MRF) and a Maximum a Posteriori (MAP) approach, by applying it to clinical data. A total of 33 images from two different hospitals are used, composed of 14 cancerous and 19 benign lesions. Results show that combining both the B-mode and strain data in a unique framework improves segmentation results for cancerous lesions (Dice Similarity Coefficient of 0.49 using B-mode, while including strain data reaches 0.70), which are difficult images where the lesions appear with blurred and not well-defined boundaries. PMID:26062760

  14. Multi-stage osteolytic spinal bone lesion detection from CT data with internal sensitivity control

    NASA Astrophysics Data System (ADS)

    Wels, M.; Kelm, B. M.; Tsymbal, A.; Hammon, M.; Soza, G.; Sühling, M.; Cavallaro, A.; Comaniciu, D.

    2012-03-01

    Spinal bone lesion detection is a challenging and important task in cancer diagnosis and treatment monitoring. In this paper we present a method for fully-automatic osteolytic spinal bone lesion detection from 3D CT data. It is a multi-stage approach subsequently applying multiple discriminative models, i.e., multiple random forests, for lesion candidate detection and rejection to an input volume. For each detection stage an internal control mechanism ensures maintaining sensitivity on unseen true positive lesion candidates during training. This way a pre-defined target sensitivity score of the overall system can be taken into account at the time of model generation. For a lesion not only the center is detected but also, during post-processing, its spatial extension along the three spatial axes defined by the surrounding vertebral body's local coordinate system. Our method achieves a cross-validated sensitivity score of 75% and a mean false positive rate of 3.0 per volume on a data collection consisting of 34 patients with 105 osteolytic spinal bone lesions. The median sensitivity score is 86% at 2.0 false positives per volume.

  15. First International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions).

    PubMed

    Rageth, Christoph J; O'Flynn, Elizabeth Am; Comstock, Christopher; Kurtz, Claudia; Kubik, Rahel; Madjar, Helmut; Lepori, Domenico; Kampmann, Gert; Mundinger, Alexander; Baege, Astrid; Decker, Thomas; Hosch, Stefanie; Tausch, Christoph; Delaloye, Jean-François; Morris, Elisabeth; Varga, Zsuzsanna

    2016-09-01

    The purpose of this study is to obtain a consensus for the therapy of B3 lesions. The first International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions) including atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), classical lobular neoplasia (LN), papillary lesions (PL), benign phyllodes tumors (PT), and radial scars (RS) took place in January 2016 in Zurich, Switzerland organized by the International Breast Ultrasound School and the Swiss Minimally Invasive Breast Biopsy group-a subgroup of the Swiss Society of Senology. Consensus recommendations for the management and follow-up surveillance of these B3 lesions were developed and areas of research priorities were identified. The consensus recommendation for FEA, LN, PL, and RS diagnosed on core needle biopsy or vacuum-assisted biopsy (VAB) is to therapeutically excise the lesion seen on imaging by VAB and no longer by open surgery, with follow-up surveillance imaging for 5 years. The consensus recommendation for ADH and PT is, with some exceptions, therapeutic first-line open surgical excision. Minimally invasive management of selected B3 lesions with therapeutic VAB is acceptable as an alternative to first-line surgical excision. PMID:27522516

  16. Classification of breast lesions presenting as mass and non-mass lesions

    NASA Astrophysics Data System (ADS)

    Gallego-Ortiz, Cristina; Martel, Anne L.

    2014-03-01

    We aim to develop a CAD system for robust and reliable di erential diagnosis of breast lesions, in particular non-mass lesions. A necessary prerequisite for the development of a successful CAD system is the selection of the best subset of lesion descriptors. But an important methodological concern is whether the selected features are in uenced by the model employed rather than by the underlying characteristic distribution of descriptors for positive and negative cases. Another interesting question is how a particular classi er exploits the relationships between descriptors to increase the accuracy of the classi cation. In this work we set to: (1) Characterize kinetic, morphological and textural features among mass and non-mass lesions; (2) Examine feature spaces and compare selection of subset of features based on similarity of feature importance across feature rankings; (3) Compare two classi er performances namely binary Support Vector Machines (SVM) and Random Forest (RF) for the task of di erentiating between positive and negative cases when using binary classi cation for mass and non-mass lesions separately or when employing a multi-class classi cation. Breast MRI datasets consists of 243 (173 mass and 70 non-mass) lesions. Results show that RF variable importance used with RF-binary based classi cation optimized for mass and non-mass lesions separately o ers the best classi cation accuracy.

  17. Expression of Malic Enzymes in Sebaceous Lesions.

    PubMed

    Su, Ting-Fu; Gao, Hong-Wei

    2016-08-01

    Malic enzymes (MEs) are involved in fatty acid biosynthesis and lipid accumulation, and their expression in sebocytes and sebaceous lesions has not been investigated. The aims of this study were to examine ME1 and ME2 expression in normal skin and sebaceous lesions. A total of 68 cases including 5 specimens of normal skin, 12 facial lesions showing sebaceous hyperplasia, 18 sebaceous adenomas, 10 sebaceomas, 13 steatocystomas, and 10 sebaceous carcinomas were examined for the expression of ME1 and ME2. All benign and malignant sebaceous lesions showed ME1 in clear cells and ME2 in nonclear cells, respectively. ME1/ME2 phenotype is seen in basal sebocytes, basal keratinocytes, sweat glands, and outer root sheath cells and hence not specific. This study demonstrates that ME1/ME2 expression phenotype may have a potential to be a valuable marker for sebaceous differentiation. It is necessary to perform large-scale studies including skin tumors with a clear cell morphology that may mimic sebaceous differentiation. PMID:26381116

  18. Laser treatment of first degree carious lesions

    NASA Astrophysics Data System (ADS)

    Rechmann, Peter; Pilgrim, Christian G.; Hennig, Thomas

    2001-04-01

    The therapy of initial carious lesions aims in a minimal invasive removal of infected dental hard tissue. Typically standard preparation instruments bear the risk of removing a big amount of sound structures as a result of access. On the other hand the competence of Er:YAG lasers for caries removal has been repeatedly proven.

  19. Magnetic resonance sees lesions of multiple sclerosis

    SciTech Connect

    Ziporyn, T.

    1985-02-15

    The value of nuclear magnetic resonance imaging in the diagnosis and quantitation of the progression of multiple sclerosis is discussed. Magnetic resonance imaging generates images that reflect differential density and velocity of hydrogen nuclei between cerebral gray and white matter, as well as between white matter and pathological lesions of the disease.

  20. SLAP lesions in the overhead athlete.

    PubMed

    Burkhart, S S; Morgan, C

    2001-07-01

    The authors report an 87% rate of return to preinjury levels of throwing in 54 baseball players and an 84% rate of return to preinjury performance levels in pitches after repair of type II SLAP lesions. The etiology, biomechanics, surgical repair, and rehabilitation are discussed in detail. PMID:11888138

  1. [Synovial tumors and tumor-like lesions].

    PubMed

    Doepfer, A-K; Meurer, A

    2015-10-01

    Synovial tumors comprise a variety of lesions, including those with benign and aggressive neoplastic changes as well as inflammatory causes. In this article we focus on neoplastic tumors. Synovial tumors with other etiologies, such as sarcoidosis, granuloma, synovitis, or gouty arthritis, are not dealt with here. Through a precise differentiation between these disease entities can an optimization of treatment be achieved. PMID:26370407

  2. Calcified lesion modeling for excimer laser ablation

    NASA Astrophysics Data System (ADS)

    Scott, Holly A.; Archuleta, Andrew; Splinter, Robert

    2009-06-01

    Objective: Develop a representative calcium target model to evaluate penetration of calcified plaque lesions during atherectomy procedures using 308 nm Excimer laser ablation. Materials and Methods: An in-vitro model representing human calcified plaque was analyzed using Plaster-of-Paris and cement based composite materials as well as a fibrinogen model. The materials were tested for mechanical consistency. The most likely candidate(s) resulting from initial mechanical and chemical screening was submitted for ablation testing. The penetration rate of specific multi-fiber catheter designs and a single fiber probe was obtained and compared to that in human cadaver calcified plaque. The effects of lasing parameters and catheter tip design on penetration speed in a representative calcified model were verified against the results in human cadaver specimens. Results: In Plaster of Paris, the best penetration was obtained using the single fiber tip configuration operating at 100 Fluence, 120 Hz. Calcified human lesions are twice as hard, twice as elastic as and much more complex than Plaster of Paris. Penetration of human calcified specimens was highly inconsistent and varied significantly from specimen to specimen and within individual specimens. Conclusions: Although Plaster of Paris demonstrated predictable increases in penetration with higher energy density and repetition rate, it can not be considered a totally representative laser ablation model for calcified lesions. This is in part due to the more heterogeneous nature and higher density composition of cadaver intravascular human calcified occlusions. Further testing will require a more representative model of human calcified lesions.

  3. [Non-neoplastic lesions of the mediastinum].

    PubMed

    Tzankov, A

    2016-09-01

    The mediastinum is a complex body region of limited space but containing numerous organs of different embryonic origins. A variety of lesions that are difficult to distinguish from each other can occur here. Non-neoplastic lesions of the mediastinum represent important differential diagnostic pitfalls to mediastinal tumors, clinically, radiologically and histopathologically. It is important to bear these lesions in mind and to adequately verify or exclude them before starting further differential diagnostic considerations on mediastinal neoplasms. The most common non-neoplastic lesions in this region include cysts and lymphadenopathies. Mediastinal cysts result from abnormal events in the branching of the tracheobronchial tree, the pharyngeal pouches, the primary intestines, the pleuropericardial membranes and the brain meninges or are complications of inflammatory and hydrostatic processes. The histogenesis of the lining epithelium and the cyst wall structure are decisive for the exact classification. The histopathologically most prevalent patterns of mediastinal lymphadenopathies are those accompanied by increased histiocytes and Castleman's disease. Sclerosis is a non-specific reaction pattern of the mediastinum and can be associated with many processes; therefore, when establishing the diagnosis of sclerosing mediastinitis, several differential diagnoses have to be excluded. Simple thymic hyperplasia can be accompanied by considerable increase in organ size with severe local symptoms, while follicular thymic hyperplasia is often associated with myasthenia gravis and represents the most common findings in non-thymoma thymectomy specimens. PMID:27465275

  4. Cutaneous lesions of the external ear

    PubMed Central

    Sand, Michael; Sand, Daniel; Brors, Dominik; Altmeyer, Peter; Mann, Benno; Bechara, Falk G

    2008-01-01

    Skin diseases on the external aspect of the ear are seen in a variety of medical disciplines. Dermatologists, othorhinolaryngologists, general practitioners, general and plastic surgeons are regularly consulted regarding cutaneous lesions on the ear. This article will focus on those diseases wherefore surgery or laser therapy is considered as a possible treatment option or which are potentially subject to surgical evaluation. PMID:18261212

  5. Simulating Clinical Carious Lesions in Composition Teeth.

    ERIC Educational Resources Information Center

    Ambrose, E. R.; And Others

    1981-01-01

    A step-by-step technique to alter stock composition teeth and create simulated carious conditions that are ideal or otherwise is presented. The procedures provide the student with life-like lesions, suitable in texture and location and similar to conditions found in the oral cavity. (MLW)

  6. Dermoscopic Features of Facial Pigmented Skin Lesions

    PubMed Central

    Goncharova, Yana; Attia, Enas A. S.; Souid, Khawla; Vasilenko, Inna V.

    2013-01-01

    Four types of facial pigmented skin lesions (FPSLs) constitute diagnostic challenge to dermatologists; early seborrheic keratosis (SK), pigmented actinic keratosis (AK), lentigo maligna (LM), and solar lentigo (SL). A retrospective analysis of dermoscopic images of histopathologically diagnosed clinically-challenging 64 flat FPSLs was conducted to establish the dermoscopic findings corresponding to each of SK, pigmented AK, LM, and SL. Four main dermoscopic features were evaluated: sharp demarcation, pigment pattern, follicular/epidermal pattern, and vascular pattern. In SK, the most specific dermoscopic features are follicular/epidermal pattern (cerebriform pattern; 100% of lesions, milia-like cysts; 50%, and comedo-like openings; 37.50%), and sharp demarcation (54.17%). AK and LM showed a composite characteristic pattern named “strawberry pattern” in 41.18% and 25% of lesions respectively, characterized by a background erythema and red pseudo-network, associated with prominent follicular openings surrounded by a white halo. However, in LM “strawberry pattern” is widely covered by psewdonetwork (87.5%), homogenous structureless pigmentation (75%) and other vascular patterns. In SL, structureless homogenous pigmentation was recognized in all lesions (100%). From the above mentioned data, we developed an algorithm to guide in dermoscopic features of FPSLs. PMID:23431466

  7. [Acute hepatic lesion caused by Giardia lamblia].

    PubMed

    Sotto, A; Alvarez, J L; García, B; Pomar, F; Cendán, A

    1990-01-01

    A study was made of 20 rats infested by Giardia muris in which a histologic study was made of the liver, as well as of 25 patients with giardiasis and elevated alanine-aminotransferase levels. Patients with positive A or B hepatitis markers, cholelithiasis or history of drug or alcohol use were excluded. Tests of liver function and liver biopsy were performed and antiparasite therapy was given during three months of follow-up, after which the liver biopsy was repeated. Humoral alterations were compared to those of 30 patients with acute viral hepatitis (15 type A and 15 type B) over the same periods of time. In 20% of the rats, nonspecific liver lesions were found. In the patients liver enzymes and the thymol test normalized a month after treatment and serum bile acids became normal in the third month. The liver biopsy demonstrated hepatic damage in 94% of the patients (in 20 cases cell lesions and in 12 cases inflammatory lesions) which regressed in the third month, the follow-up biopsy being normal after eradication of the parasite was confirmed. The comparative study with viral hepatitis showed highly significant differences in all the variables studied during the follow-up stage. Emphasis is placed on the importance of this lesion and its differential diagnosis to prevent its progression to chronic liver disease. PMID:2334580

  8. Macrovascular Lesions Underlying Spontaneous Intracerebral Hemorrhage.

    PubMed

    Yeung, Jacky; Cord, Branden J; O'Rourke, Timothy K; Maina, Renee M; Sommaruga, Samuel; Matouk, Charles C

    2016-06-01

    Spontaneous intracerebral hemorrhage (ICH) is a morbid disease with a high case fatality rate. Prognosis, rehemorrhage rates, and acute, clinical decision making are greatly affected by the underlying etiology of hemorrhage. This review focuses on the evaluation, diagnosis, and management of structural, macrovascular lesions presenting with ICH, including ruptured aneurysms, brain arteriovenous malformations, cranial dural arteriovenous fistulas, and cerebral cavernous malformations. PMID:27214699

  9. Downbeat nystagmus: characteristics and localization of lesions.

    PubMed Central

    Yee, R D

    1989-01-01

    Clinical examinations and eye movement recordings of 91 consecutive patients with DBN were analyzed to describe the characteristics of DBN and to localize the lesions producing this abnormality. Horizontal and vertical eye movement recordings were made with EOG and/or magnetic search coil. The most frequent causes were infarction, cerebellar and spinocerebellar degeneration syndromes, MS and developmental anomalies affecting the pons and cerebellum. Toxicity from anticonvulsant drugs probably caused nystagmus in a few patients. Clinical examinations, excluding electronic eye movement recordings, were used to localize lesions. Localizations included the cerebellum in 88% of the patients. However, localizations to structures outside of the cerebellum were made in several patients. The effects of DBN of gaze position, convergence, blockage of fixation, and positioning of the head and body were observed. Almost all patients had DBN in some position of gaze while sitting and fixating a distant target. A few patients demonstrated DBN only with convergence, in the dark, or with positioning of the head and body. Horizontal gaze increased DBN in most patients. The nystagmus slow components usually had constant-velocity or increasing-velocity waveforms. The effects of vertical gaze on DBN were variable. In general, statistically significant differences in the frequencies of these effects among the various causes and localizations of lesions were not found. Horizontal eye movements were electronically recorded in DBN patients, in a group of normal subjects, and in a group of patients with isolated cerebellar atrophy who did not have DBN. The pattern of abnormal horizontal eye movements characteristic of damage to the midline structures of the cerebellum (impaired pursuit, impaired OKN, and inability to suppress VOR) was found in almost all DBN patients (99%), including patients with lesions localized to structures outside the cerebellum by clinical examination. DBN is usually

  10. Vascular lesions secondary to osteotomy by corticotomy.

    PubMed

    Spinelli, Francesco; Spinelli, Renato; Stilo, Francesco; De Caridi, Giovanni; Mirenda, Francesco

    2007-01-01

    Management of vascular traumas is frequently delayed. Vascular injuries after elective operation for bone lengthening or correction of a deformity are very'rare situations. We describe 3 cases. Case 1: male, aged 22, undergoing corticotomy for bone lengthening; immediately presented acute limb ischaemia due to a partial lesion of the popliteal artery, documented by U.S. After 7 h, direct reconstruction of the artery and fasciotomies were performed. Case 2: male, aged 27, undergoing directional osteotomy for genu varus correction. For 30 days, constant increase in leg volume and decrease in function. US showed an important haematoma at the popliteal level; arteriography documented a partial lesion of the infra-genicular popliteal artery and a voluminous false aneurysm. Direct correction of the artery and fasciotomies were performed. Case 3: male, aged 22, undergoing corticotomy for leg lengthening; immediately presented leg pain with decreased distal pulses. After 4h, there was an increase in leg volume, and arteriography showed a total lesion of the infra-genicular popliteal artery and an arteriovenous fistula. Popliteo-tibial bypass with the contralateral greater saphenous vein and fasciotomies were performed. After 1 month endovascular closure of the fistula was obtained. All patients had recovered after two months with only minor leg insufficiency. Patency of the bypass and absence of infections or delayed false aneurysms were achieved. Vascular injuries after elective orthopaedic procedures are very rare situations. Such lesions are caused by an osteotomy via corticotomy performed percutaneously. The variety of clinical presentations accounts for the difficulty in diagnosing such lesions and for the delays in implementing treatment. It is very important to obtain an early diagnosis complete with an arteriography. PMID:17966782

  11. Photoacoustic characterization of radiofrequency ablation lesions

    NASA Astrophysics Data System (ADS)

    Bouchard, Richard; Dana, Nicholas; Di Biase, Luigi; Natale, Andrea; Emelianov, Stanislav

    2012-02-01

    Radiofrequency ablation (RFA) procedures are used to destroy abnormal electrical pathways in the heart that can cause cardiac arrhythmias. Current methods relying on fluoroscopy, echocardiography and electrical conduction mapping are unable to accurately assess ablation lesion size. In an effort to better visualize RFA lesions, photoacoustic (PA) and ultrasonic (US) imaging were utilized to obtain co-registered images of ablated porcine cardiac tissue. The left ventricular free wall of fresh (i.e., never frozen) porcine hearts was harvested within 24 hours of the animals' sacrifice. A THERMOCOOLR Ablation System (Biosense Webster, Inc.) operating at 40 W for 30-60 s was used to induce lesions through the endocardial and epicardial walls of the cardiac samples. Following lesion creation, the ablated tissue samples were placed in 25 °C saline to allow for multi-wavelength PA imaging. Samples were imaged with a VevoR 2100 ultrasound system (VisualSonics, Inc.) using a modified 20-MHz array that could provide laser irradiation to the sample from a pulsed tunable laser (Newport Corp.) to allow for co-registered photoacoustic-ultrasound (PAUS) imaging. PA imaging was conducted from 750-1064 nm, with a surface fluence of approximately 15 mJ/cm2 maintained during imaging. In this preliminary study with PA imaging, the ablated region could be well visualized on the surface of the sample, with contrasts of 6-10 dB achieved at 750 nm. Although imaging penetration depth is a concern, PA imaging shows promise in being able to reliably visualize RF ablation lesions.

  12. Native Chondrocyte Viability during Cartilage Lesion Progression

    PubMed Central

    Ganguly, Kumkum; McRury, Ian D.; Goodwin, Peter M.; Morgan, Roy E.; Augé, Wayne K.

