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Sample records for boy differential diagnosis

  1. Differential diagnosis of tonsillolith

    Directory of Open Access Journals (Sweden)

    Luisa Schertel Cassiano

    2010-07-01

    Full Text Available Introduction:Tonsillolith is a rare type of dystrophic calcification in the palatine tonsils or in the peritonsilar region, which can mimics several intraosseous radiopaque lesions when evaluated by two-dimensional or overlapping images.This may lead to an erroneous diagnosis and to invasive and unnecessary procedures.This study reports a case of tonsillolith that was wrongly diagnosed as an odontoma. Case report: A patient with primary diagnosis of odontoma in the mandibular ramus was referred to surgical treatment of this lesion. Conclusion: Computed tomography (CT scans are fundamentally important to establish differential diagnosis and appropriate treatment for the patient.

  2. Differential diagnosis diphtheria adults

    OpenAIRE

    Yu. I. Liashenko; D. A. Pavlovich; Yu. P. Finogeev; Yu. A. Vinakmen; V. F. Krumgolts

    2010-01-01

    A total of 1,824 human cases of diphtheria, treated at the Clinical Infectious Diseases Hospital SP Botkin (St. Petersburg) during 1993, as well as 19 deaths in 1994. It is known that early diagnosis of infectious diseases, especially diphtheria, contributes to the favorable outcome of the disease. The diagnosis of diphtheria at the prehospital stage is always difficult. Presented in detail the differential diagnosis of the disease, clinically similar to diphtheria: Lacunal angina, angina Sim...

  3. Differential diagnosis diphtheria adults

    Directory of Open Access Journals (Sweden)

    Yu. I. Liashenko

    2010-01-01

    Full Text Available A total of 1,824 human cases of diphtheria, treated at the Clinical Infectious Diseases Hospital SP Botkin (St. Petersburg during 1993, as well as 19 deaths in 1994. It is known that early diagnosis of infectious diseases, especially diphtheria, contributes to the favorable outcome of the disease. The diagnosis of diphtheria at the prehospital stage is always difficult. Presented in detail the differential diagnosis of the disease, clinically similar to diphtheria: Lacunal angina, angina Simanovsky, infectious mononucleosis, angina Ludwig’s angina Dugue, syphilis, non-infectious with clinical «masks» of diphtheria and other. Diphtheria epidemic of 1993–1994 in Russia and, in particular, in St. Petersburg, showed that the late admission of patients with diphtheria infection in hospitals, usually associated with irregular differential diagnosis of this dangerous disease.

  4. [Differential diagnosis of hoarseness].

    Science.gov (United States)

    Voigt-Zimmermann, S; Lampe, K; Arens, C

    2014-04-01

    Hoarseness can be the leading symptom of dysphonia. In combination with impaired vocal performance and subjective voice-related discomfort, it can represent an individually different handicap for patients and lead to limited participation in social and professional life. Since the reasons for dysphonia may be not only functional but also organic with a potentially poor prognosis, hoarseness must be clarified using differential diagnosis. In addition to the knowledge of possible diseases, pathogenesis, and treatment options for dysphonia, the differential diagnostic approach requires profound knowledge of the various diagnostic methods, and of the interpretation of the results in particular. The etiology of dysphonia is very diverse and rarely monocausal. Therefore, a team-based and interdisciplinary differential diagnostic approach is recommended.

  5. Reading ability and differential cognitive profiles of girls and boys.

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    Kirchner-Nebot, T; Amador-Campos, J A

    1999-12-01

    To compare the differential cognitive and stylistic profiles of Spanish-speaking girls and boys and the relation between these profiles with subjects' reading scores 50 girls and 50 boys, 8 years old, were assessed on a reading test, the Children's Embedded Figures Test, and the Intellectual Test (Escala Diferencial del Rendimiento Intelectual). Analysis showed differential cognitive profiles for the two sexes. While girls used single, essentially verbal strategies for the reading activity, boys with high reading scores used verbal and perceptual strategies. In general, for girls verbal intelligence scores had correlated the highest with reading scores and lowest with independence on the Children's Embedded Figures Test. For boys the two tests contribute to the explained variance of reading scores. Curiously for scores in reading letters, reading strategies of the two groups seemed inverted.

  6. Differential diagnosis of hyponatraemia.

    LENUS (Irish Health Repository)

    Thompson, Chris

    2012-03-01

    The appropriate management of hyponatraemia is reliant on the accurate identification of the underlying cause of the hyponatraemia. In the light of evidence which has shown that the use of a clinical algorithm appears to improve accuracy in the differential diagnosis of hyponatraemia, the European Hyponatraemia Network considered the use of two algorithms. One was developed from a nephrologist\\'s view of hyponatraemia, while the other reflected the approach of an endocrinologist. Both of these algorithms concurred on the importance of assessing effective blood volume status and the measurement of urine sodium concentration in the diagnostic process. To demonstrate the importance of accurate diagnosis to the correct treatment of hyponatraemia, special consideration was given to hyponatraemia in neurosurgical patients. The differentiation between the syndrome of inappropriate antidiuretic hormone secretion (SIADH), acute adrenocorticotropic hormone (ACTH) deficiency, fluid overload and cerebral salt-wasting syndrome was discussed. In patients with SIADH, fluid restriction has been the mainstay of treatment despite the absence of an evidence base for its use. An approach to using fluid restriction to raise serum tonicity in patients with SIADH and to identify patients who are likely to be recalcitrant to fluid restriction was also suggested.

  7. Neurofibromatoses: part 1 ? diagnosis and differential diagnosis

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    Luiz Oswaldo Carneiro Rodrigues

    2014-03-01

    Full Text Available Neurofibromatoses (NF are a group of genetic multiple tumor growing predisposition diseases: neurofibromatosis type 1 (NF1, neurofibromatosis type 2 (NF2 and schwannomatosis (SCH, which have in common the neural origin of tumors and cutaneous signs. They affect nearly 80 thousand of Brazilians. In recent years, the increased scientific knowledge on NF has allowed better clinical management and reduced complication morbidity, resulting in higher quality of life for NF patients. In most cases, neurology, psychiatry, dermatology, clinical geneticists, oncology and internal medicine specialists are able to make the differential diagnosis between NF and other diseases and to identify major NF complications. Nevertheless, due to its great variability in phenotype expression, progressive course, multiple organs involvement and unpredictable natural evolution, NF often requires the support of neurofibromatoses specialists for proper treatment and genetic counseling. This Part 1 offers step-by-step guidelines for NF differential diagnosis. Part 2 will present the NF clinical management.

  8. Neurofibromatoses: part 1 - diagnosis and differential diagnosis.

    Science.gov (United States)

    Rodrigues, Luiz Oswaldo Carneiro; Batista, Pollyanna Barros; Goloni-Bertollo, Eny Maria; de Souza-Costa, Danielle; Eliam, Lucas; Eliam, Miguel; Cunha, Karin Soares Gonçalves; Darrigo-Junior, Luiz Guilherme; Ferraz-Filho, José Roberto Lopes; Geller, Mauro; Gianordoli-Nascimento, Ingrid F; Madeira, Luciana Gonçalves; Malloy-Diniz, Leandro Fernandes; Mendes, Hérika Martins; de Miranda, Débora Marques; Pavarino, Erika Cristina; Baptista-Pereira, Luciana; Rezende, Nilton A; Rodrigues, Luíza de Oliveira; da Silva, Carla Menezes; de Souza, Juliana Ferreira; de Souza, Márcio Leandro Ribeiro; Stangherlin, Aline; Valadares, Eugênia Ribeiro; Vidigal, Paula Vieira Teixeira

    2014-03-01

    Neurofibromatoses (NF) are a group of genetic multiple tumor growing predisposition diseases: neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis (SCH), which have in common the neural origin of tumors and cutaneous signs. They affect nearly 80 thousand of Brazilians. In recent years, the increased scientific knowledge on NF has allowed better clinical management and reduced complication morbidity, resulting in higher quality of life for NF patients. In most cases, neurology, psychiatry, dermatology, clinical geneticists, oncology and internal medicine specialists are able to make the differential diagnosis between NF and other diseases and to identify major NF complications. Nevertheless, due to its great variability in phenotype expression, progressive course, multiple organs involvement and unpredictable natural evolution, NF often requires the support of neurofibromatoses specialists for proper treatment and genetic counseling. This Part 1 offers step-by-step guidelines for NF differential diagnosis. Part 2 will present the NF clinical management. PMID:24676443

  9. DIFFERENTIAL DIAGNOSIS OF OPTIC NEURITIS

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    Zoric Lepsa

    2013-12-01

    Full Text Available Abstract: Optic neuritis is inflammation of the optic nerve, which in a single or repeated attacks can severely and permanently damage visual function. Errors in diagnostic are daily and usually occur because of incomplete diagnostic procedure performed. This manuscript presents a series of 19 patients reffered with optic neuritis diagnosis. The diagnosis was confirmed in 15, while four had other changes in the optic nerve or macula. We analyzed the diagnostic specificity of the basic parameters of optic neuritis diagnosis and afferent pupillary defect showed the highest sensitivity. The spectrum of differential diagnoses is shown within this finding. Optic neuritis diagnosis should be established carefully, using usual and available diagnostic methods in ophthalmologic and neurological practice, and if necessary, refer patients to neuro-ophthalmologist, as well as to electrophysiological evaluation and other methods that help fifferentiate disease.

  10. [The differential diagnosis of tenosynovitis].

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    Brulhart, Laure; Gabay, Cem

    2011-03-16

    Etymologically a ténosynovites means inflammation of a tendon sheath. We recognize two separate presentations: exsudative and stenosing. The wide differential diagnosis includes infections, most of chronic inflammatory joint diseases, mainly connective tissue disorders, rheumatoid and psoriatic arthritis, pathology related to mechanical stress as De Quervain's tenosynovitis or trigger finger and unusually tumor. Diabetes is a risk factor for most of them and is related to poor prognosis. Musculoskeletal ultrasound is useful for diagnosis and to guide procedure as fluid aspiration or steroid injection. PMID:21510342

  11. Differential diagnosis of leg ulcers.

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    Pannier, F; Rabe, E

    2013-03-01

    Leg and foot ulcers are symptoms of very different diseases. The aim of this paper is to demonstrate the differential diagnosis of leg ulcers. The majority of leg ulcers occur in the lower leg or foot. In non-venous ulcers the localization in the foot area is more frequent. The most frequent underlying disease is chronic venous disease. In 354 leg ulcers, Koerber found 75.25% venous leg ulcers, 3.66% arterial leg ulcers, 14.66% ulcers of mixed venous and arterial origin and 13.5% vasculitic ulcers. In the Swedish population of Skaraborg, Nelzen found a venous origin in 54% of the ulcer patients. Each leg ulcer needs a clinical and anamnestic evaluation. Duplex ultrasound is the basic diagnostic tool to exclude vascular anomalies especially chronic venous and arterial occlusive disease. Skin biopsies help to find a correct diagnosis in unclear or non-healing cases. In conclusion, chronic venous disease is the most frequent cause of leg ulcerations. Because 25% of the population have varicose veins or other chronic venous disease the coincidence of pathological venous findings and ulceration is very frequent even in non-venous ulcerations. Leg ulcers without the symptoms of chronic venous disease should be considered as non-venous.

  12. Autism: Clinical Features Diagnosis and Differential Diagnosis

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    Korkmaz, Barış

    1999-01-01

    Autism is a relatively frequent neurodevelopmental disorder of childhood with behavioral problems categorized in 3 domains These problems are related to social communication and relation verbal and non verbal communication and narrow fields of interest and restricted activity including repetitive behaviors e g stereotypies The diagnosis of autism before 3 years of age pose some difficulties for the clinicians; early indicators may be difficulties in eye contact inability to point and unrespon...

  13. Radiological diagnosis in AIDS - associated diseases: survey and differential diagnosis

    International Nuclear Information System (INIS)

    Acute manifestations of illnesses in patients with HIV-infection or AIDS will benefit from rapid diagnosis. Radiologic examinations provide substantial information to narrow the differential diagnosis. This article reviews clinically important HIV-associated diseases for the radiologist. The braod spectrum of possible manifestations is illustrated by the accompanying case reports that typify the complexity of diagnoses in this growing problem worldwide. (orig.)

  14. Differential diagnosis of disseminated periventricular calcifications

    Energy Technology Data Exchange (ETDEWEB)

    Rieger, P.; Piepgras, U.

    1986-08-01

    Juvenile disseminated periventricular calcifications may occur in tuberous sclerosis, toxoplasmosis, cytomegaly, and in tuberculous meningitis. Cysticercosis, by contrast, does not result in corresponding intracerebral foci until an older age. Differential diagnosis is no problem if clinical findings are typical (tuberous sclerosis) or if serological verification is positive. However, any unclear clinical diagnosis can often be secured by CT.

  15. Identification and Differential Diagnosis of Developmental Speech Problems in a Bilingual Child

    Science.gov (United States)

    Tzivinikou, Sotiria

    2005-01-01

    The present, multi-method (methodological triangulation), case study aimed to investigate whether it is possible to obtain a differential diagnosis between the speech problems derived from bilingualism, and the developmental speech problems of an Albanian eight-year-old boy who attended a public primary school in Greece. Although there existed…

  16. Differential Diagnosis of Retinal Vasculitis

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    Abu El-Asrar, Ahmed M.; Herbort, Carl P.; Tabbara, Khalid F.

    2009-01-01

    Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings. PMID:20404987

  17. Differential Diagnosis of Retinal Vasculitis

    OpenAIRE

    Abu El-Asrar Ahmed; Herbort Carl; Tabbara Khalid

    2009-01-01

    Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein a...

  18. Differential diagnosis of retinal vasculitis

    Directory of Open Access Journals (Sweden)

    Abu El-Asrar Ahmed

    2009-01-01

    Full Text Available Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings.

  19. POLYMYOSITIS/DERMATOMIOSITIS: DIFFERENTIAL DIAGNOSIS

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    O. A. Antelava

    2016-01-01

    Full Text Available The lecture considers the problem of rare systemic connective tissue diseases, such as idiopathic inflammatory myopathies (IIMs. It underlines the clinical and immunological heterogeneity of their subtypes, which defines therapeutic tactics and prognosis. The diagnostic criteria for IIMs are given. A differential diagnostic algorithm based on the exclusion of phenotypically similar forms of myopathies of different genesis is proposed. 

  20. [Hypophysitis : Types and differential diagnosis].

    Science.gov (United States)

    Saeger, W

    2016-05-01

    Inflammatory findings in the pituitary glands account for approximately 1 % of operations in the sellar region. Primary inflammation (e.g. lymphocytic and idiopathic granulomatous hypophysitis) have to be differentiated from secondary types (e.g. concomittant inflammation with Rathke's cleft cysts, craniopharyngiomas and germinomas) and involvement of the pituitary in generalized inflammation (IgG4-related disease, sarcoidosis and septicopyemia). Langerhans cell histiocytosis also has to be considered for the differential diagnostics. Lymphocytic hypophysitis shows lymphocytic infiltrations of varying density, predominantly of the T‑cell type. Granulomatous hypophysitis has the features of sarcoidosis and can only be diagnosed by exclusion of generalized sarcoidosis. Secondary hypophysitis has a mixed cell infiltration, especially by histiocytic infiltration and predominantly originates from ruptures or bleeding from Rathke's cleft cysts. The frequently very sparse remnants of cyst epithelium should be confirmed by pankeratin immunostaining. PMID:27103256

  1. [Differential diagnosis of abdominal pain].

    Science.gov (United States)

    Frei, Pascal

    2015-09-01

    Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain. PMID:26331201

  2. Differential Reinforcement to Reduce Disruptive Behaviors in a Blind Boy with a Learning Disability.

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    Heitzman, A. J.; Alimena, M. J.

    1991-01-01

    Differential reinforcement of low rates of responding was used to reduce the disruptive behaviors of a blind 12-year-old boy with a learning disability. The subject earned reinforcers by not exceeding the established criterion of disruptive behaviors. An overall 88 percent reduction in target behaviors was observed across a 26-day period.…

  3. Differential diagnosis of tetrahydrobiopterin deficiency.

    Science.gov (United States)

    Niederwieser, A; Ponzone, A; Curtius, H C

    1985-01-01

    Six hundred and seventy-three children (483 newborns and 190 older selected children) were screened for tetrahydrobiopterin (BH4) deficiency by HPLC of urine pterins and BH4 load test. One patient with GTP cyclohydrolase I deficiency, 36 patients with dihydrobiopterin synthetase (DHBS) deficiency (of which six were in the newborn and 30 in the older children) and 14 with dihydropteridine reductase deficiency (DHPR) were found. All 37 patients with defective BH4 biosynthesis responded to a BH4 load by lowering of the elevated serum phenylalanine concentration but four of 14 patients with DHPR deficiency did not. Measurement of DHPR activity in blood spots on Guthrie cards is recommended. Since subvariants of patients with BH4 deficiency exist, homovanillic acid, 5-hydroxyindole acetic acid, pterins, phenylalanine, and tyrosine in cerebrospinal fluid should be measured for diagnosis and the control of therapy. The activity of the phosphate-eliminating enzyme (a key enzyme in BH4 biosynthesis and part of "DHBS") was measured in human liver and activities of approx. 1 n U (mg protein)-1 were found. In the liver biopsy of a patient with DHBS deficiency no activity (less than 3% of controls) was demonstrated. PMID:3930839

  4. Dentin hypersensitivity: differential diagnosis, tests, and etiology.

    Science.gov (United States)

    Trushkowsky, Richard D; Garcia-Godoy, Franklin

    2014-02-01

    Dentin hypersensitivity (DHS) is a painful condition that affects up to 57 percent of the adult population. It occurs as a result of exposure of dentin to the oral environment. Ensuring the correct diagnosis of this condition is based on history and examination. An oral screening for DHS should encompass such elements as patient history, clinical examination that includes radiographs, a variety of tests, identification of risk factors, and a differential diagnosis. An understanding of dentinal fluid and odontoblasts is also beneficial for diagnosis. PMID:24571559

  5. DIFFERENTIAL DIAGNOSIS OF NORMOCALCEMIC HYPERPARATHYROIDISM

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    N. A. Kravchun

    2015-01-01

    Full Text Available Objective: to describe a case of normocalcemic hyperparathyroidism.Materials and methods. A female patient aged 51 years sought medical advice for complaints of spinal column and bone pains, periodic dizziness, and hand numbness. The patient underwent clinical and biochemical blood tests, determination of the blood levels of calcium, phosphorus, parathyroid hormone, concentrations of total vitamin D, calciuria, electrocardiography, thyroid ultrasonography, and neck computed tomography.Results. Based on her complaints, examination evidence, evaluation of the clinical presentations of the disease, and objective and instrumental examination findings, the patient was diagnosed with left parathyroid adenoma and primary hyperparathyroidism; stage II hypertensive disease, grade I, a moderate risk; retinal angiopathy of both eyes; stage I dyscirculatory encephalopathy with liquor and venous dyscirculation and moderate vestibular ataxia; urolithiasis; kidney stones; and spondylosis mainly involving the lumbar spine. The diagnostic determinants for verifying the diagnosis were the results of neck computed tomography, namely: the signs of space-occupying lesion in the projection of the left parathyroid gland; the blood level of parathyroid hormone 118.6 pg/ml (normal value (N 9.5–75.0 pg/ml; total vitamin D 21.64 nmol/l (N 75–250 nmol/l; and calcium 2.48 mmol/l (N 2.15–2.50 mmol/l. The history of urolithiasis, repeated lithotripsy, as well as spondylosis with lumboischalgia was an absolute indication for surgical treatment.Conclusion. The practical interest in this case is due to the complexity of diagnosing normocalcemic hyperparathyroidism after vitamin D deficiency. The early stages of primary hyperparathyroidism are asymptomatic and frequently give rise to irreversible renal complications, causing renal failure and, as a consequence, disability. This clinical case demonstrates the importance of routinely determining vitamin D concentrations

  6. Diagnosis and Differential Diagnosis in Behcet’s Disease

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    Osman Köse

    2009-12-01

    Full Text Available The diagnosis of Behcet’s disease is made on the basis of the criteria proposed by the International Study group for Behcet’s disease in 1990. According to the criteria, recurrent oral ulceration must be present as well as at least two of the following: Recurrent genital ulceration, eye lesions, skin lesions and a positive pathergy test. Acute/chronic oral ulcers and genital ulcers should be regarded in the differential diagnosis of Behcet’s disease. We discussed the details of different dermatologic diseases especially of prominent with oral and genital ulcers in this article.

  7. The bronchovalvular mechanism - differential diagnosis in children

    International Nuclear Information System (INIS)

    A differential diagnosis of the bronchovalvular mechanism can usually be made by means of plain radiography of the chest in the inhalation and the exhalation phase. If respiratory distress is due to causes other than foreign body aspiration, there may arise the necessity to apply bronchoradiography or angiography, or to examine the oesophagus. (orig.)

