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Sample records for diagnostic des lesions

  1. 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

  2. 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...

  3. 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 ...

  4. Isolated sphenoid sinus lesion: A diagnostic dilemma

    PubMed Central

    Alazzawi, Sarmad; Shahrizal, Tengku; Prepageran, Narayanan; Pailoor, Jayalakshmi

    2014-01-01

    Isolated sphenoid sinus lesions are an uncommon entity and present with non-specific symptoms. In this case report, the patient presented with a history of headaches for a duration of one month without sinonasal symptoms. A computed tomography scan showed a soft tissue mass occupying the sphenoid sinus. An endoscopic biopsy revealed fungal infection. Endoscopic wide sphenoidotomy with excision of the sphenoid sinus lesion was then performed however, the microbiological examination post-surgery did not show any fungal elements. Instead, Citrobacter species was implicated to be the cause of infection. PMID:25320694

  5. Shearwave Elastography Increases Diagnostic Accuracy in Characterization of Breast Lesions

    PubMed Central

    Ng, Wei Lin; Rahmat, Kartini; Fadzli, Farhana; Rozalli, Faizatul Izza; Mohd-Shah, Mohammad Nazri; Chandran, Patricia Ann; Westerhout, Caroline Judy; Vijayananthan, Anushya; Abdul Aziz, Yang Faridah

    2016-01-01

    Abstract The purpose of this study was to investigate the diagnostic efficacy of shearwave elastography (SWE) in differentiating between benign and malignant breast lesions. One hundred and fifty-nine lesions were assessed using B-mode ultrasound (US) and SWE parameters were recorded (Emax, Emean, Emin, Eratio, SD). SWE measurements were then correlated with histopathological diagnosis. The final sample contained 85 benign and 74 malignant lesions. The maximum stiffness (Emax) with a cutoff point of ≥ 56.0 kPa (based on ROC curves) provided sensitivity of 100.0%, specificity of 97.6%, positive predictive value (PPV) of 97.4%, and negative predictive value (NPV) of 100% in detecting malignant lesions. A cutoff of ≥80 kPa managed to downgrade 95.5% of the Breast Imaging-Reporting and Data System (BI-RADS) 4a lesions to BI-RADS 3, negating the need for biopsy. Using a combination of BI-RADS and SWE, the authors managed to improve the PPV from 2.3% to 50% in BI-RADS 4a lesions. SWE of the breast provides highly specific and sensitive quantitative values that are beneficial in the characterization of breast lesions. Our results showed that Emax is the most accurate value for differentiating benign from malignant lesions. PMID:27015196

  6. Thermographic diagnostics to discriminate skin lesions: a clinical study

    NASA Astrophysics Data System (ADS)

    Stringasci, Mirian Denise; Moriyama, Lilian Tan; Salvio, Ana Gabriela; Bagnato, Vanderlei Salvador; Kurachi, Cristina

    2015-06-01

    Cancer is responsible for about 13% of all causes of death in the world. Over 7 million people die annually of this disease. In most cases, the survival rates are greater when diagnosed in early stages. It is known that tumor lesions present a different temperature compared with the normal tissues. Some studies have been performed in an attempt to establish new diagnosis methods, targeting this temperature difference. In this study, we aim to investigate the use of a handheld thermographic camera to discriminate skin lesions. The patients presenting Basal Cell Carcinoma, Squamous Cell Carcinoma, Actinic Keratosis, Pigmented Seborrheic Keratosis, Melanoma or Intradermal Nevus lesions have been investigated at the Skin Departament of Amaral Carvalho Hospital. Patients are selected by a dermatologist, and the lesion images are recorded using an infrared camera. The images are evaluated taken into account the temperature level, and differences into lesion areas, borders, and between altered and normal skin. The present results show that thermography may be an important tool for aiding in the clinical diagnostics of superficial skin lesions.

  7. Telomerase components as a diagnostic tool in human oral lesions.

    PubMed

    Sumida, T; Hamakawa, H; Sogawa, K; Sugita, A; Tanioka, H; Ueda, N

    1999-01-01

    Telomerase activity is considered to be a diagnostic marker of malignancy since most malignant cells express this activity and most somatic cells do not. However, the detection of telomerase activity is rather complicated and is affected by many factors. Recently, human telomerase components were cloned and found to consist of 3 subunits. We assessed which component of telomerase best correlates with malignancy in order to study the possibilities for developing a new diagnostic marker. Telomerase activity was measured by a telomeric repeat amplification protocol (TRAP) assay, and the telomerase components hTR, hTRT-mRNA and TP1-mRNA were detected by the reverse transcriptase-polymerase chain reaction (RT-PCR). Twenty-five of 26 oral malignant lesions, 9 of 22 benign lesions and none of 19 normal control tissues exhibited distinct telomerase activity. hTR and TP1-mRNA expression levels were detected in all malignant lesions and normal control tissues and had no significant correlation with the telomerase activity results. In contrast, hTRT-mRNA expression was closely associated with telomerase activity. All lesions expressing hTRT were telomerase positive. In addition, some samples of dysplastic lesions, benign tumors, lichen planus and normal mucosa exhibiting poor telomerase activity revealed weak expression of hTRT. Expression levels of hTRT-mRNA positively correlated with clinical and pathological findings. Detection of hTRT-mRNA by RT-PCR appeared to be more sensitive for telomerase than measurement of telomerase activity by the TRAP assay. Detection of hTRT-mRNA may provide information useful in the diagnosis of oral malignancies.

  8. Diagnostic criteria for mass lesions differentiating in electrical impedance mammography

    NASA Astrophysics Data System (ADS)

    A, Karpov; M, Korotkova

    2013-04-01

    The purpose of this research was to determine the diagnostic criteria for differentiating volumetric lesions in the mammary gland in electrical impedance mammography. The research was carried out utilizing the electrical impedance computer mammograph llMEIK v.5.6gg®, which enables to acquire images of 3-D conductivity distribution layers within mamma's tissues up to 5 cm depth. The weighted reciprocal projection method was employed to reconstruct the 3-D electric conductivity distribution of the examined organ. The results of 3,710 electrical impedance examinations were analyzed. The analysis of a volumetric lesion included assessment of its shape, contour, internal electrical structure and changes of the surrounding tissues. Moreover, mammary gland status was evaluated with the help of comparative and age-related electrical conductivity curves. The diagnostic chart is provided. Each criterion is measured in points. Using the numerical score for evaluation of mass and non-volumetric lesions within the mammary gland in electrical impedance mammography allowed comparing this information to BI-RADS categories developed by American College of Radiology experts. The article is illustrated with electrical impedance mammograms and tables.

  9. Bullous Skin Lesions in an Adult Male: A Diagnostic Dilemma

    PubMed Central

    Gulati, Gaurav; Siv, Jenny; Ware, Avis E.

    2015-01-01

    Patient: Male, 42 Final Diagnosis: Henoch-Schönlein Purpura (HSP) Symptoms: Bullous hemorrhagic lesions • elevated liver enzymes Medication: — Clinical Procedure: — Specialty: Rheumatology Objective: Unusual clinical course Background: Henoch-Schönlein Purpura (HSP) is an IgA small-vessel vasculitis that is primarily a disease of childhood. Its presentation in adulthood is rare and has a more severe disease course. We present a case with an atypical presentation of this disease that was a diagnostic challenge for multiple providers. Case Report: A 42-year-old man noticed bullous lesions over his ankles that spread to his entire legs over a few weeks. They later became necrotic and ulcerated areas. His primary care physician and 2 dermatologists could not reach a definitive diagnosis. He then presented to our hospital with new abdominal pain, rectal bleeding, and a new elevation in liver enzymes. A biopsy of his skin lesions led to the diagnosis of HSP. Conclusions: We discuss this highly unusual initial presentation with bullous skin lesions and liver enzyme abnormalities and explore the medical literature to understand its pathogenesis. Clinicians need to be aware of this rare presentation to avoid a delay in diagnosis and management. PMID:25858335

  10. Orocutaneous Fistula or Traumatic Infectious Skin Lesion: A Diagnostic Dilemma

    PubMed Central

    Vermani, Mayank; Kalia, Vimal; Singh, Sumita; Garg, Sunny; Aggarwal, Shweta; Khurana, Richa; Kalra, Geeta

    2015-01-01

    Orocutaneous fistula (OCF) (of dental origin) is an uncommon but well-described condition in the literature. These are often misdiagnosed by physicians and dentists. Careful selection of investigating modality is important in case of diagnostically challenging cases. A 19-year-old female came with a complaint of a lesion on the chin reported with h/o trauma with the impact on chin presented as diagnostic dilemma because of unusual case history and clinical examination. Commonly used radiographic investigations like IOPA and orthopantomograph did not resolve the dilemma whereas advanced imaging modality like CT scan, 3D volume imaging, and contrast enhanced CT played an important role in the diagnosis of OCF and selecting the treatment plan. PMID:26618009

  11. The Diagnostic Dilemma of Dieulafoy’s Lesion

    PubMed Central

    Khan, Rafay; Mahmad, Abdul; Gobrial, Mark; Onwochei, Francis; Shah, Kunal

    2015-01-01

    Dieulafoy’s lesion (DL) is a relatively rare condition which carries a significantly high risk for mortality. A tortuous large arteriole in the wall of the stomach can result in significant gastrointestinal (GI) hemorrhage which can result in detrimental complications. Although it only accounts for about 1% of all GI bleeding, it has been considered to be one of the most underrecognized conditions. This train of thought may unfortunately be related to the difficulty in its diagnosis. After conducting a Medline search of the medical literature, with a focus on current PubMed articles, a thorough examination of updated diagnostic and treatment approaches was compared. Diagnostic techniques in the analysis and treatment of DLs continue to be limited to this day. Endoscopy remains as the main diagnostic and therapeutic tool; however, it continues to have its limitations. Other alternatives include but are not limited to angiography and surgical interventions which at times can be more successful. Diagnostic improvements and research for the detection of DL continue to advance; however, they remain limited in their capabilities. Further analysis and workup needs to be conducted in order to reduce hospital stay and improve survival.

  12. 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

  13. [Diagnostic temporo-mandibular arthroscopy. Principle lesions, apropos of 50 case reports].

    PubMed

    Chossegros, C; Cheynet, F; Blanc, J L; Gola, R; Lachard, J

    1991-01-01

    Diagnostic arthroscopy is reserved to patients who suffer from internal temporo-mandibular joint derangements resisting to conservative treatments. This technique allows an acute diagnostic approach to the intra-articular lesions of the superior compartment.

  14. The Diagnostic Value of Superb Microvascular Imaging (SMI) in Detecting Blood Flow Signals of Breast Lesions

    PubMed Central

    Ma, Yan; Li, Gang; Li, Jing; Ren, Wei-dong

    2015-01-01

    Abstract The correlation between color Doppler flow imaging (CDFI) and Superb Microvascular Imaging (SMI) for detecting blood flow in breast lesions was investigated, as was the diagnostic value of SMI in differentiating benign from malignant breast lesions. These lesions were evaluated using both CDFI and SMI according to Adler's method. Pathologic examination showed 57 malignant lesions and 66 benign lesions. The number of blood vessels in a single mass was detected by 2 techniques (SMI and CDFI), and the difference between the 2 values (SMI-CDFI) was calculated. The optimal threshold for the diagnosis of malignant neoplasms and the diagnostic performances of SMI, CDFI, and SMI-CDFI were calculated. For the total lesions and malignant lesions alone, the difference between SMI and CDFI for detecting blood flow was significant (P < 0.01), but the difference was not significant for benign lesions (P = 0.15). The area under the receiver operating characteristic curve was 0.73 (95% confidence interval [CI]: 0.64–0.82) for CDFI; 0.81 (95% CI: 0.74–0.89) for SMI; and 0.89 (95% CI: 0.82–0.95) for SMI-CDFI. Furthermore, the modality of “SMI-CDFI” showed the best diagnostic performance. SMI provides further microvessel information in breast lesions. The diagnostic modality of “SMI-CDFI” can improve the diagnostic performance of ultrasound in the differentiation between benign and malignant masses. PMID:26356718

  15. PROPOSED DIAGNOSTIC CRITERIA FOR PROLIFERATIVE THYROID LESIONS IN BONY FISHES

    EPA Science Inventory

    Distinguishing hyperplastic lesions from neoplasia in the thyroid of bony fishes has been debated by scientists for about one hundred years. As early as the first decade of the last century, the histological interpretation of some of the striking proliferative lesions observed in...

  16. DIAGNOSTIC CRITERIA FOR PROLIFERATIVE THYROID LESIONS IN BONY FISHES

    EPA Science Inventory

    Criteria for distinguishing hyperplastic thyroid lesions from thyroid neoplasia in bony fishes have long been debated by scientists. Confusion exists because the thyroid tissue in most teleosts is unencapsulated, is occasionally found in ectopic sites, and is frequently predispos...

  17. Diagnostic considerations and prosthetic rehabilitation of a cocaine-induced midline destructive lesion: A clinical report.

    PubMed

    Hofstede, Theresa M; Jacob, Rhonda F

    2010-01-01

    The intranasal inhalation of cocaine has numerous complications. In addition to its systemic effects, cocaine can cause extensive destruction of the osteocartilaginous midline structures of the palate, nose, and sinuses. Without an accurate social and clinical history, a cocaine-induced midline destructive lesion can cause diagnostic difficulties, because its clinical presentation closely mimics other diseases. This clinical report describes an oronasal defect caused by cocaine use, the diagnostic considerations of these lesions, and prosthetic management of the defect. PMID:20105673

  18. Tularemia without lesions in grey tree squirrels: A diagnostic challenge

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Fifteen cases of Francisella tularenesis infection (tularemia) were identified in western grey (Sciurus griseus) and eastern grey (Sciurus carolinesis) squirrels submitted to the Washington Animal Disease Diagnostic Laboratory between 2008 and 2011. All of the squirrels originated in Washington stat...

  19. Diagnostic criteria for selenium toxicosis in aquatic birds: histologic lesions

    USGS Publications Warehouse

    Green, D.E.; Albers, P.H.

    1997-01-01

    Chronic selenium toxicosis was induced in 1-year-old male mallard ducks (Anas platyrhynchos) by feeding selenium, as seleno-DL-methionine, in amounts of 0, 10, 20, 40, and 80 parts per million (ppm) to five groups of 21 ducks each for 16 wk during March to July 1988. All mallards in the 80 ppm group, three in the 40 ppm group, and one in the 20 ppm group died. Histologic lesions in mallards that died of selenosis were hepatocellular vacuolar degeneration progressing to centrolobular and panlobular necrosis, nephrosis, apoptosis of pancreatic exocrine cells, hypermaturity and avascularity of contour feathers of the head with atrophy of feather follicles, lymphocytic necrosis and atrophy of lymphoid organs (spleen, gut-associated lymphoid tissue, and lumbar lymph nodes), and severe atrophy and degeneration of fat. Histologic lesions in surviving mallards in the 40 ppm group, which had tissue residues of selenium comparable to mallards that died, were fewer and much milder than mallards that died; lesions consisted of atrophy of lymphoid tissue, hyalinogranular swelling of hepatocytes, atrophy of seminiferous tubules, and senescence of feathers. No significant histologic lesions were detected in euthanized mallards in the 0, 10 and 20 ppm groups. Based on tissue residues and histologic findings, primarily in the liver, there was a threshold of selenium accumulation above which pathophysiologic changes were rapid and fatal. Pathognomonic histologic lesions of fatal and nonfatal selenosis were not detected. Criteria for diagnosis of fatal selenosis in aquatic birds include consistent histologic lesions in the liver, kidneys, and organs of the immune system. Although histologic changes were present in cases of chronic non-fatal selenosis, these were inconsistent. Consistent features of fatal and non-fatal chronic selenosis were marked weight loss and elevated concentrations of selenium in organs.

  20. Jaw lesions associated with impacted tooth: A radiographic diagnostic guide.

    PubMed

    Mortazavi, Hamed; Baharvand, Maryam

    2016-09-01

    This review article aimed to introduce a category of jaw lesions associated with impacted tooth. General search engines and specialized databases such as Google Scholar, PubMed, PubMed Central, MedLine Plus, Science Direct, Scopus, and well-recognized textbooks were used to find relevant studies using keywords such as "jaw lesion", "jaw disease", "impacted tooth", and "unerupted tooth". More than 250 articles were found, of which approximately 80 were broadly relevant to the topic. We ultimately included 47 articles that were closely related to the topic of interest. When the relevant data were compiled, the following 10 lesions were identified as having a relationship with impacted tooth: dentigerous cysts, calcifying odontogenic cysts, unicystic (mural) ameloblastomas, ameloblastomas, ameloblastic fibromas, adenomatoid odontogenic tumors, keratocystic odontogenic tumors, calcifying epithelial odontogenic tumors, ameloblastic fibro-odontomas, and odontomas. When clinicians encounter a lesion associated with an impacted tooth, they should first consider these entities in the differential diagnosis. This will help dental practitioners make more accurate diagnoses and develop better treatment plans based on patients' radiographs. PMID:27672610

  1. Jaw lesions associated with impacted tooth: A radiographic diagnostic guide

    PubMed Central

    Mortazavi, Hamed

    2016-01-01

    This review article aimed to introduce a category of jaw lesions associated with impacted tooth. General search engines and specialized databases such as Google Scholar, PubMed, PubMed Central, MedLine Plus, Science Direct, Scopus, and well-recognized textbooks were used to find relevant studies using keywords such as "jaw lesion", "jaw disease", "impacted tooth", and "unerupted tooth". More than 250 articles were found, of which approximately 80 were broadly relevant to the topic. We ultimately included 47 articles that were closely related to the topic of interest. When the relevant data were compiled, the following 10 lesions were identified as having a relationship with impacted tooth: dentigerous cysts, calcifying odontogenic cysts, unicystic (mural) ameloblastomas, ameloblastomas, ameloblastic fibromas, adenomatoid odontogenic tumors, keratocystic odontogenic tumors, calcifying epithelial odontogenic tumors, ameloblastic fibro-odontomas, and odontomas. When clinicians encounter a lesion associated with an impacted tooth, they should first consider these entities in the differential diagnosis. This will help dental practitioners make more accurate diagnoses and develop better treatment plans based on patients' radiographs.

  2. Jaw lesions associated with impacted tooth: A radiographic diagnostic guide

    PubMed Central

    Mortazavi, Hamed

    2016-01-01

    This review article aimed to introduce a category of jaw lesions associated with impacted tooth. General search engines and specialized databases such as Google Scholar, PubMed, PubMed Central, MedLine Plus, Science Direct, Scopus, and well-recognized textbooks were used to find relevant studies using keywords such as "jaw lesion", "jaw disease", "impacted tooth", and "unerupted tooth". More than 250 articles were found, of which approximately 80 were broadly relevant to the topic. We ultimately included 47 articles that were closely related to the topic of interest. When the relevant data were compiled, the following 10 lesions were identified as having a relationship with impacted tooth: dentigerous cysts, calcifying odontogenic cysts, unicystic (mural) ameloblastomas, ameloblastomas, ameloblastic fibromas, adenomatoid odontogenic tumors, keratocystic odontogenic tumors, calcifying epithelial odontogenic tumors, ameloblastic fibro-odontomas, and odontomas. When clinicians encounter a lesion associated with an impacted tooth, they should first consider these entities in the differential diagnosis. This will help dental practitioners make more accurate diagnoses and develop better treatment plans based on patients' radiographs. PMID:27672610

  3. Cytopathology in the diagnostic appraisal of uncommon malignant neoplastic lesions.

    PubMed

    Kalogeraki, A; Derdas, S; Karvela-Kalogeraki, I; Karvelas-Kalogerakis, M; Segredakis, G; Stathias, K; Sinatkas, V; Tamiolakis, D

    2015-03-01

    Cytology and fine needle aspiration (FNA) cytology are accepted means of diagnosing and typing of common forms of malignant tumors. However, their usefulness for diagnosing less common neoplasms is not clearly established and this study was designed to examine this. We report four unusual cases of patients with malignant neoplasms in which cytology and fine needle aspiration cytology or aspiration biopsy (FNAC, FNAB) contributed significantly in establishing the diagnosis. These cases facilitate the diagnostic capabilities of cytology over a wide spectrum of neoplasms including rare lymphoproliferative disorders and carcinomas. PMID:26591631

  4. Morphometry As a Diagnostic Tool for Potentially Malignant Lesions

    PubMed Central

    Murthy, Sarvani; SR, Ashwinirani; Singh, Sakshi; CP, Athira; Shivaram, Shilpa Kuppareddy; Neethupriya

    2015-01-01

    Introduction Though we are in 21st century with nano technology & tissue printing, there still exist many lacunae in the field of diagnosis. Not much is known about prognostic markers till now from literature to assess potentially malignant lesions. Lesions so called potentially malignant can be termed only after clinical & malignant changes have been developed and there are no means of predicting with certainty the risk of cancerous transformation. Aim Our present study was undertaken to establish the morphometric parameters of the parabasal and spinous cells of normal oral epithelium with the changes occurring in cells of Oral Leukoplakia (OL), Oral Verrucous Carcinoma (OVC) and Oral Squamous Cell Carcinoma (OSCC). Materials and Methods Total 40 patients were divided into Group I which includes patients with normal oral mucosa, group II oral leukoplakia patients, group III oral verrucous carcinoma patients and group IV includes oral squamous cell carcinoma patients. Tissue sections were taken and morphometric analysis of cell area, cell diameter, nuclear area, nuclear diameter, nuclear cytoplasmic ratio was done for parabasal and spinous layer cells. Statistical analysis was done using one-way ANOVA and T-test. Results Nuclear diameter, nuclear area, cell area, nuclear cytoplasmic ratio were significantly increased in OL, OVC, OSCC patients than normal oral mucosa, which was statistically significant. Cell diameter was decreased in OL, OVC, OSCC patients than with normal oral mucosa which was statistically significant. Conclusion Cellular & nuclear parameters showed statistically significant changes in oral leukoplakia, oral verrucous carcinoma & oral squamous cell carcinoma in comparison with normal oral mucosa. PMID:26816987

  5. In vivo diagnostics of human knee cartilage lesions using delayed CBCT arthrography.

    PubMed

    Kokkonen, Harri T; Suomalainen, Juha-Sampo; Joukainen, Antti; Kröger, Heikki; Sirola, Joonas; Jurvelin, Jukka S; Salo, Jari; Töyräs, Juha

    2014-03-01

    The aim of this study was to investigate the feasibility of delayed cone beam (CBCT) arthrography for clinical diagnostics of knee cartilage lesions. Knee joints with cartilage lesions were imaged using native radiography, MRI, and delayed CBCT arthrography techniques in vivo. The joints were imaged three times with CBCT, just before, immediately after (arthrography) and 45 min after the intra-articular injection of contrast agent. The arthrographic images enabled sensitive detection of the cartilage lesions. Use of arthrographic and delayed images together with their subtraction image enabled also detection of cartilage with inferior integrity. The contrast agent partition in intact cartilage (ICRS grade 0) was lower (p < 0.05) than that of cartilage surrounding the ICRS grade I-IV lesions. Delayed CBCT arthrography provides a novel method for diagnostics of cartilage lesions. Potentially, it can also be used in diagnostics of cartilage degeneration. Due to shorter imaging times, higher resolution, and lower costs of CT over MRI, this technique could provide an alternative for diagnostics of knee pathologies. However, for comprehensive evaluation of the clinical potential of the technique a further clinical study with a large pool of patients having a wide range of cartilage pathologies needs to be conducted.

  6. Place de la bili-IRM dans le diagnostic etiologique des icteres cholestatiques à Dakar

    PubMed Central

    Badji, Nfally; Akpo, Geraud; Deme, Hamidou; Toure, Mouhamadou Hamine; Ly, Mamadou; Ndong, Boucar; Niang, El Hadji

    2016-01-01

    La Bili-IRM est une méthode diagnostique d’introduction relativement récente dans l’arsenal d’exploration de la pathologie bilio-pancréatique. Il s’agit d’une technique fiable reproductible et non invasive, permettant la visualisation directe des voies biliaires et pancréatiques. Le but de ce travail était d’étudier les aspects morphologiques des principales anomalies et d’évaluer la place de la bili-IRM dans le diagnostic étiologique des ictères cholestatiques. Il s’agit d’une étude rétrospective réalisée sur 4 ans et six mois (Janvier 2008 à Juillet 2012) portant sur 17 patients colligés dans les services d’imagerie médicale du CHUN de Fann et de l’hôpital Principal de Dakar. Tous les patients ont bénéficié d’une IRM (1,5T) avec des protocoles adaptés en fonction de la pathologie explorée. Les dossiers retenus sont ceux dont le diagnostic a été établi à partir du bilan biologique et ayant bénéficié à la fois d’une bili-IRM et d’une exploration chirurgicale. Il s’agissait de 05 femmes et de 12 hommes soit un sexe ratio de 2.4. L’âge moyen des patients était de 58 ans avec des extrêmes de 35 et 81 ans. Les tumeurs de Klatskin étaient observées chez 07 patients avec une forme infiltrante dans 71% des cas et une forme exophytique dans 28% des cas. Les cancers de la vésicule biliaire étaient notés dans 28% des cas. Les cancers de la tête du pancréas représentaient 28% des cas. La lithiase de la voie biliaire principale était présente chez 05 patients avec un empierrement cholédocien dans 60% des cas et une lithiase unique dans 40% des cas. Toutes ces lésions étaient responsables d’une dilatation des VBIH. Un cas de dilatation des voies biliaires intra et extra hépatiques était retrouvé sans cause bilio-pancréatique. La bili-IRM est l’examen de choix dans l’exploration des ictères cholestatiques. Elle doit être demandée en première intention lorsqu’on suspecte une lithiase r

  7. Multiple ring-enhancing lesions: diagnostic dilemma between neurocysticercosis and tuberculoma.

    PubMed

    Verma, Rajesh; Gupta, Rahul

    2014-04-07

    Multiple ring-enhancing lesions in the brain often raise many questions about the true diagnosis. The aetiologies are many neoplastic, infectious, vascular, inflammatory and demyelinating conditions and also depend on the geographical location of the patient. The two important causes of multiple ring-enhancing lesions in the cranium are multiple neurocysticercosis and multiple tuberculomas in developing countries like India. This case report illustrates how multiple ring-enhancing lesions cause a diagnostic dilemma between neurocysticercosis and tuberculoma. A young girl with a typical presentation of neurocysticercosis finally turned out to be a case of tuberculoma. A high index of suspicion is required in appropriate clinical settings to have best clinical outcome.

  8. Early lymphoid lesions: conceptual, diagnostic and clinical challenges

    PubMed Central

    Ganapathi, Karthik A.; Pittaluga, Stefania; Odejide, Oreofe O.; Freedman, Arnold S.; Jaffe, Elaine S.

    2014-01-01

    There are no “benign lymphomas”, a fact due to the nature of lymphoid cells to circulate and home as part of their normal function. Thus, benign clonal expansions of lymphocytes are only rarely recognized when localized. Recent studies have identified a number of lymphoid proliferations that lie at the interface between benign and malignant. Some of these are clonal proliferations that carry many of the molecular hallmarks of their malignant counterparts, such as BCL2/IGH and CCND1/IGH translocations associated with the in situ forms of follicular lymphoma and mantle cell lymphoma, respectively. There are other clonal B-cell proliferations with low risk of progression; these include the pediatric variants of follicular lymphoma and marginal zone lymphoma. Historically, early or incipient forms of T/NK-cell neoplasia also have been identified, such as lymphomatoid papulosis and refractory celiac disease. More recently an indolent form of T-cell lymphoproliferative disease affecting the gastrointestinal tract has been described. Usually, CD8+, the clonal cells are confined to the mucosa. The clinical course is chronic, but non-progressive. NK-cell enteropathy is a clinically similar condition, composed of cytologically atypical NK-cells that may involve the stomach, small bowel or colon. Breast implant-associated anaplastic large cell lymphoma is a cytologically alarming lesion that is self-limited if confined to the seroma cavity. Atypical lymphoid proliferations that lie at the border of benign and malignant can serve as instructive models of lymphomagenesis. It is also critical that they be correctly diagnosed to avoid unnecessary and potentially harmful therapy. PMID:25176983

  9. All lesions great and small, part 1: diagnostic cytology in veterinary medicine.

    PubMed

    Sharkey, Leslie C; Seelig, Davis M; Overmann, Jed

    2014-06-01

    Cytopathology is a minimally invasive, rapid, and cost-effective diagnostic modality with broad utilization in veterinary medicine. Primary care clinicians often screen common cutaneous and subcutaneous aspirates, with other samples most frequently evaluated by board certified veterinary clinical pathologists in reference laboratories. Wright-Giemsa stains are frequently utilized with the application of ancillary diagnostics such as cytochemistry, immunocytochemistry, flow cytometry, and molecular diagnostic techniques complicated by the need to develop and validate species specific reagents and protocols. The interpretation of veterinary cytology samples must be undertaken with extensive knowledge of the breadth of animal species, which includes familiarity with the frequency and biological behavior of inflammatory, infectious, and neoplastic lesions that are influenced by species, breed, and husbandry conditions. This review is the first of two parts that focus on the most common domestic companion animal species (dog, cat, and horse), taking an organ system approach to survey important lesions that may be unique to veterinary species or have interesting correlates in human medicine. The first of the two-part series covers skin and subcutaneous tissue, the musculoskeletal system, and lymphoid organs. The cytologic features and biological behavior of similar lesions are compared, and selected molecular mechanisms of disease and ancillary diagnostics are reviewed when characterized. Supporting figures illustrate a subset of lesions. While not a comprehensive catalog of veterinary cytology, the goal is to give cytopathologists working in human medicine a general impression of correlates in veterinary practice.

  10. Computed tomography-guided percutaneous biopsy of bone lesions: rate of diagnostic success and complications*

    PubMed Central

    Maciel, Macello Jose Sampaio; Tyng, Chiang Jeng; Barbosa, Paula Nicole Vieira Pinto; Bitencourt, Almir Galvão Vieira; Matushita Junior, João Paulo Kawaoka; Zurstrassen, Charles Edouard; Chung, Wu Tu; Chojniak, Rubens

    2014-01-01

    Objective To determine the rates of diagnostic success and complications of computed tomography (CT)-guided percutaneous biopsy of bone lesions suspected for malignancy. Materials and Methods Retrospective study including 186 cases of CT-guided percutaneous biopsies of bone lesions in the period from January, 2010 to December, 2012. All the specimens were obtained with 8-10 gauge needles. The following data were collected: demographics, previous history of malignancy, data related to the lesion, to the procedure, and to histological results. Results Most patients were women (57%), and the mean age was 53.0 ± 16.4 years. In 139 cases (74.6%), there was diagnostic suspicion of metastasis and the most common primary tumors were breast (32.1%) and prostate (11.8%). The bones most commonly involved were spine (36.0%), hip (32.8%) and long bones (18.3%). Complications occurred in only three cases (1.6%) including bone fracture, paresthesia with functional impairment, and needle breakage requiring surgical removal. The specimens collected from 183 lesions (98.4%) were considered appropriate for diagnosis. Malignant results were more frequently found in patients who had a suspected secondary lesion and history of known malignancy (p < 0.001), and in patients who underwent PET/CT-guided procedures (p = 0.011). Conclusion CT-guided percutaneous biopsy is a safe and effective procedure for the diagnosis of suspicious bone lesions. PMID:25741100

  11. Comparison of SPECT/CT and MRI in Diagnosing Symptomatic Lesions in Ankle and Foot Pain Patients: Diagnostic Performance and Relation to Lesion Type

    PubMed Central

    Ha, Seunggyun; Hong, Sung Hwan; Paeng, Jin Chul; Lee, Dong Yeon; Cheon, Gi Jeong; Arya, Amitabh; Chung, June-Key; Lee, Dong Soo; Kang, Keon Wook

    2015-01-01

    Purpose The purpose of this study was to compare the diagnostic performance of SPECT/CT and MRI in patients with ankle and foot pain, with regard to the lesion types. Materials and Methods Fifty consecutive patients with ankle and foot pain, who underwent 99mTc-MDP SPECT/CT and MRI, were retrospectively enrolled in this study. Symptomatic lesions were determined based on clinical examination and response to treatment. On MRI and SPECT/CT, detected lesions were classified as bone, ligament/tendon, and joint lesions. Uptake on SPECT/CT was assessed using a 4-grade system. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of SPECT/CT and MRI were evaluated in all detected lesions and each lesion type. Diagnostic value of uptake grade was analyzed using receiver-operating characteristics (ROC) curve analysis, and diagnostic performance was compared using Chi-square or McNemar tests. Results In overall lesions, the sensitivity, PPV and NPV of SPECT/CT for symptomatic lesions were 93%, 56%, 91%, and they were 98%, 48%, 95% for MRI. There was no significant difference between SPECT/CT and MRI. However, the specificity of SPECT/CT was significantly higher than that of MRI (48% versus 24%, P = 0.016). Uptake grade on SPECT/CT was significantly higher in symptomatic lesions (P < 0.001), and its area under curve on ROC analysis was 0.787. In the analysis of each lesion type, the specificity of SPECT/CT was poor in joint lesions compared with other lesion types and MRI (P < 0.001, respectively). MRI exhibited lower specificity than SPECT/CT in bone lesions (P = 0.004) and ligament/tendon lesions (P < 0.001). Conclusions SPECT/CT has MRI-comparable diagnostic performance for symptomatic lesions in ankle and foot pain patients. SPECT/CT and MRI exhibit different diagnostic specificity in different lesion types. SPECT/CT may be used as a complementary imaging method to MRI for enhancing diagnostic specificity. PMID:25668182

  12. All lesions great and small, part 2. Diagnostic cytology in veterinary medicine.

    PubMed

    Sharkey, Leslie C; Seelig, Davis M; Overmann, Jed

    2014-06-01

    This is the second in a two-part review of diagnostic cytopathology in veterinary medicine. As in human medicine, cytopathology is a minimally invasive, rapid, and cost-effective diagnostic modality with broad utilization. In this second part, the diagnostic applications of cytology in respiratory, gastrointestinal, genitourinary, endocrine, ocular, and central nervous system tissues are discussed with a section describing fluid analysis in veterinary medicine. As noted in the previous manuscript, which characterized the cytology of the skin/subcutis, musculoskeletal, and lymphoid tissues, the interpretation of veterinary cytology samples must be undertaken with extensive knowledge of the breadth of animal species, including familiarity with the frequency and clinical progression of diseases, both of which can be influenced by species, breed, and husbandry conditions. Similar to part one, this review focuses on the most common domestic companion animal species (dog, cat, and horse) and highlights lesions that are either unique to veterinary species or have relevant correlates in people. The cytologic features and biological behavior of similar lesions are compared, and selected mechanisms of disease and ancillary diagnostics are reviewed when appropriate. Supporting figures illustrate a subset of lesions. While not an exhaustive archive of veterinary cytology, the goal is to give cytopathologists working in human medicine a general impression of correlates and unique entities in veterinary practice.

  13. Diagnostic value of Tzanck smear in various erosive, vesicular, and bullous skin lesions

    PubMed Central

    Yaeen, Atiya; Ahmad, Qazi Masood; Farhana, Anjum; Shah, Parveen; Hassan, Iffat

    2015-01-01

    Background: Cutaneous cytology has long been shown to be useful in the diagnosis of several erosive, vesicular, and bullous skin lesions. The Tzanck smear although an old tool, still remains a simple, rapid, easily applied, and inexpensive test for these skin lesions. Aims and Objectives: The aim of this study was to evaluate the diagnostic value of Tzanck smear by determining its sensitivity and specificity in various erosive, vesicular, and bullous skin lesions. Materials and Methods: One hundred and forty-two patients with erosive, vesicular, and/or bullous skin lesions were included in the study. Four groups of disorders were identified: infections, immunologic disorders, genodermatosis, and spongiotic dermatitis. All the study cases were evaluated by Tzanck smear. Definitive diagnosis was established by standard diagnostic techniques (including when appropriate, viral serology, bacterial culture, histopathology, direct immunoflourescence). Results: The sensitivity and specificity of cytologic findings was respectively 86.36% and 91.30% for viral infections; for bacterial infections, it was 85.7% and 66.6%. The sensitivity and specificity of Tzanck smear was respectively 85.0% and 83.33% for pemphigus; for bullous pemhigoid it was 11.11% and 100.0%. Tzanck smear sensitivity in genodermatoses was 100%. The sensitivity and specificity of the test in spongiotic dermatitis could not be calculated due to an insufficient number of patients. Conclusion: The Tzanck smear is a quick and reliable tool for the evaluation of various erosive and vesiculobullous skin lesions. PMID:26751561

  14. Digital Breast Tomosynthesis versus Supplemental Diagnostic Mammographic Views for Evaluation of Noncalcified Breast Lesions

    PubMed Central

    Bandos, Andriy I.; Ganott, Marie A.; Sumkin, Jules H.; Kelly, Amy E.; Catullo, Victor J.; Rathfon, Grace Y.; Lu, Amy H.; Gur, David

    2013-01-01

    Purpose: To compare the diagnostic performance of breast tomosynthesis versus supplemental mammography views in classification of masses, distortions, and asymmetries. Materials and Methods: Eight radiologists who specialized in breast imaging retrospectively reviewed 217 consecutively accrued lesions by using protocols that were HIPAA compliant and institutional review board approved in 182 patients aged 31–60 years (mean, 50 years) who underwent diagnostic mammography and tomosynthesis. The lesions in the cohort included 33% (72 of 217) cancers and 67% (145 of 217) benign lesions. Eighty-four percent (182 of 217) of the lesions were masses, 11% (25 of 217) were asymmetries, and 5% (10 of 217) were distortions that were initially detected at clinical examination in 8% (17 of 217), at mammography in 80% (173 of 217), at ultrasonography (US) in 11% (25 of 217), or at magnetic resonance imaging in 1% (2 of 217). Histopathologic examination established truth in 191 lesions, US revealed a cyst in 12 lesions, and 14 lesions had a normal follow-up. Each lesion was interpreted once with tomosynthesis and once with supplemental mammographic views; both modes included the mediolateral oblique and craniocaudal views in a fully crossed and balanced design by using a five-category Breast Imaging Reporting and Data System (BI-RADS) assessment and a probability-of-malignancy score. Differences between modes were analyzed with a generalized linear mixed model for BI-RADS–based sensitivity and specificity and with modified Obuchowski-Rockette approach for probability-of-malignancy–based area under the receiver operating characteristic (ROC) curve. Results: Average probability-of-malignancy–based area under the ROC curve was 0.87 for tomosynthesis versus 0.83 for supplemental views (P < .001). With tomosynthesis, the false-positive rate decreased from 85% (989 of 1160) to 74% (864 of 1160) (P < .01) for cases that were rated BI-RADS category 3 or higher and from 57% (663 of

  15. 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

  16. Diagnostic Accuracy of Frozen Section of Central Nervous System Lesions: A 10-Year Study

    PubMed Central

    KHODDAMI, Maliheh; AKBARZADEH, Ali; MORDAI, Afshin; BIDARI - ZEREHPOUSH, Farahnaz; ALIPOUR, Hamid; SAMADZADEH, Sara; ALIPOUR, Bijan

    2015-01-01

    Objective Definitive diagnosis of the central nervous system (CNS) lesions is unknown prior to histopathological examination. To determine the method and the endpoint for surgery, intraoperative evaluation of the lesion helps the surgeon. In this study, the diagnostic accuracy and pitfalls of using frozen section (FS) of CNS lesions is determined. Materials & Methods In this retrospective study, we analyzed the results of FS and permanent diagnoses of all CNS lesions by reviewing reports from 3 general hospitals between March 2001 and March 2011. Results 273 cases were reviewed and patients with an age range from 3 to 77 years of age were considered. 166 (60.4%) had complete concordance between FS and permanent section diagnosis, 83 (30.2%) had partial concordance, and 24 cases (9.5%) were discordant. Considering the concordant and partially concordant cases, the accuracy rate was 99.5%, sensitivity was 91.4%, specificity was 99.7%, and positive and negative predictive values were 88.4% and 99.8%, respectively. Conclusion Our results show high sensitivity and specificity of FS diagnosis in the evaluation of CNS lesions. A Kappa agreement score of 0.88 shows high concordance for FS results with permanent section. Pathologist’s misinterpretation, small biopsy samples (not representative of the entire tumor), suboptimal slides, and inadequate information about tumor location and radiologic findings appear to be the major causes for these discrepancies indicated from our study. PMID:25767535

  17. Increasing the Number of Thyroid Lesions Classes in Microarray Analysis Improves the Relevance of Diagnostic Markers

    PubMed Central

    Fontaine, Jean-Fred; Mirebeau-Prunier, Delphine; Raharijaona, Mahatsangy; Franc, Brigitte; Triau, Stephane; Rodien, Patrice; Goëau-Brissonniére, Olivier; Karayan-Tapon, Lucie; Mello, Marielle; Houlgatte, Rémi; Malthiery, Yves; Savagner, Frédérique

    2009-01-01

    Background Genetic markers for thyroid cancers identified by microarray analysis have offered limited predictive accuracy so far because of the few classes of thyroid lesions usually taken into account. To improve diagnostic relevance, we have simultaneously analyzed microarray data from six public datasets covering a total of 347 thyroid tissue samples representing 12 histological classes of follicular lesions and normal thyroid tissue. Our own dataset, containing about half the thyroid tissue samples, included all categories of thyroid lesions. Methodology/Principal Findings Classifier predictions were strongly affected by similarities between classes and by the number of classes in the training sets. In each dataset, sample prediction was improved by separating the samples into three groups according to class similarities. The cross-validation of differential genes revealed four clusters with functional enrichments. The analysis of six of these genes (APOD, APOE, CLGN, CRABP1, SDHA and TIMP1) in 49 new samples showed consistent gene and protein profiles with the class similarities observed. Focusing on four subclasses of follicular tumor, we explored the diagnostic potential of 12 selected markers (CASP10, CDH16, CLGN, CRABP1, HMGB2, ALPL2, ADAMTS2, CABIN1, ALDH1A3, USP13, NR2F2, KRTHB5) by real-time quantitative RT-PCR on 32 other new samples. The gene expression profiles of follicular tumors were examined with reference to the mutational status of the Pax8-PPARγ, TSHR, GNAS and NRAS genes. Conclusion/Significance We show that diagnostic tools defined on the basis of microarray data are more relevant when a large number of samples and tissue classes are used. Taking into account the relationships between the thyroid tumor pathologies, together with the main biological functions and pathways involved, improved the diagnostic accuracy of the samples. Our approach was particularly relevant for the classification of microfollicular adenomas. PMID:19893615

  18. Accuracy of fine needle aspiration cytology of salivary gland lesions: routine diagnostic experience in Bangkok, Thailand.

    PubMed

    Nguansangiam, Sudarat; Jesdapatarakul, Somnuek; Dhanarak, Nisarat; Sosrisakorn, Krittika

    2012-01-01

    Fine needle aspiration (FNA) cytology is well accepted as a safe, reliable, minimal invasive and cost-effective method for diagnosis of salivary gland lesions. This study evaluated the accuracy and diagnostic performance of FNA cytology in Thailand. A consecutive series of 290 samples from 246 patients during January 2001-December 2009 were evaluated from the archive of the Anatomical Pathology Department of our institution and 133 specimens were verified by histopathologic diagnoses, obtained with material from surgical excision or biopsy. Cytologic diagnoses classified as unsatisfactory, benign, suspicious for malignancy and malignant were compared with the histopathological findings. Among the 133 satisfactory specimens, the anatomic sites were 70 (52.6%) parotid glands and 63 (47.4 %) submandibular glands. FNA cytological diagnoses showed benign lesions in 119 cases (89.5 %), suspicious for malignancy in 3 cases (2.2 %) and malignant in 11 cases (8.3%). From the subsequent histopathologic diagnoses, 3/133 cases of benign cytology turned out to be malignant lesions, the false negative rate being 2.2 % and 1/133 case of malignant cytology turned out to be a benign lesion, giving a false positive rate was 0.8%. The overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 97.0% (95% CI, 70.6%-99.4%), 81.3% (95% CI, 54.4%-96.0%), 99.1% (95% CI, 95.4%-100%), 92.9% (95% CI, 66.1%-99.8), 97.5% (95% CI, 92.8%-99.5%), respectively. This study indicated that FNA cytology of salivary gland is a reliable and highly accurate diagnostic method for diagnosis of salivary gland lesions. It not only provides preoperative diagnosis for therapeutic management but also can prevent unnecessary surgery.

  19. Diagnostic Accuracy of Mucosal Biopsy versus Endoscopic Mucosal Resection in Barrett's Esophagus and Related Superficial Lesions.

    PubMed

    Elsadek, Hany M; Radwan, Mamdouh M

    2015-01-01

    Background. Endoscopic surveillance for early detection of dysplastic or neoplastic changes in patients with Barrett's esophagus (BE) depends usually on biopsy. The diagnostic and therapeutic role of endoscopic mucosal resection (EMR) in BE is rapidly growing. Objective. The aim of this study was to check the accuracy of biopsy for precise histopathologic diagnosis of dysplasia and neoplasia, compared to EMR in patients having BE and related superficial esophageal lesions. Methods. A total of 48 patients with previously diagnosed BE (36 men, 12 women, mean age 49.75 ± 13.3 years) underwent routine surveillance endoscopic examination. Biopsies were taken from superficial lesions, if present, and otherwise from BE segments. Then, EMR was performed within three weeks. Results. Biopsy based histopathologic diagnoses were nondysplastic BE (NDBE), 22 cases; low-grade dysplasia (LGD), 14 cases; high-grade dysplasia (HGD), 8 cases; intramucosal carcinoma (IMC), two cases; and invasive adenocarcinoma (IAC), two cases. EMR based diagnosis differed from biopsy based diagnosis (either upgrading or downgrading) in 20 cases (41.67%), (Kappa = 0.43, 95% CI: 0.170-0.69). Conclusions. Biopsy is not a satisfactory method for accurate diagnosis of dysplastic or neoplastic changes in BE patients with or without suspicious superficial lesions. EMR should therefore be the preferred diagnostic method in such patients.

  20. Diagnostic tests for the detection of human papillomavirus-associated cervical lesions.

    PubMed

    Reuschenbach, Miriam; von Knebel Doeberitz, Magnus

    2013-01-01

    Current diagnostic approaches for primary cervical cancer screening, work-up of equivocal or positive screening results or follow- up after treatment of precancerous lesions primarily rely on the morphologic interpretation of squamous epithelial cells (Pap cytology), in some setting accompanied by the detection of human papillomavirus DNA and have largely contributed to remarkable reduction of disease incidence in countries with implemented screening programs. However, these approaches are limited by a poor sensitivity and reproducibility of Pap cytology and low specificity for high grade cervical intraepithelial neoplasia of HPV DNA detection assays. Early detection might be improved by complementing or even replacing these tests by markers which are more directly related to molecular events triggering HPV-induced carcinogenesis and thereby might deliver more accurate diagnostic performance. The delineation of molecular changes which occur during different stages of HPV infections and the identification of changes which induce neoplastic alterations allow for the detection of markers that specifically highlight the transforming stage of the infection where viral oncogenes are overexpressed and therefore allow for a more specific diagnosis of lesions that require treatment. The evaluation of such markers in clinical studies revealed that some indeed show an improved diagnostic performance compared to Pap cytology or HPV DNA tests only.

  1. Diagnostic Features of Common Oral Ulcerative Lesions: An Updated Decision Tree

    PubMed Central

    Safi, Yaser

    2016-01-01

    Diagnosis of oral ulcerative lesions might be quite challenging. This narrative review article aims to introduce an updated decision tree for diagnosing oral ulcerative lesions on the basis of their diagnostic features. Various general search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of MeSH keywords such as “oral ulcer,” “stomatitis,” and “mouth diseases.” Thereafter, English-language articles published since 1983 to 2015 in both medical and dental journals including reviews, meta-analyses, original papers, and case reports were appraised. Upon compilation of the relevant data, oral ulcerative lesions were categorized into three major groups: acute, chronic, and recurrent ulcers and into five subgroups: solitary acute, multiple acute, solitary chronic, multiple chronic, and solitary/multiple recurrent, based on the number and duration of lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by stepwise progression. PMID:27781066

  2. Autofluorescence guided diagnostic evaluation of suspicious oral mucosal lesions: opportunities, limitations, and pitfalls

    NASA Astrophysics Data System (ADS)

    Vigneswaran, Nadarajah

    2011-03-01

    Wide-filed autofluorescence examination is currently considered as a standard of care for screening and diagnostic evaluation of early neoplastic changes of the skin, cervix, lung, bladder, gastrointestinal tract and oral cavity. Naturally occurring fluorophores within the tissue absorb UV and visible light and can re-emit some of this light at longer wavelengths in the form of fluorescence. This non-invasive tissue autofluorescence imaging is used in optical diagnostics, especially in the early detection of cancer. Usually, malignant transformation is associated with thickening of the epithelium, enhanced cellular density due to increased nuclear cytoplasmic ratio which may attenuate the excitation leading to a decrease in collagen autofluorescence. Hence, dysplastic and cancerous tissues often exhibit decreased blue-green autofluorescence and appear darker compared to uninvolved mucosa. Currently, there are three commercially available devices to examine tissue autofluorescence in the oral cavity. In this study we used the oral cancer screening device IdentafiTM 3000 to examine the tissue reflectance and autofluorescence of PML and confounding lesions of the oral cavity. Wide-field autofluorescence imaging enables rapid inspection of large mucosal surfaces, to aid in recognition of suspicious lesions and may also help in discriminate the PML (class 1) from some of the confounding lesions (class II). However, the presence of inflammation or pigments is also associated with loss of stromal autofluorescence, and may give rise to false-positive results with widefield fluorescence imaging. Clinicians who use these autofluorescence based oral cancer screening devices should be aware about the benign oral mucosal lesions that may give false positivity so that unnecessary patient's anxiety and the need for scalpel biopsy can be eliminated.

  3. Impact of lossy compression on diagnostic accuracy of radiographs for periapical lesions

    NASA Technical Reports Server (NTRS)

    Eraso, Francisco E.; Analoui, Mostafa; Watson, Andrew B.; Rebeschini, Regina

    2002-01-01

    OBJECTIVES: The purpose of this study was to evaluate the lossy Joint Photographic Experts Group compression for endodontic pretreatment digital radiographs. STUDY DESIGN: Fifty clinical charge-coupled device-based, digital radiographs depicting periapical areas were selected. Each image was compressed at 2, 4, 8, 16, 32, 48, and 64 compression ratios. One root per image was marked for examination. Images were randomized and viewed by four clinical observers under standardized viewing conditions. Each observer read the image set three times, with at least two weeks between each reading. Three pre-selected sites per image (mesial, distal, apical) were scored on a five-scale score confidence scale. A panel of three examiners scored the uncompressed images, with a consensus score for each site. The consensus score was used as the baseline for assessing the impact of lossy compression on the diagnostic values of images. The mean absolute error between consensus and observer scores was computed for each observer, site, and reading session. RESULTS: Balanced one-way analysis of variance for all observers indicated that for compression ratios 48 and 64, there was significant difference between mean absolute error of uncompressed and compressed images (P <.05). After converting the five-scale score to two-level diagnostic values, the diagnostic accuracy was strongly correlated (R (2) = 0.91) with the compression ratio. CONCLUSION: The results of this study suggest that high compression ratios can have a severe impact on the diagnostic quality of the digital radiographs for detection of periapical lesions.

  4. Apport de l'imagerie dans le diagnostic des sacroiliites infectieuses : à propos de 19 cas

    PubMed Central

    Abid, Hanen; Chaabouni, Salim; Frikha, Faten; Toumi, Nozha; Souissi, Basma; Lahiani, Dorra; Bahloul, Zouhir; Ben Mahfoudh, Khaireddine

    2014-01-01

    Les sacro-iliites infectieuses méritent d’être mieux connues. Leur diagnostic est souvent retardé en raison d'une symptomatologie trompeuse et des diffcultés d'exploration de l'articulation sacro-iliaque. Notre travail est basé sur une étude rétrospective portant sur les cas de SII, recueillis sur une période comprise entre 1997 et 2008 dans notre centre universitaire Sfax-Tunisie. Le diagnostic de sacro-iliite était retenu en présence d'arguments cliniques et radiologiques d'atteinte sacroiliaque. Nous rapportons dix neuf cas de sacroiliites infectieuses (10 hommes et 9 femmes), avec un âge moyen de 32 ans. L'atteinte était unilatérale dans tous les cas. Les radiographies standard faites dans tous les cas ont été suggestives dans 14 cas et normales dans les autres cas. La TDM faite dans 13 cas a montré, un abcès des parties molles dans 8 cas et un séquestre osseux dans 2 cas. L'IRM réalisée dans 8 cas, a objectivé une infiltration des parties molles dans tous les cas et un abcès dans 3 cas. Le germe a été identifié dans 9 cas (3 cas de tuberculose, 3 cas de brucellose, 2 sacro-iliites à pyogène et un cas de candidose). Cette identification était faite par biopsie dans 3 cas, hémocultures dans 2 cas, prélèvement au niveau de la porte d'entrée dans 1 cas et sérodiagnostic dans 3 cas. Pour les autres cas, l'origine pyogène a été retenue sur des arguments cliniques et biologiques. L'imagerie joue un rôle primordial dans le diagnostic précoce et l'orientation étiologique d'une sacroiliite infectieuse. PMID:25120884

  5. Role of Fine Needle Aspiration Cytology as a Diagnostic Tool in Orbital and Adnexal Lesions

    PubMed Central

    Khan, Lubna; Malukani, Kamal; Malaiya, Siddharth; Yeshwante, Prashant; Ishrat, Saba; Nandedkar, Shirish S.

    2016-01-01

    Purpose: To evaluate the role of fine needle aspiration (FNAC) as a diagnostic tool in cases of orbital and ocular adnexal masses. Cytological findings were correlated with histopathological diagnosis wherever possible. Methods: FNAC was performed in 29 patients of different age groups presenting with orbital and ocular adnexal masses. Patients were evaluated clinically and investigated by non-invasive techniques before fine needle aspiration of the masses. Smears were analyzed by a cytologist in all cases. Further, results of cytology were compared with the histopathological diagnosis. Results: The age of patients ranged from 1 to 68 years (mean: 29.79±19.29). There were 14 males and 15 females with a male to female ratio of 0.93:1. Out of 29 cases, 26 aspirates were cellular. Cellularity was insufficient in three (10.34%) aspirates. Out of 26 cellular aspirates, 11 were non-neoplastic while 15 were neoplastic on cytology. Subsequent histopathologic examination was done in 21/26 cases. Concordance rate of FNAC in orbital and ocular adnexal mass lesions with respect to the precise histologic diagnosis was 90%. Conclusion: When properly used in well-indicated patients (in cases where a diagnosis cannot be made by clinical and imaging findings alone), FNAC of orbital and periorbital lesions is an invaluable and suitable adjunct diagnostic technique that necessitates close cooperation between the ophthalmologist and cytologist. However, nondiagnostic aspirates may sometimes be obtained, and an inconclusive FNAC should not always be ignored. PMID:27621787

  6. Role of Fine Needle Aspiration Cytology as a Diagnostic Tool in Orbital and Adnexal Lesions

    PubMed Central

    Khan, Lubna; Malukani, Kamal; Malaiya, Siddharth; Yeshwante, Prashant; Ishrat, Saba; Nandedkar, Shirish S.

    2016-01-01

    Purpose: To evaluate the role of fine needle aspiration (FNAC) as a diagnostic tool in cases of orbital and ocular adnexal masses. Cytological findings were correlated with histopathological diagnosis wherever possible. Methods: FNAC was performed in 29 patients of different age groups presenting with orbital and ocular adnexal masses. Patients were evaluated clinically and investigated by non-invasive techniques before fine needle aspiration of the masses. Smears were analyzed by a cytologist in all cases. Further, results of cytology were compared with the histopathological diagnosis. Results: The age of patients ranged from 1 to 68 years (mean: 29.79±19.29). There were 14 males and 15 females with a male to female ratio of 0.93:1. Out of 29 cases, 26 aspirates were cellular. Cellularity was insufficient in three (10.34%) aspirates. Out of 26 cellular aspirates, 11 were non-neoplastic while 15 were neoplastic on cytology. Subsequent histopathologic examination was done in 21/26 cases. Concordance rate of FNAC in orbital and ocular adnexal mass lesions with respect to the precise histologic diagnosis was 90%. Conclusion: When properly used in well-indicated patients (in cases where a diagnosis cannot be made by clinical and imaging findings alone), FNAC of orbital and periorbital lesions is an invaluable and suitable adjunct diagnostic technique that necessitates close cooperation between the ophthalmologist and cytologist. However, nondiagnostic aspirates may sometimes be obtained, and an inconclusive FNAC should not always be ignored.

  7. Assembly and characterization of a fluorescence lifetime spectroscopy system for skin lesions diagnostic

    NASA Astrophysics Data System (ADS)

    Saito Nogueira, Marcelo; Texiera Rosa, Ramon Gabriel; Pratavieira, Sebastião.; D´Almeida, Camila de Paula; Kurachi, Cristina

    2015-06-01

    The fluorescence spectra and fluorescence lifetime analysis in biological tissues has been presented as a technique of a great potential for tissue characterization for diagnostic purposes. The objective of this study is to assemble and characterize a fluorescence lifetime spectroscopy system for diagnostic of clinically similar skin lesions in vivo. The fluorescence lifetime measurements were performed using the Time Correlated Single Photon Counting (Becker & Hickl, Berlin, Germany) technique. Two lasers, one emitting at 378 nm and another at 445 nm, are used for excitation with 20, 50 and 80 MHz repetition rate. A bifurcated optical fiber probe conducts the excitation light to the sample, the collected light is transmitted through bandpass filters and delivered to a hybrid photomultiplier tube detector. The fluorescence spectra were obtained by using a portable spectrometer (Ocean Optics USB-2000-FLG) with the same excitation sources. An instrument response function of about 300 ps was obtained and the spectrum and fluorescence lifetime of a standard fluorescent molecule (Rhodamine 6G) was measured for the calibration of the system ((4.1 +/- 0.3) ns). The assembled system was considered robust, well calibrated and will be used for clinical measurements of skin lesions.

  8. Magnetic resonance imaging of cystic pancreatic lesions in adults: an update in current diagnostic features and management.

    PubMed

    Barral, Matthias; Soyer, Philippe; Dohan, Anthony; Laurent, Valérie; Hoeffel, Christine; Fishman, Elliot K; Boudiaf, Mourad

    2014-02-01

    Magnetic resonance (MR) imaging has become a widespread diagnostic solving tool for the detection and characterization of a large range of pancreatic cystic lesions. Benign and malignant cystic lesions of the pancreas including serous microcystic adenoma, mucinous cystic tumor, intraductal papillary mucinous tumor, solid pseudopapillary tumor, and also the less common lesions such as cystic endocrine tumors, cystic metastases, and lymphangiomas have suggestive MR imaging presentation that allows them to be differentiated from each other. Knowledge of MR imaging findings of cystic pancreatic lesions is critical to help suggest the diagnosis and chose the best therapeutic approach. The purpose of this review is to discuss and illustrate MR imaging features that are helpful for pancreatic cystic lesion detection and characterization and to provide an update in current MR imaging diagnostic features and management. PMID:24263208

  9. Diagnostic criteria for proliferative hepatic lesions in brown bullhead Ameiurus nebulosus

    USGS Publications Warehouse

    Blazer, V.S.; Fournie, J.W.; Wolf, J.C.; Wolfe, M.J.

    2006-01-01

    Brown bullhead Ameiurus nebulosus is used as indicator species for contaminant effects at areas of concern (AOC) in the Great Lakes and other areas. One of the beneficial use impairments at numerous AOC is 'fish tumors and other deformities'. An impairment occurs when the prevalence of fish tumors and other deformities exceeds those at unimpacted or control sites or when survey data confirm the presence of neoplastic or preneoplastic liver lesions in bullhead or white sucker Catostomus commersonii. Numerous surveys have been conducted over the years assessing neoplasia in these fishes, both liver and skin tumors. However, a major problem in comparing the results has been a lack of consistent criteria for evaluating histological changes in bullhead livers. As individual AOC develop and implement remedial action plans, realistic and attainable delisting targets need to be specified. For this to occur and be consistent from site to site there must be standardization of the criteria being used to evaluate specific impairments. In this report, specific diagnostic criteria are provided for both non-neoplastic and neoplastic proliferative hepatocellular and biliary lesions. These criteria should assist fish pathologists in describing and categorizing proliferative liver lesions from brown bullhead. ?? Inter-Research 2006.

  10. A correlation study of diagnostic fine-needle aspiration with histologic diagnosis in cystic neck lesions.

    PubMed

    Moatamed, Neda A; Naini, Bita V; Fathizadeh, Payman; Estrella, Julie; Apple, Sophia K

    2009-10-01

    The clinical diagnosis of a mass in the neck region encompasses a wide spectrum of differential diagnosis. Fine-needle aspiration is a quick and safe technique, which can provide useful information for initial assessment and further therapeutic measures. The aim of this retrospective study was to evaluate the performance characteristics of the fine-needle aspiration (FNA) in cystic neck lesions. Of 142 patients with FNA for cystic neck masses during 2002-2007, 92 cases were selected with a follow-up histologic diagnosis, excluding the cystic colloid nodule of the thyroid. The cases were divided into salivary gland cystic neck (37 patients) and non-salivary cystic neck (55 patients) mass groups. False-positive and false-negative diagnoses were applied only to the malignant lesions after confirmation by histopathology. In the first group, nine malignant and 28 benign diagnoses were made by FNA; of which three were false-negative. In the second group, there were nine malignant and 46 benign diagnoses with three false negatives. The overall performance of the FNA showed 76% sensitivity and 100% specificity. In conclusion, FNA of the cystic neck lesions offers an invaluable and highly specific initial diagnostic approach for the management of the patients.

  11. Digital Breast Tomosynthesis: A New Diagnostic Method for Mass-Like Lesions in Dense Breasts.

    PubMed

    Bian, Tiantian; Lin, Qing; Cui, Chunxiao; Li, Lili; Qi, Chunhua; Fei, Jie; Su, Xiaohui

    2016-09-01

    To compare the rates and accuracy of digital breast tomosynthesis (DBT) and 2D digital mammography (DM) for detecting and diagnosing mass-like lesions in dense breasts. Mediolateral and craniocaudal images taken with DBT (affected breast) and DM (both breasts) of the dense breasts of 631 women were assessed independently using Breast Imaging Reporting and Data System (BI-RADS) scores. Images were compared for detection and diagnostic accuracy for masses; sensitivity and specificity of diagnosis; false-negative and recall rates; and clarity of display, particularly of margins and spicules. Histopathology was conducted via surgical biopsies of all patients. The detection and diagnostic accuracy rates of DBT images (84.3% and 82.3%, respectively) were significantly higher than that of DM (77.3% and 73.4%; p < 0.01, both). The sensitivity and specificity of DBT (68.1% and 95.2%) were higher than that of DM (58.8% and 86.7%), whereas the recall rate of DBT was lower (3.6% cf. 9.8%). The number of cases of benign circumscribed masses and malignant spiculated masses detected by DBT (172 and 182) was significantly higher than the number detected through DM (75 and 115; p < 0.01, both). Radiologists assigned higher BI-RADS scores for probability of malignancy to DBT images than DM, to lesions proved malignant (p = 0.025); for benign cases, the methods were comparable (p = 0.065). Compared with DM, DBT yielded significantly higher rates of detection and diagnostic accuracy for benign and malignant masses, with greater sensitivity and specificity and lower recall rates. In addition, DBT images facilitated analysis of margins, and the rate of accuracy for judgments of malignancy probability was higher, as proved on biopsy. PMID:27296324

  12. Apport de l'orientation clinique dans le diagnostic des hypertensions arterielles endocriniennes

    PubMed Central

    El Aziz, Siham; Chadli, Asma; Louda, Fatima; El Ghomari, Hassan; Farouqi, Ahmed

    2014-01-01

    L'hypertension artérielle d'origine endocrinienne représente une cause curable d'hypertension artérielle (HTA), ce qui en justifie le dépistage. Une orientation clinique est souhaitable afin de prescrire les bilans adéquats, notamment dans les pays en voie de développement. L'objectif de notre étude est décrire les aspects cliniques des patients ayant une HTA endocrinienne diagnostiquée au CHU de Casablanca. Méthodes: Il s'agit d'une étude descriptive rétrospective de 2004 à 2011, incluant tout patient ayant une HTA endocrinienne (en dehors des dysthyroïdies) admis en Endocrinologie. Les données concernant les facteurs cliniques, paracliniques et thérapeutiques ont été colligées. Au cours de la période étudiée, 53 cas d'HTA endocrinienne ont été admis, avec une age moyen au diagnostic de 39,3 ans et un sex-ratio F/H de 3,9. Trente patients (56.6%) ont un age ont un âge inférieur à 40 ans. On ne retrouve pas d'hérédité tensionelle chez 88.7% des patients. Les étiologies sont le Syndrome de cushing (41.5%), le phéochromocytome (32%), les adénomes somatotropes (15%) et les hyperaldostéronismes primaire (7.5%). L'HTA est essentiellement de grade un ou deux (69.8%), avec un retentissement cardio-vasculaire chez 11 patients (20.7%). Les patients ayant un SC avaient tous des signes cutanés spécifiques. Il s'agissait de sujets jeunes avec plusieurs facteurs de risque cardiovasculaire. Nous avons retrouvé un amaigrissement chez 37.5% des patients ayant un phéochromocytome avec un indice de masse corporel moyen de 20 kg/m2. L'HTA était permanente dans 5 cas de phéochromocytomes. Il n'existait pas d'hypokaliémie chez 50% des patients ayant un hyperaldostéronisme. Les signes cliniques des patients ayant une acromégalie étaient francs, avec un age moyen plus élevé de 50 ans. Nous avons noté une régression de l'HTA chez 59% de ces patients après guérison de l'endocrinopathie en cause. Plusieurs signes cliniques peuvent nous

  13. Uterine smooth muscle tumor analysis by comparative genomic hybridization: a useful diagnostic tool in challenging lesions.