    2010-01-01

    Objective: Early surgical intervention for articular cartilage disease is desirable before full-thickness lesions develop. As early intervention treatments are designed, native chondrocyte viability at the treatment site before intervention becomes an important parameter to consider. The purpose of this study is to evaluate native chondrocyte viability in a series of specimens demonstrating the progression of articular cartilage lesions to determine if the chondrocyte viability profile changes during the evolution of articular cartilage disease to the level of surface fibrillation. Design: Osteochondral specimens demonstrating various degrees of articular cartilage damage were obtained from patients undergoing knee total joint replacement. Three groups were created within a patient harvest based on visual and tactile cues commonly encountered during surgical intervention: group 1, visually and tactilely intact surfaces; group 2, visually intact, tactilely soft surfaces; and group 3, surface fibrillation. Confocal laser microscopy was performed following live/dead cell viability staining. Results: Groups 1 to 3 demonstrated viable chondrocytes in all specimens, even within the fibrillated portions of articular cartilage, with little to no evidence of dead chondrocytes. Chondrocyte viability profile in articular cartilage does not appear to change as disease lesion progresses from normal to surface fibrillation. Conclusions: Fibrillated partial-thickness articular cartilage lesions are a good therapeutic target for early intervention. These lesions retain a high profile of viable chondrocytes and are readily diagnosed by visual and tactile cues during surgery. Early intervention should be based on matrix failure rather than on more aggressive procedures that further corrupt the matrix and contribute to chondrocyte necrosis of contiguous untargeted cartilage. PMID:26069561

  13. Automated lesion detectors in retinal fundus images.

    PubMed

    Figueiredo, I N; Kumar, S; Oliveira, C M; Ramos, J D; Engquist, B

    2015-11-01

    Diabetic retinopathy (DR) is a sight-threatening condition occurring in persons with diabetes, which causes progressive damage to the retina. The early detection and diagnosis of DR is vital for saving the vision of diabetic persons. The early signs of DR which appear on the surface of the retina are the dark lesions such as microaneurysms (MAs) and hemorrhages (HEMs), and bright lesions (BLs) such as exudates. In this paper, we propose a novel automated system for the detection and diagnosis of these retinal lesions by processing retinal fundus images. We devise appropriate binary classifiers for these three different types of lesions. Some novel contextual/numerical features are derived, for each lesion type, depending on its inherent properties. This is performed by analysing several wavelet bands (resulting from the isotropic undecimated wavelet transform decomposition of the retinal image green channel) and by using an appropriate combination of Hessian multiscale analysis, variational segmentation and cartoon+texture decomposition. The proposed methodology has been validated on several medical datasets, with a total of 45,770 images, using standard performance measures such as sensitivity and specificity. The individual performance, per frame, of the MA detector is 93% sensitivity and 89% specificity, of the HEM detector is 86% sensitivity and 90% specificity, and of the BL detector is 90% sensitivity and 97% specificity. Regarding the collective performance of these binary detectors, as an automated screening system for DR (meaning that a patient is considered to have DR if it is a positive patient for at least one of the detectors) it achieves an average 95-100% of sensitivity and 70% of specificity at a per patient basis. Furthermore, evaluation conducted on publicly available datasets, for comparison with other existing techniques, shows the promising potential of the proposed detectors. PMID:26378502

  14. Automatic ultrasound image enhancement for 2D semi-automatic breast-lesion segmentation

    NASA Astrophysics Data System (ADS)

    Lu, Kongkuo; Hall, Christopher S.

    2014-03-01

    Breast cancer is the fastest growing cancer, accounting for 29%, of new cases in 2012, and second leading cause of cancer death among women in the United States and worldwide. Ultrasound (US) has been used as an indispensable tool for breast cancer detection/diagnosis and treatment. In computer-aided assistance, lesion segmentation is a preliminary but vital step, but the task is quite challenging in US images, due to imaging artifacts that complicate detection and measurement of the suspect lesions. The lesions usually present with poor boundary features and vary significantly in size, shape, and intensity distribution between cases. Automatic methods are highly application dependent while manual tracing methods are extremely time consuming and have a great deal of intra- and inter- observer variability. Semi-automatic approaches are designed to counterbalance the advantage and drawbacks of the automatic and manual methods. However, considerable user interaction might be necessary to ensure reasonable segmentation for a wide range of lesions. This work proposes an automatic enhancement approach to improve the boundary searching ability of the live wire method to reduce necessary user interaction while keeping the segmentation performance. Based on the results of segmentation of 50 2D breast lesions in US images, less user interaction is required to achieve desired accuracy, i.e. < 80%, when auto-enhancement is applied for live-wire segmentation.

  15. Context–Specific Social Behavior is Altered by Orbitofrontal Cortex Lesions in Adult Rhesus Macaques

    PubMed Central

    Babineau, Brooke A.; Bliss-Moreau, Eliza; Machado, Christopher J.; Toscano, Jessica E.; Mason, William A.; Amaral, David G.

    2012-01-01

    Although the orbitofrontal cortex has been implicated in important aspects of social behavior, few studies have evaluated semi-naturalistic social behavior in nonhuman primates after discrete lesions of this cortical area. In the present report, we evaluated the behavior of adult rhesus monkeys during dyadic social interactions with novel animals following discrete lesions of the orbitofrontal cortex. In a constrained condition, in which animals could engage in only restricted social behaviors, there were no significant differences in social behavior between the lesion group and the sham-operated control group. When the experimental animals could freely interact with partner animals, however, lesioned animals differed from control animals in terms of social interest and fear-related behaviors. These alterations were contingent on the partner with which they interacted. The lesioned animals, when compared to the control animals, had a significantly greater propensity to approach some but not all of their social partners. They also grimaced more towards the partner animal that they did not approach. Behavioral alterations were more apparent during the initial interactions between animals. We discuss these findings in relation to the role of the orbitofrontal cortex in context dependent modulation of social behavior. PMID:21256192

  16. Measuring the lesion load of multiple sclerosis patients within the corticospinal tract

    NASA Astrophysics Data System (ADS)

    Klein, Jan; Hanken, Katrin; Koceva, Jasna; Hildebrandt, Helmut; Hahn, Horst K.

    2015-03-01

    In this paper we present a framework for reliable determination of the lesion load within the corticospinal tract (CST) of multiple sclerosis patients. The basis constitutes a probabilistic fiber tracking approach which checks possible parameter intervals on the fly using an anatomical brain atlas. By exploiting the range of those intervals, the algorithm is able to resolve fiber crossings and to determine the CST in its full entity although it can use a simple diffusion tensor model. Another advantage is its short running time, tracking the CST takes less than a minute. For segmenting the lesions we developed a semi-automatic approach. First, a trained classifier is applied to multimodal MRI data (T1/FLAIR) where the spectrum of lesions has been determined in advance by a clustering algorithm. This leads to an automatic detection of the lesions which can be manually corrected afterwards using a threshold-based approach. For evaluation we scanned 46 MS patients and 16 healthy controls. Fiber tracking has been performed using our novel fiber tracking and a standard defection based algorithm. Regression analysis of the old and new version of the algorithm showed a highly significant superiority of the new algorithm for disease duration. Additionally, a low correlation between old and new approach supports the observation that standard DTI fiber tracking is not always able to track and quantify the CST reliably.

  17. 3D CT spine data segmentation and analysis of vertebrae bone lesions.

    PubMed

    Peter, R; Malinsky, M; Ourednicek, P; Jan, J

    2013-01-01

    A method is presented aiming at detecting and classifying bone lesions in 3D CT data of human spine, via Bayesian approach utilizing Markov random fields. A developed algorithm for necessary segmentation of individual possibly heavily distorted vertebrae based on 3D intensity modeling of vertebra types is presented as well. PMID:24110203

  18. Prefrontal Cortex Is Critical for Contextual Processing: Evidence from Brain Lesions

    ERIC Educational Resources Information Center

    Fogelson, Noa; Shah, Mona; Scabini, Donatella; Knight, Robert T.

    2009-01-01

    We investigated the role of prefrontal cortex (PFC) in local contextual processing using a combined event-related potentials and lesion approach. Local context was defined as the occurrence of a short predictive series of visual stimuli occurring before delivery of a target event. Targets were preceded by either randomized sequences of standards…

  19. Dichotic listening ear preference after childhood cerebral lesions.

    PubMed

    Woods, B T

    1984-01-01

    Patients with unilateral (right or left) nonprogressive cerebral lesions acquired in infancy (before age one) or childhood (ages one to fifteen) were given a dichotic listening test. The two groups of patients with the childhood lesions showed the pattern of ear preference typically seen after hemispheric lesions in adults; loss of right ear preference after left hemisphere (LH) lesions, and enhanced right ear preference after right hemisphere (RH) lesions. The two groups of patients with the very early lesions failed to show any consistent ear preference or to differ from one another in ear preference. It is postulated that this lack of a consistent lesion effect following very early lateralized brain lesions is due to the greater degree of functional reorganization that takes place after such lesions. PMID:6462424

  20. Effect of Lesion Baseline Severity and Mineral Distribution on Remineralization and Progression of Human and Bovine Dentin Caries Lesions.

    PubMed

    Lippert, Frank; Churchley, David; Lynch, Richard J

    2015-01-01

    The aims of this laboratory study were to compare the effects of lesion baseline severity, mineral distribution and substrate on remineralization and progression of caries lesions created in root dentin. Lesions were formed in dentin specimens prepared from human and bovine dentin using three protocols, each utilizing three demineralization periods to create lesions of different mineral distributions (subsurface, moderate softening, extreme softening) and severity within each lesion type. Lesions were then either remineralized or demineralized further and analyzed using transverse microradiography. At lesion baseline, no differences were found between human and bovine dentin for integrated mineral loss (x0394;Z). Differences in mineral distribution between lesion types were apparent. Human dentin lesions were more prone to secondary demineralization (x0394;x0394;Z) than bovine dentin lesions, although there were no differences in x0394;L. Likewise, smaller lesions were more susceptible to secondary demineralization than larger ones. Subsurface lesions were more acid-resistant than moderately and extremely softened lesions. After remineralization, differences between human and bovine dentin lesions were not apparent for x0394;x0394;Z although bovine dentin lesions showed greater reduction in lesion depth L. For lesion types, responsiveness to remineralization (x0394;x0394;Z) was in the order extremely softened>moderately softened>subsurface. More demineralized lesions exhibited greater remineralization than shallower ones. In summary, some differences exist between human and bovine dentin and their relative responsiveness to de- and remineralization. These differences, however, were overshadowed by the effects of lesion baseline mineral distribution and severity. Thus, bovine dentin appears to be a suitable substitute for human dentin in mechanistic root caries studies. PMID:26228732

  1. Skull base approaches in neurosurgery

    PubMed Central

    2010-01-01

    The skull base surgery is one of the most demanding surgeries. There are different structures that can be injured easily, by operating in the skull base. It is very important for the neurosurgeon to choose the right approach in order to reach the lesion without harming the other intact structures. Due to the pioneering work of Cushing, Hirsch, Yasargil, Krause, Dandy and other dedicated neurosurgeons, it is possible to address the tumor and other lesions in the anterior, the mid-line and the posterior cranial base. With the transsphenoidal, the frontolateral, the pterional and the lateral suboccipital approach nearly every region of the skull base is exposable. In the current state many different skull base approaches are described for various neurosurgical diseases during the last 20 years. The selection of an approach may differ from country to country, e.g., in the United States orbitozygomaticotomy for special lesions of the anterior skull base or petrosectomy for clivus meningiomas, are found more frequently than in Europe. The reason for writing the review was the question: Are there keyhole approaches with which someone can deal with a vast variety of lesions in the neurosurgical field? In my opinion the different surgical approaches mentioned above cover almost 95% of all skull base tumors and lesions. In the following text these approaches will be described. These approaches are: 1) pterional approach 2) frontolateral approach 3) transsphenoidal approach 4) suboccipital lateral approach These approaches can be extended and combined with each other. In the following we want to enhance this philosophy. PMID:20602753

  2. [Color Doppler sonography of focal abdominal lesions].

    PubMed

    Licanin, Zoran; Lincender, Lidija; Djurović, V; Salihefendić, Nizama; Smajlović, Fahrudin

    2004-01-01

    Color Doppler sonography (CDS--spectral, color and power), harmonic imaging techniques (THI, PHI), possibility of 3D analysis of picture, usage of contrast agents, have raised the values of ultrasound as a diagnostic method to a very high level. THI--non-linear gray scale modality, is based on the processing of higher reflected frequencies, that has improved a picture resolution, which is presented with less artifacts and limiting effects of obesity and gases. Ultrasound contrast agents improve analysis of micro and macro circulation of the examined area, and with the assessment of velocity of supply in ROI (wash in), distribution and time of signal weakening (wash out), are significantly increasing diagnostic value of ultrasound. Besides the anatomical and topographic presentation of examined region (color, power), Color Doppler sonography gives us haemodynamic-functional information on vascularisation of that region, as well as on pathologic vascularisation if present. Avascular aspect of a focal pathologic lesion corresponds to a cyst or haematoma, while coloration and positive spectral curve discover that anechogenic lesions actually represents aneurysms, pseudoaneurysms or AVF. In local inflammatory lesion, abscess in an acute phase, CDS shows first increased, and then decreased central perfusion, while in a chronic phase, a pericapsular vascularisation is present. Contribution of CDS in differentiation of hepatic tumors (hemangioma, HCC and metastasis) is very significant. Central color dots along the peripheral blood vessels and the blush phenomenon are characteristics of capillary hemangioma, peritumoral vascular ring "basket" of HCC, and "detour" sign of metastasis. The central artery, RI from 0.45 to 0.60 and radial spreading characterize FNH. Hepatic adenoma is characterized by an intratumoral vein, and rarely by a vascular hallo. Further on, blood velocity in tumor defined by Color Doppler, distinguishes malignant from benign lesion, where 40 cm/s is a

  3. Histochemical identification of malignant and premalignant lesions

    NASA Astrophysics Data System (ADS)

    Liebow, Charles; Maloney, M. J.

    1991-06-01

    Malignant and transforming cells can be identified by biochemical parameters which can be used to localize lesions in situ for laser surgery. These cells express unique proteins, proteins in unusual quantities, or other biochemical alterations which can be utilized to image lesions of such cells. Several methods have been identified, both in vitro and in vivo, to identify such lesions. Several antibodies were examined for their properties of tissue identification, including CEA, F36/22, and AE1/AE3. F36/22, an antibody developed by M. T. Chu against human breast cancer cells, associated with two lines of oral cancer (KB and HCPC), and against two naturally occurring human oral squamous cell cancers. CEA, an antibody developed against human colon cancer, also reacted against both cell lines and both pathological samples. AE1/AE3, developed against normal fibrous components, also reacted against the samples, but in a much less regular manner. F36/22 associated with the histologically identifiably most dedifferentiated cells at the leading edge of the invading cancer. CEA, on the other hand, associated with more quiescent, older, established cancer cells. This demonstrates that antibodies developed against cancers of different organs can be used to identify a wide variety of cancers, and may have prognostic value. F36/22 coupled to fluorescein was used to identify oral cancer cells. Other properties of cancers and developing cancers can also be exploited to identify cancers, including their over-expression of tyrosine kinase and tyrosine kinase stimulating hormones such as Epidermal Growth Factor (EGF). A model of premalignant lesion produced in the hamster buccal cheek pouch with 6 week application of DMBA over-expresses constitutive tyrosine kinase which can be demonstrated biochemically. This initiated lesion can be promoted to frank cancer by growth factors released in response to laser surgery. Preliminary results suggest that these lesions can be identified by

  4. Cystic lesions of the pancreas: challenging issues in clinical practice.

    PubMed

    Oh, Hyoung-Chul; Kim, Myung-Hwan; Hwang, Chang Yun; Lee, Tae Yoon; Lee, Sang Soo; Seo, Dong-Wan; Lee, Sung Koo

    2008-01-01

    Cystic lesions of the pancreas are being recognized with increasing frequency and have become a common finding in clinical practice. Cystic lesions of the pancreas display a wide spectrum of histopathology and biologic behavior. Differentiating among lesions and choosing an optimal therapy is challenging, and evidence-based guidelines for diagnosis, management, and follow-up for cystic lesions of the pancreas are needed. This review describes the epidemiology and typical features of cystic lesions of the pancreas, including a summary of commonly used descriptive terms, as well as the primary issues in the differential diagnosis and management of these lesions. PMID:18076739

  5. Bone marrow lesions and subchondral bone pathology of the knee.

    PubMed

    Kon, Elizaveta; Ronga, Mario; Filardo, Giuseppe; Farr, Jack; Madry, Henning; Milano, Giuseppe; Andriolo, Luca; Shabshin, Nogah

    2016-06-01

    Bone marrow lesions (BMLs) around the knee are a common magnetic resonance imaging (MRI) finding. However, despite the growing interest on BMLs in multiple pathological conditions, they remain controversial not only for the still unknown role in the etiopathological processes, but also in terms of clinical impact and treatment. The differential diagnosis includes a wide range of conditions: traumatic contusion and fractures, cyst formation and erosions, hematopoietic and infiltrated marrow, developmental chondroses, disuse and overuse, transient bone marrow oedema syndrome and, lastly, subchondral insufficiency fractures and true osteonecrosis. Regardless the heterogeneous spectrum of these pathologies, a key factor for patient management is the distinction between reversible and irreversible conditions. To this regard, MRI plays a major role, leading to the correct diagnosis based on recognizable typical patterns that have to be considered together with coexistent abnormalities, age, and clinical history. Several treatment options have been proposed, from conservative to surgical approaches. In this manuscript the main lesion patterns and their management have been analysed to provide the most updated evidence for the differential diagnosis and the most effective treatment. PMID:27075892

  6. The effects of growth factors on skeletal muscle lesions

    PubMed Central

    GIGANTE, ANTONIO; CIANFORLINI, MARCO; MANZOTTI, SANDRA; ULISSE, SERENA

    2013-01-01

    Skeletal muscle injuries are common causes of severe long-term pain and physical disability, accounting for up to 55% of all sports injuries. The phases of the healing process after direct or indirect muscle injury are complex but clearly defined processes comprising well-coordinated steps: degeneration, inflammation, regeneration, and fibrosis. Despite this frequent occurrence and the presence of a body of data on the pathophysiology of muscle injuries, none of the treatment strategies adopted to date have been shown to be really effective in strictly controlled trials. Most current muscle injury treatments are based on limited experimental and clinical data and/or were only empirically tested. Platelet-rich plasma (PRP) is a promising alternative approach based on the ability of autologous growth factors (GFs) to accelerate tissue healing, improve muscular regeneration, increase neovascularization and reduce fibrosis, allowing rapid recovery after muscle lesions. Thus, further experimental studies that include the quantification of specific GFs released by PRP, as well as additional data on angiogenesis, myogenesis and functional recovery are needed to ultimately validate the hypothesis of PRP efficacy in the treatment of muscle lesions and open the way for its wide clinical application. PMID:25606531

  7. Interrater reproducibility of clinical tests for rotator cuff lesions

    PubMed Central

    Ostor, A; Richards, C; Prevost, A; Hazleman, B; Speed, C

    2004-01-01

    Background: Rotator cuff lesions are common in the community but reproducibility of tests for shoulder assessment has not been adequately appraised and there is no uniform approach to their use. Objective: To study interrater reproducibility of standard tests for shoulder evaluation among a rheumatology specialist, rheumatology trainee, and research nurse. Methods: 136 patients were reviewed over 12 months at a major teaching hospital. The three assessors examined each patient in random order and were unaware of each other's evaluation. Each shoulder was examined in a standard manner by recognised tests for specific lesions and a diagnostic algorithm was used. Between-observer agreement was determined by calculating Cohen's κ coefficients (measuring agreement beyond that expected by chance). Results: Fair to substantial agreement was obtained for the observations of tenderness, painful arc, and external rotation. Tests for supraspinatus and subscapularis also showed at least fair agreement between observers. 40/55 (73%) κ coefficient assessments were rated at >0.2, indicating at least fair concordance between observers; 21/55 (38%) were rated at >0.4, indicating at least moderate concordance between observers. Conclusion: The reproducibility of certain tests, employed by observers of varying experience, in the assessment of the rotator cuff and general shoulder disease was determined. This has implications for delegation of shoulder assessment to nurse specialists, the development of a simplified evaluation schedule for general practitioners, and uniformity in epidemiological research studies. PMID:15361389

  8. Acquired constricting and restricting lesions of the descending duodenum.

    PubMed

    Carbo, Alberto I; Sangster, Guillermo P; Caraway, Jessica; Heldmann, Maureen G; Thomas, Jaiyeola; Takalkar, Amol

    2014-01-01

    The descending duodenum is a structure with distinct pathologic processes and anatomic relationships that requires a systematic approach to the differential diagnosis. Because of its tubular shape and fixed position in the retroperitoneum, both intrinsic duodenal and juxtaduodenal diseases are capable of producing luminal narrowing and obstruction. Duodenal lesions may be located in the mucosa or submucosa. Extraduodenal lesions may originate in adjacent structures--such as the pancreas, liver, gallbladder, colon, and lymph nodes--or from other retroperitoneal structures. Causes of duodenal obstruction include intraluminal masses, such as bezoars; duodenal inflammation, such as as peptic ulcers and Crohn disease; hematomas; and benign or malignant mucosal and intramural tumors. Pancreatic inflammation; tumors; and extrinsic compression caused by gallbladder processes, hepatic masses, retroperitoneal fluid collections, and tumors, including lymphoma, may produce duodenal obstruction. Abdominal radiography, barium studies, multidetector computed tomography, magnetic resonance imaging, and positron emission tomography may be used to depict and characterize duodenal strictures. Integration of imaging, clinical, laboratory, and endoscopic findings plays a major role in establishing a diagnosis of obstructive duodenal strictures. PMID:25208276

  9. Stepwise Excavation Allows Apexogenesis in Permanent Molars with Deep Carious Lesions and Incomplete Root Formation.

    PubMed

    Hernandéz-Gatón, Patrícia; Serrano, César Ruiz; Nelson Filho, Paulo; De Castañeda, Esther Ruiz; Lucisano, Marília P; Silva, Raquel A B da; Silva, Léa A B da

    2015-01-01

    This study evaluated the stepwise excavation technique in 138 permanent molars with deep carious lesions and incomplete root formation within a 24-month clinical and radiographic follow-up period. In 96.7% of the cases, success was observed (no pain, integrity of restoration margins, absence of radiographic alterations and apexogenesis). The cases of failure (3.3%) were due to the loss of the temporary restoration. In conclusion, the stepwise excavation is a promising technique for permanent teeth with deep carious lesions and incomplete root formation as a minimally invasive approach because it allows the preservation of pulp vitality and occurrence of apexogenesis. PMID:26655853

  10. Bosniak classification of renal cystic lesions according to multidetector computed tomography findings*

    PubMed Central

    de Miranda, Christiana Maia Nobre Rocha; Maranhão, Carol Pontes de Miranda; dos Santos, Carla Jotta Justo; Padilha, Igor Gomes; de Farias, Lucas de Pádua Gomes; da Rocha, Milzi Sarmento

    2014-01-01

    Renal cystic lesions are usually diagnosed in the radiologists’ practice and therefore their characterization is crucial to determine the clinical approach to be adopted and prognosis. The Bosniak classification based on computed tomography findings has allowed for standardization and categorization of lesions in increasing order of malignancy (I, II, IIF, III and IV) in a simple and accurate way. The present iconographic essay developed with multidetector computed tomography images of selected cases from the archives of the authors’ institution, is aimed at describing imaging findings that can help in the diagnosis of renal cysts. PMID:25741060

  11. [Placental lesions in human Trypanosoma cruzi infection].