  8. The neuromuscular differential diagnosis of joint hypermobility

    NARCIS (Netherlands)

    Donkervoort, S.; Bonnemann, C.G.; Loeys, B.L.; Jungbluth, H.; Voermans, N.C.

    2015-01-01

    Joint hypermobility is the defining feature of various inherited connective tissue disorders such as Marfan syndrome and various types of Ehlers-Danlos syndrome and these will generally be the first conditions to be considered by geneticists and pediatricians in the differential diagnosis of a patie

  9. [Rare differential diagnosis of urinary incontinence].

    Science.gov (United States)

    Coutty, Nadège; Dubreucq, Sylvie; Delahousse, Guy; Cosson, Michel

    2003-04-01

    The authors report the case of a 55-year-old woman with prolapse presenting a differential diagnosis of urinary incontinence: a peritoneo-vaginal fistula with serous discharge in a patient with ascites and a history of hysterectomy. The only cases of peritoneo-vaginal fistula reported in the literature were discovered during extra-uterine pregnancy after hysterectomy. PMID:12765075

  10. Generalized anxiety disorder: Differential diagnosis and treatment

    OpenAIRE

    Tatyana Gratsiyevna Voznesenskaya

    2013-01-01

    Generalized anxiety disorder (GAD) is poorly diagnosed and inadequately treated by general practitioners. The paper considers the major diagnostic signs of GAD, its differential diagnosis, prevalence, etiology, and pathogenesis. Antidepressants from a group of selective serotonin reuptake inhibitors in combination with psychotherapy are the drugs of first choice.

  11. [Differential diagnosis of Graves' orbitopathy. Case report].

    Science.gov (United States)

    Erdei, Annamária; Steiber, Zita; Gazdag, Annamária; Bodor, Miklós; Berta, Eszter; Szász, Róbert; Szántó, Antónia; Ujhelyi, Bernadett; Barna, Sándor; Berényi, Ervin; Nagy, V Endre

    2016-02-21

    Graves' orbitopathy is the extrathyroidal manifestation of Graves' disease, which is the most common cause of exophthalmos. As eye symptoms usually coincide with the development of thyrotoxicosis, the diagnosis of the disease is rarely difficult. The aim of the authors was to summarize the differential diagnosis of Graves' orbitopathy based on literature review and presentation of their own four problematic cases on this topic. They conclude that symptoms similar to endocrine orbitopathy are present in other disorders. Endocrinologists need to be aware of these other conditions to avoid treatment failures.

  12. Cervicogenic headache: Differential diagnosis and treatment

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    Aleksey Nikolayevich Barinov

    2012-01-01

    Full Text Available The paper discusses the issues of differential diagnosis of cervicocranialgia with tension headache and migraine with concomitant cervical myofascial syndrome. It considers the basic mechanisms of the pathogenesis of these nosological entities and common approaches to their treatment. The mechanisms of pathogenetic action of myorelaxants are shown in cervicocranialgia and myofascial pain syndromes. Methods for mini-invasive therapy for cervicogenic headache and other musculoskeletal disorders are presented.

  13. CT diagnosis and differential diagnosis of malignant pleural mesothelioma

    International Nuclear Information System (INIS)

    Objective: To study the CT features of malignant pleural mesothelioma and improve diagnostic accuracy. Methods: The CT findings of 14 patients with malignant pleural mesothelioma proven by surgery or histopathology were analyzed retrospectively. CT plain scan was performed in all cases, 9 cases received both CT plain scan and contrast CT scan. Results: All the cases demonstrated various pleural thickening including diffuse pleural thickening (n=10). Among all the cases, there were nodular pleural thickening (n=4), lumpy pleural thickening (n=7), ring-like pleural thickening (n=3). Pleural thickness which was more than 1.0 cm was found in 12 cases. Pleural effusion (n=10), mediastinum immobilization (n=10) and thoracic cavity stricture in the trouble side (n=10) were also revealed. Conclusion: Obvious characteristics in cases with malignant pleural mesothelioma was showed in CT examination, which plays an important role in the diagnosis and differential diagnosis of this disease. (authors)

  14. [Isaacs' syndrome. Diagnosis and differential diagnosis of neuromyotonia].

    Science.gov (United States)

    Fischer, D; Schröder, R

    2004-06-01

    Neuromyotonia is a clinical and electrophysiological syndrome of spontaneous muscle fiber activity due to hyperexcitability of peripheral nerve origin causing generalised, visible myokymia and muscular cramps. Electromyography shows abnormal doublet and triplet discharges of high intraburst frequency as well as myokymic and neuromyotonic discharges. Fasciculations and fibrillation potentials are common. Most commonly, neuromyotonia is an acquired immune-mediated disorder (Isaacs' syndrome) showing elevated antibody levels against presynaptic, voltage-gated, potassium channels. Some of these patients have additional autonomic (hyperhidrosis) and/or CNS symptoms similar to those from limbic encephalitis (referred to then as Morvan's syndrome). We report on a patient with Isaacs' syndrome and discuss the clinical and electrophysiological features, pathophysiology, diagnosis, and differential diagnosis of diseases with peripheral nerve hyperexcitability. PMID:15257376

  15. Cognitive Load Differentially Impacts Response Control in Girls and Boys with ADHD.

    Science.gov (United States)

    Seymour, Karen E; Mostofsky, Stewart H; Rosch, Keri S

    2016-01-01

    Children with attention-deficit hyperactivity disorder (ADHD) consistently show impaired response control, including deficits in response inhibition and increased intrasubject variability (ISV) compared to typically-developing (TD) children. However, significantly less research has examined factors that may influence response control in individuals with ADHD, such as task or participant characteristics. The current study extends the literature by examining the impact of increasing cognitive demands on response control in a large sample of 81children with ADHD (40 girls) and 100 TD children (47 girls), ages 8-12 years. Participants completed a simple Go/No-Go (GNG) task with minimal cognitive demands, and a complex GNG task with increased cognitive load. Results showed that increasing cognitive load differentially impacted response control (commission error rate and tau, an ex-Gaussian measure of ISV) for girls, but not boys, with ADHD compared to same-sex TD children. Specifically, a sexually dimorphic pattern emerged such that boys with ADHD demonstrated higher commission error rate and tau on both the simple and complex GNG tasks as compared to TD boys, whereas girls with ADHD did not differ from TD girls on the simple GNG task, but showed higher commission error rate and tau on the complex GNG task. These findings suggest that task complexity influences response control in children with ADHD in a sexually dimorphic manner. The findings have substantive implications for the pathophysiology of ADHD in boys versus girls with ADHD. PMID:25624066

  16. Mialgias: Approaches to differential diagnosis, treatment

    Directory of Open Access Journals (Sweden)

    Nadezhda Aleksandrovna Shostak

    2013-01-01

    Full Text Available Differential diagnosis in muscle pains often presents great difficulties so all existing signs of the disease should be carefully considered to make its diagnosis and to prescribe adequate therapy. The paper considers the causes of muscle pains, laboratory and instrumental studies (immunological tests, determination of the level of specific muscular enzymes, primarily creatine phosphokinase – CPK, etc., and the main reasons for enhanced plasma CPK activity. It also describes acute and chronic mialgias associated with enhanced plasma CPK activity, as well as diseases in which mialgias are related to the normal level of CPK, myofascial syndrome (MFS and fibromyalgia (FM in particular. The characteristic features of MFS are given in its diagnostic criteria. It is stated that a differential diagnosis should be made between MFS and major muscle pain-associated abnormalities, such as polymyalgia rheumatica, FM, etc. Diagnosticcriteria for polymyalgia rheumatica are given. A MFS treatment algorithm is presented. Local exposure methods applied to altered musculoligamentous structures in combination with myorelaxants and non-steroidal anti-inflammatory drugs assume paramount importance in MFS.

  17. Intracranial meningioma: an exercise in differential diagnosis.

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    Flanagan, J G; Kothe, A C

    1990-04-01

    A 48-year-old man presented with a unilateral visual disturbance including reduced visual acuity and decreased sensitivity of the temporal visual field. He was initially diagnosed as having optic neuritis. Four months later the condition not only remained unresolved, but showed signs of progression. This presentation was atypical for optic neuritis and further detailed investigation was warranted. The patient's symptoms, along with multi-channel topographic visual evoked potentials and quantitative visual field analysis, were more indicative of a diagnosis of a space occupying lesion. A CT scan confirmed the presence of an intracranial tumour which was surgically excised. Pre- and post-operative visual function are described. The case report highlights the difficulty of differential diagnosis of optic neuritis and the clinical value of the appropriate and judicious use of multi-channel evoked potentials. PMID:2371068

  18. [Differential infratentorial brain tumor diagnosis in children].

    Science.gov (United States)

    Warmuth-Metz, M; Kühl, J; Rutkowski, S; Krauss, J; Solymosi, L

    2003-11-01

    With the exception of the first year of life, infratentorial brain tumors are more frequent in the first decade than tumors in the supratentorial compartment. In particular these are cerebellar low-grade astrocytomas, medulloblastomas, brainstem gliomas and ependymomas of the fourth ventricle. The morphology on MRI and CT and the mode of dissemination permit differential diagnosis in many cases. To allow correct stratification into different treatments in possibly disseminating malignant brain tumors, knowledge of the status of dissemination is essential, and therefore not only cranial but also spinal MRI is indispensable for staging. If the spinal MRI is performed in the immediate postoperative period, knowledge of the normal non-specific purely postoperative changes, often seen as enhancement in the subdural spinal spaces, is necessary in order to avoid misinterpretation as meningial seeding. The differential diagnosis of pediatric infratentorial brain tumors and the morphology of subdural enhancement are illustrated with typical images. The natural history of the most frequent tumors and its importance for treatment decisions is discussed in light of the literature.

  19. Psoriasis: epidemiology, natural history, and differential diagnosis

    Directory of Open Access Journals (Sweden)

    Basko-Plluska JL

    2012-09-01

    Full Text Available Juliana L Basko-Plluska, Vesna Petronic-RosicDepartment of Medicine, Section of Dermatology, University of Chicago, Chicago, IL, USAAbstract: Psoriasis is a chronic, immune-mediated, inflammatory disease which affects primarily the skin and joints. It occurs worldwide, but its prevalence varies considerably between different regions of the world. Genetic susceptibility as well as environmental factors play an important role in determining the development and prognosis of psoriasis. Genome-wide association studies have identified many genetic loci as potential psoriasis susceptibility regions, including PSORS1 through PSORS7. Histocompatibility antigen (HLA studies have also identified several HLA antigens, with HLA-Cw6 being the most frequently associated antigen. Epidemiological studies identified several modifiable risk factors that may predispose individuals to developing psoriasis or exacerbate pre-existing disease. These include smoking, obesity, alcohol consumption, diet, infections, medications and stressful life events. The exact mechanism by which they trigger psoriasis remains to be elucidated; however, existing data suggest that they are linked through Th1-mediated immunological pathways. The natural history of psoriasis varies depending on the clinical subtype as well as special circumstances, including pregnancy and HIV infection. In general, psoriasis is a chronic disease with intermittent remissions and exacerbations. The differential diagnosis is vast and includes many other immune-mediated, inflammatory disorders.Keywords: psoriasis, epidemiology, natural history, differential diagnosis

  20. Diagnosis, Differential Diagnosis, and Epidemiology of Primary Sclerosing Cholangitis.

    Science.gov (United States)

    Ponsioen, Cyriel Y

    2015-01-01

    According to recent guidelines, primary sclerosing cholangitis (PSC) is diagnosed when a patient has a cholestatic liver enzyme profile, characteristic bile duct changes on imaging, and when secondary causes of sclerosing cholangitis are excluded. In patients with a clinical suspicion but normal cholangiography, a liver biopsy is indicated to establish a diagnosis of small duct PSC. Several other disease entities such as IgG4-associated cholangitis (IAC), cholangiocarcinoma (CCA), and secondary causes of sclerosing cholangitis such as choledocholithiasis, AIDS-cholangiopathy, ischemia, surgical bile duct trauma, or mast cell cholangiopathy can mimic PSC. IAC can be differentiated from PSC by applying the HISORt criteria including the serum IgG4 level. In cases where serum IgG4 is less than 2 × ULN, the ratio of IgG4/IgG1 >0.24 is indicative for IAC. Choledocholithiasis with recurrent cholangitis as a cause of sclerosing cholangitis can pose a conundrum, since PSC itself is associated with an increased prevalence of gallstones. The epidemiology of PSC worldwide has been poorly described. Incidence and prevalence rates vary from 0-1.3 and 0-16.2 per 100,000 inhabitants respectively. However, these figures are not based on population-based cohorts. A recent large population-based cohort from the Netherlands reported an incidence of 0.5 and a prevalence of 6/100,000. Approximately 10% fulfil the criteria for small duct PSC. At diagnosis of PSC, concurrent inflammatory bowel disease (IBD), primarily ulcerative colitis or Crohn's colitis is present in 50%, but increasing to 80%, 10 years or more after diagnosis. Conversely, 3% of IBD patients will develop PSC. PSC predisposes to malignancy. The estimated cumulative risk of developing CCA after 30 years is 20%. For colorectal carcinoma in PSC/colitis patients, the estimated cumulative risk at 30 years is 13%.

  1. [Cat Scratch Disease as a differential diagnosis in a patient with swelling in the groin].

    Science.gov (United States)

    Makki, Ahmad; Murra, May; Sommer, Thorbjørn

    2014-08-11

    at Scratch Disease is caused by the bacteria Bartonella henselae and presents in patients exposed to a scratch/bite from cats. We present a case with a 12-year-old boy with an enlarged inguinal lymph node, initially suspected to be a femoral hernia by ultrasonography. Histologic examination of an inguinal lymph node showed necrosis and B. henselae infection. It is important with a thorough anamnesis including any history of animal bites/scratch and it should be kept in mind as a differential diagnosis in patients with swelling in the groin, despite the rare diagnosis of this disease.

  2. Lymphangioleiomyomatosis: differential diagnosis and optimal management

    Directory of Open Access Journals (Sweden)

    Xu KF

    2014-08-01

    Full Text Available Kai-Feng Xu,1 Bee Hong Lo2 1Department of Respiratory Medicine, Peking Union Medical College Hospital, Beijing, People's Republic of China; 2Developmental Pediatrician, PECAT, Children's Hospital Westmead, Sydney, NSW, Australia Abstract: Lymphangioleiomyomatosis (LAM is an uncommon disease presented as diffuse thin-walled cystic changes in the lung. The main differential diagnoses include pulmonary Langerhans' histiocytosis (PLCH, Birt-Hogg-Dubé syndrome (BHD, lymphoid interstitial pneumonia (LIP, and amyloidosis. A combination of clinical, radiological, and pathological approaches as well as genetic testing will clarify the diagnosis in most cases. LAM is a disease almost exclusively in women. Dyspnea, pneumothorax, and hemoptysis are common presentations in LAM patients. LAM is also a lymphatic disorder affecting lymphatic vessels and lymph nodes. Chylothorax, chylous ascites, and lymphangiomyomas are frequently seen. LAM can present sporadically as a single entity or as part of tuberous sclerosis complex (TSC. Angiomyolipoma (AML is a characteristic extra-pulmonary lesion, either found in association with sporadic or TSC-related LAM. High-risk populations should be screened for LAM, including adult women with TSC and female patients with spontaneous pneumothorax, AMLs in the kidney, and diffuse cystic lung diseases. Definitive diagnosis of LAM is based on a high level of clinical suspicion on presentation supported by pathological findings or by a distinct feature, such as a history of TSC, AMLs in the kidney, chylothorax, or chylous ascites. Vascular endothelial growth factor-D (VEGF-D in serum is a noninvasive and reliable diagnostic biomarker. In experienced centers, trans-bronchial lung biopsy (TBLB provides a convenient and safe way to obtain lung specimens for diagnostic purposes. An effective treatment for LAM is now available, namely using a mechanistic target of rapamycin (mTOR inhibitor such as sirolimus. Efficacy of sirolimus has

  3. [Differential diagnosis and management of balanitis].

    Science.gov (United States)

    Borelli, S; Lautenschlager, S

    2015-01-01

    Balanitis is a descriptive diagnosis for a heterogeneous group of infectious or inflammatory dermatoses which have to be differentiated from malignant conditions. Balanitis is caused not only by Candida spp. and bacterial infections, including anaerobic bacteria: viral infections, parasites and other sexually transmitted infections (STI) also have to be considered. Lichen planus, psoriasis and contact dermatitis can characteristically lead to inflammatory conditions of the glans penis. In addition to a complete skin examination, a thorough patient history with respect to topically applied products and sexual behavior is essential. Infections must be treated and the glans penis should be kept dry. It is important to ensure a balanced genital hygiene in patients. As a last resort therapeutic circumcision can be considered for most forms of chronic balanitis. PMID:25475625

  4. Gender-Differentiated Parenting Revisited: Meta-Analysis Reveals Very Few Differences in Parental Control of Boys and Girls

    Science.gov (United States)

    Endendijk, Joyce J.; Groeneveld, Marleen G.; Bakermans-Kranenburg, Marian J.; Mesman, Judi

    2016-01-01

    Although various theories describe mechanisms leading to differential parenting of boys and girls, there is no consensus about the extent to which parents do treat their sons and daughters differently. The last meta-analyses on the subject were conducted more than fifteen years ago, and changes in gender-specific child rearing in the past decade are quite plausible. In the current set of meta-analyses, based on 126 observational studies (15,034 families), we examined mothers’ and fathers’ differential use of autonomy-supportive and controlling strategies with boys and girls, and the role of moderators related to the decade in which the study was conducted, the observational context, and sample characteristics. Databases of Web of Science, ERIC, PsychInfo, Online Contents, Picarta, and Proquest were searched for studies examining differences in observed parental control of boys and girls between the ages of 0 and 18 years. Few differences were found in parents’ use of control with boys and girls. Parents were slightly more controlling with boys than with girls, but the effect size was negligible (d = 0.08). The effect was larger, but still small, in normative groups and in samples with younger children. No overall effect for gender-differentiated autonomy-supportive strategies was found (d = 0.03). A significant effect of time emerged: studies published in the 1970s and 1980s reported more autonomy-supportive strategies with boys than toward girls, but from 1990 onwards parents showed somewhat more autonomy-supportive strategies with girls than toward boys. Taking into account parents’ gender stereotypes might uncover subgroups of families where gender-differentiated control is salient, but based on our systematic review of the currently available large data base we conclude that in general the differences between parenting of boys versus girls are minimal. PMID:27416099

  5. Gender-Differentiated Parenting Revisited: Meta-Analysis Reveals Very Few Differences in Parental Control of Boys and Girls.

    Science.gov (United States)

    Endendijk, Joyce J; Groeneveld, Marleen G; Bakermans-Kranenburg, Marian J; Mesman, Judi

    2016-01-01

    Although various theories describe mechanisms leading to differential parenting of boys and girls, there is no consensus about the extent to which parents do treat their sons and daughters differently. The last meta-analyses on the subject were conducted more than fifteen years ago, and changes in gender-specific child rearing in the past decade are quite plausible. In the current set of meta-analyses, based on 126 observational studies (15,034 families), we examined mothers' and fathers' differential use of autonomy-supportive and controlling strategies with boys and girls, and the role of moderators related to the decade in which the study was conducted, the observational context, and sample characteristics. Databases of Web of Science, ERIC, PsychInfo, Online Contents, Picarta, and Proquest were searched for studies examining differences in observed parental control of boys and girls between the ages of 0 and 18 years. Few differences were found in parents' use of control with boys and girls. Parents were slightly more controlling with boys than with girls, but the effect size was negligible (d = 0.08). The effect was larger, but still small, in normative groups and in samples with younger children. No overall effect for gender-differentiated autonomy-supportive strategies was found (d = 0.03). A significant effect of time emerged: studies published in the 1970s and 1980s reported more autonomy-supportive strategies with boys than toward girls, but from 1990 onwards parents showed somewhat more autonomy-supportive strategies with girls than toward boys. Taking into account parents' gender stereotypes might uncover subgroups of families where gender-differentiated control is salient, but based on our systematic review of the currently available large data base we conclude that in general the differences between parenting of boys versus girls are minimal. PMID:27416099

  6. Gender-Differentiated Parenting Revisited: Meta-Analysis Reveals Very Few Differences in Parental Control of Boys and Girls.