    PubMed

    Croce, Sabrina; Ribeiro, Agnes; Brulard, Celine; Noel, Jean-Christophe; Amant, Frederic; Stoeckle, Eberhard; Devouassoux-Shisheborah, Mojgan; Floquet, Anne; Arnould, Laurent; Guyon, Frederic; Mishellany, Florence; Garbay, Delphine; Cuppens, Tine; Zikan, Michal; Leroux, Agnès; Frouin, Eric; Duvillard, Pierre; Terrier, Philippe; Farre, Isabelle; Valo, Isabelle; MacGrogan, Gaetan M; Chibon, Frederic

    2015-07-01

    The diagnosis and management of uterine smooth muscle tumors with uncertain malignant potential (STUMP) is often challenging, and genomic data on these lesions as well as on uterine smooth muscle lesions are limited. We tested the hypothesis that genomic profile determination by array-CGH could split STUMP into a benign group with scarce chromosomal alterations akin to leiomyoma and a malignant group with high chromosomal instability akin to leiomyosarcoma. Array-CGH genomic profile analysis was conducted for a series of 29 cases of uterine STUMP. A group of ten uterine leiomyomas and ten uterine leiomyosarcomas served as controls. The mean age was 50 years (range, 24-85) and the follow-up ranged from 12 to 156 months (average 70 months). Since STUMP is a heterogenous group of tumors with genomic profiles that can harbor few to many chromosomal alterations, we compared genomic indices in leiomyomas and leiomyosarcomas and set a genomic index=10 threshold. Tumors with a genomic index <10 were classified as nonrecurring STUMPs and those with a genomic index >10 represented STUMPs with recurrences and unfavorable outcomes. Hence, the genomic index threshold splits the STUMP category into two groups of tumors with different outcomes: a group comparable to leiomyomas and another similar to leiomyosarcomas, but more indolent. In our STUMP series, genomic analysis by array-CGH is an innovative diagnostic tool for problematic smooth muscle uterine lesions, complementary to the morphological evaluation approach. We provide an improved classification method for distinguishing truly malignant tumors from benign lesions within the category of STUMP, especially those with equivocal morphological features.

  14. Improved diagnostic differentiation of renal cystic lesions with phase-contrast computed tomography (PCCT)

    NASA Astrophysics Data System (ADS)

    Noel, Peter B.; Willner, Marian; Fingerle, Alexander; Herzen, Julia; Münzel, Daniela; Hahn, Dieter; Rummeny, Ernst J.; Pfeiffer, Franz

    2012-03-01

    The diagnostic quality of phase-contrast computed tomography (PCCT) is one the unexplored areas in medical imaging; at the same time, it seems to offer the opportunity as a fast and highly sensitive diagnostic tool. Conventional computed tomography (CT) has had an enormous impact on medicine, while it is limited in soft-tissue contrast. One example that portrays this challenge is the differentiation between benign and malignant renal cysts. In this work we report on a feasibility study to determine the usefulness of PCCT in differentiation of renal cysts. A renal phantom was imaged with a grating-based PCCT system consisting of a standard rotating anode x-ray tube (40 kV, 70 mA) and a Pilatus II photoncounting detector (pixel size: 172 μm). The phantom is composed of a renal equivalent soft-tissue and cystic lesions grouped in non-enhancing cyst and hemorrhage series and an iodine enhancing series. The acquired projection images (absorption and phase-contrast) are reconstructed with a standard filtered backprojection algorithm. For evaluation both reconstructions are compared in respect to contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and subjective image quality. We found that with PCCT a significantly improved differentiation between hemorrhage renal cysts from contrast enhancing malignant cysts is possible. If comparing PCCT and CT with respect to CNR and SNR, PCCT shows significant improvements. In conclusion, PCCT has the potential to improve the diagnostics and characterization of renal cysts without using any contrast agents. These results in combination with a non-synchrotron setup indicate a future paradigm shift in diagnostic computed tomography.

  15. Diagnostic power of diffuse reflectance spectroscopy for targeted detection of breast lesions with microcalcifications

    PubMed Central

    Soares, Jaqueline S.; Barman, Ishan; Dingari, Narahara Chari; Volynskaya, Zoya; Liu, Wendy; Klein, Nina; Plecha, Donna; Dasari, Ramachandra R.; Fitzmaurice, Maryann

    2013-01-01

    Microcalcifications geographically target the location of abnormalities within the breast and are of critical importance in breast cancer diagnosis. However, despite stereotactic guidance, core needle biopsy fails to retrieve microcalcifications in up to 15% of patients. Here, we introduce an approach based on diffuse reflectance spectroscopy for detection of microcalcifications that focuses on variations in optical absorption stemming from the calcified clusters and the associated cross-linking molecules. In this study, diffuse reflectance spectra are acquired ex vivo from 203 sites in fresh biopsy tissue cores from 23 patients undergoing stereotactic breast needle biopsies. By correlating the spectra with the corresponding radiographic and histologic assessment, we have developed a support vector machine-derived decision algorithm, which shows high diagnostic power (positive predictive value and negative predictive value of 97% and 88%, respectively) for diagnosis of lesions with microcalcifications. We further show that these results are robust and not due to any spurious correlations. We attribute our findings to the presence of proteins (such as elastin), and desmosine and isodesmosine cross-linkers in the microcalcifications. It is important to note that the performance of the diffuse reflectance decision algorithm is comparable to one derived from the corresponding Raman spectra, and the considerably higher intensity of the reflectance signal enables the detection of the targeted lesions in a fraction of the spectral acquisition time. Our findings create a unique landscape for spectroscopic validation of breast core needle biopsy for detection of microcalcifications that can substantially improve the likelihood of an adequate, diagnostic biopsy in the first attempt. PMID:23267090

  16. [Clinical usefulness of diagnostic methods for human papilloma virus dependent lesions].

    PubMed

    Suwalska, Anna; Owczarek, Witold; Fiedor, Piotr

    2014-02-01

    Persistent infection of Human Papilloma Virus (HPV) is confirmed necessary factor for development of cervical cancer and anogenital neoplasia. DNA HPV is detected in 96% of cervical cancer, 40% of vulvar and vaginal cancer, 90% of anal cancer and 26% of oral cavity cancer cases in general population. The most common high-risk HPV types observed in anogenital intraepithelial neoplasia or anogenital cancer are HPV 16, 18 and 45. Numerous diagnostic methods of detection of HPV infection and lesions causes by persistent HPV infection are widely used. Epidemiological data reveals correlation of incidence and mortality reduction due to cervical cancer and consequent prosecution and improvement of screening programmes based on morphological assessment of exfoliative smears. In last decade some limitations of conventional smear method were pointed out and a new diagnostic techniques were introduced: liquid-based cytology and HPV DNA testing. Combination of cytological examination and HPV DNA testing seems to be optimal solution to be introduced in large population because of combining high sensitivity of molecular test with high specificity of cytological smear. PMID:24720112

  17. Preoperative Ultrasound Guided Fine Needle Aspiration Cytology of Ovarian Lesions- Is It a Rapid and Effective Diagnostic Modality?

    PubMed Central

    Datta, Saikat; Chaudhuri, Snehamay; Paul, Prabir Chandra; Khandakar, Binny; Mandal, Sonali

    2016-01-01

    Introduction The deep seated ovarian lesions unapproachable by unguided aspiration cytology were easily done under ultrasound guidance. It gave a before hand cytological diagnosis of the lesion to the surgeon determining the modality of treatment for the patient. Aim To find the diagnostic accuracy of the method of ultrasound guided cytological assessment of ovarian lesion. Materials and Methods The study was conducted as a prospective observational study over a period of one year, in hospital setting, where ultrasound guided fine needle aspiration had been used to aspirate ovarian lesions, giving a rapid cytological diagnosis. In 43 sample cases, aspiration of fluid done from ovarian lesions were followed by cyto-centrifugation and staining by May-Grunwald-Giemsa (MGG) and Papanicolaou (Pap) stain providing a cytological opinion regarding benign/malignant nature of the lesion and further categorization. Later the cytological diagnosis was compared with final histopathological diagnosis, taking it as a gold standard. Results The overall sensitivity, specificity, and diagnostic accuracy of ultrasound guided aspiration and cytological analysis were high, 96%, 76.92% and 89.47% respectively as calculated by comparing the cytological diagnosis with histological diagnosis, taking it as gold standard. Conclusion This method has evolved as a highly sensitive, rapid, simple and effective modality for screening and as well as accurate preoperative diagnosis of ovarian lesions. PMID:27134878

  18. Diagnostic value of endobronchial and endoscopic ultrasound-guided fine needle aspiration for accessible lung cancer lesions after non-diagnostic conventional techniques: a prospective study

    PubMed Central

    2013-01-01

    Background Lung cancer diagnosis is usually achieved through a set of bronchoscopic techniques or computed tomography guided-transthoracic needle aspiration (CT-TTNA). However these procedures have a variable diagnostic yield and some patients remain without a definite diagnosis despite being submitted to an extensive workup. The aim of this study was to evaluate the efficacy and cost of linear endobronchial (EBUS) and endoscopic ultrasound (EUS) guided fine needle aspiration (FNA), performed with one echoendoscope, for the diagnosis of suspicious lung cancer lesions after failure of conventional procedures. Methods One hundred and twenty three patients with an undiagnosed but suspected malignant lung lesion (paratracheal, parabronchial, paraesophageal) or with a peripheral lesion and positron emission tomography positive mediastinal lymph nodes who had undergone at least one diagnostic flexible bronchoscopy or CT-TTNA attempt were submitted to EBUS and EUS-FNA. Patients with endobronchial lesions were excluded. Results Of the 123 patients, 88 had a pulmonary nodule/mass and 35 were selected based on mediastinal PET positive lymph nodes. Two patients were excluded because an endobronchial mass was detected at the time of the procedure. The target lesion could be visualized in 121 cases and FNA was performed in 118 cases. A definitive diagnosis was obtained in 106 cases (87.6%). Eighty-eight patients (72.7%) had non-small cell lung cancer, 15 (12.4%) had small cell lung cancer and metastatic disease was found in 3 patients (2.5%). The remaining 15 negative cases were subsequently diagnosed by surgical procedures. Twelve patients (9.9%) had a malignant tumor and in 3 (2.5%) a benign lesion was found. The overall sensitivity, specificity, positive and negative predictive values of EBUS and EUS-FNA to diagnose malignancy were 89.8%, 100%, 100% and 20.0% respectively. The diagnostic accuracy was 90.1% in a population with 97.5% prevalence of cancer. The ultrasonographic

  19. Evaluation of Contrast Extravasation as a Diagnostic Criterion in the Evaluation of Arthroscopically Proven HAGL/pHAGL Lesions

    PubMed Central

    Maldjian, Catherine; Khanna, Vineet; Bradley, James; Adam, Richard

    2014-01-01

    Purpose. The validity of preoperative MRI in diagnosing HAGL lesions is debated. Various investigations have produced mixed results with regard to the utility of MRI. The purpose of this investigation is to apply a novel method of diagnosing HAGL/pHAGL lesions by looking at contrast extravasation and to evaluate the reliability of such extravasation of contrast into an extra-articular space as a sign of HAGL/pHAGL lesion. Methods. We utilized specific criteria to define contrast extravasation. We evaluated these criteria in 12 patients with arthroscopically proven HAGL/pHAGL lesion. We also evaluated these criteria in a control group. Results. Contrast extravasation occurred in over 83% of arthroscopically positive cases. Contrast extravasation as a diagnostic criterion in the evaluation of HAGL/pHAGL lesions demonstrated a high interobserver degree of agreement. Conclusions. In conclusion, extra-articular contrast extravasation may serve as a valid and reliable sign of HAGL and pHAGL lesions, provided stringent criteria are maintained to assure that the contrast lies in an extra-articular location. In cases where extravasation is not present, the “J” sign, though nonspecific, may be the only evidence of subtle HAGL and pHAGL lesions. Level of Evidence. Level IV, Retrospective Case-Control series. PMID:25530880

  20. Diagnostic Imaging Dilemma of a Clival Lesion and Its Clinical Management Implications

    PubMed Central

    Yuh, Sung-Joo; Woulfe, John; Corsten, Martin J.; Carrau, Ricardo L.; Prevedello, Daniel M.; Kassam, Amin B.

    2014-01-01

    Background A retroclival lesion can represent a notochordal remnant–derived mass. The differential diagnoses includes benign lesions such as ecchordosis physaliphora (EP) and neuroenteric cyst or malignant ones such as chordomas. In the case of EP and chordoma, although both types arise from remnants of fetal notochord tissues, they represent two separate entities with different radiographic and biologic behaviors. Case Description We present a case of an incidental finding of a retroclival lesion. The magnetic resonance imaging (MRI) characteristics of the lesion match the neuroimaging profile of a benign lesion and are suggestive of an EP. There was no enhancement noted with the addition of gadolinium. Nonetheless, pathology determined the lesion to be a malignant chordoma. Conclusion The differential diagnosis of a retroclival lesion includes benign and malignant notochordal lesions. Here we present a case of a patient with an incidental finding of a retroclival lesion. Radiographic findings were suggestive of a benign lesion, possibly EP, yet the pathology revealed a chordoma. This report suggests that despite benign imaging, chordoma cannot be excluded and the implications for treatment can be significant. It is important to achieve the correct diagnosis because the prognostic and therapeutic implications are different. PMID:24967152

  1. The Diagnostic Value of Superb Microvascular Imaging (SMI) in Detecting Blood Flow Signals of Breast Lesions: A Preliminary Study Comparing SMI to Color Doppler Flow Imaging.

    PubMed

    Ma, Yan; Li, Gang; Li, Jing; Ren, Wei-dong

    2015-09-01

    The correlation between color Doppler flow imaging (CDFI) and Superb Microvascular Imaging (SMI) for detecting blood flow in breast lesions was investigated, as was the diagnostic value of SMI in differentiating benign from malignant breast lesions.These lesions were evaluated using both CDFI and SMI according to Adler's method. Pathologic examination showed 57 malignant lesions and 66 benign lesions. The number of blood vessels in a single mass was detected by 2 techniques (SMI and CDFI), and the difference between the 2 values (SMI-CDFI) was calculated. The optimal threshold for the diagnosis of malignant neoplasms and the diagnostic performances of SMI, CDFI, and SMI-CDFI were calculated.For the total lesions and malignant lesions alone, the difference between SMI and CDFI for detecting blood flow was significant (P < 0.01), but the difference was not significant for benign lesions (P = 0.15). The area under the receiver operating characteristic curve was 0.73 (95% confidence interval [CI]: 0.64-0.82) for CDFI; 0.81 (95% CI: 0.74-0.89) for SMI; and 0.89 (95% CI: 0.82-0.95) for SMI-CDFI. Furthermore, the modality of "SMI-CDFI" showed the best diagnostic performance.SMI provides further microvessel information in breast lesions. The diagnostic modality of "SMI-CDFI" can improve the diagnostic performance of ultrasound in the differentiation between benign and malignant masses.

  2. Hybrid Intercalated Duct Lesion of the Parotid: Diagnostic Challenges of a Recently Described Entity with Fine Needle Aspiration Findings.

    PubMed

    Mok, Yingting; Pang, Yin Huei; Teh, Ming; Petersson, Fredrik

    2016-06-01

    Intercalated duct lesions (IDL) of the salivary glands are recently described, and encompass both hyperplasia and benign neoplasms that remain incompletely understood. IDLs have been linked to various benign and low-grade malignant salivary gland neoplasms. We herein present a case of a 77 year old woman with an IDL of the parotid composed of both a hyperplastic and an adenomatous component and report, for the first time, the fine needle aspiration findings of such a lesion. This case illustrates the morphologic spectrum of an IDL, as well as challenges in rendering an accurate cytological and histologic diagnosis. The potential diagnostic pitfalls presented by the hybrid pattern of this lesion are also discussed. PMID:26477034

  3. Hybrid Intercalated Duct Lesion of the Parotid: Diagnostic Challenges of a Recently Described Entity with Fine Needle Aspiration Findings.

    PubMed

    Mok, Yingting; Pang, Yin Huei; Teh, Ming; Petersson, Fredrik

    2016-06-01

    Intercalated duct lesions (IDL) of the salivary glands are recently described, and encompass both hyperplasia and benign neoplasms that remain incompletely understood. IDLs have been linked to various benign and low-grade malignant salivary gland neoplasms. We herein present a case of a 77 year old woman with an IDL of the parotid composed of both a hyperplastic and an adenomatous component and report, for the first time, the fine needle aspiration findings of such a lesion. This case illustrates the morphologic spectrum of an IDL, as well as challenges in rendering an accurate cytological and histologic diagnosis. The potential diagnostic pitfalls presented by the hybrid pattern of this lesion are also discussed.

  4. Ensemble des troubles causés par l'alcoolisation fœtale : lignes directrices canadiennes concernant le diagnostic

    PubMed Central

    Chudley, Albert E.; Conry, Julianne; Cook, Jocelynn L.; Loock, Christine; Rosales, Ted; LeBlanc, Nicole

    2005-01-01

    Résumé LE DIAGNOSTIC DE L'ENSEMBLE DES TROUBLES CAUSÉS PAR L'ALCOOLISATION FÉTALE (ETCAF) est complexe et l'élaboration de lignes directrices concernant le diagnostic est justifiée. Un sous-comité du Comité consultatif national de l'Agence de santé publique du Canada sur l'Ensemble des troubles causés par l'alcoolisation fœtale a examiné, analysé et intégré les méthodes de diagnostic actuelles afin de parvenir à une méthode de diagnostic normalisée faisant le consensus au Canada. L'objet du présent document est d'examiner et de clarifier l'utilisation des systèmes de diagnostic actuels et de formuler des recommandations quant à leur application pour le diagnostic des déficiences liées à l'ETCAF chez des individus de tous les âges. Les lignes directrices sont fondées sur un vaste consensus de praticiens et d'autres intervenants spécialisés dans le domaine. Ces lignes directrices ont été organisées en sept catégories, soit le dépistage et l'orientation vers les spécialistes, l'examen physique et le diagnostic différentiel, l'évaluation du comportement neurologique, le traitement et le suivi, les antécédents de consommation d'alcool de la mère pendant la grossesse, les critères du diagnostic pour le syndrome d'alcoolisation fœtale (SAF), SAF partiel et troubles neurologiques du développement liés à l'alcool, l'harmonisation de l'Institute of Medicine (IOM) et des approches du Code diagnostique à 4 chiffres. Le diagnostic exige une évaluation complète des antécédents, ainsi qu'un examen physique et du comportement neurologique, tout en recourant à une approche multidisciplinaire. Les présentes lignes directrices pour le diagnostic du syndrome d'alcoolisation fœtale et des déficiences qui y sont associées sont les premières à avoir été élaborées au Canada et elles sont fondées sur la consultation d'un grand éventail de spécialistes du diagnostic.

  5. Can Doppler or contrast-enhanced ultrasound analysis add diagnostically important information about the nature of breast lesions?

    PubMed Central

    Stanzani, Daniela; Chala, Luciano F.; de Barros, Nestor; Cerri, Giovanni G.; Chammas, Maria Cristina

    2014-01-01

    OBJECTIVES: Despite evidence suggesting that Doppler ultrasonography can help to differentiate between benign and malignant breast lesions, it is rarely applied in clinical practice. The aim of this study was to determine whether certain vascular features of breast masses observed by duplex Doppler and color Doppler ultrasonography (before and/or after microbubble contrast injection) add information to the gray-scale analysis and support the Breast Imaging-Reporting and Data System (BI-RADS) classification. METHODS: Seventy solid lesions were prospectively evaluated with gray-scale ultrasonography, color Doppler ultrasonography, and contrast-enhanced ultrasonography. The morphological analysis and lesion vascularity were correlated with the histological results. RESULTS: Percutaneous core biopsies revealed that 25/70 (17.5%) lesions were malignant, while 45 were benign. Hypervascular lesions with tortuous and central vessels, a resistive index (RI)≥0.73 before contrast injection, and an RI≥0.75 after contrast injection were significantly predictive of malignancy (p<0.001). CONCLUSION: The combination of gray-scale ultrasonography data with unenhanced or enhanced duplex Doppler and color Doppler US data can provide diagnostically useful information. These techniques can be easily implemented because Doppler devices are already present in most health centers. PMID:24519198

  6. Diagnostic Performances of 99mTc-Methoxy Isobutyl Isonitrile Scan in Predicting the Malignancy of Lung Lesions

    PubMed Central

    Zhang, Shuxin; Liu, Yang

    2016-01-01

    Abstract We performed a meta-analysis to evaluate the value of technetium-99m methoxy isobutyl isonitrile (99mTc-MIBI) single photon emission computed tomography (SPECT) in differentiating malignant from benign lung lesions. The PubMed and Embase databases were comprehensively searched for relevant articles that evaluated lung lesions suspicious for malignancy. Two reviewers independently extracted the data on study characteristics and examination results, and assessed the quality of each selected study. The data extracted from the eligible studies were assessed by heterogeneity and threshold effect tests. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and areas under the summary receiver-operating characteristic curves (SROC) were also calculated. Fourteen studies were included in this meta-analysis. The pooled sensitivity, specificity, positive and negative likelihood ratio, and DOR of 99mTc-MIBI scan in detecting malignant lung lesions were 0.84 (95% confidence interval [CI]: 0.81, 0.87), 0.83 (95% CI: 0.77, 0.88), 4.22 (95% CI: 2.53, 7.04), 0.20 (95% CI: 0.12, 0.31), and 25.71 (95% CI: 10.67, 61.96), respectively. The area under the SROC was 0.9062. Meta-regression analysis showed that the accuracy estimates were significantly influenced by ethnic groups (P < 0.01), but not by image analysis methods, mean lesion size, or year of publication. Deek funnel plot asymmetry test for the overall analysis did not raise suspicion of publication bias (P = 0.50). Our results indicated that 99mTc-MIBI scan is a promising diagnostic modality in predicting the malignancy of lung lesions. PMID:27149482

  7. 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

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

    PubMed

    Popp, Dominik; Schöffl, Volker

    2015-10-18

    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.

  9. Effect of adding a diagnostic aid to best practice to manage suspicious pigmented lesions in primary care: randomised controlled trial

    PubMed Central

    Morris, Helen C; Humphrys, Elka; Hall, Per N; Prevost, A Toby; Burrows, Nigel; Bradshaw, Lucy; Wilson, Edward C F; Norris, Paul; Walls, Joe; Johnson, Margaret; Kinmonth, Ann Louise; Emery, Jon D

    2012-01-01

    Objectives To assess whether adding a novel computerised diagnostic tool, the MoleMate system (SIAscopy with primary care scoring algorithm), to current best practice results in more appropriate referrals of suspicious pigmented lesions to secondary care, and to assess its impact on clinicians and patients. Design Randomised controlled trial. Setting 15 general practices in eastern England. Participants 1297 adults with pigmented skin lesions not immediately diagnosed as benign. Interventions Patients were assessed by trained primary care clinicians using best practice (clinical history, naked eye examination, seven point checklist) either alone (control group) or with the MoleMate system (intervention group). Main outcome measures Appropriateness of referral, defined as the proportion of referred lesions that were biopsied or monitored. Secondary outcomes related to the clinicians (diagnostic performance, confidence, learning effects) and patients (satisfaction, anxiety). Economic evaluation, diagnostic performance of the seven point checklist, and five year follow-up of melanoma incidence were also secondary outcomes and will be reported later. Results 1297 participants with 1580 lesions were randomised: 643 participants with 788 lesions to the intervention group and 654 participants with 792 lesions to the control group. The appropriateness of referral did not differ significantly between the intervention or control groups: 56.8% (130/229) v 64.5% (111/172); difference −8.1% (95% confidence interval −18.0% to 1.8%). The proportion of benign lesions appropriately managed in primary care did not differ (intervention 99.6% v control 99.2%, P=0.46), neither did the percentage agreement with an expert decision to biopsy or monitor (intervention 98.5% v control 95.7%, P=0.26). The percentage agreement with expert assessment that the lesion was benign was significantly lower with MoleMate (intervention 84.4% v control 90.6%, P<0.001), and a higher proportion of

  10. Improving Diagnostic Accuracy of Dermoscopically Equivocal Pink Cutaneous Lesions with Reflectance Confocal Microscopy in Telemedicine Settings: Double Reader Concordance Evaluation of 316 Cases

    PubMed Central

    Roterman-Konieczna, I.; Bassoli, S.

    2016-01-01

    Background Solitary pink lesions in differential diagnosis with hypopigmented/amelanotic melanoma present a diagnostic challenge in daily practice and are regularly referred for second expert opinion. Reflectance confocal microscopy (RCM) has been shown to improve diagnostic accuracy of dermoscopically equivocal pink lesions. No studies have been performed to evaluate the effect of adding a second expert reader and automatic removal of lesions with discordant management recommendations and its potential effect on diagnostic sensitivity and final management of these lesions in retrospective or telemedicine settings. Objective To improve diagnostic accuracy and reduce potential mismanagement of dermoscopically equivocal pink cutaneous lesions by implementing double reader concordance evaluation of RCM images. Methods 316 dermoscopically equivocal pink lesions with dermoscopy-RCM image sets were evaluated retrospectively. Accuracy of three readers was evaluated by single reader evaluation of dermoscopy only and dermoscopy-RCM image sets and finally by double reader evaluation of dermoscopy-RCM image sets. Lesions with discordant diagnosis between two readers were automatically recommended for excision. Results Dermoscopy only evaluation resulted in an overall sensitivity of 95.9% and specificity of 33.6%, with 1 of 12 amelanotic melanomas mismanaged. Dermoscopy-RCM image set single reader evaluation resulted in an overall sensitivity of 93.9% and overall specificity of 54.2%, with 1 of 12 melanomas mismanaged. Dermoscopy-RCM image set double reader concordance evaluation resulted in an overall sensitivity of 98.3% and specificity of 42.7%, with no amelanotic melanoma mismanagement. Conclusion Evaluation of dermoscopy-RCM image sets of equivocal pink lesions by a single reader in telemedicine settings is limited by the potential for misdiagnosis of dangerous malignant lesions. Double reader concordance evaluation with automatic referral of lesions for removal in the

  11. [Development and optimization of diagnostically informative boichemical and coagulative correlators in various atherosclerotic lesions of carotid arteries].

    PubMed

    Akhvlediani, M; Vorobiova, E; Emukhvari, M; Gachechiladze, D

    2014-12-01

    Diagnostically informative biochemical and coagulative correlators in various atherosclerotic lesions of carotid arteries are developed. It has been established positive correlation of the degree of stenosis and intima-media thickness of carotid arteries with the following biochemical parameters: total cholesterol, LDL cholesterol, Apo-B, Lp(a), triglycerides, hs-C-reactive protein(CRP), interleukines (IL-1ß and IL-6), fibrinogen, D-dimers. Negative correlation was stated with respect to HDL cholesterol, Apo-A-1, protein C. The established correlators of carotid intima-medial layer and the studied laboratory indices favour their inclusion into carotid atherosclerosis monitoring.

  12. miRNAs As Diagnostic and Prognostic Biomarkers in Pancreatic Ductal Adenocarcinoma and Its Precursor Lesions: A Review

    PubMed Central

    Alemar, Bárbara; Gregório, Cleandra; Ashton-Prolla, Patricia

    2015-01-01

    Pancreatic ductal adenocarcinoma (PDAC), a rare but lethal tumor, is difficult to diagnose without performing an invasive procedure. miRNAs are known to be deregulated in PDAC patients, and recent studies have shown that they can be used as diagnostic and prognostic of the disease. The detection of miRNAs in samples acquired through minimally or noninvasive procedures, such as serum, plasma, and saliva, can have a positive impact on the clinical management of these patients. This article is a comprehensive review of the major studies that have evaluated the expression of miRNAs as biomarkers in pancreatic cancer and its premalignant lesions. PMID:26688661

  13. Intermediate-grade squamous intraepithelial lesion may be a valid diagnostic/interpretive category.

    PubMed

    Ravinsky, Esther; Baker, Patricia

    2009-02-01

    We undertook this study to assess the characteristics of smears with features intermediate between high-grade squamous intraepithelial lesion (HSIL) and low-grade squamous intraepithelial lesion (ISIL). We also wanted to determine how these smears correlate with high risk biopsy diagnosis and to compare this with the biopsy correlation of LSIL and HSIL. Seventy-four squamous intraepithelial lesion (SIL) smears were identified as intermediate-grade SIL smears taken at colposcopy in a 1 year period. They were correlated with concurrent colposcopically guided biopsies. Thirty-five percent of cases with intermediate-grade SIL smears had a biopsy diagnosis of moderate dysplasia or higher as compared with 12% for LSIL 74% for HSIL. This confirmed our hypothesis that intermediate-grade SIL smears have a rate of biopsy diagnosis of moderate dysplasia or higher intermediate to that of LSIL and HSIL.

  14. Computer-aided diagnosis of diagnostically challenging lesions in breast MRI: a comparison between a radiomics and a feature-selective approach

    NASA Astrophysics Data System (ADS)

    Hoffmann, Sebastian; Lobbes, Marc; Houben, Ivo; Pinker-Domenig, Katja; Wengert, Georg; Burgeth, Bernhard; Meyer-Bäse, Uwe; Lemaitre, Guillaume; Meyer-Baese, Anke

    2016-05-01

    Diagnostically challenging lesions pose a challenge both for the radiological reading and also for current CAD systems. They are not well-defined in both morphology (geometric shape) and kinetics (temporal enhancement) and pose a problem to lesion detection and classification. Their strong phenotypic differences can be visualized by MRI. Radiomics represents a novel approach to achieve a detailed quantification of the tumour phenotypes by analyzing a large number of image descriptors. In this paper, we apply a quantitative radiomics approach based on shape, texture and kinetics tumor features and evaluate it in comparison to a reduced-order feature approach in a computer-aided diagnosis system applied to diagnostically challenging lesions.

  15. Comparison of LEP and QST and their contribution to standard sensory diagnostic assessment of spinal lesions: a pilot study.

    PubMed

    Geber, Christian; Baumgärtner, Ulf; Fechir, Marcel; Vogt, Thomas; Birklein, Frank; Treede, Rolf-Detlef

    2011-06-01

    This study evaluates the additional use of laser-evoked potentials (LEP) and quantitative sensory testing (QST) in the sensory assessment of spinal lesions. Four consecutive patients with spinal lesions verified by MRI and clinical evidence for mild spinothalamic tract involvement were included. The electrophysiological workup [somatosensory evoked potentials (SEP) and LEP] was compared to QST. Electrophysiology and QST were reassessed after about 6 months. LEP detected impaired spinothalamic tract function in 7/8 examinations. QST pointed to spinothalamic tract lesions by loss of thermal function (3/8); most frequent positive sensory signs (3/8) were paradoxical heat sensations. LEP and QST results were concordant in 6/8 examinations. SEPs were abnormal in 2/8 examinations. Congruent results between SEP and both LEP and QST were obtained in 3/8 examinations. LEP detected more deficits than any single QST parameter or their combination but additional QST allows the detection of positive sensory signs. The diagnostic gain of SEP was limited.

  16. Automated metastatic brain lesion detection: a computer aided diagnostic and clinical research tool

    NASA Astrophysics Data System (ADS)

    Devine, Jeremy; Sahgal, Arjun; Karam, Irene; Martel, Anne L.

    2016-03-01

    The accurate localization of brain metastases in magnetic resonance (MR) images is crucial for patients undergoing stereotactic radiosurgery (SRS) to ensure that all neoplastic foci are targeted. Computer automated tumor localization and analysis can improve both of these tasks by eliminating inter and intra-observer variations during the MR image reading process. Lesion localization is accomplished using adaptive thresholding to extract enhancing objects. Each enhancing object is represented as a vector of features which includes information on object size, symmetry, position, shape, and context. These vectors are then used to train a random forest classifier. We trained and tested the image analysis pipeline on 3D axial contrast-enhanced MR images with the intention of localizing the brain metastases. In our cross validation study and at the most effective algorithm operating point, we were able to identify 90% of the lesions at a precision rate of 60%.

  17. Diagnostic Value of Hook Wire Localization Technique for Non-Palpable Breast Lesions

    PubMed Central

    Demiral, Gokhan; Senol, Metin; Bayraktar, Baris; Ozturk, Hasan; Celik, Yahya; Boluk, Salih

    2016-01-01

    Background The aim of this study was to investigate the validity of hook wire localization biopsy for non-palpable breast lesions which were detected by ultrasonography (USG) or mammography (MMG). Methods In this retrospective study, USG or MMG-guided hook wire localization technique was performed on 83 patients who had non-palpable breast lesions. Then histopathological examination was performed on surgically removed specimens. All patients’ mammograms or ultrasonograms were categorized using Breast Imaging-Reporting and Data System (BI-RADS) classification. Results Radiologically, 27 (32.53%) patients were classified as BI-RADS 3, 49 (59.04%) BI-RADS 4, one (1.2%) BIRADS 5 and six (7.23%) BI-RADS 0. Histopathological results were benign in 68 (81.9%) and malignant in 15 (18.1%) patients. Twenty-seven patients were classified as BI-RADS 3 and definitive diagnoses for all were benign. Besides, 49 patients were classified as BI-RADS 4 and histopathologically 14 of them were reported as malignant, and 35 as benign. Sensitivity of MMG was 93% and specificity was 55%. For USG, the sensitivity was 100% and the specificity was 73%. Conclusion In early diagnosis of breast cancer, the validity of the imaging-guided hook wire localization biopsy of non-palpable breast lesions has been proved. The cooperation of surgeon, radiologist and pathologist increases the successfull results of hook wire localization technique. PMID:27081425

  18. Radiolucent rim as a possible diagnostic aid for differentiating jaw lesions.

    PubMed

    Mortazavi, Hamed; Baharvand, Maryam; Rahmani, Somayeh; Jafari, Soudeh; Parvaei, Parvin

    2015-12-01

    In this study, we formulate a new proposal that complements previous classifications in order to assist dental practitioners in performing a differential diagnosis based on patients' radiographs. We used general search engines and specialized databases such as Google Scholar, PubMed, PubMed Central, MedLine Plus, Science Direct, Scopus, and well-recognized textbooks to find relevant studies by using keywords such as "jaw disease," "jaw lesions," "radiolucent rim," "radiolucent border," and "radiolucent halo." More than 200 articles were found, of which 70 were broadly relevant to the topic. We ultimately included 50 articles that were closely related to the topic of interest. When the relevant data were compiled, the following eight lesions were identified as having a radiolucent rim: periapical cemento-osseous dysplasia, focal cemento-osseous dysplasia, florid cemento-osseous dysplasia, cemento-ossifying fibroma, osteoid osteoma, osteoblastoma, odontoma, and cementoblastoma. We propose a novel subcategory, jaw lesions with a radiolucent rim, which includes eight entities. The implementation of this new category can help improve the diagnoses that dental practitioners make based on patients' radiographs. PMID:26730374

  19. Radiolucent rim as a possible diagnostic aid for differentiating jaw lesions

    PubMed Central

    Mortazavi, Hamed; Rahmani, Somayeh; Jafari, Soudeh; Parvaei, Parvin

    2015-01-01

    In this study, we formulate a new proposal that complements previous classifications in order to assist dental practitioners in performing a differential diagnosis based on patients' radiographs. We used general search engines and specialized databases such as Google Scholar, PubMed, PubMed Central, MedLine Plus, Science Direct, Scopus, and well-recognized textbooks to find relevant studies by using keywords such as "jaw disease," "jaw lesions," "radiolucent rim," "radiolucent border," and "radiolucent halo." More than 200 articles were found, of which 70 were broadly relevant to the topic. We ultimately included 50 articles that were closely related to the topic of interest. When the relevant data were compiled, the following eight lesions were identified as having a radiolucent rim: periapical cemento-osseous dysplasia, focal cemento-osseous dysplasia, florid cemento-osseous dysplasia, cemento-ossifying fibroma, osteoid osteoma, osteoblastoma, odontoma, and cementoblastoma. We propose a novel subcategory, jaw lesions with a radiolucent rim, which includes eight entities. The implementation of this new category can help improve the diagnoses that dental practitioners make based on patients' radiographs. PMID:26730374

  20. A Comparative Study on Diagnostic Accuracy of Colour Coded Digital Images, Direct Digital Images and Conventional Radiographs for Periapical Lesions – An In Vitro Study

    PubMed Central

    Mubeen; K.R., Vijayalakshmi; Bhuyan, Sanat Kumar; Panigrahi, Rajat G; Priyadarshini, Smita R; Misra, Satyaranjan; Singh, Chandravir

    2014-01-01

    Objectives: The identification and radiographic interpretation of periapical bone lesions is important for accurate diagnosis and treatment. The present study was undertaken to study the feasibility and diagnostic accuracy of colour coded digital radiographs in terms of presence and size of lesion and to compare the diagnostic accuracy of colour coded digital images with direct digital images and conventional radiographs for assessing periapical lesions. Materials and Methods: Sixty human dry cadaver hemimandibles were obtained and periapical lesions were created in first and second premolar teeth at the junction of cancellous and cortical bone using a micromotor handpiece and carbide burs of sizes 2, 4 and 6. After each successive use of round burs, a conventional, RVG and colour coded image was taken for each specimen. All the images were evaluated by three observers. The diagnostic accuracy for each bur and image mode was calculated statistically. Results: Our results showed good interobserver (kappa > 0.61) agreement for the different radiographic techniques and for the different bur sizes. Conventional Radiography outperformed Digital Radiography in diagnosing periapical lesions made with Size two bur. Both were equally diagnostic for lesions made with larger bur sizes. Colour coding method was least accurate among all the techniques. Conclusion: Conventional radiography traditionally forms the backbone in the diagnosis, treatment planning and follow-up of periapical lesions. Direct digital imaging is an efficient technique, in diagnostic sense. Colour coding of digital radiography was feasible but less accurate however, this imaging technique, like any other, needs to be studied continuously with the emphasis on safety of patients and diagnostic quality of images. PMID:25584318

  1. Peste des petits ruminants diagnosis and diagnostic tools at a glance: perspectives on global control and eradication.

    PubMed

    Santhamani, Ramasamy; Singh, Rabindra Prasad; Njeumi, Felix

    2016-11-01

    Peste des petits ruminants (PPR) is a highly contagious, economically important viral disease of small ruminants, targeted for global eradication by the year 2030. The recent geographic surge in PPR virus distribution, economic implications, the success of the rinderpest eradication campaign, and ongoing national/regional efforts convinced the FAO and OIE to initiate a global PPR control and eradication strategy. Since its discovery, a series of diagnostic tools have been developed for detecting PPR virus and virus-specific antibodies. Furthermore, it is understood that diagnostic and vaccine-monitoring tools are inevitable components of the four-stage strategy of global PPR eradication from assessment to the post-eradication phase. However, these tools may not be suitable for all stages of PPR control and eradication. For instance, diagnostics such as ELISA could be used for mass screening of clinical and serum samples, whereas immunochromatographic tests can be used at the field level as a pen-side test. Yet, assays with higher sensitivity, such as RT-PCR, RT-PCR ELISA, real-time RT-PCR and LAMP are important for early diagnosis of PPR and also, theoretically, during the late stages of eradication or when sampling non-natural hosts. Moreover, during the later stages of any control program, suspected/doubtful outbreaks will have to be reconfirmed using multiple laboratory tests. Hence, diagnostics can and should be efficiently applied at different stages of the PPR control and eradication campaign based on available resources and the number of samples to be tested. This article provides an overview of the various PPR diagnostic tools and suggests where and how they should be logically applied during the different phases of global PPR control and eradication. PMID:27522587

  2. Lymphoproliferative response and its relationship with histological lesions in experimental ovine paratuberculosis and its diagnostic implications.

    PubMed

    Kurade, N P; Tripathi, B N

    2008-01-01

    Lymphoproliferative response (LPR) was studied in 19 lambs orally infected (Group I) with Mycobacterium avium subsp. paratuberculosis (MAP) with in vitro lymphocyte stimulation test using MTT dye reduction assay. The non-specific LPR against Con A and specific LPR against sonicated antigen and johnin PPD (purified protein derivatives) were estimated on preinfection (0 day) and various days postinfection period (15 to 330 dpi) in the animals, which were classified according to histological and bacteriological evidence of paratuberculosis infection. Of the two antigens used, johnin PPD was found to be superior in terms of consistency and uniformity of response over an observation period of about a year. Significantly (P<0.05) higher LPR were observed in the infected sheep during postinfection period, as compared with preinfection values and values from uninfected control sheep. It was evident from the present study that the LPR in histologically infected animals fluctuated during the long course of infection and had a definite relationship with the gut pathology and the mycobacterial load. The LPR were stronger but variable in sheep with grades 1, 2 and 3 lesions (paucibacillary) and increased progressively from 30 dpi onwards. The sheep with the advanced lesions (grade 4, multibacillary) showed progressive decline in LPR till 120 dpi after initial stronger response at 30 dpi. Most of the animals were detected by LPR before initiation of faecal shedding of MAP. The results suggested that repeated testing was required while screening an infected flock for detecting most of the positive animals. PMID:17619156

  3. Toward noninvasive microspectrofluorometry of skin lesions for diagnostic and prognostic evaluation of cell metabolism and organelle interactions

    NASA Astrophysics Data System (ADS)

    Hirschberg, Joseph G.; Schachtschabel, Astrid; Kohen, Elli; Kohen, Cahide; Schachtschabel, Dietrich O.

    1995-02-01

    studies with the new highly sensitive cyanine nucleic acid dyes and their dimers, but caution should be exerted in the use of such compounds because of cytotoxicity (e.g., limiting it to cellular studies used in the interpretation of dermatological findings). Parallel cellular and non-invasive dermatological studies will help to define the most specific set of parameters to be used in diagnostic and prognostic evaluations of skin lesions.

  4. Diagnostic Accuracy of B-mode USG and Doppler Scan for Ovarian Lesions

    PubMed Central

    Agarwal, Vinish Kumar

    2016-01-01

    Introduction Ultrasonography (USG) is considered as the primary imaging modality for confirmation of ovarian mass and to differentiate them in to benign or malignant. Aim The present study was conducted with the aim to evaluate accuracy of B- mode USG and Doppler scan (Colour Doppler + Spectral Doppler) for ovarian lesions. Materials and Methods The patients included in the study were from those referred with either palpable adnexal mass or incidentally detected adnexal masses. Total 250 women were evaluated by USG, Doppler scan. Only fifty patients who had true ovarian mass intraoperatively and on histopathology were included in study, rest masses were excluded. Study parameters were morphological indexing on B- Mode USG, flow study, vessel arrangement, and vessel morphology and vessel location in Colour Doppler and resistive index and pulsatility index in spectral Doppler. Results Total 50 women were included in present study. Out of these 46% were pre-menopausal while 54% were menopaused women, 66.7% of post-menopausal women had malignant ovarian masses compared to 8.7% of premenopausal. Sensitivity, specificity, positive predictive value and negative predictive value of B-Mode USG for ovarian masses were 94.44%, 48.15%, 54.84% and 92.86% respectively, with p-value = 0.007, while sensitivity, specificity, positive predictive value and negative predictive value of Doppler scan were 85%, 90%, 85% and 90% respectively, with p-value = 0.0001. Conclusion USG and its different techniques are accepted as the primary imaging modality for early stage diagnosis of an ovarian malignancy. Statistical analysis suggests that Doppler Scan (Colour + Spectral) was more accurate (88%) than B-Mode USG (67%), but author is in view that both of these modalities should be used in conjunction to screen the ovarian lesions. PMID:27790544

  5. Insufficiency of Bone Scintigraphy in Vertebral Lesions of Langerhans Cell Histiocytosis Compared to F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Diagnostic Computed Tomography

    PubMed Central

    Koç, Zehra Pınar; Şimşek, Selçuk; Akarsu, Saadet; Balcı, Tansel Ansal; Onur, Mehmet Ruhi; Kepenek, Ferat

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a benign disorder related to the histiocytes which can infiltrate bone tissue. The most effective method for demonstrating severity of this disease is PET/CT and bone scintigraphy might show bone lesions. We present a seventeen year old male patient with disseminated LCH presented with exophtalmos and having multiple vertebral lesions which were identified by F-18 FDG PET/CT scan and diagnostic CT but not in the bone scintigraphy. PMID:25800594

  6. Insufficiency of bone scintigraphy in vertebral lesions of langerhans cell histiocytosis compared to f-18 fluorodeoxyglucose positron emission tomography/computed tomography and diagnostic computed tomography.

    PubMed

    Koç, Zehra Pınar; Şimşek, Selçuk; Akarsu, Saadet; Balcı, Tansel Ansal; Onur, Mehmet Ruhi; Kepenek, Ferat

    2015-02-01

    Langerhans cell histiocytosis (LCH) is a benign disorder related to the histiocytes which can infiltrate bone tissue. The most effective method for demonstrating severity of this disease is PET/CT and bone scintigraphy might show bone lesions. We present a seventeen year old male patient with disseminated LCH presented with exophtalmos and having multiple vertebral lesions which were identified by F-18 FDG PET/CT scan and diagnostic CT but not in the bone scintigraphy.

  7. Squamous precursor lesions of the vulva: current classification and diagnostic challenges.

    PubMed

    Hoang, Lien N; Park, Kay J; Soslow, Robert A; Murali, Rajmohan

    2016-06-01

    Growing evidence has established two major types of vulvar intraepithelial neoplasia (VIN), which correspond to two distinct oncogenic pathways to vulvar squamous cell carcinoma (VSCC). While the incidence of VSCC has remained relatively stable over the last three decades, the incidence of VIN has increased. VIN of usual type (uVIN) is human papillomavirus (HPV)-driven, affects younger women and is a multicentric disease. In contrast, VIN of differentiated type (dVIN) occurs in post-menopausal women and develops independent of HPV infection. dVIN often arises in a background of lichen sclerosus and chronic inflammatory dermatoses. Although isolated dVIN is significantly less common than uVIN, dVIN bears a greater risk for malignant transformation to VSCC and progresses over a shorter time interval. On histological examination, uVIN displays conspicuous architectural and cytological abnormalities, while the morphological features that characterise dVIN are much more subtle and raise a wide differential diagnosis. On the molecular level, dVIN is characterised by a higher number of somatic mutations, particularly in TP53. Here we review the classification, epidemiology, clinical features, histomorphology, ancillary markers and molecular genetics of both types of VIN, and discuss the morphological challenges faced by pathologists in interpreting these lesions. PMID:27113549

  8. Metastatic lesions: A diagnostic dilemma-retrospective study, Srinagar, Jammu and Kashmir, India

    PubMed Central

    Farooq, Summyia; Nadaf, Afreen; Beigh, Ambreen; Khuroo, Mehnaaz; Bhat, Nazia; Nazir, Naila

    2016-01-01

    Background: Renal clear cell carcinoma (RCC) accounts for about 3% of adult malignancies and about 90% of neoplasms of the kidney. It is most common in men aged 50 to 60 years old. RCC has different manifestations, including metastasis in uncommon sites and paraneoplastic syndromes. Aims: To evaluate the clinicopathological pattern of RCC. Materials and Methods: This study was conducted in the Department of Pathology, Government Medical College, Srinagar. It was a retrospective study done over a period of 5 years, November 2009 to November 2014. Results: The study was done to evaluate the clinicopathological pattern of 6 cases of RCC diagnosed at a tertiary care hospital. All patients were males, presenting with submandibular swellings without any other symptom. Radiological and histopathological examination proved the lesion as metastasis of renal cell carcinoma to the mandible. Conclusion: Being a rare presentation in the head and neck region, metastatic renal cell carcinoma needs to be considered in the differential diagnosis of submandibular swellings even in patients younger than 40 years. PMID:27601819

  9. Chernobyl-Related Cancer and Precancerous Lesions: Incidence Increase vs. Late Diagnostics

    PubMed Central

    Jargin, Sergei V.

    2014-01-01

    The reported incidence of thyroid cancer in children and adolescents in Soviet Union before the Chernobyl accident was lower than in other developed countries. This is not clearly recognizable from the literature because comparisons of the high incidence figures 4 years after the accident and later have been made with those from the first years after the accident, when the registered incidence had already started to increase. Considering the low pre-accident registered incidence, there was an accumulated pool of undiagnosed thyroid tumors before the accident. The percentage of more advanced cancers, larger in size and less differentiated, was higher after the accident, when the pool of neglected cancers was diagnosed due to the screening and improved diagnostics. Some of these advanced tumors found by screening were interpreted as aggressive radiogenic cancers. The same tendency might be true also for other cancers, e.g. renal cell carcinoma. Furthermore, the screening-effect, false-positivity and registration of non-exposed patients as Chernobyl victims has obviously contributed to the registered incidence increase of malignancy. PMID:25249833

  10. Chernobyl-Related Cancer and Precancerous Lesions: Incidence Increase vs. Late Diagnostics.

    PubMed

    Jargin, Sergei V

    2014-07-01

    The reported incidence of thyroid cancer in children and adolescents in Soviet Union before the Chernobyl accident was lower than in other developed countries. This is not clearly recognizable from the literature because comparisons of the high incidence figures 4 years after the accident and later have been made with those from the first years after the accident, when the registered incidence had already started to increase. Considering the low pre-accident registered incidence, there was an accumulated pool of undiagnosed thyroid tumors before the accident. The percentage of more advanced cancers, larger in size and less differentiated, was higher after the accident, when the pool of neglected cancers was diagnosed due to the screening and improved diagnostics. Some of these advanced tumors found by screening were interpreted as aggressive radiogenic cancers. The same tendency might be true also for other cancers, e.g. renal cell carcinoma. Furthermore, the screening-effect, false-positivity and registration of non-exposed patients as Chernobyl victims has obviously contributed to the registered incidence increase of malignancy.

  11. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition symptoms of mania: which one(s) result(s) more often from right than left hemisphere lesions?

    PubMed

    Braun, Claude M J; Daigneault, Rafael; Gaudelet, Sandrine; Guimond, Anik

    2008-01-01

    Previously published single case reports of patients with a unilateral lesion were assembled. After the lesion, each of the 244 cases presented at least one of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) symptoms of a manic episode, namely, elated or irritable mood, grandiosity, talkativeness, flight of ideas, hyperhedonism, reduced need for sleep, agitation, or distractibility (all optional in DSM-IV). As expected, the subgroup of 59 manic patients had a right hemisphere lesion far more often than a left one. However, this was also true of various sets of the nonmanic cases. Furthermore, elation was not the symptom most strongly associated with lesion side. Elation without mania was not significantly predicted by lesion side. However, talkativeness was strongly predicted by right lesion side whether in manic or nonmanic patients or even when the symptom was the only symptom observed. Agitation was consistently and robustly associated with right lesion side, but not completely distinctly so (it fell short of significance when not accompanied by elation or other symptoms). It is proposed that prevalence of right hemisphere lesions causing mania is primarily related to mental and behavioral disinhibition rather than a shift of mood and that it consists of release of left hemisphere influence.

  12. Reader Variability in the Use of Diagnostic Terms to Describe White Matter Lesions Seen on Cranial Scans of Severely Premature Infants: The ELGAN Study

    PubMed Central

    Adler, Ira; Batton, Daniel; Betz, Bradford; Bezinque, Steven; Durfee, Sara; Ecklund, Kirsten; Feinstein, Kate; Fordham, Lynn; Junewick, Joseph; Lorenzo, Robert; McCauley, Roy; Miller, Cindy; Seibert, Joanna; Kuban, Karl; Allred, Elizabeth; Leviton, Alan

    2010-01-01

    Purpose To evaluate reader variability of white matter lesions seen on cranial sonographic scans of extreme low gestational age neonates (ELGANs). Methods In 1,452 ELGANs, cranial sonographic scans were obtained in the first and second postnatal weeks, and between the third postnatal week and term. All sets of scans were read independently by two sonologists. We reviewed the use of four diagnostic labels: early periventricular leucomalacia, cystic periventricular leucomalacia, periventricular hemorrhagic infarction (PVHI), and other white matter diagnosis, by 16 sonologists at 14 institutions. We evaluated the association of these labels with location and laterality of hyperechoic and hypoechoic lesions, location of intraventricular hemorrhage, and characteristics of ventricular enlargement. Results Experienced sonologists differed substantially in their application of the diagnostic labels. Three readers applied early periventricular leucomalacia to more than one fourth of all the scans they read, whereas eight applied this label to ≤5% of scans. Five applied PVHI to ≥10% of scans, while three applied this label to ≤5% of scans. More than one third of scans labeled cystic periventricular leucomalacia had unilateral hypoechoic lesions. White matter abnormalities in PVHI were more extensive than in periventricular leucomalacia and were more anteriorly located. Hypoechoic lesions on late scans tended to be in the same locations, regardless of the diagnostic label applied. Conclusions Experienced sonologists differ considerably in their tendency to apply diagnostic labels for white matter lesions. This is due to lack of universally agreed-upon definitions. We recommend reducing this variability to improve the validity of large multicenter studies. PMID:20872936

  13. The differentiation of the character of solid lesions in the breast in the compression sonoelastography. Part I: The diagnostic value of the ultrasound B-mode imaging in the differentiation diagnostics of solid, focal lesions in the breast in relation to the pathomorphological verification

    PubMed Central

    2012-01-01

    The aim of this study was to evaluate the diagnostic value of the ultrasound B-mode imaging in the differentiation diagnostics of solid lesions in the breast in relation to the pathomorphological verification. From January to July 2010, 375 ultrasound breast examinations were conducted. The study enrolled 80 women aged 17–83, with 99 solid, focal lesions present in breasts, which were qualified for pathomorphological verification on the basis of the ultrasound examination. All patients underwent: the interview, physical examination, ultrasound examination and sonoelastography. The ultrasound features of the lesions, their vascularization patterns in the Doppler examination as well as the adjacent tissues were determined. Next, the focal lesions were categorized according to the BIRADS-US classification. The obtained results were analyzed statistically. In the group of 80 patients, 99 focal, solid lesions in breasts were visualized, including 39 neoplastic, malignant lesions (group I) and 60 lesions of benign nature (group II). The malignant lesions were often characterized by: greater size, irregular shape (34/39), prevalence of the anteroposterior dimension over the lateral-lateral dimension (22/39), acoustic shadowing (20/39), the margins not well-circumscribed (37/39), spiculated margins (16/39) and the presence of calcifications (14/39). The benign lesions were much more often hyper- and isoechogenic (14/60). In group I the lesions more often demonstrated the features of increased vascularization (29/39) and the presence of irregularly shaped vessels (23/29). This vascularization more often originated in the adjacent tissues. In the surroundings of the malignant neoplastic lesions, the presence of edema (16/39) and skin thickening (6/39) occurred more frequently and the abnormal axillary lymph nodes were more often diagnosed. The lesions of group I were assigned to the following BIRADS categories: BIRADS-US 4 (9 lesions) and BIRADS-US 5 (30 lesions). In group

  14. Papanicolau smear chances to be diagnostic for cervical squamous intraepithelial lesions (SIL) with or without detectable HPV DNA at in situ hybridization analysis.

    PubMed

    Sopracordevole, F; Cadorin, L; Muffato, G; De Benetti, L; Parin, A

    1993-01-01

    The Authors have correlated 39 cervical diagnostic biopsies for squamous intraepithelial lesions (SILs) with correspective Papanicolau smears (PS), with relation to the presence or the absence of HPV of oncogenic type (HPV-one) detected by in situ hybridization (ISH). Agreement between cytological and histological diagnosis was present in 14 of 16 cases with detectable HPV-one and only in 12 of 23 cases without detectable HPV-one at ISH. The importance of the HPV type in the SILs with relation to the diagnostic accuracy of Papanicolaou smears has been discussed.

  15. Diagnostic Value of Semiquantitative Analysis of Dynamic Susceptibility Contrast Magnetic Resonance Imaging with GD-EOB-DTPA in Focal Liver Lesions Characterization: A Feasibility Study

    PubMed Central

    Colombo, Maddalena; Trattenero, Chiara; Bonaffini, Pietro Andrea; Talei Franzesi, Cammillo; Sironi, Sandro

    2015-01-01

    Purpose. To assess the diagnostic accuracy of dynamic susceptibility contrast-enhanced magnetic resonance imaging (DSCE-MRI) in differentiation between benign and malignant liver lesions by assessment of tumoral perfusion parameters. Methods Materials. Seventy-three patients with known focal liver lesions, including 45 benign (16 FNH, 27 angiomas, and 2 abscesses) and 28 malignant ones (17 metastases, 9 HCCs, and 2 cholangiocarcinoma) underwent 1.5 T MRI upper abdominal study, with standard protocol that included dynamic contrast-enhanced sequences. On dedicated workstation, time-intensity curves were determined and the following perfusion parameters were calculated: relative arterial, venous and late enhancement (RAE, RVE, RLE), maximum enhancement (ME), relative enhancement (RE), and time to peak (TTP). Results. All diagnoses were established either by histopathology or imaging follow-up. Perfusion mean values calculated in benign lesions were RAE 33.8%, RVE 66.03%, RLE 80.63%, ME 776.00%, MRE 86.27%, and TTP 146.95 sec. Corresponding perfusion values calculated in malignant lesions were RAE 22.47%, RVE 40.54%, RLE 47.52%, ME 448.78%, MRE 49.85%, and TTP 183.79 sec. Statistical difference (p < 0.05) was achieved in all the perfusion parameters calculated, obtaining different cluster of perfusion kinetics between benign and malignant lesions. Conclusions. DSCE-MRI depicts kinetic differences in perfusion parameters among the different common liver lesions, related to tumour supply and microvascular characteristics. PMID:26064093

  16. Diffusion-weighted MRI of breast lesions: a prospective clinical investigation of the quantitative imaging biomarker characteristics of reproducibility, repeatability, and diagnostic accuracy.

    PubMed

    Spick, Claudio; Bickel, Hubert; Pinker, Katja; Bernathova, Maria; Kapetas, Panagiotis; Woitek, Ramona; Clauser, Paola; Polanec, Stephan H; Rudas, Margaretha; Bartsch, Rupert; Helbich, Thomas H; Baltzer, Pascal A

    2016-10-01

    Diffusion-weighted MRI (DWI) provides insights into tissue microstructure by visualization and quantification of water diffusivity. Quantitative evaluation of the apparent diffusion coefficient (ADC) obtained from DWI has been proven helpful for differentiating between malignant and benign breast lesions, for cancer subtyping in breast cancer patients, and for prediction of response to neoadjuvant chemotherapy. However, to further establish DWI of breast lesions it is important to evaluate the quantitative imaging biomarker (QIB) characteristics of reproducibility, repeatability, and diagnostic accuracy. In this intra-individual prospective clinical study 40 consecutive patients with suspicious findings, scheduled for biopsy, underwent an identical 3T breast MRI protocol of the breast on two consecutive days (>24 h). Mean ADC of target lesions was assessed (two independent readers) in four separate sessions. Reproducibility, repeatability, and diagnostic accuracy between examinations (E1, E2), readers (R1, R2), and measurements (M1, M2) were assessed with intraclass correlation coefficients (ICCs), coefficients of variation (CVs), Bland-Altman plots, and receiver operating characteristic (ROC) analysis with calculation of the area under the ROC curve (AUC). The standard of reference was either histopathology (n = 38) or imaging follow-up of up to 24 months (n = 2). Eighty breast MRI examinations (median E1-E2, 2 ± 1.7 days, 95% confidence interval (CI) 1-2 days, range 1-11 days) in 40 patients (mean age 56, standard deviation (SD) ±14) were evaluated. In 55 target lesions (mean size 25.2 ± 20.8 (SD) mm, range 6-106 mm), mean ADC values were significantly (P < 0.0001) higher in benign (1.38, 95% CI 1.27-1.49 × 10(-3)  mm(2) /s) compared with malignant (0.86, 95% CI 0.81-0.91 × 10(-) (3)  mm(2) /s) lesions. Reproducibility and repeatability showed high agreement for repeated examinations, readers, and measurements (all ICCs >0.9, CVs 3

  17. Dedicated Cone-beam Breast Computed Tomography and Diagnostic Mammography: Comparison of Radiation Dose, Patient Comfort, And Qualitative Review of Imaging Findings in BI-RADS 4 and 5 Lesions

    PubMed Central

    O’Connell, Avice M.; Kawakyu-O’Connor, Daniel

    2012-01-01

    Objective: This pilot study was undertaken to compare radiation dose, relative visibility/conspicuity of biopsy-proven lesions, and relative patient comfort in diagnostic mammography and dedicated cone-beam breast computed tomography (CBBCT) in Breast Imaging-Reporting and Data System (BI-RADS)® 4 or 5 lesions. Materials and Methods: Thirty-six consecutive patients (37 breasts) with abnormal mammographic and/or ultrasound categorized as BI-RADS® 4 or 5 lesions were evaluated with CBBCT prior to biopsy. Administered radiation dose was calculated for each modality. Mammograms and CBBCT images were compared side-by-side and lesion visibility/conspicuity was qualitatively scored. Histopathology of lesions was reviewed. Patients were administered a survey for qualitative evaluation of comfort between the two modalities. Results: CBBCT dose was similar to or less than diagnostic mammography, with a mean dose of 9.4 mGy (±3.1 SD) for CBBCT vs. 16.9 mGy (±6.9 SD) for diagnostic mammography in a total of 37 imaged breasts (P<0.001). Thirty-three of 34 mammographic lesions were scored as equally or better visualized in CBBCT relative to diagnostic mammography. Characterization of high-risk lesions was excellent. Patients reported greater comfort in CBBCT imaging relative to mammography. Conclusion: Our experience of side-by-side comparison of CBBCT and diagnostic mammography in BI-RADS® 4 and 5 breast lesions demonstrated a high degree of correlation between the two modalities across a variety of lesion types. Owing to favorable radiation dose profile, excellent visualization of lesions, and qualitative benefits including improved patient comfort, excellent field-of-view, and more anatomical evaluation of lesion margins, CBBCT offers a promising modality for diagnostic evaluation of breast lesions. PMID:22439131

  18. Apport de la biopsie radioguidée dans le diagnostic histopathologique des tumeurs de l'enfant: expérience de l'Hôpital d'Enfant de Rabat

    PubMed Central

    El Ochi, Mohamed Réda; Bellarbi, Salma; Rouas, Lamiae; Lamalmi, Najat; Malihy, Abderrahmane; Alhamany, Zaitouna; Cherradi, Nadia

    2015-01-01

    La biopsie radioguidée constitue une alternative à la biopsie chirurgicale invasive et à la cytologie pour le diagnostic des tumeurs pédiatriques. L'intérêt de notre étude est d’évaluer la valeur diagnostique des biopsies radioguidées examinées au laboratoire d'anatomopathologie de l'hôpital d'Enfants de Rabat (HER). L’étude a porté sur 78 biopsies radioguidées recueillies dans notre laboratoire entre janvier 2008 et décembre 2011. l’âge moyen des patients était de 5 ans et 10 mois avec une prédominance masculine (65,4%). La tumeur était abdominale dans 80% des cas, thoracique dans 15% cas, thoracique et abdominale dans 2,5% et sacrée dans 1,2%. Les biopsies étaient écho-guidées dans 90% des cas et scannoguidées dans 10% des cas. Le diagnostic histopathologique était posé dans 89% des cas. L'immuno-histochimie a été indiquée dans 35% des cas. Les diagnostics les plus fréquents étaient: tumeurs neuroblastiques (42 cas), lymphomes non hodgkiniens (10 cas), rhabdomyosarcomes (6 cas), autres (sarcome d'Ewing, néphroblastomes, tumeur myofibroblastique inflammatoire, maladies de Hodgkin, leucémie aiguë, hépatoblastome et ostéosarcome). Dans notre série, la biopsie radioguidée a permis un diagnostic histopathologique certain dans 89% des cas. Elle nécessite une étroite collaboration entre clinicien, radiologue et anatomopathologiste pour discuter son indication, afin de diminuer le nombre de biopsies peu ou non représentatives. PMID:26587165

  19. Dermoscopy, confocal laser microscopy, and hi-tech evaluation of vascular skin lesions: diagnostic and therapeutic perspectives.

    PubMed

    Grazzini, Marta; Stanganelli, Ignazio; Rossari, Susanna; Gori, Alessia; Oranges, Teresa; Longo, Anna Sara; Lotti, Torello; Bencini, Pier Luca; De Giorgi, Vincenzo

    2012-01-01

    Vascular skin lesions comprise a wide and heterogeneous group of malformations and tumors that can be correctly diagnosed based on natural history and physical examination. However, considering the high incidence of such lesions, a great number of them can be misdiagnosed. In addition, it is not so rare that an aggressive amelanotic melanoma can be misdiagnosed as a vascular lesion. In this regard, dermoscopy and confocal laser microscopy examination can play a central role in increasing the specificity of the diagnosis of such lesions. In fact, the superiority of these tools over clinical examination has encouraged dermatologists to adopt these devices for routine clinical practice, with a progressive spread of their use. In this review, we will go through the dermoscopic and the confocal laser microscopy of diagnosis of most frequent vascular lesions (i.e., hemangiomas angiokeratoma, pyogenic granuloma, angiosarcoma) taking into particular consideration the differential diagnosis with amelanotic melanoma. PMID:22950556

  20. Diagnostic value of cytological analysis of tumours and tumour-like lesions of the oral cavity in dogs and cats: a prospective study on 114 cases.

    PubMed

    Bonfanti, U; Bertazzolo, W; Gracis, M; Roccabianca, P; Romanelli, G; Palermo, G; Zini, E

    2015-08-01

    Neoplastic or non-neoplastic masses are common findings in the oral cavity of cats and dogs. The aim of this prospective study was to compare the results of cytological examinations of lesions of the oral cavity following fine-needle aspiration (FNA), fine-needle insertion (FNI), and impression smear (IS) with histopathological results being considered as the diagnostic gold standard. In total, 85 dogs and 29 cats were included in the study. Cases were included when histology and cytology (FNA, FNI, and/or IS) were available from the same lesion; κ-agreement and accuracy between cytological and histopathological results were calculated. Eighteen cytological specimens were excluded, with a retrieval rate of 84.2%. Of the 96 samples analysed, FNA, FNI, and IS were available from 80, 76, and 73 animals, respectively. Overall, 60/67 (89.6%) and 21/29 (72.4%) lesions were neoplastic in dogs and cats, respectively, with the remaining being non-neoplastic. For all lesions, κ-values obtained by FNA, FNI, and IS were in dogs 0.83 (95% confidence interval [CI]: 0.77-0.90), 0.87 (95% CI: 0.81-0.93) and 0.75 (95% CI: 0.67-0.84), respectively, and in cats 0.92 (95% CI: 0.87-0.96), 0.92 (95% CI: 0.88-0.97) and 0.86 (95% CI: 0.79-0.92), respectively. The diagnostic accuracies of FNA, FNI, and IS in dogs with neoplasia were 98.2%, 98.1%, and 91.8%, respectively, and in cats with neoplasia were 95.6%, 95.6% and 95.8%, respectively. In conclusion, the high agreement with histopathology suggests that cytological examinations by FNI, FNA, and IS are all appropriate methods to correctly diagnose lesions of the oral cavity in dogs and cats.