    PubMed

    Fernandez-Aguilar, Sergio; Lambot, Maria-Alexandra; Torrico, Faustino; Alonso-Vega, Cristina; Córdoba, Marysol; Suarez, Eduardo; Noël, Jean-Christophe; Carlier, Yves

    2005-01-01

    This histopathological study analyzes placentas of babies congenitally infected with T. cruzi (M+B+), or babies not infected but born from infected- (M+B-), or non infected-mothers (M-B-). Placentas M+B+ showed lesions of chorionitis, chorioamnionitis and cord edema with lymphocyte infiltration, whereas such lesions were infiltrated only with polymorphonuclear cells in M+B- and M-B- placentas. Parasites were found in M+B+ placentas, in fibroblasts and macrophages of chorion, membranes, chorionic plate, mainly in the area of membrane insertion, as well as in cells of Wharton jelly and myocytes of umbilical cord vessels. These results suggest that the materno-fetal transmission of parasites occurs mainly through the marginal sinus, spreading into the chorionic plate infecting fibroblasts and macrophages so far as to found a fetal vessel, inducing a fetal infection by hematogenous route. PMID:16482822

  12. Furcation lesion in a mandibular canine.

    PubMed

    Fonseca, Dimitri Ribas; Sena, Larryson Goncalves; Santos, Maria Helena; Goncalves, Patricia Furtado

    2011-01-01

    Morphological changes can complicate dental treatment. This report presents a rare case of a furcation lesion in a mandibular canine with two roots. A 39-year-old man in general good health sought dental care for severe pain in his maxillary anterior teeth. The clinical examination showed localized swelling in the vestibular mucosa close to the mandibular left canine. Radiographic examination revealed two distinct roots and vertical bone resorption in the canine's mesial surface. Periodontal evaluation led to a diagnosis of periodontal abscess associated with furcation lesion. Despite the occurrence in an atypical location, the site of periodontal furcation received conventional therapy for initial decontamination, including tissue debridement and a combination of polyvinylpyrrolidone irrigation and antibiotics. To improve access, the decontamination was completed with surgical techniques and scaling and root planing. Early diagnosis of this rare morphological change helped to determine appropriate, timely treatment planning and optimal patient recovery. PMID:21903558

  13. Structural brain lesions in inflammatory bowel disease

    PubMed Central

    Dolapcioglu, Can; Dolapcioglu, Hatice

    2015-01-01

    Central nervous system (CNS) complications or manifestations of inflammatory bowel disease deserve particular attention because symptomatic conditions can require early diagnosis and treatment, whereas unexplained manifestations might be linked with pathogenic mechanisms. This review focuses on both symptomatic and asymptomatic brain lesions detectable on imaging studies, as well as their frequency and potential mechanisms. A direct causal relationship between inflammatory bowel disease (IBD) and asymptomatic structural brain changes has not been demonstrated, but several possible explanations, including vasculitis, thromboembolism and malnutrition, have been proposed. IBD is associated with a tendency for thromboembolisms; therefore, cerebrovascular thromboembolism represents the most frequent and grave CNS complication. Vasculitis, demyelinating conditions and CNS infections are among the other CNS manifestations of the disease. Biological agents also represent a risk factor, particularly for demyelination. Identification of the nature and potential mechanisms of brain lesions detectable on imaging studies would shed further light on the disease process and could improve patient care through early diagnosis and treatment. PMID:26600970

  14. Isolated, relative aproverbia without focal lesion.

    PubMed

    Brown, Cora; Smith-Benjamin, Sarah; Patira, Riddhi; Altschuler, Eric L

    2016-06-01

    We have seen a patient with a profound, isolated, and quite selective deficit in proverb interpretation-aproverbia. The patient presented to us after an anoxic brain injury with aproverbia. Interestingly, the aproverbia appeared to be premorbid to the presenting event. Furthermore, the patient had no brain lesion that has been associated or even proposed as a cause of deficit in proverb or metaphor interpretation. The patient did have acute bilateral hippocampi lesions and associated severe anterograde amnesia, but he retained good retrograde memory with which he is able to give good, logical but concrete explanations for proverbs. This case highlights the need, importance, and interest in further neuropsychologic, imaging and functional studies of proverb and interpretation in patients and normal subjects populations. PMID:26836570

  15. Systemic malignancies presenting as primary osteolytic lesion.

    PubMed

    Sirelkhatim, A; Kaiserova, E; Kolenova, A; Puskacova, J; Subova, Z; Petrzalkova, D; Banikova, K; Suvada, J; Sejnova, D

    2009-01-01

    The tumor formation may be the earliest manifestation preceeding other symptoms, signs and bone marrow evidence of systemic malignancy - leukemia/lymphoma. Here we present three cases of systemic malignancy in which bone lesions were the first manifested signs of the disease. All three cases were thought to be orthopedic cases and had been treated as so without genuing improvement. We would like to draw an attention to children who present with multifocal musculoskeletal pain and the importance of whole-body scaning. We describe interesting cases of diffuse large cell lymphoma and leukemia that initially presented as primary osteolytic bone lesion and discuss the differential diagnosis, literature review of non-Hodgkin's lymphoma arising in bone as the primary site (Tab. 1, Fig. 3, Ref. 18). Full Text (Free, PDF) www.bmj.sk. PMID:20017455

  16. Parathyroid lesions: Difficult diagnosis on cytology.

    PubMed

    Agarwal, Charu; Kaushal, Manju

    2016-08-01

    Cytology of parathyroid lesion (PL) is often confused with that of thyroid lesions. Differentiation between thyroid and PL is very difficult on cytomorphology because of their similar features and close anatomical proximity. Three cases of PLs reported on cytology in last one year were retrieved from archives of cytology department. Their cytomorphological details were studied and were correlated with the available biochemical parameters. Histopathology was available in two cases. Radiological assistance and parathyroid hormone (PTH) assessment in our cases formed the basis of diagnosing PLs on cytology. We discuss the differential diagnosis and pitfalls in cytological diagnosis of PLs. However, histopathology remains the gold standard for diagnosis. Interpretation of PLs on cytology remains problematic due to its rarity and limited available literature. The cytomorphology combined with clinical and biochemical data supported by histopathology are necessary to improve the diagnostic sensitivity of PLs. Diagn. Cytopathol. 2016;44:704-709. © 2016 Wiley Periodicals, Inc. PMID:27246113

  17. MAGE-A antigens in lesions of the oral mucosa.

    PubMed

    Krauss, Eva; Rauthe, Stephan; Gattenlöhner, Stefan; Reuther, Tobias; Kochel, Michael; Kriegebaum, Ulrike; Kübler, Alexander C; Müller-Richter, Urs D A

    2011-06-01

    Oral squamous cell carcinoma develops continuously out of predamaged oral mucosa. For the physician and pathologist, difficulties arise in distinguishing precancerous from cancerous lesions. MAGE-A antigens are tumor antigens that are found solely in malignant transformed cells. These antigens might be useful in distinguishing precancerous from cancerous lesions. The aim of this study was to verify this assumption by comparing MAGE-A expression in benign, precancerous, and cancerous lesions of the oral mucosa. Retrospectively, biopsies of different oral lesions were randomly selected. The lesions that were included are 64 benign oral lesions (25 traumatic lesions (oral ulcers), 13 dental follicles, and 26 epulis), 26 oral lichen planus, 123 epithelial precursor lesions (32 epithelial hyperplasia found in leukoplakias, 24 epithelial dysplasia found in leukoplakias, 26 erythroplasia with oral epithelial dysplasia, and 41 carcinomas in situ in erythroleukoplakias). The lesions were immunohistochemically stained with the poly-MAGE-A antibody 57B, and the results were compared. Biopsies of oral lichen planus, oral ulcers, dental follicles, epulis, and leukoplakia without dysplasia showed no positive staining for MAGE-A antigens. Leukoplakia with dysplasia, dysplasia, and carcinomata in situ displayed positive staining in 33%, 65%, and 56% of the cases, respectively. MAGE-A antigens were not detectable via immunohistochemistry in benign lesions of the oral mucosa. The staining rate of dysplastic precancerous lesions or malignant lesions ranged from 33% to 65%. The MAGE-A antigens might facilitate better differentiation between precancerous and cancerous lesions of the oral mucosa. PMID:20174843

  18. A Rare Case of Aggressive Digital Adenocarcinoma of the Lower Extremity, Masquerading as an Ulcerative Lesion that Clinically Favored Benignancy

    PubMed Central

    Vazales, Ryan; Constant, Dustin; Snyder, Robert J.

    2014-01-01

    A rare case report of Aggressive Digital Adenocarcinoma (ADPCa) is presented complete with a literature review encompassing lesions that pose potential diagnostic challenges. Similarities between basal cell carcinoma (BCC), marjolin’s ulceration/squamous cell carcinoma (MSCC) and ADPCa are discussed. This article discusses potential treatment options for ADPCa and the need for early biopsy when faced with any challenging lesion. An algorithmic approach to ADPCa treatment based on the most current research is recommended.

  19. Causes and strategies for moisture lesions.

    PubMed

    Bianchi, Janice

    Moisture lesions or incontinence-associated dermatitis are painful and distressing consequences of prolonged exposure to urine and faeces. They may adversely affect patients' physical and psychological wellbeing, so minimising damage is a vital part of the nurse's role. This article outlines their causes and strategies to prevent and treat them, as well as the causes of urinary and faecal incontinence and containment options. PMID:22439508

  20. [A girl with hypopigmented skin lesions].

    PubMed

    Martens, Bibi; Abdul Hamid, Myrurgia; Martens, Herm

    2014-01-01

    A 9-year-old girl visited the department of Dermatology with an asymptomatic hypopigmented skin eruption on her upper legs, groins and trunk since 7 years. Histopathological analysis established the diagnosis of hypopigmented mycosis fungoides, a rare subtype of cutaneous T-cell lymphoma which is most commonly seen at younger age. The lesions are successfully treated with clobetasol 0.05% ointment 4 days a week. PMID:25027222

  1. Chronic ocular lesions in Bhopal gas tragedy.

    PubMed

    Raizada, J K; Dwivedi, P C

    1987-01-01

    A comprehensive eye checkup programme was carried out in 1140 cases of affected community to evaluate the exposure response and exposure effect with Methyl Isocynate on human eyes. The final evaluation of these cases was made with standard control group of same socioeconomic status in a non-gas affected slum area of Bhopal. The main chronic lesions noticed were chronic conjunctivitis, refractive changes, deficiency of tear secretion and persistent corneal opacities of various forms. PMID:3508833

  2. Hypothalamic and pancreatic lesions with diabetes mellitus.

    PubMed Central

    Shuangshoti, S; Samranvej, P

    1975-01-01

    A case is reported of a neoplasm of mixed mesenchymal and neuroepithelial origin consisting of plasmacytoma, lymphoma, ganglioneuroma, and astrocytoma in the same mass. The tumour arose in the hypothalamus of a 43 year old diabetic woman who also had alpha cell hyperplasia and beta cell hypoplasia of the islets of Langerhans. It is suggested that both hypothalamic and pancreatic lesions produced diabetes mellitus in this patient. Images PMID:1104774

  3. Endoscopic and histologic characteristics of serrated lesions.

    PubMed

    Moussata, Driffa; Boschetti, Gilles; Chauvenet, Marion; Stroeymeyt, Karine; Nancey, Stéphane; Berger, Françoise; Lecomte, Thierry; Flourié, Bernard

    2015-03-14

    In recent years, a second pathway for colonic carcinogenesis, distinct from the adenomatous pathway, has been explored. This is referred to as serrated pathway and includes three types of polyp, characterised by a serrated appearance of the crypts: hyperplastic polyps (HP), sessile serrated adenomas (SSA) or lesions, and traditional serrated adenomas. Each lesion has its own genetic, as well as macroscopic and microscopic morphological features. Because of their flat aspect, their detection is easier with chromoendoscopy (carmin indigo or narrow-band imaging). However, as we show in this review, the distinction between SSA and HP is quite difficult. It is now recommended to resect in one piece as it is possible the serrated polyps with a control in a delay depending on the presence or not of dysplasia. These different types of lesion are described in detail in the present review in general population, in polyposis and in inflammatory bowel diseases patients. This review highlights the need to improve characterization and understanding of this way of colorectal cancerogenesis. PMID:25780286

  4. Porcine deltacoronavirus: histological lesions and genetic characterization.

    PubMed

    Wang, Leyi; Hayes, Jeff; Sarver, Craig; Byrum, Beverly; Zhang, Yan

    2016-01-01

    First identified in 2012 in a surveillance study in Hong Kong, porcine deltacoronavirus (PDCoV) is a proposed member of the genus Deltacoronavirus of the family Coronaviridae. In February of 2014, PDCoV was detected in pigs with clinical diarrheal symptoms for the first time in the USA. Since then, it has been detected in more than 20 states in the USA and in other countries, including Canada, South Korea, and mainland China. So far, histological lesions in the intestines of pigs naturally infected with PDCoV under field conditions have not been reported. In this report, we describe the characteristic histological lesions in the small intestine that were associated with PDCoV infection, as evidenced by detection of viral nucleic acid by RT-PCR. In addition, we performed genomic analysis to determine the genetic relationship of all PDCoV strains from the four countries. We found that PDCoV mainly caused histological lesions in the small intestines of naturally infected piglets. Sequence analysis demonstrated that the PDCoV strains of different countries are closely related and shared high nucleotide sequence similarity; however, deletion patterns in the spike and 3' untranslated regions are different among the strains from mainland China, Hong Kong, the USA, and South Korea. Our study highlights the fact that continual surveillance is needed to trace the evolution of this virus. PMID:26475155

  5. Lesion mapping of social problem solving.

    PubMed

    Barbey, Aron K; Colom, Roberto; Paul, Erick J; Chau, Aileen; Solomon, Jeffrey; Grafman, Jordan H

    2014-10-01

    Accumulating neuroscience evidence indicates that human intelligence is supported by a distributed network of frontal and parietal regions that enable complex, goal-directed behaviour. However, the contributions of this network to social aspects of intellectual function remain to be well characterized. Here, we report a human lesion study (n = 144) that investigates the neural bases of social problem solving (measured by the Everyday Problem Solving Inventory) and examine the degree to which individual differences in performance are predicted by a broad spectrum of psychological variables, including psychometric intelligence (measured by the Wechsler Adult Intelligence Scale), emotional intelligence (measured by the Mayer, Salovey, Caruso Emotional Intelligence Test), and personality traits (measured by the Neuroticism-Extraversion-Openness Personality Inventory). Scores for each variable were obtained, followed by voxel-based lesion-symptom mapping. Stepwise regression analyses revealed that working memory, processing speed, and emotional intelligence predict individual differences in everyday problem solving. A targeted analysis of specific everyday problem solving domains (involving friends, home management, consumerism, work, information management, and family) revealed psychological variables that selectively contribute to each. Lesion mapping results indicated that social problem solving, psychometric intelligence, and emotional intelligence are supported by a shared network of frontal, temporal, and parietal regions, including white matter association tracts that bind these areas into a coordinated system. The results support an integrative framework for understanding social intelligence and make specific recommendations for the application of the Everyday Problem Solving Inventory to the study of social problem solving in health and disease. PMID:25070511

  6. Differential diagnosis of ulcerative lesions in fish.

    PubMed Central

    Law, M

    2001-01-01

    Tissues such as skin and muscle have a limited repertoire of morphological response to injury. The two most important phenomena that determine the outcome of cell injury appear to be a) critical cell membrane damage, with associated fluid and ionic imbalances; and b) inability of mitochondria, the powerhouse of the cell, to restart ATP synthesis. In fish, skin ulcers can have many different etiologies, including infectious agents, toxins, physical causes, immunologic causes, and nutritional and metabolic perturbations. This article is concerned primarily with the possible pathways of disease involved in ulcerative lesions of fish. In particular, the high prevalence of ulcerative lesions in Atlantic menhaden found along the mid-Atlantic coast, especially in North Carolina estuarine waters, has received much recent attention. These ulcerative lesions are likely to be initiated by a series of factors that lead ultimately to a breach of the normal barrier function of the skin. Bioassays that attempt to define the role of individual etiologic agents such as fungi (oomycetes) or putative Pfiesteria toxin(s) should recognize this multiplicity of factors and should include appropriate quality control measures for water quality parameters (temperature, dissolved oxygen, nitrogenous wastes, etc.) as well as bacterial and other contaminants that may confound bioassay results and their interpretation. Consideration of these factors along with the whole animal in the context of its environment can only advance the science, perhaps provide clues to the causative pathways of skin ulcers in fish, and give us keener insight into the health of the aquatic environment. PMID:11677175

  7. Segmentation and classification of dermatological lesions

    NASA Astrophysics Data System (ADS)

    Sáez, Aurora; Acha, Begoña; Serrano, Carmen

    2010-03-01

    Certain skin diseases are chronic, inflammatory and without cure. However, there are many treatment options that can clear them for a period of time. Measuring their severity and assessing their extent, is a fundamental issue to determine the efficacy of the treatment under test. Two of the most important parameters of severity assessment are Erythema (redness) and Scaliness. Physicians classify these parameters into several grades by visual grading method. In this paper a color image segmentation and classification algorithm is developed to obtain an assessment of erythema and scaliness of dermatological lesions. Color digital photographs taken under an acquisition protocol form the database. Difference between green band and blue band of images in RGB color space shows two modes (healthy skin and lesion) with clear separation. Otsu's method is applied to this difference in order to isolate the lesion. After the skin disease is segmented, some color and texture features are calculated and they are the inputs to a Fuzzy-ARTMAP neural network. The neural network classifies them into the five grades of erythema and the five grades of scaliness. The method has been tested with 31 images with a success percentage of 83.87 % when the images are classified in erythema, and 77.42 % for scaliness classification.