    Directory of Open Access Journals (Sweden)

    Joyce J Endendijk

    Full Text Available Although various theories describe mechanisms leading to differential parenting of boys and girls, there is no consensus about the extent to which parents do treat their sons and daughters differently. The last meta-analyses on the subject were conducted more than fifteen years ago, and changes in gender-specific child rearing in the past decade are quite plausible. In the current set of meta-analyses, based on 126 observational studies (15,034 families, we examined mothers' and fathers' differential use of autonomy-supportive and controlling strategies with boys and girls, and the role of moderators related to the decade in which the study was conducted, the observational context, and sample characteristics. Databases of Web of Science, ERIC, PsychInfo, Online Contents, Picarta, and Proquest were searched for studies examining differences in observed parental control of boys and girls between the ages of 0 and 18 years. Few differences were found in parents' use of control with boys and girls. Parents were slightly more controlling with boys than with girls, but the effect size was negligible (d = 0.08. The effect was larger, but still small, in normative groups and in samples with younger children. No overall effect for gender-differentiated autonomy-supportive strategies was found (d = 0.03. A significant effect of time emerged: studies published in the 1970s and 1980s reported more autonomy-supportive strategies with boys than toward girls, but from 1990 onwards parents showed somewhat more autonomy-supportive strategies with girls than toward boys. Taking into account parents' gender stereotypes might uncover subgroups of families where gender-differentiated control is salient, but based on our systematic review of the currently available large data base we conclude that in general the differences between parenting of boys versus girls are minimal.

  7. Current differential diagnosis of hypereosinophilic syndrome

    Directory of Open Access Journals (Sweden)

    Dinić-Uzurov Vera

    2007-01-01

    syndrome is a subcategory of idiopathic eosinophilia. If the differential diagnosis of hypereosinophilia fails to resolve the etiology succesfully, the diagnosis of idiopathic HES remains.

  8. Challenges in the Diagnosis and Management of Acquired Nontraumatic Urethral Strictures in Boys in Yaoundé, Cameroon

    Science.gov (United States)

    Mouafo Tambo, F. F.; Fossi kamga, G.; Kamadjou, C.; Mbouche, L.; Nwaha Makon, A. S.; Birraux, J.; Andze, O. G.; Angwafo, F. F.; Mure, P. Y.

    2016-01-01

    Introduction. Urethral strictures in boys denote narrowing of the urethra which can be congenital or acquired. In case of acquired strictures, the etiology is iatrogenic or traumatic and rarely infectious or inflammatory. The aim of this study was to highlight the diagnostic and therapeutic difficulties of acquired nontraumatic urethral strictures in boys in Yaoundé, Cameroon. Methodology. The authors report five cases of nontraumatic urethral strictures managed at the Pediatric Surgery Department of the YGOPH over a two-year period (November 2012–November 2014). In order to confirm the diagnosis of urethral stricture, all patients were assessed with both cystourethrography and urethrocystoscopy. Results. In all the cases the urethra was inflammatory with either a single or multiple strictures. The surgical management included internal urethrotomy (n = 1), urethral dilatation (n = 1), vesicostomy (n = 2), and urethral catheterization (n = 3). With a median follow-up of 8.2 months (4–16 months) all patients remained symptoms-free. Conclusion. The authors report the difficulties encountered in the diagnosis and management of nontraumatic urethral strictures in boys at a tertiary hospital in Yaoundé, Cameroon. The existence of an inflammatory etiology of urethral strictures in boys deserves to be considered. PMID:27239364

  9. The role of bone marrow pathology in diagnosis and differential diagnosis of refractory cytopenia of children

    Institute of Scientific and Technical Information of China (English)

    李占琦

    2013-01-01

    Objective To explore the diagnosis and differential diagnosis of refractory cytopenia of children(RCC) according to WHO classification,and discuss the relationship between the cytology reviewed by hematologists and histology reviewed by pathologists. Methods

  10. DIFFERENTIAL DIAGNOSIS OF ORGANIC ACIDEMIA: CLINICAL AND NEUROIMAGING FINDINGS

    OpenAIRE

    Mahmoud Reza ASHRAFI; Alireza TAVASOLI

    2012-01-01

    Clinical differential DiagnosisThe organic acidemias are important in the differential diagnosis of metabolic and neurologic derangement in the neonate and of new-onset neurologic signs in the older child.A-Organic aciduriaSeveral disorders, not classified as primary disorders of organic acid metabolism, have a characteristic urinary organic acid profile that suggests the appropriate diagnosis.• Mevalonicaciduria, a disorder of cholesterol biosynthesis, shows mevalonic acid in the urine.• Glu...

  11. Familial Case of Cherubism from South India: Differential Diagnosis and Report of 2 Cases

    Directory of Open Access Journals (Sweden)

    Varun Muthuraman

    2014-01-01

    Full Text Available Cherubism is a rare familial multilocular cystic lesion of the jaws. The condition clinically appears as a bilateral symmetric swelling of the cheeks in children and is the primary reason for referral. It is a rare lesion of the jaws that has a dominant pattern of inheritance. We report two cases of cherubism, that of a boy and his mother suggestive of a strong familial incidence. A variety of lesions of the jaw mimic this condition and hence the differential diagnosis has been emphasised.

  12. The Wolf Boy: Reactive Attachment Disorder in an Adolescent Boy

    OpenAIRE

    Swain, James E.; Leckman, James F.; Volkmar, Fred R.

    2005-01-01

    An adolescent boy presented with episodic wolf-like aggressive behaviors, for which his rural community planned an exorcism. Admission to a tertiary care hospital revealed an adolescent suffering an array of severe psychiatric symptoms, which best fit the diagnosis of reactive attachment disorder (RAD). The differential diagnosis included delusional disorder, mood problems, anxiety, schizophrenia, and “feral child” syndrome. Nosology and pathophysiology as well as pharmacological and psychoso...

  13. Differential diagnosis of ambiguous genitalia in Chines e patients

    Institute of Scientific and Technical Information of China (English)

    田秦杰; 葛秦生

    2002-01-01

    Objective: To study the etiology and differential diagnos is of ambiguous genitalia.Methods: One hundred and five cases of ambiguous genitalia with disorders of sexual differentiation were analyzed based on clinical characterist ics and basic research. Results: Ambiguous genitalia are closely related to the functio n of androgen. It could be classified into 3 groups: androgen excess, androgen d eficiency and failure of gonadal differentiation. Differential diagnosis depends on clinical manifestations, chromosome examination, serum hormone determination s, final gonadal pathology, receptor study etc.Conclusion: Ambiguous genitalia are related to abnormal androgen ic effect and early correct etiological diagnosis is the key to its management.

  14. Differential Diagnosis in Idiopathic Granulomatous Mastitis and Tuberculous Mastitis

    OpenAIRE

    Seo, Hee Ri Na; Na, Kuk Young; Yim, Hyun Ee; Kim, Tae Hee; Kang, Doo Kyoung; Oh, Ki Keun; Kang, Seok Yun; An, Young-Sil; Chun, Mison; Kim, Woojae; Park, Rae Woong; Jung, Yong Sik; Kim, Ku Sang

    2012-01-01

    Purpose Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease of unknown etiology. The diagnosis of IGM requires that other granulomatous lesions in the breast be excluded. Tuberculous mastitis (TM) is also an uncommon disease that is often difficult to differentiate from IGM. The purpose of this study is to develop a new algorithm for the differential diagnosis and treatment of IGM and TM. Methods Medical records of 68 patients (58 with IGM and 10 with TM) between Ju...

  15. Differential association between MAOA, ADHD and neuropsychological functioning in boys and girls

    NARCIS (Netherlands)

    Lambregts-Rommelse, N.N.J.; Altink, M.E.; Arias-Vasquez, A.; Buschgens, C.J.M.; Fliers, E.; Faraone, S.V.; Buitelaar, J.K.; Sergeant, J.A.; Oosterlaan, J.; Franke, B.

    2008-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is more common in boys than in girls. It has been hypothesized that this sex difference might be related to genes on the X-chromosome, like Monoamine Oxidase A (MAOA). Almost all studies on the role of MAOA in ADHD have focused predominantly on boys, m

  16. Multiple intracranial calcifications caused by parasites and their differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Kuckein, D.

    1980-08-01

    In connection with a case of cysticercosis the CT differential diagnosis of multiple intracranial calcifications is discussed. In addition to CT, conventional X-ray diagnosis, angiography and clinical data are needed in order to clarify the origin of intracranial calcifications.

  17. Asthma in elite athletes: pathogenesis, diagnosis, differential diagnoses, and treatment

    DEFF Research Database (Denmark)

    Pedersen, Lars; Elers, Jimmi; Backer, Vibeke

    2011-01-01

    Elite athletes have a high prevalence of asthma and exercise-induced bronchoconstriction. Although respiratory symptoms can be suggestive of asthma, the diagnosis of asthma in elite athletes cannot be based solely on the presence or absence of symptoms; diagnosis should be based on objective meas...... athletes with asthma, anti-doping regulations, and differential diagnoses such as exercise-induced laryngomalacia are discussed....

  18. Surface primary bone tumors: Systematic approach and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Mendez Diaz, Cristina; Soler Fernandez, Rafaela; Rodriguez Garcia, Esther; Fernandez Armendariz, Pablo; Diaz Angulo, Carolina [Complejo Hospitalario Universitario A Coruna, Department of Radiology, A Coruna (Spain)

    2015-09-15

    Surface primary bone tumors may appear similar to their intramedullary counterpart, but because they are rare, they may pose diagnostic challenges when showing different characteristics compared to their intramedullary counterpart. It is important for radiologists to recognize the imaging findings for various uncommon surface primary bone tumors, which may help to reduce the differential diagnosis or to lead to a specific diagnosis. Radiography is typically used for first-line imaging. If necessary, it is followed by CT or MRI for evaluation and characterization of surface bone tumors. The aim of this article is to review the imaging findings and differential diagnosis for surface primary bone tumors. (orig.)

  19. Tuberculous and brucellosis meningitis differential diagnosis

    DEFF Research Database (Denmark)

    Erdem, Hakan; Senbayrak, Seniha; Gencer, Serap;

    2015-01-01

    BACKGROUND: The Thwaites and Lancet scoring systems have been used in the rapid diagnosis of tuberculous meningitis (TBM). However, brucellar meningoencephalitis (BME) has similar characteristics with TBM. The ultimate aim of this study is to infer data to see if BME should be included in the dif...

  20. [Diagnosis of mild hemophilia A made by massive intraabdominal bleeding in a 13-year-old boy].

    Science.gov (United States)

    Terao, Yoko; Akiyama, Masaharu; Yokoi, Kentaro; Yamaoka, Masayoshi; Shimizu, Mika; Kato, Yoko; Tanaka, Keiichiro; Baba, Yuji; Kuwashima, Naruo; Ashizuka, Shuichi; Yoshizawa, Jyoji; Motoki, Takanori; Saito, Yoshihiro; Ida, Hiroyuki

    2012-08-01

    We report a 13-year-old boy who had massive intra-abdominal bleeding without a history of bleeding episodes or traumatic cause of bleeding. The patient underwent surgical treatment because bleeding was not controlled after treatment with tranexamic acid and transfusions including fresh-frozen plasma. Bleeding was traced to the lower left lobe of the liver. The mother's side of the family had a history of bleeding episodes in the boy's grandfather, great uncle, and son of a great aunt. A low level of plasma factor VIII coagulant activity (22%) led to a diagnosis of mild hemophilia A. Compared with severe hemophilia, mild hemophilia is more difficult to diagnose because bleeding episodes are less frequent. Most cases are found after incidental trauma or uncontrolled surgery-related bleeding, there is rarely a family history of hemophilia and activated partial thromboplastin time is normal or slightly prolonged. However, bleeding episodes in mild hemophilia may result in excessive, sometimes life-threatening hemorrhage and require early diagnosis and replacement treatment with adequate amounts of factor VIII, as in severe hemophilia. PMID:22975817

  1. [Differential diagnosis of chronic myeloic leucemia in infancy (author's transl)].

    Science.gov (United States)

    Binder, C; Pichler, E; Radaskiewicz, T; Scheibenreiter, S

    1976-01-01

    A 3 months old girl presented with significant enlargement of liver, spleen and lymphnodes, with moderate anemia, thrombopenia and leucocytosis. In the differential count there was a shift to the left and an increase of monocyte-like cells (35%). Differential diagnosis included leucemoid reaction, infectious mononucleosis, myelo-proliferative disorder with a missing C chromosome and chronic myeloid leucemia. Clinical symptoms, cytochemistry and caryotype of bone marrow cells suggested infantile chronic myeloic leucemia and normal ALP index and possibly normal HbF. Treatment with 6-mercaptopurine was followed by partial remission. The therapeutic consequences of exact differential diagnosis are discussed.

  2. Developing a semantic web model for medical differential diagnosis recommendation.

    Science.gov (United States)

    Mohammed, Osama; Benlamri, Rachid

    2014-10-01

    In this paper we describe a novel model for differential diagnosis designed to make recommendations by utilizing semantic web technologies. The model is a response to a number of requirements, ranging from incorporating essential clinical diagnostic semantics to the integration of data mining for the process of identifying candidate diseases that best explain a set of clinical features. We introduce two major components, which we find essential to the construction of an integral differential diagnosis recommendation model: the evidence-based recommender component and the proximity-based recommender component. Both approaches are driven by disease diagnosis ontologies designed specifically to enable the process of generating diagnostic recommendations. These ontologies are the disease symptom ontology and the patient ontology. The evidence-based diagnosis process develops dynamic rules based on standardized clinical pathways. The proximity-based component employs data mining to provide clinicians with diagnosis predictions, as well as generates new diagnosis rules from provided training datasets. This article describes the integration between these two components along with the developed diagnosis ontologies to form a novel medical differential diagnosis recommendation model. This article also provides test cases from the implementation of the overall model, which shows quite promising diagnostic recommendation results.

  3. Developing a semantic web model for medical differential diagnosis recommendation.

    Science.gov (United States)

    Mohammed, Osama; Benlamri, Rachid

    2014-10-01

    In this paper we describe a novel model for differential diagnosis designed to make recommendations by utilizing semantic web technologies. The model is a response to a number of requirements, ranging from incorporating essential clinical diagnostic semantics to the integration of data mining for the process of identifying candidate diseases that best explain a set of clinical features. We introduce two major components, which we find essential to the construction of an integral differential diagnosis recommendation model: the evidence-based recommender component and the proximity-based recommender component. Both approaches are driven by disease diagnosis ontologies designed specifically to enable the process of generating diagnostic recommendations. These ontologies are the disease symptom ontology and the patient ontology. The evidence-based diagnosis process develops dynamic rules based on standardized clinical pathways. The proximity-based component employs data mining to provide clinicians with diagnosis predictions, as well as generates new diagnosis rules from provided training datasets. This article describes the integration between these two components along with the developed diagnosis ontologies to form a novel medical differential diagnosis recommendation model. This article also provides test cases from the implementation of the overall model, which shows quite promising diagnostic recommendation results. PMID:25178271

  4. Differential diagnosis of small bowel occlusions

    Directory of Open Access Journals (Sweden)

    Paolo Ghiringhelli

    2009-06-01

    Full Text Available Hereditary nonpolyposis colorectal cancer (HNPCC, also known as Lynch syndrome, is a common autosomal dominant syndrome characterized by early age at onset, and microsatellite instability (MSI. Patients with Lynch syndrome have a markedly increased risk of colorectal cancer. We report a case of a 28-year-old male with Lynch syndrome; the case allows to describe clinical manifestations and diagnostic criteria of this syndrome, and to underline the importance of genetics in the diagnosis of this disease.

  5. Differential diagnosis and treatment of vestibular vertigo

    OpenAIRE

    Vladimir Anatolyevich Parfenov; O V Abdulina; M V Zamergrad

    2010-01-01

    Vertigo is a common complaint that leads patients to visit physicians of various specialties. Diseases resulting in vestibular vertigo are very diverse and may be caused by lesion of both the central parts of the vestibular system and the peripheral vestibular apparatus. In many cases, its diagnosis can be made from complaints and a history of disease and special bedside tests requiring no sophisticated equipment. Management of vestibular vertigo should aim at treating the underlying disease;...

  6. Testicular torsion: diagnosis, differential diagnosis, and treatment in children; Hodentorsion: Diagnose, Differenzialdiagnose und Therapie im Kindesalter

    Energy Technology Data Exchange (ETDEWEB)

    Guenther, P. [Chirurgische Universitaetsklinik Heidelberg (Germany)., Abt. Kinderchirurgie; Schenk, J.P. [Universitaetsklinikum Heidelberg (Germany). Paediatrische Radiologie

    2006-07-15

    Acute scrotum represents an emergency situation although testicular torsion is present in less than 20% of the cases. Sonography has meanwhile become the definitive modality for diagnosis. Its increasing use before surgical intervention has led to technical improvements in ultrasound diagnostics and critical assessment of ultrasound criteria to exclude testicular torsion as well as standardization of examination procedures. Central arterial and venous perfusion shown to be bilaterally equal on Doppler sonography is the most important criterion for excluding torsion. This article discusses other criteria such as the ''resistance index,'' comparison of parenchymal structure of both testes, evidence for spermatic cord torsion, or differences between the sides in perfusion of the testicular parenchyma and highlights the difficulties involved in partial and intermittent testicular torsion. Alternative investigative methods and the significance of sonography in the differential diagnosis of other underlying causes are addressed. In summary, the combination of interpreting B-mode imaging, color Doppler, and power Doppler sonography and analyzing Doppler flow curves after clinical examination results in successful and conclusive evaluation of the testes in cases of acute scrotum in boys. (orig.) [German] Das akute Skrotum ist eine Notfallsituation, wobei in weniger als 20% der Faelle eine Hodentorsion vorliegt. Inzwischen hat sich die Sonographie zur entscheidenden diagnostischen Untersuchungsmodalitaet entwickelt deren zunehmende Anwendung zu technischen Fortschritten der Ultraschalldiagnostik, zu einer kritischen Bewertung von Ultraschallkriterien zum Ausschluss einer Hodentorsion und zu einer Standardisierung der Untersuchungsablaeufe gefuehrt hat. Die in der Dopplersonographie dargestellte seitengleiche zentrale arterielle und venoese Perfusion ist hierbei das wichtigste Kriterium zum Ausschluss einer Torsion. Weitere Kriterien wie &apos

  7. Diagnosis and differential diagnosis value of magnetic resonance imaging in autoimmune pancreatitis

    Institute of Scientific and Technical Information of China (English)

    汪建华

    2014-01-01

    Objective To investigate the diagnosis and differential diagnosis value of multi-sequences magnetic resonance imaging(MRI)in autoimmune pancreatitis(AIP).Methods The MRI data of twelve AIP patients were retrospectively analyzed.The sequences of MRI included T1-weighted imaging,T2-weighted imaging,magnetic resonance cholangiopancreatography(MRCP),diffusionweighted imaging(DWI)and dynamic enhancement ima-

  8. Differential diagnosis and treatment of vestibular vertigo

    Directory of Open Access Journals (Sweden)

    Vladimir Anatolyevich Parfenov

    2010-01-01

    Full Text Available Vertigo is a common complaint that leads patients to visit physicians of various specialties. Diseases resulting in vestibular vertigo are very diverse and may be caused by lesion of both the central parts of the vestibular system and the peripheral vestibular apparatus. In many cases, its diagnosis can be made from complaints and a history of disease and special bedside tests requiring no sophisticated equipment. Management of vestibular vertigo should aim at treating the underlying disease; vestibular dilators as symptomatic therapy can be effective for several days. Vestibular exercises the efficiency of which can be enhanced by betahistine and other drugs accelerating vestibular compensation should be further needed. Data on the efficacy of betaver (betahistine in patients with vestibular vertigo are given.

  9. Clinical case: Differential diagnosis of idiopathic pulmonary fibrosis

    OpenAIRE

    Cordeiro, Carlos Robalo; Alfaro, Tiago M.; Freitas, Sara

    2013-01-01

    Background The diagnosis of idiopathic pulmonary fibrosis can be quite challenging, even after careful clinical evaluation, imaging and pathological tests. This case report intends to demonstrate and discuss these difficulties, especially those concerning the differential diagnosis with chronic hypersensitivity pneumonitis. Case presentation A 58-year-old white male presented with shortness of breath, dry cough, fatigue and weight loss for two months. He was a former smoker and had regular ex...