  1. Impact of Scoring Single or Multiple Occlusal Lesions on Estimates of Diagnostic Accuracy of the Visual ICDAS-II System

    PubMed Central

    Jablonski-Momeni, Anahita; Ricketts, David N. J.; Heinzel-Gutenbrunner, Monika; Stoll, Richard; Stachniss, Vitus; Pieper, Klaus

    2009-01-01

    Carious lesions can occur at different sites on the occlusal surfaces of teeth and may differ in appearance and severity. This study aimed to evaluate how estimates of reproducibility and accuracy of ICDAS-II were affected when all lesions on occlusal surfaces, or only a representative lesion, were scored. 100 permanent teeth with 1–4 investigation sites on the occlusal surface were examined visually by four examiners. Serial sections of the teeth were assessed for lesion depth. Intra- and interexaminer reproducibility (weighted kappa values), sensitivity, and specificity were calculated for all investigation sites and for a randomly selected site per tooth. Comparing the kappa values for the whole sample and the independent sites, no effect or only a small effect was found. Comparing the areas under the ROC-curves no effect could be shown. Examining multiple sites on teeth leads to results comparable to when a single independent site is chosen per tooth. PMID:20339467

  2. Differential diagnostic value of computed tomography perfusion combined with vascular endothelial growth factor expression in head and neck lesions

    PubMed Central

    WANG, JIE; TANG, ZUOHUA; WANG, SHUYI; ZENG, WENJIAO; QIAN, WEN; WU, LINGJIE; WANG, WENZHONG; LUO, JIANFENG

    2016-01-01

    There are numerous types of head and neck lesions (HNLs), and conventional computed tomography (CT) has low specificity and sensitivity in the definitive and differential diagnosis of HNLs. The aim of the present study was to evaluate the value of perfusion CT (CTP) combined with vascular endothelial growth factor (VEGF) expression in the differentiation between malignant and benign HNLs. In total, 41 HNLs, which were pathologically confirmed, underwent CTP and VEGF expression analysis. All lesions were divided into three groups: Group A, benign hypovascular lesions; Group B, benign hypervascular lesions; and Group C, malignant lesions. Time density curve (TDC) and CTP parameters [maximum intensity projection (MIP), blood volume (BV), blood flow (BF), mean transit time and capillary permeability] were analyzed. The association between perfusion measurements and VEGF was assessed using Pearson's correlation. TDCs were classified into three types, and type I was more frequently identified in benign tumors (Groups A and B) compared with malignant tumors (Group C) (P=0.003). Malignant tumors primarily had a TDC of type II and III. MIP, BF and BV were all significantly higher in Groups B and C compared to Group A (P<0.01). VEGF expression of malignant tumors was significantly higher than benign tumors (P=0.007). No correlation was identified between VEGF and any CTP parameter. The present findings suggest that CTP combined with VEGF may differentiate between malignant and benign HNLs, and between benign hypovascular and hypervascular lesions. PMID:27123114

  3. Diagnostic cellular abnormalities in neoplastic and non-neoplastic lesions of the epidermis: a morphological and statistical study

    PubMed Central

    Malhotra, Saurabh; Kazlouskaya, Viktoryia; Andres, Christian; Gui, Jiang; Elston, Dirk

    2013-01-01

    Background Distinguishing cellular abnormalities in reactive and malignant lesions is challenging. We compared the incidence and severity of cytological abnormalities in malignant/premalignant and benign epidermal lesions. Methods One hundred fifty-two biopsies representing 69 malignant/premalignant squamous lesions and 83 benign conditions were studied. Cytological features, including nuclear hyperchromasia, nuclear overlap (crowding), irregular nuclei, high nuclear/cytoplasmic (N/C) ratio, conspicuous nucleoli, delicate inconspicuous nucleoli, clumped chromatin, pleomorphic parakeratosis, normal and abnormal mitotic figures and necrotic keratinocytes, were evaluated and graded. Statistical analysis was performed. Results Irregular nuclei, increased N/C ratio, conspicuous single prominent nucleoli, nuclear overlap (crowding), pleomorphic parakeratosis, nuclear hyperchromasia, necrotic keratinocytes, normal and abnormal mitotic figures and coarse chromatin were seen more frequently in malignant neoplasms (p < 0.05). Abnormal mitotic figures, although uncommon (20.3%), were only noted in the malignant/premalignant group. Certain cytological features were common among both malignant and benign lesions, suggesting that they are of little value. Conclusion In the setting of an atypical cutaneous squamous proliferation, nuclear irregularity, increased N/C ratio, conspicuous nucleoli, crowding and hyperchromasia are the most useful indicators of malignancy. In contrast, mitotic figures, necrotic cells and coarse chromatin are less useful. The presence of abnormal mitotic figures is very helpful when present; however, their overall rarity limits their utility. PMID:23398548

  4. Utilization of PET imaging in differential diagnostics between a tumefactive multiple sclerosis lesion and low-grade glioma.

    PubMed

    Tarkkonen, Aleksi; Rissanen, Eero; Tuokkola, Terhi; Airas, Laura

    2016-09-01

    We present a case where a 30-year-old man with a history of combined MS and Charcot-Marie-Tooth (CMT I) disease was additionally diagnosed and treated for grade II glioma (astrocytoma). Tumefactive MS and gliomas are sometimes difficult to distinguish from one another based on conventional magnetic resonance imaging (MRI). In our case, positron emission tomography (PET) scans with(11)C-methionine ((11)C-MET) and (11)C-PK11195 radioligands were performed to aid in differential diagnostics. The diagnosis was confirmed finally by brain biopsy. The usefulness of PET imaging in differential diagnostics between tumefactive MS and glioma is discussed. PMID:27645363

  5. Approche au diagnostic de la maladie cœliaque chez les patients ayant une faible densité minérale osseuse ou des fractures de fragilité

    PubMed Central

    Rios, Lorena P.; Khan, Aliya; Sultan, Muhammad; McAssey, Karen; Fouda, Mona A.; Armstrong, David

    2013-01-01

    Résumé Objectif Présenter aux cliniciens une mise à jour sur le diagnostic de la maladie cœliaque (MC), ainsi que des recommandations sur les indications de procéder au dépistage de la MC chez les patients présentant une faible densité minérale osseuse (DMO) ou des fractures de fragilité. Qualité des données Un groupe de travail multidisciplinaire a élaboré des questions cliniquement pertinentes relativement au diagnostic de la MC servant de fondement à une recherche documentaire dans les bases de données MEDLINE, EMBASE et CENTRAL (de janvier 2000 à janvier 2009) à l’aide des mots clés en anglais celiac disease, osteoporosis, osteopenia, low bone mass et fracture. Les ouvrages scientifiques existants comportent des études de niveaux I et II. Message principal La prévalence estimée de la MC asymptomatique est de 2 % à 3 % chez les personnes qui ont une faible DMO. Par ailleurs, un dépistage ciblé est recommandé pour les patients qui ont des T-scores de −1,0 ou moins à la colonne vertébrale ou aux hanches ou des antécédents de fractures de fragilité associées à des symptômes ou à des problèmes reliés à la MC, des antécédents familiaux de MC ou de bas niveaux de calcium urinaire, une insuffisance en vitamine D et des niveaux à la hausse d’hormones parathyroïdiennes en dépit d’un apport suffisant en calcium et en vitamine D. Le dépistage de la MC devrait se faire pendant que le sujet consomme un régime alimentaire contenant du gluten. On procède au dépistage initial par le dosage d’immunoglobuline (Ig) A antitransglutaminase en utilisant la transglutaminase tissulaire humaine recombinante ou une autre transglutaminase tissulaire, en association avec l’immunofluorescence des IgA anti-endomysium. Une biopsie du duodénum est nécessaire pour confirmer le diagnostic de la MC. Le typage des antigènes des leucocytes humains peut aider à confirmer ou à exclure le diagnostic de la MC dans les cas où la s

  6. Diagnostic Value of Elevated D-Dimer Level in Venous Thromboembolism in Patients With Acute or Subacute Brain Lesions

    PubMed Central

    Kim, Yeon Jin; Im, Sun; Jang, Yong Jun; Park, So Young; Sohn, Dong Gyun

    2015-01-01

    Objective To define the risk factors that influence the occurrence of venous thromboembolism (VTE) in patients with acute or subacute brain lesions and to determine the usefulness of D-dimer levels for VTE screening of these patients. Methods Medical data from January 2012 to December 2013 were retrospectively reviewed. Mean D-dimer levels in those with VTE versus those without VTE were compared. Factors associated with VTE were analyzed and the odds ratios (ORs) were calculated. The D-dimer cutoff value for patients with hemiplegia was defined using a receiver operating characteristic (ROC) curve. Results Of 117 patients with acute or subacute brain lesions, 65 patients with elevated D-dimer levels (mean, 5.1±5.8 mg/L; positive result >0.55 mg/L) were identified. Logistic regression analysis showed that the risk of VTE was 3.9 times higher in those with urinary tract infections (UTIs) (p=0.0255). The risk of VTE was 4.5 times higher in those who had recently undergone surgery (p=0.0151). Analysis of the ROC showed 3.95 mg/L to be the appropriate D-dimer cutoff value for screening for VTE (area under the curve [AUC], 0.63; 95% confidence interval [CI], 0.5-0.8) in patients with acute or subacute brain lesions. This differs greatly from the conventional D-dimer cutoff value of 0.55 mg/L. D-dimer levels less than 3.95 mg/L in the absence of surgery showed a negative predictive value of 95.8% (95% CI, 78.8-99.8). Conclusion Elevated D-dimer levels alone have some value in VTE diagnosis. However, the concomitant presence of UTI or a history of recent surgery significantly increased the risk of VTE in patients with acute or subacute brain lesions. Therefore, a different D-dimer cutoff value should be applied in these cases. PMID:26798616

  7. Detection of occlusal carious lesions: an in vitro comparison of clinicians' diagnostic abilities at varying levels of experience.

    PubMed

    Swenson, Eric; Hennessy, Bernard

    2009-01-01

    There are many different methods available for detecting occlusal caries. This in vitro study, performed on 94 extracted human teeth, examines differences in diagnostic abilities (using visual and tactile methods) and examines restorative choices among 21 dental clinicians, based on amount of clinical experience. Test subjects examined the extracted teeth and utilized a mirror explorer, bitewing radiographs, and magnification to diagnose suspected occlusal caries. The teeth were sectioned and diagnosed macroscopically to obtain a sensitivity and specificity value for each clinician. Based on the results, there is no strong correlation between a dentist's amount of experience and a more accurate diagnosis or more conservative treatment options.

  8. External validation of a publicly available computer assisted diagnostic tool for mammographic mass lesions with two high prevalence research datasets

    PubMed Central

    Benndorf, Matthias; Burnside, Elizabeth S.; Herda, Christoph; Langer, Mathias; Kotter, Elmar

    2015-01-01

    Purpose: Lesions detected at mammography are described with a highly standardized terminology: the breast imaging-reporting and data system (BI-RADS) lexicon. Up to now, no validated semantic computer assisted classification algorithm exists to interactively link combinations of morphological descriptors from the lexicon to a probabilistic risk estimate of malignancy. The authors therefore aim at the external validation of the mammographic mass diagnosis (MMassDx) algorithm. A classification algorithm like MMassDx must perform well in a variety of clinical circumstances and in datasets that were not used to generate the algorithm in order to ultimately become accepted in clinical routine. Methods: The MMassDx algorithm uses a naïve Bayes network and calculates post-test probabilities of malignancy based on two distinct sets of variables, (a) BI-RADS descriptors and age (“descriptor model”) and (b) BI-RADS descriptors, age, and BI-RADS assessment categories (“inclusive model”). The authors evaluate both the MMassDx (descriptor) and MMassDx (inclusive) models using two large publicly available datasets of mammographic mass lesions: the digital database for screening mammography (DDSM) dataset, which contains two subsets from the same examinations—a medio–lateral oblique (MLO) view and cranio–caudal (CC) view dataset—and the mammographic mass (MM) dataset. The DDSM contains 1220 mass lesions and the MM dataset contains 961 mass lesions. The authors evaluate discriminative performance using area under the receiver-operating-characteristic curve (AUC) and compare this to the BI-RADS assessment categories alone (i.e., the clinical performance) using the DeLong method. The authors also evaluate whether assigned probabilistic risk estimates reflect the lesions’ true risk of malignancy using calibration curves. Results: The authors demonstrate that the MMassDx algorithms show good discriminatory performance. AUC for the MMassDx (descriptor) model in the

  9. P16INK4a: a potential diagnostic adjunct for prediction of high-grade cervical lesions in liquid-based cytology: with HPV testing and histological correlation.

    PubMed

    Wong, Y P; Abdul Raub, S H; Mohd Dali, A Z H; Kassim, F; Visvalingam, V; Zakaria, Z; Kamaluddin, M A; Noor Akmal, S

    2016-08-01

    Human papillomavirus (HPV) is a necessary cause of cervical cancer and its precursors. Increased expression of high-risk hrHPV viral oncogenes in abnormal cells might increase the expression of p16INK4a. We aimed to determine the role of p16INK4a in detecting hrHPV-transformed epithelial cells in liquid-based cervical cytology, and compared the results with hrHPV DNA testing by realtime polymerase chain reaction (RT-PCR). Fifty-seven cytological samples were tested for p16INK4a immunomarker and hrHPV DNA. Test performance of both tests was determined by comparing sensitivity, specificity and predictive values using available histological follow-up data as gold standard. Of 57 samples, 36 (63.2%) showed immunoreactivity for p16INK4a and 43 (75.4%) were hrHPV-infected. A fairly low concordance rate (k = 0.504) between p16INK4a immunolabelling and hrHPV DNA status was noted. For prediction of cervical intraepithelial neoplasia (CIN) II and worse lesions, p16INK4a had a sensitivity and specificity of 93.5% and 60%; whereas hrHPV DNA testing had a sensitivity and specificity of 100% and 20%. Dual testing by combining p16INK4a and hrHPV showed sensitivity and specificity of 100% and 33.3%. In conclusion, p16INK4a is useful in predicting severity of the cytological abnormalities. Although p16INK4a is more specific but less sensitive than hrHPV in detecting high-grade cervical lesions, a combination of both tests failed to demonstrate significant improvement in diagnostic sensitivity, specificity and predictive value. Larger-scale prospective studies are required to assess further whether this biomarker should be routinely used as primary screening tool independently or in combination with hrHPV testing to improve diagnostic accuracy in cervical cytology. PMID:27568665

  10. P16INK4a: a potential diagnostic adjunct for prediction of high-grade cervical lesions in liquid-based cytology: with HPV testing and histological correlation.

    PubMed

    Wong, Y P; Abdul Raub, S H; Mohd Dali, A Z H; Kassim, F; Visvalingam, V; Zakaria, Z; Kamaluddin, M A; Noor Akmal, S

    2016-08-01

    Human papillomavirus (HPV) is a necessary cause of cervical cancer and its precursors. Increased expression of high-risk hrHPV viral oncogenes in abnormal cells might increase the expression of p16INK4a. We aimed to determine the role of p16INK4a in detecting hrHPV-transformed epithelial cells in liquid-based cervical cytology, and compared the results with hrHPV DNA testing by realtime polymerase chain reaction (RT-PCR). Fifty-seven cytological samples were tested for p16INK4a immunomarker and hrHPV DNA. Test performance of both tests was determined by comparing sensitivity, specificity and predictive values using available histological follow-up data as gold standard. Of 57 samples, 36 (63.2%) showed immunoreactivity for p16INK4a and 43 (75.4%) were hrHPV-infected. A fairly low concordance rate (k = 0.504) between p16INK4a immunolabelling and hrHPV DNA status was noted. For prediction of cervical intraepithelial neoplasia (CIN) II and worse lesions, p16INK4a had a sensitivity and specificity of 93.5% and 60%; whereas hrHPV DNA testing had a sensitivity and specificity of 100% and 20%. Dual testing by combining p16INK4a and hrHPV showed sensitivity and specificity of 100% and 33.3%. In conclusion, p16INK4a is useful in predicting severity of the cytological abnormalities. Although p16INK4a is more specific but less sensitive than hrHPV in detecting high-grade cervical lesions, a combination of both tests failed to demonstrate significant improvement in diagnostic sensitivity, specificity and predictive value. Larger-scale prospective studies are required to assess further whether this biomarker should be routinely used as primary screening tool independently or in combination with hrHPV testing to improve diagnostic accuracy in cervical cytology.

  11. Comparison of dermatoscopic diagnostic algorithms based on calculation: The ABCD rule of dermatoscopy, the seven-point checklist, the three-point checklist and the CASH algorithm in dermatoscopic evaluation of melanocytic lesions.

    PubMed

    Unlu, Ezgi; Akay, Bengu N; Erdem, Cengizhan

    2014-07-01

    Dermatoscopic analysis of melanocytic lesions using the CASH algorithm has rarely been described in the literature. The purpose of this study was to compare the sensitivity, specificity, and diagnostic accuracy rates of the ABCD rule of dermatoscopy, the seven-point checklist, the three-point checklist, and the CASH algorithm in the diagnosis and dermatoscopic evaluation of melanocytic lesions on the hairy skin. One hundred and fifteen melanocytic lesions of 115 patients were examined retrospectively using dermatoscopic images and compared with the histopathologic diagnosis. Four dermatoscopic algorithms were carried out for all lesions. The ABCD rule of dermatoscopy showed sensitivity of 91.6%, specificity of 60.4%, and diagnostic accuracy of 66.9%. The seven-point checklist showed sensitivity, specificity, and diagnostic accuracy of 87.5, 65.9, and 70.4%, respectively; the three-point checklist 79.1, 62.6, 66%; and the CASH algorithm 91.6, 64.8, and 70.4%, respectively. To our knowledge, this is the first study that compares the sensitivity, specificity and diagnostic accuracy of the ABCD rule of dermatoscopy, the three-point checklist, the seven-point checklist, and the CASH algorithm for the diagnosis of melanocytic lesions on the hairy skin. In our study, the ABCD rule of dermatoscopy and the CASH algorithm showed the highest sensitivity for the diagnosis of melanoma.

  12. Benign breast lesions: Ultrasound

    PubMed Central

    Masciadri, N.; Ferranti, C.

    2011-01-01

    Benign breast diseases constitute a heterogeneous group of lesions arising in the mammary epithelium or in other mammary tissues, and they may also be linked to vascular, inflammatory or traumatic pathologies. Most lesions found in women consulting a physician are benign. Ultrasound (US) diagnostic criteria indicating a benign lesion are described as well as US findings in the most frequent benign breast lesions. PMID:23396888

  13. Diagnostic Accuracy of Five Different Fecal Markers for the Detection of Precancerous and Cancerous Lesions of the Colorectum

    PubMed Central

    Rutka, Mariann; Bor, Renáta; Milassin, Ágnes; Nagy, Ferenc; Szepes, Zoltán; Szűcs, Mónika; Tiszlavicz, László; Molnár, Tamás

    2016-01-01

    Background. Colorectal cancer (CRC) is the second deadliest malignancy worldwide. This study aimed to compare the diagnostic accuracy of different fecal markers in the detection of colorectal adenomas and cancer. Methods. Stool samples of patients referred to colonoscopy were collected for the analysis of tumor M2 pyruvate kinase (M2PK), human hemoglobin (Hb), hemoglobin/haptoglobin (Hb/Hp) complex, fecal calprotectin (FC), and matrix metalloproteinase-9 (MMP-9). Results. Sensitivity and specificity of M2PK for adenomas sized > 1 cm were 60% and 67.5% and for CRC were 94.7% and 67.5%. Sensitivity and specificity of iFOBT for adenomas sized ≥ 1 cm were 80% and 72.5% and for CRC were 94.7% and 72.5%. Sensitivity and specificity of Hb/Hp complex for adenomas sized ≥ 1 cm were 80% and 52.9% and for CRC were 100% and 52.9%. Sensitivity of FC and MMP-9 for CRC was 77.8% and 72.2%. Combined use of M2PK, iFOBT, and FC resulted in a sensitivity and specificity of 95% and 47.5% for the detection of adenomas sized ≥ 1 cm. Discussion. In CRC, sensitivity of M2PK, iFOBT, and Hb/Hp complex proved to be high. Combined use of M2PK, iFOBT, and FC may be valuable in the detection of large adenomas. PMID:27413251

  14. Le diagnostic anténatal de la trisomie 21 par l'hybridation in situ en fluorescence (FISH): à propos des premiers tests réalisés au Maroc

    PubMed Central

    Lamzouri, Afaf; Natiq, Abdelhafid; Tajir, Mariam; Sendid, Mohamed; Sefiani, Abdelaziz

    2012-01-01

    Introduction Le but de cette étude était de présenter les premiers résultats de diagnostic anténatal de la trisomie 21 par la technique d'hybridation in situ en fluorescence (FISH) au Maroc et discuter son intérêt dans le diagnostic rapide de cette aneuploïdie. Méthodes Ce travail a été réalisé chez 23 femmes avec des grossesses à haut risque de trisomie 21. La moyenne d’âge des gestantes étaient de 37,43 ans avec des extrêmes de 21 et 43 ans. Toutes étaient musulmanes mariées, mariage légitimé par la Charia, dont trois mariages consanguins, sauf une originaire de la République Démocratique du Congo qui était chrétienne et concubine. La majorité des femmes étaient fonctionnaires et avaient un niveau de scolarisation moyen à élevé. Toutes les patientes ont bénéficié d'une consultation de génétique médicale au cours de laquelle il leur a été donné des informations sur la technique, son intérêt et ses limites. Il s'agit de femmes enceintes qui avaient soit un âge maternel élevé ou des signes d'appel échographiques et/ ou biochimiques. Une des patientes était porteuse d'une translocation robertsonienne t(14;21) équilibrée. Une amniocentèse a été réalisée chez toutes les gestantes et aucun avortement n'a était induit par ce geste invasif. L’âge gestationnel moyen à la première consultation était de 14 semaines d'aménorrhée (SA) et à l'amniocentèse était de 16 SA et 5 jours. L'analyse FISH a été réalisée, après consentement des couples, sur des cellules non cultivées à partir des échantillons de liquides amniotiques, en utilisant des sondes spécifiques du chromosome 21. Résultats Parmi les 23 patientes qui ont bénéficiées d'un diagnostic anténatal de la trisomie 21 par la technique FISH, nous avons pu rassurer 21 d'entre elles, et nous avons détecté deux cas de trisomie 21 fœtal. Conclusion La technique FISH permet un diagnostic anténatal rapide, en moins de 48h, de la trisomie 21 sur

  15. Utility and diagnostic accuracy of endobronchial ultrasound-guided transbronchial fine-needle aspiration cytology of mediastinal lesions: Saudi Arabian experience

    PubMed Central

    Raddaoui, Emad; Alhamad, Esam H; Zaidi, Shaesta Naseem; Al-Habeeb, Fatmah F; Arafah, Maha

    2014-01-01

    Objective: The objective of this study is to evaluate the cytological accuracy of endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-TFNA) of the mediastinal mass/nodular lesions. Study Design: Over 3½ years from inception at King Khalid University Hospital, a retrospective analysis of the cytological diagnoses of all the EBUS-TFNA procedures performed in 80 patients who had mediastinal mass/nodular enlargement. Cytology results were reviewed and correlated with the histologic follow-up. Results: Of the 80 patients who underwent EBUS-TFNA, 15 cases (18.75%) were positive for malignancy, 48 cases (60%) negative for malignancy and 17 cases (21.25%) unsatisfactory. Of the 48 cases, which were negative for malignancy, 24 (50%) cases were of granulomatous inflammation. The overall diagnostic yield of our EBUS-TFNA specimen was 78.75%. Forty-seven cases (58.75%) of 80 cases had histological follow-up biopsies. Among them, 32 cases (68%) had the same cytological and histological diagnosis and 15 cases (31.09%) had discordance between the cytology and the follow-up histological diagnosis. The sensitivity, specificity, and positive and negative predictive values for diagnosing granulomas by EBUS-TFNA are 77%, 82%, 83%, and 75% and for diagnosing malignancy are 71%, 100%, 100%, and 82%, respectively. Conclusion: Preliminary results show that cytological samples obtained through EBUS-TFNA are accurate and specific in making a diagnosis of the mediastinal mass/nodular lesions. Its optimum use depends on the effective collaboration between the cytotechnologist, pathologist, and the bronchoscopist. PMID:25191512

  16. Diagnostic performance of des-γ-carboxy prothrombin (DCP) for hepatocellular carcinoma: a bivariate meta-analysis.

    PubMed

    Gao, P; Li, M; Tian, Q B; Liu, Dian-Wu

    2012-01-01

    Serum markers are needed to be developed to specifically diagnose Hepatocellular carcinoma (HCC). Des-γ-carboxy prothrombin (DCP) is a promising tool with limited expense and widely accessibility, but the reported results have been controversial. In order to review the performance of DCP for the diagnosis of HCC, the meta-analysis was performed. After a systematic review of relevant studies, the sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR, respectively) were pooled using a bivariate meta-analysis. Potential between-study heterogeneity was explored by meta-regression model. The post-test probability and the likelihood ratio scattergram to evaluate clinical usefulness were calculated. Based on literature review of 20 publications, the overall sensitivity, specificity, PLR and NLR of DCP for the detection of HCC were 67% (95%CI, 58%-74%), 92% (95%CI, 88%-94%), 7.9 (95%CI, 5.6-11.2) and 0.36 (95%CI, 0.29-0.46), respectively. The area under the bivariate summary receiving operating characteristics curve was 0.89 (95%CI, 0.85-0.92). Significant heterogeneity was present. In conclusion, the major role of DCP is the moderate confirmation of HCC. More prospective studies of DCP are needed in future.

  17. Diagnostic utility of MYC amplification and anti-MYC immunohistochemistry in atypical vascular lesions, primary or radiation-induced mammary angiosarcomas, and primary angiosarcomas of other sites.

    PubMed

    Ginter, Paula S; Mosquera, Juan Miguel; MacDonald, Theresa Y; D'Alfonso, Timothy M; Rubin, Mark A; Shin, Sandra J

    2014-04-01

    Breast cancer patients who receive radiation therapy or develop chronic lymphedema following axillary dissection can develop secondary mammary angiosarcomas (ASs) and, additionally, atypical vascular lesions (AVLs) in the former group. Recently, MYC amplification by fluorescence in situ hybridization (FISH) has been identified in secondary mammary AS but not in AVL and most primary mammary AS as well as AS of other sites. We studied MYC amplification and MYC protein expression in 7 radiation-induced AVLs, 9 secondary mammary ASs, 17 primary mammary ASs, and 20 primary ASs of other sites by FISH analysis and immunohistochemistry. All 9 secondary mammary ASs showed gene amplification and protein expression, whereas neither was found in any of 7 AVLs. No MYC amplification or protein expression was identified in any of the 17 primary mammary ASs. Among primary ASs of other sites, 1 cardiac AS and 1 skin AS showed gene amplification and protein expression. The remaining 18 did not show amplification (90%), but some demonstrated protein expression (39%). We conclude that MYC amplification by FISH is present in secondary mammary AS but not in AVL. We also found MYC amplification in 1 primary skin AS and 1 primary cardiac AS. There was 100% concordance between MYC amplification and protein expression in all AVL, primary mammary AS, and secondary mammary AS, whereas only 65% concordance was found in AS of other sites. MYC protein expression in AS can be helpful in certain diagnostic scenarios in the breast but not in other sites.

  18. 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.

  19. Diagnostic Evaluation of Des-Gamma-Carboxy Prothrombin versus α-Fetoprotein for Hepatitis B Virus-Related Hepatocellular Carcinoma in China: A Large-Scale, Multicentre Study

    PubMed Central

    Zheng, Lei; Yin, Yuepeng; Zou, Zhenzhen; Zhou, Feiguo; Zhou, Weiping; Shen, Feng; Gao, Chunfang

    2016-01-01

    An efficient serum marker for hepatocellular carcinoma (HCC) is currently lacking and requires intensive exploration. We aimed to evaluate the performance of des-gamma-carboxy prothrombin (DCP) for identifying hepatitis B virus-related HCC in a large, multicentre study in China. A total of 1034 subjects in three cohorts (A, B, and C) including HCC and various non-HCC controls were enrolled from 4 academic medical centers in China from January 2011 to February 2014. Blind parallel detections were conducted for DCP and AFP. The area under the receiver operating characteristic curve (AUC) was used to evaluate the diagnostic efficacies. In cohort A, which comprised 521 subjects, including patients with HCC, liver metastasis, liver cirrhosis (LC), and liver hemangiomas as well as healthy controls (HCs), the accuracy of DCP for distinguishing HCC from various controls was 6.2–9.7% higher than that of AFP. In cohort B, which comprised 447 subjects, including patients with HCC, LC, and chronic hepatitis B as well as HC, the accuracy of DCP was further elevated (12.3–20.67% higher than that of AFP). The superiority of DCP to AFP was more profound in the surveillance of early HCC [AUC 0.837 (95% CI: 0.771–0.903) vs. 0.650 (0.555–0.745)] and AFP-negative HCC [AUC: 0.856 (0.798–0.914)] and in discriminating HCC from LC (accuracy: 92.9% vs.64.71%). Higher DCP levels were associated with worse clinical behaviors and shorter disease-free survival. DCP not only is complementary to AFP in identifying AFP-negative HCC and in excluding AFP-positive non-HCC (liver cirrhosis), but also demonstrates improved performance in HCC surveillance, early diagnosis, treatment response and recurrence monitoring in the HBV-related population. PMID:27070780

  20. Diagnostic Evaluation of Des-Gamma-Carboxy Prothrombin versus α-Fetoprotein for Hepatitis B Virus-Related Hepatocellular Carcinoma in China: A Large-Scale, Multicentre Study.

    PubMed

    Ji, Jun; Wang, Hao; Li, Yan; Zheng, Lei; Yin, Yuepeng; Zou, Zhenzhen; Zhou, Feiguo; Zhou, Weiping; Shen, Feng; Gao, Chunfang

    2016-01-01

    An efficient serum marker for hepatocellular carcinoma (HCC) is currently lacking and requires intensive exploration. We aimed to evaluate the performance of des-gamma-carboxy prothrombin (DCP) for identifying hepatitis B virus-related HCC in a large, multicentre study in China. A total of 1034 subjects in three cohorts (A, B, and C) including HCC and various non-HCC controls were enrolled from 4 academic medical centers in China from January 2011 to February 2014. Blind parallel detections were conducted for DCP and AFP. The area under the receiver operating characteristic curve (AUC) was used to evaluate the diagnostic efficacies. In cohort A, which comprised 521 subjects, including patients with HCC, liver metastasis, liver cirrhosis (LC), and liver hemangiomas as well as healthy controls (HCs), the accuracy of DCP for distinguishing HCC from various controls was 6.2-9.7% higher than that of AFP. In cohort B, which comprised 447 subjects, including patients with HCC, LC, and chronic hepatitis B as well as HC, the accuracy of DCP was further elevated (12.3-20.67% higher than that of AFP). The superiority of DCP to AFP was more profound in the surveillance of early HCC [AUC 0.837 (95% CI: 0.771-0.903) vs. 0.650 (0.555-0.745)] and AFP-negative HCC [AUC: 0.856 (0.798-0.914)] and in discriminating HCC from LC (accuracy: 92.9% vs.64.71%). Higher DCP levels were associated with worse clinical behaviors and shorter disease-free survival. DCP not only is complementary to AFP in identifying AFP-negative HCC and in excluding AFP-positive non-HCC (liver cirrhosis), but also demonstrates improved performance in HCC surveillance, early diagnosis, treatment response and recurrence monitoring in the HBV-related population. PMID:27070780

  1. Diagnostic Evaluation of Des-Gamma-Carboxy Prothrombin versus α-Fetoprotein for Hepatitis B Virus-Related Hepatocellular Carcinoma in China: A Large-Scale, Multicentre Study.

    PubMed

    Ji, Jun; Wang, Hao; Li, Yan; Zheng, Lei; Yin, Yuepeng; Zou, Zhenzhen; Zhou, Feiguo; Zhou, Weiping; Shen, Feng; Gao, Chunfang

    2016-01-01

    An efficient serum marker for hepatocellular carcinoma (HCC) is currently lacking and requires intensive exploration. We aimed to evaluate the performance of des-gamma-carboxy prothrombin (DCP) for identifying hepatitis B virus-related HCC in a large, multicentre study in China. A total of 1034 subjects in three cohorts (A, B, and C) including HCC and various non-HCC controls were enrolled from 4 academic medical centers in China from January 2011 to February 2014. Blind parallel detections were conducted for DCP and AFP. The area under the receiver operating characteristic curve (AUC) was used to evaluate the diagnostic efficacies. In cohort A, which comprised 521 subjects, including patients with HCC, liver metastasis, liver cirrhosis (LC), and liver hemangiomas as well as healthy controls (HCs), the accuracy of DCP for distinguishing HCC from various controls was 6.2-9.7% higher than that of AFP. In cohort B, which comprised 447 subjects, including patients with HCC, LC, and chronic hepatitis B as well as HC, the accuracy of DCP was further elevated (12.3-20.67% higher than that of AFP). The superiority of DCP to AFP was more profound in the surveillance of early HCC [AUC 0.837 (95% CI: 0.771-0.903) vs. 0.650 (0.555-0.745)] and AFP-negative HCC [AUC: 0.856 (0.798-0.914)] and in discriminating HCC from LC (accuracy: 92.9% vs.64.71%). Higher DCP levels were associated with worse clinical behaviors and shorter disease-free survival. DCP not only is complementary to AFP in identifying AFP-negative HCC and in excluding AFP-positive non-HCC (liver cirrhosis), but also demonstrates improved performance in HCC surveillance, early diagnosis, treatment response and recurrence monitoring in the HBV-related population.

  2. Monitoring pigmented skin lesions

    NASA Astrophysics Data System (ADS)

    Wallace, Vincent P.; Bamber, Jeffery C.; Ott, Robert J.; Crawford, Diane C.; Mortimer, Peter S.

    2002-06-01

    The rising incidence of skin cancer has led to an increase in the number of patients with skin lesions that require diagnosis, mostly using subjective visual examination. Successful treatment depends on early diagnosis. Unfortunately diagnostic accuracy, even by experts, can be as low as 56%; therefore, an accurate, objective diagnostic aid is greatly needed. Reflectance characteristics of pigmented skin lesions were documented to evaluate their diagnostic potential. Reflectance spectra in the wavelength range 320-1100nm were obtained from 260 lesions. Differences between spectra from benign and malignant lesions were utilized by extracting features with the best discriminating power. Discrimination was evaluated using two techniques: multivariate statistical analysis and artificial neural networks, using histology as the standard. Each technique was tested in a blind study and assessed in terms of its ability to diagnose new cases and compared to the clinical diagnosis. The artificial neural network achieved the best diagnostic performance for discriminating between malignant melanoma and benign nevi, having a sensitivity of 100% and a specificity of 65%. Utilization of visible and infrared techniques for monitoring skin lesions has lead to improvements in diagnostic accuracy. We conclude that these techniques are worthy of further development and evaluation in clinical practice as a screening tool.

  3. [Managing focal incidental renal lesions].

    PubMed

    Nicolau, C; Paño, B; Sebastià, C

    2016-01-01

    Incidental renal lesions are relatively common in daily radiological practice. It is important to know the different diagnostic possibilities for incidentally detected lesions, depending on whether they are cystic or solid. The management of cystic lesions is guided by the Bosniak classification. In solid lesions, the goal is to differentiate between renal cancer and benign tumors such as fat-poor angiomyolipoma and oncocytoma. Radiologists need to know the recommendations for the management of these lesions and the usefulness of the different imaging techniques and interventional procedures in function of the characteristics of the incidental lesion and the patient's life expectancy.

  4. Magnetic resonance imaging of liver lesions: exceptions and atypical lesions.

    PubMed

    van den Bos, Indra C; Hussain, Shahid M; de Man, Robert A; Zondervan, Pieter E; Ijzermans, Jan N M; Preda, A; Krestin, Gabriel P

    2008-01-01

    On state-of-the-art magnetic resonance imaging, most lesions can be detected and characterized with confidence according to well-known criteria. However, atypical characteristics in some common lesions and the incidental encounter with rare lesions may pose diagnostic difficulties. In this article, six challenging hepatic lesions will be discussed and evaluated on the most important magnetic resonance imaging sequences, with histological correlation when available. In addition, the background information concerning these lesions will be described based on the most recent available literature. By reading this article, the reader will be able to (1) categorize the lesion in solid and fluid-containing lesions, based on the T2 signal intensity; and (2) define the benign or malignant nature of the lesion, in relation to the signal intensity and dynamic enhancement pattern, despite the presence of atypical characteristics of some lesions. PMID:18436109

  5. 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

  6. Clinical Implication of p16, Ki-67, and Proliferating Cell Nuclear Antigen Expression in Cervical Neoplasia: Improvement of Diagnostic Accuracy for High-grade Squamous Intraepithelial Lesion and Prediction of Resection Margin Involvement on Conization Specimen

    PubMed Central

    Kim, Tae Hun; Han, Jee Hye; Shin, Eun; Noh, Jae Hong; Kim, Hee Seung; Song, Yong Sang

    2015-01-01

    Background: Cervical intraepithelial neoplasia (CIN) grading is subjective and affected by substantial rates of discordance among pathologists. Although the use of p16INK4a (p16) staining has been proven to improve diagnostic accuracy for high-grade squamous intraepithelial lesion (HSIL), the clinical evidence for use of Ki-67 and proliferating cell nuclear antigen (PCNA) is insufficient to make an independent recommendation for use, alone or in combination. The primary objective was to evaluate clinical utility of Ki-67 and PCNA in combination with p16 in diagnosing HSIL. Also, we assessed the correlation between expressions of three biomarkers and resection margin status of conization specimen. Methods: The expressions of p16, Ki-67, and PCNA were evaluated by immunohistochemical methods in 149 cervical tissues encompassing 17 negative lesion, 31 CIN 1, 25 CIN 2, 41 CIN 3, and 35 invasive squamous cell carcinoma. The immunohistochemical staining results were classified into four grades: 0, 1+, 2+ and 3+. Results: The expression of three biomarkers was positively associated with CIN grade. Ki-67 immunostaining did not increase the accuracy of HSIL diagnosis when combined with p16 immunostaining compared with p16 immunostaining alone. In contrast, combining the staining results for p16 and PCNA (p16 = 3+ and PCNA ≥2+) increased its specificity (66.7% vs. 75.0%, P = 0.031) without decrease of its sensitivity (98.7% vs. 98.7%) for diagnosis of CIN 3 and more sever lesion. Subgroup analysis for conization specimen with CIN 2 and CIN 3 showed that positive Ki-67 immunostaining was an independent risk factor for predicting resection margin positivity (odds ratio = 6.52, 95% confidence interval 1.07–39.64). Conclusions: We found that the combined use of p16 and PCNA immunostaining enhanced diagnostic accuracy for HSIL. Positive Ki-67 immunostaining was associated with incomplete excision. PMID:25853106

  7. Intraventricular mass lesions

    SciTech Connect

    Morrison, G.; Sobel, D.F.; Kelley, W.M.; Norman, D.

    1984-11-01

    Determining the precise etiology of an intraventricular mass can be a difficult diagnostic problem. CT and angiographic findings were reviewed in a series of 73 patients who had intraventricular masses. The histologic diagnosis can be suggested preoperatively by an analysis of the frequency of lesions occurring at a given ventricular location, lesion density before and after administration of contrast material, age, and sex of the patient, morphologic appearance of the mass, and presence or absence of hydrocephalus. Angiography is useful when meningioma, choroid plexus papilloma and carcinoma, or arteriovenous malformation are considered.

  8. [Evaluation of meniscal morphology and relation between the diagnostic findings of magnetic resonance imaging and arthroscopy in lesions of the knee].

    PubMed

    Esparragoza-Montero, Ricardo; Rodriguez-Diaz, José; Lanier-Dominguez, Julio; Molero-Campos, María; Puccia-Scimonello, Marianela

    2009-03-01

    Magnetic resonance imaging (MRI) is useful in the diagnosis of meniscal lesions of the knee. The purpose of this study was to relate the findings of MRI and arthroscopy and to evaluate the morphology of the menisci with tears. 39 patients of both genders were included, whose age range was 13 to 74 years old (mean: 42.6 years), with and without a history of trauma, who underwent MRI and arthroscopy of the knee, due to symptoms of articular lesion. The images of magnetic resonances were analyzed independently by two specialists prior to the arthroscopy. The measurements of the medial and lateral menisci were made in each meniscal horn with sagital images in protonic density and fat-suppression. MRI detected 8 cases of tear of the lateral meniscus of the 11 catalogued by arthroscopy, and 11 cases of tears of the medial meniscus of the 13 catalogued by arthroscopy. The sensibility and specificity of MRI for the lateral meniscal tears were 72% and 100%, and for the medial tears were 85% and 89%. The meniscal tears were localized mainly in the posterior horn. The dimensions of the posterior horn of the lateral meniscus were larger in disrupted menisci (height, 7.1 +/- 1.3 mm vs. 6.1 +/- 0.7 mm, p < .05; wide, 10.2 +/- 1.6 mm vs. 8.8 +/- 1.3 mm, p < 0.05). A meniscal tear produces morphological changes, particularly in the posterior horn of the lateral meniscus. Magnetic resonance constitutes the imaging technique of choice for the diagnosis of the meniscal tears.

  9. Diagnostic clinique et paraclinique des infections ostéoarticulaires digitales dans les brûlures thermiques de la main

    PubMed Central

    Zaoui, A.; Mahdhi, N.; Ben Maitigue, M.; Maaref, K.; Jemni, S.; Bouaziz, M.A.; Regaieg, H.; Dakkem, M.; Zine El Abidine, M.; Ben Fredj, M.; Khachnaoui, F.; Rejeb, N.

    2013-01-01

    Summary Les infections ostéo-articulaires digitales de la main brûlée sont particulières car longtemps méconnu. Leur diagnostic n’a pratiquement jamais été abordé dans la littérature. On distingue d’une part les ostéoarthrites survenant à la phase aiguë de la brûlure chez le patient grand brûlé, sédaté où le diagnostic est difficile en réanimation car la clinique n’est pas parlante et d’autre part les ostéoarthrites découvertes à la phase de rééducation, où douleur, tuméfaction, raideur et signes radiologiques sont nets. Le diagnostic de ces infections doit être précoce à fin de préserver la fonction de la main. PMID:24133401

  10. 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

  11. 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

  12. Fine needle aspiration cytology of salivary gland lesions.

    PubMed

    Jayaram, G; Verma, A K; Sood, N; Khurana, N

    1994-07-01

    247 salivary gland lesions were subjected to fine needle aspiration (FNA) cytology; 179 were designated as neoplastic lesions and 68 as non-neoplastic. Based on cytomorphologic features, the neoplastic and non-neoplastic lesions were subcategorised. All but 36 of the neoplastic lesions were subjected to histopathologic study. The overall diagnostic accuracy of FNA cytology for neoplastic lesions was 91%. The sensitivity rate for detecting malignant tumours was 87.8% and the specificity 98.0%. There was 100% sensitivity for cytodiagnosis of benign tumours. The high sensitivity and specificity of cytodiagnosis makes FNA cytology a valuable diagnostic modality in the evaluation of salivary gland lesions.

  13. Intraventricular CNS lesions: A pictorial essay.

    PubMed

    Watts, Jane; Yap, Kelvin K; Ou, Daniel; Tartaglia, Con; Trost, Nicholas; Sutherland, Tom

    2015-08-01

    Intraventricular lesions of the central nervous system (CNS) can present a diagnostic challenge due to a range of differential diagnoses and radiological appearances. Both CT and MRI imaging findings, in combination with location and patient's age, can help limit the differentials. This pictorial essay presents the salient radiological features, location and demographics of the more common intraventricular lesions of the brain.

  14. Des Moines.

    ERIC Educational Resources Information Center

    Gore, Deborah, Ed.

    1988-01-01

    This document, intended for elementary students, contains articles and activities designed to acquaint young people with the history of Des Moines, Iowa. The articles are short, and new or difficult words are highlighted and defined for young readers. "The Raccoon River Indian Agency" discusses the archeological exploration of the indian…

  15. 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

  16. Visual evoked potentials in occipital lobe lesions.

    PubMed

    Streletz, L J; Bae, S H; Roeshman, R M; Schatz, N J; Savino, P J

    1981-02-01

    Recording of visual evoked potentials (VEPs) to pattern reversal is considered to be a reliable diagnostic procedure for examining patients with anterior visual pathway lesions (optic nerves and chiasm). Less consistent results have been reported in studies of more posterior lesions. The VEPs were recorded in 20 patients with occipital lobe lesions. A maximal VEP response (P94) was recorded at the scalp electrodes situated over the involved occipital lobes and contralateral to the hemianoptic visual field defect, indicating a positive correlation of unilateral occipital lobe lesions, homonymous visual field loss, and the VEP abnormality.

  17. 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

  18. Congenital lung lesions: Postnatal management and outcome.

    PubMed

    Parikh, Dakshesh H; Rasiah, Shree Vishna

    2015-08-01

    Antenatal diagnosis of lung lesion has become more accurate resulting in dilemma and controversies of its antenatal and postnatal management. Majority of antenatally diagnosed congenital lung lesions are asymptomatic in the neonatal age group. Large lung lesions cause respiratory compromise and inevitably require urgent investigations and surgery. The congenital lung lesion presenting with hydrops requires careful postnatal management of lung hypoplasia and persistent pulmonary hypertension. Preoperative stabilization with gentle ventilation with permissive hypercapnia and delayed surgery similar to congenital diaphragmatic hernia management has been shown to result in good outcome. The diagnostic investigations and surgical management of the asymptomatic lung lesions remain controversial. Postnatal management and outcome of congenital cystic lung lesions are discussed. PMID:26051048

  19. Diagnostic problems in oral pathology.

    PubMed

    Dunlap, C L; Barker, B F

    1985-02-01

    Diagnostic problems within the oral cavity may be associated with lesions of the odontogenic apparatus, salivary glands, bone, mucosa, and connective tissue. Some lesions are unique to the oral cavity, others have a systemic distribution. Several unique and controversial lesions have been selected for discussion, including (1) necrotizing sialometaplasia, a benign salivary gland disease easily mistaken for malignancy; (2) verrucous lesions including verrucous carcinoma, verrucous hyperplasia, and papillary carcinoma; (3) spindle-cell carcinoma, which is often confused with sarcoma; (4) named and unnamed embryonic rests, which may resemble metastatic carcinomas; (5) dental pulp mistaken for odontogenic myxoma; and (6) granular cell tumor with associated pseudoepitheliomatous hyperplasia.

  20. Placental hypoxia: the lesions of maternal malperfusion.

    PubMed

    Parks, W Tony

    2015-02-01

    The placental lesions classically ascribed to placental hypoxia, here denoted maternal malperfusion (MMP), are among the more significant that a placental pathologist may encounter. Yet the appearance of these lesions may be subtle, and the clinical implication of their diagnosis is frequently unclear. The aim of this review is to provide a more nuanced perspective on the clinical utility of placental pathology for the detection of MMP. The review will first detail MMP lesions in the placenta and discuss their associations with pregnancy complications. The review will then delve into the diagnostic and interpretive difficulties of these lesions. Finally, recent research findings that may aid in the development of better diagnostic tools will be briefly discussed.

  1. Spindle cell melanocytic lesions: part II--an approach to intradermal proliferations and horizontally oriented lesions.

    PubMed

    Sade, Shachar; Al Habeeb, Ayman; Ghazarian, Danny

    2010-05-01

    Melanocytic lesions show great morphological diversity in their architecture and the cytomorphological appearance of their composite cells. Whereas functional melanocytes show a dendritic cytomorphology and territorial isolation, lesional nevomelanocytes and melanoma cells typically show epithelioid, spindled or mixed cytomorphologies, and a range of architectural arrangements. Spindling is common to melanocytic lesions, and may either be a characteristic feature or a divergent appearance. The presence of spindle cells may mask the melanocytic nature of a lesion, and is often disconcerting, either due to its infrequent appearance in a particular lesion or its interpretation as a dedifferentiated phenotype. Spindle cell melanocytic lesions follow the full spectrum of potential biological outcomes, and difficulty may be experienced judging the nature of a lesion due to a lack of consistently reliable features to predict biological behaviour. Over time, recognition of numerous histomorphological features that may portend a more aggressive lesion have been identified; however, the translation of these features into a diagnostic entity requires a gestalt approach. Although most spindle cell melanocytic lesions may reliably be resolved through this standard approach, problem areas do exist for the surgical pathologist or dermatopathologist. With this review (part II of II), we complete our discussion of spindle cell melanocytic lesions, in order to: (1) model a systematic approach to such lesions; and (2) provide familiarity with those melanocytic lesions which either typically or occasionally display a spindled cytomorphology.

  2. SLAP lesions in the overhead athlete.

    PubMed

    Rokito, Steven E; Myers, Kevin R; Ryu, Richard K N

    2014-06-01

    The diagnosis and management of SLAP lesions in the overhead athlete remains a challenge for the sports medicine specialist due to variable anatomy, changes with aging, concomitant pathology, lack of dependable physical findings on examination, and lack of sensitivity and specificity with imaging studies. This article presents a comprehensive review of the epidemiology, relevant anatomy, proposed pathogenesis, diagnostic approach, and outcomes of nonoperative and operative management of SLAP lesions in the overhead athlete.

  3. [Elevated gastric lesions].

    PubMed

    de Careaga, B; Villagómez, G; Pabón, J; Calderón, O; Elío, D; Pérez, J; Martínez, M; Patiño, F; Ponce, R; Lora, J

    1986-01-01

    Elevated gastric lesions, represent an important group among gastric pathology. To establish its incidence in our experience, we studied the endoscopic reports of two important hospitals in La Paz city: Instituto de Gastroenterología Boliviano Japonés and Hospital Obrero No. 1. In order to make a good endoscopic diagnosis among different elevated lesions we use some parameters like: location, shape, size, diameter, surface of the lesion and surrounding mucosa and characteristics of the falls. 10.472 endoscopic reports were reviewed, 497 elevated gastric lesions were found, 475 corresponded to mucosal lesions (352 benign lesions and 123 malignant lesions), 11 to submucosal and 11 extragastric lesions.

  4. [Diagnostics in osteology].

    PubMed

    Jakob, F; Genest, F; Seefried, L; Tsourdi, E; Lapa, C; Hofbauer, L C

    2016-07-01

    Clinical diagnostics in metabolic bone diseases cover a broad spectrum of conventional and state of the art methods ranging from the medical history and clinical examination to molecular imaging. Patient treatment is carried out in an interdisciplinary team due to the multiple interactions of bone with other organ systems. Diagnosis of osteoporosis is supported by high level national guidelines. A paradigm shift concerning the clinical relevance of bone mineral density measurement renders this now to be a strong risk factor rather than a diagnostic parameter, while strengthening the value of other clinical factors for risk assessment. The impact of parameters for muscle mass, structure and function is steadily increasing in all age groups. In order to identify underlying diseases that influence bone metabolism a panel of general laboratory diagnostic parameters is recommended. Markers for bone formation and resorption and specific parameters for the regulation of calcium and phosphate metabolism should be evaluated by specialists because they require diligence in preanalytics and experience in interpretation. Genetic diagnosis is well established for rare bone diseases while diagnostic panels are not yet available for routine diagnostics in polygenetic diseases such as osteoporosis. Conventional radiology is still very important to identify, e. g. fractures, osteolytic and osteoblastic lesions and extraosseous calcifications; however tomography-based methods which combine, e. g. scintigraphy or positron emission technologies with anatomical imaging are of increasing significance. Clinical diagnostics in osteology require profound knowledge and are subject to a dynamic evolution. PMID:27307159

  5. Adrenal imaging (Part 1): Imaging techniques and primary cortical lesions

    PubMed Central

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

    2015-01-01

    Adrenal glands can be affected by a variety of lesions. Adrenal lesions can either be primary, of adrenal origin, or secondary to other pathologies. Primary adrenal lesions can further be either of cortical or medullary origin. Functioning adrenal lesions can also give clues to the histologic diagnosis and direct workup. Over the years, various imaging techniques have been developed that have increased diagnostic accuracy and helped in better characterization of adrenal lesions non-invasively. In the first part of the two part series, we review adrenal imaging techniques and adrenal cortical tumors such as adenomas, adrenocortical tumors, adrenal hyperplasia and oncocytomas. PMID:25593820

  6. Evaluation of hepatic cystic lesions

    PubMed Central

    Lantinga, Marten A; Gevers, Tom JG; Drenth, Joost PH

    2013-01-01

    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

  7. Spindle cell melanocytic lesions--part I: an approach to compound naevoidal pattern lesions with spindle cell morphology and Spitzoid pattern lesions.

    PubMed

    Sade, Shachar; Al Habeeb, Ayman; Ghazarian, Danny

    2010-04-01

    Melanocytic lesions show great morphological diversity in their architecture and the cytomorphological appearance of their composite cells. Whereas functional melanocytes reveal a dendritic cytomorphology and territorial isolation, lesional naevomelanocytes and melanoma cells typically show epithelioid, spindled or mixed cytomorphologies and a range of architectural arrangements. Spindling is common to melanocytic lesions, and may be either a characteristic feature or a divergent appearance. The presence of spindle cells may mask the melanocytic nature of a lesion, and is often disconcerting, either because of its infrequent appearance in a particular lesion or its interpretation as a dedifferentiated phenotype. Spindle cell melanocytic lesions follow the full spectrum of potential biological outcomes, and difficulty may be experienced judging the nature of a lesion because of a lack of consistently reliable features to predict biological behaviour. Over time, recognition of numerous histomorphological features that may portend a more aggressive lesion have been identified. However, the translation of these features into a diagnostic entity requires a gestalt approach. Although most spindle cell melanocytic lesions can reliably be resolved with this standard approach, problem areas do exist and cause no end of grief to the surgical pathologist or dermatopathologist. In this review, the authors present their algorithmic approach to spindle cell melanocytic lesions and discuss each entity in turn, in order to (1) model a systematic approach to such lesions, and (2) provide familiarity with those melanocytic lesions that either typically or occasionally display a spindled cytomorphology.

  8. 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.

  9. Example Based Lesion Segmentation

    PubMed Central

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

    2016-01-01

    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.

  10. Peste des petits ruminants.

    PubMed

    Parida, S; Muniraju, M; Mahapatra, M; Muthuchelvan, D; Buczkowski, H; Banyard, A C

    2015-12-14

    Peste des petits ruminants virus causes a highly infectious disease of small ruminants that is endemic across Africa, the Middle East and large regions of Asia. The virus is considered to be a major obstacle to the development of sustainable agriculture across the developing world and has recently been targeted by the World Organisation for Animal Health (OIE) and the Food and Agriculture Organisation (FAO) for eradication with the aim of global elimination of the disease by 2030. Fundamentally, the vaccines required to successfully achieve this goal are currently available, but the availability of novel vaccine preparations to also fulfill the requisite for differentiation between infected and vaccinated animals (DIVA) may reduce the time taken and the financial costs of serological surveillance in the later stages of any eradication campaign. Here, we overview what is currently known about the virus, with reference to its origin, updated global circulation, molecular evolution, diagnostic tools and vaccines currently available to combat the disease. Further, we comment on recent developments in our knowledge of various recombinant vaccines and on the potential for the development of novel multivalent vaccines for small ruminants.

  11. Peste des petits ruminants.

    PubMed

    Parida, S; Muniraju, M; Mahapatra, M; Muthuchelvan, D; Buczkowski, H; Banyard, A C

    2015-12-14

    Peste des petits ruminants virus causes a highly infectious disease of small ruminants that is endemic across Africa, the Middle East and large regions of Asia. The virus is considered to be a major obstacle to the development of sustainable agriculture across the developing world and has recently been targeted by the World Organisation for Animal Health (OIE) and the Food and Agriculture Organisation (FAO) for eradication with the aim of global elimination of the disease by 2030. Fundamentally, the vaccines required to successfully achieve this goal are currently available, but the availability of novel vaccine preparations to also fulfill the requisite for differentiation between infected and vaccinated animals (DIVA) may reduce the time taken and the financial costs of serological surveillance in the later stages of any eradication campaign. Here, we overview what is currently known about the virus, with reference to its origin, updated global circulation, molecular evolution, diagnostic tools and vaccines currently available to combat the disease. Further, we comment on recent developments in our knowledge of various recombinant vaccines and on the potential for the development of novel multivalent vaccines for small ruminants. PMID:26443889

  12. Peste des petits ruminants

    PubMed Central

    Parida, S.; Muniraju, M.; Mahapatra, M.; Muthuchelvan, D.; Buczkowski, H.; Banyard, A.C.

    2015-01-01

    Peste des petits ruminants virus causes a highly infectious disease of small ruminants that is endemic across Africa, the Middle East and large regions of Asia. The virus is considered to be a major obstacle to the development of sustainable agriculture across the developing world and has recently been targeted by the World Organisation for Animal Health (OIE) and the Food and Agriculture Organisation (FAO) for eradication with the aim of global elimination of the disease by 2030. Fundamentally, the vaccines required to successfully achieve this goal are currently available, but the availability of novel vaccine preparations to also fulfill the requisite for differentiation between infected and vaccinated animals (DIVA) may reduce the time taken and the financial costs of serological surveillance in the later stages of any eradication campaign. Here, we overview what is currently known about the virus, with reference to its origin, updated global circulation, molecular evolution, diagnostic tools and vaccines currently available to combat the disease. Further, we comment on recent developments in our knowledge of various recombinant vaccines and on the potential for the development of novel multivalent vaccines for small ruminants. PMID:26443889

  13. Aspiration cytology of salivary gland lesions advantages and pitfalls.

    PubMed

    Kamal, M M; Dani, A A; Kotwal, M N; Kherdekar, M S

    1994-07-01

    FNAC of the major salivary glands was performed on 72 patients during a period of two and a half years. In 64 patients samples were satisfactory. The cytologic diagnosis was correlated with histology available in 36 cases. 21 out of 22 benign lesions and 12 out 4 malignant lesions were correctly identified rendering a diagnostic accuracy of 91 percent. The pitfalls of FNAC of salivary gland lesions are reflected by the overall false positive rate of 5.5 percent of false negative rate of 2.7 percent. Diagnostic pitfalls are due to variability of tumor morphology which makes sampling & interpretation difficult. Multiple sampling and increasing experience help to minimize errors.

  14. The Management of Benign Bone Lesions

    PubMed Central

    Moore, Tillman M.; Harvey, J. Paul

    1976-01-01

    The almost bewildering variety of lesions that can affect bone contrasts sharply with the limited potential of bone to differentially respond to those lesions. This paradox can create a challenging problem when a bone lesion is shown on an x-ray film. Although heavily populated with pleuripotential primitive mesenchymal cells, there is seldom a histologic or radiographic change in the involved bone specific enough to allow a comfortable diagnostic autonomy to be enjoyed by surgical pathologists, radiologists or orthopaedic surgeons. Even when diligent and astute clinical evaluation has excluded infectious, parasitic, metabolic and metastatic causes of the change seen on x-ray studies, a physician is often still uncertain as to the exact nature of the lesion. A knowledge of the relative frequency of the common lesions, an acceptance that biopsy studies and treatment must be combined at times, an appreciation of the possibility of malignant change in a given lesion and a tendency to seek early consultation will likely lead to timely and accurate diagnosis. Once the diagnosis is made, optimum management must be selected. The best current opinion categorizes the lesions into treatment groups consisting of observation, curettage and graft, block excision, cryotherapy and radiotherapy. PMID:1246894

  15. Sonographic diagnosis of an acute Stener lesion: a case report.

    PubMed

    Mattox, Ross; Welk, Aaron B; Battaglia, Patrick J; Scali, Frank; Nunez, Mero; Kettner, Norman W

    2016-01-01

    This case report describes the use of diagnostic ultrasound to diagnose a Stener lesion in a patient who presented for conservative care of thumb pain following a fall on an outstretched hand. Conventional radiographic images demonstrated an avulsion fracture at the ulnar aspect of the base of the first proximal phalanx. Diagnostic ultrasound revealed a torn ulnar collateral ligament of the thumb that was displaced proximal to the adductor aponeurosis, consistent with a Stener lesion. Dynamic imaging with ultrasound confirmed displacement of the fully torn ligament. Surgical repair followed the diagnosis. Diagnostic ultrasound in this case provided an accurate diagnosis obviating further imaging. This allowed an optimal outcome due to early intervention.

  16. Imaging caries lesions and lesion progression with polarization-sensitive optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Fried, Daniel; Xie, John; Shafi, Sahar; Featherstone, John D. B.; Breunig, Thomas; Le, Charles Q.

    2002-06-01

    New diagnostic tools are needed for the characterization of dental caries in the early stages of development. If carious lesions are detected early enough, they can be arrested without the need for surgical intervention. The objective of this study was to demonstrate that polarization sensitive optical coherence tomography (PS-OCT) can be used for the imaging of early caries lesions and for the monitoring of lesion progression over time. High-resolution polarization resolved images were acquired of natural caries lesions and simulated caries lesions of varying severity created over time periods of 1 to 14 days. Linearly polarized light was incident on the tooth samples and the reflected intensity in both orthogonal polarizations was measured. PS-OCT was invaluable for removing the confounding influence of surface reflections and native birefringence and for resolving the surface structure of caries lesions. This study demonstrated that PS-OCT is well suited for the resolution of interproximal and occlusal caries, early root caries, and secondary caries around composite fillings. Longitudinal measurements of lesion progression established a strong correlation (p<0.001) between the reflected light from the lesion area and the square root of time indicating that PS-OCT is well suited for monitoring changes in enamel mineralization over time.

  17. 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

  18. Potentially malignant oral lesions: clinicopathological correlations

    PubMed Central

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

    2016-01-01

    ABSTRACT 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

  19. Ultrasonic diagnosis of renal and retroperitoneal lesions.

    PubMed

    Asher, W M; Freimanis, A K

    1977-05-01

    The unique ability of ultrasound to detect soft tissue interfaces makes it a prime tool for at least one major diagnostic approach to soft tissue lesions. Systematic ultrasonic examination of suspected masses in the abdomen should be performed early in the course of investigation. It will help direct additional studies and often result in cost savings by making the diagnostic process more efficient. The method is painless, to the best of our knowledge harmless and can be repeated at will for early study or late follow-up. The ultrasonic look into the body has provided us with a major tool for obtaining far more information on internal structures than was possible even a few years ago. Ultrasonic scans, radioisotope examinations and computerized x-ray tomography are leading us into an era of much increased anatomic knowledge about lesions which heretofore were obscure and difficult to evaluate.

  20. Enhancement of International Dermatologists’ Pigmented Skin Lesion Biopsy Decisions Following Dermoscopy with Subsequent Integration of Multispectral Digital Skin Lesion Analysis

    PubMed Central

    Farberg, Aaron S.; Tucker, Natalie; White, Richard; Rigel, Darrell S.

    2016-01-01

    Background: Early detection and subsequent management of melanoma are critical for patient survival. New technologies have been developed to augment clinician analysis of suspicious pigmented skin lesions. Objective: To determine how information provided by a multispectral digital skin lesion analysis device affects the biopsy decisions of international dermatologists following clinical and dermoscopic pigmented skin lesion evaluation. Methods: Participants at a dermoscopy conference in Vienna, Austria, were shown 12 clinical and dermoscopic images of pigmented skin lesions (2 melanomas in situ, 3 invasive melanomas, and 7 low-grade dysplastic nevi) previously analyzed by multispectral digital skin lesion analysis. Participants were asked if they would biopsy the lesion based on clinical images, again after observing high-resolution dermoscopy images, and again when subsequently shown multispectral digital skin lesion analysis information. Results: Data were analyzed from a total of 70 international dermatologists. Overall, sensitivity was 58 percent after clinical evaluation (C) and 59 percent post-dermoscopy (D), but 74 percent after multispectral digital skin lesion analysis. Participant specificity was 56 percent (C) decreasing to 51 percent (D), but increasing to 61 percent with multispectral digital skin lesion analysis. Diagnostic accuracy was 57 percent (C) decreasing to 54 percent (D), but increasing to 67 percent for dermatologists after integrating the multispectral digital skin lesion analysis data into the biopsy decision. The overall number of lesions biopsied increased from 50 percent (C) to 53 percent (D), rising to 54 percent after multispectral digital skin lesion analysis. Conclusion: Decisions to biopsy melanocytic lesions were more sensitive and specific when multispectral digital skin lesion analysis information was provided with no significant increase in the number of biopsies recommended. Providing multispectral digital skin lesion analysis

  1. Enhancement of International Dermatologists’ Pigmented Skin Lesion Biopsy Decisions Following Dermoscopy with Subsequent Integration of Multispectral Digital Skin Lesion Analysis

    PubMed Central

    Farberg, Aaron S.; Tucker, Natalie; White, Richard; Rigel, Darrell S.