  8. Cystic lesion around the hip joint.

    PubMed

    Yukata, Kiminori; Nakai, Sho; Goto, Tomohiro; Ikeda, Yuichi; Shimaoka, Yasunori; Yamanaka, Issei; Sairyo, Koichi; Hamawaki, Jun-Ichi

    2015-10-18

    This article presents a narrative review of cystic lesions around the hip and primarily consists of 5 sections: Radiological examination, prevalence, pathogenesis, symptoms, and treatment. Cystic lesions around the hip are usually asymptomatic but may be observed incidentally on imaging examinations, such as computed tomography and magnetic resonance imaging. Some cysts may enlarge because of various pathological factors, such as trauma, osteoarthritis, rheumatoid arthritis, or total hip arthroplasty (THA), and may become symptomatic because of compression of surrounding structures, including the femoral, obturator, or sciatic nerves, external iliac or common femoral artery, femoral or external iliac vein, sigmoid colon, cecum, small bowel, ureters, and bladder. Treatment for symptomatic cystic lesions around the hip joint includes rest, nonsteroidal anti-inflammatory drug administration, needle aspiration, and surgical excision. Furthermore, when these cysts are associated with osteoarthritis, rheumatoid arthritis, and THA, primary or revision THA surgery will be necessary concurrent with cyst excision. Knowledge of the characteristic clinical appearance of cystic masses around the hip will be useful for determining specific diagnoses and treatments. PMID:26495246

  9. Cystic lesion around the hip joint

    PubMed Central

    Yukata, Kiminori; Nakai, Sho; Goto, Tomohiro; Ikeda, Yuichi; Shimaoka, Yasunori; Yamanaka, Issei; Sairyo, Koichi; Hamawaki, Jun-ichi

    2015-01-01

    This article presents a narrative review of cystic lesions around the hip and primarily consists of 5 sections: Radiological examination, prevalence, pathogenesis, symptoms, and treatment. Cystic lesions around the hip are usually asymptomatic but may be observed incidentally on imaging examinations, such as computed tomography and magnetic resonance imaging. Some cysts may enlarge because of various pathological factors, such as trauma, osteoarthritis, rheumatoid arthritis, or total hip arthroplasty (THA), and may become symptomatic because of compression of surrounding structures, including the femoral, obturator, or sciatic nerves, external iliac or common femoral artery, femoral or external iliac vein, sigmoid colon, cecum, small bowel, ureters, and bladder. Treatment for symptomatic cystic lesions around the hip joint includes rest, nonsteroidal anti-inflammatory drug administration, needle aspiration, and surgical excision. Furthermore, when these cysts are associated with osteoarthritis, rheumatoid arthritis, and THA, primary or revision THA surgery will be necessary concurrent with cyst excision. Knowledge of the characteristic clinical appearance of cystic masses around the hip will be useful for determining specific diagnoses and treatments. PMID:26495246

  10. Novel 3-D laparoscopic magnetic ultrasound image guidance for lesion targeting

    PubMed Central

    Sindram, David; McKillop, Iain H; Martinie, John B; Iannitti, David A

    2010-01-01

    Objectives: Accurate laparoscopic liver lesion targeting for biopsy or ablation depends on the ability to merge laparoscopic and ultrasound images with proprioceptive instrument positioning, a skill that can be acquired only through extensive experience. The aim of this study was to determine whether using magnetic positional tracking to provide three-dimensional, real-time guidance improves accuracy during laparoscopic needle placement. Methods: Magnetic sensors were embedded into a needle and laparoscopic ultrasound transducer. These sensors interrupted the magnetic fields produced by an electromagnetic field generator, allowing for real-time, 3-D guidance on a stereoscopic monitor. Targets measuring 5 mm were embedded 3–5 cm deep in agar and placed inside a laparoscopic trainer box. Two novices (a college student and an intern) and two experts (hepatopancreatobiliary surgeons) targeted the lesions out of the ultrasound plane using either traditional or 3-D guidance. Results: Each subject targeted 22 lesions, 11 with traditional and 11 with the novel guidance (n = 88). Hit rates of 32% (14/44) and 100% (44/44) were observed with the traditional approach and the 3-D magnetic guidance approach, respectively. The novices were essentially unable to hit the targets using the traditional approach, but did not miss using the novel system. The hit rate of experts improved from 59% (13/22) to 100% (22/22) (P < 0.0001). Conclusions: The novel magnetic 3-D laparoscopic ultrasound guidance results in perfect targeting of 5-mm lesions, even by surgical novices. PMID:21083797

  11. [Premalignant lesions and conditions of the oral mucosa].

    PubMed

    Bruaset, I

    1989-04-01

    An overview is presented of the premalignant lesions and conditions of the oral mucosa. The dentist can play an important role in the detection of these lesions, thereby reducing the chance of premalignant transformation. PMID:2622509

  12. Prevalence of Oral Mucosal Lesions in Male Smokers and Nonsmokers

    PubMed Central

    Ahmadi-Motamayel, Fatemeh; Falsafi, Parisa; Hayati, Zahra; Rezaei, Farzad

    2013-01-01

    Tobacco smoking is one of the most important risk factors for the development of oral mucosal lesions such as leukoplakia and hairy tongue. Controversy exists in the literature, however, about the prevalence of oral lesions in smokers. The aim of this study was to evaluate oral lesions in male smokers compared with nonsmokers in Hamadan. A total of 516 male participants were assessed, 258 of whom were smokers and 258 of whom were healthy nonsmokers. The prevalence of lesions was evaluated by clinical observation and biopsy. We found that the most prevalent lesions among smokers were gingival problems and coated tongue; smokers had significantly more lesions than did nonsmokers. Malignant and premalignant lesions were found in a higher age range. Among all participants in our study, we found a large number of oral mucosal lesions in smokers that had a strong correlation with smoking. Dental services need to implement care and health education for smokers to promote health. PMID:24010068

  13. Quantitative analysis of colorectal mucosal lesions by autofluorescence endoscopy: discrimination of carcinomas from other lesions.

    PubMed

    Arita, Keiko; Mitsuyama, Keiichi; Kawano, Hiroshi; Hasegawa, Shin; Maeyama, Yasuhiko; Masuda, Junya; Akagi, Yoshito; Watanabe, Yasutomo; Okabe, Yoshinobu; Tsuruta, Osamu; Sata, Michio

    2011-07-01

    A newly developed autofluorescence (AF) imaging technique was applied during colonoscopy in a clinical setting. This pilot study was conducted to evaluate the clinical feasibility of applying AF endoscopy for distinguishing colorectal lesions. A total of 54 colorectal mucosal lesions obtained from 43 patients who underwent both white-light and AF endoscopy and were treated by endoscopy or surgery were assessed. Of the lesions, 11 were hyperplastic polyps, 30 were adenomas and 13 were carcinomas. To quantify the AF intensity, a color-contrast index (CCI) was determined and evaluated in relation to the histology, size and shape of each lesion. CCI was significantly associated with the histology and size of the lesions, but not their shape. CCI increased as the malignant potential increased (in the order of hyperplastic polyps→adenomas→carcinomas), irrespective of the lesion size (r=0.797, p<0.0001 for size>8 mm; r=0.622, p=0.0045 for size>8 mm but >15 mm; r=0.644, p=0.0071 for size>15 mm). In each size group, CCI tended to be higher for carcinomas than for adenomas, and also higher for adenomas than for hyperplastic polyps. CCI allowed discrimination of adenomas/carcinomas from hyperplastic polyps with 95.3% sensitivity and 63.6% specificity (cut-off value, 14.5), and of colorectal carcinomas from adenomas with 84.6% sensitivity and 80.0% specificity (cut-off value, 28.0). These results suggest that the quantitative analysis of AF intensity using CCI is helpful to discriminate among different types of colorectal mucosal lesions, including carcinomas. PMID:21573495

  14. Automated Dermoscopy Image Analysis of Pigmented Skin Lesions

    PubMed Central

    Baldi, Alfonso; Quartulli, Marco; Murace, Raffaele; Dragonetti, Emanuele; Manganaro, Mario; Guerra, Oscar; Bizzi, Stefano

    2010-01-01

    Dermoscopy (dermatoscopy, epiluminescence microscopy) is a non-invasive diagnostic technique for the in vivo observation of pigmented skin lesions (PSLs), allowing a better visualization of surface and subsurface structures (from the epidermis to the papillary dermis). This diagnostic tool permits the recognition of morphologic structures not visible by the naked eye, thus opening a new dimension in the analysis of the clinical morphologic features of PSLs. In order to reduce the learning-curve of non-expert clinicians and to mitigate problems inherent in the reliability and reproducibility of the diagnostic criteria used in pattern analysis, several indicative methods based on diagnostic algorithms have been introduced in the last few years. Recently, numerous systems designed to provide computer-aided analysis of digital images obtained by dermoscopy have been reported in the literature. The goal of this article is to review these systems, focusing on the most recent approaches based on content-based image retrieval systems (CBIR). PMID:24281070

  15. Accurate GM atrophy quantification in MS using lesion-filling with co-registered 2D lesion masks☆

    PubMed Central

    Popescu, V.; Ran, N.C.G.; Barkhof, F.; Chard, D.T.; Wheeler-Kingshott, C.A.; Vrenken, H.

    2014-01-01

    Background In multiple sclerosis (MS), brain atrophy quantification is affected by white matter lesions. LEAP and FSL-lesion_filling, replace lesion voxels with white matter intensities; however, they require precise lesion identification on 3DT1-images. Aim To determine whether 2DT2 lesion masks co-registered to 3DT1 images, yield grey and white matter volumes comparable to precise lesion masks. Methods 2DT2 lesion masks were linearly co-registered to 20 3DT1-images of MS patients, with nearest-neighbor (NNI), and tri-linear interpolation. As gold-standard, lesion masks were manually outlined on 3DT1-images. LEAP and FSL-lesion_filling were applied with each lesion mask. Grey (GM) and white matter (WM) volumes were quantified with FSL-FAST, and deep gray matter (DGM) volumes using FSL-FIRST. Volumes were compared between lesion mask types using paired Wilcoxon tests. Results Lesion-filling with gold-standard lesion masks compared to native images reduced GM overestimation by 1.93 mL (p < .001) for LEAP, and 1.21 mL (p = .002) for FSL-lesion_filling. Similar effects were achieved with NNI lesion masks from 2DT2. Global WM underestimation was not significantly influenced. GM and WM volumes from NNI, did not differ significantly from gold-standard. GM segmentation differed between lesion masks in the lesion area, and also elsewhere. Using the gold-standard, FSL-FAST quantified as GM on average 0.4% of the lesion area with LEAP and 24.5% with FSL-lesion_filling. Lesion-filling did not influence DGM volumes from FSL-FIRST. Discussion These results demonstrate that for global GM volumetry, precise lesion masks on 3DT1 images can be replaced by co-registered 2DT2 lesion masks. This makes lesion-filling a feasible method for GM atrophy measurements in MS. PMID:24567908

  16. Lesion in Scalp and Skull as the First Manifestation of Hepatocellular Carcinoma

    PubMed Central

    Vitorino-Araújo, J. L.; Veiga, J. C. E.

    2016-01-01

    Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver and the fifth most common cancer in the world. The lungs, bone, and lymph nodes are frequent sites of metastasis of HCC. The purpose of the present study is show that metastases, although rare, must be among the differential diagnosis of skin lesions and that a diagnostic research based on these findings can be conducted. The authors report a rare case of metastatic hepatocellular injury to the scalp and skull treated by a radical surgical approach. Excision of the lesion in the scalp was performed “en bloc.” The tumor was supplied by the frontal branch of the superficial temporal artery. There are few case reports of metastatic HCC to scalp and skull; treatment of these lesions should be individualized in order to control symptoms, improve quality of life, and promote an increase in survival. PMID:27403358

  17. Speech rate as a sticky switch: a multiple lesion case analysis of mutism and hyperlalia.

    PubMed

    Braun, Claude M J; Dumont, Mathieu; Duval, Julie; Hamel-Hébert, Isabelle

    2004-04-01

    Though it has long been known on the basis of clinical associations and serendipitous observation that speech rate is related to mood and psychomotor baseline, it is less known that speech rate is also related to libido and to immune function. We make the case for a bipolar phenomenon of "psychic tonus," encompassing all these dimensions. The elated, agitated, libidinal, immunofacilitated, and talkative pole is an "approach" disposition primarily activated by the normal left hemisphere-especially, though not exclusively, its frontal lobe. The dejected, lethargic, delibidinized, immunosuppressed, and mute pole is an "avoidance" disposition primarily activated by the normal right hemisphere-especially, though not exclusively, its frontal lobe. In support of this proposed model, we present new evidence, via meta-analysis of previously published single lesion case reports, of a highly significant association between right hemisphere lesions and non-aphasic hyperlalia, and between left hemisphere lesions and non-aphasic mutism. PMID:15010256

  18. Dataset for the quantitative proteomics analysis of the primary hepatocellular carcinoma with single and multiple lesions.

    PubMed

    Xing, Xiaohua; Huang, Yao; Wang, Sen; Chi, Minhui; Zeng, Yongyi; Chen, Lihong; Li, Ling; Zeng, Jinhua; Lin, Minjie; Han, Xiao; Liu, Jingfeng; Liu, Xiaolong

    2015-12-01

    Hepatocellular Carcinoma (HCC) is one of the most common malignant tumor, which is causing the second leading cancer-related death worldwide. The tumor tissues and the adjacent noncancerous tissues obtained from HCC patients with single and multiple lesions were quantified using iTRAQ. A total of 5513 proteins (FDR of 1%) were identified which correspond to roughly 27% of the total liver proteome. And 107 and 330 proteins were dysregulated in HCC tissue with multiple lesions (MC group) and HCC tissue with a single lesion (SC group), compared with their noncancerous tissue (MN and SN group) respectively. Bioinformatics analysis (GO, KEGG and IPA) allowed these data to be organized into distinct categories. The data accompanying the manuscript on this approach (Xing et al., J. Proteomics (2015), http://dx.doi.org/10.1016/j.jprot.2015.08.007[1]) have been deposited to the iProX with identifier IPX00037601. PMID:26543886

  19. Treatment of bifurcation lesions with drug-coated balloons: A review of currently available scientific data.

    PubMed

    Cortese, Bernardo; Piraino, Davide; Buccheri, Dario; Alfonso, Fernando

    2016-10-01

    Bifurcation lesion management still represents a challenge for interventional cardiologists and currently there is a number of different approaches/techniques involving coronary stents. The use of a drug-coated balloon for native coronary vessel management is emerging as an alternative treatment, although in selected patient populations only. In particular, this technology has been tested for the treatment of bifurcations, both for the main vessel and the side branches. Several studies have evaluated this treatment as an alternative or as a therapeutic option complementary to stents, with conflicting and debatable results. However, the perspective of leaving lower metallic burden in this type of lesions is highly appealing and should be deeply investigated. We review here the currently available scientific data and future perspectives on drug-coated balloon use for bifurcation lesions. PMID:27390995

  20. Dataset for the quantitative proteomics analysis of the primary hepatocellular carcinoma with single and multiple lesions

    PubMed Central

    Xing, Xiaohua; Huang, Yao; Wang, Sen; Chi, Minhui; Zeng, Yongyi; Chen, Lihong; Li, Ling; Zeng, Jinhua; Lin, Minjie; Han, Xiao; Liu, Jingfeng; Liu, Xiaolong

    2015-01-01

    Hepatocellular Carcinoma (HCC) is one of the most common malignant tumor, which is causing the second leading cancer-related death worldwide. The tumor tissues and the adjacent noncancerous tissues obtained from HCC patients with single and multiple lesions were quantified using iTRAQ. A total of 5513 proteins (FDR of 1%) were identified which correspond to roughly 27% of the total liver proteome. And 107 and 330 proteins were dysregulated in HCC tissue with multiple lesions (MC group) and HCC tissue with a single lesion (SC group), compared with their noncancerous tissue (MN and SN group) respectively. Bioinformatics analysis (GO, KEGG and IPA) allowed these data to be organized into distinct categories. The data accompanying the manuscript on this approach (Xing et al., J. Proteomics (2015), http://dx.doi.org/10.1016/j.jprot.2015.08.007[1]) have been deposited to the iProX with identifier IPX00037601. PMID:26543886

  1. Detection of early carious lesions using contrast enhancement with coherent light scattering (speckle imaging)

    NASA Astrophysics Data System (ADS)

    Deana, A. M.; Jesus, S. H. C.; Koshoji, N. H.; Bussadori, S. K.; Oliveira, M. T.

    2013-07-01

    Currently, dental caries still represent one of the chronic diseases with the highest prevalence and present in most countries. The interaction between light and teeth (absorption, scattering and fluorescence) is intrinsically connected to the constitution of the dental tissue. Decay induced mineral loss introduces a shift in the optical properties of the affected tissue; therefore, study of these properties may produce novel techniques aimed at the early diagnosis of carious lesions. Based on the optical properties of the enamel, we demonstrate the application of first-order spatial statistics in laser speckle imaging, allowing the detection of carious lesions in their early stages. A highlight of this noninvasive, non-destructive, real time and cost effective approach is that it allows a dentist to detect a lesion even in the absence of biofilm or moisture.

  2. Molecular profiling of premalignant lesions in lung squamous cell carcinomas identifies mechanisms involved in stepwise carcinogenesis.

    PubMed

    Ooi, Aik T; Gower, Adam C; Zhang, Kelvin X; Vick, Jessica L; Hong, Longsheng; Nagao, Brian; Wallace, W Dean; Elashoff, David A; Walser, Tonya C; Dubinett, Steven M; Pellegrini, Matteo; Lenburg, Marc E; Spira, Avrum; Gomperts, Brigitte N

    2014-05-01

    Lung squamous cell carcinoma (SCC) is thought to arise from premalignant lesions in the airway epithelium; therefore, studying these lesions is critical for understanding lung carcinogenesis. Previous microarray and sequencing studies designed to discover early biomarkers and therapeutic targets for lung SCC had limited success identifying key driver events in lung carcinogenesis, mostly due to the cellular heterogeneity of patient samples examined and the interindividual variability associated with difficult to obtain airway premalignant lesions and appropriate normal control samples within the same patient. We performed RNA sequencing on laser-microdissected representative cell populations along the SCC pathologic continuum of patient-matched normal basal cells, premalignant lesions, and tumor cells. We discovered transcriptomic changes and identified genomic pathways altered with initiation and progression of SCC within individual patients. We used immunofluorescent staining to confirm gene expression changes in premalignant lesions and tumor cells, including increased expression of SLC2A1, CEACAM5, and PTBP3 at the protein level and increased activation of MYC via nuclear translocation. Cytoband enrichment analysis revealed coordinated loss and gain of expression in chromosome 3p and 3q regions, respectively, during carcinogenesis. This is the first gene expression profiling study of airway premalignant lesions with patient-matched SCC tumor samples. Our results provide much needed information about the biology of premalignant lesions and the molecular changes that occur during stepwise carcinogenesis of SCC, and it highlights a novel approach for identifying some of the earliest molecular changes associated with initiation and progression of lung carcinogenesis within individual patients. PMID:24618292

  3. Molecular profiling of premalignant lesions in lung squamous cell carcinomas identifies mechanisms involved in stepwise carcinogenesis

    PubMed Central

    Ooi, Aik T.; Gower, Adam C.; Zhang, Kelvin X.; Vick, Jessica L.; Hong, Longsheng; Nagao, Brian; Wallace, W. Dean; Elashoff, David A.; Walser, Tonya C.; Dubinett, Steven M.; Pellegrini, Matteo; Lenburg, Marc E.; Spira, Avrum; Gomperts, Brigitte N.