  10. Hepatic adenoma and focal nodular hyperplasia: differential diagnosis and treatment.

    Science.gov (United States)

    Herman, P; Pugliese, V; Machado, M A; Montagnini, A L; Salem, M Z; Bacchella, T; D'Albuquerque, L A; Saad, W A; Machado, M C; Pinotti, H W

    2000-03-01

    The diagnosis of benign hepatic tumors as hepatic adenoma (HA) and focal nodular hyperplasia (FNH) remains a challenge for clinicians and surgeons. The importance of differentiating between these lesions is based on the fact that HA must be surgically resected and FNH can be only observed. A series of 23 female patients with benign liver tumors (13 FNH, 10 HA) were evaluated, and a radiologic diagnostic algorithm was employed with the aim of establishing preoperative criteria for the differential diagnosis. All patients were submitted to surgical biopsy or hepatic resection to confirm the diagnosis. Based only on clinical and laboratory data, distinction was not possible. According to the investigative algorithm, the diagnosis was correct in 82.6% of the cases; but even with the development of imaging methods, which were used in combination, the differentiation was not possible in four patients. For FNH cases scintigraphy presented a sensitivity of 38.4% and specificity of 100%, whereas for HA the sensitivity reached 60% and specificity 85.7%. Magnetic resonance imaging, employed when scintigraphic findings were not typical, presented sensitivities of 71.4% and 80% and specificities of 100% and 100% for FNH and HA, respectively. Preoperative diagnosis of FNH was possible in 10 of 13 (76.9%) patients and was confirmed by histology in all of them. In one case, FNH was misdiagnosed as HA. The diagnosis of HA was possible in 9 of 10 (90%) adenoma cases. Surgical biopsy remains the best method for the differential diagnosis between HA and FNH and must be performed in all doubtful cases. Surgical resection is the treatment of choice for all patients with adenoma and can be performed safely. With the evolution of imaging methods it seems that the preoperative diagnosis of FNH may be considered reliable, thereby avoiding unnecessary surgical resection. PMID:10658075

  11. Possibilities of differential diagnosis of liver damage in oncologic patients

    International Nuclear Information System (INIS)

    Double scintigraphy of the liver, using two radiopharmaceuticals (sup(99m)Tc-sulphur coloid, 67Ga-citrate), is a contribution to the differential diagnosis of malignant and benign lesions of the liver parenchyma. Apart from increased sensitivity it decreases the comparatively high percentage of falsely-positive results with a common radiocoloidal hepatoscan. The separation of isoenzymes of alcaline phosphatase and γ-glutamyltranspherase yields important information about the nature of the lesion of the hepatic parenchyma. The determination isoenzymes of lactate dehydrogenase and carcinoembryonal antigen has no differentiating value for the diagnosis. (author)

  12. Historical background, definitions and differential diagnosis.

    Science.gov (United States)

    Sampson, Hugh A

    2015-01-01

    Although awareness that food can cause adverse symptoms and even death in some individuals has been present since the times of Hippocrates, it was not until the seminal experiment of Prausnitz that the investigation of food allergy had a more scientific basis. In the first half of the 20th century, there were periodic reports in the medical literature describing various food allergic reactions. Until the studies of Charles May and colleagues in the mid- to late '70s, there was a great deal of skepticism in the medical world about the relevance of food allergy and how to diagnose it, since standard skin testing was known to correlate poorly with clinical symptoms. With the introduction of the double-blind, placebo-controlled oral food challenge by May, the study of food allergy has become evidence based, and tremendous strides have been made in the study of basic immunopathogenic mechanisms and natural history as well as in the diagnosis and management of food allergies. Today, various IgE- and non-IgE-mediated food allergic disorders have been well characterized, and efforts to reverse these allergies using various immunotherapeutic strategies are well under way. PMID:26022859

  13. Lennox-Gastaut syndrome: a consensus approach to differential diagnosis.

    Science.gov (United States)

    Bourgeois, Blaise F D; Douglass, Laurie M; Sankar, Raman

    2014-09-01

    Lennox-Gastaut syndrome (LGS) is a severe epileptic encephalopathy that shares many features and characteristics of other treatment-resistant childhood epilepsies. Accurate and early diagnosis is essential to both prognosis and overall patient management. However, accurate diagnosis of LGS can be clinically challenging. This article summarizes key characteristics of LGS and areas of overlap with other childhood epilepsies. Drawing upon input from a committee of established LGS experts convened in June 2012 in Chicago, Illinois, the authors highlight key diagnostic tests for making the differential diagnosis and propose a diagnostic scheme for people with suspected LGS.

  14. Tuberculosis in the head and neck - a forgotten differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Vaid, S., E-mail: vaids@vsnl.co [Department of Radiology and Imaging, Grant Medical Foundation, Pune (India); Lee, Y.Y.P. [Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Hong Kong (China); Rawat, S.; Luthra, A.; Shah, D. [Department of Radiology and Imaging, Grant Medical Foundation, Pune (India); Ahuja, A.T. [Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hongkong, Hong Kong (China)

    2010-01-15

    The aim of the present review is to illustrate the pathogenesis and imaging findings of tuberculosis in specific head and neck regions to avoid pitfalls in diagnosis. It is imperative to be aware of, and provide an early diagnosis for, extra-pulmonary tubercular lesions in the head and neck. A high index of suspicion combined with an appropriate clinical setting serves as an important background to diagnose tubercular lesions in the head and neck region and differentiate them from malignancy and other disease entities. Early diagnosis and treatment can prevent irreversible and debilitating complications and mortality from disseminated tuberculosis.

  15. ICON: An artificial intelligence approach to radiologic differential diagnosis

    International Nuclear Information System (INIS)

    ICON is a computer system, developed using artificial intelligence techniques, that is designed to help radiologists manage the large body of knowledge needed to perform differential diagnosis in radiology. The system's domain is lung disease in patients with lymphoproliferative disorders. The radiologist proposes a diagnostic hypothesis which he or she thinks explains the known clinical and chest radiographic findings. ICON responds with an English-language prose critique that discusses how and why the proposed diagnosis is or is not supported by the clinical literature and suggests further findings or clinical information that might make the diagnosis more secure

  16. "Racialised Facilitative Capital" and the Paving of Differential Paths to Achievement of Afro-Trinidadian Boys

    Science.gov (United States)

    Rampersad, Ravi

    2014-01-01

    Bourdieu describes capital as the political building blocks of social order that give meaning to social accumulation and consumption. Through a combination of Bourdieu's sociology and critical race theory, this sojourn into Afro-Trinidadian boys' achievement seeks to elucidate an approach to understanding capital as inherently raced.…

  17. Differential diagnosis of mesiotemporal lesions: case report of neurosyphilis

    Energy Technology Data Exchange (ETDEWEB)

    Vieira Santos, A.; Matias, S.; Saraiva, P.; Goulao, A. [Garcia de Orta Hospital, Neuroradiology Department, Almada (Portugal)

    2005-09-01

    We report a clinical and imaging case of suspected herpes simplex encephalitis subsequently diagnosed as neurosyphilis based on positive antibodies in the CSF. MRI of the brain showed cortical and subcortical lesions in the mesial temporal region, septal area, insula and cingulated gyrus of the right cerebral hemisphere. Neurosyphilis should be included in the differential diagnosis of mesial temporal region lesions on MRI. (orig.)

  18. Autism and Rett Syndrome: Behavioural Investigations and Differential Diagnosis.

    Science.gov (United States)

    Olsson, Bo; Rett, Andreas

    1987-01-01

    Differential diagnosis of Rett syndrome and infantile autism among 63 female patients (22 months to 15 years) was investigated. Conclusions concerned: characteristics of some Rett subjects but no autistic subjects, characteristics of all Rett subjects but not all autistic subjects, and characteristics of most Rett subjects and some autistic…

  19. Delayed puberty and hypogonadotropic hypogonadism. Differential diagnosis and treatment

    NARCIS (Netherlands)

    Snoep, Marinus Cornelis

    1978-01-01

    This thesis describes a method enabling a prospecrive differential diagnosis to be made berween delayed puberty (DP) and hypogonadotropic hypogonadism (HH). The influence of androgen administration on the gonadal feedback sysrem of patients with delayed puberty was also studied. ... Zie: Summary

  20. HYPERMOBILITY SYNDROME: CLINICAL MANIFESTATIONS, DIFFERENTIAL DIAGNOSIS, THERAPY APPROACHES

    OpenAIRE

    N. A. Shostak; N. G. Pravdyuk

    2016-01-01

    Connective tissue dysplasia (CTD) represents special ontogenetic abnormality which is a complex problem of contemporary medicine. The principles of differential diagnosis of various forms of CTD are considered. A clinical estimation and therapy approaches are discussed with focus on hypermobility syndrome as one of undifferentiated form of CTD.

  1. HYPERMOBILITY SYNDROME: CLINICAL MANIFESTATIONS, DIFFERENTIAL DIAGNOSIS, THERAPY APPROACHES

    Directory of Open Access Journals (Sweden)

    N. A. Shostak

    2016-01-01

    Full Text Available Connective tissue dysplasia (CTD represents special ontogenetic abnormality which is a complex problem of contemporary medicine. The principles of differential diagnosis of various forms of CTD are considered. A clinical estimation and therapy approaches are discussed with focus on hypermobility syndrome as one of undifferentiated form of CTD.

  2. When to consider acute HIV infection in the differential diagnosis.

    Science.gov (United States)

    Grimes, Richard M; Hardwicke, Robin L; Grimes, Deanna E; DeGarmo, D Sean

    2016-01-16

    Patients presenting with fever, pharyngitis, and lymphadenopathy are likely to have mononucleosis; however, patients with acute HIV infection may present with similar symptoms. Acute HIV infection should be considered as a differential diagnosis if test results for mononucleosis are negative. This article describes when to order HIV testing and discusses the importance of early intervention for acute HIV infection. PMID:26678418

  3. Isolated femoral hypoplasia: an intrauterine differential diagnosis to campomelia

    Energy Technology Data Exchange (ETDEWEB)

    Koerber, Friederike; Benz-Bohm, Gabriele [University of Cologne, Department of Paediatric Radiology, Cologne (Germany); Schoenau, Eckard [University of Cologne, Department of Paediatrics, Cologne (Germany); Horwitz, A.Eldad [Klinikum Krefeld, Department of Paediatric Radiology, Krefeld (Germany)

    2005-06-01

    The isolated form of femoral bowing is an important differential diagnosis of campomelia. Therefore, knowledge of isolated anomalies is fundamental for prenatal diagnosis, especially for the differential diagnosis from severe syndromes. Four cases are presented to discuss the differential diagnosis of femoral bowing including a review of the literature. We report four newborn babies with unilateral bowing and shortening of the femur. Three had no further anomaly; one child had additional abnormalities due to coumarin embryopathy. The radiological findings were shortened femora with bowing and varus deformity and cortical thickening on the concave side. All other parts showed normal bone structure. The aetiology of femoral bowing is unknown. Early damage of the cartilaginous model followed by remodelling with thickening on the concave side of the bone similar to the healing of malaligned fractures is suspected. The isolated form of femoral bowing without any other anomalies has to be differentiated from complex and more often severe congenital syndromes such as campomelia. Postpartum radiological examination should be reduced to a single exposure of the affected limb and follow-up should be done by clinical examination. (orig.)

  4. Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years After Initial Diagnosis.

    Science.gov (United States)

    Gillberg, I Carina; Helles, Adam; Billstedt, Eva; Gillberg, Christopher

    2016-01-01

    We examined comorbid psychiatric and neurodevelopmental disorders in fifty adult males (mean age 30 years) with Asperger syndrome (AS) diagnosed in childhood and followed up prospectively for almost two decades (13-26 years). Only three of the 50 men had never met criteria for an additional psychiatric/neurodevelopmental diagnosis and more than half had ongoing comorbidity (most commonly either ADHD or depression or both). Any psychiatric comorbidity increased the risk of poorer outcome. The minority of the AS group who no longer met criteria for a full diagnosis of an autism spectrum disorder were usually free of current psychiatric comorbidity. The high rate of psychiatric/neurodevelopmental comorbidities underscores the need for a full psychiatric/neurodevelopmental assessment at follow-up of males with AS.

  5. Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years After Initial Diagnosis.

    Science.gov (United States)

    Gillberg, I Carina; Helles, Adam; Billstedt, Eva; Gillberg, Christopher

    2016-01-01

    We examined comorbid psychiatric and neurodevelopmental disorders in fifty adult males (mean age 30 years) with Asperger syndrome (AS) diagnosed in childhood and followed up prospectively for almost two decades (13-26 years). Only three of the 50 men had never met criteria for an additional psychiatric/neurodevelopmental diagnosis and more than half had ongoing comorbidity (most commonly either ADHD or depression or both). Any psychiatric comorbidity increased the risk of poorer outcome. The minority of the AS group who no longer met criteria for a full diagnosis of an autism spectrum disorder were usually free of current psychiatric comorbidity. The high rate of psychiatric/neurodevelopmental comorbidities underscores the need for a full psychiatric/neurodevelopmental assessment at follow-up of males with AS. PMID:26210519

  6. Syndromal versus contextualized personality assessment: differentiating environmental and dispositional determinants of boys' aggression.

    Science.gov (United States)

    Wright, J C; Lindgren, K P; Zakriski, A L

    2001-12-01

    Two studies examined how "syndromal" approaches to assessment confound differences between individuals in the person and situation variables that contribute to their behavior. In a field study, a widely used instrument was found to be sensitive to the base rates of boys' aggression but, as expected, did not discriminate between boys who were similar in their behavior base rates but different in their social environments and how they responded to them. A laboratory experiment replicated this finding and demonstrated that social observers discriminated between targets on the basis of their functional properties even though syndrome scores did not. The results clarify how syndromal methods can obscure situational factors, conflict with people's social knowledge, and reinforce the view that syndromes exist "in the individual" rather than in person-environment interactions. Implications for developing more contextually sensitive instruments are discussed.

  7. Liver biopsy interpretation in the differential diagnosis of autoimmune liver disease in children

    Directory of Open Access Journals (Sweden)

    Clara Gerosa

    2013-06-01

    Full Text Available Autoimmune liver disease  (AILD represents a group of complex inflammatory liver diseases, all characterized by an aberrant autoreactivity against hepatocytes and/or biliary structures. AILD may be subclassified into four major diseases: autoimmune hepatitis (AIH, primary biliary cirrhosis (PBC, primary sclerosing cholangitis (PSC, and autoimmune cholangitis (AIC. Recently a new entity frequently associated with autoimmune pancreatitis and defined IgG4-related cholangitis (IgG4-RC,  has been added to the spectrum of AILD. The most frequent autoimmune liver diseases  of the AILD spectrum occurring in children and in young adults are  AIH  and PSC, overlap syndrome between AIH and PSC, also defined as autoimmune sclerosing cholangitis (ASC, representing a frequent finding in pediatric patients. Here,  the morphological findings that may help liver pathologists in the differential diagnosis of AILD in pediatric patients are reviewed, underlying the frequency in liver biopsy interpretation of complex cases in which a precise diagnosis may remain controversial, due to overlap of hepatocytic and bile duct cell lesions. Among the multiple morphological changes typical of AILD,  the detection of an high number of plasma cell clusters in the portal and periportal regions is generally considered one of the main clue for the diagnosis of AIH. The recent report in a 13-year old  boy of IgG4-associated cholangitis, induces  pathologists when detecting a huge number of plasmacells, to consider the differential diagnosis between AIH and IgG4-RC.Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge research

  8. Oral angioleiomyoma: a case report and considerations on differential diagnosis

    Directory of Open Access Journals (Sweden)

    Carlos Augusto Galvão Barboza

    2013-12-01

    Full Text Available Angioleiomyomas are benign mesenchymal tumors derived from smooth muscle, which rarely occur in the oral cavity. We report a case of an angioleiomyoma occurring in the maxillary gingiva. The lesion was painless, with a lobulated surface, fibrous in consistency, and firm upon palpation. Microscopic examination showed an encapsulated tumor mass composed of large vascular channels of varying calibers, surrounded by thick walls of irregularly arranged, spindle-shaped cells, which were immunopositive for smooth-muscle actin. It is sometimes difficult to differentiate an angioleiomyoma from other spindle-cell tumors, thus we emphasize its histological differential diagnosis.

  9. Infective endocarditis: the specific features of its course, the criteria for diagnosis, differential diagnosis (part II

    Directory of Open Access Journals (Sweden)

    B S Belov

    2008-01-01

    Full Text Available Infective endocarditis (IE is today characterized by polyetiology due to a wide range of pathogens. The paper describes the specific features of the clinical picture of the disease in relation to the etiological agent, which have, in some cases, a crucial role in the choice of empiric antibiotic therapy. Significant clinical polymorphism, obscure symptoms, and monosyndromic onset as guises all enhance the importance of the differential diagnosis of IE, at its early stages in particular. Basic approaches to differentiating IE from the diseases in which differentially diagnostic problems arise to the utmost are outlined.

  10. Endoscopic Diagnosis and Differentiation of Inflammatory Bowel Disease

    Science.gov (United States)

    Lee, Ji Min; Lee, Kang-Moon

    2016-01-01

    Patients with inflammatory bowel disease have significantly increased in recent decades in Korea. Intestinal tuberculosis (ITB) and intestinal Behcet’s disease (BD), which should be differentiated from Crohn’s disease (CD), are more frequent in Korea than in the West. Thus, the accurate diagnosis of these inflammatory diseases is problematic in Korea and clinicians should fully understand their clinical and endoscopic characteristics. Ulcerative colitis mostly presents with rectal inflammation and continuous lesions, while CD presents with discontinuous inflammatory lesions and frequently involves the ileocecal area. Involvement of fewer than four segments, a patulous ileocecal valve, transverse ulcers, and scars or pseudopolyps are more frequently seen in ITB than in CD. A few ulcers with discrete margins are a typical endoscopic finding of intestinal BD. However, the differential diagnosis is difficult in many clinical situations because typical endoscopic findings are not always observed. Therefore, clinicians should also consider symptoms and laboratory, pathological, and radiological findings, in addition to endoscopic findings. PMID:27484813

  11. Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder

    Directory of Open Access Journals (Sweden)

    Michelle Nigri Levitan

    2013-12-01

    Full Text Available Objective: To present the most relevant findings regarding the Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder. Methods: We used the methodology proposed by the Brazilian Medical Association for the Diretrizes Project. The MEDLINE (PubMed, Scopus, Web of Science, and LILACS online databases were queried for articles published from 1980 to 2012. Searchable questions were structured using the PICO format (acronym for “patient” [or population], “intervention” [or exposure], “comparison” [or control], and “outcome”. Results: We present data on clinical manifestations and implications of panic disorder and its association with depression, drug abuse, dependence and anxiety disorders. In addition, discussions were held on the main psychiatric and clinical differential diagnoses. Conclusions: The guidelines are proposed to serve as a reference for the general practitioner and specialist to assist in and facilitate the diagnosis of panic disorder.

  12. Application of 1H magnetic resonance spectroscopy in diagnosis and differential diagnosis of cerebral infection

    International Nuclear Information System (INIS)

    Objective: To study the application of single voxel proton magnetic resonance spectroscopy in diagnosis and differential diagnosis of cerebral infection according to manifestations of the 8 patients with cerebritis and 13 patients with gliomas. Methods: The patients including 8 cerebral abscess and 13 gliomas were examined with MRS. And the quantity of the NAA, Cho, Cr, Lip, Lac, AA were measured and compared. Results: There were differences between cerebral abscess and tumors on MRS. NAA/Cr and Cho/Cr of abscess were 4.114±3.637 and 3.084±0.933. NAA/Cr and Cho/Cr of tumors were 1.064±0.823 and 5.987±4.380. There was amino acids (AA) could be seen in some of cerebral abscess. Conclusion: 1H magnetic resonance spectroscopy can supply important information in diagnosis cerebral infection and differentiate information with tumor. (authors)

  13. [Anorexia nervosa as differential diagnosis in underweight patients].

    Science.gov (United States)

    Rapps, Nora; Skoda, Eva; Zipfel, Stephan

    2016-02-01

    Anorexia nervosa is a differential diagnosis in underweight patients, especially in young underweight women. Diagnostic criteria for anorexia nervosa are self-induced weight loss due to restrictive eating or purging behaviour, intense fear of gaining weight and disturbance in the way in which one`s shape is experienced, undue influence of body weight on self-evaluation and persistent lack of recognition of the seriousness of the current low body weight. Anorexia nervosa is associated with numerous medical complications. PMID:26886039

  14. Celiac Disease and Cystic Fibrosis: Challenges to Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Ramos Alessandra Teixeira Pessoa

    2016-06-01

    Full Text Available Cystic fibrosis and celiac disease were considered a single clinical entity for many years. Differentiation between the diseases occurred some time in the 1930s of the 20th Century. Both diseases may present the intestinal malabsorption syndrome and similar clinical manifestations that contribute to difficulties with clinical distinction. We describe a report of two patients with initial diagnosis of cystic fibrosis, who were subsequently diagnosed with celiac disease.

  15. [Several techniques proposed for the differential diagnosis of diabetic impotence].

    Science.gov (United States)

    Lavoisier, P

    1988-01-01

    The measurements of changes in penile circumference during nocturnal erection is commonly used to differentiate between organic and psychogenic impotence. Unfortunately, this measuring technique do not record variations in penile rigidity which may be insufficient to achieve coitus despite a normal circumference. We carried out a study with a penile cuff to measure penile rigidity. The validation of this penile cuff as a measurement device of penile rigidity permits us to determine the criteria of normality of penile rigidity and, subsequently, to differentiate more accurately between organic and psychogenic dysfunctions. Measurement of the bulbocavernous reflex (BCR) is widely used to diagnose underlying neurologic disorders in erectile dysfunctions. A prolonged BCR latency, more than 45 ms, or absence of a reflex response of the BC muscles during electrical stimulation of the glans penis, is considered like a sign of neurologic disease. We recorded the BCR in 90 subjects. Nineteen had abnormal BCR latencies. Furthermore, eight of these 19 subjects had normal nocturnal erections, thus confirming the diagnosis of psychogenic impotence. These results cast doubt on the validity of BCR measurements of the diagnosis of organic erectile dysfunction due to a neurologic disease. We recorded the BCR in 90 subjects. Nineteen had abnormal BCR latencies. Furthermore, eight of these 19 subjects had normal nocturnal erections, thus confirming the diagnosis of psychogenic impotence. These results cast doubt on the validity of BCR measurements for the diagnosis of organic erectile dysfunction due to a neurologic disease.