    2016-01-01

    Background: Early detection and subsequent management of melanoma are critical for patient survival. New technologies have been developed to augment clinician analysis of suspicious pigmented skin lesions. Objective: To determine how information provided by a multispectral digital skin lesion analysis device affects the biopsy decisions of international dermatologists following clinical and dermoscopic pigmented skin lesion evaluation. Methods: Participants at a dermoscopy conference in Vienna, Austria, were shown 12 clinical and dermoscopic images of pigmented skin lesions (2 melanomas in situ, 3 invasive melanomas, and 7 low-grade dysplastic nevi) previously analyzed by multispectral digital skin lesion analysis. Participants were asked if they would biopsy the lesion based on clinical images, again after observing high-resolution dermoscopy images, and again when subsequently shown multispectral digital skin lesion analysis information. Results: Data were analyzed from a total of 70 international dermatologists. Overall, sensitivity was 58 percent after clinical evaluation (C) and 59 percent post-dermoscopy (D), but 74 percent after multispectral digital skin lesion analysis. Participant specificity was 56 percent (C) decreasing to 51 percent (D), but increasing to 61 percent with multispectral digital skin lesion analysis. Diagnostic accuracy was 57 percent (C) decreasing to 54 percent (D), but increasing to 67 percent for dermatologists after integrating the multispectral digital skin lesion analysis data into the biopsy decision. The overall number of lesions biopsied increased from 50 percent (C) to 53 percent (D), rising to 54 percent after multispectral digital skin lesion analysis. Conclusion: Decisions to biopsy melanocytic lesions were more sensitive and specific when multispectral digital skin lesion analysis information was provided with no significant increase in the number of biopsies recommended. Providing multispectral digital skin lesion analysis

  2. Peste des Petits Ruminants Virus.

    PubMed

    Baron, M D; Diallo, A; Lancelot, R; Libeau, G

    2016-01-01

    Peste des petits ruminants virus (PPRV) causes a severe contagious disease of sheep and goats and has spread extensively through the developing world. Because of its disproportionately large impact on the livelihoods of low-income livestock keepers, and the availability of effective vaccines and good diagnostics, the virus is being targeted for global control and eventual eradication. In this review we examine the origin of the virus and its current distribution, and the factors that have led international organizations to conclude that it is eradicable. We also review recent progress in the molecular and cellular biology of the virus and consider areas where further research is required to support the efforts being made by national, regional, and international bodies to tackle this growing threat. PMID:27112279

  3. Comparison of Full Lesion Coverage versus Spot Drug-Eluting Stent Implantation for Coronary Artery Stenoses

    PubMed Central

    Kim, Seunghwan; Yun, Kyeong Ho; Shin, Dong-Ho; Kim, Jung-Sun; Kim, Byeong-Keuk; Ko, Young-Guk; Choi, Donghoon; Jang, Yangsoo

    2014-01-01

    Purpose The aim of this study was to evaluate and compare the long-term clinical outcomes of the spot drug-eluting stent (DES) implantation strategy, which is used to minimize implanted stent length and the number of stents, versus full lesion coverage for treatment of coronary artery stenoses. Materials and Methods We evaluated 1-year clinical outcomes of 1619 patients with stent implantation for a single coronary lesion. They were divided into two groups: those treated by full lesion coverage (n=1200) and those treated with the spot stenting strategy (n=419). The combined occurrence of 1-year target vessel failure (TVF), including cardiac death, target-vessel related myocardial infarction, or ischemia-driven target-vessel revascularization was evaluated. Results The spot DES implantation group had a shorter stent length (23.14±9.70 mm vs. 25.44±13.24 mm, respectively; p<0.001) and a fewer number of stents (1.09±0.30 vs. 1.16±0.41, respectively; p<0.001), even though the average lesion length was similar to the full lesion coverage group (21.36±10.30 mm vs. 20.58±10.97 mm, respectively; p=0.206). Spot DES implantation was superior to full DES coverage with respect to 1-year TVF (1.4% vs. 3.3%, p=0.044). Cox proportional hazard model analysis showed that the risk for 1-year TVF was almost 60% lower among patients who received spot DESs compared to those who received full DES coverage after adjustment for other risk factors (HR=0.40, 95% confidence interval=0.17-0.98; p=0.046). Conclusion Minimizing stent length and the number of stents with overlapping by spot DES implantation may result in reduced rates of 1-year TVF, compared with full DES coverage. PMID:24719123

  4. Advanced bronchoscopy for the diagnosis of peripheral pulmonary lesions.

    PubMed

    Asano, Fumihiro

    2016-07-01

    Bronchoscopy to examine peripheral pulmonary lesions is performed using a bronchoscope with an outer diameter of 5-6mm under fluoroscopy, but the diagnostic yield can be insufficient. Problems with transbronchial biopsy include a limited range of bronchoscope insertion, difficulty in guiding a bronchoscope and biopsy instruments to lesions, and insufficient confirmation of the arrival of biopsy instruments at the target lesion; as such, new techniques have been used to overcome these individual problems. Radial-endobronchial ultrasound is used to identify peripheral pulmonary lesions and sampling sites. In a meta-analysis, the diagnostic yield, that of lesions smaller than 2cm, and complication rate were 73, 56.3, and 1.0%, respectively. Virtual bronchoscopic navigation is a method to guide a bronchoscope to peripheral lesions under direct vision using virtual bronchoscopic images of the bronchial route, and the diagnostic yield, that of 2-cm or smaller lesions, and complication rate were 73.8, 67.4, and 1.0%, respectively. Electromagnetic navigation utilizes electromagnetism; the diagnostic yield was 64.9-71%, and the pneumothorax complication rate was 4% for this modality. Ultrathin bronchoscopes can be advanced to the peripheral bronchus under direct vision in contrast to normal-size bronchoscopes, and the diagnostic yield and pneumothorax complication rates were reported to be 63 and 1.5%, respectively. The overall diagnostic yield of these new techniques on meta-analysis was 70%, a higher yield than that obtained with conventional transbronchial biopsy. Each technique has advantages and disadvantages, and the investigation of appropriate combinations corresponding to individual cases is necessary. PMID:27424820

  5. 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

  6. 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

  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. [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

  9. Molecular Diagnostics

    PubMed Central

    Choe, Hyonmin; Deirmengian, Carl A.; Hickok, Noreen J.; Morrison, Tiffany N.; Tuan, Rocky S.

    2015-01-01

    Orthopaedic infections are complex conditions that require immediate diagnosis and accurate identification of the causative organisms to facilitate appropriate management. Conventional methodologies for diagnosis of these infections sometimes lack accuracy or sufficient rapidity. Current molecular diagnostics are an emerging area of bench-to-bedside research in orthopaedic infections. Examples of promising molecular diagnostics include measurement of a specific biomarker in the synovial fluid, polymerase chain reaction–based detection of bacterial genes, and metabolomic determination of responses to orthopaedic infection. PMID:25808967

  10. Spectrum of superficial nerve-related tumor and tumor-like lesions: MRI features.

    PubMed

    Wadhwa, Vibhor; Lee, Pearlene P; Strome, Glenn M; Suh, Kyung Jin; Carrino, John A; Chhabra, Avneesh

    2014-04-01

    Superficial soft-tissue masses arising from skin appendages, metastasis, and inflammatory lesions have been widely reported. However, nerve-related superficial mass-like lesions other than peripheral nerve sheath tumors are less commonly described. High resolution magnetic resonance imaging (MRI) is an excellent non-invasive tool for the evaluation of such lesions. In this article, the authors discuss the entire spectrum of these lesions and also outline a systemic diagnostic approach.

  11. Multifocal vascular lesions.

    PubMed

    Levin, Laura E; Lauren, Christine T

    2016-03-01

    Multifocal vascular lesions are important to recognize and appropriately diagnose. Generally first noticed on the skin, multifocal vascular lesions may have systemic involvement. Distinguishing among the different types of multifocal vascular lesions is often based on clinical features; however, radiological imaging and/or biopsy are frequently needed to identify distinct features and guide treatment. Knowledge of the systemic associations that can occur with different vascular anomalies may reduce life-threatening complications, such as coagulopathy, bleeding, cardiac compromise, and neurologic sequelae. This review provides a synopsis of the epidemiology, pathogenesis, presentation, workup, and treatment of several well-recognized multifocal vascular tumors and malformations. PMID:27607324

  12. 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

  13. Des ballons pour demain

    NASA Astrophysics Data System (ADS)

    Régipa, R.

    A partir d'une théorie sur la détermination des formes et des contraintes globales d'un ballon de révolution, ou s'en rapprochant, une nouvelle famille de ballons a été définie. Les ballons actuels, dits de ``forme naturelle'', sont calculés en général pour une tension circonférencielle nulle. Ainsi, pour une mission donnée, la tension longitudinale et la forme de l'enveloppe sont strictement imposées. Les ballons de la nouvelle génération sont globalement cylindriques et leurs pôles sont réunis par un câble axial, chargé de transmettre une partie des efforts depuis le crochet (pôle inférieur), directement au pôle supérieur. De plus, la zone latérale cylindrique est soumise à un faible champ de tensions circonférencielles. Ainsi, deux paramètres permettent de faire évoluer la distribution des tensions et la forme de l'enveloppe: - la tension du câble de liaison entre pôles (ou la longueur de ce câble) - la tension circonférencielle moyenne désirée (ou le rayon du ballon). On peut donc calculer et réaliser: - soit des ballons de forme adaptée, comme les ballons à fond plat pour le bon fonctionnement des montgolfières infrarouge (projet MIR); - soit des ballons optimisés pour une bonne répartition des contraintes et une meilleure utilisation des matériaux d'enveloppe, pour l'ensemble des programmes stratosphériques. Il s'ensuit une économie sensible des coûts de fabrication, une fiabilité accrue du fonctionnement de ces ballons et une rendement opérationnel bien supérieur, permettant entre autres, d'envisager des vols à très haute altitude en matériaux très légers.

  14. Laser therapy of pigmented lesions: pro and contra.

    PubMed

    Bukvić Mokos, Zrinka; Lipozenčić, Jasna; Ceović, Romana; Stulhofer Buzina, Daška; Kostović, Krešimir

    2010-01-01

    Although frequently performed, laser removal of pigmented lesions still contains certain controversial issues. Epidermal pigmented lesions include solar lentigines, ephelides, café au lait macules and seborrheic keratoses. Dermal lesions include melanocytic nevi, blue nevi, drug induced hyperpigmentation and nevus of Ota and Ito. Some lesions exhibit both an epidermal and dermal component like Becker's nevus, postinflammatory hyperpigmentations, melasma and nevus spilus. Due to the wide absorption spectrum of melanin (500-1100 nm), several laser systems are effective in removal of pigmented lesions. These lasers include the pigmented lesion pulsed dye laser (510 nm), the Q-switched ruby laser (694 nm), the Q-switched alexandrite laser (755 nm) and the Q-switched Nd:YAG laser (1064 nm), which can be frequency-doubled to produce visible green light with a wavelength of 532 nm. The results of laser therapy are usually successful. However, there are still many controversies regarding the use of lasers in treating certain pigmented lesions. Actually, the essential question in removing pigmented lesions with lasers is whether the lesion has atypical features or has a malignant potential. Dermoscopy, used as a routine first-level diagnostic technique, is helpful in most cases. If there is any doubt whether the lesion is benign, then a biopsy for histologic evaluation is obligatory.

  15. Skin lesion of blastomycosis

    MedlinePlus

    ... in: Africa Canada Central and southeastern United States India Israel Saudi Arabia A person gets infected by ... is diagnosed by identifying the fungus in a culture taken from a skin lesion. This usually requires ...

  16. Fungal Diagnostics

    PubMed Central

    Kozel, Thomas R.; Wickes, Brian

    2014-01-01

    Early diagnosis of fungal infection is critical to effective treatment. There are many impediments to diagnosis such as a diminishing number of clinical mycologists, cost, time to result, and requirements for sensitivity and specificity. In addition, fungal diagnostics must meet the contrasting needs presented by the increasing diversity of fungi found in association with the use of immunosuppressive agents in countries with high levels of medical care and the need for diagnostics in resource-limited countries where large numbers of opportunistic infections occur in patients with AIDS. Traditional approaches to diagnosis include direct microscopic examination of clinical samples, histopathology, culture, and serology. Emerging technologies include molecular diagnostics and antigen detection in clinical samples. Innovative new technologies that use molecular and immunoassay platforms have the potential to meet the needs of both resource-rich and resource-limited clinical environments. PMID:24692193

  17. Acute nontraumatic liver lesions.

    PubMed

    Caremani, Marcello; Tacconi, Danilo; Lapini, Laura

    2013-11-26

    The principal conditions requiring emergency/urgent intervention in patients with nontraumatic liver lesions are hemorrhage (with or without tumor rupture), rupture of hydatid cysts (with or without infection), complications arising from liver abscesses or congenital liver cysts, rupture related to peliosis hepatis, and in rare cases spontaneous hemorrhage. This article examines each of these conditions, its appearance on ultrasound (the first-line imaging method of choice for assessing any urgent nontraumatic liver lesion) and indications for additional imaging studies.

  18. [Osteoarticular lesions from parachuting].

    PubMed

    Orso, C A; Valbonesi, L; Calabrese, B F; D'Onofrio, S

    1990-01-01

    Based on personal experience gained in a parachuting centre (Pescara Aero-club) from 1975 up to 1988, the authors report their evaluation on chronic and acute osteoarticular lesions. The review of the cases was not based on the incidence of the lesions nor on their characteristics, normally found in common traumatology, but it was related to the dynamics of the trauma during the landing and to painful syndromes following a prolonged parachuting activity.

  19. Diagnostic riddles

    USGS Publications Warehouse

    Sileo, L.; Greiner, E.C.

    1993-01-01

    A bridled white-eye (Zosterops conspicillata) was captured in a mist net on the island of Saipan and transported to the island of Guam for an experimental study. Beginning on day three, it was immunosuppressed by intramuscular injections of dexamethasone. It was unexpectedly found dead on day 20, at which time it had lost 0.9 g (12.9% of initial body weight). Gross Pathology: Despite the weight loss, the white-eye was in good flesh, with abundant subcutaneous and visceral fat. The spleen was 3 x 11 mm, about 5 times normal size. The striatum of the forebrain was congested. There were no other lesions. Histopathology: There were microscopic abnormalities in skeletal muscle, brain, and gizzard (Figs. 1 and 2; Figure 2 is from a different white-eye which had virtually identical gizzard lesions).

  20. Diagnostic imaging.

    PubMed

    Morris, Peter; Perkins, Alan

    2012-04-21

    Physical techniques have always had a key role in medicine, and the second half of the 20th century in particular saw a revolution in medical diagnostic techniques with the development of key imaging instruments: x-ray imaging and emission tomography (nuclear imaging and PET), MRI, and ultrasound. These techniques use the full width of the electromagnetic spectrum, from gamma rays to radio waves, and sound. In most cases, the development of a medical imaging device was opportunistic; many scientists in physics laboratories were experimenting with simple x-ray images within the first year of the discovery of such rays, the development of the cyclotron and later nuclear reactors created the opportunity for nuclear medicine, and one of the co-inventors of MRI was initially attempting to develop an alternative to x-ray diffraction for the analysis of crystal structures. What all these techniques have in common is the brilliant insight of a few pioneering physical scientists and engineers who had the tenacity to develop their inventions, followed by a series of technical innovations that enabled the full diagnostic potential of these instruments to be realised. In this report, we focus on the key part played by these scientists and engineers and the new imaging instruments and diagnostic procedures that they developed. By bringing the key developments and applications together we hope to show the true legacy of physics and engineering in diagnostic medicine. PMID:22516558

  1. Diagnostic Imaging

    MedlinePlus

    Diagnostic imaging lets doctors look inside your body for clues about a medical condition. A variety of machines and techniques can create pictures of the structures and activities inside your body. The type of imaging your doctor uses depends on your symptoms and ...

  2. Percutaneous Transluminal Angioplasty and Drug-Eluting Stents for Infrapopliteal Lesions in Critical Limb Ischemia (PADI) Trial

    PubMed Central

    Spreen, Marlon I.; Martens, Jasper M.; Hansen, Bettina E.; Knippenberg, Bob; Verhey, Elke; van Dijk, Lukas C.; de Vries, Jean-Paul P.M.; Vos, Jan-Albert; de Borst, Gert Jan; Vonken, Evert-Jan P.A.; Wever, Jan J.; Statius van Eps, Randolph G.; Mali, Willem P.Th.M.

    2016-01-01

    Background— Endovascular infrapopliteal treatment of patients with critical limb ischemia using percutaneous transluminal angioplasty (PTA) and bail-out bare metal stenting (BMS) is hampered by restenosis. In interventional cardiology, drug-eluting stents (DES) have shown better patency rates and are standard practice nowadays. An investigator-initiated, multicenter, randomized trial was conducted to assess whether DES also improve patency and clinical outcome of infrapopliteal lesions. Methods and Results— Adults with critical limb ischemia (Rutherford category ≥4) and infrapopliteal lesions were randomized to receive PTA±BMS or DES with paclitaxel. Primary end point was 6-month primary binary patency of treated lesions, defined as ≤50% stenosis on computed tomographic angiography. Stenosis >50%, retreatment, major amputation, and critical limb ischemia–related death were regarded as treatment failure. Severity of failure was assessed with an ordinal score, ranging from vessel stenosis through occlusion to the clinical failures. Seventy-four limbs (73 patients) were treated with DES and 66 limbs (64 patients) received PTA±BMS. Six-month patency rates were 48.0% for DES and 35.1% for PTA±BMS (P=0.096) in the modified-intention-to-treat and 51.9% and 35.1% (P=0.037) in the per-protocol analysis. The ordinal score showed significantly worse treatment failure for PTA±BMS versus DES (P=0.041). The observed major amputation rate remained lower in the DES group until 2 years post-treatment, with a trend toward significance (P=0.066). Less minor amputations occurred after DES until 6 months post-treatment (P=0.03). Conclusions— In patients with critical limb ischemia caused by infrapopliteal lesions, DES provide better 6-month patency rates and less amputations after 6 and 12 months compared with PTA±BMS. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00471289. PMID:26861113

  3. Management of a massive resorptive lesion with multiple perforations in a molar: case report.

    PubMed

    Borkar, Swati; de Noronha de Ataide, Ida

    2015-05-01

    Internal resorption is usually asymptomatic. Large resorption defects may result in penetration of the root dentin leading to perforation. In this case report, we describe the diagnosis and nonsurgical repair of a large resorptive lesion with multiple perforations in a mandibular first molar using cone-beam computed tomographic technology. The 3 different root perforations were located in the mesial root and repaired using Biodentine (Septodont, Saint-Maur des Fossés, France). The mesial root weakened from resorption was reinforced by replacing the lost root dentin with calcium silicate-based cement and placement of a glass fiber post. The 18-month follow-up confirmed remineralization of the osseous defect and asymptomatic function of the tooth. A further follow-up at 43 months revealed retention of the tooth and absence of root fracture. Usually, a tooth with multiple perforations and such a severe tooth material loss would have been destined for extraction. However, with contemporary diagnostic techniques such as cone-beam computed tomography and use of advanced biomaterials and root reinforcement methods, such teeth can be salvaged.

  4. Tumefactive Demyelinating Lesions in Multiple Sclerosis and Associated Disorders.

    PubMed

    Frederick, Meredith C; Cameron, Michelle H

    2016-03-01

    Tumefactive demyelinating lesions are rare consequences of central nervous system (CNS) idiopathic inflammatory demyelinating diseases. Tumefactive demyelinating lesions pose a diagnostic challenge because they can mimic tumors and abscesses and because they can be caused by a heterogeneous range of disorders. This article reviews the recent literature on the clinical presentation; radiographic features; prognosis; and management of tumefactive demyelinating lesions in multiple sclerosis, acute demyelinating encephalomyelitis, neuromyelitis optica, and the rare variants of multiple sclerosis including Schilder's disease, Marburg acute multiple sclerosis, and Balo's concentric sclerosis.

  5. Noninvasive spectroscopic diagnosis of superficial ocular lesions and corneal infections

    SciTech Connect

    Mourant, J.R.; Bigio, I.J.; Johnson, T.; Shimada, T.; Gritz, D.C.; Storey-Held, K.

    1994-02-01

    The potential of a rapid noninvasive diagnostic system to detect tissue abnormalities on the surface of the eye has been investigated. The optical scatter signal from lesions and normal areas on the conjunctival sclera of the human eye were measured in vivo. It is possible to distinguish nonpigmented pingueculas from other lesions. The ability of the system to detect malignancies could not be tested because none of the measured and biopsied lesions were malignant. Optical scatter and fluorescence spectra of bacterial and fungal suspensions, and corneal irritations were also collected. Both scattering and fluorescence show potential for diagnosing corneal infections.

  6. Radiographic and Pathologic Manifestations of Uncommon and Rare Pulmonary Lesions.

    PubMed

    Pfeifer, Kyle; Mian, Ali; Adebowale, Adeniran; Alomari, Ahmed; Kalra, Vivek; Krejci, Elise; Shin, Myung Soo

    2016-05-01

    Pulmonary opacities/nodules are common findings on computed tomography examinations, which may represent an underlying infections or malignancy. However, not every pulmonary nodule or opacity represents malignancy or infection. We present a pictorial essay illustrating common as well as obscure noninfectious, nonmalignant pulmonary lesions. Lesions discussed include organizing pneumonia, Langerhans cell histiocytosis, pulmonary amyloidosis, hyalinizing granuloma, tumourlet (benign localized neuroendocrine cell proliferations), atypical alveolar hyperplasia, inflammatory myofibroblastic tumour, papillary alveolar adenoma, plasma cell granuloma, juvenile xanthogranuloma, and sclerosing hemangiomas. We discuss the clinical presentation, prevalence, radiographic clues, pathology, and diagnostic pitfalls of these rare lesions. PMID:26690551

  7. Abdominal mass lesions in the newborn: diagnosis and treatment.

    PubMed

    Hartman, G E; Shochat, S J

    1989-03-01

    Most neonatal abdominal masses will be due to benign retroperitoneal lesions such as hydronephrosis and multicystic dysplastic kidney. Although history and physical examination, plain radiographs and ultrasonography will confirm most diagnoses, severe unilateral hydronephrosis, hemorrhagic neuroblastoma, and intraperitoneal cysts may provide diagnostic difficulties. Masses identified by prenatal ultrasound need careful evaluation as they may represent normal structures, nonsignificant variants, or physiologically significant anomalies. Many lesions will require operative intervention, which can be safely performed in small infants by trained personnel at facilities with appropriate support services. Genuine controversy exists in the management of some of these lesions including MDK, renal vein thrombosis, and acalculous cholecystitis.

  8. Respiratory Disease: Diagnostic Approaches in the Horse.

    PubMed

    Hewson, Joanne; Arroyo, Luis G

    2015-08-01

    Evaluation of the upper and lower respiratory tract of horses requires strategic selection of possible diagnostic tests based on location of suspected pathologic lesions and purpose of testing and must also include consideration of patient status. This article discusses the various diagnostic modalities that may be applied to the respiratory system of horses under field conditions, indications for use, and aspects of sample collection, handling, and laboratory processing that can impact test results and ultimately a successful diagnosis in cases of respiratory disease.

  9. Endoscopic Ultrasonography in the Diagnosis of Gastric Subepithelial Lesions

    PubMed Central

    Gong, Eun Jeong; Kim, Do Hoon

    2016-01-01

    Subepithelial lesions occasionally found in the stomach of patients undergoing endoscopy may be either benign lesions or tumors with malignant potential. They may also appear due to extrinsic compression. Discrimination of gastric subepithelial lesions begins with meticulous endoscopic examination for size, shape, color, mobility, consistency, and appearance of the overlying mucosa. Accurate diagnosis can be achieved with endoscopic ultrasonography, which provides useful information on the exact size, layer-of-origin, and characteristic morphologic features to support a definitive diagnosis. Endoscopic ultrasonography also aids in the prediction of malignant potential, especially in gastrointestinal stromal tumors. Features of subepithelial lesions identified on endoscopic ultrasonography can be used to determine whether further diagnostic procedures such as endoscopic resection, fine needle aspiration, or core biopsy are required. Endoscopic ultrasonography is a valuable tool for diagnosis and clinical decision making during follow-up of gastric subepithelial lesions. PMID:27744661

  10. Proposed Clinico-Pathological Classification for Oral Exophytic Lesions

    PubMed Central

    Boyd, Doryck; Laxminarayana, Kumaraswamy Kikeri

    2015-01-01

    Oral exophytic lesions often have proven to be diagnostically challenging due to the varied clinical presentation. The exophytic growth of the oral lesions is due to the type of pathology and histological changes. Careful clinical interpretation with a better histological understanding of exophytic lesions may ease the diagnosis from the differential diagnosis panel. The purpose of proposing classification system is to categorize the exophytic lesions of interest under specific clinical and/or histological explanation; and this will eventually lead to better understanding of the pathological condition that is described. To the best of our knowledge, there is no such classification system available for oral exophytic lesions and hence proposal of classification system is attempted in this study. Further, proposing a new classification system is not just to influence the academic contribution, but also to assist at greatest extent for diagnosis during clinical practice. PMID:26501030

  11. 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.

  12. 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

  13. Proposed Clinico-Pathological Classification for Oral Exophytic Lesions.

    PubMed

    Santosh, Arvind Babu Rajendra; Boyd, Doryck; Laxminarayana, Kumaraswamy Kikeri

    2015-09-01

    Oral exophytic lesions often have proven to be diagnostically challenging due to the varied clinical presentation. The exophytic growth of the oral lesions is due to the type of pathology and histological changes. Careful clinical interpretation with a better histological understanding of exophytic lesions may ease the diagnosis from the differential diagnosis panel. The purpose of proposing classification system is to categorize the exophytic lesions of interest under specific clinical and/or histological explanation; and this will eventually lead to better understanding of the pathological condition that is described. To the best of our knowledge, there is no such classification system available for oral exophytic lesions and hence proposal of classification system is attempted in this study. Further, proposing a new classification system is not just to influence the academic contribution, but also to assist at greatest extent for diagnosis during clinical practice. PMID:26501030

  14. Diagnostic Procedures of Itch.

    PubMed

    Reich, Adam; Szepietowski, Jacek C

    2016-01-01

    A complex and multifactorial pathogenesis of itch makes the proper diagnosis of underlying disease a difficult and challenging clinical problem. The examination of every patient with itch should be started by gathering an accurate history. During the anamnesis it is important to obtain data about the beginning of the appearance of symptoms, its location, diurnal variation, and the factors influencing itch perception. After careful anamnesis the patient should undergo a detailed physical examination, with particular attention to the skin in order to look for any signs of skin lesions. Special attention should be paid to distinguish the primary lesion from the changes resulting from scratching. In patients in whom the etiology of the itch cannot be identified on the basis of the medical examination, a panel of primary screen laboratory examination may be required, and if necessary, depending on the results of basic laboratory results and data from medical history, additional diagnostic tests should be considered. In patients in whom an organic cause of itching has not been established, itch is most likely of undetermined origin; however, psychogenic causes should also be suspected and ruled out. In conclusion, it could be stated that itch is a common symptom of many skin diseases, systemic of neurological diseases. Despite the complex etiology of the disease, an exact cause of itch should be searched for in each patient, as successful therapy is largely dependent on the determination of the cause of the itching. PMID:27578067

  15. Imaging of the adrenal gland lesions.

    PubMed

    Herr, Keith; Muglia, Valdair F; Koff, Walter José; Westphalen, Antonio Carlos

    2014-01-01

    With the steep increase in the use of cross-sectional imaging in recent years, the incidentally detected adrenal lesion, or "incidentaloma", has become an increasingly common diagnostic problem for the radiologist, and a need for an approach to classifying these lesions as benign, malignant or indeterminate with imaging has spurred an explosion of research. While most incidentalomas represent benign disease, typically an adenoma, the possibility of malignant involvement of the adrenal gland necessitates a reliance on imaging to inform management decisions. In this article, we review the literature on adrenal gland imaging, with particular emphasis on computed tomography, magnetic resonance imaging, and photon-emission tomography, and discuss how these findings relate to clinical practice. Emerging technologies, such as contrast-enhanced ultrasonography, dual-energy computed tomography, and magnetic resonance spectroscopic imaging will also be briefly addressed.

  16. Imaging of the adrenal gland lesions*

    PubMed Central

    Herr, Keith; Muglia, Valdair F.; Koff, Walter José; Westphalen, Antonio Carlos

    2014-01-01

    With the steep increase in the use of cross-sectional imaging in recent years, the incidentally detected adrenal lesion, or "incidentaloma", has become an increasingly common diagnostic problem for the radiologist, and a need for an approach to classifying these lesions as benign, malignant or indeterminate with imaging has spurred an explosion of research. While most incidentalomas represent benign disease, typically an adenoma, the possibility of malignant involvement of the adrenal gland necessitates a reliance on imaging to inform management decisions. In this article, we review the literature on adrenal gland imaging, with particular emphasis on computed tomography, magnetic resonance imaging, and photon-emission tomography, and discuss how these findings relate to clinical practice. Emerging technologies, such as contrast-enhanced ultrasonography, dual-energy computed tomography, and magnetic resonance spectroscopic imaging will also be briefly addressed. PMID:25741090

  17. Le syndrome des brides amniotiques et ses difficultés diagnostiques et de prise en charge au Burkina Faso

    PubMed Central

    Nagalo, Kisito; Badiel, Roger; Kouéta, Fla; Tall, François Housséini; Yé, Diarra

    2015-01-01

    Le syndrome des brides amniotiques est une embryo-foetopathie rare, d’étiopathogénie encore inconnue, caractérisé par des malformations crânio-faciales, thoraco-abdominales, des membres et des extrémités. Afin de discuter des difficultés diagnostiques et thérapeutiques du syndrome des brides amniotiques, nous rapportons cinq cas de ce syndrome. Ces cas représentaient autant de phénotypes de la maladie mais avec quelques singularités. Les deux premiers étaient des cas de maladie des brides amniotiques caractérisés l'un par une amputation d'un membre inférieur associée à des lésions cutanées et à une surdité, l'autre par des strictions avec amputation des doigts associées à une fente labio-palatine, une cataracte congénitale et un strabisme. Les trois autres cas correspondaient à des formes létales du Limb Body Wall Complex dont deux avec attache placento-crânienne et un avec attache placento-abdominale. Le renforcement du diagnostic anténatal, l'instauration du conseil génétique et la mise en place d'un registre national des malformations devraient permettre d'améliorer la prise en charge des cas du syndrome des brides amniotiques. PMID:26113939

  18. [Current perspectives on endodontic treatment of teeth with chronic periapical lesions].

    PubMed

    Canalda Sahli, C

    1990-01-01

    The author study in this article histopathological aspects of periapical lesions, intra-granulomatous epithelial proliferation phenomenon as pathogenic mechanism of microscopic cystic cavities formation, diagnostic problems of them all, as well as the most actual therapeutic perspectives.

  19. [Current perspectives on endodontic treatment of teeth with chronic periapical lesions].

    PubMed

    Canalda Sahli, C

    1990-01-01

    The author study in this article histopathological aspects of periapical lesions, intra-granulomatous epithelial proliferation phenomenon as pathogenic mechanism of microscopic cystic cavities formation, diagnostic problems of them all, as well as the most actual therapeutic perspectives. PMID:1964067

  20. Intracranial Lesions with Low Signal Intensity on T2-weighted MR Images - Review of Pathologies.

    PubMed

    Zimny, Anna; Neska-Matuszewska, Małgorzata; Bladowska, Joanna; Sąsiadek, Marek J

    2015-01-01

    In this article we presented intracranial pathological substances and lesions with low signal intensity on T2-weighted images. Eight groups of substances were discussed i.e. 1. Gadolinium-based contrast materials, 2. hemoglobin degradation products 3. melanin, 4. mucous- or protein-containing lesions, 5. highly cellular lesions, 6. lesions containing mineral substances such as: calcium, copper and iron, 7. turbulent and rapid blood or CSF flow 8. air-containing spaces. Appropriate interpretation of signal intensity as well as analysis of lesion location and clinical symptoms enable a correct choice of a further diagnostic algorithm or, in many cases, final diagnosis based exclusively on an MRI examination. PMID:25628772

  1. Application of principal component analysis to multispectral imaging data for evaluation of pigmented skin lesions

    NASA Astrophysics Data System (ADS)

    Jakovels, Dainis; Lihacova, Ilze; Kuzmina, Ilona; Spigulis, Janis

    2013-11-01

    Non-invasive and fast primary diagnostics of pigmented skin lesions is required due to frequent incidence of skin cancer - melanoma. Diagnostic potential of principal component analysis (PCA) for distant skin melanoma recognition is discussed. Processing of the measured clinical multi-spectral images (31 melanomas and 94 nonmalignant pigmented lesions) in the wavelength range of 450-950 nm by means of PCA resulted in 87 % sensitivity and 78 % specificity for separation between malignant melanomas and pigmented nevi.

  2. Contrast-Enhanced Harmonic Endoscopic Ultrasonography of Solid Pancreatic Lesions

    PubMed Central

    Kwek, Boon Eu Andrew; Ang, Tiing Leong; Seo, Dong Wan; Imazu, Hiroo

    2013-01-01

    Endoscopic ultrasonography is the best modality for pancreatic lesion evaluation as its superior spatial resolution allows small lesions to be identified and fine needle aspiration (FNA) cytology performed under ultrasound-guidance. Despite this, differentiating benign from malignant lesions remains a challenge as conventional ultrasound imaging is unable to differentiate lesions accurately and tissue yield is poorly diagnostic or limited in patients with the chronic inflammation. Contrast-harmonic technology uses a wide-band transducer capable of inducing sufficient acoustic energy to create harmonic microbubble oscillations of the newer second-generation ultrasound contrast agents (UCAs). These microbubbles are more stable, remaining within the intravascular component longer and emit significantly more harmonic content than surrounding tissue, thus allowing pancreatic parenchymal differentiation and microvascular architecture visualization. The use of UCAs is generally safe, but should be especially avoided in patients with unstable ischemic heart disease. During CH endosonography, pancreatic adenocarcinoma is commonly seen as an inhomogenous hypoenhancing lesion, focal pancreatitis as a hypo- or iso-enhancing lesion and neuroendocrine tumor as a hyperenhancing lesion. The presence of hyperenhancement is a strong predictor of non-adenocarcinoma etiology. Furthermore, in patients with the chronic pancreatitis or biliary stents that may obscure pancreatic inspection, the addition of contrast-harmonic endosonography to guide FNA cytology improves its diagnostic yield and accuracy. Quantitative analysis of perfusion through the time intensity curve is promising as an objective and accurate method to differentiate pancreatic lesions. Furthermore, studies are required to fully determine the role of contrast harmonic endosonography in the differential diagnosis of solid pancreatic lesions. PMID:24949382

  3. Giant intraosseous cyst-like lesions in rheumatoid arthritis report of a case.

    PubMed

    Lohse, Anne; Carbillet, Jean-Pierre; Onimus, Michel; Stevenel, Françoise; Toussirot, Eric; Wendling, Daniel

    2003-02-01

    The term "intraosseous synovial cyst" is used to designate both the epiphyseal cyst-like lesions seen in patients with rheumatoid arthritis (RA) and mucoid cysts, which occur in a different setting. We report the case of a patient in whom a 4-cm cyst-like lesion developed in the left tibia 18 years after onset of RA and 6 years after osmic acid synovectomy of the left knee. Positive contrast arthrography and magnetic resonance imaging visualized a communication between the lesion and the joint space. Preexisting bone and joint lesions and increased intraarticular pressure play a major role in the genesis of cyst-like lesions in RA. In our patient, the osmic acid synovectomy may have contributed to the development of the lesion. "Synovial cyst" is a misnomer for these giant lesions, which are geodes rather than cysts. Despite their low incidence, these lesions deserve attention because they raise diagnostic and therapeutic problems.

  4. Negative Predictive Value of Pigmented Lesion Evaluation by Multispectral Digital Skin Lesion Analysis in a Community Practice Setting

    PubMed Central

    Rigel, Darrell S.; Kollmann, Emily; Swenson, Nicole; Tucker, Natalie; Nestor, Mark S.

    2015-01-01

    of “Low Disorganization” may be considered for observation versus biopsy. Similar to what was noted in the academic center setting, multispectral digital skin lesion analysis may help dermatologists reduce the number of unnecessary biopsies while improving diagnostic accuracy. PMID:25852810

  5. [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

  6. [Endosonographic diagnostics of hepatobiliary and pancreatic diseases].

    PubMed

    Starkov, Iu G; Solodinina, E N; Shishin, K V; Plotnikova, A S; Kobesova, T A; Dubova, E A

    2009-01-01

    Clinical use of endoscopic ultrasound (EUS) diagnostics of 550 patients with diseases of hepatobiliary and pancreas was analyzed. The procedure of the examination was thoroughly described. Ultrasound semiotics of the pancreas, papilla Vateri and bile ducts' lesions was defined. Accuracy of EUS in the diagnostics of solid pancreas tumors was 81,6%. Accuracy of the method in the diagnostics of the vessel invasion was 81,6%. EUS was considered to be leading in the diagnostics of papilla Vateri and duodenal tumors, its accuracy was up to 97,2%, which is much higher then other radiological and endoscopic methods. EUS was highly effective in diagnostics of choledocholithiasis and comprised 90,2%. The introduction of thin-needle biopsy, Doppler mapping and elastography in the EUS protocol permitted further increase of the accuracy and value of the method for the surgical practice.

  7. Sonographic diagnosis of an acute Stener lesion: a case report.

    PubMed

    Mattox, Ross; Welk, Aaron B; Battaglia, Patrick J; Scali, Frank; Nunez, Mero; Kettner, Norman W

    2016-01-01

    This case report describes the use of diagnostic ultrasound to diagnose a Stener lesion in a patient who presented for conservative care of thumb pain following a fall on an outstretched hand. Conventional radiographic images demonstrated an avulsion fracture at the ulnar aspect of the base of the first proximal phalanx. Diagnostic ultrasound revealed a torn ulnar collateral ligament of the thumb that was displaced proximal to the adductor aponeurosis, consistent with a Stener lesion. Dynamic imaging with ultrasound confirmed displacement of the fully torn ligament. Surgical repair followed the diagnosis. Diagnostic ultrasound in this case provided an accurate diagnosis obviating further imaging. This allowed an optimal outcome due to early intervention. PMID:27298646

  8. The Impact of Multispectral Digital Skin Lesion Analysis on German Dermatologist Decisions to Biopsy Atypical Pigmented Lesions with Clinical Characteristics of Melanoma

    PubMed Central

    Winkelmann, Richard R.; Hauschild, Axel; Tucker, Natalie; White, Richard; Rigel, Darrell S.

    2015-01-01

    Objective: To determine the impact of multispectral digital skin lesion analysis on German dermatologist biopsy decisions of atypical pigmented skin lesions. Design: Participants were shown high-resolution clinical images of 12 atypical pigmented skin lesions previously analyzed by multispectral digital skin lesion analysis. Participants were asked if they would biopsy the lesion based on clinical images and high-resolution dermoscopy images and again when subsequently shown multispectral digital skin lesion analysis probability information. Setting/participants: Forty-one dermatologists at a skin cancer conference in Germany in September 2014. Measurements: Sensitivity, specificity, diagnostic accuracy, percent biopsying all melanomas, and overall biopsy rates. Results: Sensitivity for the detection of melanoma following clinical evaluation was 64 percent. After receipt of multispectral digital skin lesion analysis probability information, sensitivity decreased nonsignificantly to 62 percent. Specificity with clinical evaluation was 57 percent and increased to 73 percent using multispectral digital skin lesion analysis. Overall biopsy accuracy increased from 60 percent with clinical evaluation to 68 percent with multispectral digital skin lesion analysis. The percentage of low-grade dysplastic nevi chosen for biopsy decreased from 43 percent after clinical evaluation to 27 percent with multispectral digital skin lesion analysis. Finally, the overall percentage of lesions biopsied decreased from 52 percent with clinical evaluation to 42 percent after multispectral digital skin lesion analysis. Conclusion: Multispectral digital skin lesion analysis can be used reliably to detect melanoma as well as clinical evaluation. Dermatologists can confidently use multispectral digital skin lesion analysis to significantly improve specificity and reduce their overall number of biopsies while increasing overall diagnostic accuracy. PMID:26557216

  9. Use of the inverted “T” incision to approach a plantar nodular lesion*

    PubMed Central

    Sampaio, Felipe Maurício Soeiro; Gualberto, Gustavo Vieira; de Souza, Paulo Roberto Cotrim; Lourenço, Fabrício Tinoco; de Cerqueira, Fernando Gustavo Mósca

    2015-01-01

    Knowledge of the inverted "T" incision - used in plastic, oncologic and orthopedic surgery - has allowed its adaptation for the diagnostic assessment and therapeutical approach of acral, nodular lesions. The authors describe the use of this technique for the surgical approach of a patient with a plantar nodular lesion, further diagnosed as a calcified angioleiomyoma. PMID:25672316

  10. Des Vents et des Jets Astrophysiques

    NASA Astrophysics Data System (ADS)

    Sauty, C.

    well expected result from the theory. Although, collimation may be conical, paraboloidal or cylindrical (Part 4), cylindrical collimation is the more likely to occur. The shape of outflows may then be used as a tool to predict physical conditions on the flows or on their source. L'éjection continue de plasma autour d'objets massifs est un phénomène largement répandu en astrophysique, que ce soit sous la forme du vent solaire, de vents stellaires, de jets d'étoiles en formation, de jets stellaires autour d'objets compacts ou de jets extra-galactiques. Cette zoologie diversifiée fait pourtant l'objet d'un commun effort de modélisation. Le but de cette revue est d'abord de présenter qualitativement le développement, depuis leur origine, des diverses théories de vents (Partie 1) et l'inter disciplinarité dans ce domaine. Il s'agit d'une énumération, plus ou moins exhaustive, des idées proposées pour expliquer l'accélération et la morphologie des vents et des jets, accompagnée d'une présentation sommaire des aspects observationnels. Cette partie s'abstient de tout aspect faisant appel au formalisme mathématique. Ces écoulements peuvent être décrits, au moins partiellement, en résolvant les équations magnétohydrodynamiques, axisymétriques et stationnaires. Ce formalisme, à la base de la plupart des théories, est exposé dans la Partie 2. Il permet d'introduire quantitativement les intégrales premières qu'un tel système possède. Ces dernières sont amenées à jouer un rôle important dans la compréhension des phénomènes d'accélération ou de collimation, en particulier le taux de perte de masse, le taux de perte de moment angulaire ou l'énergie du rotateur magnétique. La difficulté de modélisation réside dans l'existence de points critiques, propres aux équations non linéaires, qu'il faut franchir. La nature physique et la localisation de ces points critiques fait l'objet d'un débat important car ils sont la clef de voute de la r

  11. Sequential multimodality bronchoscopic investigation of peripheral pulmonary lesions.

    PubMed

    Steinfort, Daniel P; Bonney, Asha; See, Katharine; Irving, Louis B

    2016-02-01

    Multiple guidance modalities may be combined during bronchoscopic investigation of peripheral pulmonary lesions (PPLs). The relative contribution of each modality to diagnostic performance remains uncertain.Endobronchial ultrasound (EBUS) with virtual bronchoscopy (VB) was routinely performed, with electromagnetic navigation (EMN) utilised only where EBUS was unable to locate PPLs or where the probe was adjacent to the lesion and on-site cytologic examination was nondiagnostic.236 consecutive patients with 245 PPLs had lesion size 22.8±12.4 mm (mean±sd). PPLs were localised using EBUS+VB alone in 188 (77%) and was diagnostic in 134 of these (71.3%). EBUS localisation was predicted by PPL size (23.7±10.5 versus 19.7±9.8 mm, p=0.003), but not by bronchus sign, PPL-hilum distance or PPL-pleura distance. EMN in 57 patients achieved EBUS localisation in a further 17 patients (30.9%), improving overall visualisation yield to 85%. Nine of these 57 procedures achieved a definitive diagnosis (16%), improving overall diagnostic yield to 58.4%. Probe position and lesion type influenced overall diagnostic yield. Sensitivity for diagnosis of lung cancer was 70% (131/188; 95% CI 63-76%).Localisation rate and diagnostic sensitivity of radial probe EBUS+VB alone for diagnosis of PPLs is high. EBUS localisation rates and procedural yield are improved only modestly (by 8% and 4%, respectively) with addition of EMN. Sampling following EMN should include all available methods to maximise diagnostic yield. PMID:26541529

  12. Injectabilite des coulis de ciment dans des milieux fissures

    NASA Astrophysics Data System (ADS)

    Mnif, Thameur

    Le travail presente ici est un bilan du travaux de recherche effectues sur l'injectabilite des coulis de ciment dans lu milieux fissures. Un certain nombre de coulis a base de ciment Portland et microfin ont ete selectionnes afin de caracteriser leur capacite a penetrer des milieux fissures. Une partie des essais a ete menee en laboratoire. L'etude rheologique des differents melanges a permis de tester l'influence de l'ajout de superplastifiant et/ou de fumee de silice sur la distribution granulometrique des coulis et par consequent sur leur capacite a injecter des colonnes de sable simulant un milieu fissure donne. La classe granulometrique d'un coulis, sa stabilite et sa fluidite sont apparus comme les trois facteurs principaux pour la reussite d'une injection. Un facteur de finesse a ete defini au cours de cette etude: base sur la classe granulometrique du ciment et sa stabilite, il peut entrer dans la formulation theorique du debit d'injection avant application sur chantier. La deuxieme et derniere partie de l'etude presente les resultats de deux projets de recherche sur l'injection realises sur chantier. L'injection de dalles de beton fissurees a permis le suivi de l'evolution des pressions avec la distance au point d'injection. L'injection de murs de maconnerie a caractere historique a montre l'importance de la definition de criteres de performance des coulis a utiliser pour traiter un milieu donne et pour un objectif donne. Plusieurs melanges peuvent ainsi etre predefinis et mis a disposition sur le chantier. La complementarite des ciments traditionnels et des ciments microfins devient alors un atout important. Le choix d'utilisation de ces melanges est fonction du terrain rencontre. En conclusion, cette recherche etablit une methodologie pour la selection des coulis a base de ciment et des pressions d'injection en fonction de l'ouverture des fissures ou joints de construction.

  13. Rotorcraft Diagnostics

    NASA Technical Reports Server (NTRS)

    Haste, Deepak; Azam, Mohammad; Ghoshal, Sudipto; Monte, James

    2012-01-01

    Health management (HM) in any engineering systems requires adequate understanding about the system s functioning; a sufficient amount of monitored data; the capability to extract, analyze, and collate information; and the capability to combine understanding and information for HM-related estimation and decision-making. Rotorcraft systems are, in general, highly complex. Obtaining adequate understanding about functioning of such systems is quite difficult, because of the proprietary (restricted access) nature of their designs and dynamic models. Development of an EIM (exact inverse map) solution for rotorcraft requires a process that can overcome the abovementioned difficulties and maximally utilize monitored information for HM facilitation via employing advanced analytic techniques. The goal was to develop a versatile HM solution for rotorcraft for facilitation of the Condition Based Maintenance Plus (CBM+) capabilities. The effort was geared towards developing analytic and reasoning techniques, and proving the ability to embed the required capabilities on a rotorcraft platform, paving the way for implementing the solution on an aircraft-level system for consolidation and reporting. The solution for rotorcraft can he used offboard or embedded directly onto a rotorcraft system. The envisioned solution utilizes available monitored and archived data for real-time fault detection and identification, failure precursor identification, and offline fault detection and diagnostics, health condition forecasting, optimal guided troubleshooting, and maintenance decision support. A variant of the onboard version is a self-contained hardware and software (HW+SW) package that can be embedded on rotorcraft systems. The HM solution comprises components that gather/ingest data and information, perform information/feature extraction, analyze information in conjunction with the dependency/diagnostic model of the target system, facilitate optimal guided troubleshooting, and offer

  14. Pituitary stalk lesion in a 13-year-old female.

    PubMed

    Zilbermint, Mihail; Ramnitz, Mary S; Lodish, Maya B; Kanaka-Gantenbein, Christina; Kattamis, Antonis; Lyssikatos, Charalampos; Patronas, Nicholas J; Quezado, Martha M; Stratakis, Constantine A

    2014-03-01

    Germinomas presenting with a pituitary stalk lesion and panhypopituitarism are rare in children, and their definite diagnosis is challenging. An invasive diagnostic approach, such as a transsphenoidal biopsy, is often required prior to establishing a treatment regimen. A 13-year-old female presented with 1 year of secondary amenorrhea, fatigue, and progressive thirst with polyuria. Laboratory work-up revealed panhypopituitarism (central hypothyroidism, hypogonadotropic hypogonadism, adrenal insufficiency and central diabetes insipidus). α-Fetoprotein and β-human chorionic gonadotropin were not elevated in serum nor in cerebrospinal fluid. The magnetic resonance imaging (MRI) of the pituitary region showed an enhancing infundibular lesion, extending into the hypothalamus, and infiltrating the pituitary gland. A transsphenoidal biopsy of the infundibular lesion confirmed the diagnosis of germinoma (germ-cell tumor). After appropriate hormone replacement therapy, chemotherapy and low-dose radiation therapy, the patient achieved complete resolution of the pituitary stalk lesion on the MRI.

  15. Pituitary stalk lesion in a 13-year-old female

    PubMed Central

    Zilbermint, Mihail; Ramnitz, Mary S.; Lodish, Maya B.; Kanaka-Gantenbein, Christina; Kattamis, Antonis; Lyssikatos, Charalampos; Patronas, Nicholas J.; Quezado, Martha M.

    2016-01-01

    Germinomas presenting with a pituitary stalk lesion and panhypopituitarism are rare in children, and their definite diagnosis is challenging. An invasive diagnostic approach, such as a transsphenoidal biopsy, is often required prior to establishing a treatment regimen. A 13-year-old female presented with 1 year of secondary amenorrhea, fatigue, and progressive thirst with polyuria. Laboratory work-up revealed panhypopituitarism (central hypothyroidism, hypogonadotropic hypogonadism, adrenal insufficiency and central diabetes insipidus). α-Fetoprotein and β-human chorionic gonadotropin were not elevated in serum nor in cerebrospinal fluid. The magnetic resonance imaging (MRI) of the pituitary region showed an enhancing infundibular lesion, extending into the hypothalamus, and infiltrating the pituitary gland. A transsphenoidal biopsy of the infundibular lesion confirmed the diagnosis of germinoma (germ-cell tumor). After appropriate hormone replacement therapy, chemotherapy and low-dose radiation therapy, the patient achieved complete resolution of the pituitary stalk lesion on the MRI. PMID:24129100

  16. Approche à l’endroit des blessures traumatiques à la main en soins primaires

    PubMed Central

    Cheung, Kevin; Hatchell, Alexandra; Thoma, Achilleas

    2013-01-01

    Résumé Objectif Passer en revue la prise en charge initiale des blessures traumatiques communes à la main que voient les médecins de soins primaires. Sources des données Nous avons examiné les données cliniques probantes et les ouvrages spécialisés récents cernés par des recherches dans la base de données électronique MEDLINE. Nous avons utilisé l’opinion d’experts pour compléter les recommandations dans les domaines où les données scientifiques étaient rares. Message principal Les médecins de soins primaires sont couramment appelés à prendre en charge des patients victimes de blessures traumatiques à la main. Dans le contexte d’un cas clinique, nous examinons l’évaluation, le diagnostic et la prise en charge initiale des traumatismes communs à la main. La présentation et la prise en charge des blessures au lit de l’ongle, des amputations de l’extrémité du doigt, des doigts en maillet, des fractures à la main, des lacérations de tendons, des morsures et de la ténosynovite infectieuse seront aussi discutées. Les principes de la prise en charge des blessures traumatiques à la main comportent la réduction et l’immobilisation des fractures, la prescription d’imagerie radiographique post-réduction, l’obtention d’un recouvrement par les tissus mous, la prévention et le traitement des infections et l’assurance d’une prophylaxie antitétanique. Conclusion Il est essentiel d’assurer une évaluation et une prise en charge appropriées des blessures traumatiques à la main pour prévenir une morbidité considérable à long terme dans une population autrement en santé. La reconnaissance sans délai des blessures qui nécessitent une demande de consultation urgente ou rapide auprès d’un chirurgien spécialiste de la main est également critique.

  17. Characterization of ovine Nectin-4, a novel peste des petits ruminants virus (PPRV) receptor

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Small ruminants infected with peste des petits ruminants virus (PPRV) exhibit lesions typical of epithelial infection and necrosis. However, the only established host receptor for this virus is the immune cell marker signalling lymphocyte activation molecule (SLAM). We have confirmed that the ovine ...

  18. 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.

  19. Jaw expansive lesions: population incidence and CT dentalscan role

    PubMed Central

    FIASCHETTI, V.; FANUCCI, E.; RASCIONI, M.; OTTRIA, L.; BARLATTANI, A.; SIMONETTI, G.

    2011-01-01

    SUMMARY Aim The aim of the study is to evaluate the incidence of different expansive lesions and the advantages of the clinical employment of Dentalscan to study bones lesions and to establish a common diagnostic path. Materials and methods Since January 2005 to November 2009, 3200 patients, not selected for sex or age, have undergone a CT “Dentalscan” in the department of Diagnostic Imaging, Tor Vergata University Hospital (PTV), a suspect bone pathology was found in 704 of them through the XR-orthopantomograpy (OPT). CT images were obtained with General Electric CT Light Speed multislice. Images were saved in the Advantage Workstation (GE) supported by the “Dentascan” dedicated software and by the 3D software (3D SSD). The protocol was : Slice thickness 1,25 mm, gap 0, matrix 512 × 512, 140 KV and 70 mA. All the lesions were also studied with the dedicated three-dimensional reconstructor 3D SSD. Biopsy for diagnosis was performed on all the lesions, except one (false positive with digital OPT). The technique sensitivity was assessed for two important classes: benign and malignant lesions. Results Through CT Dentascan a detailed evaluation of the jaws lesions and their extension was obtained. 656 patients (93.1 %) out of 704 examined for a suspicious lesion on the orthopantomography had a benign lesion: (127 follicular cysts (18.2 %), 181 radicular cysts (25.1%), 93 non odontogenic cysts (13.2%), 29 fibroma (4.2%), 198 odontomes (28.2%), 24 ameloblastoma (3.6%), 4 brown tumors (0.7%), 47 (6.9%) had malignant lesions: (12 carcinoma (1.7%), 29 metastasis (4.3%), 6 sarcoma (0.8%), 1 Dentascan CT resulted to be negative (1 false positive of digital OPT). The sensitivity of the technique for both groups was 99% for benign lesions and 98% for malign lesions. Conclusions CT Dentascan characteristics suggest to consider these techniques as the gold standard for the evaluation of jaw expansive lesions and the support of surgical planning. PMID:23285385

  20. Lesion mimic mutants

    PubMed Central

    Moeder, Wolfgang

    2008-01-01

    Over the last decade a substantial number of lesion mimic mutants (LMM) have been isolated and a growing number of the genes have been cloned. It is now becoming clear that these mutants are valuable tools to dissect various aspects of programmed cell death (PCD) and pathogen resistance pathways in plants. Together with other forward genetics approaches LMMs shed light on the PCD machinery in plant cells and revealed important roles for sphingolipids, Ca2+ and chloroplast-derived porphyrin-metabolites during cell death development. PMID:19513227

  1. 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

  2. Retrospective analysis of radial EBUS outcome for the diagnosis of peripheral pulmonary lesion: sensitivity and complications

    PubMed Central

    Durakovic, Amal; Andersen, Henrik; Christiansen, Anders; Hammen, Irena

    2015-01-01

    Background The purpose of the current study was to clarify the sensitivity and complication rate of the radial (endobronchial ultrasound, EBUS) without the use of guide-sheath (GS) and fluoroscopy for lung cancer (LC), by measuring the distance from the orifice of the bronchus to the pulmonary lesion, as well as to analyze factors that can predict the diagnostic outcome. Materials and methods A total of 147 patients with peripheral pulmonary lesions (PPL) underwent radial EBUS-guided transbronchial biopsy (TBB) in between August 1, 2013, and August 31, 2014. We analyzed retrospectively radiological data, diagnostic work-up in everyday clinical settings, final diagnosis and complication rates, as well as factors influencing the diagnostic outcome. Results Around 63.9% of PPLs were visualized by ultrasound. A definitive malignant diagnosis was established in 39 patients (26.5%) using radial EBUS. In the remaining 108 patients, additional procedures were performed. We missed LC diagnosis in 40 cases that results in a sensitivity of 49%. For malignant lesions visualized by radial EBUS, the sensitivity was 60%, compared with 24% for not visualized lesions. For malignant lesions, logistic regression was performed to identify the factors that had significant influence on visualization of the lesion and on diagnostic yield. Logistic regression analysis showed significant odds ratios (OR) for visualization depending on location of the lesion; upper lobe lesions were identified more frequent with OR of 3.85 (95% CI 1.42 – 10.98, p=0.009). Size above 30 mm had a non-significant OR of 2.11 (95% CI 0.80−5.73, p=0.134) for visualization. Diagnostic yield was only significantly influenced by visualization with the radial EBUS, OR 3.70 (95% CI 1.35−11.02, p=0.014). Location (p=0.745) and size above 30 mm (p=0.308) showed no significant increase in diagnostic yield. Other lesion characteristics defined on computed tomography, such as distance to carina and pleura, did not

  3. DES the year in review: controversies.

    PubMed

    Garg, S; Bourantas, C; Serruys, P W

    2013-04-01

    Drug-eluting stents (DES) have transformed interventional cardiology over the past decade. Whilst their efficacy has rarely been called into question, there have been concerns over the safety of the early devices, which has prompted the development of new coronary stents. Many of these new devices have entered clinical practice, however questions remain as to whether they offer the improvements in clinical outcomes that were originally anticipated. In addition, there is a debate whether the reported high efficacy of these devices enables percutaneous coronary intervention (PCI) to be performed in patient and lesion sub-groups previous entirely the domain of the cardiac surgeon. This review paper addresses these outstanding questions. PMID:23492595

  4. 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

  5. All That Swells Is Not A Bruise The Morel-Lavallée Lesion.

    PubMed

    Callahan, Carol L; Eisenman, Justin

    2016-01-01

    Frequently overlooked, Morel-Lavallée lesions are associated with a closed degloving or shearing mechanism causing a dehiscence of underlying soft tissue with formation of a potential space. This space fills with blood, lymph, and cellular debris, giving the lesion a fluctuant appearance on examination. The potential space associated with larger lesions can be a source for hemorrhage in the appropriate clinical context. However, these lesions are often diagnosed late in their clinical course or are misdiagnosed, leading to long-term complications. Management of this injury typically depends upon the size of the lesion. This article discusses a Morel-Lavallée lesion in an active-duty Servicemember requiring treatment by a plastic surgeon and includes the pathophysiology of Morel-Lavallée lesions, diagnostic strategies, and management pearls. PMID:27045507

  6. [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

  7. Cytodiagnosis of 112 salivary gland lesions. Correlation with histologic and frozen section diagnosis.

    PubMed

    Chan, M K; McGuire, L J; King, W; Li, A K; Lee, J C

    1992-01-01

    Aspirates of 112 cases of salivary gland lesions with histologic correlation were reviewed. Fifty-five cases (49%) had frozen sections made. The 112 cases included 76 cases of benign lesions (31 cases of pleomorphic adenoma, 19 of Warthin's tumor and 26 of nonneoplastic lesions), 22 of primary salivary gland malignancy and 14 of metastatic malignant lesions. The overall accuracy in diagnosing benign and malignant lesions was 95%. The accuracy in diagnosing the exact category of neoplastic lesions was 70%. The diagnostic sensitivity for malignant lesions was 86% and the specificity, 99%. There was one false positive, in which a pleomorphic adenoma was diagnosed as small cell carcinoma. Five false-negative cases were encountered that were due to underdiagnosis of mucoepidermoid carcinoma and adenoid cystic carcinoma. The smears were reviewed, and the diagnostic pitfalls are discussed. A comparison of the cytodiagnosis and frozen section diagnosis was made. In frozen sections there were two false negatives, and two diagnoses were deferred. The overall diagnostic accuracy was 91%. The accuracy in diagnosing the exact category of neoplastic disease was 77%. The diagnostic sensitivity for malignant disease was 70% and specificity, 100%. Frozen section, however, did supplement the fine needle aspiration diagnosis in 13 cases.

  8. Optical Assessment of Caries Lesion Structure and Activity

    NASA Astrophysics Data System (ADS)

    Lee, Robert Chulsung

    New, more sophisticated diagnostic tools are needed for the detection and characterization of caries lesions in the early stages of development. It is not sufficient to simply detect caries lesions, methods are needed to assess the activity of the lesion and determine if chemical or surgical intervention is needed. Previous studies have demonstrated that polarization sensitive optical coherence tomography (PS-OCT) can be used to nondestructively image the subsurface lesion structure and measure the thickness of the highly mineralized surface zone. Other studies have demonstrated that the rate of dehydration can be correlated with the lesion activity and that the rate can be measured using optical methods. The main objective of this work was to test the hypothesis that optical methods can be used to assess lesion activity on tooth coronal and root surfaces. Simulated caries models were used to develop and validate an algorithm for detecting and measuring the highly mineralized surface layer using PS-OCT. This work confirmed that the algorithm was capable of estimating the thickness of the highly mineralized surface layer with high accuracy. Near-infrared (NIR) reflectance and thermal imaging methods were used to assess activity of caries lesions by measuring the state of lesion hydration. NIR reflectance imaging performed the best for artificial enamel and natural coronal caries lesion samples, particularly at wavelengths coincident with the water absorption band at 1460-nm. However, thermal imaging performed the best for artificial dentin and natural root caries lesion samples. These novel optical methods outperformed the conventional methods (ICDAS II) in accurately assessing lesion activity of natural coronal and root caries lesions. Infrared-based imaging methods have shown potential for in-vivo applications to objectively assess caries lesion activity in a single examination. It is likely that if future clinical trials are a success, this novel imaging

  9. Grundlagen des Tissue Engineering

    NASA Astrophysics Data System (ADS)

    Mayer, Jörg; Blum, Janaki; Wintermantel, Erich

    Die Organtransplantation stellt eine verbreitete Therapie dar, um bei krankheitsoder unfallbedingter Schädigung eines Organs die Gesamtheit seiner Funktionen wieder herzustellen, indem es durch ein Spenderorgan ersetzt wird. Organtransplantationen werden für die Leber, die Niere, die Lunge, das Herz oder bei schweren grossflächigen Verbrennungen der Haut vorgenommen. Der grosse apparative, personelle und logistische Aufwand und die Risiken der Transplantationschirurgie (Abstossungsreaktionen) sowie die mangelnde Verfügbarkeit von immunologisch kompatiblen Spenderorganen führen jedoch dazu, dass der Bedarf an Organtransplantaten nur zu einem sehr geringen Teil gedeckt werden kann. Sind Spenderorgane nicht verfügbar, können in einzelnen Fällen lebenswichtige Teilfunktionen, wie beispielsweise die Filtrationsfunktion der Niere durch die Blutreinigung mittels Dialyse ersetzt oder, bei mangelnder Funktion der Bauchspeicheldrüse (Diabetes), durch die Verabreichung von Insulin ein normaler Zustand des Gesamtorganismus auch über Jahre hinweg erhalten werden. Bei der notwendigen lebenslangen Anwendung apparativer oder medikamentöser Therapie können für den Patienten jedoch häufig schwerwiegende, möglicherweise lebensverkürzende Nebenwirkungen entstehen. Daher werden in der Forschung Alternativen gesucht, um die Funktionen des ausgefallenen Organs durch die Implantation von Zellen oder in vitro gezüchteten Geweben möglichst umfassend wieder herzustellen. Dies erfordert biologisch aktive Implantate, welche die für den Stoffwechsel des Organs wichtigen Zellen enthalten und einen organtypischen Stoffwechsel entfalten.

  10. VS38 immunostaining in melanocytic lesions.

    PubMed Central

    Shanks, J H; Banerjee, S S

    1996-01-01

    AIMS: To investigate the immunoreactivity of a range of melanocytic lesions, both benign and malignant, with the monoclonal antibody VS38. This was recently described as a marker of reactive/neoplastic plasma cells and, therefore, is useful in the diagnosis of plasmacytoma/myeloma and lymphomas with plasmacytic differentiation. This study was prompted by the recent observation that a plasmacytoid melanoma arising in the nasal cavity was strongly immunoreactive with VS38, which was therefore a potential source of major diagnostic error. METHODS: The Streptavidin-peroxidase complex technique was used on paraffin wax embedded sections of 167 melanocytic lesions. Diaminobenzidine (DAB) was used as chromogen for non-pigmented or lightly pigmented lesions and nickel/DAB for more heavily pigmented lesions. RESULTS: Positive immunostaining for VS38 was seen in 14.5% (10/69) of benign naevi (including 40% (four of 10) of Spitz naevi), 10.5% (two of 19) of dysplastic naevi/in situ melanomas, 92% (35/38) of primary cutaneous melanomas, 100% (four of four) of primary mucosal melanomas, 91.7% (33/36) of recurrent/metastatic melanomas, and 100% (one of one) of clear cell sarcomas of soft tissues. CONCLUSIONS: VS38 immunostaining is frequently positive in primary and recurrent/metastatic malignant melanoma and is also reactive less commonly with benign naevi. These results should be borne in mind when this recently described marker of normal/neoplastic plasma cells is used to identify tumour lineage, particularly in tumours arising at unusual sites, such as in the nasal cavity. The possibility of malignant melanoma should be actively considered and excluded in any undifferentiated tumour which shows VS38 immunoreactivity. Images PMID:8675729

  11. Value of Apparent Diffusion Coefficient Values in Differentiating Malignant and Benign Breast Lesions

    PubMed Central

    Bozkurt Bostan, Tuğba; Koç, Gonca; Sezgin, Gülten; Altay, Canan; Fazıl Gelal, M.; Oyar, Orhan

    2016-01-01

    Background: Magnetic resonance imaging (MRI) has become a diagnostic and problem solving method for the breast examinations in addition to conventional breast examination methods. Diffusion-weighted imaging (DWI) adds valuable information to conventional MRI. Aims: Our aim was to show the impact of apparent diffusion coefficient (ADC) values acquired with DWI to differentiate benign and malignant breast lesions. Study Design: Diagnostic accuracy study. Methods: Forty-six women with 58 breast masses (35 malignant, 23 benign) were examined on a 1.5 T clinical MRI scanner. The morphologic characteristics of the lesions on conventional MRI sequences and contrast uptake pattern were assessed. ADC values of both lesions and normal breast parenchyma were measured. The ADC values obtained were statistically compared with the histopathologic results using Paired Samples t-Test. Results: Multiple lesions were detected in 12 (26%) of the patients, while only one lesion was detected in 34 (74%). Overall, 35 lesions out of 58 were histopathologically proven to be malignant. In the dynamic contrast-enhanced series, 5 of the malignant lesions were type 1, while 8 benign lesions revealed either type 2 or 3 time signal intensity curves (85% sensitivity, 56% spesifity). Mean ADC values were significantly different in malignant vs. benign lesions. (1.04±0.29×10−3 cm2/sec vs. 1.61±0.50×10−3 cm2/sec for the malignant and benign lesions, respectively, p=0.03). A cut-off value of 1.30×10−3 mm2/sec for ADC detected with receiver operating characteristic analysis yielded 89.1% sensitivity and 100% specificity for the differentiation between benign and malignant lesions. Conclusion: ADC values improve the diagnostic accuracy of solid breast lesions when evaluated with the conventional MRI sequences. Therefore, DWI should be incorporated to routine breast MRI protocol. PMID:27308073

  12. The most common mistakes on dermatoscopy of melanocytic lesions

    PubMed Central

    Kamińska-Winciorek, Grażyna

    2015-01-01

    Dermatoscopy is a method of in vivo evaluation of the structures within the epidermis and dermis. Currently, it may be the most precise pre-surgical method of diagnosing melanocytic lesions. Diagnostic errors may result in unnecessary removal of benign lesions or what is even worse, they can cause early and very early melanomas to be overlooked. Errors in assessment of dermatoscopy can be divided into those arising from failure to maintain proper test procedures (procedural and technical errors) and knowledge based mistakes related to the lack of sufficient familiarity and experience in dermatoscopy. The article discusses the most common mistakes made by beginner or inexperienced dermatoscopists. PMID:25821425

  13. Yellow and orange in cutaneous lesions: clinical and dermoscopic data.

    PubMed

    Bañuls, J; Arribas, P; Berbegal, L; DeLeón, F J; Francés, L; Zaballos, P

    2015-12-01

    Colour of the lesions is clue for the clinical and dermoscopic diagnosis. Nevertheless, we have detected in the literature an uneven relevance of the colours as a diagnostic criterion. Thus, while red, brown and blue have taken important role in dermoscopic descriptions, other like yellow and orange have been given much less importance. This article reviews those lesions in which the yellow and orange colours have been considered constitutive or essential for diagnosis, and on the other hand it emphasizes the entities in which may appear these colours and are not well reflected in the literature. We believe that organize all this information will help us in a better understanding of these pathologies.

  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. Scintigraphic diagnosis of hepatic hemangioma: its role in the management of hepatic mass lesions

    SciTech Connect

    Moinuddin, M.; Allison, J.R.; Montgomery, J.H.; Rockett, J.F.; McMurray, J.M.