    2014-01-01

    Lung squamous cell carcinoma (SCC) is thought to arise from premalignant lesions in the airway epithelium; therefore studying these lesions is critical for understanding lung carcinogenesis. Previous microarray and sequencing studies designed to discover early biomarkers and therapeutic targets for lung SCC had limited success identifying key driver events in lung carcinogenesis, mostly due to the cellular heterogeneity of patient samples examined and the inter-individual variability associated with difficult to obtain airway premalignant lesions and appropriate normal control samples within the same patient. We performed RNA sequencing on laser-microdissected representative cell populations along the SCC pathological continuum of patient-matched normal basal cells, premalignant lesions, and tumor cells. We discovered transcriptomic changes and identified genomic pathways altered with initiation and progression of SCC within individual patients. We used immunofluorescent staining to confirm gene expression changes in premalignant lesions and tumor cells, including increased expression of SLC2A1, CEACAM5, and PTBP3 at the protein level and increased activation of MYC via nuclear translocation. Cytoband enrichment analysis revealed coordinated loss and gain of expression in chromosome 3p and 3q regions, respectively, during carcinogenesis. This is the first gene expression profiling study of airway premalignant lesions with patient-matched SCC tumor samples. Our results provide much needed information about the biology of premalignant lesions and the molecular changes that occur during stepwise carcinogenesis of SCC, and it highlights a novel approach for identifying some of the earliest molecular changes associated with initiation and progression of lung carcinogenesis within individual patients. PMID:24618292

  4. Characterization and fine mapping of a light-dependent leaf lesion mimic mutant 1 in rice.

    PubMed

    Wang, Jing; Ye, Bangquan; Yin, Junjie; Yuan, Can; Zhou, Xiaogang; Li, Weitao; He, Min; Wang, Jichun; Chen, Weilan; Qin, Peng; Ma, Bintian; Wang, Yuping; Li, Shigui; Chen, Xuewei

    2015-12-01

    Plants that spontaneously produce lesion mimics or spots, without any signs of obvious adversity, such as pesticide and mechanical damage, or pathogen infection, are so-called lesion mimic mutants (lmms). In rice, many lmms exhibit enhanced resistance to pathogens, which provides a unique opportunity to uncover the molecular mechanism underlying lmms. We isolated a rice light-dependent leaf lesion mimic mutant 1 (llm1). Lesion spots appeared in the leaves of the llm1 mutant at the tillering stage. Furthermore, the mutant llm1 had similar agronomic traits to wild type rice. Trypan blue and diamiobenzidine staining analyses revealed that the lesion spot formation on the llm1 mutant was due to programmed cell death and reactive oxygen species. The chloroplasts were severely damaged in the llm1 mutant, suggesting that chloroplast damage was associated with the formation of lesion spots in llm1. More importantly, llm1 exhibited enhanced resistance to bacterial blight pathogens within increased expression of pathogenesis related genes (PRs). Using a map-based cloning approach, we delimited the LLM1 locus to a 121-kb interval between two simple sequence repeat markers, RM17470 and RM17473, on chromosome 4. We sequenced the candidate genes on the interval and found that a base mutation had substituted adenine phosphate for thymine in the last exon of LOC_Os04g52130, which led to an amino acid change (Asp(388) to Val) in the llm1 mutant. Our investigation showed that the putative coproporphyrinogen III oxidase (CPOX) encoded by LOC_Os04g52130 was produced by LLM1 and that amino acid Asp(388) was essential for CPOX function. Our study provides the basis for further investigations into the mechanism underlying lesion mimic initiation associated with LLM1. PMID:26410574

  5. Pharmacokinetic Evaluation of the Penetration of Antituberculosis Agents in Rabbit Pulmonary Lesions

    PubMed Central

    Kjellsson, Maria C.; Via, Laura E.; Goh, Anne; Weiner, Danielle; Low, Kang Min; Kern, Steven; Pillai, Goonaseelan; Barry, Clifton E.

    2012-01-01

    Standard antituberculosis (anti-TB) therapy requires the use of multiple drugs for a minimum of 6 months, with variable outcomes that are influenced by a number of microbiological, pathological, and clinical factors. This is despite the availability of antibiotics that have good activity against Mycobacterium tuberculosis in vitro and favorable pharmacokinetic profiles in plasma. However, little is known about the distribution of widely used antituberculous agents in the pulmonary lesions where the pathogen resides. The rabbit model of TB infection was used to explore the hypothesis that standard drugs have various abilities to penetrate lung tissue and lesions and that adequate drug levels are not consistently reached at the site of infection. Using noncompartmental and population pharmacokinetic approaches, we modeled the rate and extent of distribution of isoniazid, rifampin, pyrazinamide, and moxifloxacin in rabbit lung and lesions. Moxifloxacin reproducibly showed favorable partitioning into lung and granulomas, while the exposure of isoniazid, rifampin, and pyrazinamide in lesions was markedly lower than in plasma. The extent of penetration in lung and lesions followed different trends for each drug. All four agents distributed rapidly from plasma to tissue with equilibration half-lives of less than 1 min to an hour. The models adequately described the plasma concentrations and reasonably captured actual lesion concentrations. Though further refinement is needed to accurately predict the behavior of these drugs in human subjects, our results enable the integration of lesion-specific pharmacokinetic-pharmacodynamic (PK-PD) indices in clinical trial simulations and in in vitro PK-PD studies with M. tuberculosis. PMID:21986820

  6. Partly segregated cortico-subcortical pathways support phonologic and semantic verbal fluency: A lesion study.

    PubMed

    Chouiter, Leila; Holmberg, Josefina; Manuel, Aurelie L; Colombo, Françoise; Clarke, Stephanie; Annoni, Jean-Marie; Spierer, Lucas

    2016-08-01

    Verbal fluency refers to the ability to generate as many words as possible in a limited time interval, without repetition and according to either a phonologic (each word begins with a given letter) or a semantic rule (each word belongs to a given semantic category). While current literature suggests the involvement of left fronto-temporal structures in fluency tasks, whether the same or distinct brain areas are necessary for each type of fluency remains unclear. We tested the hypothesis for an involvement of partly segregated cortico-subcortical structures between phonologic and semantic fluency by examining with a voxel-based lesion symptom mapping approach the effects of brain lesions on fluency scores corrected for age and education level in a group of 191 unselected brain-damaged patients with a first left or right hemispheric lesion. There was a positive correlation between the scores to the two types of fluency, suggesting that common mechanisms underlie the word generation independent of the production rule. The lesion-symptom mapping revealed that lesions to left basal ganglia impaired both types of fluency and that left superior temporal, supramarginal and rolandic operculum lesions selectively impaired phonologic fluency and left middle temporal lesions impaired semantic fluency. Our results corroborate current neurocognitive models of word retrieval and production, and refine the role of cortical-subcortical interaction in lexical search by highlighting the common executive role of basal ganglia in both types of verbal fluency and the preferential involvement of the ventral and dorsal language pathway in semantic and phonologic fluency, respectively. PMID:27217213

  7. DIAGNOSTIC CRITERIA FOR PROLIFERATIVE THYROID LESIONS IN BONY FISHES II

    EPA Science Inventory

    Thyroid proliferative lesions are rather common in bony fishes but diagnostic terminology and criteria for these lesions are inconsistent in the literature. The diagnosis of proliferative thyroid lesions is especially challenging in fish due to the fact that the thyroid is not a ...

  8. 21 CFR 882.5500 - Lesion temperature monitor.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Lesion temperature monitor. 882.5500 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5500 Lesion temperature monitor. (a) Identification. A lesion temperature monitor is a device used to monitor the...

  9. 21 CFR 884.2990 - Breast lesion documentation system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Breast lesion documentation system. 884.2990... Devices § 884.2990 Breast lesion documentation system. (a) Identification. A breast lesion documentation system is a device for use in producing a surface map of the breast as an aid to document palpable...

  10. 21 CFR 884.2990 - Breast lesion documentation system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Breast lesion documentation system. 884.2990... Devices § 884.2990 Breast lesion documentation system. (a) Identification. A breast lesion documentation system is a device for use in producing a surface map of the breast as an aid to document palpable...

  11. 21 CFR 884.2990 - Breast lesion documentation system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Breast lesion documentation system. 884.2990... Devices § 884.2990 Breast lesion documentation system. (a) Identification. A breast lesion documentation system is a device for use in producing a surface map of the breast as an aid to document palpable...

  12. 21 CFR 884.2990 - Breast lesion documentation system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Breast lesion documentation system. 884.2990... Devices § 884.2990 Breast lesion documentation system. (a) Identification. A breast lesion documentation system is a device for use in producing a surface map of the breast as an aid to document palpable...

  13. 21 CFR 884.2990 - Breast lesion documentation system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Breast lesion documentation system. 884.2990... Devices § 884.2990 Breast lesion documentation system. (a) Identification. A breast lesion documentation system is a device for use in producing a surface map of the breast as an aid to document palpable...

  14. Osteoporotic skull lesions in moose at Isle Royale National Park.

    PubMed

    Hindelang, M; Peterson, R O

    1996-01-01

    Osteoporotic lesions were evaluated in the skulls of moose (Alces alces) collected in Isle Royale National Park, Michigan (USA), from 1958 to 1994. Circular lesions which penetrated the outer table of the skull were distributed over the frontal and nasal bones asymmetrically in both sexes. About 32% of skulls recovered had some porotic lesions with slightly greater prevalence among males. PMID:8627919

  15. 21 CFR 882.5500 - Lesion temperature monitor.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Lesion temperature monitor. 882.5500 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5500 Lesion temperature monitor. (a) Identification. A lesion temperature monitor is a device used to monitor the...

  16. 21 CFR 882.5500 - Lesion temperature monitor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Lesion temperature monitor. 882.5500 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5500 Lesion temperature monitor. (a) Identification. A lesion temperature monitor is a device used to monitor the...

  17. 21 CFR 882.5500 - Lesion temperature monitor.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Lesion temperature monitor. 882.5500 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5500 Lesion temperature monitor. (a) Identification. A lesion temperature monitor is a device used to monitor the...

  18. 21 CFR 882.5500 - Lesion temperature monitor.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Lesion temperature monitor. 882.5500 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5500 Lesion temperature monitor. (a) Identification. A lesion temperature monitor is a device used to monitor the...

  19. Deficits in reproductive behaviour in septally lesioned female rats.

    PubMed

    Gogate, M G; Brid, S V; Wingkar, K C

    1991-12-01

    Estrous cycle and sexual behaviour were studied in septally lesioned female albino Wistar rats. In lesioned rats the vaginal smears showed continuous diestrus and the females failed to exhibit sexual receptivity during the postoperative period. Ovarian and uterine weights in lesioned rats were also significantly decreased. The results suggest that the septal nuclei exert a modulatory influence on female sexual behaviour. PMID:1816101

  20. 21 CFR 882.4400 - Radiofrequency lesion generator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Radiofrequency lesion generator. 882.4400 Section 882.4400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... lesion generator. (a) Identification. A radiofrequency lesion generator is a device used to...

  1. 21 CFR 882.4400 - Radiofrequency lesion generator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiofrequency lesion generator. 882.4400 Section 882.4400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... lesion generator. (a) Identification. A radiofrequency lesion generator is a device used to...

  2. 21 CFR 882.4400 - Radiofrequency lesion generator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Radiofrequency lesion generator. 882.4400 Section 882.4400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... lesion generator. (a) Identification. A radiofrequency lesion generator is a device used to...

  3. 21 CFR 882.4400 - Radiofrequency lesion generator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Radiofrequency lesion generator. 882.4400 Section 882.4400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... lesion generator. (a) Identification. A radiofrequency lesion generator is a device used to...

  4. 21 CFR 882.4400 - Radiofrequency lesion generator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Radiofrequency lesion generator. 882.4400 Section 882.4400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... lesion generator. (a) Identification. A radiofrequency lesion generator is a device used to...

  5. Intra-arterial Onyx Embolization of Vertebral Body Lesions

    PubMed Central

    Sedora-Roman, Neda I.; Reddy, Arra Suresh; Ogilvy, Christopher S.; Thomas, Ajith J.

    2013-01-01

    While Onyx embolization of cerebrospinal arteriovenous shunts is well-established, clinical researchers continue to broaden applications to other vascular lesions of the neuraxis. This report illustrates the application of Onyx (eV3, Plymouth, MN) embolization to vertebral body lesions, specifically, a vertebral hemangioma and renal cell carcinoma vertebral body metastatic lesion. PMID:24729960

  6. Oral Lesions in Elderly Patients in Referral Centers for Oral Lesions of Bahia

    PubMed Central

    Souza, Sarah; Alves, Técia; Santos, Jean; Oliveira, Márcio

    2015-01-01

    Introduction The aging population phenomenon is occurring on a global scale; aging affects all of the structures of organisms, including the oral cavity. Objective To estimate the frequency of oral lesions, according to the clinical and histopathologic diagnoses, and to describe the sociodemographic profile of the elderly treated at the referral centers of oral lesions of public universities in Bahia, Brazil. Methods A descriptive epidemiologic study with transverse characteristics was conducted with elderly patients between August 2010 and January 2012. A form was used to collect data. The descriptive analysis consisted of calculating the simple and relative frequencies of sociodemographic variables and oral lesions. Results The population was predominantly black women, and the minority of elderly people were retired. Fibroid (13%) and squamous cell carcinoma (145%) were more prevalent clinical diagnoses, with squamous cell carcinoma (30.7%) and fibrous hyperplasia more prevalent histopathologic diagnoses. Conclusion A prevention policy needs to be implemented to reduce new cases of oral lesions in Bahia, Brazil and to aid in early diagnosis and appropriate treatment of oral lesions. PMID:26491471

  7. Theoretical evaluation of the detectability of random lesions in bayesian emission reconstruction

    SciTech Connect

    Qi, Jinyi

    2003-05-01

    Detecting cancerous lesion is an important task in positron emission tomography (PET). Bayesian methods based on the maximum a posteriori principle (also called penalized maximum likelihood methods) have been developed to deal with the low signal to noise ratio in the emission data. Similar to the filter cut-off frequency in the filtered backprojection method, the prior parameters in Bayesian reconstruction control the resolution and noise trade-off and hence affect detectability of lesions in reconstructed images. Bayesian reconstructions are difficult to analyze because the resolution and noise properties are nonlinear and object-dependent. Most research has been based on Monte Carlo simulations, which are very time consuming. Building on the recent progress on the theoretical analysis of image properties of statistical reconstructions and the development of numerical observers, here we develop a theoretical approach for fast computation of lesion detectability in Bayesian reconstruction. The results can be used to choose the optimum hyperparameter for the maximum lesion detectability. New in this work is the use of theoretical expressions that explicitly model the statistical variation of the lesion and background without assuming that the object variation is (locally) stationary. The theoretical results are validated using Monte Carlo simulations. The comparisons show good agreement between the theoretical predications and the Monte Carlo results.

  8. Lesions to right prefrontal cortex impair real-world planning through premature commitments.

    PubMed

    Goel, Vinod; Vartanian, Oshin; Bartolo, Angela; Hakim, Lila; Ferraro, Anna Maria; Isella, Valeria; Appollonio, Ildebrando; Drei, Silvia; Nichelli, Paolo

    2013-03-01

    While it is well accepted that the left prefrontal cortex plays a critical role in planning and problem-solving tasks, very little is known about the role of the right prefrontal cortex. We addressed this issue by testing five neurological patients with focal lesions to right prefrontal cortex on a real-world travel planning task, and compared their performance with the performance of five neurological patients with focal lesions to left prefrontal cortex, five neurological patients with posterior lesions, and five normal controls. Only patients with lesions to right prefrontal cortex generated substandard solutions compared to normal controls. Examination of the underlying cognitive processes and strategies revealed that patients with lesions to right prefrontal cortex approached the task at an excessively precise, concrete level compared to normal controls, and very early locked themselves into substandard solutions relative to the comparison group. In contrast, the behavior of normal controls was characterized by a judicious interplay of concrete and abstract levels/modes of representations. We suggest that damage to the right prefrontal system impairs the encoding and processing of more abstract and vague representations that facilitate lateral transformations, resulting in premature commitment to precise concrete patterns, and hasty albeit substandard conclusions (because the space of possibilities has not been properly explored). PMID:23266766

  9. The development of an MRI lesion quantifying system for multiple sclerosis patients undergoing treatment

    NASA Astrophysics Data System (ADS)

    Moin, Paymann; Ma, Kevin; Amezcua, Lilyana; Gertych, Arkadiusz; Liu, Brent

    2009-02-01

    Multiple sclerosis (MS) is a demyelinating disease of the central nervous system that affects approximately 2.5 million people worldwide. Magnetic resonance imaging (MRI) is an established tool for the assessment of disease activity, progression and response to treatment. The progression of the disease is variable and requires routine follow-up imaging studies. Currently, MRI quantification of multiple sclerosis requires a manual approach to lesion measurement and yields an estimate of lesion volume and interval change. In the setting of several prior studies and a long treatment history, trends related to treatment change quickly become difficult to extrapolate. Our efforts seek to develop an imaging informatics based MS lesion computer aided detection (CAD) package to quantify and track MS lesions including lesion load, volume, and location. Together, with select clinical parameters, this data will be incorporated into an MS specific e- Folder to provide decision support to evaluate and assess treatment options for MS in a manner tailored specifically to an individual based on trends in MS presentation and progression.

  10. Patch-Based Segmentation with Spatial Consistency: Application to MS Lesions in Brain MRI

    PubMed Central

    Mechrez, Roey; Goldberger, Jacob; Greenspan, Hayit

    2016-01-01

    This paper presents an automatic lesion segmentation method based on similarities between multichannel patches. A patch database is built using training images for which the label maps are known. For each patch in the testing image, k similar patches are retrieved from the database. The matching labels for these k patches are then combined to produce an initial segmentation map for the test case. Finally an iterative patch-based label refinement process based on the initial segmentation map is performed to ensure the spatial consistency of the detected lesions. The method was evaluated in experiments on multiple sclerosis (MS) lesion segmentation in magnetic resonance images (MRI) of the brain. An evaluation was done for each image in the MICCAI 2008 MS lesion segmentation challenge. Results are shown to compete with the state of the art in the challenge. We conclude that the proposed algorithm for segmentation of lesions provides a promising new approach for local segmentation and global detection in medical images. PMID:26904103

  11. Contrast-enhanced ultrasound in diagnosis and characterization of focal hepatic lesions

    PubMed Central

    Molins, Inés Gómez; Font, Juan Manuel Fernández; Álvaro, Juan Carrero; Navarro, Jose Luís Lledó; Gil, Marta Fernández; Rodríguez, Conrado M Fernández

    2010-01-01

    The extensive use of imaging techniques in differential diagnosis of abdominal conditions and screening of hepatocellular carcinoma in patients with chronic hepatic diseases, has led to an important increase in identification of focal liver lesions. The development of contrast-enhanced ultrasound (CEUS) opens a new window in the diagnosis and follow-up of these lesions. This technique offers obvious advantages over the computed tomography and magnetic resonance, without a decrease in its sensitivity and specificity. The new second generation contrast agents, due to their intravascular distribution, allow a continuous evaluation of the enhancement pattern, which is crucial in characterization of liver lesions. The dual blood supply in the liver shows three different phases, namely arterial, portal and late phases. The enhancement during portal and late phases can give important information about the lesion’s behavior. Each liver lesion has a different enhancement pattern that makes possible an accurate approach to their diagnosis. The role of emerging techniques as a contrast-enhanced three-dimensional US is also discussed. In this article, the advantages, indications and technique employed during CEUS and the different enhancement patterns of most benign and malignant focal liver lesions are discussed. PMID:21225000

  12. CCL19 and CCL21 modulate the inflammatory milieu in atherosclerotic lesions

    PubMed Central

    Akhavanpoor, Mohammadreza; Gleissner, Christian A; Gorbatsch, Stephanie; Doesch, Andreas O; Akhavanpoor, Hamidreza; Wangler, Susanne; Jahn, Frederik; Lasitschka, Felix; Katus, Hugo A; Erbel, Christian

    2014-01-01

    Despite advances in the pharmacologic and interventional treatment of coronary artery disease, atherosclerosis remains the leading cause of death worldwide. Atherosclerosis is a chronic inflammatory disease, and elevated expression of CCL19 and CCL21 has been observed in ruptured lesions of coronary arteries of patients with myocardial infarction and carotid plaques of patients with ischemic symptoms, as well as in plasma of coronary artery disease patients. However, the exact role of CCL19 and CCL21 in atherosclerosis remains unknown. In order to identify CCL19 and CCL21 as a novel therapeutic target, we performed bone marrow transplantation as an immunomodulatory treatment concept. Bone marrow of plt/plt mice (lacking CCL19 and CCL21-Ser) was transplanted into atherogenic Ldlr−/− mice. The study demonstrated a significantly increased inflammatory cellular infiltration into the lesions of plt/plt/Ldlr−/− mice versus controls. Although the level of chemoattraction was increased, messenger ribonucleic acid and protein levels in thoracic aorta and serum of several proinflammatory cytokines (TNFα, IFNγ, IL-6, IL-12, and IL-17) were significantly reduced in plt/plt/Ldlr−/− versus control mice. Increased influx, accompanied by reduced activation of leukocytes in atherosclerotic lesion, was accompanied by increased plaque stability but unchanged lesion development. In conclusion, modulation of the chemokines CCL19 and CCL21 represents a potent immunoregulatory treatment approach, and thus represents a novel therapeutic target to stabilize atherosclerotic lesions. PMID:25473269

  13. CCL19 and CCL21 modulate the inflammatory milieu in atherosclerotic lesions.

    PubMed

    Akhavanpoor, Mohammadreza; Gleissner, Christian A; Gorbatsch, Stephanie; Doesch, Andreas O; Akhavanpoor, Hamidreza; Wangler, Susanne; Jahn, Frederik; Lasitschka, Felix; Katus, Hugo A; Erbel, Christian

    2014-01-01

    Despite advances in the pharmacologic and interventional treatment of coronary artery disease, atherosclerosis remains the leading cause of death worldwide. Atherosclerosis is a chronic inflammatory disease, and elevated expression of CCL19 and CCL21 has been observed in ruptured lesions of coronary arteries of patients with myocardial infarction and carotid plaques of patients with ischemic symptoms, as well as in plasma of coronary artery disease patients. However, the exact role of CCL19 and CCL21 in atherosclerosis remains unknown. In order to identify CCL19 and CCL21 as a novel therapeutic target, we performed bone marrow transplantation as an immunomodulatory treatment concept. Bone marrow of plt/plt mice (lacking CCL19 and CCL21-Ser) was transplanted into atherogenic Ldlr(-/-) mice. The study demonstrated a significantly increased inflammatory cellular infiltration into the lesions of plt/plt/Ldlr(-/-) mice versus controls. Although the level of chemoattraction was increased, messenger ribonucleic acid and protein levels in thoracic aorta and serum of several proinflammatory cytokines (TNFα, IFNγ, IL-6, IL-12, and IL-17) were significantly reduced in plt/plt/Ldlr(-/-) versus control mice. Increased influx, accompanied by reduced activation of leukocytes in atherosclerotic lesion, was accompanied by increased plaque stability but unchanged lesion development. In conclusion, modulation of the chemokines CCL19 and CCL21 represents a potent immunoregulatory treatment approach, and thus represents a novel therapeutic target to stabilize atherosclerotic lesions. PMID:25473269

  14. Automated White Matter Total Lesion Volume Segmentation in Diabetes

    PubMed Central

    Maldjian, J.A.; Whitlow, C.T.; Saha, B.N.; Kota, G.; Vandergriff, C.; Davenport, E.M.; Divers, J.; Freedman, B.I.; Bowden, D.W.