  16. The reversed halo sign: update and differential diagnosis.

    Science.gov (United States)

    Godoy, M C B; Viswanathan, C; Marchiori, E; Truong, M T; Benveniste, M F; Rossi, S; Marom, E M

    2012-09-01

    The reversed halo sign is characterised by a central ground-glass opacity surrounded by denser air-space consolidation in the shape of a crescent or a ring. It was first described on high-resolution CT as being specific for cryptogenic organising pneumonia. Since then, the reversed halo sign has been reported in association with a wide range of pulmonary diseases, including invasive pulmonary fungal infections, paracoccidioidomycosis, pneumocystis pneumonia, tuberculosis, community-acquired pneumonia, lymphomatoid granulomatosis, Wegener granulomatosis, lipoid pneumonia and sarcoidosis. It is also seen in pulmonary neoplasms and infarction, and following radiation therapy and radiofrequency ablation of pulmonary malignancies. In this article, we present the spectrum of neoplastic and non-neoplastic diseases that may show the reversed halo sign and offer helpful clues for assisting in the differential diagnosis. By integrating the patient's clinical history with the presence of the reversed halo sign and other accompanying radiological findings, the radiologist should be able to narrow the differential diagnosis substantially, and may be able to provide a presumptive final diagnosis, which may obviate the need for biopsy in selected cases, especially in the immunosuppressed population. PMID:22553298

  17. Parkinsonian syndroms: Clinical phenotype, differential diagnosis and disease progression

    International Nuclear Information System (INIS)

    Parkinsonian syndromes include idiopathic Parkinson's disease (IPD), other neurodegenerative diseases with parkinsonism, the so-called atypical parkinsonian syndromes, and symptomatic parkinsonian syndromes, such as Wilson's disease. IPD is the most frequent disease with parkinsonism as the main clinical feature and is responsible for approx. 80% of all parkinsonian syndromes. Atypical parkinsonian syndromes are the most important differential diagnoses of IPD. The two most frequent types are multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). For clinical diagnosis it is essential to take a careful medical history and to examine the patients physically in regular intervals. However, various clinico-pathological studies have shown that approx. 25% of patients with clinical diagnosis of IPD may have other causes of parkinsonism. Selected technical investigations, in particular functional imaging of the central dopaminergic system using PET or SPECT, may help to make clinical diagnosis more secure. This paper reviews the clinical features and diagnostic findings in diseases with parkinsonism and summarises the difficulties in establishing early and differential diagnoses. (orig.)

  18. Differential diagnosis of cystic bone tumors in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Refior, H.J.; Stuerz, H.

    1982-09-01

    Skeletal changes leading to a suspicion of the presence of a tumour frequently occur in childhood with the roentgenological manifestation of a cyst. X-ray morphology can differ depending upon the localisation and the course. In childhood, however such findings are mainly classified as tumour-like bone lesions. This group comprises, inter alia, the juvenile bone cyst, the aneurysmatic bone cyst and fibrous dysplasia. However, it is necessary to exclude by differential diagnosis - even though the main age of manifestation is after completion of growth - genuine bone tumours with cystic phenomena, such as the giant cell tumour, chondroma or chondroblastoma. Verification of the diagnosis can be effected via radiologic-diagnostic methods such as tomography and angiography as well as computerized tomography. The use of scintigraphy of the skeleton can likewise be indicated. Numerous laboratory parameters can be used in individual cases to exclude certain diagnoses. Taking these aspects into consideration, the article reviews differential diagnosis of the most frequent skeletal affections in childhood. Great emphasis is given to the ranking and importance of the individual diagnostic methods.

  19. Differential Diagnosis of Chronic Rhinosinusitis with Nasal Polyps.

    Science.gov (United States)

    London, Nyall R; Reh, Douglas D

    2016-01-01

    Nasal polyps are semi-translucent mucosal outgrowths of the paranasal sinuses which typically arise in the setting of chronic rhinosinusitis (CRS). Nasal polyps are also associated with asthma, aspirin sensitivity, cystic fibrosis and allergic fungal rhinosinusitis (AFS). The majority of nasal polyps are bilateral and characterized by tissue edema and eosinophil infiltration. Patients with nasal polyps often present with complaints including nasal obstruction, congestion, rhinorrhea or altered sense of smell. The differential diagnosis ranges from benign masses such as schneiderian papilloma, antrochoanal polyp, angiofibroma and encephalocele to malignant neoplasms such as squamous cell carcinoma (SCC), esthesioneuroblastoma, nasal lymphoma and rhabdomyosarcoma. These lesions may have a similar appearance as nasal polyps and particular attention to an alternative diagnosis for nasal polyps should be entertained if the mass is unilateral or congenital in nature. Workup for patients with a unilateral mass should include radiographic imaging, possible biopsy and careful follow-up when appropriate. Here, we review the disease etiology of nasal polyps and describe the approach to the patient with nasal polyps with emphasis on differential diagnosis and workup. PMID:27466841

  20. Double-Fock superposition interferometry for differential diagnosis of decoherence

    International Nuclear Information System (INIS)

    Interferometric signals are degraded by decoherence, which encompasses dephasing, mixing and any distinguishing which-path information. These three paradigmatic processes are fundamentally different, but, for coherent, single-photon and N00N-states, they degrade interferometric visibility in the very same way, which impedes the diagnosis of the cause for reduced visibility in a single experiment. We introduce a versatile formalism for many-boson interferometry based on double-sided Feynman diagrams, which we apply to a protocol for differential decoherence diagnosis: twin-Fock states ∣N,N〉 with N⩾2 reveal to what extent decoherence is due to path distinguishability or to mixing, while double-Fock superpositions ∣N:M〉=(∣N,M〉+∣M,N〉)/√2 with N>M>0 additionally witness the degree of dephasing. Hence, double-Fock superposition interferometry permits the differential diagnosis of decoherence processes in a single experiment, indispensable for the assessment of interferometers. (paper)

  1. RLS, PLM, and their differential diagnosis--a video guide.

    Science.gov (United States)

    Högl, Birgit; Zucconi, Marco; Provini, Federica

    2007-01-01

    This video guide has been designed as an introduction to the full spectrum of nocturnal presentations of restless legs syndrome (RLS) and periodic limb movements (PLM), and to their differential diagnoses. The DVD consists of four sections: In the first part, clinical presentations of RLS are covered (videos 1-3). In the second part, the variety of typical and less frequent presentations of PLM are demonstrated (videos 4-14). The third part shows the clinical presentation of augmentation (videos 15-19). The last section is dedicated to the differential diagnosis of RLS and PLM and demonstrates nocturnal manifestations of other motor disorders during sleep, which must be distinguished: Epilepsy, parasomnias, and other movement disorders (of sleep) (videos 20-33). After viewing this DVD, the reader should be able to: (1) appreciate the spectrum of voluntary and unvoluntary movements seen in patients with RLS during wakefulness; (2) recognize typical PLM during sleep in subjects with RLS, and appreciate the enormous variability of clinical presentations of PLM; (3) describe specific and distinct aspects of motor activity in augmentation in patients with RLS; and (4) be aware of the most important differential diagnosis of RLS/PLM from a video or nocturnal motor activity point of view, namely, nocturnal epilepsy, parasomnias, and others.

  2. Poroma with sebaceous differentiation: Dermoscopy for the diagnosis of skin tumor with sebaceous differentiation

    Directory of Open Access Journals (Sweden)

    Takamichi Ito

    2015-01-01

    Full Text Available Although divergent adnexal differentiations are occasionally seen in poroma, poroma with sebaceous differentiation is extremely rare. We present here the second case of dermoscopy on poroma with sebaceous differentiation. A 38-year-old Japanese female presented with a 2-year history of a slow-growing nodule on her left forearm. Dermoscopically, fine hairpin-like vessels, beige lobular structures were seen in the nodule. Many small yellow dots were scattered between beige lobular structures, giving orange-beige in color as a whole. On the basis of histopathologic findings, a diagnosis of poroma with sebaceous differentiation was made. Some sebaceous tumors are known to exhibit yellowish structures on dermoscopy. Tumors with sebaceous differentiation, as well as conventional sebaceous tumors, can show yellow structures on dermoscopy.

  3. [Differential diagnosis of essential adiposity and Cushings syndrome].

    Science.gov (United States)

    Kubel, M; Schwerdtner, U

    1975-04-01

    On account of the increasing number of patients with essential obesity the delimitation of the Cushing-syndrome is of actual importance. Two observations of hypercortisolism in hyperplasia of the adrenal glands are reported on and the differential-diagnostically important parameters are demonstrated. According to our opinion anamnesis and clinical findings give the possibility of making a diagnosis already on a large scale. Analyses of the hormones and special X-ray examinations only serve for the preoperative ascertainment and localisation of the endocrine defective function. With the help of literary data causes and possibilities of treatment of Cushing's syndrome are entered.

  4. Radiological findings and differential diagnosis in childhood asthma

    International Nuclear Information System (INIS)

    In children with asthma, routine chest X-ray typically shows bilaterally increased air volume, low diaphragms, wide diaphragmatic angles, and often a slender cardiac silhouette with a prominent pulmonic arch. Such an X-ray is not diagnostic of asthma itself, however, but rather of its complications: pneumonitis (particularly in toddlers with infectious asthma), atelectasis due to mucus obstruction, and, rarely, extra-alveolar air trapping (pneumomediastinum with or without cutaneous emphysema more often than pneumothorax). The differential diagnosis has to rule out 'pseudoasthma' due to cystic fibrosis, alveolitis, achalasia, and foreign body aspiration. (orig.)

  5. Neural network approach for differential diagnosis of interstitial lung diseases

    Science.gov (United States)

    Asada, Naoki; Doi, Kunio; MacMahon, Heber; Montner, Steven M.; Giger, Maryellen L.; Abe, Chihiro; Wu, Chris Y.

    1990-07-01

    A neural network approach was applied for the differential diagnosis of interstitial lung diseases. The neural network was designed for distinguishing between 9 types of interstitial lung diseases based on 20 items of clinical and radiographic information. A database for training and testing the neural network was created with 10 hypothetical cases for each of the 9 diseases. The performance of the neural network was evaluated by ROC analysis. The optimal parameters for the current neural network were determined by selecting those yielding the highest ROC curves. In this case the neural network consisted of one hidden layer including 6 units and was trained with 200 learning iterations. When the decision performances of the neural network chest radiologists and senior radiology residents were compared the neural network indicated high performance comparable to that of chest radiologists and superior to that of senior radiology residents. Our preliminary results suggested strongly that the neural network approach had potential utility in the computer-aided differential diagnosis of interstitial lung diseases. 1_

  6. Differential diagnosis of cervical radiculopathy and superior pulmonary sulcus tumor

    Institute of Scientific and Technical Information of China (English)

    GU Rui; KANG Ming-yang; GAO Zhong-li; ZHAO Jian-wu; WANG Jin-cheng

    2012-01-01

    Background The result would be disastrous if the superior pulmonary sulcus tumor (Pancoast tumor) was misdiagnosed as degenerative cervical spine diseases.The aim of this study was to investigate the differential diagnosis methods of cervical radiculopathy and superior pulmonary sulcus tumor.Methods Clinical manifestations,physical,and radiological findings of 10 patients,whose main complaints were radiating shoulder and arm pain and later were diagnosed with superior pulmonary sulcus tumor,were reviewed and compared with those of cervical radiculopathy.Results Superior pulmonary sulcus tumor patients have shorter mean history and fewer complaints of neck pain or limitation of neck movement.Physical examination showed almost normal cervical spine range of motion.Spurling's neck compression test was negative in all patients.Anteroposterior cervical radiographs showed the lack of pulmonary air at the top of the affected lung in all cases and first rib encroachment in one case.The diagnosis of superior pulmonary sulcus tumor can be further confirmed by CT and MRI.Conclusions By the method of combination of history,physical examination,and radiological findings,superior pulmonary sulcus tumor can be efficiently differentiated from cervical radiculopathy.Normal motion range of the cervical spine,negative Spurling's neck compression test,and the lack of pulmonary air at the top of the affected lung in anteroposterior cervical radiographs should be considerad as indications for further chest radiograph examinations.

  7. Multivariable Discriminant Analysis for the Differential Diagnosis of Microcytic Anemia

    Directory of Open Access Journals (Sweden)

    Eloísa Urrechaga

    2013-01-01

    Full Text Available Introduction. Iron deficiency anemia and thalassemia are the most common causes of microcytic anemia. Powerful statistical computer programming enables sensitive discriminant analyses to aid in the diagnosis. We aimed at investigating the performance of the multiple discriminant analysis (MDA to the differential diagnosis of microcytic anemia. Methods. The training group was composed of 200 β-thalassemia carriers, 65 α-thalassemia carriers, 170 iron deficiency anemia (IDA, and 45 mixed cases of thalassemia and acute phase response or iron deficiency. A set of potential predictor parameters that could detect differences among groups were selected: Red Blood Cells (RBC, hemoglobin (Hb, mean cell volume (MCV, mean cell hemoglobin (MCH, and RBC distribution width (RDW. The functions obtained with MDA analysis were applied to a set of 628 consecutive patients with microcytic anemia. Results. For classifying patients into two groups (genetic anemia and acquired anemia, only one function was needed; 87.9% β-thalassemia carriers, and 83.3% α-thalassemia carriers, and 72.1% in the mixed group were correctly classified. Conclusion. Linear discriminant functions based on hemogram data can aid in differentiating between IDA and thalassemia, so samples can be efficiently selected for further analysis to confirm the presence of genetic anemia.

  8. DIFFERENTIAL DIAGNOSIS OF ORGANIC ACIDEMIA: CLINICAL AND NEUROIMAGING FINDINGS

    Directory of Open Access Journals (Sweden)

    Mahmoud Reza ASHRAFI

    2012-03-01

    Full Text Available Clinical differential DiagnosisThe organic acidemias are important in the differential diagnosis of metabolic and neurologic derangement in the neonate and of new-onset neurologic signs in the older child.A-Organic aciduriaSeveral disorders, not classified as primary disorders of organic acid metabolism, have a characteristic urinary organic acid profile that suggests the appropriate diagnosis.• Mevalonicaciduria, a disorder of cholesterol biosynthesis, shows mevalonic acid in the urine.• Glutaricacidemia type II, a disorder of fatty acid oxidation, has multiple organic acids in abnormal concentration in urine. These organic acids include ethylmalonic acid, glutaric acid, dicarboxylic acids, and glycine conjugates of medium chain dicarboxylic acids.• The fatty acylCoA-glycine conjugates that signal incomplete fatty acid oxidation and serves as signals to the diagnosis of MCAD defeciency and other disorders of fatty acid oxidation and transport.• Biotinidase deficiency, a disorder of biotin recycling, results in the urinary excretion of several unusual organic acids, including 3-hydroxy-isovaleric, 3-hydroxypropionic, 3-hydroxybutyric acids, and acetoacetate. Propionyl glycine may also be seen.• Mitochondrial diseases with disordered oxidative phosphorylation often demonstrate the presence of abnormal organic acids in the urine.B-AcidosisNon-genetic conditions, such as shock, sepsis, DKA, liver and kidney failure, thiamine deficiency, RTA, some drug intoxication cause acidosis- genetic conditions are include: inherited metabolic disorders of lactate and pyruvate metabolism and oxidative phosphorylation, disorders of the Krebs cycle such as fumarase deficiency.C-HyperammonemiaDisorders of the urea cycle and the hyperammonemia-hypoglycemia syndrome.Neuroimaging• A variety of MRI abnormalities have been described in the organic academia, including distinctive basal ganglia lesions in glutaricacidemia type I (GA I, white matter changes in

  9. Modified Calgary score in differential diagnosis between cardiac syncope and postural orthostatic tachycardia syndrome-associated syncope in children.

    Science.gov (United States)

    Yang, Jinyan; Zhu, Lulu; Chen, Stella; Li, Xueying; Zhang, Qingyou; Zhang, Fengwen; Chen, Li; Tang, Chaoshu; Du, Junbao; Jin, Hongfang

    2013-06-01

    The present study was designed to analyse the usefulness of a modified Calgary score system during differential diagnosis between cardiac syncope and postural orthostatic tachycardia syndrome-associated syncope through a large sample sized clinical investigation. The study included 213 children, including 101 boys and 112 girls, with cardiac syncope or postural orthostatic tachycardia syndrome-associated syncope in the age group of 2-19 years (mean 11.8 ± 2.9 years). A modified Calgary score was created, which was analysed to predict differential diagnoses between cardiac syncope and postural orthostatic tachycardia syndrome-associated syncope using a receiver operating characteristic curve. The median of modified Calgary scores for cardiac syncope was -5.0, which significantly differed from that of postural orthostatic tachycardia syndrome (0.0; p postural orthostatic tachycardia syndrome-associated syncope in the clinic.

  10. Differential Diagnosis of CNS Angiostrongyliasis: A Short Review

    Science.gov (United States)

    Senthong, Vichai; Chindaprasirt, Jarin

    2013-01-01

    The diagnostic criterion for eosinophilic meningitis (EOM) is the identification of an absolute count of 10 eosinophils per ml or more than 10% of the total white blood cells in the cerebrospinal fluid (CSF) in the proper clinical context. The most common cause of EOM is Angiostrongylus cantonensis infection, termed meningitic angiostrongyliasis (MA). Neurognathostomiasis (NG) is the main parasitic disease in the differential diagnosis of meningitic angiostrongyliasis. This short review is based on articles published on Medline between 2000 and 2012 related to EOM. There are three main approaches that can be used to differentiate between MA and NG, involving clinical factors, history of larval exposure, and serological tests. MA patients presented with acute severe headache but without neurological deficit, combined with a history of eating uncooked snails or slugs. NG patients always presented with motor weakness, migratory swelling, radicular pain and had history of eating uncooked poultry or fish. Specific antigenic bands in immunoblot tests are helpful tools to differentiate the two diseases. Other causes of eosinophilic meningitis are neurocysticercosis, cerebral paragonimiasis, Toxoplasma canis, Baylisascaris, tuberculous meningitis, and cryptococcal meningitis. PMID:23901385

  11. Screening for Differentially Expressed Proteins Relevant to the Differential Diagnosis of Sarcoidosis and Tuberculosis.

    Directory of Open Access Journals (Sweden)

    Shan-Shan Du

    Full Text Available In this study, we sought to identify differentially expressed proteins in the serum of patients with sarcoidosis or tuberculosis and to evaluate these proteins as markers for the differential diagnosis of sarcoidosis and sputum-negative tuberculosis.Using protein microarrays, we identified 3 proteins exhibiting differential expression between patients with sarcoidosis and tuberculosis. Elevated expression of these proteins was verified using the enzyme-linked immunosorbent assay (ELISA and was further confirmed by immunohistochemistry. Receiver operating characteristic (ROC curve, logistic regression analysis, parallel, and serial tests were used to evaluate the diagnostic efficacy of the proteins.Intercellular Adhesion Molecule 1(ICAM-1 and leptin were screened for differentially expressed proteins relevant to sarcoidosis and tuberculosis. Using ROC curves, we found that ICAM-1 (cutoff value: 57740 pg/mL had an area under the curve (AUC, sensitivity, and specificity of 0.718, 62.3%, and 79.5% respectively, while leptin (cutoff value: 1193.186 pg/mL had an AUC, sensitivity, and specificity of 0.763, 88.3%, and 65.8%, respectively. Logistic regression analysis revealed that the AUC, sensitivity, and specificity of combined leptin and ICAM-1 were 0.787, 89.6%, and 65.8%, respectively, while those of combined leptin, ICAM-1, and body mass index (BMI were 0.837, 90.9%, and 64.4%, respectively, which had the greatest diagnostic value. Parallel and serial tests indicated that the BMI-leptin parallel with the ICAM-1 serial was the best diagnostic method, achieving a sensitivity and specificity of 86.5% and 73.1%, respectively. Thus, our results identified elevated expression of ICAM-1 and leptin in serum and granulomas of sarcoidosis patients.ICAM-1 and leptin were found to be potential markers for the diagnosis of sarcoidosis and differential diagnosis of sarcoidosis and sputum-negative tuberculosis.