    1985-08-01

    Hepatic cavernous hemangiomas are benign tumors of the liver that are often an incidental finding. They are usually asymptomatic but may cause symptoms when traumatized, may bleed spontaneously, or may produce pain by virtue of their large size and mass effect. A retrospective analysis of the clinical presentation, liver function tests, and diagnostic imaging procedures in 20 patients with hepatic hemangiomas is presented and the literature is reviewed. The 20 patients had 27 mass lesions as seen on liver scintigraphy, computed tomography, or sonography. Technetium-99m-labeled red blood cell flow studies and blood pool scintigrams showed delayed filling of the mass lesions, diagnostic of hemangiomas. This finding was not encountered in any other type of lesion. A new diagnostic algorithm is proposed in which flood-flow and blood-pool scintigraphy play a more prominent role in the diagnostic workup.

  16. Behavioral diagnostics.

    PubMed

    Bailey, J S; Pyles, D A

    1989-01-01

    The contemporary behavior analyst, to operate ethically and effectively, must be aware of many more factors affecting behavior than simple consequences. Although the literature demonstrating the effectiveness of active behavior management is impressive, a compelling argument can be made that a great number of behavior problem seen in individuals with developmental disabilities may be attributable to factors other than consequences. Our experience has been more often than not that physiological, organic, medication, or situational variables are the actual culprits in maladaptive behavior. Individuals with severe or profound retardation may respond to aversive features of their environment by displaying noncompliance, tantrums, aggression, or self-injurious behavior. These antecedents can affect their behavior just as powerfully as can the consequences of their behavior. Behavior analysts must become sensitive to these potential factors and be prepared to employ behavioral diagnostic strategies in the search for the causes of maladaptive behavior. Finally, they must be prepared to design rather unconventional passive behavior management treatment programs involving the manipulation of the antecedent environment. In the case of Carrie, from the example at the beginning of this paper, the analysis yielded the hypothesis that her face scratching was a reaction to sinus blockage caused by seasonal allergies. Her treatment involved daily dosages of antihistamines administered by our nurses and subsequent elimination of the scratching. Tom was found to be suffering from "wheelchair fatigue." When he was allowed to recline on other surfaces (e.g., bean bag chair, mat, bolster) on a regular basis, he did not attempt any form of self-injury. Melissa was found to have a severe case of Pre Menstrual Syndrome as well as seizure disorder, and was treated with the appropriate medications. Her headbanging was reduced to a few minor incidents per month. Walter's tantrums on closer

  17. Reticulation des fibres lignocellulosiques

    NASA Astrophysics Data System (ADS)

    Landrevy, Christel

    Pour faire face à la crise économique la conception de papier à valeur ajoutée est développée par les industries papetières. Le but de se projet est l'amélioration des techniques actuelles de réticulation des fibres lignocellulosiques de la pâte à papier visant à produire un papier plus résistant. En effet, lors des réactions de réticulation traditionnelles, de nombreuses liaisons intra-fibres se forment ce qui affecte négativement l'amélioration anticipée des propriétés physiques du papier ou du matériau produit. Pour éviter la formation de ces liaisons intra-fibres, un greffage sur les fibres de groupements ne pouvant pas réagir entre eux est nécessaire. La réticulation des fibres par une réaction de « click chemistry » appelée cycloaddition de Huisgen entre un azide et un alcyne vrai, catalysée par du cuivre (CuAAC) a été l'une des solutions trouvée pour remédier à ce problème. De plus, une adaptation de cette réaction en milieux aqueux pourrait favoriser son utilisation en milieu industriel. L'étude que nous désirons entreprendre lors de ce projet vise à optimiser la réaction de CuAAC et les réactions intermédiaires (propargylation, tosylation et azidation) sur la pâte kraft, en milieu aqueux. Pour cela, les réactions ont été adaptées en milieu aqueux sur la cellulose microcristalline afin de vérifier sa faisabilité, puis transférée à la pâte kraft et l'influence de différents paramètres comme le temps de réaction ou la quantité de réactifs utilisée a été étudiée. Dans un second temps, une étude des différentes propriétés conférées au papier par les réactions a été réalisée à partir d'une série de tests papetiers optiques et physiques. Mots Clés Click chemistry, Huisgen, CuAAC, propargylation, tosylation, azidation, cellulose, pâte kraft, milieu aqueux, papier.

  18. Thalamic Lesions: A Radiological Review

    PubMed Central

    Renard, Dimitri; Campello, Chantal; Bouly, Stephane; Le Floch, Anne; Thouvenot, Eric; Waconge, Anne; Taieb, Guillaume

    2014-01-01

    Background. Thalamic lesions are seen in a multitude of disorders including vascular diseases, metabolic disorders, inflammatory diseases, trauma, tumours, and infections. In some diseases, thalamic involvement is typical and sometimes isolated, while in other diseases thalamic lesions are observed only occasionally (often in the presence of other typical extrathalamic lesions). Summary. In this review, we will mainly discuss the MRI characteristics of thalamic lesions. Identification of the origin of the thalamic lesion depends on the exact localisation inside the thalamus, the presence of extrathalamic lesions, the signal changes on different MRI sequences, the evolution of the radiological abnormalities over time, the history and clinical state of the patient, and other radiological and nonradiological examinations. PMID:25100900

  19. 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

  20. 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

  1. Peste des petits ruminants outbreaks in White Nile State, Sudan.

    PubMed

    Ishag, Osama M; Saeed, Intisar K; Ali, Yahia H

    2015-01-01

    Eight outbreaks of peste des petits ruminants in sheep and goats were reported in White Nile State, Sudan, between 2008 and 2009. A mortality rate of 4.2% was reported across the different outbreaks. Clinically the disease was characterised by high fever, ocular and nasal discharge, pneumonia, ulceration of the mucous membranes, diarrhoea and death. The postmortem findings included necrotic lesions in the mouth and gastrointestinal tract, and swollen, oedematous lymph nodes associated with the lungs and intestine. Of the 209 serum samples tested by competitive enzyme-linked immunosorbent assay, 113 (54%) were found positive. Peste des petits ruminants virus was confirmed in tissues, nasal swabs and blood samples by immunocapture enzyme-linked immunosorbent assay, reverse-transcription polymerase chain reaction and isolation of the virus in culture of lamb testicle cells. PMID:26304168

  2. Peste des petits ruminants outbreaks in White Nile State, Sudan.

    PubMed

    Ishag, Osama M; Saeed, Intisar K; Ali, Yahia H

    2015-08-21

    Eight outbreaks of peste des petits ruminants in sheep and goats were reported in White Nile State, Sudan, between 2008 and 2009. A mortality rate of 4.2% was reported across the different outbreaks. Clinically the disease was characterised by high fever, ocular and nasal discharge, pneumonia, ulceration of the mucous membranes, diarrhoea and death. The postmortem findings included necrotic lesions in the mouth and gastrointestinal tract, and swollen, oedematous lymph nodes associated with the lungs and intestine. Of the 209 serum samples tested by competitive enzyme-linked immunosorbent assay, 113 (54%) were found positive. Peste des petits ruminants virus was confirmed in tissues, nasal swabs and blood samples by immunocapture enzyme-linked immunosorbent assay, reverse-transcription polymerase chain reaction and isolation of the virus in culture of lamb testicle cells.

  3. Jaw Intraosseous Lesions Biopsied Extracted From 1998 to 2010 in an Iranian Population

    PubMed Central

    Jamshidi, Shokoofeh; Shojaei, Setareh; Roshanaei, Ghodratollah; Modabbernia, Shirin; Bakhtiary, Esmaeel

    2015-01-01

    Background: Jaw bones might be potential locations for different lesions. Differences in prevalence and the type of lesions can help in designing and programming prevention procedures in health care centers. Objectives: The aim of the present study was to evaluate the prevalence of intraosseous lesions in the jaws of patients referred to diagnostic and therapeutic centers in Hamadan during 1990-2010. Patients and Methods: This cross-sectional descriptive analytical study was carried out in Hamadan in 2011. Data sheets of the subjects were used to collect all the data of patients with intraosseous lesions, including their age, gender, location of the lesion, the radiographic view of lesions, and their type and histopathological diagnoses. Data were analyzed with SPSS, using means and frequencies. Results: A total of 284 intraosseous lesions were reported in our study. The mean age of the subjects was 28.8 ± 15.2 years. The lesions were distributed in males and females almost similarly. The most prevalent lesions were cystic lesions (54.58%), manifestations of systemic conditions in jaw bones (18.3%), benign tumors (15.5%), malignant lesions (6.7%), and inflammatory lesions (4.92%), in a descending order. The most common cystic lesion was radicular cyst; the most common manifestation of systemic conditions in jaw bones was central giant cell granuloma; the most common benign tumor was ameloblastoma; the most common malignant lesion was osteosarcoma; and the most common inflammatory lesion was periapical granuloma. Conclusions: Our data provided information on the prevalence and types of intraosseous lesions among an Iranian population. This study provided baseline information to help in designing and programming procedures in health care centers in every community so that preventive therapeutic measures can be adopted. PMID:26328061

  4. Solitary nodular lesion of tongue- a rare entity.

    PubMed

    Sarada, P; Reddy, C H Sampath; A K, Patil; Kurra, Saritha

    2014-02-01

    The solitary, nodular lesions of the oral mucosa present a diagnostic dilemma to the dentist with their analogous presentation. The lesions that appear on the tongue, a soft muscular organ are distinct and even rarer with varied manifestations. Oral mucosa presents lesions of the tongue in all age groups that may range from a small nodular swelling and ulcer formation in an infant of a few days old to an ulcer or a lesion in a 70-year-old. The reason for the appearance of an ulcer may be trauma to the soft tissues in an infant may be due to the presence of natal teeth to the presence of a sharp tooth in the older individuals. These lesions have to be clinically and histologically correlated for the final outcome of the diagnosis, so that there is no chance of any recurrence. We present a unique case of a solitary nodular lesion on the ventral surface of tongue On a 6 year female, where there was a recurrence after surgical excision and after an unusual therapy of non surgical resolution, no recurrence was observed.

  5. Solitary Nodular Lesion of Tongue- A Rare Entity

    PubMed Central

    Sarada, P.; Reddy, C.H. Sampath; A.K, Patil; Kurra, Saritha

    2014-01-01

    The solitary, nodular lesions of the oral mucosa present a diagnostic dilemma to the dentist with their analogous presentation. The lesions that appear on the tongue, a soft muscular organ are distinct and even rarer with varied manifestations. Oral mucosa presents lesions of the tongue in all age groups that may range from a small nodular swelling and ulcer formation in an infant of a few days old to an ulcer or a lesion in a 70-year-old. The reason for the appearance of an ulcer may be trauma to the soft tissues in an infant may be due to the presence of natal teeth to the presence of a sharp tooth in the older individuals. These lesions have to be clinically and histologically correlated for the final outcome of the diagnosis, so that there is no chance of any recurrence. We present a unique case of a solitary nodular lesion on the ventral surface of tongue On a 6 year female, where there was a recurrence after surgical excision and after an unusual therapy of non surgical resolution, no recurrence was observed. PMID:24701550

  6. Insight to neoplastic thyroid lesions by fine needle aspiration cytology

    PubMed Central

    Rangaswamy, M; Narendra, KL; Patel, S; Gururajprasad, C; Manjunath, GV

    2013-01-01

    Background: Fine needle aspiration cytology (FNAC) is a valuable adjunct to pre-operative screening in the diagnosis of thyroid nodules, and in most cases, it can distinguish between benign and malignant lesions. Aim: To study the cytology of neoplastic thyroid lesions to minimize surgical intervention and for confirmation of the diagnosis by histopathological study. Materials and Methods: 100 cases of thyroid FNAC smears were analyzed and cyto-histopathological correlation was done in 47 cases. Galen and Gambino's method was used to calculate the sensitivity and positive predictive value. Results: Of the 100 cases, 90 were diagnosed as neoplastic lesions by FNAC and ten cases as non-neoplastic lesions, which turned out to be neoplasms on histopathological study. Among 100 cases, 47 were biopsied and subjected to histopathological study. The sensitivity of FNAC was 75.60%, and positive predictive value was 83.78% for malignant lesions. Conclusions: FNAC is a rapid, efficient, cost-effective, relatively painless procedure with a high diagnostic accuracy. It has high rate of sensitivity and positive predictive value in diagnosing thyroid neoplastic lesions. Hence, it is a valuable tool in the diagnosis and management of patients. PMID:23661936

  7. Evaluation of premalignant and malignant lesions by fluorescent light (VELscope)

    PubMed Central

    Sawan, Dania; Mashlah, Ammar

    2015-01-01

    Aim: The purpose of this study was the early detection of premalignant and malignant oral soft lesions by fluorescent light (VELscope). Materials and Methods: A total of 748 patients were evaluated through clinical and fluorescent light analysis of the entire oral cavity. Any lesion that was detected underwent a surgical excision biopsy as the golden standard for the detection of the lesion's histology; then a comparison was made between the results to assure the efficacy of the fluorescent light analysis outcome. Results: About 9.4% of the lesions detected were abnormal lesions and 83.09% had loss of fluorescent light effect. Based on the use of surgical biopsy, the machine had a sensitivity of 74.1% and a specificity of 96.3%. According to the statistical analysis, the P value was much lower than 0.05, so we can conclude that at 95% confidence level, there was significant agreement between VELscope results and biopsy results. Kappa coefficient value was approximately 0.5, which means that the strength of the agreement was medium. Conclusion: VELscope can be used as a clinical diagnostic aid in the detection of premalignant and malignant lesions of the oral cavity. In addition, it helps in the detection of the borders in both surgical biopsy and surgical excision. PMID:26236687

  8. 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

  9. SA-SVM based automated diagnostic system for skin cancer

    NASA Astrophysics Data System (ADS)

    Masood, Ammara; Al-Jumaily, Adel

    2015-03-01

    Early diagnosis of skin cancer is one of the greatest challenges due to lack of experience of general practitioners (GPs). This paper presents a clinical decision support system aimed to save time and resources in the diagnostic process. Segmentation, feature extraction, pattern recognition, and lesion classification are the important steps in the proposed decision support system. The system analyses the images to extract the affected area using a novel proposed segmentation method H-FCM-LS. The underlying features which indicate the difference between melanoma and benign lesions are obtained through intensity, spatial/frequency and texture based methods. For classification purpose, self-advising SVM is adapted which showed improved classification rate as compared to standard SVM. The presented work also considers analyzed performance of linear and kernel based SVM on the specific skin lesion diagnostic problem and discussed corresponding findings. The best diagnostic rates obtained through the proposed method are around 90.5 %.

  10. Infections fongiques des brûlé : revue

    PubMed Central

    Arnould, JF.; Le Floch, R.

    2015-01-01

    Summary Les infections fongiques locales ou générales sont souvent d’une extrême gravité chez les brûlés. Les brûlés combinent de nombreux facteurs de risque à une immunodépression induite par la brûlure. Les infections de plaies sont le fait des genres Candida, Aspergillus et des agents de mucormycoses. Ces deux derniers cas sont à l’origine de lésions particulièrement sévères. Leur diagnostic repose sur la biopsie cutanée avec examens mycologique et anatomopathologique. Le traitement est essentiellement chirurgical, associé à une antibiothérapie adaptée. Les septicémies sont le fait de levures, essentiellement du genre Candida. Le diagnostic en est difficile dans le contexte des brûlés et repose souvent sur une forte suspicion clinique. Leur traitement repose sur les échinocandines et plus secondairement sur le fluconazole. PMID:26668558

  11. Fine needle aspiration cytology of salivary gland lesions.

    PubMed

    Young, J A; Smallman, L A; Thompson, H; Proops, D W; Johnson, A P

    1990-01-01

    Eighty-eight fine needle aspirates from 79 salivary gland lesions in 77 patients were examined. The overall diagnostic sensitivity was 84% and the specificity 98.41%. When the 14 unsatisfactory specimens were excluded the sensitivity rose to 95.45%. Correct identification of the disease process was possible in nearly 80% of cases with a final benign diagnosis. The histological tumour type was correctly predicted in 75% of the malignancies. In the others the cytological diagnosis was anaplastic malignant neoplasm.

  12. [The focal renal lesions].

    PubMed

    Tuma, Jan

    2013-06-01

    The focal renal lesions are altogether common. Most frequently are found Columna Bertini hypertrophies (so called pseudotumors) and simple renal cysts. The role of sonography in the practice is to distinguish pseudotumors from real renal tumors, and simple renal cysts from complex cysts. The differentiation of complex renal cysts is possible with the help of the CEUS (= contrast enhanced ultrasound) and other imaging modalities such as CT or MRI. In these cases, the CEUS imaging agent has clear advantages over CT and MRI, because it is composed of gas bubbles, which are only slightly smaller than red blood cells and remains exclusively intravascularly while the CT and MRI contrast agents diffuse into the interstitial space without any real perfusion. The real tumors can be differentiated from certain focal non-tumorous changes based on the ultrasound and clinic. The further differentiation of individual kidney tumors and metastases using ultrasound, MRI, CT and CEUS is only partly possible. In all uncertain or unclear cases, therefore, an open or ultrasound-guided biopsy is useful.

  13. Diagnostic pathology in microbial diseases of sheep or goats.

    PubMed

    Benavides, J; González, L; Dagleish, M; Pérez, V

    2015-12-14

    Post-mortem examination is a key step in the diagnostic process of infectious diseases in sheep and goats. Diagnostic pathology deals with identification and study of lesions, at the same time providing also significant clues regarding pathogenesis of the diseases. This article reviews the salient pathological findings associated with the most significant infectious diseases of sheep and goats present in countries where small ruminants are a relevant agricultural industry. Lesions are reviewed according to the different organ systems where they occur. Emphasis has been given in the description of the salient lesional patterns than can be identified in each organ and which can be of help in the differential diagnosis of the lesions caused by bacteria, viruses, fungi or prions. Finally, a review of the usefulness of ancillary tests that may be used on various tissue samples for performing an aetiological diagnosis, is included; the application of various techniques, from immunohistochemistry to molecular biology-based tests, is described.

  14. Diagnostic and therapeutic endoscopic approaches to intraductal papillary mucinous neoplasm.

    PubMed

    Turner, Brian G; Brugge, William R

    2010-10-27

    Pancreatic cystic lesions are increasingly identified on routine imaging. One specific lesion, known as intraductal papillary mucinous neoplasm (IPMN), is a mucinous, pancreatic lesion characterized by papillary cells projecting from the pancreatic ductal epithelium. The finding of mucin extruding from the ampulla is essentially pathognomonic for diagnosing these lesions. IPMNs are of particular interest due to their malignant potential. Lesions range from benign, adenomatous growths to high-grade dysplasia and invasive cancer. These mucinous lesions therefore require immediate attention to determine the probability of malignancy and whether observation or resection is the best management choice. Unresected lesions need long-term surveillance monitoring for malignant transformation. The accurate diagnosis of these lesions is particularly challenging due to the substantial similarities in morphology of pancreatic cystic lesions and limitations in current imaging technologies. Endoscopic evaluation of these lesions provides additional imaging, molecular, and histologic data to aid in the identification of IPMN and to determine treatment course. The aim of this article is to focus on the diagnostic and therapeutic endoscopic approaches to IPMN.

  15. Parotid Cystic Lesion in Amelanotic Malignant Melanoma.

    PubMed

    Santos, Vitorino Modesto Dos; Gondim Neto, Manoel da Costa; de Melo, Tereza Rodrigues de Carvalho Vieira; Motta, Iara Machado

    2016-09-01

    A 60-year Brazilian woman, presented with an enlarged lymph node in the neck for one year, and a superficial nonulcerated lesion was observed in the scalp. Fine needle aspiration and biopsy of the lymph node revealed amelanocytic metastasis, and immunohistochemistry study showed Melan-A/ Mart-1 antigen (clone A103 and S-100 protein). The entire suspected area of the scalp was further resected and an amelanotic melanoma without angiolymphatic invasion was diagnosed. Ultrasonography and PET-computed tomography showed hypermetabolic cystic area in the right parotid. Furthermore, aspiration biopsy and surgical samples from parotid cyst confirmed the malignant amelanotic melanoma. Cystic metastases are scarcely reported in parotid gland, and can pose diagnostic challenges. PMID:27671185

  16. Amelanotic Melanoma Masquerading as a Granular Cell Lesion

    PubMed Central

    Pandiar, Deepak; Basheer, Shaini; Shameena, P. M.; Sudha, S.; Dhana, Lakshmi J.

    2013-01-01

    Amelanotic melanoma (AM) presents a diagnostic challenge due to its wide clinical presentations, lack of pigmentation, and varied histological appearances. Immunohistochemistry plays a crucial role in the diagnosis of these lesions. Amelanotic melanoma of oral mucosa is an uncommon lesion. We report a case of a 50-year-old male patient with a growth on the anterior mandibular gingiva of seven-month duration. In the present case, histologically, the tumour resembled a granular cell lesion, which has not been reported previously in AM. Diagnosis was possible by a sequential panel of immunohistochemical markers, of which finally vimentin, S100, HMB45, and Melan-A were positive. The tumor was surgically excised, and postsurgical radiotherapy was given. PMID:23533832

  17. Clinics in diagnostic imaging (95). Os trigonum.

    PubMed

    Poh, A C C; Peh, W C G

    2004-03-01

    A 19-year-old boy presented to the Accident and Emergency Department after sustaining trauma to his left ankle and foot while playing soccer. The radiograph of his left ankle showed a well-corticated triangular fragment of bone posterior to the left talus, typical of an os trigonum. This accessory bone was initially mistaken for a fracture fragment and a plaster cast was applied. The term, do not touch lesion, has been coined to describe this group of benign bony entities which may be classified into three broad categories, namely: normal variants, lesions that are real but obviously benign, and lesions that are related to degenerative disease. The importance of recognising the characteristic radiographical appearances of these entities is emphasised, as the need for further imaging or diagnostic tests can usually be avoided.

  18. Tuberculosis diagnostics in Fiji: how reliable is culture?

    PubMed

    Reddy, M; Gounder, S; Reid, S A

    2014-09-21

    Contexte : L'examen microscopique de crachats à la recherche de bacilles acido-alcoolo résistants (AFB) et la culture de Mycobacterium tuberculosis sont des examens de première intention dans le diagnostic de la tuberculose (TB). La contamination des cultures de TB réduit la fiabilité du diagnostic.Objectif: Examiner les facteurs associés à la contamination des cultures de TB aux Fidji et les performances relatives de la culture et de l'AFB.Méthodes : Tous les examens réalisés au Laboratoire de Référence des Mycobacterium de Daulakao aux Fidji de 2010 à 2012 ont été inclus. Les variables comprenaient les résultats de l'AFB et de la culture, l'âge et le type de spécimen, le centre d'examen ayant envoyé l'échantillon et l'âge du patient.Résultats: Des 5708 spécimens enregistrés, 70% comprenaient à la fois les résultats du frottis AFB et de la culture. Une contamination est survenue dans 421 spécimens et 2,7% d'entre eux étaient soit dégradés, soit sans résultats. L'accord entre les deux tests était modéré (κ = 0,577). La culture avait plus de chances d'être positive quand le score du frottis AFB était plus élevé. La contamination de la culture était associée à la distance par rapport au laboratoire de référence, à l'âge de l'échantillon et à des facteurs liés à l'opérateur.Conclusion : Une plus grande rapidité de transmission des échantillons de crachats depuis le centre d'examens anti-tuberculeux ou l'adjonction de conservateurs aux spécimens de crachats pourrait amener une diminution du taux de contamination des cultures. L'introduction de techniques de cultures liquides combinée à la culture sur milieu Ogawa augmentera la sensibilité du diagnostic de la TB aux Fidji.

  19. Optimized lesion detection in digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Chawla, Amarpreet S.; Samei, Ehsan; Lo, Joseph Y.

    2009-02-01

    While diagnostic improvement via breast tomosynthesis has been notable, the full potential of tomosynthesis has not yet been realized. This is because of the complex task of optimizing multiple parameters that constitute image acquisition and thus affect tomosynthesis performance. Those parameters include dose, number of angular projections, and the total angular span of those projections. In this study, we investigated the effects of acquisition parameters, independent of each other, on the overall diagnostic image quality of tomosynthesis. Five mastectomy specimens were imaged using a prototype tomosynthesis system. 25 angular projections of each specimen were acquired at 6.2 times typical single-view mammographic dose level. Images at lower dose levels were then simulated using a noise modification routine. Each projection image was supplemented with 84 simulated 3 mm 3D lesions embedded at the center of 84 non-overlapping ROIs. The projection images were then reconstructed using a filtered-back projection (FBP) algorithm at 224 different combinations of acquisition parameters to investigate which one of the many possible combinations maximized performance. Performance was evaluated in terms of a Laguerre-Gauss channelized Hotelling observer model-based measure of lesion detectability. Results showed that performance improved with an increase in the total acquisition dose level and the angular span. At a constant dose level and angular span, the performance rolled-off beyond a certain number of projections, indicating that simply increasing the number of projections in tomosynthesis may not necessarily improve its performance. The best performance was obtained with 15-17 projections spanning an angular arc of ~45° - the maximum tested in our study, and for an acquisition dose equal to single-view mammography. The optimization framework developed in this framework is applicable to other reconstruction techniques and other multi-projection systems.

  20. Endoscopic ultrasound-guided techniques for diagnosing pancreatic mass lesions: Can we do better?

    PubMed Central

    Storm, Andrew C; Lee, Linda S

    2016-01-01

    The diagnostic approach to a possible pancreatic mass lesion relies first upon various non-invasive imaging modalities, including computed tomography, ultrasound, and magnetic resonance imaging techniques. Once a suspect lesion has been identified, tissue acquisition for characterization of the lesion is often paramount in developing an individualized therapeutic approach. Given the high prevalence and mortality associated with pancreatic cancer, an ideal approach to diagnosing pancreatic mass lesions would be safe, highly sensitive, and reproducible across various practice settings. Tools, in addition to radiologic imaging, currently employed in the initial evaluation of a patient with a pancreatic mass lesion include serum tumor markers, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). EUS-FNA has grown to become the gold standard in tissue diagnosis of pancreatic lesions.

  1. Nonproliferative and Proliferative Lesions of the Gastrointestinal Tract, Pancreas and Salivary Glands of the Rat and Mouse

    PubMed Central

    Nolte, Thomas; Brander-Weber, Patricia; Dangler, Charles; Deschl, Ulrich; Elwell, Michael R.; Greaves, Peter; Hailey, Richard; Leach, Michael W.; Pandiri, Arun R.; Rogers, Arlin; Shackelford, Cynthia C.; Spencer, Andrew; Tanaka, Takuji; Ward, Jerrold M.

    2016-01-01

    The INHAND (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) project is a joint initiative of the Societies of Toxicologic Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP), and North America (STP) to develop an internationally accepted nomenclature and diagnostic criteria for nonproliferative and proliferative lesions in laboratory animals. The purpose of this publication is to provide a standardized nomenclature and diagnostic criteria for classifying lesions in the digestive system including the salivary glands and the exocrine pancreas of laboratory rats and mice. Most lesions are illustrated by color photomicrographs. The standardized nomenclature, the diagnostic criteria, and the photomicrographs are also available electronically on the Internet (http://www.goreni.org/). Sources of material included histopathology databases from government, academia, and industrial laboratories throughout the world. Content includes spontaneous and age related lesions as well as lesions induced by exposure to test items. Relevant infectious and parasitic lesions are included as well. A widely accepted and utilized international harmonization of nomenclature and diagnostic criteria for the digestive system will decrease misunderstandings among regulatory and scientific research organizations in different countries and provide a common language to increase and enrich international exchanges of information among toxicologists and pathologists. PMID:26973378

  2. Nonproliferative and Proliferative Lesions of the Gastrointestinal Tract, Pancreas and Salivary Glands of the Rat and Mouse.

    PubMed

    Nolte, Thomas; Brander-Weber, Patricia; Dangler, Charles; Deschl, Ulrich; Elwell, Michael R; Greaves, Peter; Hailey, Richard; Leach, Michael W; Pandiri, Arun R; Rogers, Arlin; Shackelford, Cynthia C; Spencer, Andrew; Tanaka, Takuji; Ward, Jerrold M

    2016-01-01

    The INHAND (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) project is a joint initiative of the Societies of Toxicologic Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP), and North America (STP) to develop an internationally accepted nomenclature and diagnostic criteria for nonproliferative and proliferative lesions in laboratory animals. The purpose of this publication is to provide a standardized nomenclature and diagnostic criteria for classifying lesions in the digestive system including the salivary glands and the exocrine pancreas of laboratory rats and mice. Most lesions are illustrated by color photomicrographs. The standardized nomenclature, the diagnostic criteria, and the photomicrographs are also available electronically on the Internet (http://www.goreni.org/). Sources of material included histopathology databases from government, academia, and industrial laboratories throughout the world. Content includes spontaneous and age related lesions as well as lesions induced by exposure to test items. Relevant infectious and parasitic lesions are included as well. A widely accepted and utilized international harmonization of nomenclature and diagnostic criteria for the digestive system will decrease misunderstandings among regulatory and scientific research organizations in different countries and provide a common language to increase and enrich international exchanges of information among toxicologists and pathologists.

  3. Secondary Syphilitic Lesions

    PubMed Central

    Baughn, Robert E.; Musher, Daniel M.

    2005-01-01

    An important theme that emerges from all early historical accounts is that in addition to the decreased virulence of Treponema pallidum, the incidence of secondary syphilis has decreased drastically over the past three centuries. Even in the early 20th century, most syphilologists were of the opinion that the disease had undergone changes in its manifestations and that they were dealing with an attenuated form of the spirochete. Such opinions were based primarily on the observations that violent cutaneous reactions and fatalities associated with the secondary stage had become extremely rare. The rate of primary and secondary syphilis in the United States increased in 2002 for the second consecutive year. After a decade-long decline that led to an all-time low in 2000, the recent trend is attributable, to a large extent, by a increase in reported syphilis cases among men, particularly homosexual and bisexual men having sex with men. The present review addresses the clinical and diagnostic criteria for the recognition of secondary syphilis, the clinical course and manifestations of the disease if allowed to proceed past the primary stage of disease in untreated individuals, and the treatment for this stage of the disease. PMID:15653827

  4. Benign lymphoepithelial lesions of the parotid.

    PubMed

    Shaha, A R; DiMaio, T; Webber, C; Thelmo, W; Jaffe, B M

    1993-10-01

    Persistent generalized lymphadenopathy has been well described in patients with seropositivity to the human immunodeficiency virus (HIV). Moreover, isolated enlargement of the parotid gland and parotid lymphadenopathy have been noted much more frequently over the past few years. Histologically, these lesions demonstrate follicular hyperplasia, cystic dilatation of the ducts lined by pseudo-stratified squamous epithelium, and lymphocytic infiltrates. They are generally considered to be benign lymphoepithelial lesions of the parotid or hyperplastic periparotid lymph nodes. The relationship of this entity to the AIDS-related complex (ARC) and the subsequent development of AIDS is not clear. Over the past 7 years, we have seen 50 patients with parotid enlargement in whom the diagnosis of benign lymphoepithelial lesion was made. Fine-needle aspiration was performed in 32 patients. Although not conclusively diagnostic, needle aspirates ruled out primary salivary glandular pathology. Most patients gave a history of intravenous drug abuse. HIV tests have been performed on a routine basis only in the last 2 years, and these were positive in the majority of the patients. Thirty-five patients underwent surgical excision. In the initial 20 patients, we routinely performed parotid exploration, identification of the facial nerve, and superficial parotidectomy. In the last 15 patients, we changed our surgical approach to parotid exploration and excision of the mass in the tail of the parotid. The exposure of the posterior belly of the digastric muscle, with identification and removal of the deep jugular node, has become routine. In each case, we found an enlarged lymph node in the deep jugular region, which was not clinically palpable preoperatively. The rate of surgical complications was minimal, and, after resection of the mass, patients improved symptomatically. If the patient shows obvious signs of AIDS, a nonsurgical approach with repeated aspirations should be considered

  5. [Video capsule endoscopy in the diagnostics of small intestine diseases].

    PubMed

    Nakatis, Ia A; Borisov, A E; Kashchenko, V A; Sishkova, E A; Raspereza, D V; Lobach, S M; Tiniakova, T V; Pavlov, A V

    2008-01-01

    Video capsule endoscopy is a safe and noninvasive, well-endurable method of the direct visual inspection of the whole of the small intestine. The most frequent indications for video capsule endoscopy are the diagnostics of latent gastro-intestinal bleedings, angiodysplasias, Crohn disease, celiac disease, syndromes of hereditary polyposis and tumors of the small intestine. The authors describe the first experience of using this new method in the domestic clinical practice. Data concerning the diagnostics of lesions of the small intestine by the method of video capsule endoscopy as well as the wide range of lesions of the mucous membrane in different diseases of the small intestine are presented.

  6. Médecine des voyages

    PubMed Central

    Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

    2014-01-01

    Résumé Objectif Définir la pratique de la médecine des voyages, présenter les éléments fondamentaux d’une consultation complète préalable aux voyages à des voyageurs internationaux et aider à identifier les patients qu’il vaudrait mieux envoyer en consultation auprès de professionnels de la médecine des voyages. Sources des données Les lignes directrices et les recommandations sur la médecine des voyages et les maladies liées aux voyages publiées par les autorités sanitaires nationales et internationales ont fait l’objet d’un examen. Une recension des ouvrages connexes dans MEDLINE et EMBASE a aussi été effectuée. Message principal La médecine des voyages est une spécialité très dynamique qui se concentre sur les soins préventifs avant un voyage. Une évaluation exhaustive du risque pour chaque voyageur est essentielle pour mesurer avec exactitude les risques particuliers au voyageur, à son itinéraire et à sa destination et pour offrir des conseils sur les interventions les plus appropriées en gestion du risque afin de promouvoir la santé et prévenir les problèmes médicaux indésirables durant le voyage. Des vaccins peuvent aussi être nécessaires et doivent être personnalisés en fonction des antécédents d’immunisation du voyageur, de son itinéraire et du temps qu’il reste avant son départ. Conclusion La santé et la sécurité d’un voyageur dépendent du degré d’expertise du médecin qui offre le counseling préalable à son voyage et les vaccins, au besoin. On recommande à ceux qui donnent des conseils aux voyageurs d’être conscients de l’ampleur de cette responsabilité et de demander si possible une consultation auprès de professionnels de la médecine des voyages pour tous les voyageurs à risque élevé.

  7. La trochantérite tuberculeuse, un diagnostic souvent difficile

    PubMed Central

    Mhammdi, Younes; Boufettal, Moncef; Kharmaz, Mohamed; Lahlou, Abdou; Mahfoud, Mustapha; EL Bardouni, Ahmed; Berrada, Mohamed Saleh

    2016-01-01

    La trochantérite tuberculeuse est une affection rare (<2% des tuberculoses ostéo-articulaires), même en pays à forte endémie, elle est caractérisée par une symptomatologie insidieuse rendant souvent son diagnostic tardif. Les auteurs rapportent une série de 9 cas, le diagnostic a été posé sur des études bactériologiques et histologiques après un bilan d'imagerie (échographie, IRM, TDM). Le traitement de cette affection est médical (antibiothérapie antituberculeuse), et la chirurgie ne trouve sa place qu'en cas de complications et permet d'améliorer l’évolution. PMID:27279938

  8. A RETROSPECTIVE STUDY OF CAUSES OF SKIN LESIONS IN WILD TURKEYS (MELEAGRIS GALLOPAVO) IN THE EASTERN USA, 1975-2013.

    PubMed

    Elsmo, Elizabeth J; Allison, Andrew B; Brown, Justin D

    2016-07-01

    Skin lesions of Wild Turkeys ( Meleagris gallopavo ) are a common cause of concern to wildlife biologists and the general public and are a frequent reason for submission to diagnostic laboratories. The purpose of this retrospective study is to evaluate the causes, occurrence, and epidemiologic patterns of skin lesions in Wild Turkeys in the eastern US. Skin lesions were diagnosed in 30% (n=199) of the 660 Wild Turkey samples submitted to the Southeastern Cooperative Wildlife Disease Study diagnostic service from 1975 to 2013. Avian pox was the most frequent cause of skin lesions (66%, n=131), followed by bacterial dermatitis (22%, n=44), ectoparasitism-related dermatitis (3%, n=6), fungal dermatitis (2.5%, n=5), and neoplasia (2.0%, n=4). Although the gross appearance of skin lesions is often insufficient to determine the etiology, the anatomic distribution of lesions and temporal occurrence of certain diseases may offer insights into likely causes. Cases with lesions involving or restricted to the head and neck were much more likely to be caused by avian pox than other etiologies. Similarly, lesions restricted to the feet were more likely to be of bacterial origin. Skin lesions observed in the fall and winter were more likely to be caused by avian pox, whereas bacterial dermatitis was more frequently observed in the spring and summer. This retrospective study provides a summary of the causes of skin lesions in Wild Turkeys and serves as a useful reference to diagnosticians and biologists when evaluating Wild Turkeys with skin lesions.

  9. [Shaken baby syndrome: which lesions in imaging ?].

    PubMed

    Adamsbaum, C; Husson, B

    2012-09-01

    Non-accidental brain trauma (also called shaken baby syndrome) represent the main cause for morbidity and mortality in the context of child abuse. It often occur in young infants aged less than 8months. The shaking leading to brain injuries are very violent and sometimes associated with a final impact. Intracranial injuries may be isolated without skeletal trauma or bruising. In any suspicion of such a diagnosis, emergency hospitalization is indicated. Brain CT, easy to perform in emergency, is the diagnostic key. It discloses diffuse subdural hematomas in typical sites as vertex, interhemispheric space and tentorium. There is no clear background of trauma and the related story is changing over time. The 3D analysis of the skull looks for signs of recent impact as a fracture that is sometimes complex and/or a soft tissue swelling of the scalp. Intraparenchymal injuries (contusions, tearing, and overall anoxic ischemic injuries) are better analyzed with MRI. The prognosis depends on their extent. Ophtalmologic examination is systematically performed looking for retinal hemorrhages (around one third of cases) which may be very subtle. Bruising is a major diagnostic sign, but inconstantly present. A precise datation of skeletal and/or brain injuries is not possible with imaging and the only indication of use is to establish the presence of "age different lesions". This indicates repeated trauma and thereby a high risk of recurrence.

  10. La dysplasie fibreuse: état des lieux

    PubMed Central

    Akasbi, Nessrine; Abourazzak, Fatima Ezzahra; Talbi, Sofia; Tahiri, Latifa; Harzy, Taoufik

    2015-01-01

    La dysplasie fibreuse des os est une affection osseuse bénigne congénitale mais non héréditaire, où l'os normal est remplacé par un tissu fibreux renfermant une ostéogenèse immature. Elle est due à une mutation du gène GNAS 1sur le chromosome 20q13, une mutation activatrice de la sous-unité α de la protéine G. C'est une pathologie qui est le plus souvent silencieuse, de découverte fortuite sur une radiographie standard ou révélée par une douleur osseuse ou une fracture pathologique. L'imagerie et l'histologie, quand elle est nécessaire, permettent d’établir le diagnostic. Bien qu'il ne s'agisse pas d'une tumeur, elle est souvent classée dans la catégorie des tumeurs osseuses bénignes pour des raisons de diagnostic différentiel radiographique et anatomopathologique. Elle peut être monostotique ou polyostotique. L'approche thérapeutique est essentiellement symptomatique. Quelques publications récentes ont suggéré l'intérêt majeur d'un bisphosphonate, en particulier le pamidronate, qui diminuerait les douleurs et stimulerait une reminéralisation progressive des zones ostéolytiques chez les patients traités. D'autres traitements tels que la thérapie ciblée sont en cours d’évaluation. PMID:26401215

  11. Voxelwise Bayesian Lesion Deficit Analysis

    PubMed Central

    Chen, Rong; Hillis, Argye E.; Pawlak, Mikolaj; Herskovits, Edward H

    2008-01-01

    Relating cognitive deficits to the presence of lesions has been an important means of delineating structure-function associations in the human brain. We propose a voxel-based Bayesian method for lesion-deficit analysis, which identifies complex linear or nonlinear associations among brain-lesion locations, and neurological status. We validated this method using a simulated data set, and we applied this algorithm to data obtained from an acute-stroke study to identify associations among voxels with infarct or hypoperfusion, and impaired word reading. We found that a distributed region involving Brodmann areas (BA) 22, 37, 39, and 40 was implicated in word reading. PMID:18328733

  12. 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.

  13. 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

  14. Fine needle aspiration biopsy of cystic lesions of the head and neck, excluding the thyroid.

    PubMed

    Dejmek, A; Lindholm, K

    1990-01-01

    The occurrence of cystic lesions of the head and neck region (excluding the thyroid gland) and their diagnosis by fine needle aspiration (FNA) biopsy were reviewed for a two-year period. Of the 967 total aspirates of the region, 98 were cystic. The frequency of cysts was thus 10% in the total material, including 23% in parotid gland aspirates and 3% in lymph node aspirates. Salivary gland cysts occurred more often on the right side. The overall malignancy rate was the same for cysts and solid lesions (16%); however, 81% of cystic lymph node lesions were malignant. There was no difference in the frequency of nondiagnostic FNA material between solid and cystic lesions. A histologically correct diagnosis of benign or malignant was rendered by cytology in 85% of the cystic cases, with 4% false negatives and 2% false positives. This diagnostic accuracy was similar to that of the solid lesions. The FNA diagnostic problems were concentrated in the salivary gland lesions, with the false diagnoses illustrating the difficulties of interpreting atypical oxyphilic epithelium. The results suggest that a true neoplastic lesion should be seriously considered when a single population of oxyphilic epithelium is identified, even at the risk of overdiagnosing benign lesions.

  15. Analyse des facteurs prédictifs de malignité des goitres nodulaires : à propos de 500 cas

    PubMed Central

    Bouaity, Brahim; Darouassi, Youssef; Chihani, Mehdi; Touati, Mohamed Mliha; Ammar, Haddou

    2016-01-01

    Les nodules thyroïdiens sont très fréquents et moins de 10% d'entre eux sont malin. Ils posent un véritable problème diagnostique et thérapeutique surtout par rapport à leur nature bénigne ou maligne. L’étude de certains facteurs cliniques et paracliniques de présomption de malignité permet de bien codifier la stratégie thérapeutique. Le but de ce travail est d’étudier les facteurs prédictifs de malignité des goitres nodulaires et comparer nos résultats à ceux de la littérature. Il s'agit d'une étude rétrospective à propos de 500 cas de goitres nodulaires opérés au service d'Oto-rhino-laryngologie (ORL) et Chirurgie cervico-faciale (CCF) de l'hôpital militaire Avicenne de Marrakech entre 2006 et 2012. Le pourcentage de cancers a été de 6,8%. L’âge moyen de nos patients était de 46 ans, avec une sex-ratio de 5 (F/H). A la palpation cervicale; le caractère dure du nodule a été constaté dans 94,4% des cas de cancer, avec des limites irrégulières dans 64,70% des cas de cancer. Trois nodules étaient fixes et ils étaient tous malins. Les adénopathies cervicales ont été constatées chez 8 malades dont 7 présentaient des cancers. A l’échographie, 61,8% des nodules malins présentaient un aspect hypoéchogène, avec des contours flous dans 88,24% des cas. La vascularisation intra nodulaire était présente dans 35,3% de ces cas des cancers avec des microcalcifications chez 55,9% d'entre eux. Le halo hypoéchogene périnodulaire était incomplet dans 73,5% des cas de cancer. Nos patients étaient en euthyroïdie dans 84,6% des cas. Les facteurs prédictifs de malignité d'un goitre nodulaire, étaient donc dans notre étude d'abord cliniques: l’âge supérieur à 60 ans, la consistance dure du nodule, sa fixité, son caractère irrégulier et mal limité à la palpation, ainsi que la présence d'adénopathie(s) cervicale(s) à l'examen; et échographiques: le caractère hypoéchogène, les limites floues, la présence de

  16. Proliferative and nonproliferative lesions of the rat and mouse central and peripheral nervous systems.

    PubMed

    Kaufmann, Wolfgang; Bolon, Brad; Bradley, Alys; Butt, Mark; Czasch, Stephanie; Garman, Robert H; George, Catherine; Gröters, Sibylle; Krinke, Georg; Little, Peter; McKay, Jenny; Narama, Isao; Rao, Deepa; Shibutani, Makoto; Sills, Robert

    2012-06-01

    Harmonization of diagnostic nomenclature used in the pathology analysis of tissues from rodent toxicity studies will enhance the comparability and consistency of data sets from different laboratories worldwide. The INHAND Project (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) is a joint initiative of four major societies of toxicologic pathology to develop a globally recognized nomenclature for proliferative and nonproliferative lesions in rodents. This article recommends standardized terms for classifying changes observed in tissues of the mouse and rat central (CNS) and peripheral (PNS) nervous systems. Sources of material include academic, government, and industrial histopathology databases from around the world. Covered lesions include frequent, spontaneous, and aging-related changes as well as principal toxicant-induced findings. Common artifacts that might be confused with genuine lesions are also illustrated. The neural nomenclature presented in this document is also available electronically on the Internet at the goRENI website (http://www.goreni.org/).

  17. Scabies presenting with bullous pemphigoid-like lesions.

    PubMed

    Ansarin, Habib; Jalali, Mir Hadi Aziz; Mazloomi, Shadi; Soltani-Arabshahi, Razieh; Setarehshenas, Roya

    2006-01-01

    A wide range of clinical manifestations may be seen in scabies, from classic pruritic papules and burrows to secondary features such as impetigo. Bullus lesions are a less frequent. Twenty cases of scabies presenting with bullae have been reported so far in the medical literature. Differentiating this subtype of scabies from the immunobullous disease bullus pemphigoid is a diagnostic challenge. A 42-year-old man was referred to our dermatology outpatient clinic with 3-month history of severe pruritus and tense blisters affecting mainly the lower trunk, arms and legs. An initial biopsy was suggestive for bullous pemphigoid. Close physical examination revealed small excoriated papules and a few burrows on borders of the hands and wrists. Skin scraping of the lesions on wrists was positive for Sarcoptes scabiei. Another biopsy specimen from a recent blister revealed subepidermal bullae with fibrin and inflammatory cells, particularly eosinophils. Direct immunofluorescence exam was negative. The patient was treated with lindane lotion followed by crotamiton cream with near complete resolution of the lesions. Scabies must be considered in patients presenting with recent onset of unexplained pruritic bullous lesions. Biopsy and immunofluorescence studies together with skin scrapings for Sarcoptes scabiei could help to differentiate these cases from bullous pemphigoid. Antiscabietic treatment results in resolution of bullous lesions in the affected patients.

  18. 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.

  19. Meniscal Ramp Lesions: Anatomy, Incidence, Diagnosis, and Treatment.

    PubMed

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

    2016-07-01

    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

  20. Meniscal Ramp Lesions: Anatomy, Incidence, Diagnosis, and Treatment.

    PubMed

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

    2016-07-01

    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.

  1. Diagnostic value of fundus examination in familial adenomatous polyposis

    PubMed Central

    Tiret, A.; Taiel-Sartral, M.; Tiret, E.; Laroche, L.

    1997-01-01

    BACKGROUND—Multiple, bilateral lesions of congenital hypertrophy of the retinal pigment epithelium (CHRPE) have been described in patients suffering from familial adenomatous polyposis (FAP) since 1980. This study aimed to determine a reliable diagnostic criterion, based on the size and number of retinal CHRPE lesions, allowing the screening of patient carriers of the gene responsible for FAP.
METHODS—32 control subjects and 144 patients belonging to 85 FAP families were studied, divided into 124 carriers of the genetic alteration and 20 non-carriers.
RESULTS—In carriers of the deleted gene, multiple, bilateral retinal lesions were consistently observed. Lesion situation, size, shape, and degree of pigmentation were variable however. A positive criterion for FAP was defined as the presence of at least four lesions whatever their size, or at least two lesions one of which is large. This criterion showed a high sensitivity (0.68) and a maximal specificity (1). Within each family, the retinal phenotypic expression was homogeneous. CHRPE lesions were observed in two thirds of the FAP families and absent from the remaining third.
CONCLUSION—By using this new positive diagnostic criterion, fundus examination allows early detection of those children carrying the gene responsible for FAP in families positive at ocular examination.

 PMID:9422927

  2. Diagnostic sonography in general surgery.

    PubMed

    Hill, B A; Yamaguchi, K; Flynn, J J; Miller, D R

    1975-09-01

    Eighty-seven patients who had sonographic examinations at the Orange County Medical Center were studied retrospectively to evaluate the usefulness and reliability of this noninvasive technique, and sonographic results were compared with findings at operation or findings made using other diagnostic methods. With a variety of lesions, the overall accuracy of diagnosis by sonography was 85%. In the remaining 15% of studies, false-positive or false-negative results were observed. The accuracy varied with the organ involved, the greatest being renal and hepatic masses. Ultrasound, when used in addition to careful surgical assessment of the patient, was found to be most useful in the diagnosis and follow-up of abdominal problems in surgical patients.

  3. 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.

  4. Gram stain of skin lesion

    MedlinePlus

    ... may be done along with this test. Other studies are often done on a skin sample to determine if cancer is present. Viral skin lesions like herpes simplex are examined by other tests or a viral culture.

  5. Osteochondral Lesions of Major Joints

    PubMed Central

    Durur-Subasi, Irmak; Durur-Karakaya, Afak; Yildirim, Omer Selim

    2015-01-01

    This paper provides information about osteochondral lesions (OCL) and example cases of OCL occurring in major joints, some of which are rarely seen. This simple tutorial is presented in question and answer format. PMID:26180500

  6. Asterixis in focal brain lesions.

    PubMed

    Degos, J D; Verroust, J; Bouchareine, A; Serdaru, M; Barbizet, J

    1979-11-01

    Asterixis was observed in 20 cases of focal brain lesions. Metabolic or toxic factors were excluded. An electromyogram study of asterixis was carried out in nine cases to establish the diagnosis. The site of the focal lesion was either parietal or mesencephalic and was always contralateral to the asterixis. "Focal asterixis" could result from a dysfunction of the sensorimotor integration in the parietal lobe and the midbrain.

  7. 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.

  8. Endoscopic Management of Dieulafoy's Lesion

    PubMed Central

    Jeon, Hye Kyung

    2015-01-01

    A Dieulafoy's lesion is a vascular abnormality consisting of a large caliber-persistent tortuous submucosal artery. A small mucosal defect with the eruption of this protruding vessel can cause bleeding. In fact, a Dieulafoy's lesion is a relatively rare but potentially life-threatening condition. It accounts for 1% to 2% of cases of acute gastrointestinal bleeding. Although there is no consensus on the treatment of Dieulafoy's lesions; treatment options depend on the mode of presentation, site of the lesion, and available expertise. Endoscopic therapy is usually successful in achieving primary hemostasis, with hemostasis success rates reaching 75% to 100%. Although various therapeutic endoscopic methods are used to control bleeding in Dieulafoy's lesions, the best method for endoscopic intervention is not clear. Combination endoscopic therapy is known to be superior to monotherapy because of a lower rate of recurrent bleeding. In addition, mechanical therapies including hemostatic clipping and endoscopic band ligation are more effective and successful in controlling bleeding than other endoscopic methods. Advances in endoscopic techniques have reduced mortality in patients with Dieulafoy's lesion-from 80% to 8%-and consequently, the need for surgical intervention has been reduced. Currently, surgical intervention is used for cases that fail therapeutic endoscopic or angiographic interventions. PMID:25844338

  9. 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.

  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. Diagnostics for ITER

    SciTech Connect

    Donne, A. J. H.; Hellermann, M. G. von; Barnsley, R.

    2008-10-22

    After an introduction into the specific challenges in the field of diagnostics for ITER (specifically high level of nuclear radiation, long pulses, high fluxes of particles to plasma facing components, need for reliability and robustness), an overview will be given of the spectroscopic diagnostics foreseen for ITER. The paper will describe both active neutral-beam based diagnostics as well as passive spectroscopic diagnostics operating in the visible, ultra-violet and x-ray spectral regions.

  12. Poor correlation between spectrophotometric intracutaneous analysis and histopathology in melanoma and nonmelanoma lesions

    NASA Astrophysics Data System (ADS)

    Terstappen, Karin; Suurküla, Mart; Hallberg, Håkan; Ericson, Marica B.; Wennberg, Ann-Marie

    2013-06-01

    Spectrophotometric intracutaneous analysis (SIAscopy) is an imaging technique developed for diagnostics of pigmented skin lesions. By image analysis, the displayed images indicate the potential distribution and position of melanin, blood, and collagen within the lesion. A topographic comparison was performed between SIAscopic findings and histopathology. In total, 60 patients with suspicious pigmented skin lesions were included. The lesions were SIAscopically imaged and documented before excision and histopathological preparation. Topographical comparisons between SIAscopy findings and histopathology were made. A sensitivity and specificity of 24% and 84%, respectively, were obtained for invasive melanomas. The positive and negative predicted values were 58% and 54%, respectively. The features indicating dermal melanin, blood displacement and collagen holes did only show "no" to "slight" agreement with histopathology, i.e., κ≤0.21. It was concluded that (i) SIAscopy-based diagnosis has low diagnostic accuracy for melanoma, (ii) single SIAscopic features do not provide reliable diagnostic information relating to the lesions internal structure on histopathology examination and (iii) SIAscopy cannot be used as a guide for localizing the maximum tumor thickness when performing the histopathological examination. The importance of validating new optical tools for tumor diagnostics with histopathological findings was demonstrated.

  13. Poor correlation between spectrophotometric intracutaneous analysis and histopathology in melanoma and nonmelanoma lesions.

    PubMed

    Terstappen, Karin; Suurküla, Mart; Hallberg, Håkan; Ericson, Marica B; Wennberg, Ann-Marie

    2013-06-01

    Spectrophotometric intracutaneous analysis (SIAscopy) is an imaging technique developed for diagnostics of pigmented skin lesions. By image analysis, the displayed images indicate the potential distribution and position of melanin, blood, and collagen within the lesion. A topographic comparison was performed between SIAscopic findings and histopathology. In total, 60 patients with suspicious pigmented skin lesions were included. The lesions were SIAscopically imaged and documented before excision and histopathological preparation. Topographical comparisons between SIAscopy findings and histopathology were made. A sensitivity and specificity of 24% and 84%, respectively, were obtained for invasive melanomas. The positive and negative predicted values were 58% and 54%, respectively. The features indicating dermal melanin, blood displacement and collagen holes did only show "no" to "slight" agreement with histopathology, i.e., κ ≤ 0.21. It was concluded that (i) SIAscopy-based diagnosis has low diagnostic accuracy for melanoma, (ii) single SIAscopic features do not provide reliable diagnostic information relating to the lesions internal structure on histopathology examination and (iii) SIAscopy cannot be used as a guide for localizing the maximum tumor thickness when performing the histopathological examination. The importance of validating new optical tools for tumor diagnostics with histopathological findings was demonstrated. PMID:23296145

  14. Poor correlation between spectrophotometric intracutaneous analysis and histopathology in melanoma and nonmelanoma lesions.

    PubMed

    Terstappen, Karin; Suurküla, Mart; Hallberg, Håkan; Ericson, Marica B; Wennberg, Ann-Marie

    2013-06-01

    Spectrophotometric intracutaneous analysis (SIAscopy) is an imaging technique developed for diagnostics of pigmented skin lesions. By image analysis, the displayed images indicate the potential distribution and position of melanin, blood, and collagen within the lesion. A topographic comparison was performed between SIAscopic findings and histopathology. In total, 60 patients with suspicious pigmented skin lesions were included. The lesions were SIAscopically imaged and documented before excision and histopathological preparation. Topographical comparisons between SIAscopy findings and histopathology were made. A sensitivity and specificity of 24% and 84%, respectively, were obtained for invasive melanomas. The positive and negative predicted values were 58% and 54%, respectively. The features indicating dermal melanin, blood displacement and collagen holes did only show "no" to "slight" agreement with histopathology, i.e., κ ≤ 0.21. It was concluded that (i) SIAscopy-based diagnosis has low diagnostic accuracy for melanoma, (ii) single SIAscopic features do not provide reliable diagnostic information relating to the lesions internal structure on histopathology examination and (iii) SIAscopy cannot be used as a guide for localizing the maximum tumor thickness when performing the histopathological examination. The importance of validating new optical tools for tumor diagnostics with histopathological findings was demonstrated.

  15. Angiomyolipomes épithélioïdes rénal bénin: à propos de deux cas

    PubMed Central

    Bagayogo, Tidiani; Othmane, Yddoussalah; Tarik, Karmouni; Khalid, Elkhader; Abdellatif, Koutani; Ahmed, Ibn Attya Andaloussi

    2015-01-01

    Les angiomyolipomes épithélioïdes rénaux (AMLeR) sont des tumeurs rares (identifiées chez moins de 0,1 patients pour 1000 habitants) et représentent 8% des angiomyolipomes (AML) opérés. Il a longtemps été considérécomme un hamartome mais plusieurs articles récents font penser qu'il s'agir d'une tumeur dérivant de cellules épithélioïdespérivasculaires. L'angiomyolipome épithélioïde est une forme rare d'angiomyolipome à potentiel malin, composé decellules épithélioïdes posant des problèmes de diagnostic différentiel avec les carcinomes à cellules rénales. L'immunohistochimie,en révélant la positivité des cellules épithélioïdes au marqueur HMB45 est essentielle au diagnostic. Les auteursrapportent l'aspect tomodensitométrique et histologique d'angiomyolipomes épithélioïdes chez deux patientes. PMID:26953738

  16. Modélisation des profils de raie dans les plasmas : PPP nouvelle version

    NASA Astrophysics Data System (ADS)

    Calisti, A.; Ferri, S.; Mossé, C.

    2006-12-01

    Le code de calcul de profils de raie PPP a été développé à l'origine avec l'objectif de synthétiser les raies spectrales émises par les plasmas et ce pour n'importe quel émetteur et n'importe quelles conditions de plasmas. Les motivations de ce travail ont été d'une part le diagnostic et d'autre part les études de la dynamique non linéaire des charges dans les plasmas. Le code numérique basé sur des modèles originaux met en jeu des algorithmes qui réalisent le meilleur compromis entre précision et rapidité. En particulier, le mouvement des charges perturbatrices est pris en compte par le Modèle de Fluctuation de Fréquences qui transforme le profil statique en profil dynamique. Ce code a été sans cesse amélioré au cours des dix dernières années avec l'aide d'une technique de simulation numérique basée sur la méthode de dynamique moléculaire qui fournit des profils dits de référence.

  17. [Diagnostic imaging of splenic disease].

    PubMed

    Völk, M; Strotzer, M

    2006-03-01

    Primary diseases of the spleen are relatively rare. More frequently, the spleen is involved secondarily in hematological, oncological, infectious, immunological, vascular, and other systemic diseases. The spleen is the most commonly injured organ in blunt abdominal trauma. Anatomical and physiological basics are explained, in addition to embryological facts with resulting abnormalities, such as accessory and "wandering" spleen, and polysplenia. The most frequent primary and secondary diseases of the spleen, including rare diagnoses, are presented and illustrated. Hemangioma represents the most common primary benign tumor, and lymphoma the most common primary malignant tumor of the spleen. Diagnostic imaging does not a allow safe differentiation between Hodgkin's and non-Hodgkin's lymphoma. One section deals with the clinical value and diagnostic workup of incidentally detected lesions. Simple cysts and calcifications need neither clarification nor a follow-up examination. Atypical cysts should be controlled within 3-6 months. Additional clarification using CT or MRT should be reserved for cases with a strong suspicion of clinically relevant primary or secondary splenic disease. PMID:16435091

  18. [Rare tumors and tumor-like lesions of the testis and paratesticular structures].

    PubMed

    Schweyer, S

    2014-05-01

    Tumors and tumor-like lesions of the testes and paratesticular structures are rare neoplasms often documented solely in case reports but are morphologically similar to their counterparts in other organ systems. According to the World Health Organization (WHO) classification, miscellaneous tumors of the testis, tumors of collecting ducts and rete testis, tumors of paratesticular structures are differentiated from mesenchymal tumors of the spermatic cord and testicular adnexa. In the differential diagnostics of a space-occupying mass in the testis or paratesticular region, tumor-like lesions should be considered because these lesions represent a large collection pot and occur more often than was originally assumed.

  19. Review of approaches to the recording of background lesions in toxicologic pathology studies in rats.

    PubMed

    McInnes, E F; Scudamore, C L

    2014-08-17

    Pathological evaluation of lesions caused directly by xenobiotic treatment must always take into account the recognition of background (incidental) findings. Background lesions can be congenital or hereditary, histological variations, changes related to trauma or normal aging and physiologic or hormonal changes. This review focuses on the importance and correct approach to recording of background changes and includes discussion on sources of variability in background changes, the correct use of terminology, the concept of thresholds, historical control data, diagnostic drift, blind reading of slides, scoring and artifacts. The review is illustrated with background lesions in Sprague Dawley and Wistar rats.

  20. [Topographic diagnosis of lesions of the acoustico-facial nerve complex using the winking reflex].

    PubMed

    Molina-Negro, P; Martin, E; Bujanda, M

    1979-04-01

    An electrophysiological study in close to 1,500 cases of various lesions of the trigeminal nerve, the acoustico-facial complex and the brain stem was presented. It was concluded that following a detailed clinical examination which, most often, allows precise topographical diagnosis, the study of the trigemino-facial and facial reflexes appears to be an essential diagnostic tool to determine the topography of a lesion. Moreover, this method may give prognostic evaluation as well as facilitate the choice of surgical approach to the lesions of the acoustico-facial complex.

  1. Profil épidémiologique des uvéites: à propos de 105 cas

    PubMed Central

    Souley, Abdoul Salam Youssoufou; Abdellah, Hamed Ould Mohamed; Khmamouche, Mehdi; Naji, Alwan Alsubari; Elasri, El Ouatassi Narjis Fouad; Reda, Karim; Oubaaz, Abdelbarre

    2016-01-01

    La difficulté du diagnostic des uvéites réside dans la multiplicité des étiologies. La détermination des facteurs épidémiologiques des uvéites permettent une meilleure orientation diagnostique et facilitent leur prise en charge thérapeutique. C'une étude rétrospective s’étalant sur 4 ans de janvier 2012 à décembre 2015. Nous avons colligé 105 dossiers d'uvéite et étudié les aspects épidémiologiques, cliniques et étiologiques. L’âge moyen était de 42 ans, la tranche d’âge la plus touchée était de 40-50ans. Les hommes étaient plus atteints (57,14%) que les femmes (42,86%). L'uvéite était unilatérale dans 60,95% des cas. Nous avons noté une uvéite antérieure dans 35,24%, une uvéite intermédiaire dans 5,71%, une uvéite postérieure dans 10,48% et une panuvéite dans 48,57%. Les étiologies étaient dominées par la maladie de Behçet, la sarcoïdose, et la maladie de Vogt-Koyanagi-Harada. L'origine restait indéterminée dans 43,81% des cas. L’évolution était variable. Les uvéites sont des inflammations intraoculaires qui peuvent représenter une réelle menace pour la vision. La démarche permettant de découvrir la cause doit être codifiée et repose sur plusieurs étapes. Nos résultats sont relativement proches de ceux de la littérature. Les uvéites constituent une entité clinique où ophtalmologie et médecine interne se rejoignent. Le champ des causes et des investigations permettant le diagnostic est vaste voire illimité. Cette étude a permis de mettre en évidence les difficultés cliniques et de souligner les limites de notre formation sanitaire dans la prise en charge des uvéites. PMID:27642436

  2. 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

  3. 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.

  4. [Diverse histological lesions in a patient with antiphospholipid syndrome (APS)].

    PubMed

    Salvatore, Ermanno; Luciani, Remo; Di Palma, Annamaria; Aversano, Arturo; Stellato, Davide; Liuzzi, Marco; Iele, Emilio; Martignetti, Vinicio; Spagnuolo, Enrico; Morrone, Luigi

    2011-01-01

    Antiphospholipid syndrome (APS) is a rare autoimmune disorder. It can be secondary to systemic lupus erythematosus (SLE) or occur in the absence of autoimmune disease. The hallmark of this so-called primary APS is the presence of circulating antiphospholipid antibodies. Renal involvement in primary APS is caused by thrombosis within the renal vasculature. Recently, nonthrombotic glomerulonephritic renal lesions have been described in primary APS as a new histological entity. We here report a patient with primary APS in whom both lesion types were present. A 58-year-old Caucasian man with no significant past medical history presented to our nephrology unit with diffuse edema. Urinalysis showed proteinuria exceeding 400 mg/dL. The autoantibody panel (p-ANCA, c- ANCA, anti-nucleus, anti-DS-DNA) was negative except for anticardiolipin antibodies, which tested positive in two different samples. The diagnostic workup included a kidney biopsy that revealed thrombotic lesions compatible with primary APS and a typical pattern of focal segmental glomerulosclerosis. The kidney is a major target in APS but the exact mechanism underlying the pathogenesis of APS nephropathy has been poorly recognized. The use of kidney biopsy is a fundamental diagnostic tool in this setting, with possible implications also from a prognostic and therapeutic viewpoint.

  5. Multicentric Osteoid Osteoma Presenting a Diagnostic Dilemma.

    PubMed

    Bush, Lisabeth A; Gayle, Robert B; Berkey, Bryan D

    2008-01-01

    We present a case of a relatively common benign tumor that was a diagnostic dilemma because of its atypical appearance in multiple imaging modalities. Our patient was a 22-year-old man who presented with complaint of three months of shin pain with running. The radiographically demonstrated sclerotic lesion in his right tibia initially was thought most likely to be a stress fracture, but on further evaluation, it had features that suggested a subacute osteomyelitis or Brodie's abscess with focal sequestra. It was in fact, biopsy proven to be an osteoid osteoma with multiple, closely adjacent nidi. Its elongate, multicentric, "string of beads" arrangement as well as its intramedullary location is uncommon and it was larger than normally expected. Because of the unusual presentation and appearance of this lesion it caused a diagnostic dilemma. This lesion was evaluated with a full spectrum of modalities including radiographs, CT, MRI, Technetium 99m-MDP bone scan and Indium-111 white blood cell scan. After biopsy achieved a definite diagnosis, this tumor was successfully treated with radiofrequency ablation of all nidi in one session.

  6. Intracranial Lesions with Low Signal Intensity on T2-weighted MR Images – Review of Pathologies

    PubMed Central

    Zimny, Anna; Neska-Matuszewska, Małgorzata; Bladowska, Joanna; Sąsiadek, Marek J.