    2014-01-01

    Background and Purpose WM lesion segmentation is often performed with the use of subjective rating scales because manual methods are laborious and tedious; however, automated methods are now available. We compared the performance of total lesion volume grading computed by use of an automated WM lesion segmentation algorithm with that of subjective rating scales and expert manual segmentation in a cohort of subjects with type 2 diabetes. Materials and Methods Structural T1 and FLAIR MR imaging data from 50 subjects with diabetes (age, 67.7 ± 7.2 years) and 50 nondiabetic sibling pairs (age, 67.5 ± 9.4 years) were evaluated in an institutional review board–approved study. WM lesion segmentation maps and total lesion volume were generated for each subject by means of the Statistical Parametric Mapping (SPM8) Lesion Segmentation Toolbox. Subjective WM lesion grade was determined by means of a 0–9 rating scale by 2 readers. Ground-truth total lesion volume was determined by means of manual segmentation by experienced readers. Correlation analyses compared manual segmentation total lesion volume with automated and subjective evaluation methods. Results Correlation between average lesion segmentation and ground-truth total lesion volume was 0.84. Maximum correlation between the Lesion Segmentation Toolbox and ground-truth total lesion volume (ρ = 0.87) occurred at the segmentation threshold of k = 0.25, whereas maximum correlation between subjective lesion segmentation and the Lesion Segmentation Toolbox (ρ = 0.73) occurred at k = 0.15. The difference between the 2 correlation estimates with ground-truth was not statistically significant. The lower segmentation threshold (0.15 versus 0.25) suggests that subjective raters overestimate WM lesion burden. Conclusions We validate the Lesion Segmentation Toolbox for determining total lesion volume in diabetes-enriched populations and compare it with a common subjective WM lesion rating scale. The Lesion Segmentation

  15. Early Results of Retrograde Transpopliteal Angioplasty of Iliofemoral Lesions

    SciTech Connect

    Saha, Saumitra; Gibson, Matthew; Magee, Timothy R.; Galland, Robert B.; Torrie, E. Peter H.

    2001-12-15

    Purpose: To assess whether the retrograde transpopliteal approach is a safe, practical and effective alternative to femoral puncture for percutaneous transluminal angioplasty (PTA).Methods: Forty PTAs in 38 patients were evaluated. Intentional subintimal recanalization was performed in 13 limbs. Ultrasound evaluation of the popliteal fossa was carried out 30 min and 24 hr post procedurally in the first 10 patients to exclude local complications. All patients had a follow-up of at least 6 weeks.Results: The indication for PTA was critical ischemia in seven limbs and disabling claudication in the remainder.Stenoses (single or multiple) were present in 24 and occlusion in 15.The superficial femoral artery (SFA) was the commonest segment affected(36) followed by common femoral artery (CFA) in four and iliac artery in four. Technical success was achieved in 38 of 39 limbs where angioplasty was carried out. In one limb no lesion was found.Immediate complications were distal embolization in two and thrombosis in one. None of these required immediate surgery. There were no puncture site hematomas or popliteal arteriovenous fistulae.Symptomatic patency at 6 weeks was 85%. Further reconstructive surgery was required in three limbs and amputation in two.Conclusion: The transpopliteal approach has a high technical success rate and a low complication rate with a potential to develop into an outpatient procedure. It should be considered for flush SFA occulsions or iliac disease with tandem CFA/SFA disease where the contralateral femoral approach is often technically difficult.

  16. Radiopaque Tagging Masks Caries Lesions following Incomplete Excavation in vitro.

    PubMed

    Schwendicke, F; Meyer-Lueckel, H; Schulz, M; Dörfer, C E; Paris, S

    2014-06-01

    One-step incomplete excavation seals caries-affected dentin under a restoration and appears to be advantageous in the treatment of deep lesions. However, it is impossible to discriminate radiographically between intentionally left, arrested lesions and overlooked or active lesions. This diagnostic uncertainty decreases the acceptance of minimally invasive excavation and might lead to unnecessary re-treatment of incompletely excavated teeth. Radiopaque tagging of sealed lesions might mask arrested lesions and assist in discrimination from progressing lesions. Therefore, we microradiographically screened 4 substances (SnCl2, AgNO3, CsF, CsCH3COO) for their effect on artificial lesions. Since water-dissolved tin chloride (SnCl2×Aq) was found to stably mask artificial lesions, we then investigated its radiographic effects on progressing lesions. Natural lesions were incompletely excavated and radiopaque tagging performed. Grey-value differences (△GV) between sound and carious dentin were determined and radiographs assessed by 20 dentists. While radiographic effects of SnCl2×Aq were stable for non-progressing lesions, they significantly decreased during a second demineralization (p < .001, t test). For natural lesions, tagging with SnCl2×Aq significantly reduced △GV (p < .001, Wilcoxon). Tagged lesions were detected significantly less often than untagged lesions (p < .001). SnCl2×Aq was suitable to mask caries-affected dentin and discriminate between arrested and progressing lesions in vitro. Radiopaque tagging could resolve diagnostic uncertainties associated with incomplete excavation. PMID:24718110

  17. The Immune Landscapes of Polypoid and Nonpolypoid Precancerous Colorectal Lesions.

    PubMed

    Maglietta, Antonella; Maglietta, Rosalia; Staiano, Teresa; Bertoni, Ramona; Ancona, Nicola; Marra, Giancarlo; Resta, Leonardo

    2016-01-01

    Little is known about the immunoediting process in precancerous lesions. We explored this aspect of benign colorectal adenomas with a descriptive analysis of the immune pathways and immune cells whose regulation is linked to the morphology and size of these lesions. Two series of polypoid and nonpolypoid colorectal adenomas were used in this study: 1) 84 samples (42 lesions, each with matched samples of normal mucosa) whose gene expression data were used to quantify the tumor morphology- and size-related dysregulation of immune pathways collected in the Molecular Signature Database, using Gene Set Enrichment Analysis; 2) 40 other lesions examined with immunohistochemistry to quantify the presence of immune cells in the stromal compartment. In the analysis of transcriptomic data, 429 immune pathways displayed significant differential regulation in neoplasms of different morphology and size. Most pathways were significantly upregulated or downregulated in polypoid lesions versus nonpolypoid lesions (regardless of size). Differential pathway regulation associated with lesion size was observed only in polypoid neoplasms. These findings were mirrored by tissue immunostaining with CD4, CD8, FOXP3, MHC-I, CD68, and CD163 antibodies: stromal immune cell counts (mainly T lymphocytes and macrophages) were significantly higher in polypoid lesions. Certain markers displayed significant size-related differences regardless of lesion morphology. Multivariate analysis of variance showed that the marker panel clearly discriminated between precancerous lesions of different morphologies and sizes. Statistical analysis of immunostained cell counts fully support the results of the transcriptomic data analysis: the density of infiltration of most immune cells in the stroma of polypoid precancerous lesions was significantly higher than that observed in nonpolypoid lesions. Large neoplasms also have more immune cells in their stroma than small lesions. Immunoediting in precancerous

  18. Classification of dependence-related skin lesions: a new proposal.

    PubMed

    García-Fernández, F P; Soldevilla Agreda, J Javier; Pancorbo-Hidalgo, P L; Verdu-Soriano, J; López Casanova, P; Rodríguez-Palma, M

    2016-01-01

    A new theoretical framework on the development of pressure ulcers and other dependence-related lesions requires continued in-depth analysis of their conceptual bases. This study reports the historical background, definitions, and production mechanisms of these lesions, describing the differential pathognomonic features of pressure and/or shear ulcers, moisture-associated skin damage, and lesions from rubbing or friction. It also discusses the combined/multifactorial lesions that can be found in the clinical setting. Finally, it presents the new classification of these lesions proposed by the Spanish Pressure Ulcers and Chronic Wounds Advisory Panel. PMID:26762495

  19. Bleeding Scrotal Vascular Lesions: Interventional Management with Transcatheter Embolization

    SciTech Connect

    Jaganathan, Sriram; Gamanagatti, Shivanand Mukund, Amar; Dhar, Anita

    2011-02-15

    Vascular lesions of the scrotum are uncommon; the most common among them are varicocele lesions. The other vascular lesions that may involve the scrotum are hemangioma, lymphangioma, and arteriovenous malformations, which are exceedingly rare. The imaging modalities useful in the diagnosis and management of scrotal vascular lesions are grayscale sonography, color Doppler sonography, magnetic resonance imaging, magnetic resonance angiography, and digital subtraction angiography. We present two cases of scrotal vascular lesions involving the extratesticular scrotal soft tissues. Patients presented with bleeding and were treated by radiological interventional technique. We emphasize the importance of superselective catheterization and distal embolization.

  20. Nonodontogenic mandibular lesions: differentiation based on CT attenuation

    PubMed Central

    Özgür, Anıl; Kara, Engin; Arpacı, Rabia; Arpacı, Taner; Esen, Kaan; Kara, Taylan; Duce, Meltem Nass; Apaydın, Feramuz Demir

    2014-01-01

    Mandibular lesions are classified as odontogenic and nonodontogenic based on the cell of origin. Odontogenic lesions are frequently encountered at head and neck imaging. However, several nonodontogenic pathologies may also involve mandible and present further diagnostic dilemma. Awareness of the imaging features of nonodontogenic lesions is crucial in order to guide clinicians in proper patient management. Computed tomography (CT) may provide key information to narrow diagnostic considerations. Nonodontogenic mandibular lesions may have lytic, sclerotic, ground-glass, or mixed lytic and sclerotic appearances on CT. In this article, our aim is to present various nonodontogenic lesions of the mandible by categorizing them according to their attenuations on CT. PMID:25297390

  1. Relationship between tail lesions and lung health in slaughter pigs.

    PubMed

    van Staaveren, Nienke; Vale, Ana P; Manzanilla, Edgar G; Teixeira, Dayane L; Leonard, Finola C; Hanlon, Alison; Boyle, Laura A

    2016-05-01

    Tail lesions are associated with poor health either because they serve as a point of entry for pathogens or because of shared risk factors. This study investigated the relationship between carcass tail lesion and lung lesion severity scores in slaughter pigs. Carcasses were scored after scalding/dehairing for tail lesion severity (0-4). Lungs were scored according to an adapted version of the BPEX pig health scheme. Severity of enzootic pneumonia (EP-like lesions) was recorded on a scale of 0-50. Severity of pleurisy was scored on a 0-2 scale with score 2 equating to severe pleurisy or those lungs that remained attached to the chest wall ('lungs in chest'). The database for assessing pleurisy lesions contained all pleurisy scores (n=5628). Lungs with a score of 2 for pleurisy were excluded from the analysis of all other lung lesions as such lungs could not be assessed for other lesions (n=4491). Associations between tail lesions and different lung lesion outcomes were analysed using generalized linear mixed models (PROC GLIMMIX) with random effect for batch. Males were more affected by moderate (OR=1.9, 95% CI 1.51-2.34) and severe (OR=5.8, 95% CI 3.45-9.70) tail lesions than females. EP-like lesions and pleurisy were most commonly observed. Pigs with severe tail lesions tended to have more 'lungs in chest' than pigs with moderate tail lesions (P=0.1). No other associations between tail lesions and lung lesions were found. Males had higher odds of having EP-like lesions (OR=1.2, 95% CI 1.05-1.36) than females. Tail lesions on the carcass may not be an accurate predictor of lung health. However, tail lesions are important welfare indicators and respiratory disease is a significant infectious condition affecting pigs. Thus, recording of tail and lung lesions at meat inspection provides valuable information regarding on-farm health and welfare of pigs. PMID:27094136

  2. Can bioabsorbable scaffolds be used in calcified lesions?

    PubMed

    Basavarajaiah, Sandeep; Naganuma, Toru; Latib, Azeem; Colombo, Antonio

    2014-07-01

    The technology of bioabsorbable vascular scaffolds (BVSs) that disappears with minimal trace essentially eliminating the risk of very late stent thrombosis appears exciting. However, these scaffolds have only been tried in simple lesions in which the risk of late stent thrombosis is very low. We would like to report the use of everolimus-eluting BVS in calcified coronary lesions following debulking the lesions using scoring balloons and rotational atherectomy. With the use of intravascular ultrasound, we have confirmed the adequate expansion of these scaffolds. These cases demonstrate the feasibility of BVS in complex lesions, but appropriate lesion preparation remains the key to aid adequate expansion of these scaffolds. PMID:23592566

  3. Expression of adhesion molecules in leprosy lesions.

    PubMed Central

    Sullivan, L; Sano, S; Pirmez, C; Salgame, P; Mueller, C; Hofman, F; Uyemura, K; Rea, T H; Bloom, B R; Modlin, R L

    1991-01-01

    Leprosy presents as a clinical spectrum that is precisely paralleled by a spectrum of immunological reactivity. The disease provides a useful and accessible model, in this case in the skin, in which to study the dynamics of cellular immune responses to an infectious pathogen, including the role of adhesion molecules in those responses. In lesions characterized by strong delayed-type hypersensitivity against Mycobacterium leprae (tuberculoid, reversal reaction, and Mitsuda reaction), the overlying epidermis exhibited pronounced keratinocyte intracellular adhesion molecule 1 (ICAM-1) expression and contained lymphocytes expressing the ICAM-1 ligand, LFA-1. Conversely, in lesions in which delayed-type hypersensitivity was lacking (lepromatous), keratinocyte ICAM-1 expression was low and LFA-1+ lymphocytes were rare. Expression of these adhesion molecules on the cells within the dermal granulomas was equivalent throughout the spectrum of leprosy. The percentage of lymphocytes in these granulomas containing mRNA coding for gamma interferon and tumor necrosis factor alpha, synergistic regulators of ICAM-1 expression, paralleled epidermal ICAM-1 expression. In lesions of erythema nodosum leprosum, a reactional state of lepromatous leprosy thought to be due to immune complex deposition, keratinocyte ICAM-1 expression and gamma interferon mRNA+ cells were both prominent. Antibodies to LFA-1 and ICAM-1 blocked the response of both alpha beta and gamma delta T-cell clones in vitro to mycobacteria. Overall, the expression of adhesion molecules by immunocompetent epidermal cells, as well as the cytokines which regulate such expression, correlates with the outcome of the host response to infection. Images PMID:1718871

  4. Widespread telomere instability in prostatic lesions.

    PubMed

    Tu, LiRen; Huda, Nazmul; Grimes, Brenda R; Slee, Roger B; Bates, Alison M; Cheng, Liang; Gilley, David

    2016-05-01

    A critical function of the telomere is to disguise chromosome ends from cellular recognition as double strand breaks, thereby preventing aberrant chromosome fusion events. Such chromosome end-to-end fusions are known to initiate genomic instability via breakage-fusion-bridge cycles. Telomere dysfunction and other forms of genomic assault likely result in misregulation of genes involved in growth control, cell death, and senescence pathways, lowering the threshold to malignancy and likely drive disease progression. Shortened telomeres and anaphase bridges have been reported in a wide variety of early precursor and malignant cancer lesions including those of the prostate. These findings are being extended using methods for the analysis of telomere fusions (decisive genetic markers for telomere dysfunction) specifically within human tissue DNA. Here we report that benign prostatic hyperplasia (BPH), high-grade prostatic intraepithelial neoplasia (PIN), and prostate cancer (PCa) prostate lesions all contain similarly high frequencies of telomere fusions and anaphase bridges. Tumor-adjacent, histologically normal prostate tissue generally did not contain telomere fusions or anaphase bridges as compared to matched PCa tissues. However, we found relatively high levels of telomerase activity in this histologically normal tumor-adjacent tissue that was reduced but closely correlated with telomerase levels in corresponding PCa samples. Thus, we present evidence of high levels of telomere dysfunction in BPH, an established early precursor (PIN) and prostate cancer lesions but not generally in tumor adjacent normal tissue. Our results suggest that telomere dysfunction may be a common gateway event leading to genomic instability in prostate tumorigenesis. . PMID:25917938

  5. Imaging Granulomatous Lesions with Optical Coherence Tomography

    PubMed Central

    Banzhaf, Christina; Jemec, Gregor B.E.