  12. Radiological diagnosis and differential diagnosis of headache; Radiologische Diagnostik und Differenzialdiagnostik bei Kopfschmerzen im Erwachsenenalter

    Energy Technology Data Exchange (ETDEWEB)

    Langner, S.; Kirsch, M. [University Medicine Greifswald (Germany). Inst. for Diagnostic Radiology and Neuroradiology

    2015-10-15

    Headache is very common and affects almost everyone at some point. It is one of the most common disorders that leads patients to see their physician. All different forms have the nociception via trigeminal nerve fibers in common. Beside the clinical course headaches are classified as either primary or secondary, with the latter having an identifiable structural or biochemical cause. Imaging has a low diagnostic yield in primary headache but play an important role in the differential diagnosis of secondary forms. An overview of different forms of secondary headache is given, outlining diagnostic procedures and the morphologic imaging features of each syndrome.

  13. Olfactory Reference Syndrome: Diagnostic Criteria and Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Lochner C

    2003-01-01

    Full Text Available Olfactory reference syndrome (ORS has been defined as a psychiatric condition characterized by persistent preoccupation about body odour accompanied by shame, embarrassment, significant distress, avoidance behaviour and social isolation. ORS has however not been included in the Diagnostic and Statistical Manual of Mental Disorders (4th edition (DSM-IV and, given that its primary symptoms may be found in various other disorders, differential diagnosis can be problematic. Using an illustrative case of ORS, we propose diagnostic criteria for ORS. We also argue that ORS represents a unique cluster of symptoms that can be delineated as a separate diagnostic entity, and that ORS falls on a spectrum of social anxiety disorders that includes social anxiety disorder, taijin kyofusho, and body dysmorphic disorder.

  14. MEDICAL DIAGNOSIS CLASSIFICATION USING MIGRATION BASED DIFFERENTIAL EVOLUTION ALGORITHM

    Directory of Open Access Journals (Sweden)

    Htet Thazin Tike Thein

    2014-12-01

    Full Text Available Constructing a classification model is important in machine learning for a particular task. A classification process involves assigning objects into predefined groups or classes based on a number of observed attributes related to those objects. Artificial neural network is one of the classification algorithms which, can be used in many application areas. This paper investigates the potential of applying the feed forward neural network architecture for the classification of medical datasets. Migration based differential evolution algorithm (MBDE is chosen and applied to feed forward neural network to enhance the learning process and the network learning is validated in terms of convergence rate and classification accuracy. In this paper, MBDE algorithm with various migration policies is proposed for classification problems using medical diagnosis.

  15. Differential diagnosis and management of liver tumors in infants

    Institute of Scientific and Technical Information of China (English)

    Israel; Fernez-Pineda; Rosa; Cabello-Laureano

    2014-01-01

    During the first year of life, most of the liver neoplasms are benign in origin, but some of these histologically benign lesions may be challenging in their management. Although most hepatic hemangiomas can be safely observed until involution is documented, some patients will need treatment due to progressive hepatomegaly, hypothyroidism and/or cardiac failure. Large mesenchymal hamartomas may require extensive hepatic resection and an appropriate surgical plan is critical to obtain good results. For malignant neoplasms such as hepatoblastoma, complete surgical resection is the mainstay of curative therapy. The decision about whether to perform an upfront or delayed resection of a primary liver malignant tumor is based on many considerations, including the ease of resection, surgical expertise, tumor histology and stage, and the likely chemosensitivity of the tumor. This article reviews the initial management of the more common hepatic tumors of infancy, focusing on the differential diagnosis and treatment options.

  16. Imaging of the dopaminergic system in differential diagnosis of dementia

    Energy Technology Data Exchange (ETDEWEB)

    Tatsch, Klaus [University of Munich Hospital - Campus Grosshadern, Department of Nuclear Medicine, Munich (Germany)

    2008-03-15

    Neurodegenerative dementia is an increasingly common disorder with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) accounting for most cases. Due to the overlap in clinical symptoms, their differential diagnosis may be challenging. As clinical classification is not completely satisfying, there is a need to improve the diagnostic accuracy by complementary methods such as functional single-photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging. The latter may be helpful to address one distinct biological difference between DLB and AD, the severe nigrostriatal degeneration which occurs in DLB, but not to any significant extent in AD. Based on this principle, autoradiographic studies targeting presynaptic dopaminergic functions have consistently demonstrated the ability to distinguish DLB from AD in postmortem series. At the same time, several single-site and one multicentre study have independently confirmed - no matter what technique was used (SPECT or PET) and which presynaptic function was addressed (dopamine turnover, dopamine transporter, vesicular monoamine transporter) - significantly compromised scan results in DLB subjects, whereas AD patients maintained almost normal findings. Even more important, in vivo findings of presynaptic dopaminergic imaging correlated well with neuropathological findings at autopsy, suggesting a remarkable sensitivity of 88% and a specificity of 100% for the imaging procedure to distinguish between DLB and AD. Taken together, imaging of presynaptic dopaminergic terminal functions with SPECT and PET has currently the greatest evidence base to support its use, and therefore, may be highly recommended to help in the discrimination between DLB and AD. Compared to presynaptic functions, corresponding data targeting postsynaptic dopamine receptors are comparatively rare, less conclusive and suggest a very limited role for this purpose. This review discusses the findings of studies

  17. Ewing sarcoma versus osteomyelitis: differential diagnosis with magnetic resonance imaging

    International Nuclear Information System (INIS)

    To find and evaluate characteristic magnetic resonance imaging (MRI) patterns for the differentiation between Ewing sarcoma and osteomyelitis. We identified 28 consecutive patients referred to our department for MRI (1.5 T) of an unclear bone lesion with clinical symptoms suggestive of Ewing sarcoma or osteomyelitis. MRI scans were re-evaluated by two experienced radiologists, typical MR imaging features were documented and a diagnostic decision between Ewing sarcoma and osteomyelitis was made. Statistical significance of the association between MRI features and the biopsy-based diagnosis was assessed using Fisher's exact test. The most clear-cut pattern for determining the correct diagnosis was the presence of a sharp and defined margin of the bone lesion, which was found in all patients with Ewing sarcoma, but in none of the patients with osteomyelitis (P < 0.0001). Contrast enhancing soft tissue was present in all cases with Ewing sarcoma and absent in 4 patients with osteomyelitis (P = 0.0103). Cortical destruction was found in all patients with Ewing sarcoma, 4 patients with osteomyelitis did not present any cortical reaction (P = 0.0103). Cystic or necrotic areas were identified in 13 patients with Ewing sarcoma and in 1 patient with osteomyelitis (P = 0.004). Interobserver reliability was very good (kappa = 1) in Ewing sarcoma and moderate (kappa = 0.6) in patients with osteomyelitis. A sharp and defined margin, optimally visualized on T1-weighted images in comparison to short tau inversion recovery (STIR) images, is the most significant feature of Ewing sarcoma in differentiating from osteomyelitis. (orig.)

  18. Ewing sarcoma versus osteomyelitis: differential diagnosis with magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Henninger, B.; Glodny, B.; Rudisch, A.; Trieb, T.; Loizides, A.; Judmaier, W.; Schocke, M.F. [Innsbruck Medical University, Department of Radiology, Innsbruck (Austria); Putzer, D. [Innsbruck Medical University, Department of Nuclear Medicine, Innsbruck (Austria)

    2013-08-15

    To find and evaluate characteristic magnetic resonance imaging (MRI) patterns for the differentiation between Ewing sarcoma and osteomyelitis. We identified 28 consecutive patients referred to our department for MRI (1.5 T) of an unclear bone lesion with clinical symptoms suggestive of Ewing sarcoma or osteomyelitis. MRI scans were re-evaluated by two experienced radiologists, typical MR imaging features were documented and a diagnostic decision between Ewing sarcoma and osteomyelitis was made. Statistical significance of the association between MRI features and the biopsy-based diagnosis was assessed using Fisher's exact test. The most clear-cut pattern for determining the correct diagnosis was the presence of a sharp and defined margin of the bone lesion, which was found in all patients with Ewing sarcoma, but in none of the patients with osteomyelitis (P < 0.0001). Contrast enhancing soft tissue was present in all cases with Ewing sarcoma and absent in 4 patients with osteomyelitis (P = 0.0103). Cortical destruction was found in all patients with Ewing sarcoma, 4 patients with osteomyelitis did not present any cortical reaction (P = 0.0103). Cystic or necrotic areas were identified in 13 patients with Ewing sarcoma and in 1 patient with osteomyelitis (P = 0.004). Interobserver reliability was very good (kappa = 1) in Ewing sarcoma and moderate (kappa = 0.6) in patients with osteomyelitis. A sharp and defined margin, optimally visualized on T1-weighted images in comparison to short tau inversion recovery (STIR) images, is the most significant feature of Ewing sarcoma in differentiating from osteomyelitis. (orig.)

  19. Imaging of the dopaminergic system in differential diagnosis of dementia

    International Nuclear Information System (INIS)

    Neurodegenerative dementia is an increasingly common disorder with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) accounting for most cases. Due to the overlap in clinical symptoms, their differential diagnosis may be challenging. As clinical classification is not completely satisfying, there is a need to improve the diagnostic accuracy by complementary methods such as functional single-photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging. The latter may be helpful to address one distinct biological difference between DLB and AD, the severe nigrostriatal degeneration which occurs in DLB, but not to any significant extent in AD. Based on this principle, autoradiographic studies targeting presynaptic dopaminergic functions have consistently demonstrated the ability to distinguish DLB from AD in postmortem series. At the same time, several single-site and one multicentre study have independently confirmed - no matter what technique was used (SPECT or PET) and which presynaptic function was addressed (dopamine turnover, dopamine transporter, vesicular monoamine transporter) - significantly compromised scan results in DLB subjects, whereas AD patients maintained almost normal findings. Even more important, in vivo findings of presynaptic dopaminergic imaging correlated well with neuropathological findings at autopsy, suggesting a remarkable sensitivity of 88% and a specificity of 100% for the imaging procedure to distinguish between DLB and AD. Taken together, imaging of presynaptic dopaminergic terminal functions with SPECT and PET has currently the greatest evidence base to support its use, and therefore, may be highly recommended to help in the discrimination between DLB and AD. Compared to presynaptic functions, corresponding data targeting postsynaptic dopamine receptors are comparatively rare, less conclusive and suggest a very limited role for this purpose. This review discusses the findings of studies

  20. [Adult ADHD versus borderline personality disorder: criteria for differential diagnosis].

    Science.gov (United States)

    Witt, O; Brücher, K; Biegel, G; Petermann, F; Schmidt, S

    2014-06-01

    The present study focuses on selected symptom criteria to distinguish between attention deficit/hyperactivity disorder (ADHD) in adults and borderline personality disorder (BPD). A sample of n = 158 subjects was examined, consisting of BPD patients (n = 37), ADHD patients (n = 58), comorbid BPD/ADHD patients (n = 19), a clinical group of patients fulfilling the diagnostic criteria of a depressive disorder (DEP; n = 22) and a non-clinical control group (KG; n = 22). Selected symptom criteria were investigated by using the German scales "Skala zur Erfassung der Impulsivität und emotionalen Dysregulation der Borderline-Persönlichkeitsstörung" (IES-27), "ADHS-Screening für Erwachsene" (ADHS-LE), "Fragebogen zu dissoziativen Symptomen" (FDS) and a scale for the assessment of paranoid and dichotomous thinking (PADI). Multivariate analyses of variance revealed that BPD patients differed significantly with respect to self-mutilating behaviour, suicidality, dissociation, paranoia and dichotomy from all other groups. The same effect was found for affect regulation. Furthermore BPD patients differed significantly from ADHD patients by a more severe impulsiveness (IES-27), but not through disturbed impulse control and disinhibition overall. Regarding mean differences between ADHD and BPD patients for attentional control, ADHD patients revealed higher scores which just missed significance. For hyperactivity no significant group differences were found which is assumed to be influenced by symptom overlap like restlessness and aversive tension. The findings suggest that BPD-specific criteria, a stronger affective dysregulation and a higher tendency for autoaggressive impulsive reactions are more selective for differential diagnosis than the core symptoms of adult ADHD. Only attentional control might be a useful criterion for differential diagnosis, which should be examined in future studies.

  1. CT findings and differential diagnosis of cystic neck masses

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Yeon; Lee, Kil Jun; Jeong, Seong Ki; Han, Seong Nim; Tae, Seok; Shin, Kyoung Ja; Lee, Sang Chun [Seoul Red Cross Hospital, Seoul (Korea, Republic of)

    1995-10-15

    The purpose of this study is to analyze the CT features of the cystic masses in the neck and to review differential diagnosis. We retrospectively reviewed and analyzed the CT findings of 22 histopathologically proved, cystic neck masses in regard to the location in fascial plane and relationship with adjacent organ. Of 22 cases, ten congenital cysts two ranulas, seven inflammatory lesions, and three solid tumors were included. Ten congenital cystic masses were located in typical locations as branchial cleft cyst (5) in mandibular angle, thyroglossal duct cyst (3) in visceral space embeded within the strap muscles, cystic hygroma (1) and cavernous hemangioma (1) in posterior cervical space with insinuating appearance. Two cases of ranula included one simple ranula localized in sublingual space and a plunging ranula extending to adjacent submandibular space. Seven cases of inflammatory lesions were characterized by multispatial locations and good contrast-enhancement of walls and adjacent tissue. Solid masses of low density mimicking cyst were two pleomorphic adenomas of submandibular gland and one neurilemmoma. It is considered that thorough analysis of the CT findings with attention to typical location, CT appearance, and the relationship with the adjacent structures usually leads to the correct diagnosis.

  2. Differential diagnosis of breast lesions using ultrasound elastography

    Directory of Open Access Journals (Sweden)

    Ioana Andreea Gheonea

    2011-01-01

    Full Text Available Context: The recent introduction of elastography has increased the specificity of USG and enabled early diagnosis of breast cancer. Quantitative elastography, especially with strain ratio (SR index, improves diagnostic accuracy and decreased number of biopsies. Aims: The purpose of this study was to assess the role of USG elastography in the differential diagnosis of breast lesions. Settings and Design: This prospective study was conducted in the University of Medicine and Pharmacy Research Centre of Craiova. Materials and Methods: Fifty-eight patients diagnosed with breast lesions between January 2009 and January 2010 were included in this prospective study. All the patients were examined in the supine position, and the B-mode USG image was displayed alongside the elastography strain image. For obtaining the elastography images we used a EUS Hitachi EUB 8500 ultrasound system with a 6.5-MHz linear probe. The elastography strain images were scored according to the Tsukuba elasticity score. Statistical Analysis: We performed receiver operator characteristic (ROC analysis for assessment of the role of USG elastography in the diagnosis of breast lesions. Results: We obtained a sensitivity of 86.7% and a specificity of 92.9% for elasticity score and a sensitivity of 93.3% and a specificity of 92.9% for SR (when a cutoff point of 3.67 was used. There was very good correlation between SR and elasticity score (Spearman coefficient of 0.911. Conclusions: Elastography is a fast, simple method that can complement conventional USG examination. This method has the lowest cost/efficiency ratio and it is also the most noninvasive and accessible imaging method, with an accuracy comparable to MRI.

  3. Gender stereotype endorsement differentially predicts girls' and boys' trait-state discrepancy in math anxiety

    Directory of Open Access Journals (Sweden)

    Madeleine eBieg

    2015-09-01

    Full Text Available Mathematics is associated with anxiety for many students; an emotion linked to lower well-being and poorer learning outcomes. While findings typically show females to report higher trait math anxiety than males, no gender differences have to date been found in state (i.e., momentary math anxiety. The present diary study aimed to replicate previous findings in investigating whether levels of academic self-concept was related to this discrepancy in trait versus state anxiety measures. Additionally, mathematics-related gender stereotype endorsement (mathematics is a male domain was investigated as an additional predictor of the trait-state discrepancy. The sample included 755 German 9th and 10th graders who completed self-report measures of trait math anxiety, math self-concept, and gender stereotype endorsement, in addition to state measures of anxiety after math classes by use of a standardized diary for 2-3 weeks (Nwithin = 6207. As expected, females reported higher trait math anxiety but no gender differences were found for state math anxiety. Also in line with our assumptions, multilevel analyses showed the discrepancy between trait and state anxiety to be negatively related to students’ self-concept (i.e., a lower discrepancy for students with higher self-concepts. Furthermore, gender stereotype endorsement differentially predicted the trait-state discrepancy: When controlling for self-concept in mathematics, females who endorsed the gender stereotype of math being a male domain more strongly overestimated their trait math anxiety as compared to their state anxiety whereas this effect was not significant for males. The present findings suggest that gender stereotype endorsement plays an important role in explaining gender differences in math anxiety above and beyond academic self-concept. Implications for future research and educational practice are discussed.

  4. Gender stereotype endorsement differentially predicts girls' and boys' trait-state discrepancy in math anxiety.

    Science.gov (United States)

    Bieg, Madeleine; Goetz, Thomas; Wolter, Ilka; Hall, Nathan C

    2015-01-01

    Mathematics is associated with anxiety for many students; an emotion linked to lower well-being and poorer learning outcomes. While findings typically show females to report higher trait math anxiety than males, no gender differences have to date been found in state (i.e., momentary) math anxiety. The present diary study aimed to replicate previous findings in investigating whether levels of academic self-concept was related to this discrepancy in trait vs. state anxiety measures. Additionally, mathematics-related gender stereotype endorsement (mathematics is a male domain) was investigated as an additional predictor of the trait-state discrepancy. The sample included 755 German 9th and 10th graders who completed self-report measures of trait math anxiety, math self-concept, and gender stereotype endorsement, in addition to state measures of anxiety after math classes by use of a standardized diary for 2-3 weeks (N within = 6207). As expected, females reported higher trait math anxiety but no gender differences were found for state math anxiety. Also in line with our assumptions, multilevel analyses showed the discrepancy between trait and state anxiety to be negatively related to students' self-concept (i.e., a lower discrepancy for students with higher self-concepts). Furthermore, gender stereotype endorsement differentially predicted the trait-state discrepancy: When controlling for self-concept in mathematics, females who endorsed the gender stereotype of math being a male domain more strongly overestimated their trait math anxiety as compared to their state anxiety whereas this effect was not significant for males. The present findings suggest that gender stereotype endorsement plays an important role in explaining gender differences in math anxiety above and beyond academic self-concept. Implications for future research and educational practice are discussed.

  5. The application of DWI in the differential diagnosis between malignant glioma and solitary metastases

    International Nuclear Information System (INIS)

    Glioma and brain metastases are common tumors in clinical practice. It's difficult to diagnose and differentiate glioma from solitary metastases, because they have similar clinical characters and conventional imaging manifestations. Because of different treatments and prognosis for the two types of tumor, it's important for us to accurately diagnose and differentiate them. Some scholars have used diffusion weighted imaging in diagnosis and differential diagnosis of brain tumors. In this paper, we reviewed the usefulness of diffusion weighted imaging in diagnosis and differential diagnosis between glioma and solitary metastases. (authors)

  6. Prenatal Diagnosis of Cloacal Exstrophy: A Case Report and Differential Diagnosis with a Simple Omphalocele

    Directory of Open Access Journals (Sweden)

    Ching-Yu Chou

    2015-03-01

    Full Text Available Cloacal exstrophy is a rare congenital disorder that may lead to mortality and morbidity. Although the prenatal diagnosis of cloacal exstrophy can be made by a midtrimester ultrasound, it is difficult to differentiate it from a simple omphalocele that can be corrected completely by surgery without morbidity. We reported a case with cloacal exstrophy and reviewed previous literature on differentiating it from an omphalocele. A 33-year-old, pregnant female visited our outpatient center for prenatal care at the 22nd gestational week. The midtrimester ultrasound showed fetal anomalies including a protruding mass from umbilicus, absence of bladder, ambiguous genitalia, and bilateral renal hydronephrosis. The parents received prenatal genetic counseling and decided to continue the pregnancy. A female baby was delivered at the 37th gestational week via vaginal delivery, and cloacal exstrophy without omphalocele was diagnosed. Cloacal exstrophy is a complicated congenital disorder that should be differentiated from a simple omphalocele. Prenatal counseling and postnatal care in a tertiary medical center are important for parents and the fetus, respectively.