    2015-01-01

    Summary In this article we presented intracranial pathological substances and lesions with low signal intensity on T2-weighted images. Eight groups of substances were discussed i.e. 1. Gadolinium-based contrast materials, 2. hemoglobin degradation products 3. melanin, 4. mucous- or protein-containing lesions, 5. highly cellular lesions, 6. lesions containing mineral substances such as: calcium, copper and iron, 7. turbulent and rapid blood or CSF flow 8. air-containing spaces. Appropriate interpretation of signal intensity as well as analysis of lesion location and clinical symptoms enable a correct choice of a further diagnostic algorithm or, in many cases, final diagnosis based exclusively on an MRI examination. PMID:25628772

  7. The National Toxicology Program Web-based nonneoplastic lesion atlas: a global toxicology and pathology resource.

    PubMed

    Cesta, Mark F; Malarkey, David E; Herbert, Ronald A; Brix, Amy; Hamlin, Melvin H; Singletary, Emily; Sills, Robert C; Bucher, John R; Birnbaum, Linda S

    2014-01-01

    Toxicologists and pathologists worldwide will benefit from a new, website-based, and completely searchable Nonneoplastic Lesion Atlas just released by the U.S. National Toxicology Program (NTP). The atlas is a much-needed resource with thousands of high-quality, zoomable images and diagnostic guidelines for each rodent lesion. Liver, gallbladder, nervous system, bone marrow, lower urinary tract and skin lesion images, and diagnostic strategies are available now. More organ and biological systems will be added with a total of 22 chapters planned for the completed project. The atlas will be used by the NTP and its many pathology partners to standardize lesion diagnosis, terminology, and the way lesions are recorded. The goal is to improve our understanding of nonneoplastic lesions and the consistency and accuracy of their diagnosis between pathologists and laboratories. The atlas is also a useful training tool for pathology residents and can be used to bolster any organization's own lesion databases. Researchers have free access to this online resource at www.ntp.niehs.nih.gov/nonneoplastic.

  8. Regulatory Forum Opinion Piece*: Dispelling Confusing Pathology Terminology: Recognition and Interpretation of Selected Rodent Renal Tubule Lesions.

    PubMed

    Seely, John Curtis; Frazier, Kendall S

    2015-06-01

    Renal tubule lesions often prove troublesome for toxicologic pathologists because of the diverse nature and interrelated cell types within the kidney and the presence of spontaneous lesions with overlapping morphologies similar to those induced by renal toxicants. Although there are a number of guidance documents available citing straightforward diagnostic criteria of tubule lesions for the pathologist to refer to, most are presented without further advice on the when to or to the why and the why not of diagnosing one lesion over another. Documents presenting diagnostic perspectives and recommendations derived from an author's experience are limited since guidance documents are generally based on descriptive observations. In this Regulatory Forum opinion piece, the authors attempt to dispel confusing renal tubule lesion terminology in laboratory animal species by suggesting histological advice on the recognition and interpretation of these complex entities.

  9. Unusual benign polypoid and papular neoplasms and tumor-like lesions of the vulva.

    PubMed

    AbdullGaffar, Badr; Keloth, Tasnim R; Raman, Lakshmiah G; Mahmood, Suaad; Almulla, Amal; AlMarzouqi, Mamoun; Al-Hasani, Salam

    2014-04-01

    We aimed to investigate the prevalence and spectrum of unusual benign neoplasms and tumor-like lesions presenting as vulvar polyps and papules, to study their clinical, pathologic, hormonal, and developmental features and whether they have important associations with other pathologic lesions or clinical diseases. We conducted a retrospective review study of 115 vulvar specimens over 7 years. Common lesions, for example, fibroepithelial polyps, skin tags, papillomas, abscesses, viral warts and common cysts, were excluded. We found 21 cases (18%) with uncommon benign vulvar lesions. They included 7 epithelial cysts, 3 vascular lesions, 3 glandular neoplasms, 3 endometrioses, 1 caruncle, 1 pilonidal sinus, 1 prolapsed urethra, 1 seborrheic keratosis, and 1 granular cell tumor. The age range was between 1 and 64 years with a mean age of 33 years. Most (86%) were 2.5 cm or less. Many were asymptomatic incidental pathologic findings that can be missed clinically. Nine cases have important clinical associations or coexisting incidental pathologic lesions. Some lesions demonstrated hormone receptors. Some were clinically confused with fibroepithelial polyps, abscesses, warts, melanocytic lesions, and tumors. In conclusion, although the vulva is a small compartment, its developmental and histologic complexity can result in a variety of unusual and rare benign polypoid and papular lesions, some unique to the vulva, which might present diagnostic challenges to the clinicians and pathologists. In addition, many bear controversy regarding their histogenesis and origin of development in the vulva.

  10. Atypical idiopathic inflammatory demyelinating lesions: prognostic implications and relation to multiple sclerosis.

    PubMed

    Wallner-Blazek, Mirja; Rovira, Alex; Fillipp, Massimo; Rocca, Mara A; Miller, David H; Schmierer, Klaus; Frederiksen, Jette; Gass, Achim; Gama, Hugo; Tilbery, Charles P; Rocha, Antonio J; Flores, José; Barkhof, Frederik; Seewann, Alexandra; Palace, Jacqueline; Yousry, Tarek; Montalban, Xavier; Enzinger, Christian; Fazekas, Franz

    2013-08-01

    Atypical lesions of a presumably idiopathic inflammatory demyelinating origin present quite variably and may pose diagnostic problems. The subsequent clinical course is also uncertain. We, therefore, wanted to clarify if atypical idiopathic inflammatory demyelinating lesions (AIIDLs) can be classified according to previously suggested radiologic characteristics and how this classification relates to prognosis. Searching the databases of eight tertiary referral centres we identified 90 adult patients (61 women, 29 men; mean age 34 years) with ≥ 1 AIIDL. We collected their demographic, clinical and magnetic resonance imaging data and obtained follow-up (FU) information on 77 of these patients over a mean duration of 4 years. The AIIDLs presented as a single lesion in 72 (80 %) patients and exhibited an infiltrative (n = 35), megacystic (n = 16), Baló (n = 10) or ring-like (n = 16) lesion appearance in 77 (86 %) patients. Additional multiple sclerosis (MS)-typical lesions existed in 48 (53 %) patients. During FU, a further clinical attack occurred rarely (23-35 % of patients) except for patients with ring-like AIIDLs (62 %). Further attacks were also significantly more often in patients with coexisting MS-typical lesions (41 vs. 10 %, p < 0.005). New AIIDLs developed in six (7 %), and new MS-typical lesions in 29 (42 %) patients. Our findings confirm the previously reported subtypes of AIIDLs. Most types confer a relatively low risk of further clinical attacks, except for ring-like lesions and the combination with MS-typical lesions.

  11. 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

  12. Benign lymphoepithelial lesion and malignancy.

    PubMed

    Hordijk, G J; Meyer, C J

    1981-01-01

    Whereas most patients with benign lymphoepithelial lesion suffer from the involvement of a major salivary gland a number evolve into a clinical form of Sjögren's syndrome or Mikulicz's disease. In a small number development of malignant lymphomas, especially non-Hodgkin's lymphomas, have been described. Therefore, regular follow-up and appropriate histological evaluation of suspected areas in all patients with a benign lymphoepithelial lesion is indicated. Histologically, diagnosis of a non-Hodgkin's lymphoma may be difficult. Demonstration of a cell pattern, monoclonal for cytoplasmic Ig by means of the immunoperoxidase technique may facilitate the diagnosis. In this report we present the history of two cases out of our series with benign lymphoepithelial lesion who developed a non-Hodgkin's lymphoma.

  13. Péritonite primitive: entité réelle mais de diagnostic difficile

    PubMed Central

    Yamou, Rajae; Najih, Mohammed; Absi, Mohamed; Ouanani, Mohamed; Echerrab, Mahjoub; EL Alami, Hassan; Amraoui, Mohamed; Errougani, Abdelkader; Chkoff, Mohamed Rachid

    2012-01-01

    Les péritonites primitives sont rares chez des patients sans facteurs de risques. Elles simulent les péritonites secondaires. C'est pourquoi leur diagnostic ne peut être que peropératoire. Nous rapportons deux cas de péritonites primitives dans le but de discuter leurs aspects diagnostique et thérapeutiques. PMID:23077704

  14. Salivary gland lesions: recent advances and evolving concepts.

    PubMed

    Gupta, Ruta; Balasubramanian, Deepak; Clark, Jonathan R

    2015-06-01

    Recently, there have been significant developments in our understanding of salivary gland pathology, and new entities, such as mammary analogue secretory carcinoma, have been described. Attempts are being made to identify effective therapeutic agents for salivary duct carcinomas by using molecular diagnostic techniques. Concepts such as high-grade transformation have been described, which not only influence macroscopic and microscopic evaluation of a specimen but, given the high incidence of metastases and morbidity, also carry significant treatment implications. Specific chromosomal translocations, which can be detected by fluorescent in situ hybridization, can augment diagnostic accuracy and carry prognostic implications. The landscape of benign salivary gland lesions is changing with better understanding of chronic sclerosing sialadenitis related to IgG4. This multiorgan inflammatory condition may primarily present as a salivary gland lesion and clinically and radiologically mimic a salivary gland malignancy. Histology and immunohistochemistry play a critical role in its accurate diagnosis. The purpose of this article is to review these changes, with an emphasis on their effect on patient management. Given their diagnostic, prognostic, and therapeutic implications, it is critical that surgeons, oncologists, pathologists, and those involved in caring for patients with salivary gland tumors are aware of these changes while considering management options.

  15. Malignancy Risk Models for Oral Lesions

    PubMed Central

    Zarate, Ana M.; Brezzo, María M.; Secchi, Dante G.; Barra, José L.

    2013-01-01

    Objectives: The aim of this work was to assess risk habits, clinical and cellular phenotypes and TP53 DNA changes in oral mucosa samples from patients with Oral Potentially Malignant Disorders (OPMD), in order to create models that enable genotypic and phenotypic patterns to be obtained that determine the risk of lesions becoming malignant. Study Design: Clinical phenotypes, family history of cancer and risk habits were collected in clinical histories. TP53 gene mutation and morphometric-morphological features were studied, and multivariate models were applied. Three groups were estabished: a) oral cancer (OC) group (n=10), b) OPMD group (n=10), and c) control group (n=8). Results: An average of 50% of patients with malignancy were found to have smoking and drinking habits. A high percentage of TP53 mutations were observed in OC (30%) and OPMD (average 20%) lesions (p=0.000). The majority of these mutations were GC ? TA transversion mutations (60%). However, patients with OC presented mutations in all the exons and introns studied. Highest diagnostic accuracy (p=0.0001) was observed when incorporating alcohol and tobacco habits variables with TP53 mutations. Conclusions: Our results prove to be statistically reliable, with parameter estimates that are nearly unbiased even for small sample sizes. Models 2 and 3 were the most accurate for assessing the risk of an OPMD becoming cancerous. However, in a public health context, model 3 is the most recommended because the characteristics considered are easier and less costly to evaluate. Key words:TP53, oral potentially malignant disorders, risk factors, genotype, phenotype. PMID:23722122

  16. 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

  17. 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…

  18. 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

  19. 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

  20. Pediatric Knee Osteochondritis Dissecans Lesions.

    PubMed

    Cruz, Aristides I; Shea, Kevin G; Ganley, Theodore J

    2016-10-01

    Osteochondritis dissecans (OCD) can cause knee pain and dysfunction in children. The etiology of OCD remains unclear; theories on causes include inflammation, ischemia, ossification abnormalities, genetic factors, and repetitive microtrauma. Most OCD lesions in skeletally immature patients will heal with nonoperative treatment. The success of nonoperative treatment decreases once patients reach skeletal maturity. The goals of surgical treatment include maintenance of articular cartilage congruity, rigid fixation of unstable fragments, and repair of osteochondral defects with cells or tissues that can adequately replace lost or deficient cartilage. Unsalvageable OCD lesions can be treated with various surgical techniques. PMID:27637663

  1. Intraoperative pathology consultation for pulmonary lesions: errors and deferrals.

    PubMed

    Akyildiz, Elif Ulker

    2015-01-01

    The accuracy rate of frozen section constitutes an important step of quality assessment step in pathology practice. This study aimed to investigate pulmonary lesions that were incorrectly diagnosed or postponed for routine examination by pathologists at frozen section examination; it also aimed to discuss the reasons for difficult diagnoses and the various clues enabling the correct diagnosis to be made when such lesions are encountered. This study retrospectively reviewed the medical data of the thoracic surgery cases that underwent frozen section examination between 2009 and 2014. Frozen section errors and deferrals were identified in 25 cases. Fourteen (56%) lesions were of pulmonary parenchymal origin and 11 (44%) were of pleural origin. The number of cases in which the pathologists postponed the diagnosis without making any approach was 14. Of these, 9 (64%) were benign lesions such as bronchiectasis, fibrosis anthracosis, chronic inflammatory cell infiltration, chronic pleuritis, and mesothelial proliferation. The number of misdiagnosed cases was 11. Of these, 7 (64%) were of pulmonary and 4 (36%) were of pleural origin. Because the examination techniques of each pathology department may differ from one another, the comparative examination of frozen sections and routine sections would aid in becoming familiar with various pathologies and would be beneficial for pathologists in minimizing their diagnostic errors.

  2. Assessment of the Focal Hepatic Lesions Using Diffusion Tensor Magnetic Resonance Imaging

    PubMed Central

    Oussous, Siham Ait; Boujraf, Saïd; Kamaoui, Imane

    2016-01-01

    The goal is assessing the diffusion magnetic resonance imaging (dMRI) method efficiency in characterizing focal hepatic lesions (FHLs). About 28-FHL patients were studied in Radiology and Clinical Imaging Department of our University Hospital using 1.5 Tesla MRI system between January 2010 and June 2011. Patients underwent hepatic MRI consisting of dynamic T1- and T2-weighted imaging. The dMRI was performed with b-values of 200 s/mm2 and 600 s/mm2. About 42 lesions measuring more than 1 cm were studied including the variation of the signal according to the b-value and the apparent diffusion coefficient (ADC). The diagnostic imaging reference was based on standard MRI techniques data for typical lesions and on histology after surgical biopsy for atypical lesions. About 38 lesions were assessed including 13 benign lesions consisting of 1 focal nodular hyperplasia, 8 angiomas, and 4 cysts. About 25 malignant lesions included 11 hepatocellular carcinoma, 9 hepatic metastases, 1 cholangiocarcinoma, and 4 lymphomas. dMRI of soft lesions demonstrated higher ADC of 2.26 ± 0.75 mm2/s, whereas solid lesions showed lower ADC 1.19 ± 0.33 mm2/s with significant difference (P = 0.05). Discrete values collections were noticed. These results were correlated to standard MRI and histological findings. Sensitivity of 93% and specificity of 84% were found in diagnoses of malignant tumors with an ADC threshold of 1.6 × 10−3 mm2/s. dMRI is important characterization method of FHL. However, it should not be used as single criteria of hepatic lesions malignity. MRI, clinical, and biological data must be correlated. Significant difference was found between benign and solid malignant lesions without threshold ADC values. Hence, it is difficult to confirm ADC threshold differentiating the lesion classification. PMID:27186537

  3. Diagnostic bronchoscopy--current and future perspectives.

    PubMed

    Leong, Steven; Shaipanich, Tawimas; Lam, Stephen; Yasufuku, Kazuhiro

    2013-10-01

    Lung cancer is the leading cause of cancer-related mortality worldwide. Standard bronchoscopy has limited ability to accurately localise and biopsy pulmonary lesions that cannot be directly visualised. The field of advanced diagnostic bronchoscopy is rapidly evolving due to advances in electronics and miniaturisation. Bronchoscopes with smaller outer working diameters, coupled with miniature radial and convex ultrasound probes, allow accurate central and peripheral pulmonary lesion localisation and biopsy while at the same time avoiding vascular structures. Increases in computational processing power allow three-dimensional reconstruction of computed tomographic raw data to enable virtual bronchoscopy (VB), providing the bronchoscopist with a preview of the bronchoscopy prior to the procedure. Navigational bronchoscopy enables targeting of peripheral pulmonary lesions (PPLs) via a "roadmap", similar to in-car global positioning systems. Analysis of lesions on a cellular level is now possible with techniques such as optical coherence tomography (OCT) and confocal microscopy (CM). All these tools will hopefully allow earlier and safer lung cancer diagnosis and in turn better patient outcomes. This article describes these new bronchoscopic techniques and reviews the relevant literature.

  4. Brain modules of hallucination: an analysis of multiple patients with brain lesions

    PubMed Central

    Braun, Claude M.J.; Dumont, Mathieu; Duval, Julie; Hamel-Hébert, Isabelle; Godbout, Lucie

    2003-01-01

    We systematically reviewed the localization of focal brain lesions that cause isolated hallucination in a single sensory modality. Case reports of post-lesion nonparoxysmal hallucination in 1 (and only 1) of 3 sensory modalities (i.e., visual, auditory, somatic) were reviewed, and the content of the qualitative descriptions was analyzed for each modality. The lesion is practically always located in the brain pathway of the sensory modality of the hallucination. There seem to exist localized sensory brain circuits that in healthy people diminish the intensity of internal sensory representation. After a lesion, hallucinosis seems to be caused also by compensatory overactivation of tissue in the nearby brain sensory pathway. This type of hallucination may indeed be termed a “release” form, whereby patients are aware of the hallucinatory nature of their experience, but not usually of “dream centres” as proposed by Lhermitte. Instead, we propose that it is dreaming that should be considered a special case of neural “release.” Nous avons passé en revue systématiquement l'emplacement des lésions cérébrales focales qui causent des hallucinations isolées dans un seul mode sensoriel. On a analysé des rapports de cas portant sur l'hallucination non paroxystique postlésionnelle dans un mode sensoriel (et un seulement) sur trois (c.-à-d. visuel, auditif, somatique), et on a analysé le contenu des descriptions qualitatives de chaque mode. La lésion est presque toujours située dans la voie cérébrale du mode sensoriel de l'hallucination. Il semble y avoir des circuits cérébraux sensoriels localisés qui, chez les gens en bonne santé, «atténuent» l'intensité de la représentation sensorielle interne. Après une lésion, l'hallucinose semble être causée aussi par une suractivation compensatoire de tissus de la voie sensorielle cérébrale voisine. On peut en fait qualifier ce type d'hallucination de forme de «libération», dans laquelle les

  5. 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.

  6. My approach to the diagnosis of mesothelial lesions

    PubMed Central

    Butnor, K J

    2006-01-01

    Mesothelial lesions pose considerable diagnostic challenges not only because benign tumours, reactive proliferations and malignant mesothelioma can mimic one another, but also because the morphological patterns displayed by malignant mesothelioma can simulate a variety of epithelial and non‐epithelial malignancies. Immunohistochemical markers can aid in distinguishing epithelioid malignant mesothelioma from metastatic adenocarcinoma, but because no single marker reliably separates all cases, a panel of stains is recommended. Immunohistochemical studies are of more limited value in sarcomatoid malignant mesothelioma, and other features often play an essential role. The separation of reactive mesothelial proliferations from malignant mesothelioma on small biopsy can be quite difficult, as distinguishing features, such as stromal invasion, often cannot be adequately assessed. In adequately sampled lesions, however, the distinction between malignant mesothelioma, benign mesothelial proliferations and other tumours can be achieved in most cases by using a carefully intergrated approach that incorporates clinical and radiographic data, immunohistochemical studies and, in selected cases, histochemical and ultrastructural techniques. PMID:16731600

  7. Single oral paracoccidioidomycosis mimicking other lesions: report of eight cases.

    PubMed

    de Oliveira Gondak, Rogério; Mariano, Fernanda Viviane; dos Santos Silva, Alan Roger; Vargas, Pablo Agustin; Lopes, Márcio Ajudarte

    2012-01-01

    Paracoccidioidomycosis is a fungal infection caused by Paracoccidioides brasiliensis. It is an endemic disease, representing a serious health problem in Latin American countries. This infection primarily affects the lungs and is acquired by inhalation of the fungus. It can spread to other organs and tissues, mainly the oral cavity affecting more adult men from 30 to 50 years of age. On clinical presentation, several signs associated with impaired general and nutritional conditions can be noted. Oral manifestation is more common in the soft palate, gingiva, lower lip, buccal mucosa, and tongue. The classical clinical presentation is a superficial ulcer with granular appearance and hemorrhagic points. Usually, the oral lesion is extensive and generalized. Although uncommon, when the oral manifestation is single, others lesions, particularly squamous cell carcinoma, must be included in the differential diagnosis. In this article, the authors discuss the unusual presentation of eight cases of single oral paracoccidioidomycosis and its diagnostic importance. PMID:21837507

  8. Molecular Characterization of Clear Cell Lesions of Head and Neck.

    PubMed

    Jain, Anshi; Shetty, Devi Charan; Juneja, Saurabh; Narwal, Nidhi

    2016-05-01

    The salivary glands, oral mucosa and jaws constitute a group of lesions which are heterogeneous in nature and are odontogenic, salivary or metastatic in origin. This group of tumours is termed as Clear Cell Tumours. Fixation artifacts are one of the most important reasons for the cell to appear clear but clearing of cells may also result from cytoplasmic accumulation of water, presence of glycogen within the cell, intermediate filaments, immature zymogen granules, or a paucity of cellular organelles. Clear cell Odontogenic neoplasms predominantly include odontogenic carcinoma, ameloblastoma and calcifying epithelial odontogenic tumour. Clear cell tumours of salivary gland origin are almost invariably malignant in nature but they do include two benign lesions. Very frequently, surgical pathologist encounters clear cells in many malignant neoplasms, the nature and sources of which are undetermined on the basis of conventional histopathology. This review will selectively discuss the clinicopathological features of neoplasms which at times may pose a diagnostic challenge and dilemma due to clear cell changes.

  9. DIAGNOSTIC METHODS IN AYURVEDA

    PubMed Central

    Thakar, V. J.

    1982-01-01

    This is an analytical study of the Diagnostic methods Prescribes in Ayurveda. As in the case of disease and treatments the concept of diagnosis also is unique in Ayurveda. It goes to the Nidana of Doshicimbalance by studying the physical, physiological, psychic and behavoural aspects of the patient. The paper gives an insight into the various diagnostic methods enunciated in Sastras which turns out to be a fore-runner of any of modern diagnostic methods. PMID:22556480

  10. Plasma diagnostics for FED

    SciTech Connect

    Nelson, W.D.

    1981-01-01

    An overview of the plasma diagnostic instruments recommended for the Fusion Engineering Device (FED) is described. First the role and need for plasma diagnostics is discussed. This is followed by an identification of particles and radiation eminating from the plasma. Next some design considerations are presented for the overall set of diagnostic instruments. Finally, instruments used for control and for plasma performance measurements are included in separate lists.

  11. Diagnostic Development on NSTX

    SciTech Connect

    A.L. Roquemore; D. Johnson; R. Kaita; et al

    1999-12-16

    Diagnostics are described which are currently installed or under active development for the newly commissioned NSTX device. The low aspect ratio (R/a less than or equal to 1.3) and low toroidal field (0.1-0.3T) used in this device dictate adaptations in many standard diagnostic techniques. Technical summaries of each diagnostic are given, and adaptations, where significant, are highlighted.

  12. TFTR diagnostic vacuum controller

    SciTech Connect

    Olsen, D.; Persons, R.

    1981-01-01

    The TFTR diagnostic vacuum controller (DVC) provides in conjunction with the Central Instrumentation Control and Data Acquisition System (CICADA), control and monitoring for the pumps, valves and gauges associated with each individual diagnostic vacuum system. There will be approximately 50 systems on TFTR. Two standard versions of the controller (A and B) wil be provided in order to meet the requirements of two diagnostic manifold arrangements. All pump and valve sequencing, as well as protection features, will be implemented by the controller.

  13. Tinea cutis glabrae: causes of diagnostic challenge

    PubMed Central

    Łuczkowska, Magdalena; Żaba, Ryszard; Adamski, Zygmunt

    2014-01-01

    Dermatophytoses belong to the most common disease entities encountered in everyday dermatological practice. Despite the fact that their clinical presentation, course and treatment response remain rather typical, they often present a considerable diagnostic and therapeutic challenge. We present a case of a 54-year-old male who presented to the outpatient clinic of the Department of Dermatology in December 2012 with the diagnosis of erythema gyratum repens for further diagnosis and treatment of skin lesions gradually intensifying in the previous 2 years. The skin changes presented as spreading annular erythematous lesions, with papules and plaques located peripherally, and accompanying pruritus. Due to the clinical presentation and anamnesis, working conditions (poultry farm), and lack of response to previous treatment, mycological culture was performed. Epithelial scrapings of the trunk and the groins proved to be positive. After 3 weeks, Trichophyton mentagrophytes var mentagrophytes was identified by epithelial cell culture. PMID:25610361

  14. Lignes directrices sur la prise en charge en soins primaires des céphalées chez l’adulte

    PubMed Central

    Becker, Werner J.; Findlay, Ted; Moga, Carmen; Scott, N. Ann; Harstall, Christa; Taenzer, Paul

    2015-01-01

    Résumé Objectif Accroître l’utilisation d’approches éclairées par des données probantes pour diagnostiquer, investiguer et traiter en soins primaires les céphalées des patients. Qualité des données Une recherche documentaire exhaustive a été effectuée pour trouver des lignes directrices et des révisions systématiques publiées entre janvier 2000 et mai 2011. La grille d’évaluation de la qualité des recommandations pour la pratique clinique AGREE a servi à l’analyse critique des lignes directrices. Les 6 guides de pratique clinique de la plus grande qualité ont servi de base dans le processus d’adaptation. Message principal Un groupe d’élaboration multidisciplinaire de professionnels des soins primaires ont formulé 91 recommandations précises à l’aide d’un processus consensuel. Les recommandations portent sur le diagnostic, l’investigation et la prise en charge de la migraine, de la céphalée de tension, de la céphalée due à une surmédication et de la céphalée vasculaire de Horton. Conclusion Un guide de pratique clinique adapté au contexte des soins de santé au Canada a été produit en suivant un processus d’adaptation de lignes directrices dans le but d’aider les professionnels de toutes les disciplines des soins primaires à dispenser des soins éclairés par des données probantes aux patients souffrant de céphalées.

  15. Etude des Abondances de MG et de fe dans la Composante Stellaire des Disques des Galaxies Spirales

    NASA Astrophysics Data System (ADS)

    Beauchamp, Dominique

    Je presente ici une technique d'observation par imagerie des disques stellaires des galaxies spirales. Je tente, a l'aide d'un modele evolutif multiphase, de determiner les abondances de fer et de magnesium dans les disques. Dans ce but, je mesure les indices Mg2 et Fe5270 du systeme de Lick. Ces elements representent un choix judicieux d'indicateurs car ils sont formes par des supernovae de deux types differents ayant des durees de vie differentes. Le rapport d'abondances de ces deux elements est un indicateur du taux de formation des populations stellaires. Je decris, en premier lieu, les observations, la technique de mesure, ainsi que son application. J'analyse ensuite les indices mesures. A partir du modele multiphase, j'explore differents parametres physiques des spirales comme le taux de formation stellaire, l'evolution des abondances, les effets possibles de la presence de la barre, etc.

  16. 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.

  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. Devic disease with brainstem lesions.

    PubMed

    Chalumeau-Lemoine, Ludivine; Chretien, Fabrice; Gaëlle Si Larbi, Anne; Brugieres, Pierre; Gray, Françoise; Brun-Buisson, Christian; Creange, Alain

    2006-04-01

    We describe a patient who suffered from an unusually severe form of neuromyelitis optica with a hyperacute time-course evolution requiring mechanical ventilation within 3 days. The patient died after 72 days and autopsy showed major spinal cord, optic nerve, and brainstem necrosis, and multifocal necrotic lesions on the cerebellum and cerebral white matter. PMID:16606774

  19. Aspects cliniques des cancers bronchopulmonaires primitifs au service d'oncologie du CHUA-HUJRA Antananarivo

    PubMed Central

    Refeno, Valéry; Hasiniatsy, Nomeharisoa Rodrigue Emile; Andrianandrasana, Ny Ony Tiana Florence; Ramahandrisoa, Andriatsihoarana Voahary Nasandratriniavo; Rakotonarivo, Jean Marc; Maevazaka, Joée Larissa; Rakotovao, Hanitrala Jean Louis; Rafaramino, Florine

    2015-01-01

    Le retard de diagnostic des cancers broncho-pulmonaires est l'une des sources du retard de leur prise en charge dans les pays en développement. A notre connaissance, l'aspect clinique des cancers broncho-pulmonaires au Centre Hospitalier Universitaire d'Antananarivo-Hôpital Universitaire Joseph Ravoahangy Andrianavalona (CHUA-HUJRA) n'a jamais été étudié. L'objectif était de décrire les aspects cliniques des cancers broncho-pulmonaires primitifs dans le plus grand centre de cancérologie de Madagascar. C'est une étude rétrospective et descriptive des patients atteints de cancers broncho-pulmonaires primitifs vus au service d'oncologie du CHUA-HUJRA du 1er janvier 2008 au 31 décembre 2013. Nous avons recensé 101 patients (80 hommes et 21 femmes). Les circonstances de découverte sont principalement la toux chronique (n = 29), la dyspnée (n = 16) et l'association d'une hémoptysie à la toux chronique (n = 12). Soixante et onze patients avaient un index de performans status ≥ à 2 au moment du diagnostic. On a retrouvé des bacilles de Koch actives dans le crachat de deux patients. Le délai moyen entre l'apparition des premiers signes et la première consultation était de 11 mois. Le délai moyen entre la première consultation et le diagnostic anatomopathologique était de 3 mois. Le cancer broncho-pulmonaire peut avoir des manifestations cliniques non spécifiques parfois trompeuses qui peuvent retarder leur prise en charge. De ce fait, il doit être recherché devant tout signe respiratoire persistant. Par ailleurs, le délai de prise en charge pré-hospitalière et hospitalière de ces cancers doit être amélioré. PMID:26958134

  20. [Diagnostic Errors in Medicine].

    PubMed

    Buser, Claudia; Bankova, Andriyana

    2015-12-01

    The recognition of diagnostic errors in everyday practice can help improve patient safety. The most common diagnostic errors are the cognitive errors, followed by system-related errors and no fault errors. The cognitive errors often result from mental shortcuts, known as heuristics. The rate of cognitive errors can be reduced by a better understanding of heuristics and the use of checklists. The autopsy as a retrospective quality assessment of clinical diagnosis has a crucial role in learning from diagnostic errors. Diagnostic errors occur more often in primary care in comparison to hospital settings. On the other hand, the inpatient errors are more severe than the outpatient errors.

  1. [Diagnostic Errors in Medicine].

    PubMed

    Buser, Claudia; Bankova, Andriyana

    2015-12-01

    The recognition of diagnostic errors in everyday practice can help improve patient safety. The most common diagnostic errors are the cognitive errors, followed by system-related errors and no fault errors. The cognitive errors often result from mental shortcuts, known as heuristics. The rate of cognitive errors can be reduced by a better understanding of heuristics and the use of checklists. The autopsy as a retrospective quality assessment of clinical diagnosis has a crucial role in learning from diagnostic errors. Diagnostic errors occur more often in primary care in comparison to hospital settings. On the other hand, the inpatient errors are more severe than the outpatient errors. PMID:26649954

  2. Classification of 20 DES Supernova with OzDES

    NASA Astrophysics Data System (ADS)

    Davis, T. M.; Kim, A. G.; Macualay, E.; Lidman, C.; Sharp, R.; Tucker, B. E.; Yuan, F.; Zhang, B.; Lewis, G. F.; Sommer, N. E.; Martini, P.; Mould, J.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; Gladney, L.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Nichol, R.; Papadopoulos, A.; Childress, M.; D'Andrea, C.; Smith, M.; Sullivan, M.; Maartens, R.; Gupta, R.; Kovacs, E.; Kuhlmann, S.; Spinka, H.

    2015-12-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  3. Classification of 8 DES Supernova with OzDES

    NASA Astrophysics Data System (ADS)

    King, A.; Moller, A.; Sommer, N. E.; Tucker, B. E.; Childress, M. J.; Lewis, G. F.; Lidman, C.; OâNeill, C.; Casas, R.; Castander, F. J.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; Gladney, L.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Nichol, R.; Papadopoulos, A.; D'Andrea, C.; Prajs, S.; Smith, M.; Sullivan, M.; Maartens, R.; Gupta, R.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.

    2016-09-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  4. Classification of 13 DES supernova with OzDES

    NASA Astrophysics Data System (ADS)

    Sommer, N.; Tucker, B. E.; Moller, A.; Zhang, B.; Macualay, E.; Lidman, C.; Gshwend, J.; Martini, P.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; Gladney, L.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Nichol, R.; Papadopoulos, A.; Childress, M.; D'Andrea, C.; Prajs, S.; Smith, M.; Sullivan, M.; Maartens, R.; Gupta, R.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.

    2016-09-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  5. Classification of 3 DES Supernovae with OzDES

    NASA Astrophysics Data System (ADS)

    Moller, A.; Tucker, B. E.; Yuan, F.; Lewis, G.; Lidman, C.; Macaulay, E.; Nichol, R.; Papadopoulos, A.; Childress, M.; D'Andrea, C.; Smith, M.; Sullivan, M.; Maartens, R.; Gupta, R.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; Gladney, L.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.

    2016-02-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  6. Classification of 2 DES supernova with OzDES

    NASA Astrophysics Data System (ADS)

    O'Neill, C. R.; Moller, A.; Sommer, N. E.; Tucker, B. E.; Childress, M. J.; Lewis, G. F.; Lidman, C.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; D'Andrea, C.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Macaulay, E.; Nichol, R.; Prajs, S.; Smith, M.; Sullivan, M.; Maartens, R.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Gupta, R.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Papadopoulos, A.; Morganson, E.

    2016-10-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  7. 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.

  8. CO2 laser irradiation enhances CaF2 formation and inhibits lesion progression on demineralized dental enamel-in vitro study.

    PubMed

    Zancopé, Bruna R; Rodrigues, Lívia P; Parisotto, Thais M; Steiner-Oliveira, Carolina; Rodrigues, Lidiany K A; Nobre-dos-Santos, Marinês

    2016-04-01

    This study evaluated if Carbon dioxide (CO2) (λ 10.6 μm) laser irradiation combined with acidulated phosphate fluoride gel application (APF gel) enhances "CaF2" uptake by demineralized enamel specimens (DES) and inhibits enamel lesion progression. Thus, two studies were conducted and DES were subjected to APF gel combined or not with CO2 laser irradiation (11.3 or 20.0 J/cm(2), 0.4 or 0.7 W) performed before, during, or after APF gel application. In study 1, 165 DES were allocated to 11 groups. Fluoride as "CaF2 like material" formed on enamel was determined in 100 DES (n = 10/group), and the surface morphologies of 50 specimens were evaluated by scanning electron microscopy (SEM) before and after "CaF2" extraction. In study 2, 165 DES (11 groups, n = 15), subjected to the same treatments as in study 1, were further subjected to a pH-cycling model to simulate a high cariogenic challenge. The progression of demineralization in DES was evaluated by cross-sectional microhardness and polarized light microscopy analyses. Laser at 11.3 J/cm(2) applied during APF gel application increased "CaF2" uptake on enamel surface. Laser irradiation and APF gel alone arrested the lesion progression compared with the control (p < 0.05). Areas of melting, fusion, and cracks were observed. CO2 laser irradiation, combined with a single APF application enhanced "CaF2" uptake on enamel surface and a synergistic effect was found. However, regarding the inhibition of caries lesion progression, no synergistic effect could be demonstrated. In conclusion, the results have shown that irradiation with specific laser parameters significantly enhanced CaF2 uptake by demineralized enamel and inhibited lesion progression.

  9. A Case of Tuberculous Meningitis with Atypical Multiple Lesions

    PubMed Central

    Zhang, W; Hu, Z; Li, T

    2014-01-01

    ABSTRACT This case describes a rare case of tuberculous meningitis. A 50-year old female presented with seven days of numbness on the left side, fatigue and a three-day headache. Magnetic resonance imaging (MRI) showed multiple lesions in the dorsal medulla and upper cervical spine. After admission, she developed a long-term fever, cranial nerves palsy and showed little response to corticosteroid, antibacterial and antiviral therapy. She received a diagnostic anti-tuberculous therapy (ATT); despite that, all examinations for tuberculosis were negative. After ATT lasting 16 days, she recovered and was discharged from hospital with slight asthenia and hypoesthesia. PMID:25867567

  10. [Image-guided stereotaxic biopsy of central nervous system lesions].

    PubMed

    Nasser, J A; Confort, C I; Ferraz, A; Esperança, J C; Duarte, F

    1998-06-01

    In a series of 44 image guided stereotactic biopsy from August 1995 until March 1997, findings were as follows (frequency order). Tumors, glioblastoma was the most frequent. Primary lymphoma and other conditions associated to AIDS. Metastasis, three cases, Vasculites, two cases, Arachnoid cyst, Creutzfeldt-Jakob, cortical degeneration, inespecific calcification (one case each). The age varied from 1 to 83 years. Forty one lesions were supratentorial, two infratentorial, and one was outside the brain (dura and skull) and we used stereotaxy to localize it. There was no mortality and morbidity was 2.3%. The literature is reviewed. We conclude that this procedure is safe and highly diagnostic.

  11. [Image-guided stereotaxic biopsy of central nervous system lesions].

    PubMed

    Nasser, J A; Confort, C I; Ferraz, A; Esperança, J C; Duarte, F

    1998-06-01

    In a series of 44 image guided stereotactic biopsy from August 1995 until March 1997, findings were as follows (frequency order). Tumors, glioblastoma was the most frequent. Primary lymphoma and other conditions associated to AIDS. Metastasis, three cases, Vasculites, two cases, Arachnoid cyst, Creutzfeldt-Jakob, cortical degeneration, inespecific calcification (one case each). The age varied from 1 to 83 years. Forty one lesions were supratentorial, two infratentorial, and one was outside the brain (dura and skull) and we used stereotaxy to localize it. There was no mortality and morbidity was 2.3%. The literature is reviewed. We conclude that this procedure is safe and highly diagnostic. PMID:9698729

  12. CT of Hepatic Sarcoidosis: Small Nodular Lesions Simulating Metastatic Disease

    PubMed Central

    Ufuk, Furkan; Herek, Duygu

    2015-01-01

    Summary Background Sarcoidosis is a multisystemic inflammatory disease of unknown origin. The lymphoid system and the lungs are the most commonly involved organs. The frequency of signs or symptoms of hepatic involvement is very low. Case Report We present a case of symptomatic granulomatous liver disease secondary to sarcoidosis, mimicking a metastatic disease on ultrasonography and CT. Conclusions Hepatic involvement in sarcoidosis might be a perplexing diagnostic problem. The decisive CT finding with respect to the differential diagnosis was the absence of a mass effect and intact vascular architecture around the lesions. PMID:25908950

  13. Practice Gaps in Dermatology: Melanocytic Lesions and Melanoma.

    PubMed

    Marino, Maria L; Carrera, Cristina; Marchetti, Michael A; Marghoob, Ashfaq A

    2016-07-01

    Early detection remains the most important strategy to reduce melanoma mortality. The identification and evaluation of new or changing skin lesions are important components of melanoma screening and are best performed today using complementary noninvasive imaging technologies, such as total body photography (TBP), dermoscopy, sequential digital dermoscopic imaging (SDDI), and reflectance confocal microscopy (RCM). Despite strong evidence showing that these screening techniques improve diagnostic accuracy for melanoma, they are not widely used by dermatologists. In this practice gaps review, the authors highlight the use, evidence, and rationale for TBP, dermoscopy, SDDI, and RCM. PMID:27363893

  14. Diagnostic angiography of the cerebrospinal vasculature.

    PubMed

    Rabinov, James D; Leslie-Mazwi, Thabele M; Hirsch, Joshua A

    2016-01-01

    Diagnostic catheter angiography remains the gold standard for evaluation of vascular lesions of the brain, head and neck, and spine. It is often combined with cross-sectional and functional imaging to provide a complete anatomic and physiologic workup of patients. Such data are combined with clinical information to help make treatment decisions. This chapter describes the specific techniques for arterial access and catheter navigation of the cerebrospinal vasculature. Discussion of patient positioning, injection rates, and basic anatomy of arterial and venous systems is included. Finally, important safety issues related to contrast allergy, renal failure, and complications are considered. PMID:27432664

  15. Oral lichen planus to oral lichenoid lesions: Evolution or revolution

    PubMed Central

    Dudhia, Bhavin B; Dudhia, Sonal B; Patel, Purv S; Jani, Yesha V

    2015-01-01

    The diagnosis between different diseases may be impaired by clinical and histopathologic similarities, as observed in the oral lichen planus (OLP) and oral lichenoid lesion (OLL). Inspite of similar clinicopathological features; etiology, diagnosis and prognosis differ which mandates separation of OLL from OLP. Hence, it is essential for the oral physician and oral pathologist to be familiarized with the individual variations among clinicopathological features of OLP and OLL as well as to obtain a thorough history and perform a complete mucocutaneous examination in addition to specific diagnostic testing. The difficulties faced to establish the diagnosis between these two pathologies are widely investigated in the literature with a lack of definite conclusion. This review is an attempt to throw some light on these clinicopathologic entities with the aim to resolve the diagnostic dilemma. PMID:26980966

  16. Gastrointestinal bleeding from Dieulafoy’s lesion: Clinical presentation, endoscopic findings, and endoscopic therapy

    PubMed Central

    Nojkov, Borko; Cappell, Mitchell S

    2015-01-01

    Although relatively uncommon, Dieulafoy’s lesion is an important cause of acute gastrointestinal bleeding due to the frequent difficulty in its diagnosis; its tendency to cause severe, life-threatening, recurrent gastrointestinal bleeding; and its amenability to life-saving endoscopic therapy. Unlike normal vessels of the gastrointestinal tract which become progressively smaller in caliber peripherally, Dieulafoy’s lesions maintain a large caliber despite their peripheral, submucosal, location within gastrointestinal wall. Dieulafoy’s lesions typically present with severe, active, gastrointestinal bleeding, without prior symptoms; often cause hemodynamic instability and often require transfusion of multiple units of packed erythrocytes. About 75% of lesions are located in the stomach, with a marked proclivity of lesions within 6 cm of the gastroesophageal junction along the gastric lesser curve, but lesions can also occur in the duodenum and esophagus. Lesions in the jejunoileum or colorectum have been increasingly reported. Endoscopy is the first diagnostic test, but has only a 70% diagnostic yield because the lesions are frequently small and inconspicuous. Lesions typically appear at endoscopy as pigmented protuberances from exposed vessel stumps, with minimal surrounding erosion and no ulceration (visible vessel sans ulcer). Endoscopic therapy, including clips, sclerotherapy, argon plasma coagulation, thermocoagulation, or electrocoagulation, is the recommended initial therapy, with primary hemostasis achieved in nearly 90% of cases. Dual endoscopic therapy of epinephrine injection followed by ablative or mechanical therapy appears to be effective. Although banding is reportedly highly successful, it entails a small risk of gastrointestinal perforation from banding deep mural tissue. Therapeutic alternatives after failed endoscopic therapy include repeat endoscopic therapy, angiography, or surgical wedge resection. The mortality has declined from about 30

  17. Nonproliferative and Proliferative Lesions of the Rat and Mouse Female Reproductive System

    PubMed Central

    Dixon, Darlene; Alison, Roger; Bach, Ute; Colman, Karyn; Foley, George L.; Harleman, Johannes H.; Haworth, Richard; Herbert, Ronald; Heuser, Anke; Long, Gerald; Mirsky, Michael; Regan, Karen; Van Esch, Eric; Westwood, F. Russell; Vidal, Justin; Yoshida, Midori

    2014-01-01

    The INHAND (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) Project (www.toxpath.org/inhand.asp) is a joint initiative of the Societies of Toxicological Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP) and North America (STP) to develop an internationally accepted nomenclature for proliferative and nonproliferative lesions in laboratory animals. The purpose of this publication is to provide a standardized nomenclature for classifying microscopic lesions observed in the female reproductive tract of laboratory rats and mice, with color photomicrographs illustrating examples of some lesions. The standardized nomenclature presented in this document is also available electronically on the internet (http://www.goreni.org/). Sources of material included histopathology databases from government, academia, and industrial laboratories throughout the world. Content includes spontaneous and aging lesions as well as lesions induced by exposure to test materials. There is also a section on normal cyclical changes observed in the ovary, uterus, cervix and vagina to compare normal physiological changes with pathological lesions. A widely accepted and utilized international harmonization of nomenclature for female reproductive tract lesions in laboratory animals will decrease confusion among regulatory and scientific research organizations in different countries and provide a common language to increase and enrich international exchanges of information among toxicologists and pathologists. PMID:25516636

  18. Nonproliferative and proliferative lesions of the rat and mouse female reproductive system.

    PubMed

    Dixon, Darlene; Alison, Roger; Bach, Ute; Colman, Karyn; Foley, George L; Harleman, Johannes H; Haworth, Richard; Herbert, Ronald; Heuser, Anke; Long, Gerald; Mirsky, Michael; Regan, Karen; Van Esch, Eric; Westwood, F Russell; Vidal, Justin; Yoshida, Midori

    2014-01-01

    The INHAND (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) Project (www.toxpath.org/inhand.asp) is a joint initiative of the Societies of Toxicological Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP) and North America (STP) to develop an internationally accepted nomenclature for proliferative and nonproliferative lesions in laboratory animals. The purpose of this publication is to provide a standardized nomenclature for classifying microscopic lesions observed in the female reproductive tract of laboratory rats and mice, with color photomicrographs illustrating examples of some lesions. The standardized nomenclature presented in this document is also available electronically on the internet (http://www.goreni.org/). Sources of material included histopathology databases from government, academia, and industrial laboratories throughout the world. Content includes spontaneous and aging lesions as well as lesions induced by exposure to test materials. There is also a section on normal cyclical changes observed in the ovary, uterus, cervix and vagina to compare normal physiological changes with pathological lesions. A widely accepted and utilized international harmonization of nomenclature for female reproductive tract lesions in laboratory animals will decrease confusion among regulatory and scientific research organizations in different countries and provide a common language to increase and enrich international exchanges of information among toxicologists and pathologists.

  19. Advanced MRI Techniques in the Evaluation of Complex Cystic Breast Lesions

    PubMed Central

    Popli, Manju Bala; Gupta, Pranav; Arse, Devraj; Kumar, Pawan; Kaur, Prabhjot

    2016-01-01

    OBJECTIVE The purpose of this research work was to evaluate complex cystic breast lesions by advanced MRI techniques and correlating imaging with histologic findings. METHODS AND MATERIALS In a cross-sectional design from September 2013 to August 2015, 50 patients having sonographically detected complex cystic lesions of the breast were included in the study. Morphological characteristics were assessed. Dynamic contrast-enhanced MRI along with diffusion-weighted imaging and MR spectroscopy were used to further classify lesions into benign and malignant categories. All the findings were correlated with histopathology. RESULTS Of the 50 complex cystic lesions, 32 proved to be benign and 18 were malignant on histopathology. MRI features of heterogeneous enhancement on CE-MRI (13/18), Type III kinetic curve (13/18), reduced apparent diffusion coefficient (18/18), and tall choline peak (17/18) were strong predictors of malignancy. Thirteen of the 18 lesions showed a combination of Type III curve, reduced apparent diffusion coefficient value, and tall choline peak. CONCLUSIONS Advanced MRI techniques like dynamic imaging, diffusion-weighted sequences, and MR spectroscopy provide a high level of diagnostic confidence in the characterization of complex cystic breast lesion, thus allowing early diagnosis and significantly reducing patient morbidity and mortality. From our study, lesions showing heterogeneous contrast enhancement, Type III kinetic curve, diffusion restriction, and tall choline peak were significantly associated with malignant complex cystic lesions of the breast. PMID:27330299

  20. Effects of Gray-Scale Ultrasonography Immediate Post-Contrast on Characterization of Focal Liver Lesions.

    PubMed

    Yang, Wei; Chen, Min-Hua; Wu, Wei; Dai, Ying; Fan, Zhi-Hui

    2015-01-01

    This study compared the imaging features of conventional gray scale ultrasound (US) before and after contrast-enhanced ultrasound (CEUS) for focal liver lesions and 22 evaluated the role of US post-CEUS in characterizing liver lesions. 126 patients with 158 focal liver lesions underwent CEUS and US post-CEUS examination and entered this study. There were 74 hepatocellular carcinomas (HCC), 43 hepatic metastases, and 41 hemangiomas. Imaging features of US pre-CEUS and US post-CEUS were analyzed offsite by two blinded experienced radiologists to evaluate size, boundary, echogenicity, internal texture, posterior acoustic enhancement, spatial resolution, and contrast resolution. In the end with pathological and clinical evidence, the diagnostic accuracy rate of US pre-CEUS was 53.8% (85/158 lesions), lower than that of CEUS (88.0%, 139/158 lesions); with the complementation of US post-CEUS the rate rose to 93.0% (147/158 lesions). US post-CEUS could improve the visibility of typical structures of focal liver lesions and might provide important complementary information for CEUS diagnosis. It also increases the visibility of small liver lesions compared with US pre-CEUS and helps to guide local interventional procedure. PMID:26090387

  1. 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.

  2. Automotive Diagnostic Technologies.

    ERIC Educational Resources Information Center

    Columbus State Community Coll., OH.

    This document contains materials developed for and about the automotive diagnostic technologies tech prep program of the South-Western City Schools in Ohio. Part 1 begins with a map of the program, which begins with an automotive/diagnostic technologies program in grades 11 and 12 that leads to entry-level employment or a 2-year automotive…

  3. Efficacy and safety of electromagnetic navigation bronchoscopy with or without radial endobronchial ultrasound for peripheral lung lesions

    PubMed Central

    Ozgul, Guler; Cetinkaya, Erdogan; Ozgul, Mehmet Akif; Abul, Yasin; Gencoglu, Atayla; Kamiloglu, Emine; Gul, Sule; Dincer, H. Erhan

    2016-01-01

    Background and Objectives: Electromagnetic navigation bronchoscopy (ENB) is a promising new technology to increase the diagnostic yield of peripheral lung and mediastinal lesions. Conventional flexible bronchoscopy has a limited yield in peripheral pulmonary lesions, even in experienced hands. Radial endobronchial ultrasound (r-EBUS) with its real-time imaging capability can help to diagnose peripheral pulmonary lesions. In the present study, we aimed to investigate the diagnostic yield and safety of ENB with or without r-EBUS for peripheral lung lesions. Materials and Methods: This study was conducted in a tertiary medical center, and 56 consecutive patients who were thought to be the best candidates for bronchoscopic biopsies at a multidisciplinary meeting were enrolled. ENB was performed under conscious sedation by using an electromagnetic tracking system with multiplanar reconstruction of previously acquired computed tomography (CT) data. Sampling was performed by biopsy forceps, endobronchial brush, and bronchoalveolar lavage. Results: Fifty-six patients (50 men and 6 women; mean age, 60 ± 9 years) were studied. While an electromagnetic navigation system was used in all patients, r-EBUS was used in 26 of 56 patients. The median diameter of the lesions was 30 mm (interquartile range: 23-44 mm). Mean distance of the lesions from the pleura was 14.9 ± 14.6 mm. Mean procedure time was 20 ± 11.5 min. Mean registration error was 5.8 ± 1.5 mm. Mean navigation error was 1.2 ± 0.5 mm. The diagnostic yield of the procedure was 71.4% for peripheral lesions (non-small cell lung cancer = 23, small cell lung cancer = 3, benign diseases = 14). Pneumothorax occurred in only 1 patient (1.7%). Conclusion: ENB with or without r-EBUS is a safe, efficient, and easily applied method for sampling of peripheral lung lesions, with high diagnostic yield independent of lesion size and location. PMID:27386477

  4. Assessment of texture analysis on DCE-MRI data for the differentiation of breast tumor lesions

    NASA Astrophysics Data System (ADS)

    Loose, Jennifer; Harz, Markus T.; Laue, Hendrik; Twellmann, Thorsten; Bick, Ulrich; Rominger, Marga; Hahn, Horst K.; Peitgen, Heinz-Otto

    2009-02-01

    Breast cancer diagnosis based on magnetic resonance images (breast MRI) is increasingly being accepted as an additional diagnostic tool to mammography and ultrasound, with distinct clinical indications.1 Its capability to detect and differentiate lesion types with high sensitivity and specificity is countered by the fact that visual human assessment of breast MRI requires long experience. Moreover, the lack of evaluation standards causes diagnostic results to vary even among experts. The most important MR acquisition technique is dynamic contrast enhanced (DCE) MR imaging since different lesion types accumulate contrast material (CM) differently. The wash-in and wash-out characteristic as well as the morphologic characteristic recorded and assessed from MR images therefore allows to differentiate benign from malignant lesions. In this work, we propose to calculate second order statistical features (Haralick textures) for given lesions based on subtraction and 4D images and on parametermaps. The lesions are classified with a linear classification scheme into probably malignant or probably benign. The method and model was developed on 104 histologically graded lesions (69 malignant and 35 benign). The area under the ROC curve obtained is 0.91 and is already comparable to the performance of a trained radiologist.

  5. 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.

  6. Rayleigh Scattering Diagnostics Workshop

    NASA Technical Reports Server (NTRS)

    Seasholtz, Richard (Compiler)

    1996-01-01

    The Rayleigh Scattering Diagnostics Workshop was held July 25-26, 1995 at the NASA Lewis Research Center in Cleveland, Ohio. The purpose of the workshop was to foster timely exchange of information and expertise acquired by researchers and users of laser based Rayleigh scattering diagnostics for aerospace flow facilities and other applications. This Conference Publication includes the 12 technical presentations and transcriptions of the two panel discussions. The first panel was made up of 'users' of optical diagnostics, mainly in aerospace test facilities, and its purpose was to assess areas of potential applications of Rayleigh scattering diagnostics. The second panel was made up of active researchers in Rayleigh scattering diagnostics, and its purpose was to discuss the direction of future work.

  7. Apport de l’IRM dans la prise en charge des compressions médullaires lentes non traumatiques

    PubMed Central

    Badji, Nfally; Deme, Hamidou; Akpo, Geraud; Ndong, Boucar; Toure, Mouhamadou Hamine; Diop, Sokhna Ba; Niang, El Hadji

    2016-01-01

    Les compressions médullaires lentes sont dues au développement dans le canal médullaire d’une lésion expansive. C’est une pathologie très fréquente dont le diagnostic est essentiellement clinique. L’imagerie par résonnance magnétique occupe une place incontournable dans le diagnostic de localisation et la recherche étiologique. En Europe l’étiologie tumorale est prépondérante. Le but de cette étude était de décrire les aspects IRM des compressions médullaires lentes et de déterminer le profil étiologique. Il s’agit d’une étude rétrospective portant sur 97 observations colligées au service de radiologie du CHUN de Fann sur une période de 30 mois (du 08/03/10 au 29/09/12). On été inclus dans l’étude, tous les patients adressés pour un tableau de compression médullaire lente survenu dans un contexte non traumatique. L’âge moyen des patients était de 42,6 ans avec des extrêmes compris entre 04 mois et 85 ans. Nous avons étudié la topographie des lésions (étage rachidien, compartiments canalaires) leur rehaussement et les critères d’orientation étiologique. Le protocole d’examen permettait la réalisation de séquence pondérées T1 sans avec injection de gado, T2, STIR et T2 DRIVE centrées sur les niveaux lésionnels ou les zones suspectes. L’IRM a permis de préciser le siège exact et l’étendue des lésions. L’atteinte du rachis dorsal représentait 42% des cas, suivi du rachis cervical avec 32% des cas. Les atteintes lombo-sacrées et pluri-étagées représentaient respectivement 18% et 08% des cas. Les lésions extradurales représentaient 87% des cas, suivi des lésions intradurales extramédullaires avec 08% des cas et des lésions intramédullaires dans 05% des cas. La particularité du profil étiologique de notre étude est la prédominance des épidurites infectieuses et la fréquence relative des épidurites métastatiques comparée aux séries occidentales. L’IRM vertébro-médullaire occupe

  8. L'astronomie des Anciens

    NASA Astrophysics Data System (ADS)

    Nazé, Yaël

    2009-04-01

    Quelle que soit la civilisation à laquelle il appartient, l'être humain cherche dans le ciel des réponses aux questions qu'il se pose sur son origine, son avenir et sa finalité. Le premier mérite de ce livre est de nous rappeler que l'astronomie a commencé ainsi à travers les mythes célestes imaginés par les Anciens pour expliquer l'ordre du monde et la place qu'ils y occupaient. Mais les savoirs astronomiques passés étaient loin d'être négligeables et certainement pas limités aux seuls travaux des Grecs : c'est ce que l'auteur montre à travers une passionnante enquête, de Stonehenge à Gizeh en passant par Pékin et Mexico, fondée sur l'étude des monuments anciens et des sources écrites encore accessibles. Les tablettes mésopotamiennes, les annales chinoises, les chroniques médiévales, etc. sont en outre d'une singulière utilité pour les astronomes modernes : comment sinon remonter aux variations de la durée du jour au cours des siècles, ou percer la nature de l'explosion qui a frappé tant d'observateurs en 1054 ? Ce livre offre un voyage magnifiquement illustré à travers les âges, entre astronomie et archéologie.

  9. Lupus systémique et atteinte rénale: apport des anticorps anti-SSA

    PubMed Central

    Baline, Kenza; Zaher, Karim; Fellah, Hassan; Benchikhi, Hakima

    2015-01-01

    Le but de notre travail est de déterminer le profil des auto-anticorps chez 30 patients ayant un lupus systémique avec ou sans atteinte rénale afin d’établir une corrélation clinico-immunologique entre la néphropathie lupique et ces auto-anticorps. Il s'agit d'une étude transversale de 30 patients atteints de lupus érythémateux systémique diagnostiqués au service de dermatologie durant la période de Décembre 2010 à Décembre 2012 et réalisée conjointement avec le laboratoire d'immunologie. Les anticorps anti-ADN étaient retrouvés chez 17 patients (56.7%) suivis des anti-SSA dans 12 cas (40%). Cinq patients (62.5%) ayant une atteinte rénale avaient des anticorps anti DNA négatifs. Parmi ces patients avec atteinte rénale, 37.5% avaient des anticorps anti SSA sans anticorps anti DNA. La moitié des patients ayant une atteinte rénale (50%) avaient des anticorps anti SSA positifs. Notre série montre l'importance des anticorps anti-SSA surtout chez des patients avec des anticorps anti-DNA négatifs non seulement pour le diagnostic du lupus systémique mais aussi pour déceler certaines manifestations systémiques comme l'atteinte rénale. PMID:26029328

  10. [Cystic testicular lesions in infancy].

    PubMed

    Calleja Escudero, J; Pascual Samaniego, M; Garrido Redondo, M; Matas Gómez, V; Fernández Domínguez, L; Fernández del Busto, E

    2004-09-01

    The present article reports a case 11 month-old infant with a right intratesticular cyst. We analyze the etiology, differential diagnosis and management off all cystic lesions of the pediatric testis. Patient age at presentation, examination features, tumor markers and sonographic appearance may assist in making a presumptive and occasionally definitive diagnosis preoperatively. The differential diagnosis include intratesticular simple cyst, epidermoid cyst, tunica albuginea cyst, testicular teratoma, juvenil granulosa cell tumor-gonadal stromal tumor, cystic dysplasia of the rete testis, cystic lymphangioma, and testicular torsion. Usually enucleation is the best treatment. A thorough understanding of potentially cystic testis lesions in children leads to the best management choices and often to preservation of a substantial portion of the affected testis.

  11. Molecular Analysis of Precursor Lesions in Familial Pancreatic Cancer

    PubMed Central

    Crnogorac-Jurcevic, Tatjana; Chelala, Claude; Barry, Sayka; Harada, Tomohiko; Bhakta, Vipul; Lattimore, Sam; Jurcevic, Stipo; Bronner, Mary; Lemoine, Nicholas R.; Brentnall, Teresa A.

    2013-01-01

    Background With less than a 5% survival rate pancreatic adenocarcinoma (PDAC) is almost uniformly lethal. In order to make a significant impact on survival of patients with this malignancy, it is necessary to diagnose the disease early, when curative surgery is still possible. Detailed knowledge of the natural history of the disease and molecular events leading to its progression is therefore critical. Methods and Findings We have analysed the precursor lesions, PanINs, from prophylactic pancreatectomy specimens of patients from four different kindreds with high risk of familial pancreatic cancer who were treated for histologically proven PanIN-2/3. Thus, the material was procured before pancreatic cancer has developed, rather than from PanINs in a tissue field that already contains cancer. Genome-wide transcriptional profiling using such unique specimens was performed. Bulk frozen sections displaying the most extensive but not microdissected PanIN-2/3 lesions were used in order to obtain the holistic view of both the precursor lesions and their microenvironment. A panel of 76 commonly dysregulated genes that underlie neoplastic progression from normal pancreas to PanINs and PDAC were identified. In addition to shared genes some differences between the PanINs of individual families as well as between the PanINs and PDACs were also seen. This was particularly pronounced in the stromal and immune responses. Conclusions Our comprehensive analysis of precursor lesions without the invasive component provides the definitive molecular proof that PanIN lesions beget cancer from a molecular standpoint. We demonstrate the need for accumulation of transcriptomic changes during the progression of PanIN to PDAC, both in the epithelium and in the surrounding stroma. An identified 76-gene signature of PDAC progression presents a rich candidate pool for the development of early diagnostic and/or surveillance markers as well as potential novel preventive/therapeutic targets for

  12. 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.

  13. 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

  14. 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.

  15. [Benign lymphoepithelial lesion of the salivary glands].

    PubMed

    Dusek, J; Cerný, L; Wiedermann, B

    1977-05-01

    A series of eight observations serves for demonstrating the clinico-pathological picture of the benign lymphoepithelial lesion of salivary glands. The glandular lesion was associated with joint symptoms, one of the female patients developed malignant lymphoma.

  16. Cable Diagnostic Focused Initiative

    SciTech Connect

    Hartlein, R.A.; Hampton, R.N.

    2010-12-30

    This report summarizes an extensive effort made to understand how to effectively use the various diagnostic technologies to establish the condition of medium voltage underground cable circuits. These circuits make up an extensive portion of the electric delivery infrastructure in the United States. Much of this infrastructure is old and experiencing unacceptable failure rates. By deploying efficient diagnostic testing programs, electric utilities can replace or repair circuits that are about to fail, providing an optimal approach to improving electric system reliability. This is an intrinsically complex topic. Underground cable systems are not homogeneous. Cable circuits often contain multiple branches with different cable designs and a range of insulation materials. In addition, each insulation material ages differently as a function of time, temperature and operating environment. To complicate matters further, there are a wide variety of diagnostic technologies available for assessing the condition of cable circuits with a diversity of claims about the effectiveness of each approach. As a result, the benefits of deploying cable diagnostic testing programs have been difficult to establish, leading many utilities to avoid the their use altogether. This project was designed to help address these issues. The information provided is the result of a collaborative effort between Georgia Tech NEETRAC staff, Georgia Tech academic faculty, electric utility industry participants, as well as cable system diagnostic testing service providers and test equipment providers. Report topics include: •How cable systems age and fail, •The various technologies available for detecting potential failure sites, •The advantages and disadvantages of different diagnostic technologies, •Different approaches for utilities to employ cable system diagnostics. The primary deliverables of this project are this report, a Cable Diagnostic Handbook (a subset of this report) and an online

  17. High-throughput sequencing approach uncovers the miRNome of peritoneal endometriotic lesions and adjacent healthy tissues.

    PubMed

    Saare, Merli; Rekker, Kadri; Laisk-Podar, Triin; Sõritsa, Deniss; Roost, Anne Mari; Simm, Jaak; Velthut-Meikas, Agne; Samuel, Külli; Metsalu, Tauno; Karro, Helle; Sõritsa, Andrei; Salumets, Andres; Peters, Maire

    2014-01-01

    Accumulating data have shown the involvement of microRNAs (miRNAs) in endometriosis pathogenesis. In this study, we used a novel approach to determine the endometriotic lesion-specific miRNAs by high-throughput small RNA sequencing of paired samples of peritoneal endometriotic lesions and matched healthy surrounding tissues together with eutopic endometria of the same patients. We found five miRNAs specific to epithelial cells--miR-34c, miR-449a, miR-200a, miR-200b and miR-141 showing significantly higher expression in peritoneal endometriotic lesions compared to healthy peritoneal tissues. We also determined the expression levels of miR-200 family target genes E-cadherin, ZEB1 and ZEB2 and found that the expression level of E-cadherin was significantly higher in endometriotic lesions compared to healthy tissues. Further evaluation verified that studied miRNAs could be used as diagnostic markers for confirming the presence of endometrial cells in endometriotic lesion biopsy samples. Furthermore, we demonstrated that the miRNA profile of peritoneal endometriotic lesion biopsies is largely masked by the surrounding peritoneal tissue, challenging the discovery of an accurate lesion-specific miRNA profile. Taken together, our findings indicate that only particular miRNAs with a significantly higher expression in endometriotic cells can be detected from lesion biopsies, and can serve as diagnostic markers for endometriosis.

  18. Melioidosis Diagnostic Workshop, 20131

    PubMed Central

    AuCoin, David; Baccam, Prasith; Baggett, Henry C.; Baird, Rob; Bhengsri, Saithip; Blaney, David D.; Brett, Paul J.; Brooks, Timothy J.G.; Brown, Katherine A.; Chantratita, Narisara; Cheng, Allen C.; Dance, David A.B.; Decuypere, Saskia; Defenbaugh, Dawn; Gee, Jay E.; Houghton, Raymond; Jorakate, Possawat; Lertmemongkolchai, Ganjana; Limmathurotsakul, Direk; Merlin, Toby L.; Mukhopadhyay, Chiranjay; Norton, Robert; Peacock, Sharon J.; Rolim, Dionne B.; Simpson, Andrew J.; Steinmetz, Ivo; Stoddard, Robyn A.; Stokes, Martha M.; Sue, David; Tuanyok, Apichai; Whistler, Toni; Wuthiekanun, Vanaporn; Walke, Henry T.

    2015-01-01

    Melioidosis is a severe disease that can be difficult to diagnose because of its diverse clinical manifestations and a lack of adequate diagnostic capabilities for suspected cases. There is broad interest in improving detection and diagnosis of this disease not only in melioidosis-endemic regions but also outside these regions because melioidosis may be underreported and poses a potential bioterrorism challenge for public health authorities. Therefore, a workshop of academic, government, and private sector personnel from around the world was convened to discuss the current state of melioidosis diagnostics, diagnostic needs, and future directions. PMID:25626057

  19. Plasma diagnostic reflectometry

    SciTech Connect

    Cohen, B.I.; Afeyan, B.B.; Garrison, J.C.; Kaiser, T.B.; Luhmann, N.C. Jr.; Domier, C.W.; Chou, A.E.; Baang, S.