    2012-01-01

    Aim To investigate and compare the presentation of granulomatous lesions in optical coherence tomography (OCT) images and compare this to previous studies of nonmelanoma skin tumors. Methods Two patients with granulomas, tophi and granuloma annulare (GA), respectively, were photographed digitally, OCT-scanned and biopsied in the said order. Normal skin was OCT-scanned for comparison, but not biopsied. The OCT images from each lesion were compared with their histologic images as well as with OCT images with similar characteristics obtained from nonmelanoma skin tumors. Results The OCT images of the tophi showed hyperreflective, rounded cloud-like structures in dermis, their upper part sharply delineated by a hyporeflective fringe. The deeper areas appeared blurred. The crystalline structures were delineated by a hyporeflective fringe. OCT images of GA showed two different structures in dermis: a hyporeflective rounded one, and one that was lobulated and wing-like. Conclusion Granulomatous tissue surrounding urate deposits appeared as a clear hyporeflective fringe surrounding a light, hyperreflective area. The urate crystals appeared as hyperreflective areas, shielding the deeper part of dermis, meaning OCT could only visualize the upper part of the lesions. The lobulated, wing-like structure in GA may resemble diffuse GA or a dense lymphocytic infiltrate as seen on histology. The rounded structure in GA may represent an actual granuloma or either diffuse GA or a dense lymphocytic infiltrate as described above. This case suggests that OCT images granulomatous tissue as absorbent, hyporeflective areas, and urate crystals appear as reflective areas, obscuring the underlying tissue. In GA a new image shape looking like a wing has been found. The frequency, specificity and sensitivity of this new pattern in OCT imaging will require further studies. PMID:22493578

  6. Automated segmentation of chronic stroke lesions using LINDA: Lesion identification with neighborhood data analysis.

    PubMed

    Pustina, Dorian; Coslett, H Branch; Turkeltaub, Peter E; Tustison, Nicholas; Schwartz, Myrna F; Avants, Brian

    2016-04-01

    The gold standard for identifying stroke lesions is manual tracing, a method that is known to be observer dependent and time consuming, thus impractical for big data studies. We propose LINDA (Lesion Identification with Neighborhood Data Analysis), an automated segmentation algorithm capable of learning the relationship between existing manual segmentations and a single T1-weighted MRI. A dataset of 60 left hemispheric chronic stroke patients is used to build the method and test it with k-fold and leave-one-out procedures. With respect to manual tracings, predicted lesion maps showed a mean dice overlap of 0.696 ± 0.16, Hausdorff distance of 17.9 ± 9.8 mm, and average displacement of 2.54 ± 1.38 mm. The manual and predicted lesion volumes correlated at r = 0.961. An additional dataset of 45 patients was utilized to test LINDA with independent data, achieving high accuracy rates and confirming its cross-institutional applicability. To investigate the cost of moving from manual tracings to automated segmentation, we performed comparative lesion-to-symptom mapping (LSM) on five behavioral scores. Predicted and manual lesions produced similar neuro-cognitive maps, albeit with some discussed discrepancies. Of note, region-wise LSM was more robust to the prediction error than voxel-wise LSM. Our results show that, while several limitations exist, our current results compete with or exceed the state-of-the-art, producing consistent predictions, very low failure rates, and transferable knowledge between labs. This work also establishes a new viewpoint on evaluating automated methods not only with segmentation accuracy but also with brain-behavior relationships. LINDA is made available online with trained models from over 100 patients. PMID:26756101

  7. Ultraviolet B radiation-induced DNA lesions in mouse epidermis: an assessment using a novel 32P-postlabelling technique.

    PubMed

    Chatterjee, M L; Agarwal, R; Mukhtar, H

    1996-12-13

    Ultraviolet B (UVB) component of the sunlight is the major cause of nonmelanoma skin cancer (NMSC) in humans. UVB is absorbed directly by cellular DNA and produces lesions that may cause mutation(s) in target gene(s) ultimately leading to cancer. Early detection of these lesions, therefore, may help to identify individuals at a high risk to develop NMSC, and devise approaches for the prevention of this common malignancy. Employing mouse skin as a model, we applied a 32P postlabelling method to detect UVB-induced DNA lesions in the epidermis in nanomole quantities. Autoradiography maps showed that epidermal DNA from UVB exposed mice at 24 h contain up to five DNA lesions; the quantitation of these lesions showed that their formation increased in a UVB dose-dependent manner. Treatment of DNA samples with the bacteriophage DNA repair enzyme T4 endonuclease V confirmed that four of these lesions are pyrimidine dimers. While, some of these lesions were repaired 18 h after UVB irradiation, 30% of them persisted even 48 h post-irradiation. Application of a sunscreen containing ethylhexyl-p-methoxycinnamate or chemopreventive agent green tea polyphenols or silymarin to the skin of the mice prior to UVB exposure was found to prevent the formation of pyrimidine dimers. PMID:8954942

  8. Vestibular-induced vomiting after vestibulocerebellar lesions

    NASA Technical Reports Server (NTRS)

    Miller, A. D.; Wilson, V. J.

    1982-01-01

    Vestibular stimulation, by sinusoidal electrical polarization of the labyrinths of decerebrate cats which can produce vomiting and related activity which resembles motion sickness was examined. The symptoms include panting, salivation, swallowing, and retching as well as vomiting. These symptoms can be produced in cats with lesions of the posterior cerebellar vermis. It is suggested that a transcerebellar pathway from the vestibular apparatus through the nodulus and uvula to the vomiting center is not essential for vestibular induced vomiting and the occurrence of many symptoms of motion.

  9. Morel-lavallee lesion in children

    PubMed Central

    2013-01-01

    Morel-Lavallee lesion (MLL) is a closed degloving injury resulting from blunt shearing or tangential forces. In this condition, hemolymph is collected in the closed space between the separated subcutaneous tissue and the underlying fascia. The clinical manifestation of MLL varies from soft fluctuant swelling to skin necrosis or wound sepsis. Due to its inconsistent clinical manifestations and delayed onset, it is rarely described. We present a case of a 28-month-old child who developed delayed MLL arising from pelvic fracture after a motor vehicle accident. In addition, we provide a review of MLL and describe rare cases of it in children. PMID:24377750

  10. Vestibular-induced vomiting after vestibulocerebellar lesions

    NASA Technical Reports Server (NTRS)

    Miller, A. D.; Wilson, V. J.

    1983-01-01

    Vestibular stimulation, by sinusoidal electrical polarization of the labyrinths of decerebrate cats which can produce vomiting and related activity which resembles motion sickness was examined. The symptoms include panting, salivation, swallowing, and retching as well as vomiting. These symptoms can be produced in cats with lesions of the posterior cerebellar vermis. It is suggested that a transcerebellar pathway from the vestibular apparatus through the nodulus and uvula to the vomiting center is not essential for vestibular induced vomiting and the occurrence of many symptoms of motion.

  11. Aorta Atherosclerosis Lesion Analysis in Hyperlipidemic Mice

    PubMed Central

    Mohanta, Sarajo; Yin, Changjun; Weber, Christian; Hu, Desheng; Habenicht, Andreas JR

    2016-01-01

    Atherosclerosis is a chronic inflammatory disease of large and medium-sized arteries. Apolipoprotein E-deficient (ApoE-/-) mice are used as experimental models to study human atherosclerosis. ApoE-/- mice are constitutively hyperlipidemic and develop intima plaques that resemble human plaques. Various issues including experimental design for lesion analysis, dietary conditions, isolation of the aorta, staining methods, morphometry, group size, age, the location within the arterial tree, and statistical analyses are important parameters that need to be addressed to obtain robust data. Here, we provide detailed methods to quantify aorta atherosclerosis. PMID:27366759

  12. A lesion stabilization method for coronary angiography.

    PubMed

    Robert, Normand; Komljenovic, Philip T; Grant, Ryan; Sussman, Marshall S; Rowlands, J A

    2005-03-21

    A method to make a coronary artery segment of interest appear stationary when viewing a sequence of angiographic images is proposed. The purpose of this method is to facilitate the assessment of lesions caused by coronary artery disease by improving detectability. A description of the stabilization algorithm based on template matching is given. Stabilization was performed on 41 clinical coronary angiograms exhibiting various stenoses and was successful in 39/41 cases. A quantitative analysis of stabilization errors was performed by introducing simulated moving vessels of decreasing contrast into sequences of clinical images. PMID:15798323

  13. A lesion stabilization method for coronary angiography

    NASA Astrophysics Data System (ADS)

    Robert, Normand; Komljenovic, Philip T.; Grant, Ryan; Sussman, Marshall S.; Rowlands, J. A.

    2005-03-01

    A method to make a coronary artery segment of interest appear stationary when viewing a sequence of angiographic images is proposed. The purpose of this method is to facilitate the assessment of lesions caused by coronary artery disease by improving detectability. A description of the stabilization algorithm based on template matching is given. Stabilization was performed on 41 clinical coronary angiograms exhibiting various stenoses and was successful in 39/41 cases. A quantitative analysis of stabilization errors was performed by introducing simulated moving vessels of decreasing contrast into sequences of clinical images.

  14. Chemical and Radiation-Associated Jaw Lesions.

    PubMed

    Omolehinwa, Temitope T; Akintoye, Sunday O

    2016-01-01

    Osteonecrosis of the jaw is a major public health concern throughout the world. Use of radiotherapy for head and neck cancer and bone antiresorptives and antiangiogenic agents have increased its incidence. Medication-related osteonecrosis of the jaw is more common relative to other types of osteonecrosis. Osteoradionecrosis occurs despite better treatment planning and shielding to minimize collateral damage to bone. Other related necrotic lesions are secondary to usage of recreational drugs and steroids. This article provides comprehensive information about these different types of bone necrosis; provides the readers with radiographic diagnostic criteria and updates on current theories on pathophysiology of osteonecrosis. PMID:26614957

  15. Monte Carlo modeling of pigmented lesions

    NASA Astrophysics Data System (ADS)

    Gareau, Daniel; Jacques, Steven; Krueger, James

    2014-03-01

    Colors observed in clinical dermoscopy are critical to diagnosis but the mechanisms that lead to the spectral components of diffuse reflectance are more than meets the eye: combinations of the absorption and scattering spectra of the biomolecules as well as the "structural color" effect of skin anatomy. We modeled diffuse remittance from skin based on histopathology. The optical properties of the tissue types were based on the relevant chromophores and scatterers. The resulting spectral images mimic the appearance of pigmented lesions quite well when the morphology is mathematically derived but limited when based on histopathology, raising interesting questions about the interaction between various wavelengths with various pathological anatomical features.

  16. Cryotherapy for treatment of oral lesions.

    PubMed

    Farah, C S; Savage, N W

    2006-03-01

    Cryotherapy is the deliberate destruction of tissue by application of extreme cold. It is well received by patients due to a relative lack of discomfort, the absence of bleeding and minimal to no scarring after healing. It has many applications in oral medicine and clinical oral pathology, and is extremely usefu in patients for whom surgery is contra-indicated due to either age or medical history. In this paper we outline the principles, mechanisms of action, and current applications of cryotherapy in the treatment of oral lesions, and present some clinical cases. PMID:16669469

  17. Hematolymphoid lesions of the sinonasal tract.

    PubMed

    Crane, Genevieve M; Duffield, Amy S

    2016-03-01

    Various hematolymphoid lesions involve the sinonasal tract, including aggressive B, T, and NK-cell neoplasms; myeloid sarcoma; low-grade lymphomas; indolent T-lymphoblastic proliferations; and Rosai-Dorfman disease. Differentiating aggressive lymphomas from non-hematopoietic neoplasms such as poorly differentiated squamous cell carcinoma, olfactory neuroblastoma, or sinonasal undifferentiated carcinoma may pose diagnostic challenges. In addition, the necrosis, vascular damage, and inflammatory infiltrates that are associated with some hematolymphoid disorders can result in misdiagnosis as infectious, autoimmune, or inflammatory conditions. Here, we review hematolymphoid disorders involving the sinonasal tract including their key clinical and histopathologic features. PMID:26472692

  18. Combination of Autofluorescence imaging and salivary protoporphyrin in Oral precancerous and cancerous lesions: Non-invasive tools

    PubMed Central

    Jacobs, Reinhilde

    2015-01-01

    Background Normal and cancerous tissues have distinct auto-fluorescence properties because of differences in their biophysical and biochemical agents. Scientific evidences related to diagnostic fluorescence imaging for detection of oral precancerous and cancerous lesions are very limited. Objectives The aim of this study was to find out potential relationships between serum, salivary and tissue protoporphyrin IX ( PX) levels in subjects with or without oral precancerous and cancerous lesions. Also , to find out diagnostic value of fluorescence imaging (VELscope® system , LED Dental Inc., White Rock, B.C.) and salivary protoporphyrin IX (PX) in oral precancerous and cancerous lesions. Furthermore this study attempts to find out diagnostic value of the combination of approaches of fluorescence imaging and salivary protoporphyrin for detection of oral precancerous and cancerous lesions. Material and Methods The study sample comprised 3 test groups, with biopsy confirmed precancerous (leukoplakia and lichen planus) and cancerous lesions (squamous cell carcinoma) and one control group of 25 healthy individuals. To find out sensitivity and specificity, another 100 patients presenting for routine dental care were selected and clinical examinations were followed by fluorescence imaging and normal photography, which were finally confirmed by biopsy. The clinical and histopathogical examinations were done in conjunction with photography of the oral cavity using digital camera and fluorescence imaging. Serum, tissue and salivary protoporphyrin (PX) levels were measured. Results Using fluorescence imaging, oral cancerous and precancerous lesions showed deep purple to deep brown and dark green colour respectively, while normal tissues showed pale green colour in contrast. The PX levels in serum, salivary and tissues were significantly higher in precancerous and cancerous lesions as compared to normal healthy tissues. Salivary and serum PX levels were highly correlated in all

  19. Dental students' ability to detect and diagnose oral mucosal lesions.

    PubMed

    Ali, Mohammad A; Joseph, Bobby K; Sundaram, Devipriya B

    2015-02-01

    The aim of this study was to assess the ability of dental students in the screening clinic of the Kuwait University Dental Center to detect and diagnose oral mucosal lesions. Clinical examinations performed by dental students between January 2009 and February 2011 were included. All their findings regarding the oral mucosal lesions and dental carious lesions detected were recorded, after which the patients were re-examined by faculty examiners. The students rated their own ability to detect mucosal and carious lesions before each examination. Among the 341 patients screened, 375 oral mucosal lesions were found by the faculty examiners. Of those, the students detected 178 (47.5%). Out of the 375 lesions, including the ones they failed to detect, the students diagnosed 272 (72.5%) correctly. The students were more likely (p≤0.01) to correctly diagnose a mucosal lesion when they themselves had detected it (n=169/178) than when they failed to detect it and had it subsequently pointed out by the faculty examiners (n=103/197). The students were more competent in detecting carious lesions (p≤0.001) than in detecting mucosal lesions. A significantly higher proportion of students who felt confident in detecting mucosal lesions were actually more competent in detecting the lesions than those who were not confident (p≤0.001). Further educational strategies are needed to motivate Kuwait University dental students to develop the knowledge, skills, and judgment necessary to integrate a complete intraoral examination into their routine practice. PMID:25640618

  20. Detection of endometrial lesions by degree of linear polarization maps

    NASA Astrophysics Data System (ADS)

    Kim, Jihoon; Fazleabas, Asgerally; Walsh, Joseph T.

    2010-02-01

    Endometriosis is one of the most common causes of chronic pelvic pain and infertility and is characterized by the presence of endometrial glands and stroma outside of the uterine cavity. A novel laparoscopic polarization imaging system was designed to detect endometriosis by imaging endometrial lesions. Linearly polarized light with varying incident polarization angles illuminated endometrial lesions. Degree of linear polarization image maps of endometrial lesions were constructed by using remitted polarized light. The image maps were compared with regular laparoscopy image. The degree of linear polarization map contributed to the detection of endometriosis by revealing structures inside the lesion. The utilization of rotating incident polarization angle (IPA) for the linearly polarized light provides extended understanding of endometrial lesions. The developed polarization system with varying IPA and the collected image maps could provide improved characterization of endometrial lesions via higher visibility of the structure of the lesions and thereby improve diagnosis of endometriosis.

  1. Discrimination of retinal images containing bright lesions using sparse coded features and SVM.

    PubMed

    Sidibé, Désiré; Sadek, Ibrahim; Mériaudeau, Fabrice

    2015-07-01

    Diabetic Retinopathy (DR) is a chronic progressive disease of the retinal microvasculature which is among the major causes of vision loss in the world. The diagnosis of DR is based on the detection of retinal lesions such as microaneurysms, exudates and drusen in retinal images acquired by a fundus camera. However, bright lesions such as exudates and drusen share similar appearances while being signs of different diseases. Therefore, discriminating between different types of lesions is of interest for improving screening performances. In this paper, we propose to use sparse coding techniques for retinal images classification. In particular, we are interested in discriminating between retinal images containing either exudates or drusen, and normal images free of lesions. Extensive experiments show that dictionary learning techniques can capture strong structures of retinal images and produce discriminant descriptors for classification. In particular, using a linear SVM with the obtained sparse coded features, the proposed method achieves superior performance as compared with the popular Bag-of-Visual-Word approach for image classification. Experiments with a dataset of 828 retinal images collected from various sources show that the proposed approach provides excellent discrimination results for normal, drusen and exudates images. It achieves a sensitivity and a specificity of 96.50% and 97.70% for the normal class; 99.10% and 100% for the drusen class; and 97.40% and 98.20% for the exudates class with a medium size dictionary of 100 atoms. PMID:25935125

  2. Remote optical configuration of pigmented lesion detection and diagnosis of bone fractures

    NASA Astrophysics Data System (ADS)

    Ozana, Nisan; Bishitz, Yael; Beiderman, Yevgeny; Garcia, Javier; Zalevsky, Zeev; Schwarz, Ariel

    2016-02-01

    In this paper we present a novel approach of realizing a safe, simple, and inexpensive sensor applicable to bone fractures and pigmented lesions detection. The approach is based on temporal tracking of back-reflected secondary speckle pattern generated while illuminating the affected area with a laser and applying periodic pressure to the surface via a controlled vibration. The use of such a concept was already demonstrated for non-contact monitoring of various bio-medical parameters such as heart rate, blood pulse pressure, concentration of alcohol and glucose in the blood stream and intraocular pressure. The presented technique is a safe and effective method of detecting bone fractures in populations at risk. When applied to pigmented lesions, the technique is superior to visual examination in avoiding many false positives and resultant unnecessary biopsies. Applying a series of different vibration frequencies at the examined tissue and analyzing the 2-D speckle pattern trajectory in response to the applied periodic pressure creates a unique signature for each and different pigmented lesion. Analyzing these signatures is the first step toward detection of malignant melanoma. In this paper we present preliminary experiments that show the validity of the developed sensor for both applications: the detection of damaged bones as well as the classification of pigmented lesions.

  3. The Immune Landscapes of Polypoid and Nonpolypoid Precancerous Colorectal Lesions

    PubMed Central

    Staiano, Teresa; Bertoni, Ramona; Ancona, Nicola; Marra, Giancarlo; Resta, Leonardo

    2016-01-01

    Little is known about the immunoediting process in precancerous lesions. We explored this aspect of benign colorectal adenomas with a descriptive analysis of the immune pathways and immune cells whose regulation is linked to the morphology and size of these lesions. Two series of polypoid and nonpolypoid colorectal adenomas were used in this study: 1) 84 samples (42 lesions, each with matched samples of normal mucosa) whose gene expression data were used to quantify the tumor morphology- and size-related dysregulation of immune pathways collected in the Molecular Signature Database, using Gene Set Enrichment Analysis; 2) 40 other lesions examined with immunohistochemistry to quantify the presence of immune cells in the stromal compartment. In the analysis of transcriptomic data, 429 immune pathways displayed significant differential regulation in neoplasms of different morphology and size. Most pathways were significantly upregulated or downregulated in polypoid lesions versus nonpolypoid lesions (regardless of size). Differential pathway regulation associated with lesion size was observed only in polypoid neoplasms. These findings were mirrored by tissue immunostaining with CD4, CD8, FOXP3, MHC-I, CD68, and CD163 antibodies: stromal immune cell counts (mainly T lymphocytes and macrophages) were significantly higher in polypoid lesions. Certain markers displayed significant size-related differences regardless of lesion morphology. Multivariate analysis of variance showed that the marker panel clearly discriminated between precancerous lesions of different morphologies and sizes. Statistical analysis of immunostained cell counts fully support the results of the transcriptomic data analysis: the density of infiltration of most immune cells in the stroma of polypoid precancerous lesions was significantly higher than that observed in nonpolypoid lesions. Large neoplasms also have more immune cells in their stroma than small lesions. Immunoediting in precancerous

  4. Automatic ultrasonic breast lesions detection using support vector machine based algorithm

    NASA Astrophysics Data System (ADS)

    Yeh, Chih-Kuang; Miao, Shan-Jung; Fan, Wei-Che; Chen, Yung-Sheng

    2007-03-01

    evaluate the performance of our approach. Several types of cysts with different contours and contrast resolutions images were simulated with speckle characteristics. Four thousand sub-images of tumor objects and speckle-noised background were used for SVM training. Comparison with conventional algorithms such as active contouring, the proposed algorithm does not need to position any initial seed point within the lesion and is able to detect simultaneously multiple irregular shape lesions in a single image, thus it can be regarded as a fully automatic process. The results show that the mean normalized true positive area overlap between true contour and contour obtained by the proposed approach is 90%.

  5. Detecting circumscribed lesions with the Hough transform

    SciTech Connect

    Groshong, B.R; Kegelmeyer, W.P., Jr

    1996-01-11

    We have designed and implemented a circumscribed lesion detection algorithm, based on the Hough Transform, which will detect zero or more approximately circular structures in a mammogram over a range of radii from a few pixels to nearly the size of the breast. We address the geometrical behavior of peaks in Hough parameter space (x,y,r) for both the true radius of a circular structure in the image (r = r{sub o}), and for the parameter r as it passes through this radius. In addition, we evaluate peaks in Hough parameter space by re-analyzing the underlying mammogram in the vicinity of the circular disk indicated by the peak. Discs suggested by the resulting peaks are accumulated in a feature image, scaled by a measure of their quality. These results are then rectified with respect to image contrast extremes and average value. The result is a feature with a continuously scaled pixel level output which suggests the likelihood that a pixel is located inside a circular structure, irrespective of the radius of the structure and overall mammogram contrast. These features are evaluated fast qualitative and quantitative performance metrics which permit circumscribed lesion detection features to be initially evaluated without a full end-to-end classification experiment.