  7. Chronic Lyme Disease and Co-infections: Differential Diagnosis.

    Science.gov (United States)

    Berghoff, Walter

    2012-01-01

    In Lyme disease concurrent infections frequently occur. The clinical and pathological impact of co-infections was first recognized in the 1990th, i.e. approximately ten years after the discovery of Lyme disease. Their pathological synergism can exacerbate Lyme disease or induce similar disease manifestations. Co-infecting agents can be transmitted together with Borrelia burgdorferi by tick bite resulting in multiple infections but a fraction of co-infections occur independently of tick bite. Clinically relevant co-infections are caused by Bartonella species, Yersinia enterocolitica, Chlamydophila pneumoniae, Chlamydia trachomatis, and Mycoplasma pneumoniae. In contrast to the USA, human granulocytic anaplasmosis (HGA) and babesiosis are not of major importance in Europe. Infections caused by these pathogens in patients not infected by Borrelia burgdorferi can result in clinical symptoms similar to those occurring in Lyme disease. This applies particularly to infections caused by Bartonella henselae, Yersinia enterocolitica, and Mycoplasma pneumoniae. Chlamydia trachomatis primarily causes polyarthritis. Chlamydophila pneumoniae not only causes arthritis but also affects the nervous system and the heart, which renders the differential diagnosis difficult. The diagnosis is even more complex when co-infections occur in association with Lyme disease. Treatment recommendations are based on individual expert opinions. In antibiotic therapy, the use of third generation cephalosporins should only be considered in cases of Lyme disease. The same applies to carbapenems, which however are used occasionally in infections caused by Yersinia enterocolitica. For the remaining infections predominantly tetracyclines and macrolides are used. Quinolones are for alternative treatment, particularly gemifloxacin. For Bartonella henselae, Chlamydia trachomatis, and Chlamydophila pneumoniae the combination with rifampicin is recommended. Erythromycin is the drug of choice for

  8. Elastofibroma dorsi – differential diagnosis in chest wall tumours

    Directory of Open Access Journals (Sweden)

    Steinau Hans-Ulrich

    2007-02-01

    Full Text Available Abstract Background Elastofibromas are benign soft tissue tumours mostly of the infrascapular region between the thoracic wall, the serratus anterior and the latissimus dorsi muscle with a prevalence of up to 24% in the elderly. The pathogenesis of the lesion is still unclear, but repetitive microtrauma by friction between the scapula and the thoracic wall may cause the reactive hyperproliferation of fibroelastic tissue. Methods We present a series of seven cases with elastofibroma dorsi with reference to clinical findings, further clinical course and functional results after resection, as well as recurrence. Data were obtained retrospectively by clinical examination, phone calls to the patients' general practitioners and charts review. Follow-up time ranged from four months to nine years and averaged 53 months. Results The patients presented with swelling of the infrascapular region or snapping scapula. In three cases, the lesion was painful. The ratio men/women was 2/5 with a mean age of 64 years. The tumor sizes ranged from 3 to 13 cm. The typical macroscopic aspect was characterized as poorly defined fibroelastic soft tissue lesion with a white and yellow cut surface caused by intermingled remnants of fatty tissue. Microscopically, the lesions consisted of broad collagenous strands and densely packed enlarged and fragmented elastic fibres with mostly round shapes. In all patients but one, postoperative seroma (which had to be punctuated occurred after resection; however, at follow-up time, no patient reported any decrease of function or sensation at the shoulder or the arm of the operated side. None of the patients experienced a relapse. Conclusion In differential diagnosis of soft tissue tumors located at this specific site, elastofibroma should be considered as likely diagnosis. Due to its benign behaviour, the tumor should be resected only in symptomatic patients.

  9. Restless legs syndrome: differential diagnosis and management with pramipexole

    Directory of Open Access Journals (Sweden)

    Francesca Brindani

    2009-06-01

    Full Text Available Francesca Brindani, Francesca Vitetta, Franco GemignaniDepartment of Neurosciences, University of Parma, ItalyAbstract: Restless legs syndrome (RLS is a condition characterized by discomfort at rest and urge to move focused on the legs. RLS may occur as an idiopathic, often hereditary condition (primary RLS, or in association with medical conditions (secondary RLS including iron deficiency, uremia, and polyneuropathy. Current understanding of the pathophysiology of RLS points to the involvement of three interrelated components: dopaminergic dysfunction, impaired iron homeostasis, and genetic mechanisms. The diagnosis of RLS is made according to the consensus criteria by a National Institutes of Health panel: 1 an urge to move the legs, usually accompanied by uncomfortable sensations; 2 beginning or worsening during rest; 3 relieved by movement; and 4 worse, or only occurring, in the evening or at night. The differential diagnosis of RLS aims to: 1 distinguish RLS from other disorders with RLS-like symptoms and 2 identify secondary forms, with investigation of underlying diseases. The treatment of RLS demands a clinical evaluation to rule out and cure causes of secondary RLS, including iron supplementation when deficient, and to eliminate the triggering factors. The presence of neuropathy should be especially investigated in nonhereditary, late-onset RLS, in view of a possible treatment of the underlying disease. The first line treatment for idiopathic RLS is represented by dopamine agonists, in particular nonergot-derived ropinirole and pramipexole, whereas ergot dopamine agonists (cabergoline and pergolide are no longer in first-line use given the risks of cardiac valvulopathy. Although no comparative trials have been published, a meta-analysis of pramipexole versus ropinirole suggests differences in efficacy and tolerability favoring pramipexole.Keywords: restless legs syndrome, pramipexole, dopamine, agonists, small fiber neuropathy

  10. Differential diagnosis of cavitary lung masses by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyung Sik; Choi, Kyu Ok; Lee, Jong Doo [Yonsei University College of Medicine, Seoul (Korea, Republic of); Choi, Soon Seob [Hae Sung Hospital, Seoul (Korea, Republic of)

    1990-12-15

    Wall thickness and inner wall nodularity are two major criteria in the differential diagnosis of benign and malignant cavitating pulmonary nodule by using conventional radiographs. It is assumed that post-contrast enhanced CT scan differentiate necrotic and viable portion of the cavity wall by difference in CT density. To evaluate the difference in terms of diagnostic accuracy between the two methods: measuring summed up thickness of both lower (necrotic) and higher (viable) density portion and measuring only higher density portion. 37 cavitary lung masses(18 malignant, 19 benign) from 32 patients were studied retrospectively. CT measurements were compared with that of plain radiographs. The mean thickness of the thickest part of the wall were 20{+-}13 mm and 30{+-}17 mm in benign and malignant cavity (p>0.05), respectively, when both lower and higher density were measured. However, when measured only higher density portion, the means were 5{+-}3 mm in benign and 15{+-}9 mm in malignant lesions, of which difference was statistically significant (p<0.01). The thickest part of the higher density portion was less than 5 mm in all 14 benign lesions, while seven of eight (87.5%) malignant lesions had 16 mm or grater. The inner wall of the cavity was smooth in 84.2% and 6% of the benign and malignant lesions, respectively. In conclusion, our data suggests that assessing the wall thickness and inner wall nodularity by measuring higher (enhancing) density portion of the cavitary mass is superior to the methods that measures the whole wall thickness.

  11. Mucins in the diagnosis and differential diagnosis of pancreatic cystic neoplasms: report of 40 cases

    Institute of Scientific and Technical Information of China (English)

    JI Yuan; TAN Yun-shan; XU Jian-fang; QI Wei-dong; LI Xiao-ping; SU-JIE Ake-su; ZHU Xiong-zeng

    2006-01-01

    @@ Cystic neoplasms of the pancreas account for 10% to 15% of all cystic pancreatic lesions.The majority (85% to 90%) of cystic lesions of the pancreas are pseudocysts. Although cystic neoplasms of the pancreas are rare, they range from benign to malignant neoplasms. The clinical challenge is the differential diagnosis and management of the cystic neoplasms, which represent 10% to 25% of primary pancreatic neoplasms. Pancreatic neoplasms and tumour like lesions with cystic features have been recently reviewed. The incidence of pancreatic cystic neoplasms reported is variable. Because there is no large, systematic study on tne cases from China comparing the incidence and biology of cystic neoplasms of pancreas to that of Western series, we reviewed all the cases of cystic neoplasms from Zhongshan Hospital over 6 years. Most of the neoplasms in our series were classified according to the recent World Health Organization (WHO)classification.1,2

  12. Differential diagnosis between odontogenic keratocyst and ameloblastoma by computed tomography

    International Nuclear Information System (INIS)

    The objective of this study is to find the differentiating characteristics of ameloblastomas and odontogenic keratocysts of the jaw by analyzing computed tomography (CT) images of the lesions, clarify radiological characteristics associated with jaw lesions, and to make a diagnosis based on these findings. Test subjects were chosen among the patients who were diagnosed as having an odontogenic keratocyst or ameloblastoma at the Yonsei University Dental Hospital from January 1996 to December 2000 and had CT scans taken preoperatively. The subject pool was comprised of 51 cases of odontogenic keratocyst and 37 cases of ameloblastoma. The following measures were used for image analysis of the lesion : the anatomic location, CT pattern, mesiodistal width, buccolingual width, the ratios between mesiodistal width and buccolingual width, height, CT number, homogeneity of radiodensity, the appearance of a sclerotic rim, continuity of adjacent cortical bone, and displacement and resorption of adjacent teeth. Comparing the CT patten, mesiodistal width, buccolingual width, height, CT number, homogeneity, appearance of sclerotic rim, continuity of adjacent cortical bone, there were statistically significant differences between ameloblastoma and odontogenic keratocyst test subjects (p0.05). We compared odontogenic keratocysts and ameloblastomas in CT scans. They occurred most frequently in the posterior to the ramus of the mandible. The findings of patterns of the CT images showed that size and border of lesions were more aggressive in ameloblastomas than in odontogenic keratocysts. The internal contents represented an increased attenuation area (IAA) in odontopenic keratocyst. Odontogenic keratocysts were shown to have higher CT numbers than ameloblastomas.

  13. Differential Diagnosis for Multiple Sclerosis-related Optic Neuritis

    Institute of Scientific and Technical Information of China (English)

    Yan Zhang; Xiaolei Liang; Shihui Wei; Hongyang Li

    2015-01-01

    Purpose:.To analyze clinical features and main causes of multiple sclerosis-related optic neuritis (MS-ON), providing evidence for the differential diagnosis of MS-ON. Methods: Clinical data were collected from 527 patients, 123 males and 404 females, diagnosed with MS-ON between June 2008 and June 2013. Visual acuity, optometry, visual field, slit-lamp microscopy, indirect ophthalmoscopy (20D), opti-cal coherence tomography (OCT) and magnetic resonance imaging (MRI) were performed. Venous blood was sampled for detection of autoimmune antibodies and Aquaporin (AQP-4). Results:.Fifty nine cases were diagnosed with neuromyelitis optica-related optic neuritis. (NMO-ON),.27 Sjogren's syn-drome-related optic neuropathy,.22 tumors,.21 anterior is-chemic optic neuropathy, 15 radiation-induced optic neuropa-thy, 14 optic neuropathy-related infection, 17 genetic eye dis-eases and 10 open angle glaucoma. Among168 MS-ON pa-tients undergoing optic nerve MRI,90 cases (53.57%) had a lesion 30 mm in two (1.19%). Conclusion:.MS-ON is more commonly misdiagnosed with NMO-ON and Sjogren's syndrome, when compared to optic neuropathy, tumors and ischemic optic neuropathy.

  14. Multiple sclerosis: imaging, diagnostic criteria and differential diagnosis

    International Nuclear Information System (INIS)

    Multiple sclerosis (MS) is the most common demyelinating inflammatory disease of the central nervous system (CNS), presenting with multifocal, disseminated inflammatory lesions referred to as plaques. Magnetic resonance imaging (MRI) typically depicts multiple, round to oval, circumscript lesions predominantly involving periventricular and subcortical white matter, brainstem and cerebellum. More recent investigations have demonstrated that the macroscopically visible plaques only present the tip of the iceberg: Already early in its course, MS causes neuroaxonal damage and diffusely involves the entire brain parenchyma including normal appearing white matter. These changes are reflected by strongly T1w hypointense lesions and atrophy of early onset, by reduction of the neuronal Marker N-acetylaspartate (NAA) on spectroscopy, by a decrease of the magnetization transfer ratio (MTR), by an increased in diffusibility and decreased anisotropy on diffusion-weighted imaging (DWI). MRI imaging is an important tool in the diagnosis of MS by revealing the characteristic spatial and temporal dissemination of the cerebral and spinal manifestations of this disease. Diagnostic criteria increase the diagnostic specificity and allow better differentiation from other diseases with multifocal white matter abnormalities. (orig.)

  15. Differential Diagnosis of Cardiac Malposition by Fetal Echocardiography

    Institute of Scientific and Technical Information of China (English)

    Ying WU; Feng TAO; Tao LIU; Ling ZANG; Shi-long LIU

    2009-01-01

    Objectives To explore the method and operating skill of fetal echocardiography in diagnosing cardiac malposition. Methods 91 consecutive fetuses were studied (control: 50 cases, cardiac malposition : 41 cases) between 2003 and 2008. The position of fetal heart was evaluated according to the fetal posture and the visceral situs by fetal routine scan-ning. The detailed echocardiography should be performed in the differential diagnosis of cardiac lesions when the heart was found to be abnormal position. Results In the control group, all fetuses were levocardia. 39 cases of cardiac mal-positions were detected by fetal echocardiography, included 25 fetuses with dextrocardia, 6 mesocard, 5 with levover-sion of heart, 3 common heart of conjoined twins and 2 extrathorax heart. Two of dextroversion were missed by fetal routine scanning, but found by autopsy or operation after birth. Conclusions When the abnormal visceral situs was found by fetal routine scanning, there is exceedingly high incidence of cardiac malpositions. Proficiently operating skill of fetal echocardiography is helpful to detect abnormal fetal cardiac position.

  16. CT differential diagnosis of stroke in subacute and chronic stage

    International Nuclear Information System (INIS)

    Computed tomography (CT) is a very useful method for the diagnosis of cerebrovascular diseases, especially in the acute stage. In the subacute stage, however, it is difficult to determine whether a lesion is a hematoma or an ischemia. It is necessary to use contrast agents to differentiate these two types of lesions. Therefore, it is very important to study the plain and the enhanced CT findings of these lesions in the acute and subacute stages. The author analysed the sequential CT findings of cerebral hemorrhage (60 cases), ischemic infarction (22 cases), and hemorrhagic infarction (22 cases) and reaches the following conclusions: 1) In cerebral hemorrhage, the high-density area disappears within weeks at a rate related with the length (cm) of the maximum diameter of the high-density area in the first week, contrast enhancement also disappears within months in parallel with the length of the maximum diameter of the high-density area in the first week. 2) In contrast-enhanced CT, cerebral hemorrhage showed a ring enhancement in all stages and sometimes showed a slit enhancement in the chronic stage. In general however, ischemic infarction did not show ring enhancement. 3) Mass effect and contrast enhancement disappear within the first month in ischemic infarction, but continue for two months in hemorrhagic infarction. (author)

  17. CT differential diagnosis of stroke in subacute and chronic stage

    Energy Technology Data Exchange (ETDEWEB)

    Matsuzaki, T.; Mizukami, M.; Kawase, T.; Tazawa, T.; Araki, G. (Mihara Memorial Hospital, Isesaki, Gunma (Japan). Inst. of Brain and Blood Vessels)

    1981-02-01

    Computed tomography (CT) is a very useful method for the diagnosis of cerebrovascular diseases, especially in the acute stage. In the subacute stage, however, it is difficult to determine whether a lesion is a hematoma or an ischemia. It is necessary to use contrast agents to differentiate these two types of lesions. Therefore, it is very important to study the plain and the enhanced CT findings of these lesions in the acute and subacute stages. The author analysed the sequential CT findings of cerebral hemorrhage (60 cases), ischemic infarction (22 cases), and hemorrhagic infarction (22 cases) and reaches the following conclusions: 1) In cerebral hemorrhage, the high-density area disappears within weeks at a rate related with the length (cm) of the maximum diameter of the high-density area in the first week, contrast enhancement also disappears within months in parallel with the length of the maximum diameter of the high-density area in the first week. 2) In contrast-enhanced CT, cerebral hemorrhage showed a ring enhancement in all stages and sometimes showed a slit enhancement in the chronic stage. In general however, ischemic infarction did not show ring enhancement. 3) Mass effect and contrast enhancement disappear within the first month in ischemic infarction, but continue for two months in hemorrhagic infarction.

  18. Serum Fragments of Tau for the Differential Diagnosis of Alzheimer's Disease

    DEFF Research Database (Denmark)

    Inekci, Dilek; Henriksen, K.; Linemann, T.;

    2015-01-01

    Differential diagnosis of AD is still a challenge due to overlapping features with other types of dementia. Biomarkers for the differential diagnosis of AD can improve the diagnostic value of the disease and ensure an appropriate treatment of patients. The aim of this study was to evaluate the po...

  19. Second Malignancy in Pediatric Patients: Imaging Findings and Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    N. Tayari

    2010-05-01

    Full Text Available Therapeutic advances in the treatment of pediatric neoplasms have improved the prognosis but have also increased the risk of developing rare second malignancies."nPrimary neoplasms which are often associated with second malignancies include lymphoma, retinoblas-toma, medulloblastoma and leukemia. The most common second malignancies are central nervous system (CNS tumors, sarcomas, thyroid and parathyroid gland carcinoma and leukemia, particularly acute myeloblastic leukemia. Genetic predisposition, chemotherapy, and especially radiation therapy are included as pathogenic factors in second malignancies. We know all survivors of childhood cancer should have lifelong follow-up, preferably with US, magnetic resonance imaging and other procedures with no ionizing radiation. A new progressive lesion may represent recurrence of the primitive neoplastic process, late radiation injury, or more infrequently, a second malignancy. Differential diagnosis may be very difficult and the outcome is often fatal. "nTreatment protocols should be modified to reduce the risk of second malignancies without compromising the effectiveness of initial therapy. "nClinicians should individualize treatment for patients who are genetically predisposed. In addition, radiologists should be familiar with the long-term consequences of antineoplastic therapy."nIn a report of new England journal of medicine in 2007, 357:227-2284 by Dr. Brenner and Hall, 2% of all carcinomas in U.S.A are due to more use of CT exam and children are three to four times more sensitive to ionization radiation. "nSo all the radiologists and clinicians should be aware of the complications and should recommend follow up exams in children who have had previous treatments for such carcinomas.

  20. Equilibrium disorders in elderly: diagnostic classification and differential diagnosis

    Directory of Open Access Journals (Sweden)

    Alessandro Castiglione

    2013-04-01

    Full Text Available Background: Balance is primarily related to the proper functioning of three sensory input: vestibular, visual and proprioceptive. The integration of these different afferences contributes to the proper attitude of the body in static and dynamic conditions. Equilibrium disorders are common among elderly patients and are responsible for falls and fractures, leading sometimes to catastrophic outcomes, representing a serious health and social problem. Approximately one third of elderly patients at home and about 50% of institutionalized, over 75 year-old, suffer from this particular condition, with at least one fall a year and almost 50% of these with recurrent episodes. Females are more affected than males. Attempts to ascertain the underlying cause of unbalance should be done, leading then to specific treatment. Nevertheless, many elderly patients do not have a single disease but rather a multitude of medical conditions which may cause dizziness, imbalance and vertigo: effects of ageing, drugs, cardiovascular and neurological disorders, ocular and orthopaedic diseases. Aim of the study: A literature review was carried out with the intention to offer practical and useful notions for the management and treatment of equilibrium disorders. Discussion: In clinical practice, the main challenge is to distinguish between peripheral and central imbalance disorders. The data collected from history and clinical exams should be integrated with the intent to include the patient in one of the following clinical conditions: vertiginous syndrome, pre-syncope and/or syncope, neurological diseases, other conditions.Conclusions: Following the differential diagnosis, treatment mainly consists in drug administration (antiemetic and vestibular suppressor drugs and vestibular rehabilitation (physiotherapy and vestibular exercises.

  1. [Differential diagnosis of pulmonary tuberculosis and community-acquired pneumonia].

    Science.gov (United States)

    Deĭkina, O N; Mishin, V Iu; Demikhova, O V

    2007-01-01

    The purpose of this investigation was to enhance the efficiency of differential diagnosis of pneumonia and pulmonary tuberculosis. A hundred and fifty-nine adult patients were examined. These included 78 patients with pulmonary tuberculosis and 81 with community-acquired p neumonia. The clinical features of infiltrative pulmonary tuberculosis (n = 48) and mild community-acquired pneumonia (n = 51) were compared. The course of caseous pneumonia (n = 30) was compared with that of moderate and severe community-acquired pneumonia (n = 30). Significant differences in the manifestations of the intoxication and bronchopulmonary syndrome were not found in patients with community-acquired pneumonia and infiltrative pulmonary tuberculosis. Physical studies showed that in patients with community-acquired pneumonia, moist rale (54.9%) and crepitation (11.8%) were prevalent, but in those with infiltrative tuberculosis rale was absent in 60.4% of cases and the pattern of respiration was unchanged in 79.2%. Chest X-ray studies indicated that in patients with community-acquired pneumonia, lower lobar inflammatory changes were predominant in 62.8% of cases whereas in those with infiltrative pulmonary tuberculosis the process was mainly bilateral (43.8%) with the presence of destructive changes (83.3%) and bronchogenic dissemination (66.7%). In patients with caseous pneumonia, the intoxication syndrome was more significant than in those with severe community-acquired pneumonia. Chest X-ray studies demonstrated that in patients with caseous pneumonia, specific changes were bilateral with the involvement of 2 lobes or more, with destruction and bronchogenic dissemination while in those with community-acquired pneumonia, the pulmonary processes were predominantly bilateral (76.6%) at the lower lobar site (36.7%).