    1996-02-26

    Theoretical and experimental studies of plasma diagnostic reflectometry have been undertaken as a collaborative research project between the Lawrence Livermore National Laboratory (LLNL) and the University of California Department of Applied Science Plasma Diagnostics Group under the auspices of the Laboratory Directed Research and Development Program at LLNL. Theoretical analyses have explored the basic principles of reflectometry to understand its limitations, to address specific gaps in the understanding of reflectometry measurements in laboratory experiments, and to explore extensions of reflectometry such as ultra-short-pulse reflectometry. The theory has supported basic laboratory reflectometry experiments where reflectometry measurements can be corroborated by independent diagnostic measurements.

  20. Nonproliferative and Proliferative Lesions of the Rat and Mouse Skeletal Tissues (Bones, Joints, and Teeth).

    PubMed

    Fossey, Stacey; Vahle, John; Long, Philip; Schelling, Scott; Ernst, Heinrich; Boyce, Rogely Waite; Jolette, Jacquelin; Bolon, Brad; Bendele, Alison; Rinke, Matthias; Healy, Laura; High, Wanda; Roth, Daniel Robert; Boyle, Michael; Leininger, Joel

    2016-01-01

    The INHAND (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) Project (www.toxpath.org/inhand.asp) is an initiative of the Societies of Toxicological Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP) and North America (STP) to develop an internationally accepted nomenclature for proliferative and nonproliferative lesions in laboratory animals. The purpose of this publication is to provide a standardized nomenclature for classifying microscopic lesions observed in the skeletal tissues and teeth of laboratory rats and mice, with color photomicrographs illustrating examples of many common lesions. The standardized nomenclature presented in this document is also available on the internet (http://www.goreni.org/). Sources of material were databases from government, academic and industrial laboratories throughout the world.

  1. Nonproliferative and Proliferative Lesions of the Rat and Mouse Skeletal Tissues (Bones, Joints, and Teeth)

    PubMed Central

    Fossey, Stacey; Vahle, John; Long, Philip; Schelling, Scott; Ernst, Heinrich; Boyce, Rogely Waite; Jolette, Jacquelin; Bolon, Brad; Bendele, Alison; Rinke, Matthias; Healy, Laura; High, Wanda; Roth, Daniel Robert; Boyle, Michael; Leininger, Joel

    2016-01-01

    The INHAND (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) Project (www.toxpath.org/inhand.asp) is an initiative of the Societies of Toxicological Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP) and North America (STP) to develop an internationally accepted nomenclature for proliferative and nonproliferative lesions in laboratory animals. The purpose of this publication is to provide a standardized nomenclature for classifying microscopic lesions observed in the skeletal tissues and teeth of laboratory rats and mice, with color photomicrographs illustrating examples of many common lesions. The standardized nomenclature presented in this document is also available on the internet (http://www.goreni.org/). Sources of material were databases from government, academic and industrial laboratories throughout the world.

  2. Precursor Lesions for Sporadic Pancreatic Cancer: PanIN, IPMN, and MCN

    PubMed Central

    Distler, M.; Aust, D.; Weitz, J.; Pilarsky, C.; Grützmann, Robert

    2014-01-01

    Pancreatic cancer is still a dismal disease. The high mortality rate is mainly caused by the lack of highly sensitive and specific diagnostic tools, and most of the patients are diagnosed in an advanced and incurable stage. Knowledge about precursor lesions for pancreatic cancer has grown significantly over the last decade, and nowadays we know that mainly three lesions (PanIN, and IPMN, MCN) are responsible for the development of pancreatic cancer. The early detection of these lesions is still challenging but provides the chance to cure patients before they might get an invasive pancreatic carcinoma. This paper focuses on PanIN, IPMN, and MCN lesions and reviews the current level of knowledge and clinical measures. PMID:24783207

  3. Nonproliferative and Proliferative Lesions of the Rat and Mouse Skeletal Tissues (Bones, Joints, and Teeth).

    PubMed

    Fossey, Stacey; Vahle, John; Long, Philip; Schelling, Scott; Ernst, Heinrich; Boyce, Rogely Waite; Jolette, Jacquelin; Bolon, Brad; Bendele, Alison; Rinke, Matthias; Healy, Laura; High, Wanda; Roth, Daniel Robert; Boyle, Michael; Leininger, Joel

    2016-01-01

    The INHAND (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) Project (www.toxpath.org/inhand.asp) is an initiative of the Societies of Toxicological Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP) and North America (STP) to develop an internationally accepted nomenclature for proliferative and nonproliferative lesions in laboratory animals. The purpose of this publication is to provide a standardized nomenclature for classifying microscopic lesions observed in the skeletal tissues and teeth of laboratory rats and mice, with color photomicrographs illustrating examples of many common lesions. The standardized nomenclature presented in this document is also available on the internet (http://www.goreni.org/). Sources of material were databases from government, academic and industrial laboratories throughout the world. PMID:27621538

  4. Nonproliferative and Proliferative Lesions of the Rat and Mouse Skeletal Tissues (Bones, Joints, and Teeth)

    PubMed Central

    Fossey, Stacey; Vahle, John; Long, Philip; Schelling, Scott; Ernst, Heinrich; Boyce, Rogely Waite; Jolette, Jacquelin; Bolon, Brad; Bendele, Alison; Rinke, Matthias; Healy, Laura; High, Wanda; Roth, Daniel Robert; Boyle, Michael; Leininger, Joel

    2016-01-01

    The INHAND (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) Project (www.toxpath.org/inhand.asp) is an initiative of the Societies of Toxicological Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP) and North America (STP) to develop an internationally accepted nomenclature for proliferative and nonproliferative lesions in laboratory animals. The purpose of this publication is to provide a standardized nomenclature for classifying microscopic lesions observed in the skeletal tissues and teeth of laboratory rats and mice, with color photomicrographs illustrating examples of many common lesions. The standardized nomenclature presented in this document is also available on the internet (http://www.goreni.org/). Sources of material were databases from government, academic and industrial laboratories throughout the world. PMID:27621538

  5. Intracranial lesions with high signal intensity on T1-weighted MR images - review of pathologies.

    PubMed

    Zimny, Anna; Zińska, Lidia; Bladowska, Joanna; Neska-Matuszewska, Małgorzata; Sąsiadek, Marek

    2013-10-01

    In the article we present pathological intracranial substances and lesions, which produce high signal intensity on T1-weighted MR images. Six groups of substances are discussed: 1. Gadolinium - based contrast agents, 2.hemoglobin degradation products (intra- and extra-cellular methemoglobin), 3. lipid-containing lesions (lipoma, dermoid cyst, implanted fatty materials, laminar cortical necrosis), 4. substances with high concentration of proteins (colloid cyst, craniopharyngioma, Rathke's cleft cyst, ectopic posterior pituitary gland), 5. melanin (metastatic melanoma), 6. lesions containing mineral substances such as: calcium (calcifications, Fahr's disease), copper (Wilson's disease) and manganese (hepatic encephalopathy, manganese intoxication in intravenous drug abusers). Appropriate interpretation of signal intensity as well as analysis of location of lesions and clinical symptoms enables planning of further diagnostics and, in many cases, establishing the final diagnosis based on MR examination. PMID:24505222

  6. Intracranial lesions with high signal intensity on T1-weighted MR images – review of pathologies

    PubMed Central

    Zimny, Anna; Zińska, Lidia; Bladowska, Joanna; Neska-Matuszewska, Małgorzata; Sąsiadek, Marek

    2013-01-01

    Summary In the article we present pathological intracranial substances and lesions, which produce high signal intensity on T1-weighted MR images. Six groups of substances are discussed: 1. Gadolinium – based contrast agents, 2.hemoglobin degradation products (intra- and extra-cellular methemoglobin), 3. lipid-containing lesions (lipoma, dermoid cyst, implanted fatty materials, laminar cortical necrosis), 4. substances with high concentration of proteins (colloid cyst, craniopharyngioma, Rathke’s cleft cyst, ectopic posterior pituitary gland), 5. melanin (metastatic melanoma), 6. lesions containing mineral substances such as: calcium (calcifications, Fahr’s disease), copper (Wilson’s disease) and manganese (hepatic encephalopathy, manganese intoxication in intravenous drug abusers). Appropriate interpretation of signal intensity as well as analysis of location of lesions and clinical symptoms enables planning of further diagnostics and, in many cases, establishing the final diagnosis based on MR examination. PMID:24505222

  7. [Two cystic retroperitoneal lesions mimicking adrenal cysts].

    PubMed

    Grabellus, F; Dereskewitz, C; Schmitz, K J; Kaiser, G M; Kühl, H; Kersting, C; Frilling, A; Metz, K A; Baba, H A

    2005-05-01

    Adrenal cysts are uncommon lesions and most of them are found incidentally during abdominal imaging. We report on two benign extraadrenal lesions mimicking adrenal tumors in abdominal imaging. The histopathological investigation of the lesions revealed a foregut duplication cyst of the lesser gastric curvature and an epithelial inclusion cyst (epidermoid cyst) in an intrapancreatic accessory spleen respectively.

  8. Contact and contactless diffuse reflectance spectroscopy: potential for recovery monitoring of vascular lesions after intense pulsed light treatment

    NASA Astrophysics Data System (ADS)

    Kuzmina, Ilona; Diebele, Ilze; Spigulis, Janis; Valeine, Lauma; Berzina, Anna; Abelite, Anita

    2011-04-01

    Optical fiber contact probe diffuse reflectance spectroscopy and remote multispectral imaging methods in the spectral range of 400 to 1100 nm were used for skin vascular malformation assessment and recovery tracing after treatment by intense pulsed light. The results confirmed that oxy-hemoglobin relative changes and the optical density difference between lesion and healthy skin in the spectral region 500 to 600 nm may be successfully used for objective appraisal of the therapy effect. Color redness parameter a* = 2 is suggested as a diagnostic border to distinguish healthy skin and vascular lesions, and as the indicator of phototreatment efficiency. Valuable diagnostic information on large area (>5 mm) lesions and lesions with uncertain borders can be proved by the multispectral imaging method.

  9. Utility of fine-needle aspiration in the diagnosis of salivary gland lesions in patients infected with human immunodeficiency virus.

    PubMed

    Chhieng, D C; Argosino, R; McKenna, B J; Cangiarella, J F; Cohen, J M

    1999-10-01

    Fine-needle aspiration (FNA) has been increasingly utilized as a diagnostic tool in evaluating salivary gland masses, primarily to differentiate nonneoplastic from neoplastic lesions. Patients infected with human immunodeficiency virus (HIV) frequently present with salivary gland lesions. In this study, we reviewed the cytology of salivary gland lesions in HIV-infected patients and assessed the value of FNA in the diagnosis of salivary gland lesions in HIV-infected patients. One hundred and three FNAs of salivary gland lesions from 78 HIV-infected patients (63 males and 15 females) were included in our study. The patients' ages ranged from 7-65 yr, with a mean age of 40.9 yr. FNAs were classified into three categories: benign lymphoepithelial lesions (BLL) (77 cases or 74.8%), inflammatory processes (14 cases or 13.6%), including 3 reactive lymphoid hyperplasia, and neoplastic lesions (6 cases or 5.8%). The latter included three malignant lymphomas, a multiple myeloma, a metastatic adenocarcinoma from a lung primary, and a direct extension of basal-cell carcinoma. Six (5.8%) aspirates were nondiagnostic. No false-positive or false-negative cases were noted during follow-up of these patients. In conclusion, FNA is a simple and cost-effective procedure for the diagnosis of HIV-related salivary gland lesions. The majority of these lesions are cystic BLL and can be managed conservatively. Malignant lesions are rarely encountered and are readily recognized by FNA. Diagn. Cytopathol. 1999;21:260-264.

  10. UNUSUAL FINDINGS IN ZEBRAFISH, DANIO RERIO, FROM TOXICOLOGICAL STUDIES AND THE ZEBRAFISH INTERNATIONAL RESOURCE CENTER DIAGNOSTIC SERVICE

    EPA Science Inventory

    A number of interesting and unusual lesions have been diagnosed in zebrafish that have been evaluated from toxicological studies or submitted as cases to the Diagnostic Service at Oregon State University. Lesions were observed in various wild-type and mutant lines of zebrafish an...

  11. Diagnostic Immunohistochemistry in Cutaneous Neoplasia: An Update

    PubMed Central

    Compton, Leigh A.; Murphy, George F.; Lian, Christine G.

    2015-01-01

    Immunohistochemistry (IHC) is an important adjunct in the diagnosis of neoplastic skin diseases. In addition to the many established IHC markers currently in use, new markers continue to emerge, although their general acceptance and routine application requires robust validation. Here, we summarize the most well-established and commonly used biomarkers along with an array of newer ones reported in the past several decades that either demonstrate or hold high clinical promise in the field of cutaneous pathology. We also highlight recent applications of novel IHC markers in melanoma diagnosis including genetic mutation status markers [e.g. BRAF (v-raf murine sarcoma viral oncogene homolog B) and NRAS (neuroblastoma RAS viral oncogene homolog)] and an epigenetic alteration marker (e.g. 5-hydroxymethylcytosine). We specifically focus on the role of IHC in the differential diagnosis of cutaneous lesions that fall under the following categories: melanoma, epidermal tumors with an intraepidermal epitheliomatous pattern, spindle cell lesions of the dermis, small round blue cell tumors of the dermis, and cutaneous adnexal tumors. While IHC is a valuable tool in diagnostic dermatopathology, marker selection and interpretation must be highly informed by clinical context and the histologic differential diagnosis. With rapid progress in our understanding of the genetic and epigenetic mechanisms of tumorigenesis, new IHC markers will continue to emerge in the field of diagnostic dermatopathology. PMID:27047932

  12. Radioactive diagnostic agent

    SciTech Connect

    Shigematsu, A.; Aihara, M.; Matsuda, M.; Suzuki, A.; Tsuya, A.

    1984-02-07

    A radioactive diagnostic agent for renal cortex, adrenal cortex, myocardium, brain stem, spinal nerve, etc., which comprises as an essential component monoiodoacetic acid wherein the iodine atom is radioactive.

  13. 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. PMID:27429279

  14. Manual of diagnostic imaging

    SciTech Connect

    Gaylord, G.; Baker, S.; Davis, L.

    1988-01-01

    This book is on ordering and understanding the results of radiologic studies. Main sections are (I) Diagnostic Radiology serves as a basic introduction; (II) Diagnostic Modalities dedicates a chapter to each imaging modality in a clinical context, with a brief technical description and patient preparation guidelines; and (III) Organ System Imaging contains a chapter on each major organ system, covering the abilities and limitations of each modality to image a specific organ system and the significance of anatomic, physiologic, and general pathologic information.

  15. Diagnostics for pulmonary tuberculosis

    PubMed Central

    Cudahy, Patrick

    2016-01-01

    Tuberculosis (TB) remains a leading cause of human suffering and mortality despite decades of effective treatment being available. Accurate and timely diagnosis remains an unmet goal. The HIV epidemic has also led to new challenges in the diagnosis of TB. Several new developments in TB diagnostics have the potential to positively influence the global campaign against TB. We aim to review the performance of both established as well as new diagnostics for pulmonary TB in adults, and discuss the ongoing challenges. PMID:27005271

  16. Risk Factors for Coronary Drug-Eluting Stent Thrombosis: Influence of Procedural, Patient, Lesion, and Stent Related Factors and Dual Antiplatelet Therapy

    PubMed Central

    Hermiller, James B.; Ferguson, Joanne M.; Simonton, Charles A.

    2013-01-01

    The complication of stent thrombosis (ST) emerged at a rate of 0.5% annually for first-generation drug-eluting stents (DES), often presenting as death or myocardial infarction. Procedural factors such as stent underexpansion and malapposition are risk factors for ST in patients. The type of lesion being treated and lesion morphology also influence healing after treatment with DES and can contribute to ST. Second-generation DES such as the XIENCE V everolimus-eluting stent differ from the first-generation stents with respect to antiproliferative agents, coating technologies, and stent frame. Improvements in stent structure have resulted in a more complete endothelialization, thereby decreasing the incidence of ST. Bioresorbable scaffolds show promise for restoring vasomotor function and minimizing rates of very late ST. Post-PCI treatment with aspirin and clopidogrel for a year is currently the standard of care for DES, but high-risk patients may benefit from more potent antiplatelet agents. The optimal duration of DAPT for DES is currently unclear and will be addressed in large-scale randomized clinical trials. PMID:23862074

  17. A microbiological study of primary root-caries lesions with different treatment needs.

    PubMed

    Beighton, D; Lynch, E; Heath, M R

    1993-03-01

    Samples of altered or carious dentin for microbiological culture were obtained from 301 primary root-caries lesions in 59 patients by means of a standardized sampling procedure. This involved the cleansing of each root surface of extraneous supragingival plaque by means of a hand-held toothbrush and distilled water and the collection of the sample with a sterile dental excavator passed through the entire vertical dimension of each lesion. The total number of colony-forming units (cfu) in each sample and the numbers of mutans streptococci (primarily Streptococcus mutans), lactobacilli, yeasts, and Gram-positive pleomorphic rods (GPPR) were determined. Individual bacterial counts were expressed as log10 (cfu per sample), as a percentage of the total number of bacteria per sample, and as a frequency of isolation from lesions with different clinical diagnostic criteria. Clinical measurements of each lesion were made for color, texture, position relative to the gingival margin, and treatment need. Lesions classified as soft yielded significantly more bacteria, mutans streptococci, lactobacilli, and GPPR than leathery lesions, which yielded more bacteria than hard lesions. Lesions were classified into 5 treatment categories: soft and restore, leathery and restore, leathery and debride of caries; leathery and treat therapeutically; and hard no treatment. The total numbers of bacteria, mutans streptococci, lactobacilli, GPPR, and yeasts decreased significantly with decreasing treatment need. The frequency of isolation of mutans streptococci, lactobacilli, and yeasts was significantly greater from lesions requiring restoration and from lesions situated within 1 mm of the gingival margin. We suggest that the majority of root caries is initiated adjacent to the gingival margin.

  18. [HPV-associated cutaneous lesions].

    PubMed

    Kiyofumi, Egawa

    2008-12-01

    More than 100 HPV genotypes are presently distinguished by comparing the DNA sequence of the L1 ORF of each HPV. Two important aspects of the nature of this group of heterogeneous viruses are the way in which specific HPV genotypes are associated with distinct clinical and histological morphologies and the way specific HPV genotypes affect distinct anatomical sites. The former is best evidenced by the HPV type specific cytopathic or cytopathogenic effect (CPE), whereas the latter is suggested by the marked preference of each HPV genotype for specific tissues and sites. Recent studies have also suggested that specific HPV genotypes may target epithelial stem cells at specific anatomical sites. HPV type-specific CPE is the central schema when we analyze and understand the HPV-associated diseases. The concept was suggested by the characterization of distinct HPVs from different types of warts: HPV 2/27/57 from common warts, HPV 3/10/28 from flat warts, HPV 6/11 from condyloma acuminatum, and HPV 5/8 from lesions of epidermodysplasia verruciformis (EV). In this paper, I summarize recent advances in HPV study field, especially on HPV-associated cutaneous lesions. These include inclusion warts, HPV-associated epidermoid cysts, HPV type specific activation of melanogenesis, a double infection with HPV 1 and HPV 63 within a single cell, primary target cells and life cycle of the virus, and the identification of novel genes that are associated EV. The HPV-associated cutaneous lesions thus pose important problems to be resolved in virology and human pathology. PMID:19374195

  19. Chlamydia pecorum: fetal and placental lesions in sporadic caprine abortion.

    PubMed

    Giannitti, Federico; Anderson, Mark; Miller, Myrna; Rowe, Joan; Sverlow, Karen; Vasquez, Marce; Cantón, Germán

    2016-03-01

    Chlamydial abortion in small ruminants is usually associated with Chlamydia abortus infection. Although Chlamydia pecorum has been detected in aborted ruminants and epidemiological data suggests that C. pecorum is abortigenic in these species, published descriptions of lesions in fetuses are lacking. This work describes fetoplacental lesions in a caprine abortion with C. pecorum infection, and further supports the abortigenic role of C. pecorum in ruminants. A 16-month-old Boer goat aborted twin fetuses at ~130 days of gestation. Both fetuses (A and B) and the placenta of fetus A were submitted for postmortem examination and diagnostic workup. At autopsy, the fetuses had moderate anasarca, intermuscular edema in the hindquarters (A), and brachygnathia and palatoschisis (B). In the placenta, the cotyledons were covered by yellow fibrinosuppurative exudate that extended into the adjacent intercotyledonary areas. Histologically, there was severe suppurative and necrotizing placentitis with vasculitis (arteriolitis) and thrombosis, multifocal lymphohistiocytic and neutrophilic hepatitis (A), and fibrinosuppurative enteritis in both fetuses. Chlamydia antigen was detected in the placenta by the direct fluorescent antibody test and in fetal intestines by immunohistochemistry. Nested polymerase chain reaction of DNA extracted from formalin-fixed, paraffin-embedded sections of placenta and intestine amplified 400 bp of the Chlamydia 16S rRNA gene that was sequenced and found to be 99% identical to C. pecorum by BLAST analysis. Other known abortigenic infectious agents were ruled out by specific testing. It is concluded that C. pecorum infection is associated with fetoplacental lesions and sporadic abortion in goats. PMID:26965241

  20. Prostatic adenocarcinoma with mandibular metastatic lesion: case report.

    PubMed

    Reyes Court, Daniel; Encina, Susana; Levy, Irene

    2007-10-01

    Metastatic lesions of primary tumors, which originate in different parts of the body, comprise almost 1 % of different types of oral cancers. These lesions can affect either bones or soft tissues in the maxillofacial region. Whenever the maxillofacial area is affected, the most common location is in the molar region of the mandible. The clinical presentation of mandibular metastasis follows a clinical pattern characterized by irradiated dental pain in the third molar region. The most frequent sign is parethesia of the area innervated by the mandibular alveolar dental nerve. Differential diagnosis and treatment of these patients can be extremely difficult because there a number of pathologic conditions with similar symptoms and because diagnostic examination can be highly confusing. The aim of this article is to present a case of prostatic adenocarcinoma where the only metastasis was found in the jaw. A literature review will be presented, hoping to contribute to the scarce information regarding this lesion, due to its low frequency and atypical expression of this type of metastasis in terms of etiology, biological behavior and treatment.

  1. 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

  2. Hemoptysis with diagnostic dilemma.

    PubMed

    Pramanik, Bimalendu

    2013-02-01

    Hemoptysis is a common symptom. Although initial diagnostic workup, including a chest radiograph, often gives a clue to the cause, it provides no diagnostic hints in 3.0-42.2% of episodes of hemoptysis. To describe those cases with no diagnostic hints at initial investigations, experts have used different terms, including unexplained hemoptysis, idiopathic hemoptysis, cryptogenic hemoptysis and hemoptysis with normal chest radiographs. As hemoptysis is a common symptom of bronchogenic carcinoma, there is a concern of having underlying malignancy. Physicians value high-resolution computed tomography and fiberoptic bronchoscopy as the next investigations to establish diagnosis. These investigations however are expensive and nonspecific results are common in those cases of hemoptysis where initial diagnostic workup gives no clues to the cause. As a result, controversies exist with regard to their use. In this article, the author has proposed diagnostic approaches to evaluate those cases of hemoptysis with no diagnostic hints at initial investigation, after extensive review of published articles related to the case scenario. PMID:23362818

  3. Neutron Diagnostics for NIF

    NASA Astrophysics Data System (ADS)

    Barnes, Cris W.; Berggren, R.; Caldwell, S.; Chrien, R. C.; Cverna, F.; Faulkner, J.; Mack, J. M.; Morgan, G. L.; Murphy, T. J.; Oertel, J. A.; Tegtmeier, J.; Walton, R.; Wilke, M.; Wilson, D. C.; Young, C. S.

    1999-11-01

    The National Ignition Facility (NIF) will be a pre-emminent facility for research on burning plasmas. Los Alamos National Laboratory is developing a focus area of coordinating fusion reaction product diagnostics on NIF and studying fusion burn. We will be developing ``core'' diagnostics for NIF including neutron time-of-flight and single-hit systems for ion temperature and neutron spectra, measurements of ``bang-time'' (time of fusion burn relative to start of laser pulse), and support for activation measurements for high-yield and radiochemical analysis. We are also developing advanced Phase 2 diagnostics including a gas Cerenkov burn history diagnostic and work on apertures and detectors for neutron imaging. This will include tests of these diagnostic systems on the OMEGA laser in the coming years. The measurement requirements and system descriptions of these NIF diagnostics will be described. This work was performed under the auspices of the U. S. Department of Energy by the Los Alamos National Laboratory under contract No. W-7405-Eng-36.

  4. Atypical Apocrine Adenosis: Diagnostic Challenges and Pitfalls.

    PubMed

    Asirvatham, Jaya Ruth; Falcone, Maria Monica Garcia; Kleer, Celina G

    2016-10-01

    Apocrine change in the breast is an extremely common finding. In most cases, the benign or malignant nature of the lesion is easily recognized. Apocrine adenosis is used to describe sclerosing adenosis with apocrine change. The term apocrine atypia is used when there is significant cytologic atypia in apocrine cells, characterized by a 3-fold nuclear enlargement, prominent/multiple nucleoli, and hyperchromasia. Atypical apocrine adenosis is diagnosed when apocrine adenosis and apocrine atypia are superimposed. However, there are no definite criteria to distinguish atypical apocrine adenosis from apocrine ductal carcinoma in situ. Immunohistochemical markers can be confounding and may lead to erroneous diagnoses. Atypical apocrine features in sclerosing lesions may be misinterpreted as invasive carcinoma if the underlying lesion is not recognized. In the absence of definite features of malignancy, the diagnosis of apocrine ductal carcinoma in situ may be extremely difficult. In the present article, we review atypical apocrine adenosis focusing on diagnostic challenges and their implications on clinical management. PMID:27684975

  5. Incidentally diagnosed pulmonary nodule: a diagnostic algorithm.

    PubMed

    Dziedzic, Robert; Rzyman, Witold

    2014-12-01

    Asymptomatic solitary pulmonary nodules incidentally revealed by computed tomography has become a serious medical problem. Depending on their diameter, solid, part-solid, or pure ground-glass pulmonary nodules may be observed, diagnosed radiologically/invasively, or resected in accordance with international guidelines. Pure ground-glass nodules, semi-solid lesions, or solid lesions smaller than 8 mm should be monitored by serial low-dose computed tomography. In the case of solid nodules greater than 8 mm, the assessment of the risk of malignancy is recommended. Patients at high risk of lung cancer with pulmonary lesions should undergo diagnostic investigation, or the nodule should be resected. If the risk of lung cancer is low, the patients may be monitored. Needle aspiration biopsy is the most important invasive method of tumor diagnosis. Cytological or histopathological diagnosis is helpful in appropriate clinical decision making that reduces the risk of unnecessary surgery, decreasing the rate of benign nodule resections and thus reducing the costs of medical treatment.

  6. 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.

  7. Proliferative and nonproliferative lesions of the rat and mouse male reproductive system.

    PubMed

    Creasy, Dianne; Bube, Axel; de Rijk, Eveline; Kandori, Hitoshi; Kuwahara, Maki; Masson, Regis; Nolte, Thomas; Reams, Rachel; Regan, Karen; Rehm, Sabine; Rogerson, Petrina; Whitney, Katharine

    2012-08-01

    The INHAND Project (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) is a joint initiative of the Societies of Toxicologic Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP), and North America (STP) to develop an internationally accepted nomenclature for proliferative and nonproliferative lesions in laboratory animals. The purpose of this publication is to provide a standardized nomenclature and differential diagnosis for classifying microscopic lesions observed in the male reproductive system of laboratory rats and mice, with color microphotographs illustrating examples of some lesions. The standardized nomenclature presented in this document is also available for society members electronically on the Internet (http://goreni.org). Sources of material included histopathology databases from government, academia, and industrial laboratories throughout the world. Content includes spontaneous and aging lesions as well as lesions induced by exposure to test materials. A widely accepted and utilized international harmonization of nomenclature for lesions of the male reproductive system in laboratory animals will decrease confusion among regulatory and scientific research organizations in different countries and provide a common language to increase and enrich international exchanges of information among toxicologists and pathologists.

  8. Accurate diagnosis of thyroid follicular lesions from nuclear morphology using supervised learning.

    PubMed

    Ozolek, John A; Tosun, Akif Burak; Wang, Wei; Chen, Cheng; Kolouri, Soheil; Basu, Saurav; Huang, Hu; Rohde, Gustavo K

    2014-07-01

    Follicular lesions of the thyroid remain significant diagnostic challenges in surgical pathology and cytology. The diagnosis often requires considerable resources and ancillary tests including immunohistochemistry, molecular studies, and expert consultation. Visual analyses of nuclear morphological features, generally speaking, have not been helpful in distinguishing this group of lesions. Here we describe a method for distinguishing between follicular lesions of the thyroid based on nuclear morphology. The method utilizes an optimal transport-based linear embedding for segmented nuclei, together with an adaptation of existing classification methods. We show the method outputs assignments (classification results) which are near perfectly correlated with the clinical diagnosis of several lesion types' lesions utilizing a database of 94 patients in total. Experimental comparisons also show the new method can significantly outperform standard numerical feature-type methods in terms of agreement with the clinical diagnosis gold standard. In addition, the new method could potentially be used to derive insights into biologically meaningful nuclear morphology differences in these lesions. Our methods could be incorporated into a tool for pathologists to aid in distinguishing between follicular lesions of the thyroid. In addition, these results could potentially provide nuclear morphological correlates of biological behavior and reduce health care costs by decreasing histotechnician and pathologist time and obviating the need for ancillary testing.

  9. Accurate diagnosis of thyroid follicular lesions from nuclear morphology using supervised learning

    PubMed Central

    Ozolek, John A.; Tosun, Akif Burak; Wang, Wei; Chen, Cheng; Kolouri, Soheil; Basu, Saurav; Huang, Hu; Rohde, Gustavo K.

    2014-01-01

    Follicular lesions of the thyroid remain significant diagnostic challenges in surgical pathology and cytology. The diagnosis often requires considerable resources and ancillary tests including immunohistochemistry, molecular studies, and expert consultation. Visual analyses of nuclear morphological features, generally speaking, have not been helpful in distinguishing this group of lesions. Here we describe a method for distinguishing between follicular lesions of the thyroid based on nuclear morphology. The method utilizes an optimal transport-based linear embedding for segmented nuclei, together with an adaptation of existing classification methods. We show the method outputs assignments (classification results) which are near perfectly correlated with the clinical diagnosis of several lesion types' lesions utilizing a database of 94 patients in total. Experimental comparisons also show the new method can significantly outperform standard numerical feature-type methods in terms of agreement with the clinical diagnosis gold standard. In addition, the new method could potentially be used to derive insights into biologically meaningful nuclear morphology differences in these lesions. Our methods could be incorporated into a tool for pathologists to aid in distinguishing between follicular lesions of the thyroid. In addition, these results could potentially provide nuclear morphological correlates of biological behavior and reduce health care costs by decreasing histotechnician and pathologist time and obviating the need for ancillary testing. PMID:24835183

  10. Optoacoustic monitoring of real-time lesion formation during radiofrequency catheter ablation

    NASA Astrophysics Data System (ADS)

    Pang, Genny A.; Bay, Erwin; Deán-Ben, Xosé L.; Razansky, Daniel

    2015-03-01

    Current radiofrequency cardiac ablation procedures lack real-time lesion monitoring guidance, limiting the reliability and efficacy of the treatment. The objective of this work is to demonstrate that optoacoustic imaging can be applied to develop a diagnostic technique applicable to radiofrequency ablation for cardiac arrhythmia treatment with the capabilities of real-time monitoring of ablated lesion size and geometry. We demonstrate an optoacoustic imaging method using a 256-detector optoacoustic imaging probe and pulsed-laser illumination in the infrared wavelength range that is applied during radiofrequency ablation in excised porcine myocardial tissue samples. This technique results in images with high contrast between the lesion volume and unablated tissue, and is also capable of capturing time-resolved image sequences that provide information on the lesion development process. The size and geometry of the imaged lesion were shown to be in excellent agreement with the histological examinations. This study demonstrates the first deep-lesion real-time monitoring for radiofrequency ablation generated lesions, and the technique presented here has the potential for providing critical feedback that can significantly impact the outcome of clinical radiofrequency ablation procedures.

  11. Utility and challenges in intraoperative consultation of spinal lesions by crush smear cytology

    PubMed Central

    Dikondwar, Aparna R.; Dani, Aarti A.; Gaikwad, Saroj A.; Tathe, Shilpa P.; Randale, Archana A.; Chawhan, Sanjay M.; Kumbhalkar, Dinkar T.

    2016-01-01

    Background: Various methods are used for intraoperative consultation of spinal lesions. Crush smear cytology is one such method that is accurate, rapid, and allows preservation of tissue for paraffin-embedded sections. Aims: To study the cytomorphology of various neoplastic and nonneoplastic lesions involving and compressing the spinal cord. To evaluate accuracy and discuss diagnostic pitfalls of crush smear cytology. Materials and Methods: Over a period of 5 years (January 2008 to October 2012), a total of 57 spinal lesions were referred for intraoperative cytology. In four cases, material was inadequate for evaluation, so we analyzed 53 cases. Results: Majority of lesions were neoplastic accounting for 86.79% whereas nonneoplastic lesions constituted 13.20%. Most of the tumors were low grade (82.92%). Overall accuracy rate was 90.56% with accuracy of 91.30% and 85.71% for neoplastic and inflammatory lesions, respectively. Conclusion: Crush smear technique is a simple, reliable, easy, and rapid method for diagnosing neoplastic and inflammatory lesions involving and compressing the spinal cord. It gives an immediate idea of prognosis so that surgeon can modify the operative procedure, if necessary. PMID:27057218

  12. [Diagnostic imaging and therapy of chondroblastoma].

    PubMed

    Nickel, Jens; Meyer, Dirk-Roelfs; Geufke, Peter; Andresen, Reimer

    2002-01-01

    The chondroblastoma is a rare lytic osseous lesion, which is typically to be found in the epiphyses of the long tubular bones. We present a case report with the differential diagnostic imaging and the surgical therapy of a chondroblastoma of the proximal tibial epiphysis. A 16-year-old male presented in the traumatological accident and emergency centre with knee pain of unclear origin that had been increasing for several months. He had no memory of any acute trauma. For further clarification, a conventional radiograph in two planes, a thin-layer CT, a multiplanar MRI before and after Gd-DTPA, and a bone scan were performed. The conventional radiological diagnostics show a smoothly circumscribed, osteolytic, eccentric lesion with marginal sclerosis, which not exceeds the epiphyseal seam of the proximal tibia. The thin-layer CT reveals an eccentric osteolysis, with a typical, narrow sclerotic seam and central calcifications. In the high-resolution MRI, the T2-weighted sequences show a locally limited, epiphyseal, lobulated lesion with a heterogeneous, in part raised signal. A further signal increase can be seen in the T1-weighted sequences after administration of Gd-DTPA. Perifocally, there is an epiphyseal edema and discrete (intraarticular fluid collection) fluid in the inner knee. In the skeletal scintigraphy, there is a strong focal and diffuse increased activity from the proximal, lateral tibial epiphysis. After the diagnosis had been rendered, curettage of the defect was performed and then, after histological confirmation of the diagnosis, completing spongiosaplasty was conducted. Taking into account the localisation and the patient's age, a virtually certain diagnosis can already be rendered using conventional imaging. A supplementary MRI or CT can be helpful for final clarification, while 3-phase skeletal scintigraphy is superfluous. The therapy of choice is curettage and subsequent filling of the defect with autologous spongiosa.

  13. A study of fine needle aspiration cytology of salivary gland lesions with histopathological corroboration.

    PubMed

    Bandyopadhyay, Anjali; Das, Tushar Kanti; Raha, Kalpana; Hati, Ganesh Chandra; Mitra, Pradip Kumar; Dasgupta, Anjali

    2005-06-01

    The diagnostic utility of fine needle aspiration cytology as initial work up of salivary gland enlargement was assessed in one hundred and eighty-five salivary gland specimens over three years period and corroborated with histopathology, whenever feasible. All smears were evaluated according to cell size, amount of cytoplasm, cytologic atypia and presence of lymphocytes. (a) Variable cytologic appearances of pleomorphic salivary adenoma were observed. (b) Cellular pleomorphic adenoma and adenoid cystic carcinoma showed basaloid cell features. (c) Tumours with intermediate size cells and bland cytology included low grade muco-epidermoid carcinoma and cystic lesions. (d) Warthin's tumour, oncocytoma, salivary duct carcinoma and high grade muco-epidermoid carcinoma revealed large cells and abundant cytoplasm with or without atypia. A major diagnostic categories were inflammatory lesions (n = 7 5), cystic lesions (n = 9), benign tumours (n = 81), malignant neoplasms (n = 1 8) and normal acinar pattern (n = 2). Malignant tumours included muco-epidermoid carcinoma (n = 5), adenoid cystic carcinoma (n = 3), acinic cell carcinoma (n = 2), adenocarcinoma (n= 2), squamous cell carcinoma (n = 1), undifferentiated carcinoma (n= 4) and malignant lymphoma (n = 1). Histopathological correlation was possible in 40% of benign and 80% of malignant neoplasms. The overall sensitivity, specificity and diagnostic accuracy were very high. So it can be concluded that fine needle aspiration cytology can play important role in early diagnosis and subsequent therapeutic planning of salivary gland lesions.

  14. 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.

  15. Multispectral Video-Microscope Modified for Skin Diagnostics

    NASA Astrophysics Data System (ADS)

    Rubins, U.; Zaharans, J.; Ļihačova, I.; Spigulis, J.

    2014-12-01

    Commercial DinoLite AD413 digital microscope was modified for skin diagnostics purposes. The original LED ring (4 white and 4 ultraviolet light emitters) of microscope was replaced by a custom-designed 16-LED ring module consisting of four LED groups (450, 545, 660 and 940 nm), and an onboard LED controller with USB hub was added. The video acquisition and LED switching are performed using custom-designed Matlab software which provides real-time spectral analysis of multi-spectral images and calculation of skin chromophore optical density. The developed multispectral video-microscope is mainly meant for diagnostics of skin malformations, e.g. skin cancerous lesions.

  16. Prospective study to evaluate safety and efficacy of Zotarolimus Eluting Stent (PSEZES) in patients with long coronary artery lesions

    PubMed Central

    Bahuleyan, C.G.; Krishna Kumar, V.V.; Babu, Shifas

    2015-01-01

    Background Although the safety and effectiveness of Drug-Eluting Stents (DES) has been established extensively, reports on long term clinical outcome with angiographic findings in patients with long coronary artery lesions are not many. Methods In this single-center prospective registry of 100 patients, a total of 110 denovo long lesions (>20 mm) were treated with Resolute Zotarolimus Eluting Stent (R-ZES). The patients were followed up clinically at 3, 6 and 12 months and follow up coronary angiography was performed at 9-months. The primary end point was one year rate of target lesion failure (TLF) which is a composite of cardiac death, target lesion myocardial infarction or ischemia driven target lesion revascularization (TLR). The secondary end points included definite or probable stent thrombosis, 9-month angiographic restenosis and late lumen loss. Results The mean age of patients was 58.7 ± 9.50 years with prevalence of diabetes as high as 60%. The mean lesion length was 24.67 ± 4.87 mm with a mean reference vessel diameter of 2.85 ± 0.32 mm and 67.3% were Type C lesions (ACC/AHA classification). Two patients died during follow-up, of which one was non-cardiac death. One patient had target vessel myocardial infarction and five patients (4.5%) had ischemia driven TLR. The incidence of TLF was 6.36%. Binary restenosis was seen in 7 out of 93 lesions (7.5%). Median late lumen loss at 9 month was 0.22 mm. No stent thrombosis was noted in the study. Conclusion Implantation of R-ZES in real-world patients with long coronary artery lesions is safe with comparable efficacy to what is observed in the treatment of less complex lesions. PMID:26138180

  17. Contrast-enhanced ultrasound (CEUS) for the study of peripheral lung lesions: a preliminary study.

    PubMed

    Sperandeo, Marco; Sperandeo, Giuseppe; Varriale, Antonio; Filabozzi, Paola; Decuzzi, Marco; Dimitri, Lucia; Vendemiale, Gianluigi

    2006-10-01

    The use of contrast-enhanced ultrasound (CEUS) for the study of peripheral lung lesions has never been systematically investigated. We evaluated the CEUS patterns of 98 peripheral lung lesions before performing US-guided fine-needle biopsies (FNB). The examinations were done with an Esaote Technos MPX scanner in the harmonic mode with a mechanical index of 0.04 or less. Contrast enhancement was achieved with a 4.8 mL bolus of SonoVue (Bracco) administered via an antecubital vein. All FNBs performed under CEUS guidance were adequate for pathologic diagnosis. Seventy-eight lesions were malignant: 33 (41.9%) were adenocarcinomas, 29 (36.5%) were squamous-cell carcinomas, 13 (17.6%) were undifferentiated large-cell carcinomas and the remaining three (4.1%) were small-cell carcinomas. All presented intralesional enhancement consistent with tumor neovascularization. In some cases, there were unenhanced areas consistent with zones of necrosis and these areas were avoided during FNB. The other 20 lesions were benign (four lipomas, two fibrous lung tumor, two noncaseous granulomas, six abscesses, one rheumatoid nodule, one histiocytosis X, one chondroid hamartoma, one sclerosing hemangioma, two sarcoid nodules) and none presented intralesional enhancement. This initial and admittedly limited experience suggests that CEUS may provide diagnostically useful information on peripheral lung lesions and increase the diagnostic yield of transthoracic FNB by reducing the risk of inadequate tissue sampling.

  18. Immune-phenotypical markers for the differential diagnosis of melanocytic lesions

    PubMed Central

    Botti, Gerardo; Marra, Laura; Anniciello, Annamaria; Scognamiglio, Giosuè; Gigantino, Vincenzo; Cantile, Monica

    2015-01-01

    For specific subsets of melanocytic proliferations, there are morphologic limitations in the histological diagnosis, especially for borderline melanocytic tumors. In particular, Spitzoid proliferations can be difficult to diagnose. For these reasons, in the last years, clinic research has focusedattention on discovery of new diagnostic markers. Published gene expression and proteomic profiling data indicate new candidate molecules involved in melanoma pathogenesis, and useful in differential diagnosis of difficult melanocytic lesions. Recently, the diagnostic power of galectin-3 was demonstrated in series of melanocytic lesions, with a strong increasing of expression in malignant lesions compared with benign lesions. Similarly, the accumulation of Collagen XVII antibody was detected in vertical melanoma fronts and associated with invasive phenotype. Moreover, overexpression of cyclin D1 and p21 was detected in Spitz nevi compared with non-spitzoid melanomas; Ki-67 appears highly expressed in deep areas of non-spitzoid melanomas. In this review,werealizedan overviewofthe main molecular markersthat canbe a usefultoolfor the differential diagnosisofbenign, borderlineand malignant melanocytic lesions, related to their biological behavior, useful also for predicting the evolutionof the disease. PMID:26617684

  19. Transport quantique dans des nanostructures

    NASA Astrophysics Data System (ADS)

    Naud, C.

    2002-09-01

    structure des oscillations de conductance en fonction du flux du champ magnétique de période h/e dont l'amplitude est beaucoup plus importante que celle mesurée sur un réseau carré de même dimension. Cette différence constitue une signature d'un effet de localisation induit par le champ magnétique sur la topologie mathcal{T}3. Pour des valeurs spécifiques du champ magnétique, du fait des interférences destructives Aharonov-Bohm, la propagation des fonctions d'ondes est limitée à un ensemble fini de cellule du réseau appelé cage. De la dépendance en température des oscillations de période h/e mesurées sur le réseau mathcal{T}3 nous avons tiré une longueur caractéristique qui peut être rattachée au périmètre des cages. Un phénomène inattendu fut l'observation, pour des champs magnétiques plus importants, d'un doublement de fréquence des oscillations. Ces oscillations de période h/2e pouvant avoir une amplitude supérieure aux oscillations de période h/e, une interprétation en terme d'harmonique n'est pas possible. Enfin, l'influence de la largeur électrique des fils constituant le réseau et donc celle du nombre de canaux par brin a été étudiée en réalisant des grilles électrostatique. Les variations de l'amplitude des signaux en h/e et h/2e en fonction de la tension de grille ont été mesurés.

  20. Role of Liquid-based Cytology and Cell Block in the Diagnosis of Endometrial Lesions

    PubMed Central

    Zhang, Hui; Wen, Jia; Xu, Pi-Li; Chen, Rui; Yang, Xi; Zhou, Lian-Er; Jiang, Ping; Wan, An-Xia; Liao, Qin-Ping

    2016-01-01

    Background: Liquid-based cytology (LBC) offers an alternative method to biopsy in screening endometrial cancer. Cell block (CB), prepared by collecting residual cytological specimen, represents a novel method to supplement the diagnosis of endometrial cytology. This study aimed to compare the specimen adequacy and diagnostic accuracy of LBC and CB in the diagnosis of endometrial lesions. Methods: A total of 198 women with high risks of endometrial carcinoma (EC) from May 2014 to April 2015 were enrolled in this study. The cytological specimens were collected by the endometrial sampler (SAP-1) followed by histopathologic evaluation of dilatation and curettage or biopsy guided by hysteroscopy. The residual cytological specimens were processed into paraffin-embedded CB after LBC preparation. Diagnostic accuracies of LBC and CB for detecting endometrial lesions were correlated with histological diagnoses. Chi-square test was used to compare the specimen adequacies of LBC and CB. Results: The specimen inadequate rate of CB was significantly higher than that of LBC (22.2% versus 7.1%, P < 0.01). There were 144 cases with adequate specimens for LBC and CB preparation. Among them, 29 cases were atypical endometrial hyperplasia (11 cases) or carcinoma (18 cases) confirmed by histology evaluation. Taking atypical hyperplasia and carcinoma as positive, the diagnostic accuracy of CB was 95.1% while it was 93.8% in LBC. When combined LBC with CB, the diagnostic accuracy was improved to 95.8%, with a sensitivity of 89.7% and specificity of 97.4%. Conclusions: CB is a feasible and reproducible adjuvant method for screening endometrial lesions. A combination of CB and LBC can improve the diagnostic accuracy of endometrial lesions. PMID:27270542

  1. Efficiency of Core Biopsy for BI-RADS-5 Breast Lesions.

    PubMed

    Wolf, Ronald; Quan, Glenda; Calhoun, Kris; Soot, Laurel; Skokan, Laurie

    2008-01-01

    Stereotactic biopsy has proven more cost effective for biopsy of lesions associated with moderately suspicious mammograms. Data regarding selection of stereotactic biopsy (CORE) instead of excisional biopsy (EB) as the first diagnostic procedure in patients with nonpalpable breast lesions and highest suspicion breast imaging-reporting and data system (BI-RADS)-5 mammograms are sparse. Records from a regional health system radiology database were screened for mammograms associated with image-guided biopsy. A total of 182 nonpalpable BI-RADS-5 lesions were sampled in 178 patients over 5 years, using CORE or EB. Initial surgical margins, number of surgeries, time from initial procedure to last related surgical procedure, and hospital and professional charges for related admissions were compared using chi-squared, t-test, and Wilcoxon Mann-Whitney tests. A total of 108 CORE and 74 EB were performed as the first diagnostic procedure. Invasive or in situ carcinoma was diagnosed in 156 (86%) of all biopsies, 95 in CORE and 61 in EB groups. Negative margins of the first surgical procedure were more frequent in CORE (n = 70, 74%) versus EB (n = 17, 28%), p < 0.05. Use of CORE was associated with fewer total surgical procedures per lesion (1.29 +/- 0.05 versus 1.8 +/- 0.05, p < 0.05). Time of initial diagnostic procedure to final treatment did not vary significantly according to group (27 +/- 2 days versus 22 +/- 2 days, CORE versus EB). Mean charges including the diagnostic procedure and all subsequent surgeries were not different between CORE and EB groups ($10,500 +/- 300 versus $11,500 +/- 500, p = 0.08). Use of CORE as the first procedure in patients with highly suspicious mammograms is associated with improved pathologic margins and need for fewer surgical procedures than EB, and should be considered the preferred initial diagnostic approach. PMID:18821933

  2. Impact de la preparation des anodes crues et des conditions de cuisson sur la fissuration dans des anodes denses

    NASA Astrophysics Data System (ADS)

    Amrani, Salah

    La fabrication de l'aluminium est realisee dans une cellule d'electrolyse, et cette operation utilise des anodes en carbone. L'evaluation de la qualite de ces anodes reste indispensable avant leur utilisation. La presence des fissures dans les anodes provoque une perturbation du procede l'electrolyse et une diminution de sa performance. Ce projet a ete entrepris pour determiner l'impact des differents parametres de procedes de fabrication des anodes sur la fissuration des anodes denses. Ces parametres incluent ceux de la fabrication des anodes crues, des proprietes des matieres premieres et de la cuisson. Une recherche bibliographique a ete effectuee sur tous les aspects de la fissuration des anodes en carbone pour compiler les travaux anterieurs. Une methodologie detaillee a ete mise au point pour faciliter le deroulement des travaux et atteindre les objectifs vises. La majorite de ce document est reservee pour la discussion des resultats obtenus au laboratoire de l'UQAC et au niveau industriel. Concernant les etudes realisees a l'UQAC, une partie des travaux experimentaux est reservee a la recherche des differents mecanismes de fissuration dans les anodes denses utilisees dans l'industrie d'aluminium. L'approche etait d'abord basee sur la caracterisation qualitative du mecanisme de la fissuration en surface et en profondeur. Puis, une caracterisation quantitative a ete realisee pour la determination de la distribution de la largeur de la fissure sur toute sa longueur, ainsi que le pourcentage de sa surface par rapport a la surface totale de l'echantillon. Cette etude a ete realisee par le biais de la technique d'analyse d'image utilisee pour caracteriser la fissuration d'un echantillon d'anode cuite. L'analyse surfacique et en profondeur de cet echantillon a permis de voir clairement la formation des fissures sur une grande partie de la surface analysee. L'autre partie des travaux est basee sur la caracterisation des defauts dans des echantillons d'anodes crues

  3. [Diagnostic invasive procedures in the diagnosis of primary lung cancer. Diagnostic value and complications].

    PubMed

    Almind, M; Faurschou, P; Viskum, K

    1996-12-30

    The invasive procedures used in the diagnosis of primary lung cancer are reviewed based on the literature. The choice of method should be related to its diagnostic accuracy, complications and cost. The chest x-ray provides the background for the further choice of diagnostic method. In central tumors, bronchoscopy meets the requirements and in peripheral lesions percutaneous transthoracic needle biopsy fulfils the conditions. In some centres, mediastinoscopy is preferred in all cases preoperatively, while others only perform this examination if a CT-scan shows mediastinal lymph nodes larger than 1 cm in diameter. If the latter procedure is followed, 10-30% of the patients will have lymph node metastases. Thoracoscopy is used when a pleural effusion remains undiagnosed after pleuracentesis. A considerable amount of patients will be shown to have pleural neoplastic spread even though cytological examination of the pleural fluid did not demonstrate malignant cells. The complication rates in all methods are low. PMID:9012072

  4. Management of an Endodontic-Periodontal Lesion in a Maxillary Lateral Incisor with Palatal Radicular Groove: A Case Report

    PubMed Central

    Sooratgar, Aidin; Tabrizizade, Mehdi; Nourelahi, Maryam; Asadi, Yasin; Sooratgar, Hosein

    2016-01-01

    The radicular groove is a developmental anomaly that predisposes the tooth to periodontal break-down. Sometimes the situation becomes more complicated by pulp necrosis and development of a combined endodontic-periodontal lesion which is a diagnostic and treatment challenge for the clinician. This report presents the successful management of an endodontic-periodontal lesion in a maxillary lateral incisor that has a developmental palatal radicular groove using a combination of nonsurgical endodontic therapy and periodontal regenerative techniques. Conclusion: The combination of nonsurgical endodontic and periodontal regenerative treatment is a predictable method in treating combined endodontic-periodontal lesions caused by palato-gingival groove. PMID:27141225

  5. Development of Companion Diagnostics.

    PubMed

    Mankoff, David A; Edmonds, Christine E; Farwell, Michael D; Pryma, Daniel A

    2016-01-01

    The goal of individualized and targeted treatment and precision medicine requires the assessment of potential therapeutic targets to direct treatment selection. The biomarkers used to direct precision medicine, often termed companion diagnostics, for highly targeted drugs have thus far been almost entirely based on in vitro assay of biopsy material. Molecular imaging companion diagnostics offer a number of features complementary to those from in vitro assay, including the ability to measure the heterogeneity of each patient's cancer across the entire disease burden and to measure early changes in response to treatment. We discuss the use of molecular imaging methods as companion diagnostics for cancer therapy with the goal of predicting response to targeted therapy and measuring early (pharmacodynamic) response as an indication of whether the treatment has "hit" the target. We also discuss considerations for probe development for molecular imaging companion diagnostics, including both small-molecule probes and larger molecules such as labeled antibodies and related constructs. We then describe two examples where both predictive and pharmacodynamic molecular imaging markers have been tested in humans: endocrine therapy for breast cancer and human epidermal growth factor receptor type 2-targeted therapy. The review closes with a summary of the items needed to move molecular imaging companion diagnostics from early studies into multicenter trials and into the clinic.

  6. MJO Simulation Diagnostics

    SciTech Connect

    Waliser, D; Sperber, K; Hendon, H; Kim, D; Maloney, E; Wheeler, M; Weickmann, K; Zhang, C; Donner, L; Gottschalck, J; Higgins, W; Kang, I; Legler, D; Moncrieff, M; Schubert, S; Stern, W; Vitart, F; Wang, B; Wang, W; Woolnough, S

    2008-06-02

    The Madden-Julian Oscillation (MJO) interacts with, and influences, a wide range of weather and climate phenomena (e.g., monsoons, ENSO, tropical storms, mid-latitude weather), and represents an important, and as yet unexploited, source of predictability at the subseasonal time scale. Despite the important role of the MJO in our climate and weather systems, current global circulation models (GCMs) exhibit considerable shortcomings in representing this phenomenon. These shortcomings have been documented in a number of multi-model comparison studies over the last decade. However, diagnosis of model performance has been challenging, and model progress has been difficult to track, due to the lack of a coherent and standardized set of MJO diagnostics. One of the chief objectives of the US CLIVAR MJO Working Group is the development of observation-based diagnostics for objectively evaluating global model simulations of the MJO in a consistent framework. Motivation for this activity is reviewed, and the intent and justification for a set of diagnostics is provided, along with specification for their calculation, and illustrations of their application. The diagnostics range from relatively simple analyses of variance and correlation, to more sophisticated space-time spectral and empirical orthogonal function analyses. These diagnostic techniques are used to detect MJO signals, to construct composite life-cycles, to identify associations of MJO activity with the mean state, and to describe interannual variability of the MJO.

  7. Development of Companion Diagnostics.

    PubMed

    Mankoff, David A; Edmonds, Christine E; Farwell, Michael D; Pryma, Daniel A

    2016-01-01

    The goal of individualized and targeted treatment and precision medicine requires the assessment of potential therapeutic targets to direct treatment selection. The biomarkers used to direct precision medicine, often termed companion diagnostics, for highly targeted drugs have thus far been almost entirely based on in vitro assay of biopsy material. Molecular imaging companion diagnostics offer a number of features complementary to those from in vitro assay, including the ability to measure the heterogeneity of each patient's cancer across the entire disease burden and to measure early changes in response to treatment. We discuss the use of molecular imaging methods as companion diagnostics for cancer therapy with the goal of predicting response to targeted therapy and measuring early (pharmacodynamic) response as an indication of whether the treatment has "hit" the target. We also discuss considerations for probe development for molecular imaging companion diagnostics, including both small-molecule probes and larger molecules such as labeled antibodies and related constructs. We then describe two examples where both predictive and pharmacodynamic molecular imaging markers have been tested in humans: endocrine therapy for breast cancer and human epidermal growth factor receptor type 2-targeted therapy. The review closes with a summary of the items needed to move molecular imaging companion diagnostics from early studies into multicenter trials and into the clinic. PMID:26687857

  8. Development of Companion Diagnostics

    PubMed Central

    Mankoff, David A.; Edmonds, Christine E.; Farwell, Michael D.; Pryma, Daniel A.

    2016-01-01

    The goal of individualized and targeted treatment and precision medicine requires the assessment of potential therapeutic targets to direct treatment selection. The biomarkers used to direct precision medicine, often termed companion diagnostics, for highly targeted drugs have thus far been almost entirely based on in vitro assay of biopsy material. Molecular imaging companion diagnostics offer a number of features complementary to those from in vitro assay, including the ability to measure the heterogeneity of each patient’s cancer across the entire disease burden and to measure early changes in response to treatment. We discuss the use of molecular imaging methods as companion diagnostics for cancer therapy with the goal of predicting response to targeted therapy and measuring early (pharmacodynamic) response as an indication of whether the treatment has “hit” the target. We also discuss considerations for probe development for molecular imaging companion diagnostics, including both small-molecule probes and larger molecules such as labeled antibodies and related constructs. We then describe two examples where both predictive and pharmacodynamic molecular imaging markers have been tested in humans: endocrine therapy for breast cancer and human epidermal growth factor receptor type 2–targeted therapy. The review closes with a summary of the items needed to move molecular imaging companion diagnostics from early studies into multicenter trials and into the clinic. PMID:26687857

  9. Combining CRF and multi-hypothesis detection for accurate lesion segmentation in breast sonograms.

    PubMed

    Hao, Zhihui; Wang, Qiang; Seong, Yeong Kyeong; Lee, Jong-Ha; Ren, Haibing; Kim, Ji-yeun

    2012-01-01

    The implementation of lesion segmentation for breast ultrasound image relies on several diagnostic rules on intensity, texture, etc. In this paper, we propose a novel algorithm to achieve a comprehensive decision upon these rules by incorporating image over-segmentation and lesion detection in a pairwise CRF model, rather than a term-by-term translation. Multiple detection hypotheses are used to propagate object-level cues to segments and a unified classifier is trained based on the concatenated features. The experimental results show that our algorithm can avoid the drawbacks of separate detection or bottom-up segmentation, and can deal with very complicated cases. PMID:23285589

  10. [NERVOUS SYSTEM LESIONS ASSOCIATED WITH RELAPSING POLYCHONDRITIS: ANALYSIS OF ORIGINAL OBSERVATIONS].

    PubMed

    Chernyak, V I; Savel'ev A I; Men'shikova, I V; Pogromov, A P

    2016-01-01

    Three clinical cases are described including two of relapsing polychondritis with lesions in the central and peripheral nervous system (one of long-standing aseptic lymphocytic meningitis and one of cranial neuropathy of 2, 5, 7, and 8 pairs) and the third case of the optic nerve lesion with amblyopia. The two former cases were successfully treated with high doses of corticosteroids, the third one with moderate doses of the same medications. The data from the current literature concerning variants of clinical manifestations, methods for diagnostics and treatment of neurologic manifestations of relapsing polychondritis are discussed. PMID:27459759

  11. Angiography in the diagnosis and management of extracranial vascular lesions of the head and neck.

    PubMed

    Overholt, S L; Gado, M; Sessions, D G; Ogura, J H

    1978-11-01

    The angiographic features of various lesions of the head and neck are presented. Angiographically, cavernous hemangiomas display large venous lakes with calcified phleboliths. Arteriovenous malformations reveal massive tumor stain with well delineated feeding vessels from multiple systems. Chemodectomas and juvenile nasopharyngeal angiofibromas are clearly vascular with homogenous tumor staining in the capillary phase. Angiography of cavernous hemangioma, AVM, chemodectoma, and angiofibroma is diagnostic and may preclude the need for tissue biopsy. Angiographically neurilemmomas are less vascular with non-homogenous tumor stain. Carcinomas are typically avascular. The use and benefits of arterial embolization in the management of these lesions is presented.

  12. Interesting clinical presentation of anterior knee pain causing diagnostic dilemma.

    PubMed

    Morgan, Samer S; Balasubramanian, S; Teanby, D

    2009-09-01

    A diverse variety of lesions may occasionally occur in the patella. In this case report, we are presenting an interesting case of anterior knee pain in middle aged gentleman. Initial investigations including Magnetic Resonance Imaging not showed any abnormality. Due to prolonged continued pain he had bone scan and MRI, which confirmed the diagnosis of Brodie's abscess. We are presenting this case of Brodie's abscess of the patella causing diagnostic dilemma because of its rarity.

  13. Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal staging in lung cancer*

    PubMed Central

    Fernández-Bussy, Sebastián; Labarca, Gonzalo; Canals, Sofia; Caviedes, Iván; Folch, Erik; Majid, Adnan

    2015-01-01

    OBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic test with a high diagnostic yield for suspicious central pulmonary lesions and for mediastinal lymph node staging. The main objective of this study was to describe the diagnostic yield of EBUS-TBNA for mediastinal lymph node staging in patients with suspected lung cancer. METHODS: Prospective study of patients undergoing EBUS-TBNA for diagnosis. Patients ≥ 18 years of age were recruited between July of 2010 and August of 2013. We recorded demographic variables, radiological characteristics provided by axial CT of the chest, location of the lesion in the mediastinum as per the International Association for the Study of Lung Cancer classification, and definitive diagnostic result (EBUS with a diagnostic biopsy or a definitive diagnostic method). RESULTS: Our analysis included 354 biopsies, from 145 patients. Of those 145 patients, 54.48% were male. The mean age was 63.75 years. The mean lymph node size was 15.03 mm, and 90 lymph nodes were smaller than 10.0 mm. The EBUS-TBNA method showed a sensitivity of 91.17%, a specificity of 100.0%, and a negative predictive value of 92.9%. The most common histological diagnosis was adenocarcinoma. CONCLUSIONS: EBUS-TBNA is a diagnostic tool that yields satisfactory results in the staging of neoplastic mediastinal lesions. PMID:26176519

  14. Can model observers be developed to reproduce radiologists' diagnostic performances? Our study says not so fast!

    NASA Astrophysics Data System (ADS)

    Lee, Juhun; Nishikawa, Robert M.; Reiser, Ingrid; Boone, John M.

    2016-03-01

    The purpose of this study was to determine radiologists' diagnostic performances on different image reconstruction algorithms that could be used to optimize image-based model observers. We included a total of 102 pathology proven breast computed tomography (CT) cases (62 malignant). An iterative image reconstruction (IIR) algorithm was used to obtain 24 reconstructions with different image appearance for each image. Using quantitative image feature analysis, three IIRs and one clinical reconstruction of 50 lesions (25 malignant) were selected for a reader study. The reconstructions spanned a range of smooth-low noise to sharp-high noise image appearance. The trained classifiers' AUCs on the above reconstructions ranged from 0.61 (for smooth reconstruction) to 0.95 (for sharp reconstruction). Six experienced MQSA radiologists read 200 cases (50 lesions times 4 reconstructions) and provided the likelihood of malignancy of each lesion. Radiologists' diagnostic performances (AUC) ranged from 0.7 to 0.89. However, there was no agreement among the six radiologists on which image appearance was the best, in terms of radiologists' having the highest diagnostic performances. Specifically, two radiologists indicated sharper image appearance was diagnostically superior, another two radiologists indicated smoother image appearance was diagnostically superior, and another two radiologists indicated all image appearances were diagnostically similar to each other. Due to the poor agreement among radiologists on the diagnostic ranking of images, it may not be possible to develop a model observer for this particular imaging task.

  15. Comparative efficacy of peste des petits ruminants (PPR) vaccines.

    PubMed

    Saravanan, P; Sen, A; Balamurugan, V; Rajak, K K; Bhanuprakash, V; Palaniswami, K S; Nachimuthu, K; Thangavelu, A; Dhinakarraj, G; Hegde, Raveendra; Singh, R K

    2010-07-01

    Peste des petits ruminants (PPR) is a highly contagious, economically important viral disease of sheep and goats with high morbidity and mortality rates. In order to control the disease effectively, highly sensitive diagnostic tests coupled with potent vaccines are important pre-requisites. At present, there are three live attenuated PPR vaccines available in India including Sungri 96, Arasur 87 and Coimbatore 97. Indian Veterinary Research Institute (IVRI) Mukteswar developed the PPR Sungri 96 (isolate of goat origin) vaccine; while Tamil Nadu Veterinary and Animal Sciences University (TANUVAS) developed the Arasur 87 (isolate of sheep origin) and Coimbatore 97 (isolate of goat origin). In this study, the potency of these vaccines including a fourth vaccine from Institute of Animal Health and Veterinary Biologicals, Bangalore (IAH&VB) were tested as per the office International des Epizooties (OIE) guidelines by challenge studies in sheep and goats and their efficacies were evaluated using PPR C-ELISA. Potency tests of these vaccines in sheep and goats revealed that three of the vaccines were potent; however, the IAH &VB vaccine was comparatively less potent. The three vaccines could presumably be used for mass vaccination of both sheep and goats while contemplating PPR control program.

  16. ORION laser target diagnostics.

    PubMed

    Bentley, C D; Edwards, R D; Andrew, J E; James, S F; Gardner, M D; Comley, A J; Vaughan, K; Horsfield, C J; Rubery, M S; Rothman, S D; Daykin, S; Masoero, S J; Palmer, J B; Meadowcroft, A L; Williams, B M; Gumbrell, E T; Fyrth, J D; Brown, C R D; Hill, M P; Oades, K; Wright, M J; Hood, B A; Kemshall, P

    2012-10-01

    The ORION laser facility is one of the UK's premier laser facilities which became operational at AWE in 2010. Its primary mission is one of stockpile stewardship, ORION will extend the UK's experimental plasma physics capability to the high temperature, high density regime relevant to Atomic Weapons Establishment's (AWE) program. The ORION laser combines ten laser beams operating in the ns regime with two sub ps short pulse chirped pulse amplification beams. This gives the UK a unique combined long pulse/short pulse laser capability which is not only available to AWE personnel but also gives access to our international partners and visiting UK academia. The ORION laser facility is equipped with a comprehensive suite of some 45 diagnostics covering optical, particle, and x-ray diagnostics all able to image the laser target interaction point. This paper focuses on a small selection of these diagnostics. PMID:23126904

  17. Beamlet laser diagnostics

    SciTech Connect

    Burkhart, S.C.; Behrendt, W.C.; Smith, I.

    1996-06-01

    Beamlet is instrumented extensively to monitor the performance of the overall laser system and many of its subsystems. Beam diagnostics, installed in key locations, are used to fully characterize the beam during its propagation through the multipass cavity and the laser`s output section. This article describes the diagnostics stations located on Beamlet and discusses the design, calibration, and performance of the Beamlet calorimeters. The authors used Nova`s diagnostics packages to develop the Beamlet design to determine beam energy, spatial profile, temporal profile, and other beam parameters. Technologic improvements within the last several years in controls, charge-coupled device (CCD) cameras, and fast oscilloscopes have allowed the authors to obtain more accurate measurements on the Beamlet laser system. They briefly cover some of these techniques, including a description of their LabVIEW based data acquisition system.