  6. Lesion mapping of social problem solving

    PubMed Central

    Colom, Roberto; Paul, Erick J.; Chau, Aileen; Solomon, Jeffrey; Grafman, Jordan H.

    2014-01-01

    Accumulating neuroscience evidence indicates that human intelligence is supported by a distributed network of frontal and parietal regions that enable complex, goal-directed behaviour. However, the contributions of this network to social aspects of intellectual function remain to be well characterized. Here, we report a human lesion study (n = 144) that investigates the neural bases of social problem solving (measured by the Everyday Problem Solving Inventory) and examine the degree to which individual differences in performance are predicted by a broad spectrum of psychological variables, including psychometric intelligence (measured by the Wechsler Adult Intelligence Scale), emotional intelligence (measured by the Mayer, Salovey, Caruso Emotional Intelligence Test), and personality traits (measured by the Neuroticism-Extraversion-Openness Personality Inventory). Scores for each variable were obtained, followed by voxel-based lesion–symptom mapping. Stepwise regression analyses revealed that working memory, processing speed, and emotional intelligence predict individual differences in everyday problem solving. A targeted analysis of specific everyday problem solving domains (involving friends, home management, consumerism, work, information management, and family) revealed psychological variables that selectively contribute to each. Lesion mapping results indicated that social problem solving, psychometric intelligence, and emotional intelligence are supported by a shared network of frontal, temporal, and parietal regions, including white matter association tracts that bind these areas into a coordinated system. The results support an integrative framework for understanding social intelligence and make specific recommendations for the application of the Everyday Problem Solving Inventory to the study of social problem solving in health and disease. PMID:25070511

  7. Malignant skin lesions in Oshogbo, Nigeria

    PubMed Central

    Oseni, Ganiyu Oyediran; Olaitan, Peter Babatunde; Komolafe, Akinwumi Oluwole; Olaofe, Olaejirinde Olaniyi; Akinyemi, Hezekiah Adebola Morakinyo; Suleiman, Oreoluwa Adeola

    2015-01-01

    Introduction The aim of this study is to retrospectively assess the prevalence of some of skin malignancies in our environment and to provide a data base for creating awareness for prevention and early detection of the diseases in order to reduce morbidity and mortality associated with these skin lesions in our environment. Methods This is a retrospective study of all histologically diagnosed malignant skin lesions which presented at Ladoke Akintola University of Technology Teaching Hospital Osogbo Osun State between January 2006 and December 2010. Results Ninety- eight patients presented with skin cancers out of which 60 (61.2%)were males and 38 (38.8%) were females. Malignant melanoma ranked highest followed by squamous cell carcinoma, dermatofibrosarcoma and basal cell carcinoma in that order. Malignant melanoma affects male more than female and it commonly affects lower limbs. Conclusion Skin malignancies pose a burden to the economy of the country. Efforts should be directed toward prevention, early diagnosis and management in order to abolish or reduce morbidity, as well as mortality associated with late presentation of people in the developing countries. PMID:26161176

  8. Bilateral dorsolateral thalamic lesions disrupts conscious recollection.

    PubMed

    Edelstyn, Nicola M J; Hunter, Ben; Ellis, Simon J

    2006-01-01

    In an earlier study we disputed the claim that the mediodorsal thalamic nucleus is critical for familiarity. We reported patient (QX) who showed a severe deficit in conscious recollection, and behavioural problems (disinhibition, emotional lability) with relative sparing of familiarity-aware memory following a left mediodorsal thalamic lesion. More recent MR imaging has revealed that QX's lesions are more extensive than previously reported and involve both dorsolateral thalamic nuclei, and whilst there is evidence of left mediodorsal thalamic damage, it is not the main focus of damage. This paper reports a full analysis of QX's thalamic pathology alongside a more detailed investigation of his recognition memory, using yes/no and forced-choice procedures, and executive function. The results revealed impairments in yes/no recognition and conscious recollection rates of famous, artist and unknown names. In addition to the previously noted behavioural disinhibition and emotional lability, a deficit in spontaneous planning ability was evident on the Zoo Map Test (subtest of the Bahavioural Assessment of the Dysexecutive Syndrome). Forced-choice recognition, familiarity estimates and remote memory showed higher levels of preservation. The findings indicate that the dorsolateral thalamus is part of the extended hippocampal circuit which is causally critical only for recall and conscious recollection of complex associations rather than for the more automatic processes linked with novelty detection. PMID:16253293

  9. Controversies in the treatment of patients with STEMI and multivessel disease: is it time for PCI of all lesions?

    PubMed

    Ong, Peter; Sechtem, Udo

    2016-06-01

    Several randomized trials have suggested a benefit for multivessel PCI in patients with STEMI and multivessel disease. However, none of the studies compared multivessel PCI with a staged PCI-approach which is the current guideline recommended approach. The results of the trials may overestimate the beneficial effect of the multivessel PCI approach because the control group did not receive any ischaemia testing for evaluation of the significance of remaining lesions. Thus, unfavourable aspects of the multivessel PCI approach such as overestimation of non-culprit lesions at the time of acute coronary angiography, complications associated with PCI of the non-culprit lesion (i.e. dissection, no-reflow, acute stent thrombosis) or increased risk for contrast induced nephropathy may have gone unnoticed as the comparative management pathway was unusual and likely inferior to the guideline recommended approach. We believe that culprit lesion only PCI and staged evaluation of remaining areas of myocardial ischaemia with subsequent PCI is still preferable in patients with STEMI and multivessel disease but a randomized study comparing this approach with multivessel PCI is needed. PMID:26850062

  10. Endovascular strategies for treatment of embolizing thoracoabdominal aortic lesions

    PubMed Central

    Jeyabalan, Geetha; Wallace, Justin R.; Chaer, Rabih Antoine; Leers, Steven A.; Marone, Luke Keith; Makaroun, Michel S.

    2014-01-01

    Objective Aortic sources of peripheral and visceral embolization remain challenging to treat. The safety of stent graft coverage continues to be debated. This study reports the outcomes of stent coverage of these complex lesions. Methods Hospital records were retrospectively reviewed for patients undergoing aortic stenting between 2006 and 2013 for visceral and peripheral embolic disease. Renal function, method of coverage, and mortality after stent grafting were reviewed. Results Twenty-five cases of embolizing aortic lesions treated with an endovascular approach were identified. The mean age was 65 ± 13 years (range, 45–87 years), and 64% were female. Sixteen (64%) patients presented with peripheral embolic events, six with concomitant renal embolization. Five patients presented with abdominal or flank pain, and two were discovered incidentally. Three patients had undergone an endovascular procedure for other indications within the preceding 6 months of presentation. Nineteen patients had existing chronic kidney disease (stage II or higher), but only three had stage IV disease. Of the eight patients tested, four had a diagnosed hypercoagulable state. Eight of the patients had lesions identified in multiple aortic segments, and aortic aneurysm disease was present in 24%. Coverage of both abdominal and thoracic sources occurred in eight patients, whereas 17 had only one segment covered. Minimal intraluminal catheter and wire manipulation was paired with the use of intravascular ultrasound in an effort to reduce embolization and contrast use. Intravascular ultrasound was used in the majority of cases and transesophageal echo in 28% of patients. Two patients with stage IV kidney disease became dialysis-dependent within 3 months of the procedure. No other patients had an increase in their postoperative or predischarge serum creatinine levels. No embolic events were precipitated during the procedure, nor were there any recurrent embolic events detected on follow

  11. Functional MRI Preprocessing in Lesioned Brains: Manual Versus Automated Region of Interest Analysis

    PubMed Central

    Garrison, Kathleen A.; Rogalsky, Corianne; Sheng, Tong; Liu, Brent; Damasio, Hanna; Winstein, Carolee J.; Aziz-Zadeh, Lisa S.

    2015-01-01

    Functional magnetic resonance imaging (fMRI) has significant potential in the study and treatment of neurological disorders and stroke. Region of interest (ROI) analysis in such studies allows for testing of strong a priori clinical hypotheses with improved statistical power. A commonly used automated approach to ROI analysis is to spatially normalize each participant’s structural brain image to a template brain image and define ROIs using an atlas. However, in studies of individuals with structural brain lesions, such as stroke, the gold standard approach may be to manually hand-draw ROIs on each participant’s non-normalized structural brain image. Automated approaches to ROI analysis are faster and more standardized, yet are susceptible to preprocessing error (e.g., normalization error) that can be greater in lesioned brains. The manual approach to ROI analysis has high demand for time and expertise, but may provide a more accurate estimate of brain response. In this study, commonly used automated and manual approaches to ROI analysis were directly compared by reanalyzing data from a previously published hypothesis-driven cognitive fMRI study, involving individuals with stroke. The ROI evaluated is the pars opercularis of the inferior frontal gyrus. Significant differences were identified in task-related effect size and percent-activated voxels in this ROI between the automated and manual approaches to ROI analysis. Task interactions, however, were consistent across ROI analysis approaches. These findings support the use of automated approaches to ROI analysis in studies of lesioned brains, provided they employ a task interaction design. PMID:26441816

  12. Voxel-based lesion-symptom mapping of stroke lesions underlying somatosensory deficits

    PubMed Central

    Meyer, Sarah; Kessner, Simon S.; Cheng, Bastian; Bönstrup, Marlene; Schulz, Robert; Hummel, Friedhelm C.; De Bruyn, Nele; Peeters, Andre; Van Pesch, Vincent; Duprez, Thierry; Sunaert, Stefan; Schrooten, Maarten; Feys, Hilde; Gerloff, Christian; Thomalla, Götz; Thijs, Vincent; Verheyden, Geert

    2015-01-01

    The aim of this study was to investigate the relationship between stroke lesion location and the resulting somatosensory deficit. We studied exteroceptive and proprioceptive somatosensory symptoms and stroke lesions in 38 patients with first-ever acute stroke. The Erasmus modified Nottingham Sensory Assessment was used to clinically evaluate somatosensory functioning in the arm and hand within the first week after stroke onset. Additionally, more objective measures such as the perceptual threshold of touch and somatosensory evoked potentials were recorded. Non-parametric voxel-based lesion-symptom mapping was performed to investigate lesion contribution to different somatosensory deficits in the upper limb. Additionally, structural connectivity of brain areas that demonstrated the strongest association with somatosensory symptoms was determined, using probabilistic fiber tracking based on diffusion tensor imaging data from a healthy age-matched sample. Voxels with a significant association to somatosensory deficits were clustered in two core brain regions: the central parietal white matter, also referred to as the sensory component of the superior thalamic radiation, and the parietal operculum close to the insular cortex, representing the secondary somatosensory cortex. Our objective recordings confirmed findings from clinical assessments. Probabilistic tracking connected the first region to thalamus, internal capsule, brain stem, postcentral gyrus, cerebellum, and frontal pathways, while the second region demonstrated structural connections to thalamus, insular and primary somatosensory cortex. This study reveals that stroke lesions in the sensory fibers of the superior thalamocortical radiation and the parietal operculum are significantly associated with multiple exteroceptive and proprioceptive deficits in the arm and hand. PMID:26900565

  13. Prevalence of lip lesions in an Indian population

    PubMed Central

    Maheshwari, Sneha

    2014-01-01

    Objectives: Lip lesions are a frequent cause of consultation in dentistry, as they comprise a significant proportion of the oral lesions. The aim of the present study was to identify the different lip lesions and determine their prevalence in an Indian population. Material and Methods: 5231 patients visiting a Department of Oral Medicine and Radiology were examined for the presence of different lip lesions during the period from October, 2011 to May, 2013. The statistical analysis was done using Chi-square test and p<0.05 was considered to be statistically significant. Results: The age of the patients ranged from 8-70 years with a mean age of 32.6 years. The prevalence of lip lesions was 18.8%. The most commonly diagnosed lesions were those due to infections, which affected 32.6% of the population, followed by mucocele (29.8%) and premalignant lesions and conditions which were observed in 20.6% of the population. Males were more commonly affected than females. Conclusions: The relatively high prevalence of the lip lesions suggests dental practitioners and health care workers to educate the patients and create more awareness regarding them. The dentists should have adequate knowledge about the etiology, clinical features, diagnosis and management of the lip lesions. Key words: Lip, lesions, India, prevalence. PMID:25593659

  14. Prevalence of tongue lesions in the Indian population

    PubMed Central

    Kaswan, Sumita; Rahman, Farzan; Doni, Bharati

    2013-01-01

    Objective: Tongue lesions are a health concern for the dental practitioners and the patients as they constitute a significant proportion of oral mucosal lesions. The aim of the present study was to determine the prevalence of various tongue lesions in the Indian population. Material and methods: 4926 patients attending the Department of Oral Medicine and Radiology were examined for the presence of various tongue lesions during the period from October, 2010 to September, 2012. The age of the patients ranged from 12-80 years with a mean age of 36.51 years. Results: The prevalence of tongue lesions was 12.07%. The most common lesion diagnosed was coated tongue affecting 28.0% of the subjects, followed by geographic tongue (16.4%), fissured tongue (14.9%) and depapillated tongue (11.5%). Males were more frequently affected than females. The most common systemic condition observed in the patients with tongue lesions was anaemia (189), followed by hypertension (47) and diabetes mellitus (38). Conclusion: The high prevalence necessitates adequate awareness of the various tongue lesions in the general population. The dental clinicians should also be knowledgeable about the etiopathogenesis, clinical presentation, diagnosis, and treatment of these lesions. Key words:Tongue lesions, prevalence, Indian population, coated tongue. PMID:24455067

  15. Hock lesion epidemiology in cubicle housed dairy cows across two breeds, farming systems and countries.

    PubMed

    Brenninkmeyer, Christine; Dippel, Sabine; Brinkmann, Jan; March, Solveig; Winckler, Christoph; Knierim, Ute

    2013-05-01

    This cross-sectional study examined various aspects of cubicle design and management in terms of their potential as risk factors for hock lesions, using an epidemiological approach. Cubicle dairy farms in Germany and Austria with Holstein Friesian or Simmental cows were visited during the winter housing season. 105 farms and 3691 cows were included in the analysis which consisted of three steps: bifactorial regression, regression trees and multiple linear regression. The mean farm prevalence of hock lesions, i.e. scabs, wounds, and swellings was 50%, with a range from 0 to 100%. The final model contained eight factors which were largely related to lying comfort and explained 75% of the variance. The presence of a curb turned out to be the most influential beneficial factor. Additionally, there were fewer hock lesions when cows were housed with deep bedded cubicles compared to cubicles without deep bedding. Other factors in the regression model were softness and length of the lying surface and height of free space under cubicle partitions, the proportion of overconditioned cows and a variable encoding three different combinations of region, husbandry system (organic and conventional) and breed. Independently from the risk factor model hock lesions were positively correlated with lameness at herd level as well as at animal level. This probably results from related risk factors for both conditions. It can be concluded that lying comfort of dairy cows should be improved in order to prevent hock lesions. In addition, preventive measures for hock lesions at the same time have a potential of reducing lameness and thus to improve cow welfare in several aspects. PMID:23174217

  16. Internal Carotid Artery Pseudoaneurysm after Tonsillectomy Treated by Endovascular Approach

    PubMed Central

    Raffin, C.N.; Montovani, J.C.; Neto, J.M.P.; Campos, C.M.S.; Piske, R.L.

    2002-01-01

    Summary Surgery on the head and neck region may be complicated by vascular trauma, caused by direct injury on the vascular wall. Lesions of the arteries are more dangerous than the venous one. The traumatic lesion may cause laceration of the artery wall, spasm, dissection, arteriovenous fistula, occlusion or pseudoaneurysm. We present a case of a child with a giant ICA pseudoaneurysm after tonsillectomy, manifested by pulsing mass and respiratory distress, which was treated by endovascular approach, occluding the lesion and the proximal artery with Histoacryl. We reinforce that the endovascular approach is the better way to treat most of the traumatic vascular lesions. PMID:20594516

  17. A classification of lesions around interventricular foramen and its clinical value

    PubMed Central

    Cai, Qiang; Wang, Jun; Wang, Long; Deng, Gang; Chen, Qianxue; Chen, Zhibiao

    2015-01-01

    Objectives: Lesions around interventricular foramen are difficult to remove for their important adjacent structures. We classify these tumors according their location on Magnetic Resonance Image (MRI) to help us resect these lesions. Methods: Thirty-two tumors around the interventricular foramen were studied according their location and anatomic relations in MRI. Results: Tumors around interventricular foramen were classified into three types. The first one mainly locates in lateral ventricle and the second one growth both in lateral ventricle, interventricular foramen and third ventricle, while the third one mainly in third ventricle. Different surgical approaches were adopted according their classification and the patients recovered well. Conclusion: This classification can help us to chose the surgical approach for these tumors. PMID:26617704

  18. PMMA Cementoplasty in Symptomatic Metastatic Lesions of the S1 Vertebral Body

    SciTech Connect

    Dehdashti, Amir R.; Martin, Jean-Baptiste; Jean, Beatrix; Ruefenacht, Daniel A.

    2000-03-15

    We describe a lateral transiliac direct puncture approach to the S1 vertebral body for polymethylmethacrylate (PMMA) cementoplasty of painful metastatic lesions. This approach was performed using a 15-cm-long trocar needle with 3-mm outer diameter, introduced under general anesthesia and fluoroscopic control. A lateral projection was used to center the needle just in front of the spinal canal and subjacent to the superior plate of the S1 vertebral body. Needle progression was controlled using anteroposterior and lateral fluoroscopic projections alternately with a needle course parallel to an axial plane, avoiding conflict with the S1 foramen. After needle tip placement in the center of the S1 vertebral body, diluted PMMA with a setting time of 8 min was delivered. Ipsilateral lesions of the lateral sacral compartment were filled with the same needle by stepwise withdrawal and continuous PMMA injection.

  19. Visualization of time-varying MRI data for MS lesion analysis

    NASA Astrophysics Data System (ADS)

    Tory, Melanie K.; Moeller, Torsten; Atkins, M. Stella

    2001-05-01

    Conventional methods to diagnose and follow treatment of Multiple Sclerosis require radiologists and technicians to compare current images with older images of a particular patient, on a slic-by-slice basis. Although there has been progress in creating 3D displays of medical images, little attempt has been made to design visual tools that emphasize change over time. We implemented several ideas that attempt to address this deficiency. In one approach, isosurfaces of segmented lesions at each time step were displayed either on the same image (each time step in a different color), or consecutively in an animation. In a second approach, voxel- wise differences between time steps were calculated and displayed statically using ray casting. Animation was used to show cumulative changes over time. Finally, in a method borrowed from computational fluid dynamics (CFD), glyphs (small arrow-like objects) were rendered with a surface model of the lesions to indicate changes at localized points.

  20. Treatment to sustain a Th17-type phenotype to prevent skewing toward Treg and to limit premalignant lesion progression to cancer.

    PubMed

    Young, M Rita I; Levingston, Corinne A; Johnson, Sara D

    2016-05-15

    While immune suppression is a hallmark of head and neck squamous cell carcinoma (HSNCC), the immunological impact of premalignant oral lesions, which often precedes development of HNSCC, is unknown. The present study assessed the changes in splenic and draining lymph node CD4(+) cell populations and their production of select cytokines that occur in mice with carcinogen-induced premalignant oral lesions and the changes that occur as lesions progress to oral cancer. These studies found skewing toward Th1 and Th17-type phenotypes in the spleen and lymph nodes of mice with premalignant oral lesions and a shift to Treg as lesions progress to cancer. Since the role of Th17 cells in the progression from premalignant lesions to cancer is not clear, studies determined the immunological and clinical effect of treating mice bearing premalignant oral lesions with a TGF-β type 1 receptor inhibitor plus IL-23 as an approach to sustain the Th17 phenotype. These studies showed that the treatment approach not only sustained the Th17 phenotype, but also increased distal spleen cell and regional lymph node cell production of other stimulatory/inflammatory mediators and slowed premalignant lesion progression to cancer. PMID:26756968