  18. ORION laser target diagnostics.

    PubMed

    Bentley, C D; Edwards, R D; Andrew, J E; James, S F; Gardner, M D; Comley, A J; Vaughan, K; Horsfield, C J; Rubery, M S; Rothman, S D; Daykin, S; Masoero, S J; Palmer, J B; Meadowcroft, A L; Williams, B M; Gumbrell, E T; Fyrth, J D; Brown, C R D; Hill, M P; Oades, K; Wright, M J; Hood, B A; Kemshall, P

    2012-10-01

    The ORION laser facility is one of the UK's premier laser facilities which became operational at AWE in 2010. Its primary mission is one of stockpile stewardship, ORION will extend the UK's experimental plasma physics capability to the high temperature, high density regime relevant to Atomic Weapons Establishment's (AWE) program. The ORION laser combines ten laser beams operating in the ns regime with two sub ps short pulse chirped pulse amplification beams. This gives the UK a unique combined long pulse/short pulse laser capability which is not only available to AWE personnel but also gives access to our international partners and visiting UK academia. The ORION laser facility is equipped with a comprehensive suite of some 45 diagnostics covering optical, particle, and x-ray diagnostics all able to image the laser target interaction point. This paper focuses on a small selection of these diagnostics.

  19. ORION laser target diagnostics

    SciTech Connect

    Bentley, C. D.; Edwards, R. D.; Andrew, J. E.; James, S. F.; Gardner, M. D.; Comley, A. J.; Vaughan, K.; Horsfield, C. J.; Rubery, M. S.; Rothman, S. D.; Daykin, S.; Masoero, S. J.; Palmer, J. B.; Meadowcroft, A. L.; Williams, B. M.; Gumbrell, E. T.; Fyrth, J. D.; Brown, C. R. D.; Hill, M. P.; Oades, K.; and others

    2012-10-15

    The ORION laser facility is one of the UK's premier laser facilities which became operational at AWE in 2010. Its primary mission is one of stockpile stewardship, ORION will extend the UK's experimental plasma physics capability to the high temperature, high density regime relevant to Atomic Weapons Establishment's (AWE) program. The ORION laser combines ten laser beams operating in the ns regime with two sub ps short pulse chirped pulse amplification beams. This gives the UK a unique combined long pulse/short pulse laser capability which is not only available to AWE personnel but also gives access to our international partners and visiting UK academia. The ORION laser facility is equipped with a comprehensive suite of some 45 diagnostics covering optical, particle, and x-ray diagnostics all able to image the laser target interaction point. This paper focuses on a small selection of these diagnostics.

  20. Reversed field pinch diagnostics

    SciTech Connect

    Weber, P.G.

    1986-01-01

    The Reversed Field Pinch (RFP) is a toroidal, axisymmetric magnetic confinement configuration characterized by a magnetic field configuration in which the toroidal magnetic field is of similar strength to the poloidal field, and is reversed at the edge compared to the center. The RFP routinely operates at high beta, and is a strong candidate for a compact fusion device. Relevant attributes of the configuration will be presented, together with an overview of present and planned experiments and their diagnostics. RFP diagnostics are in many ways similar to those of other magnetic confinement devices (such as tokamaks); these lectures will point out pertinent differences, and will present some diagnostics which provide special insights into unique attributes of the RFP.

  1. PDX diagnostic control system

    SciTech Connect

    Mika, R.

    1981-01-01

    This paper describes a computer-base diagnostic control system operating on the PDX Tokamak. The prime function of the system is to control mechanical positioning devices associated with various diagnostics including Thomson Scattering, X-Ray Pulse Height Analyzer, Rotating Scanning Monochromator, Fast Ion Detection Experiment, Bolometers and Plasma Limiters. The diagnostic control system consists of a PDP-11/34 computer, a CAMAC system partitioned between the PDX control room and the PDX machine area, and special electronic control modules developed at PPL. The special modules include a digital closed loop motor controller and user interface control panel for control and status display. A standard control panel was developed for interfacing each system user with the PDP-11/34 computer, through specially developed CAMAC modules.

  2. Bacteriology of diabetic foot lesions.

    PubMed

    Anandi, C; Alaguraja, D; Natarajan, V; Ramanathan, M; Subramaniam, C S; Thulasiram, M; Sumithra, S

    2004-01-01

    Clinical grading and bacteriological study of 107 patients with diabetic foot lesions revealed polymicrobial aetiology in 69 (64.4%) and single aetiology in 21 (19.6%). Among 107 patients 62 had ulcer. Of these 31 had mixed aerobes. Twenty six patients with cellulitis and 12 with gangrene had more than 5 types of aerobes and anaerobes such as E. coli, Klebsiella spp., Pseudomonas spp., Proteus spp., Enterobactor spp., Enterococci spp., Clostridium perfringens, Bacteroides spp., Prevotella spp. and Peptostreptococcus spp. It was noted that 50 out of 62 patients with ulcer, and all the patients with cellulitis and gangrene were given surgical management and treated with appropriate antibiotics based on antimicrobial susceptibility testing. PMID:17642727

  3. [Management of the meniscal lesion].

    PubMed

    Baillon, B; Cermak, K; Vancabeke, M

    2011-01-01

    About 1,5 million arthroscopies are each year performed in the world, 50 % for meniscal affections. The menisci participate in the femoro-tibial load transmission and in the joint shock absorption; they contribute to the knee stability and play a role in the joint lubrication. The menisci are therefore important structures, and, in the case of a lesion, surgical abstention or repair should be favoured. When a meniscectomy has to be performed, it should be economical, preserving the meniscal wall. Meniscectomy is contra-indicated in the child and in the case of knee osteoarthrosis. Meniscal healing is compromised if the knee is unstable. If after total meniscectomy a patient presents symptomatic early osteoarthrosis, without marked loss of alignment, meniscal allografting is a therapeutic option, especially at the lateral compartment.

  4. Radial-probe EBUS for the diagnosis of peripheral pulmonary lesions

    PubMed Central

    Jacomelli, Marcia; Demarzo, Sergio Eduardo; Cardoso, Paulo Francisco Guerreiro; Palomino, Addy Lidvina Mejia; Figueiredo, Viviane Rossi

    2016-01-01

    ABSTRACT Objective: Conventional bronchoscopy has a low diagnostic yield for peripheral pulmonary lesions. Radial-probe EBUS employs a rotating ultrasound transducer at the end of a probe that is passed through the working channel of the bronchoscope. Radial-probe EBUS facilitates the localization of peripheral pulmonary nodules, thus increasing the diagnostic yield. The objective of this study was to present our initial experience using radial-probe EBUS in the diagnosis of peripheral pulmonary lesions at a tertiary hospital. Methods: We conducted a retrospective analysis of 54 patients who underwent radial-probe EBUS-guided bronchoscopy for the investigation of pulmonary nodules or masses between February of 2012 and September of 2013. Radial-probe EBUS was performed with a flexible 20-MHz probe, which was passed through the working channel of the bronchoscope and advanced through the bronchus to the target lesion. For localization of the lesion and for collection procedures (bronchial brushing, transbronchial needle aspiration, and transbronchial biopsy), we used fluoroscopy. Results: Radial-probe EBUS identified 39 nodules (mean diameter, 1.9 ∓ 0.7 cm) and 19 masses (mean diameter, 4.1 ∓ 0.9 cm). The overall sensitivity of the method was 66.7% (79.5% and 25.0%, respectively, for lesions that were visible and not visible by radial-probe EBUS). Among the lesions that were visible by radial-probe EBUS, the sensitivity was 91.7% for masses and 74.1% for nodules. The complications were pneumothorax (in 3.7%) and bronchial bleeding, which was controlled bronchoscopically (in 9.3%). Conclusions: Radial-probe EBUS shows a good safety profile, a low complication rate, and high sensitivity for the diagnosis of peripheral pulmonary lesions.

  5. Measurement of small lesions near metallic implants with mega-voltage cone beam CT

    NASA Astrophysics Data System (ADS)

    Grigorescu, Violeta; Prevrhal, Sven; Pouliot, Jean

    2008-03-01

    Metallic objects severely limit diagnostic CT imaging because of their high X-ray attenuation in the diagnostic energy range. In contrast, radiation therapy linear accelerators now offer CT imaging with X-ray energies in the megavolt range, where the attenuation coefficients of metals are significantly lower. We hypothesized that Mega electron-Voltage Cone-Beam CT (MVCT) implemented on a radiation therapy linear accelerator can detect and quantify small features in the vicinity of metallic implants with accuracy comparable to clinical Kilo electron-Voltage CT (KVCT) for imaging. Our test application was detection of osteolytic lesions formed near the metallic stem of a hip prosthesis, a condition of severe concern in hip replacement surgery. Both MVCT and KVCT were used to image a phantom containing simulated osteolytic bone lesions centered around a Chrome-Cobalt hip prosthesis stem with hemispherical lesions with sizes and densities ranging from 0.5 to 4 mm radius and 0 to 500 mg•cm -3, respectively. Images for both modalities were visually graded to establish lower limits of lesion visibility as a function of their size. Lesion volumes and mean density were determined and compared to reference values. Volume determination errors were reduced from 34%, on KVCT, to 20% for all lesions on MVCT, and density determination errors were reduced from 71% on KVCT to 10% on MVCT. Localization and quantification of lesions was improved with MVCT imaging. MVCT offers a viable alternative to clinical CT in cases where accurate 3D imaging of small features near metallic hardware is critical. These results need to be extended to other metallic objects of different composition and geometry.

  6. Clinicopathologic Similarities of the Main and Minor Lesions of Synchronous Multiple Early Gastric Cancer

    PubMed Central

    2016-01-01

    The detection rate of early gastric cancer (EGC) is increasing due to improvements in diagnostic methods, but synchronous multiple EGC (SMEGC) remains a major problem. Therefore, we investigated the characteristics of and the correlation between the main and minor lesions of SMEGC. We retrospectively reviewed the medical records of patients with EGC between April 2008 and May 2013. The main lesion was defined as the one with the greatest invasion depth. If lesions had the same invasion depth, the tumor diameter was used to define the main lesion. Of 963 patients who had treatment for EGC, 37 patients with SMEGC were analyzed. The main and minor lesions showed a significant positive correlation of size (r = 0.533, P = 0.001). The main and minor lesions of SMEGC showed the same vertical and horizontal locations at 70.3% and 64.9%, respectively (P = 0.002 and P = 0.002). Macroscopic types were identical in 67.6% (P < 0.001), and 32.4% had identical macroscopic type and location. The main and minor lesions had identical characteristics of invasion depth, presence of lymphovascular invasion (LVI), and differentiation in 78.4%, 83.8%, and 83.8%, respectively. Differentiation, LVI, and invasion depth (microscopic characteristics) were simultaneously the same in 62.2%. The location, macroscopic type, and 3 microscopic characteristics were matched in 27%. The main and minor lesions of SMEGC have similar clinicopathologic characteristics. Therefore, the possibility of SMEGC should not be neglected in cases of EGC, considering an understanding of the characteristics and association of lesions. PMID:27247495

  7. Clinicopathologic Similarities of the Main and Minor Lesions of Synchronous Multiple Early Gastric Cancer.

    PubMed

    Kim, Jung Ho; Jeong, Seok Hoo; Yeo, Jina; Lee, Woon Kee; Chung, Dong Hae; Kim, Kyoung Oh; Chung, Jun-Won; Kim, Yoon Jae; Kwon, Kwang An; Park, Dong Kyun

    2016-06-01

    The detection rate of early gastric cancer (EGC) is increasing due to improvements in diagnostic methods, but synchronous multiple EGC (SMEGC) remains a major problem. Therefore, we investigated the characteristics of and the correlation between the main and minor lesions of SMEGC. We retrospectively reviewed the medical records of patients with EGC between April 2008 and May 2013. The main lesion was defined as the one with the greatest invasion depth. If lesions had the same invasion depth, the tumor diameter was used to define the main lesion. Of 963 patients who had treatment for EGC, 37 patients with SMEGC were analyzed. The main and minor lesions showed a significant positive correlation of size (r = 0.533, P = 0.001). The main and minor lesions of SMEGC showed the same vertical and horizontal locations at 70.3% and 64.9%, respectively (P = 0.002 and P = 0.002). Macroscopic types were identical in 67.6% (P < 0.001), and 32.4% had identical macroscopic type and location. The main and minor lesions had identical characteristics of invasion depth, presence of lymphovascular invasion (LVI), and differentiation in 78.4%, 83.8%, and 83.8%, respectively. Differentiation, LVI, and invasion depth (microscopic characteristics) were simultaneously the same in 62.2%. The location, macroscopic type, and 3 microscopic characteristics were matched in 27%. The main and minor lesions of SMEGC have similar clinicopathologic characteristics. Therefore, the possibility of SMEGC should not be neglected in cases of EGC, considering an understanding of the characteristics and association of lesions. PMID:27247495

  8. [Diagnostic models. 2. Fabrication].

    PubMed

    Lefèvre, M; Vincent, G; L'Official-Vincent, M

    1989-09-01

    After describing in Part I the preparation of diagnostic cast, the authors describe the Wax Up preparation. Most of the definition of centric relation agree that the position of the mandible is slightly behind its position in centric occlusion. The Hinge axis position is used for mounting the cast on articulator. The final restauration must reconstruct both position and the occlusion should be established in front the centric occlusion. After equilibration anterior guidance is studied and restaured if necessary. After creating the different curve of occlusion, the final Wax Up is settled. The use of the diagnostic cast so obtained will be presented in Part III.

  9. Diagnostic hematology of reptiles.

    PubMed

    Stacy, Nicole I; Alleman, A Rick; Sayler, Katherine A

    2011-03-01

    The hematologic evaluation of reptiles is an indispensable diagnostic tool in exotic veterinary practice. The diversity of reptile species, their characteristic physiologic features, and effects of intrinsic and extrinsic factors present unique challenges for accurate interpretation of the hemogram. Combining the clinical presentation with hematologic findings provides valuable information in the diagnosis and monitoring of disease and helps guide the clinician toward therapy and further diagnostic testing. This article outlines the normal and pathologic morphology of blood cells of reptile species. The specific comparative aspects of reptiles are emphasized, and structural and functional abnormalities in the reptilian hemogram are described.

  10. Hemidystonia secondary to cervical demyelinating lesions.

    PubMed

    Yücesan, C; Tuncel, D; Akbostanci, M C; Yücemen, N; Mutluer, N

    2000-09-01

    Hemidystonia is usually associated with a structural lesion in the contralateral basal ganglia. We report a patient with definite multiple sclerosis, according to Poser's criteria, presenting with an acute-onset sustained left hemidystonia. Cranial T2-weighted magnetic resonance imaging (MRI) showed several hyperintense lesions in the centri semiovali and in the periventricular area without basal ganglia involvement. Moreover cervical spinal cord T2-weighted MRI showed two hyperintense lesions in the left posterolateral spine at C2 and C3, and one lesion in the right posterolateral spine at C4 levels. The hemidystonia improved completely after daily treatment with 1000 mg of methylprednisolone, and cervical MRI was performed after the improvement which showed that the lesions had become smaller and less intense. Finally we consider that the hemidystonia may be caused by the cervical spinal cord lesions of multiple sclerosis. PMID:11054144

  11. Detection of Fundus Lesions Using Classifier Selection

    NASA Astrophysics Data System (ADS)

    Nagayoshi, Hiroto; Hiramatsu, Yoshitaka; Sako, Hiroshi; Himaga, Mitsutoshi; Kato, Satoshi

    A system for detecting fundus lesions caused by diabetic retinopathy from fundus images is being developed. The system can screen the images in advance in order to reduce the inspection workload on doctors. One of the difficulties that must be addressed in completing this system is how to remove false positives (which tend to arise near blood vessels) without decreasing the detection rate of lesions in other areas. To overcome this difficulty, we developed classifier selection according to the position of a candidate lesion, and we introduced new features that can distinguish true lesions from false positives. A system incorporating classifier selection and these new features was tested in experiments using 55 fundus images with some lesions and 223 images without lesions. The results of the experiments confirm the effectiveness of the proposed system, namely, degrees of sensitivity and specificity of 98% and 81%, respectively.

  12. 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.

  13. Facial Skin Lesions Dentists Should Know.

    PubMed

    Sibai, Louna; Kudsi, Zaki

    2015-01-01

    Facial skin lesions are common; patients may present with a.nodule, crack, ulcer or abnormal discoloration of the skin that is not normally present. Ideally, dentists should include face examination in their routine clinical examination. Any suspicious lesion should be referred to a dermatologist as an early diagnosis and treatment could be life-saving. This article will discuss the diagnosis and treatment of common lesions of the face.

  14. Etiologies des hypertensions artérielles endocrines: à propos d'une série de cas

    PubMed Central

    Bouznad, Naima; El Mghari, Ghizlane; El Ansari, Nawal

    2016-01-01

    Les hypertensions artérielles (HTA) d'origine endocrine restent une cause rare d'HTA, sa prévalence globale n'excède pas 4% des hypertendus. L'intérêt de la recherche des HTA endocrines réside dans la gravité de certaines formes parfois mortelles et le caractère potentiellement curable et réversible de ces HTA. Le but du travail est de déterminer le profil clinique, para clinique, étiologique et thérapeutique des HTA secondaires d'origine endocrine chez les patients suivis au service d'endocrinologie au CHU Mohamed IV à Marrakech. Il s'agit d'une étude descriptive prospective s’étalant sur une période de 4 ans incluant 45 patients ayant une HTA endocrinienne. La moyenne d’âge est de 44,89 ans, avec une nette prédominance du sexe féminine (sexe ratio de 0,49). Les étiologies des HTA endocrines étaient dominées par le phéochromocytome (17 cas), l'hypercorticisme (11 cas) et l'acromégalie (8 cas). L'HTA était paroxystique dans 24,4%. Elle était d'emblée sevère classée grade 3 dans 40% des cas. L'HTA a été compliquée de cardiopathie dans 24% des cas et de néphropathie dans 20% des cas. Le traitement curatif a permis une guérison de l'HTA chez 60% (27 cas). Le diagnostic des HTA secondaires endocrines est parfois difficile du fait de l'absence de spécificité clinique. Il n'est pas exceptionnel que l'HTA soit l'unique manifestation de la maladie. Dans notre travail nous notons le caractère paroxystique et sévère de l'HTA. Le caractère éventuellement curable des HTA endocrines, dans plus des deux tiers des cas, fait qu'il est important de la dépister devant toute HTA sévère, résistante au traitement, ou en présence de signes cliniques, biologiques ou radiologiques évocateurs. PMID:27303586

  15. Approche pour les comportements sexuels inappropriés chez des personnes atteintes de démence

    PubMed Central

    Joller, Petra; Gupta, Neeraj; Seitz, Dallas P.; Frank, Christopher; Gibson, Michelle; Gill, Sudeep S.

    2013-01-01

    Résumé Objectif Présenter aux médecins de famille une mise à jour sur l’approche au diagnostic et à la prise en charge des comportements sexuels inappropriés (CSI) chez les personnes atteintes de démence. Sources des données On a fait une recherche dans MEDLINE et EMBASE pour cerner des articles pertinents publiés avant juin 2012. On n’a trouvé aucune étude de niveau I; la plupart des articles fournissaient des données probantes de niveau III. Message principal Les comportements sexuels inappropriés sont fréquents chez les personnes atteintes de démence. Divers facteurs (p. ex., culturels, religieux, perspectives sociétales de la sexualité gériatrique, questions médicolégales) pourraient compliquer l’évaluation de tels comportements et doivent être pris en compte pour permettre une prise en charge appropriée à chaque patient. Il existe des outils pour documenter les CSI. Des interventions créatives non pharmacologiques pour les CSI pourraient être efficaces quand elles sont adaptées à chaque patient. Certaines pharmacothérapies (p. ex., antidépresseurs, antiandrogènes, antipsychotiques et anticonvulsifs) ont été proposées pour les symptômes qui ne répondent pas aux interventions non pharmacologiques. Par ailleurs, les données probantes à l’appui des traitements à l’aide de médicaments sont limitées, les effets secondaires demeurent un aspect important à considérer et il est incertain s’ils devraient être utilisés comme traitement de première ou de deuxième intention. Conclusion Quoiqu’il n’y ait pas d’algorithme de traitements empiriquement établi pour les CSI reliés à la démence, les ouvrages actuels offrent certaines données probantes concernant diverses thérapies pharmacologiques et non pharmacologiques. Des recherches de grande qualité plus approfondies sont nécessaires de toute urgence pour guider les médecins de famille qui prennent en charge des patients qui ont des CSI reliés à la

  16. Primitive cerebral melanoma: a diagnostic and management challenge. About 2 cases.

    PubMed

    Mondot, L; Almairac, F; Vandenbos, F; Fontaine, D; Frenay, M; Chanalet, S

    2012-07-01

    In this report of two cases of solitary cerebral meningeal melanoma, a rare tumor that presents both diagnostic and management challenges, the diagnosis of these lesions was based on a solitary leptomeningeal mass on MRI, a high mitotic rate on histology and the absence of extracerebral localizations. Although the radiological patterns can mimic those of other melanocytic tumors, MRI is a useful diagnostic tool for narrowing the differential diagnosis. Surgical removal remains the only effective treatment of these lesions, and can lead to prolonged survival in a few cases. PMID:22169116

  17. Human papillomavirus DNA in oral mucosal lesions.

    PubMed

    Giovannelli, Lucia; Campisi, Giuseppina; Lama, Anna; Giambalvo, Ornella; Osborn, John; Margiotta, Valerio; Ammatuna, Pietro

    2002-03-15

    This study determined the presence of human papillomavirus (HPV) DNA in oral mucosa cells from 121 patients with different types of oral mucosal lesions (13 squamous cell carcinomas, 59 potentially malignant lesions, 49 benign erosive ulcerative lesions) and from 90 control subjects. HPV DNA was detected by nested polymerase chain reaction, and genotype was determined by DNA sequencing. HPV prevalence was 61.5% in carcinomas, 27.1% in potentially malignant lesions, 26.5% in erosive ulcerative lesions, and 5.5% in control subjects. The risk of malignant or potentially malignant lesions was associated with HPV and was statistically significant. HPV-18 was found in 86.5% of HPV-positive lesions but was not associated with a particular type of lesion and was found in 80% of the HPV-positive control subjects. HPV infection was related to older age but not to sex, smoking, or alcohol use; the presence of lesions in the oral cavity increased the risk of HPV infection.

  18. Histopathological characterization of a Cameron lesion.

    PubMed

    Katz, Jordan; Brar, Sonia; Sidhu, Jagmohan S

    2012-10-01

    Cameron lesions are linear erosions located at the neck of a hiatal hernia (HH) in patients with a large HH. The prevalence has been seen in up to 5% of patients with HH who undergo esophagogastroduodenoscopy, and they can be associated with overt gastrointestinal bleeding or anemia. These lesions occur due to vascular compression by the diaphragm in a large sliding HH. Histopathologic changes seen in the biopsy tissue of a Cameron lesion are due to ischemia, but this ischemia is reversible with treatment of HH. The existence of this entity and the histopathologic picture of a Cameron lesion is not well known to pathologists, and therefore, a microscopic picture of a Cameron lesion can be easily confused with ischemic gastritis. Ischemic gastritis is the result of atherosclerosis, usually seen in older people, unrelated to HH, and is not easily reversible. The authors received a gastric biopsy of a hiatal hernia without any associated clinical diagnosis of a Cameron lesion conveyed to the pathologist. This biopsy tissue showed ischemic changes in the gastric mucosa on microscopic examination. Diagnosis of ischemic gastritis was considered but ruled out after the case was discussed with the gastroenterologist. The correct diagnosis was made once the clinical diagnosis of HH with Cameron lesion (ie, a vertical red erosion) was made known to the pathologist. By reporting this case, the authors aim to increase awareness of Cameron lesion among pathologists so that they ask about the presence of a Cameron lesion before making the diagnosis of ischemic gastritis.

  19. Polypoid Lesions of the Gallbladder in Children

    PubMed Central

    Beneck, Debra; Bostwick, Howard E.

    1997-01-01

    Polypoid lesions of the gallbladder in children are rare. We report a case of a gallbladder polyp in a 14-year-old boy who presented with recurrent right upper quadrant abdominal pain. Ultrasound examination of the abdomen revealed a polypoid lesion of the gallbladder. His symptoms resolved after laparoscopic cholecystectomy. Histological examination of the gallbladder demonstrated a benign adenomatous polyp. Although the experience with polypoid lesions of the gallbladder in children is limited, we currently recommend cholecystectomy because these lesions are associated with acalculous cholecystitis, and because their long-term effects are unknown. PMID:9876680

  20. The Bennett lesion of the shoulder.

    PubMed

    De Maeseneer, M; Jaovisidha, S; Jacobson, J A; Tam, W; Schils, J P; Sartoris, D J; Fronek, J; Resnick, D

    1998-01-01

    In this article we review the imaging features and significance of the Bennett lesion of the shoulder. Standard radiographic, computed arthrotomographic, and MR findings in three baseball pitchers diagnosed with Bennett lesions of the shoulder are discussed. A crescent-shaped region of mineralization at the posteroinferior aspect of the glenoid rim, consistent with a Bennett lesion, arises at the insertion of the posterior joint capsule. The diagnosis of this lesion, typically in baseball pitchers, should raise suspicion for associated labral and rotator cuff abnormalities.

  1. Comet Lesions in Patients with Pseudoxanthoma Elasticum

    PubMed Central

    Tatlıpınar, Sinan; Şahan, Berna; Altunsoy, Muhsin

    2015-01-01

    Pseudoxanthoma elasticum (PXE) is a genetic multisystemic disorder affecting the skin, eyes and cardiovascular system. Basic fundoscopic findings in PXE result from Bruch’s membrane involvement. The most important fundoscopic findings are angioid streaks. Other significant ocular findings are peau d’orange appearance, optic disc drusen, pattern dystrophy-like macular appearance, comet lesions, and choroidal neovascularization. Comet lesions are a pathognomonic ocular finding for PXE. The presence of both angioid streaks in the fundus and typical skin lesions should alert clinicians to PXE. Herein, we present two PXE cases with comet lesions. PMID:27800246

  2. Benign lymphoepithelial lesions of the salivary glands.

    PubMed

    Kelly, D R; Spiegel, J C; Maves, M

    1975-01-01

    The benign lymphoepithelial lesion of the salivary glands has been labeled with multiple, confusing terms. We recommend the abandonment of the vague term of Mikulicz disease. The histopathologic findings of lymphoid infiltration, intraductal proliferation, epimyoepithelial islands, and acinar atrophy are presented. The relationship between this lesion and autoimmune diseases, including Sjögren syndrome, is noted. Difficulty of histopathologic differentiation between this lesion and malignant lymphoma can occur. The association of the benign lymphoepithelial lesion with the simultaneous presence or future development of lymphoma is discussed.

  3. Ulcere de Marjolin: complication redoutable des sequelles de brûlures

    PubMed Central

    Ouahbi, S.; Droussi, H.; Boukind, S.; Dlimi, M.; Elatiqi, O.K.; Elamrani, M.D.; Benchamkha, Y.; Ettalbi, S.

    2013-01-01

    Summary L’ulcère de Marjolin désigne la transformation maligne d’une cicatrice de brûlure ou de toute autre plaie ou ulcération chronique. Le type histologique prédominant reste le carcinome épidermoïde, et il est caractérisé par son agressivité locale, des métastases plus fréquentes, un risque de récurrence et une mortalité plus importante que les carcinomes épidermoïdes classiques. Notre travail est une étude rétrospective portant sur 21 cas d’ulcère de Marjolin, colligés au service de chirurgie plastique du CHU Mohammed VI de Marrakech, avec pour but de relever les aspects épidémiologiques, thérapeutiques et évolutifs de cette pathologie. L’amélioration du pronostic nécessite non seulement un diagnostic et un traitement précoce, mais surtout une attitude préventive qui consiste en des greffes cutanées précoces et des soins réguliers de toute cicatrice de brûlure. PMID:24799850

  4. Characteristics, detection methods, and treatment of questionable occlusal carious lesions: findings from The National Dental Practice-Based Research Network

    PubMed Central

    Makhija, Sonia K; Gilbert, Gregg H.; Funkhouser, Ellen; Bader, James D; Gordan, Valeria V.; Rindal, D. Brad; Pihlstrom, Daniel J.; Qvist, Vibeke

    2014-01-01

    Questionable occlusal carious lesions (QOC) can be defined as an occlusal tooth surface with no cavitation and no radiographic radiolucencies, but caries is suspected due to roughness, surface opacities, or staining. An earlier analysis of data from this study indicates ⅓ of patients have a QOC. The objective of this report is to quantify the characteristics of these common lesions, diagnostic aids used, and treatment of QOC. A total of 82 dentist and hygienist practitioner-investigators from the United States and Denmark in The National Dental Practice-Based Research Network participated. When consented patients presented with a QOC, information was recorded about the patient, tooth, lesion, and treatments. 2,603 QOC from 1,732 patients were analyzed. Lesions were usually associated with a fissure, on molars, and varied from yellow to black in color. Half presented with a chalky luster and had a rough surface when examined with an explorer. There was an association between color and luster, 10% were chalky-light, 47% were shiny-dark, and 42% were mixtures. A higher proportion of chalky than shiny lesions were light (22% vs. 9%; p < 0.001). Lesions light in color were less common in adults than pediatric patients (9% vs. 32%; p < 0.001). Lesions that were chalky and light were more common among pediatric than adult patients (22% vs. 6%, p < 0.001). This is the first study to investigate characteristics of QOC in routine clinical practice. Clinicians commonly face this diagnostic uncertainty. Determining the characteristics of these lesions are relevant when making diagnostic and treatment decisions. PMID:24480989

  5. Characteristics, detection methods and treatment of questionable occlusal carious lesions: findings from the national dental practice-based research network.

    PubMed

    Makhija, S K; Gilbert, G H; Funkhouser, E; Bader, J D; Gordan, V V; Rindal, D B; Pihlstrom, D J; Qvist, V

    2014-01-01

    Questionable occlusal carious lesions (QOC) can be defined as an occlusal tooth surface with no cavitation and no radiographic radiolucencies, but caries is suspected due to roughness, surface opacities or staining. An earlier analysis of data from this study indicates 1/3 of patients have a QOC. The objective of this report has been to quantify the characteristics of these common lesions, the diagnostic aids used and the treatment of QOC. A total of 82 dentist and hygienist practitioner-investigators from the USA and Denmark in the National Dental Practice-Based Research Network participated. When consenting patients presented with a QOC, information was recorded about the patient, tooth, lesion and treatments. A total of 2,603 QOC from 1,732 patients were analyzed. The lesions were usually associated with a fissure, on molars, and varied from yellow to black in color. Half presented with a chalky luster and had a rough surface when examined with an explorer. There was an association between color and luster: 10% were chalky-light, 47% were shiny-dark and 42% were mixtures. A higher proportion of chalky than of shiny lesions were light (22 vs. 9%; p < 0.001). Lesions light in color were less common in adults than in pediatric patients (9 vs. 32%; p < 0.001). Lesions that were chalky and light were more common among pediatric than among adult patients (22 vs. 6%; p < 0.001). This is the first study to investigate characteristics of QOC in routine clinical practice. Clinicians commonly face this diagnostic uncertainty. Determining the characteristics of these lesions is relevant when making diagnostic and treatment decisions. PMID:24480989

  6. Les conseils des cliniciens canadiens en matière de commotion dans le sport sont-ils cohérents?

    PubMed Central

    Carson, James D.; Rendely, Alexandra; Garel, Alisha; Meaney, Christopher; Stoller, Jacqueline; Kaicker, Jatin; Hayden, Leigh; Moineddin, Rahim; Frémont, Pierre

    2016-01-01

    Résumé Objectif Comparer les connaissances et l’utilisation des recommandations concernant la prise en charge de la commotion dans le sport (CDS) démontrées par les spécialistes de la médecine du sport et de l’exercice (SMSE) et les urgentologues afin d’évaluer la réussite du transfert des connaissances sur la CDS au Canada. Conception Un sondage à choix multiples envoyé par courriel et autoadministré par des SMSE et des urgentologues. La validité du contenu du sondage a fait l’objet d’une évaluation. Contexte Canada. Participants Le sondage a été complété entre mai et juillet 2012 par des SMSE qui ont réussi l’examen menant au diplôme de l’Académie canadienne de la médecine du sport et de l’exercice et des urgentologues qui n’avaient pas ce diplôme. Principaux paramètres à l’étude La connaissance et l’identification des sources d’information sur la prise en charge des commotions, l’utilisation des stratégies de diagnostic de la commotion et l’utilisation d’une terminologie courante et cohérente dans l’explication des stratégies de repos aux patients après une CDS. Résultats Le taux de réponse était de 28 % (305 sur 1085). Les taux de réponse par les SMSE et les urgentologues se situaient respectivement à 41 % (147 sur 360) et 22 % (158 sur 725). Parmi les répondants, 41 % des urgentologues et 3 % des SMSE n’étaient pas au courant de l’existence de déclarations consensuelles sur la commotion dans le sport; 74 % des SMSE utilisaient « habituellement ou toujours » la version 2 de l’Outil d’évaluation de la commotion dans le sport (SCAT2), tandis que 88 % des urgentologues n’utilisaient jamais le SCAT2. Aucune réponse uniforme n’a été documentée à la question visant à connaître les meilleurs modes de repos cognitif. Conclusion Nous avons cerné des différences et un manque d’uniformité chez les SMSE et les urgentologues dans la mise en application des recommandations

  7. Diagnostic Lessons as Assessment.

    ERIC Educational Resources Information Center

    Walker, Barbara J.

    Embedded in a sensitive instructional context rather than a stifling testing atmosphere, diagnostic lessons provide assessment that is reliable, practical, valid, and efficient. In this type of assessment, there are several determiners of instructional placement: (1) students' propensity to adapt strategies as a result of specified instruction,…

  8. Sexual Addiction: Diagnostic Problems

    ERIC Educational Resources Information Center

    Giugliano, John R.

    2009-01-01

    In recent years clinicians report a great deal of concern about definition, diagnostic assessment, and treatment modalities when dealing with what might be called out-of-control sexual behavior. Many terms have been used to describe the phenomenon of problematic sexual behavior. Many of these concepts overlap, some are no longer popular, and some…

  9. Diagnostic Testing Project.

    ERIC Educational Resources Information Center

    McArthur, David L.

    This paper presents an explanation of the program design of the three separate Pascal-language programs which comprise UCLA's Diagnostic Testing Package "DX." The three parts of the DX test package are three closely interrelated programs--Editest, Runtest, and Summary. Editest serves the following functions: (1) the creation of a suitable…

  10. Equivalent Diagnostic Classification Models

    ERIC Educational Resources Information Center

    Maris, Gunter; Bechger, Timo

    2009-01-01

    Rupp and Templin (2008) do a good job at describing the ever expanding landscape of Diagnostic Classification Models (DCM). In many ways, their review article clearly points to some of the questions that need to be answered before DCMs can become part of the psychometric practitioners toolkit. Apart from the issues mentioned in this article that…

  11. Heterodyne laser diagnostic system

    DOEpatents

    Globig, Michael A.; Johnson, Michael A.; Wyeth, Richard W.

    1990-01-01

    The heterodyne laser diagnostic system includes, in one embodiment, an average power pulsed laser optical spectrum analyzer for determining the average power of the pulsed laser. In another embodiment, the system includes a pulsed laser instantaneous optical frequency measurement for determining the instantaneous optical frequency of the pulsed laser.

  12. Diagnostics for induction accelerators

    SciTech Connect

    Fessenden, T.J.

    1996-04-01

    The induction accelerator was conceived by N. C. Christofilos and first realized as the Astron accelerator that operated at LLNL from the early 1960`s to the end of 1975. This accelerator generated electron beams at energies near 6 MeV with typical currents of 600 Amperes in 400 ns pulses. The Advanced Test Accelerator (ATA) built at Livermore`s Site 300 produced 10,000 Ampere beams with pulse widths of 70 ns at energies approaching 50 MeV. Several other electron and ion induction accelerators have been fabricated at LLNL and LBNL. This paper reviews the principal diagnostics developed through efforts by scientists at both laboratories for measuring the current, position, energy, and emittance of beams generated by these high current, short pulse accelerators. Many of these diagnostics are closely related to those developed for other accelerators. However, the very fast and intense current pulses often require special diagnostic techniques and considerations. The physics and design of the more unique diagnostics developed for electron induction accelerators are presented and discussed in detail.

  13. Beam Diagnostics for FACET

    SciTech Connect

    Li, S.Z.; Hogan, M.J.; /SLAC

    2011-08-19

    FACET, the Facility for Advanced Accelerator and Experimental Tests, is a new facility being constructed in sector 20 of the SLAC linac primarily to study beam driven plasma wakefield acceleration beginning in summer 2011. The nominal FACET parameters are 23GeV, 3nC electron bunches compressed to about 20 {micro}m long and focussed to about 10 {micro}m wide. Characterization of the beam-plasma interaction requires complete knowledge of the incoming beam parameters on a pulse-to-pulse basis. FACET diagnostics include Beam Position Monitors, Toroidal current monitors, X-ray and Cerenkov based energy spectrometers, optical transition radiation (OTR) profile monitors and coherent transition radiation (CTR) bunch length measurement systems. The compliment of beam diagnostics and their expected performance are reviewed. Beam diagnostic measurements not only provide valuable insights to the running and tuning of the accelerator but also are crucial for the PWFA experiments in particular. Beam diagnostic devices are being set up at FACET and will be ready for beam commissioning in summer 2011.

  14. Evaluation of submucosal lesions of the large intestine: part 1. Neoplasms.

    PubMed

    Pickhardt, Perry J; Kim, David H; Menias, Christine O; Gopal, Deepak V; Arluk, Glen M; Heise, Charles P

    2007-01-01

    At luminal evaluation of the large intestine, any masslike protrusion that is covered by normal mucosa, whether the underlying process is intramural or extramural in origin, may be reported as a submucosal lesion. The full characterization of submucosal lesions may be difficult with optical colonoscopy alone, and endoscopic biopsy is often nondiagnostic. Cross-sectional radiologic imaging studies allow evaluation of the entire thickness of the bowel wall and surrounding tissues and often provide additional information with regard to lesion origin, internal composition, and extent of disease. Likewise, it may be difficult to distinguish submucosal lesions from mucosal polyps on radiologic images, and optical colonoscopy may provide complementary information about superficial submucosal soft-tissue lesions that are detected at computed tomographic (CT) colonography or barium imaging. Depending on the specific clinical situation, colonoscopy, CT colonography, transrectal ultrasonography, and magnetic resonance imaging all may play an important role in the diagnostic evaluation of submucosal lesions of the large intestine. It is important that radiologists be familiar with the multimodality imaging appearances of such entities so that neoplasms--especially those that are malignant--can be accurately identified and characterized and effectively managed.

  15. Proliferative and nonproliferative lesions of the rat and mouse urinary system.

    PubMed

    Frazier, Kendall S; Seely, John Curtis; Hard, Gordon C; Betton, Graham; Burnett, Roger; Nakatsuji, Shunji; Nishikawa, Akiyoshi; Durchfeld-Meyer, Beate; Bube, Axel

    2012-06-01

    The INHAND Project (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) is a joint initiative of the Societies of Toxicologic Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP), and North America (STP) to develop an internationally accepted nomenclature for proliferative and nonproliferative lesions in laboratory animals. The purpose of this publication is to provide a standardized nomenclature for classifying lesions observed in the urinary tract of rats and mice. The standardized nomenclature of urinary tract lesions presented in this document is also available electronically on the Internet (http://www.goreni.org/). Sources of material included histopathology databases from government, academia, and industrial laboratories throughout the world. Content includes spontaneous developmental and aging lesions as well as those induced by exposure to test materials. A widely accepted and utilized international harmonization of nomenclature for urinary tract lesions in laboratory animals will decrease confusion among regulatory and scientific research organizations in different countries and provide a common language to increase and enrich international exchanges of information among toxicologists and pathologists.

  16. New brain lesions in a patient with sarcoidosis: is it neurosarcoidosis?

    PubMed

    Pandey, Subodh; Mukhopadhyay, Sanjay; Iannuzzi, Michael C; Sah, Birendra P

    2014-01-01

    A 45-year-old woman with pulmonary sarcoidosis diagnosed 5 years previously, who was on treatment with prednisone and methotrexate for 1year, developed partial seizure with secondary generalization. MRI showed three non-cavitary enhancing lesions in the cerebello-occipital region. These lesions were presumed to be neurosarcoidosis. Methotrexate was discontinued, prednisone dose was increased and azathiopurine and levetiracetam were added. While on treatment, follow up imaging showed enlarging brain lesions. Biopsy of the lesions showed Epstein Barr virus (EBV) positive diffuse B cell lymphoma. Immunosuppressants were tapered off and she was begun on Rituximab. Because of lack of improvement after 4 cycles of Rituximab, she was then treated with high dose Methotrexate and Temozolamide. We present this case as a diagnostic challenge. New enhancing brain lesions occurring in a patient with long standing sarcoidosis, while likely to be neurosarcoidosis, may be due to a complication of immunosuppressant therapy. The need for early biopsy, if the lesions do not improve, should be considered. PMID:24751455

  17. Diagnostic yield of brain biopsies in children presenting to neurology.

    PubMed

    Venkateswaran, Sunita; Hawkins, Cynthia; Wassmer, Evangeline

    2008-03-01

    The role of brain biopsy is well established in patients with neoplastic lesions, with a diagnostic yield approaching 95%. The diagnostic yield of brain biopsy in adults with neurological decline varies from 20% to 43%. Only a few studies have examined the diagnostic yield of brain biopsy in children with idiopathic neurological decline. A retrospective analysis was conducted on all open and closed pediatric brain biopsies performed between January 1988 and May 2003. Biopsies were performed for diagnostic purposes in patients showing a progressively deteriorating neurologic course in whom less-invasive modalities such as neuroimaging, electroencephalography (EEG), and molecular genetic studies were either negative or inconclusive. Immunocompromised patients were included. Patients were excluded if the preoperative diagnosis was a neoplasm or if the patient was undergoing a resection as part of a work-up for intractable epilepsy. Each patient underwent numerous investigations before brain biopsy. The utility of each biopsy was analyzed. Sixty-six children had brain biopsies performed for diagnostic purposes during the study period. Patient ages ranged from 2 months to 16 years and 9 months at the time of biopsy. The diagnostic yield was 48.5% overall, with a yield of 68.8% between 1996 and 2003. Of the total, 26 (39.4%) biopsies were both diagnostic and useful. Patients most frequently presented with seizures (56.1%) and encephalopathy (33%). The most frequently diagnosed disease was vasculitis (18.2%). A total of 71.9% of patients with diagnostic biopsies improved with appropriate treatment. Brain biopsy in children had a diagnostic yield of 48.5% in our series. A specific diagnosis may help in management and outcome, especially with a diagnosis of vasculitis. PMID:18192645

  18. Diagnostic application of KRAS mutation testing in uterine microglandular proliferations.

    PubMed

    Hong, Wei; Abi-Raad, Rita; Alomari, Ahmed K; Hui, Pei; Buza, Natalia

    2015-07-01

    Microglandular proliferations often pose a diagnostic challenge in small endocervical and endometrial biopsies. Microglandular hyperplasia (MGH) is one of the most common pseudoneoplastic glandular proliferations of uterine cervix, which can closely mimic endometrial adenocarcinomas (EAC) with a microglandular pattern (microglandular EAC). Although MGH is typically characterized by relatively uniform nuclei and rare to absent mitoses, atypical forms with architectural and/or cytologic deviation from the usual morphology have been previously described. Recently, a series of MGH with high mitotic activity has also been documented. Although careful morphological assessment and immunohistochemical workup can resolve the diagnostic dilemma in some cases, additional differential diagnostic tools are needed to separate both the common and atypical variants of MGH from EAC with microglandular pattern. Frequent KRAS mutation has been previously reported in endometrial complex mucinous lesions and endometrial mucinous carcinomas. However, the diagnostic utility of KRAS mutation analysis has not yet been explored in the context of cervical and endometrial microglandular lesions. Twelve mitotically active MGH cases and 15 cases of EAC with microglandular growth pattern were selected for the study. KRAS mutation analysis was performed in all cases by highly sensitive single-strand conformation polymorphism analysis. Clinical history and follow-up data were retrieved from electronic medical records. KRAS mutation was absent in all MGH cases, whereas 9 (60%) of 15 microglandular EAC cases tested positive for KRAS mutation. Our data indicate that KRAS mutation analysis may offer additional discriminatory power in separating benign MGH from EAC with microglandular pattern.

  19. Application of cytology and molecular biology in diagnosing premalignant or malignant oral lesions

    PubMed Central

    Mehrotra, Ravi; Gupta, Anurag; Singh, Mamta; Ibrahim, Rahela

    2006-01-01

    Early detection of a premalignant or cancerous oral lesion promises to improve the survival and the morbidity of patients suffering from these conditions. Cytological study of oral cells is a non-aggressive technique that is well accepted by the patient, and is therefore an attractive option for the early diagnosis of oral cancer, including epithelial atypia and squamous cell carcinoma. However its usage has been limited so far due to poor sensitivity and specificity in diagnosing oral malignancies. Lately it has re-emerged due to improved methods and it's application in oral precancer and cancer as a diagnostic and predictive method as well as for monitoring patients. Newer diagnostic techniques such as "brush biopsy" and molecular studies have been developed. Recent advances in cytological techniques and novel aspects of applications of scraped or exfoliative cytology for detecting these lesions and predicting their progression or recurrence are reviewed here. PMID:16556320

  20. Oral precancerous lesions: Problems of early detection and oral cancer prevention

    NASA Astrophysics Data System (ADS)

    Gileva, Olga S.; Libik, Tatiana V.; Danilov, Konstantin V.

    2016-08-01

    The study presents the results of the research in the structure, local and systemic risk factors, peculiarities of the clinical manifestation, and quality of primary diagnosis of precancerous oral mucosa lesions (OMLs). In the study a wide range of OMLs and high (25.4%) proportion of oral precancerous lesions (OPLs) in their structure was indicated. The high percentage of different diagnostic errors and the lack of oncological awareness of dental practitioners, as well as the sharp necessity of inclusion of precancer/cancer early detection techniques into their daily practice were noted. The effectiveness of chemilumenescence system of early OPLs and oral cancer detection was demonstrated, the prospects of infrared thermography as a diagnostic tool were also discussed.

  1. Amylase crystalloids in salivary gland lesions: report of a case with a review of the literature.

    PubMed

    López-Ríos, F; Díaz-Bustamante, T; Serrano-Egea, A; Jiménez, J; de Agustín, P

    2001-07-01

    Several types of crystalloids may be found in fine-needle aspiration cytology of salivary gland lesions. Amylase crystalloids (sometimes referred to as nontyrosine crystalloids) are tabular structures with frequent pointed ends that have received little attention until recent years. We report on a parotid cyst containing the latter type of crystalloids in a 51-yr-old white woman. The cytologic and radiologic findings were diagnostic of sialolithiasis. To the best of our knowledge, amylase crystalloids have been observed only in benign salivary gland lesions. Although this statement may be helpful in the diagnostic workup of patients presenting with parotid lumps, we do not recommend rendering a specific diagnosis based on the presence of such crystalloids. Good clinical and radiological correlation, as well as close follow-up, is mandatory in this setting.

  2. MR imaging with Gd-DTPA in lesions of the head and neck.

    PubMed

    Vogl, T h; Dresel, S; Juergens, M; Assal, J; Lissner, J

    1993-08-01

    The diagnostic value of MR in the head and neck with special emphasis on the contrast medium Gd-DTPA will be demonstrated. A total of 1,260 patients underwent MR with different pulse sequences plain and with Gd-DTPA. The sequences were analyzed and compared with CT. Due to the different pattern of enhancement the contrast medium helped in differentiating malignant and benign tumors from other processes like cysts and inflammatory changes. Except lesions with small bony erosion and inflammatory changes of the salivary glands MR with Gd-DTPA proved to be diagnostically advantageous in all cases. Gd-DTPA improved the delineation of tumor margins. MR in combination with Gd-DTPA offers a lot of new advantages for diagnosing lesions of the head and neck. However, due to the prolonged examination time and the lack of noninvasiveness the use of Gd-DTPA has to be considered critical for every single area of the head and neck.

  3. Etude des effets du martelage repetitif sur les contraintes residuelles

    NASA Astrophysics Data System (ADS)

    Hacini, Lyes

    L'assemblage par soudage peut engendrer des contraintes residuelles. Ces contraintes provoquent des fissurations prematurees et un raccourcissement de la duree de vie des composants. Dans ce contexte, le martelage robotise est utilise pour relaxer ces contraintes residuelles. Trois volets sont presentes: le premier est l'evaluation des effets des impacts unitaires repetes sur le champ de contraintes developpe dans des plaques d'acier inoxydable austenitique 304L vierges ou contenant des contraintes residuelles initiales. Dans la deuxieme partie de ce projet, le martelage est applique grace au robot SCOMPI. Les contraintes residuelles induites et relaxees par martelage sont ensuite mesurees par la methode des contours, qui a ete adaptee a cet effet. Dans la troisieme partie, le martelage est modelise par la methode des elements finis. Un modele axisymetrique developpe grace au logiciel ANSYS permet de simuler des impacts repetes d'un marteau elastique sur une plaque ayant un comportement elastoplastique.

  4. Pigmented purpuric dermatosis or mycosis fungoides: A diagnostic dilemma.

    PubMed

    Riyaz, Najeeba; Sasidharanpillai, Sarita; Abdul Latheef, Ettappurath N; Davul, Hena; Ashraf, Febin

    2016-01-01

    Pigmented purpuric dermatoses (PPD), a group of vascular disorders with variable clinical picture is reported in all races and age groups with a male predilection. There are reports of mycosis fungoides manifesting as pigmented purpura as well as progression of PPD to cutaneous T-cell lymphoma. The diagnostic dilemma is compounded by PPD manifesting histological similarity to mycosis fungoides. Currently, it is believed that PPD with monoclonal T-cell population is more likely to progress to malignancy. We report a 31-year-old male patient who presented with the lichenoid clinical variant of PPD lesions that mimicked mycosis fungoides on histopathology. Gene rearrangement studies identified a polyclonal T-cell population. The patient responded to photochemotherapy, which is beneficial in both PPD and mycosis fungoides. Our case signifies the limitations of current diagnostic modalities in accurately distinguishing PPD from cutaneous lymphoma. Data on disease progression in similar cases may enable us to formulate better diagnostic definitions.

  5. Pigmented purpuric dermatosis or mycosis fungoides: A diagnostic dilemma

    PubMed Central

    Riyaz, Najeeba; Sasidharanpillai, Sarita; Abdul Latheef, Ettappurath N.; Davul, Hena; Ashraf, Febin

    2016-01-01

    Pigmented purpuric dermatoses (PPD), a group of vascular disorders with variable clinical picture is reported in all races and age groups with a male predilection. There are reports of mycosis fungoides manifesting as pigmented purpura as well as progression of PPD to cutaneous T-cell lymphoma. The diagnostic dilemma is compounded by PPD manifesting histological similarity to mycosis fungoides. Currently, it is believed that PPD with monoclonal T-cell population is more likely to progress to malignancy. We report a 31-year-old male patient who presented with the lichenoid clinical variant of PPD lesions that mimicked mycosis fungoides on histopathology. Gene rearrangement studies identified a polyclonal T-cell population. The patient responded to photochemotherapy, which is beneficial in both PPD and mycosis fungoides. Our case signifies the limitations of current diagnostic modalities in accurately distinguishing PPD from cutaneous lymphoma. Data on disease progression in similar cases may enable us to formulate better diagnostic definitions. PMID:27294054

  6. Application of Raman spectroscopy to identify microcalcifications and underlying breast lesions at stereotactic core needle biopsy

    PubMed Central

    Barman, Ishan; Dingari, Narahara Chari; Saha, Anushree; McGee, Sasha; Galindo, Luis H.; Liu, Wendy; Plecha, Donna; Klein, Nina; Dasari, Ramachandra Rao; Fitzmaurice, Maryann

    2013-01-01

    Microcalcifications are a feature of diagnostic significance on a mammogram and a target for stereotactic breast needle biopsy. Here, we report development of a Raman spectroscopy technique to simultaneously identify microcalcification status and diagnose the underlying breast lesion, in real-time, during stereotactic core needle biopsy procedures. Raman spectra were obtained ex vivo from 146 tissue sites from fresh stereotactic breast needle biopsy tissue cores from 33 patients, including 50 normal tissue sites, 77 lesions with microcalcifications, and 19 lesions without microcalcifications, using a compact clinical system. The Raman spectra were modeled based on the breast tissue components and a support vector machine framework was used to develop a single-step diagnostic algorithm to distinguish normal tissue, fibrocystic change (FCC), fibroadenoma (FA) and breast cancer, in the absence and presence of microcalcifications. This algorithm was subjected to leave-one-site-out cross-validation, yielding a positive predictive value, negative predictive value, sensitivity and specificity of 100%, 95.6%, 62.5% and 100% for diagnosis of breast cancer (with or without microcalcifications) and an overall accuracy of 82.2% for classification into specific categories of normal tissue, FCC, FA or breast cancer (with and without microcalcifications). Notably, the majority of breast cancers diagnosed are ductal carcinoma in situ (DCIS), the most common lesion associated with microcalcifications, which could not be diagnosed using previous Raman algorithm(s). Our study demonstrates the potential of Raman spectroscopy to concomitantly detect microcalcifications and diagnose associated lesions, including DCIS, and thus provide real-time feedback to radiologists during such biopsy procedures, reducing non-diagnostic and false negative biopsies. PMID:23729641

  7. Arthroscopic optical coherence tomography provides detailed information on articular cartilage lesions in horses.

    PubMed

    te Moller, N C R; Brommer, H; Liukkonen, J; Virén, T; Timonen, M; Puhakka, P H; Jurvelin, J S; van Weeren, P R; Töyräs, J

    2013-09-01

    Arthroscopy enables direct inspection of the articular surface, but provides no information on deeper cartilage layers. Optical coherence tomography (OCT), based on measurement of reflection and backscattering of light, is a diagnostic technique used in cardiovascular surgery and ophthalmology. It provides cross-sectional images at resolutions comparable to that of low-power microscopy. The aim of this study was to determine if OCT is feasible for advanced clinical assessment of lesions in equine articular cartilage during diagnostic arthroscopy. Diagnostic arthroscopy of 36 metacarpophalangeal joints was carried out ex vivo. Of these, 18 joints with varying degrees of cartilage damage were selected, wherein OCT arthroscopy was conducted using an OCT catheter (diameter 0.9 mm) inserted through standard instrument portals. Five sites of interest, occasionally supplemented with other locations where defects were encountered, were arthroscopically graded according to the International Cartilage Repair Society (ICRS) classification system. The same sites were evaluated qualitatively (ICRS classification and morphological description of the lesions) and quantitatively (measurement of cartilage thickness) on OCT images. OCT provided high resolution images of cartilage enabling determination of cartilage thickness. Comparing ICRS grades determined by both arthroscopy and OCT revealed poor agreement. Furthermore, OCT visualised a spectrum of lesions, including cavitation, fibrillation, superficial and deep clefts, erosion, ulceration and fragmentation. In addition, with OCT the arthroscopically inaccessible area between the dorsal MC3 and P1 was reachable in some cases. Arthroscopically-guided OCT provided more detailed and quantitative information on the morphology of articular cartilage lesions than conventional arthroscopy. OCT could therefore improve the diagnostic value of arthroscopy in equine orthopaedic surgery. PMID:23810744

  8. High-flow priapism: a novel way of lateralizing the lesion in radiologically inapparent cases.

    PubMed

    Ankem, M K; Gazi, M A; Ferlise, V J; Hartanto, V H; Doshi, N M; Diamond, S M

    2001-04-01

    High-flow priapism is a rare entity, which is typically diagnosed with the help of either color flow Doppler ultrasound or arteriogram. In the case presented, both of these diagnostic modalities were unsuccessful in uncovering a vascular lesion. The patient underwent an empiric selective embolization of the left pudendal artery followed by a repeat angiogram of the right because of persistent tumescence. This procedure uncovered a previously unseen arteriolacunar fistula, which was treated successfully with a second selective embolization.

  9. Symmetrical thalamic lesions in infants.

    PubMed Central

    Eicke, M; Briner, J; Willi, U; Uehlinger, J; Boltshauser, E

    1992-01-01

    Clinical observations and findings on imaging are reported in six newborns with symmetrical thalamic lesions (STL). In three cases the diagnosis was confirmed by postmortem examination. Characteristic observations in this series and 17 previously reported cases include no evidence of perinatal asphyxia, high incidence of polyhydramnios, absent suck and swallow, absent primitive reflexes, appreciable spasticity at or within days of birth, lack of psychomotor development, and death within days or months. Characteristic pathological findings include loss of neurons, astrogliosis, and 'incrusted' neurons particularly in the thalamus. In two thirds of cases the basal ganglia and brain stem are involved as well. A hypoxic-ischaemic event occurring two to four weeks before birth is most likely responsible for STL. Bilateral thalamic calcification can often, but not always, be demonstrated in the newborn period by computed tomography and/or cranial ultrasound. The presence of these calcifications and the observation of spasticity at birth imply that the responsible insult occurred at least two to four weeks earlier. The small number of published cases with STL suggest that it may be easily missed. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:1536580

  10. [Asterixis in focal brain lesions].

    PubMed

    Velasco, F; Gomez, J C; Zarranz, J J; Lambarri, I; Ugalde, J

    2004-05-01

    Asterixis is a motor control disorder characterized by the presence of abnormal movements of the lower limbs in the vertical plane during posture maintenance. Asterixis is usually bilateral and associated with toxic-metabolic metabolic encephalopathies. Unilateral asterixis is less frequent and it normally indicates focal brain damage. We report the cases of four patients (two males/two females), aged 57 to 83 years, suffering from uni or bilateral asterixis associated with focal brain damage. All patients underwent CT brain scan and a neurophysiological study (parietal EMG and/or PES). In addition, any toxic-metabolic cause that could be produced by this clinical phenomenon was ruled out with the appropriate testing. Unilateral asterixis is a clinical symptom that may indicate the presence of focal brain damage. Often, it is ignored or overlooked during routine neurological examinations. On the other hand, the presence of a bilateral asterixis is not always indicative of a toxic-metabolic encephalopathy.Rarely, such as in one of the cases herein presented, bilateral asterixis can also appear associated with structural brain lesions. Although asterixis diagnosis is fundamentally clinical, the neurophysiological study contributes to verify the diagnosis.

  11. DEK Expression in Melanocytic Lesions

    PubMed Central

    Kappes, Ferdinand; Khodadoust, Michael S; Yu, Limin; Kim, David SL; Fullen, Douglas R; Markovitz, David M; Ma, Linglei

    2011-01-01

    The diagnosis of malignant melanoma presents a clinical challenge and relies principally on histopathological evaluation. Previous studies have indicated that increased expression of the DEK oncogene, a chromatin-bound factor, could contribute to the development of melanoma and may be a frequent event in melanoma progression. Here, we investigated DEK expression by immunohistochemistry in a total of 147 melanocytic lesions, including ordinary nevi, dysplastic nevi, Spitz nevi, melanoma in situ, primary invasive melanomas, and metastatic melanomas. Most benign nevi (ordinary, dysplastic and Spitz nevi) were negative or exhibited weak staining for DEK with only 4 of 49 cases showing strong staining. Similar to benign nevi, melanoma in situ also demonstrated low levels of DEK expression. In contrast, the expression of DEK in primary invasive melanomas was significantly higher than benign nevi (p<0.0001). Moreover, DEK expression was significantly increased in deep melanomas (Breslow depth > 1mm) and metastatic melanomas as compared to superficial melanomas (Breslow depth ≤ 1mm) (p<0.05). Our findings indicate that DEK overexpression may be a frequent event in invasive melanomas, and further augmentation of DEK expression may be associated with the acquisition of ominous features such as deep dermal invasion and metastasis. These data suggest a role of DEK in melanoma progression. PMID:21316078

  12. Focal liver lesions found incidentally.

    PubMed

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

    2016-03-28

    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

  13. 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

  14. Clinical Data as an Adjunct to Ultrasound Reduces the False-Negative Malignancy Rate in BI-RADS 3 Breast Lesions

    PubMed Central

    Ackermann, S.; Schoenenberger, C.-A.; Zanetti-Dällenbach, R.

    2016-01-01

    Purpose: Ultrasound (US) is a well-established diagnostic procedure for breast examination. We investigated the malignancy rate in solid breast lesions according to their BI-RADS classification with a particular focus on false-negative BI-RADS 3 lesions. We examined whether patient history and clinical findings could provide additional information that would help determine further diagnostic steps in breast lesions. Materials and Methods: We conducted a retrospective study by exploring US BI-RADS in 1469 breast lesions of 1201 patients who underwent minimally invasive breast biopsy (MIBB) from January 2002 to December 2011. Results: The overall sensitivity and specificity of BI-RADS classification was 97.4% and 66.4%, respectively, with a positive (PPV) and negative predictive value (NPV) of 65% and 98%, respectively. In 506 BI-RADS 3 lesions, histology revealed 15 malignancies (2.4% malignancy rate), which corresponds to a false-negative rate (FNR) of 2.6%. Clinical evaluation and patient requests critically influenced the further diagnostic procedure, thereby prevailing over the recommendation given by the BI-RADS 3 classification. Conclusion: Clinical criteria including age, family and personal history, clinical examination, mammography and patient choice ensure adequate diagnostic procedures such as short-term follow-up or MIBB in patients with lesions classified as US-BI-RADS 3. PMID:27689181

  15. Clinical Data as an Adjunct to Ultrasound Reduces the False-Negative Malignancy Rate in BI-RADS 3 Breast Lesions

    PubMed Central

    Ackermann, S.; Schoenenberger, C.-A.; Zanetti-Dällenbach, R.

    2016-01-01

    Purpose: Ultrasound (US) is a well-established diagnostic procedure for breast examination. We investigated the malignancy rate in solid breast lesions according to their BI-RADS classification with a particular focus on false-negative BI-RADS 3 lesions. We examined whether patient history and clinical findings could provide additional information that would help determine further diagnostic steps in breast lesions. Materials and Methods: We conducted a retrospective study by exploring US BI-RADS in 1469 breast lesions of 1201 patients who underwent minimally invasive breast biopsy (MIBB) from January 2002 to December 2011. Results: The overall sensitivity and specificity of BI-RADS classification was 97.4% and 66.4%, respectively, with a positive (PPV) and negative predictive value (NPV) of 65% and 98%, respectively. In 506 BI-RADS 3 lesions, histology revealed 15 malignancies (2.4% malignancy rate), which corresponds to a false-negative rate (FNR) of 2.6%. Clinical evaluation and patient requests critically influenced the further diagnostic procedure, thereby prevailing over the recommendation given by the BI-RADS 3 classification. Conclusion: Clinical criteria including age, family and personal history, clinical examination, mammography and patient choice ensure adequate diagnostic procedures such as short-term follow-up or MIBB in patients with lesions classified as US-BI-RADS 3.

  16. Diagnostic and surgical challenges in resection of cerebellar angle tumors and acoustic neuromas

    PubMed Central

    Patel, Neal; Wilkinson, Jared; Gianaris, Nicholas; Cohen-Gadol, Aaron A.

    2012-01-01

    Background: Cerebellopontine angle (CPA) lesions can mimic more common tumors through nonspecific symptoms and radiologic findings. Methods: To increase the preoperative diagnostic accuracy for CPA pathologies, the authors review the full spectrum of reported CPA lesions. Results: A wide spectrum of lesions mimics vestibular schwannoma (VS) in the space of the CPA. Conclusion: The presence of any suspicious clinical and radiographic finding uncharacteristic of VS makes it necessary to maintain a broad differential diagnosis list. Differentiation of CPA lesions, although challenging, may be best achieved by incorporating the clinical history, physical exam findings, audiometry results, and multi-modality imaging studies to construct a comprehensive preoperative knowledge of the lesion. This knowledge will allow improved operative execution and outcomes. PMID:22439108

  17. The Etiology and Arthroscopic Surgical Management of Cam Lesions.

    PubMed

    Werner, Brian C; Gaudiani, Michael A; Ranawat, Anil S

    2016-07-01

    Cam-type deformity of the proximal femur is a relative increase in the discrepancy of the femoral head-neck offset. The etiology is unknown; several conditions have been implicated in the development of abnormal proximal femoral anatomy. Recent evidence suggests that high-impact sports place stress on the immature physis during growth and may play an important role. Imaging is essential in the initial diagnostic workup, characterization of pathology, preoperative planning, and intraoperative decision making. Short-term and mid-term outcomes for arthroscopic osteoplasty of cam lesions for both isolated cam-type deformity and mixed cam-pincer femoroacetabular impingement have been well-described and are favorable. PMID:27343392

  18. [Preinvasive lesions in gynecology -  vulva].

    PubMed

    Chovanec, J; Mouková, L; Feranec, R

    2013-01-01

    For preinvasive lesions of vulva, a common term VIN -  vulval intraepithelial neoplasia is used. VIN is a histological dia-gnosis based on abnormal squamous epithelial proliferation. There are two types of VIN apart from their association with human papillomavirus (HPV). Undifferentiated (usual) vulval intraepithelial neoplasia is commonly associated with carcinogenic genotypes of HVP, whereas differentiated vulval intraepithelial neoplasia is not associated with high-risk genotypes of HPV. The article presents an overview of VIN occurence and epidemiology, its classification system and dia-gnostics. In conclusion, VIN therapeutical possibilities are presented. It can be treated with surgical therapy (local excision, partial vulvectomy, vulvectomy, laser vaporization) or medical therapy (imiquimod). PMID:24325163

  19. Benign lesions of the external auditory canal.

    PubMed

    Tran, L P; Grundfast, K M; Selesnick, S H

    1996-10-01

    Benign mass lesions of the external auditory canal, such as exostoses and osteomas, are common findings on physical examination but most often do not require treatment. The differential diagnosis of lesions in the external auditory canal, however, should not be limited to those benign processes discussed here, but should also include infectious, dermatologic, congenital, and malignant processes.

  20. Elementary lesions in dermatological semiology: literature review*

    PubMed Central

    Cardili, Renata Nahas; Roselino, Ana Maria

    2016-01-01

    Discrepancies in the terminology of elementary lesions persist when texts from Dermatology and Semiology books are compared, which can cause some confusion in both the teaching of undergraduate medical students and the learning acquired by professionals in the field. This review aims to compare and clarify the differences in the description of elementary lesions by many authors, used as references for specialists in dermatology.