  2. [Differential diagnosis of pulmonary tuberculosis and community-acquired pneumonia].

    Science.gov (United States)

    Deĭkina, O N; Mishin, V Iu; Demikhova, O V

    2007-01-01

    The purpose of this investigation was to enhance the efficiency of differential diagnosis of pneumonia and pulmonary tuberculosis. A hundred and fifty-nine adult patients were examined. These included 78 patients with pulmonary tuberculosis and 81 with community-acquired p neumonia. The clinical features of infiltrative pulmonary tuberculosis (n = 48) and mild community-acquired pneumonia (n = 51) were compared. The course of caseous pneumonia (n = 30) was compared with that of moderate and severe community-acquired pneumonia (n = 30). Significant differences in the manifestations of the intoxication and bronchopulmonary syndrome were not found in patients with community-acquired pneumonia and infiltrative pulmonary tuberculosis. Physical studies showed that in patients with community-acquired pneumonia, moist rale (54.9%) and crepitation (11.8%) were prevalent, but in those with infiltrative tuberculosis rale was absent in 60.4% of cases and the pattern of respiration was unchanged in 79.2%. Chest X-ray studies indicated that in patients with community-acquired pneumonia, lower lobar inflammatory changes were predominant in 62.8% of cases whereas in those with infiltrative pulmonary tuberculosis the process was mainly bilateral (43.8%) with the presence of destructive changes (83.3%) and bronchogenic dissemination (66.7%). In patients with caseous pneumonia, the intoxication syndrome was more significant than in those with severe community-acquired pneumonia. Chest X-ray studies demonstrated that in patients with caseous pneumonia, specific changes were bilateral with the involvement of 2 lobes or more, with destruction and bronchogenic dissemination while in those with community-acquired pneumonia, the pulmonary processes were predominantly bilateral (76.6%) at the lower lobar site (36.7%). PMID:17338353

  3. ON DIFFERENTIAL DIAGNOSIS BETWEEN AUTISTIC DISORDER AND ASPERGER’S SYNDROME

    Directory of Open Access Journals (Sweden)

    Stefan Todorov

    2012-11-01

    Full Text Available The differential diagnosis between Autistic disorder (AD and Asperger’s syndrome (AS in most cases is quite difficult since most of the symptoms are clinically undistinguished. Several factors complicate the diagnosis of AS- an autism spectrum disorder (ASD. It is considered by some authors to be simply a milder version of autistic disorder. Problems in diagnosis include disagreement among diagnostic criteria, controversy over the distinction between AS and other ASD forms or even whether AS exists as a separate syndrome, and over- and under-diagnosis. Our paper is based on the diagnostic and differential diagnostic criteria of DSM-IV, ICD-10 and our clinical experience.In the process of diagnosis and differential diagnosis we, naturally, illustrate and discuss the similarities and differences between the two disorders.

  4. Mucocele appendix: A rare differential diagnosis of pelvic mass

    Directory of Open Access Journals (Sweden)

    Vishal Yadav

    2013-01-01

    Full Text Available Mucocele of the appendix is a descriptive term that implies a dilated appendiceal lumen caused by abnormal accumulation of mucus. Mucocele is found in 0.2-0.3% of all appendectomy specimens. The male to female ratio is 1:4 and the average age at the time of diagnosis is over 50 years. Ultrasonography and computed tomography are useful tools for the diagnosis of appendiceal mucocele. Pre-operative diagnosis is a major component for minimizing intra operative and post-operative complications. We herein report a case of 40-year-old female presented as pelvic mass and this pose a diagnostic challenge

  5. Barrio Boy.

    Science.gov (United States)

    Galarza, Ernesto

    An autobiography, "Barrio Boy" is the story of Little Ernie, a boy born in the tiny mountain village of Jalcocotan in the State of Nayarit, Mexico. Divided into 5 parts, the book offers vivid descriptions of the author's early life--his family, his friends, his surroundings, as well as events in the journey from Jalcocotan that eventually ended in…

  6. Differential diagnosis of neurodegenerative diseases using structural MRI data

    Directory of Open Access Journals (Sweden)

    Juha Koikkalainen

    2016-01-01

    The results prove that automatic quantification methods and computerized decision support methods are feasible for clinical practice and provide comprehensive information that may help clinicians in the diagnosis making.

  7. DIFFERENTIAL DIAGNOSIS OF ROSACEA AND SKIN TUBERCULOSIS AS AN EXAMPLE OF A CLINICAL CASE

    Directory of Open Access Journals (Sweden)

    M. L. Aripova

    2014-01-01

    Full Text Available In this paper for a clinical observation of a patient with rosacea, and patients with a flat form of lupus tuberculosis presented a differential clinical diagnosis of tuberculosis of the skin.

  8. Metastatic changes to the colon - a differential diagnosis to Crohn's disease

    International Nuclear Information System (INIS)

    Metastatic seeding of malignomas in the peritoneum infiltrating the colon may cause changes which may suggest regional enteritis in terms of differential diagnosis, too. Such findings must be clarified histologically. (orig.)

  9. Diagnostic Value of Urine Microscopy for Differential Diagnosis of Acute Kidney Injury in Hospitalized Patients

    OpenAIRE

    Perazella, Mark A.; Coca, Steven G.; Kanbay, Mehmet; Brewster, Ursula C.; Parikh, Chirag R.

    2008-01-01

    Background and objectives: Urine microscopy is the oldest and one of the most commonly used tests for differential diagnosis of acute kidney injury (AKI), but its performance has not been adequately studied in the setting of AKI.

  10. The clinical assessment of intraductal ultrasonography in the differential diagnosis of pancreatic carcinoma and chronic pancreatitis.

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To assess and compare the clinical value of intraductal ultrasonography (IDUS) in the differential diagnosis of pancreatic carcinoma and chronic pancreatitis with conventional imaging methods. Methods: IDUS was carried out in eighteen patients with pancreatic carcinoma and chronic pancreatitis

  11. Rabies encephalomyelitis vs. ADEM: Usefulness of MR imaging in differential diagnosis

    Directory of Open Access Journals (Sweden)

    Asokan Santhoshkumar

    2012-01-01

    Full Text Available We report a case of rabies encephalomyelitis in a 12-year-old boy who had received anti-rabies vaccine 6 weeks after being bitten by a puppy. The MR (magnetic resonance imaging helped to differentiate rabies from acute disseminated encephalomyelitis (ADEM. ADEM involves the white matter predominantly, whereas rabies has a predilection for grey matter, that too of midline regions. This report emphasizes the usefulness of MRI in differentiating rabies and ADEM when encephalomyelitis occurs in a vaccinated child.

  12. Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years after Initial Diagnosis

    Science.gov (United States)

    Gillberg, I. Carina; Helles, Adam; Billstedt, Eva; Gillberg, Christopher

    2016-01-01

    We examined comorbid psychiatric and neurodevelopmental disorders in fifty adult males (mean age 30 years) with Asperger syndrome (AS) diagnosed in childhood and followed up prospectively for almost two decades (13-26 years). Only three of the 50 men had "never" met criteria for an additional psychiatric/neurodevelopmental diagnosis and…

  13. [Differential diagnosis of multiple pulmonary coin lesions--pulmonary hyaline granuloma].

    Science.gov (United States)

    Banaschak, S; Müller, K M

    1996-02-01

    In addition to metastases, the differential diagnosis of pulmonary nodules also includes tuberculosis, sarcoidosis, and silicosis. Rarer diseases such as amyloid tumors, rheumatic nodules, and plasma-cell granulomas can, depending on the clinical situation, be the cause of this finding. For the example of the clinical picture of pulmonary hyalinizing granuloma, the differential diagnosis of multiple pulmonary nodules is illustrated under consideration of the pathognomonic, morphologic observations. PMID:8868595

  14. [Desmoplastic fibroma. Differential diagnosis of a periapical lesion from endodontic failure].

    Science.gov (United States)

    Zabalegui, B; Gil, J; Zabalegui, I

    1989-01-01

    Treatment of endodontically involved teeth requires accurate diagnosis of the clinical pulpal condition to determine the primary cause of pathosis. The case presented shows the differential diagnosis between a desmoplastic fibroma and a failure of a misdiagnosed endodontic treatment. The initial direction of treatment should had never been the endodontic therapy but local surgical curettage of the lesion. PMID:2638020

  15. [Desmoplastic fibroma. Differential diagnosis of a periapical lesion from endodontic failure].

    Science.gov (United States)

    Zabalegui, B; Gil, J; Zabalegui, I

    1989-01-01

    Treatment of endodontically involved teeth requires accurate diagnosis of the clinical pulpal condition to determine the primary cause of pathosis. The case presented shows the differential diagnosis between a desmoplastic fibroma and a failure of a misdiagnosed endodontic treatment. The initial direction of treatment should had never been the endodontic therapy but local surgical curettage of the lesion.

  16. Staphylococcal Scalded Skin Syndrome: Criteria for Differential Diagnosis from Lyell's Syndrome. Two Cases in Adult Patients

    OpenAIRE

    Napoli, B.; D'Arpa, N.; D'Amelio, L.; S. Chimenti; Pileri, D.; Accardo-Palumbo, A.; F. Conte

    2006-01-01

    A review of the relative international literature of the last few years is followed by a description of two cases of staphylococcal scalded skin syndrome in adults. As in both cases the initial diagnosis was that of Lyell's syndrome, the main criteria for the differential diagnosis of the two pathologies are considered in order to permit specific and effective treatment.

  17. ON DIFFERENTIAL DIAGNOSIS BETWEEN AUTISTIC DISORDER AND ASPERGER’S SYNDROME

    OpenAIRE

    Stefan Todorov; Mariana Arnaoudova

    2012-01-01

    The differential diagnosis between Autistic disorder (AD) and Asperger’s syndrome (AS) in most cases is quite difficult since most of the symptoms are clinically undistinguished. Several factors complicate the diagnosis of AS- an autism spectrum disorder (ASD). It is considered by some authors to be simply a milder version of autistic disorder. Problems in diagnosis include disagreement among diagnostic criteria, controversy over the distinction between AS and other ASD forms or even whether ...

  18. Differential diagnosis of seizure disorders: a conversation analytic approach.

    Science.gov (United States)

    Schwabe, Meike; Howell, Stephen J; Reuber, Markus

    2007-08-01

    "Taking the history" remains the most important diagnostic tool in the assessment of people who have lost consciousness. The distinction of epileptic and non-epileptic seizures (NES) is particularly difficult and relevant. Whereas epileptic seizures can usually be controlled with antiepileptic drugs, NES are considered an expression of psychosocial distress and may improve with psychotherapy. The recording of typical seizures with simultaneous video and electroencephalography (EEG) can produce almost complete certainty about the diagnosis but access to video-EEG is limited, the test is very expensive and often video-EEG fails to capture typical seizures. A German research group used conversation analysis (CA) to examine patients' descriptions of seizures to their doctors. They found that certain linguistic and interactional features clustered together and that these clusters were usually concordant with particular medical diagnoses. This study was undertaken to establish whether the observations made in German-speaking patients could be replicated in English speakers presenting to a less specialised epilepsy service. The findings presented here are based on transcripts of interviews with 11 patients admitted to a neurology ward in England because their consultant felt unable to make a clear diagnosis clinically. Transcripts were only analysed if the diagnosis of epilepsy or NES had been proven with video-EEG. The medical diagnosis was only disclosed to the linguist once a linguistic hypothesis of the diagnosis had been formulated to ensure that the linguist's decision would not be influenced by factors not contained in the 30-min-interview between doctor and patient. The linguist predicted the correct diagnosis in all cases. PMID:17482737

  19. Imaging and differential diagnosis of pediatric spinal tuberculosis

    Directory of Open Access Journals (Sweden)

    Xiao-ying Xing

    2015-03-01

    Conclusion: Pediatric spinal tuberculosis often occurs in the cervical and thoracic vertebrae with typical imaging findings. The cases with atypical manifestations should be differentiated from other diseases such as Langerhans cell histiocytosis and metastatic neoplasm.

  20. Clinicoradiologic Differential Diagnosis of Odontogenic Keratocyst and Ameloblastoma

    International Nuclear Information System (INIS)

    To clarify the clinical and radiologic parameters that can be used to differentiate odontogenic keratocyst and ameloblastoma. The records of 46 patients of ameloblstoma and 48 patients of odontogenic keratocyst at the Yonsei University Dental Hospital during the period of 1979 to 1995 were retrospectively reviewed. As a possible means for differentiating between the odontogenic keratocyst and ameloblastoma, the clinical parameters and the radiologic parameters were evaluated. In the clinical parameters, there was no significant deference in age, sex, and sign and symptoms (p>0.05).In the radiologic parameters, there was significant difference in site, shape of the lesion, and external root resorption of adjacent teeth (p<0.05). The site, shape of the lesion, and external root resorption of adjacent teeth can be the parameters to differentiate odontogenic keratocyst and ameloblastoma, but a definite differentiation of these two lesions needs a more specialized imaging modality.

  1. DIFFERENTIAL DIAGNOSIS OF PRIMARY AND METASTATIC OVARIAN TUMORS IN PATIENTS WITH COLONIC CANCER

    Directory of Open Access Journals (Sweden)

    I. G. Komarov

    2013-01-01

    Full Text Available This report summarizes existing data on differential diagnosis between primary and metastatic ovarian cancer in patients with colorectal cancer (CRC. The results obtained in N.N. Blokhin Russian Cancer Research Center on the management of this malignancy are also presented. The evidence in favour of the need of genetic counseling and monitoring of the patients with aggravated familial history for early diagnosis of synchronous and metachronous ovarian cancer in patients with CRC is produced. A number of clinical, laboratory and diagnostic methods in addition to immunohistology and molecular genetics should be used for differential diagnosis of primary and metastatic ovarian cancer in patients with CRC.

  2. High-resolution CT in the differential diagnosis of consolidative lung processes. Pt. 2. Chronic processes

    International Nuclear Information System (INIS)

    Consolidations are characterized on CT by the presence of one or more air-space opacities with little or no volume loss. Because HRCT findings overlap among various entities, it may be sometimes to be impossible to make a definite diagnosis with imaging criteria alone. If the symptoms are chronic (weeks to months) the differential diagnosis may include alveolar proteinosis, bronchioloalveolar carcinoma, lymphoma as well as inflammatory diseases. This review describes the most common types of lung diseases associated with chronic appearance of consolidation and discuss the differential diagnosis. (orig.)

  3. MRI findings and differential diagnosis in children with cerebral paragonimiasis

    Directory of Open Access Journals (Sweden)

    Zhen Zeng

    2016-06-01

    Conclusions: The clinical manifestations of cerebral paragonimiasis are nonspecific in children while the MRI findings of cerebral paragonimiasis are characteristic, including irregular hemorrhage, ring-like enhancement and disproportionately large areas of surrounding edema. Brain MRI plays an important role in the diagnosis of cerebral paragonimiasis in children.

  4. Diagnostic Accuracy of Cerebrospinal Fluid Amyloid-beta Isoforms for Early and Differential Dementia Diagnosis

    NARCIS (Netherlands)

    Struyfs, Hanne; Van Broeck, Bianca; Timmers, Maarten; Fransen, Erik; Sleegers, Kristel; Van Broeckhoven, Christine; De Deyn, Peter P.; Streffer, Johannes R.; Mercken, Marc; Engelborghs, Sebastiaan

    2015-01-01

    Background: Overlapping cerebrospinal fluid biomarkers (CSF) levels between Alzheimer's disease (AD) and non-AD patients decrease differential diagnostic accuracy of the AD core CSF biomarkers. Amyloid-beta (A beta) isoforms might improve the AD versus non-AD differential diagnosis. Objective: To de

  5. [Confusing clinical presentations and differential diagnosis of bipolar disorder].

    Science.gov (United States)

    Gorwood, P

    2004-01-01

    An early recognition of bipolar disorders may have an important impact on the prognosis of this disorder according to different mechanisms. Bipolar disorder is nevertheless not easy to detect, the diagnosis being correctly proposed after, in average more than a couple of Years and three different doctors assessments. A short delay before introducing the relevant treatment should help avoiding inappropriate treatments (prescribing, for example, neuroleptics for long periods, antidepressive drugs each time depressive symptoms occurs, absence of treatment despite mood disorders), with their associated negative impact such as mood-switching, rapid cycling or presence of chronic side-effects stigmates. Furthermore, non-treated mood disorders in bipolar disorder are longer, more stigmatizing and may be associated with an increased risk of suicidal behaviour and mortality. Lastly, compliance, an important factor regarding the long term prognosis of bipolar disorder, should be improved when there is a short delay between correct diagnosis and treatment and onset of the disorder. We therefore propose to review the literature for the different pitfalls involved in the diagnosis of bipolar disorder. Non-bipolar mood-disorders are frequently quoted as one of the alternative diagnosis. Hyperthymic temperament, side-effects of prescribed treatments and organic comorbid disorders may be involved. Bipolar disorders have a sex-ratio closer to 1 (men are thus more frequently of the bipolar type in mood-disorders), with earlier age at onset, and more frequent family history of suicidal attempts and bipolar disorder. Schizo-affective disorders are also a major concern regarding the diagnosis of bipolar disorder. This is explained by flat affects sometimes close to anhedonia, presence of a schizoïd personality in bipolar disorder, persecutive hostility that can be considered to be related to irritability rather than a schizophrenic symptom. Rapid cycling, mixed episodes and short

  6. Diagnosis and Treatment of Odontogenic Cutaneous Sinus Tracts in an 11-Year-Old Boy: A Case Report.

    Science.gov (United States)

    Chen, Ke; Liang, Yun; Xiong, Huacui

    2016-05-01

    Odontogenic cutaneous sinus tracts (OCSTs) are generally primarily misdiagnosed and inappropriately treated by virtue of their rarity and the absence of dental symptoms. Accurate diagnosis and treatment and the elimination of the source of infection can reduce the incidence of complications and relieve the pain of the patient.In this case report, we present the case of an 11-year-old patient with an apparent abscess but an unobvious draining sinus tract in his left cheek. Intraorally, a glass-ionomer-cement filling on the occlusal surface of the left mandibular first molar (tooth 36) was noted. Radiographic examination revealed a radiopaque mass inside the crown and pulp chamber and an irregular, radiolucent periapical lesion surrounding the distal root apex. He was diagnosed with an OCTS secondary to a periapical abscess of tooth 36. Precise root canal therapy (RCT) and chronic granuloma debridement was performed; 6 months later, the abscess and sinus had healed completely, and the periapical lesion had resolved.Odontogenic cutaneous sinus tracts are uncommon in the clinic. This case report reminds us of the significance of OCSTs and provides some implications for their diagnosis and treatment. PMID:27196471

  7. [Kala azar. Rare import and significant differential diagnosis].

    Science.gov (United States)

    Sudeck, H

    2006-08-01

    After traveling into regions endemic for leishmaniasis all patients presenting with generalized febrile symptoms, pancytopenia, hepatosplenomegaly and symptoms as well as laboratory parameters also seen in autoimmune diseases should be screened for leishmaniasis even after a longer time period. Doctors should bear in mind that especially immunosuppressed patients can present with atypical and abortive symptoms and that in this group of patients immune diagnosis is unreliable. A diagnosis of a lymphoma related only to the spleen should not be made and splenectomy must not be carried out before reliable exclusion of kala azar, using modern diagnostic tools like PCR. Patients should be referred to specialized centers e.g. institutes for tropical medicine and therapy must follow actual guidelines, such as the German guidelines published by the AWMF. PMID:16819655

  8. SONOGRAPHIC PATTERNS AND DIFFERENTIAL DIAGNOSIS OF CYSTIC RENAL CARCINOMAS

    Institute of Scientific and Technical Information of China (English)

    蔡胜; 李建初; 等

    2002-01-01

    Objective:To study the sonographic features and patterns of cystic renal carcinomas.Methods:Thirteen cases of cystic renal carcinoma confirmed by operation and pathology were examined by ultrasonography,and the cystic walls,septa and solid mural nodules were studied.Results:Solid mural nodules of some cases and irregular thickening of the cystic walls and septa were characteristic findings for the ultrasonic diagnosis of cystic renal carcinomas.According to their pathologic mechanisms and sonographic features,cystic renal carcinomas were classified into 3 patterns:unilocular cystic mass,multiloculated cystic mass and cystic-solid mass.Conclusions:Typical cystic renal carcinomas can be well diagnosed,while atypical cases may be misdiagnosed as benign renal cysts by ultrasonography.Color Doppler ultrasonography and needle aspiration guided by ultrasonography are helpful in the diagnosis of these atypical cases.

  9. SONOGRAPHIC PATTERNS AND DIFFERENTIAL DIAGNOSIS OF CYSTIC RENAL CARCINOMAS

    Institute of Scientific and Technical Information of China (English)

    蔡胜; 李建初; 姜玉新; 戴晴; 谭莉; 张缙熙

    2002-01-01

    Objective. To study the sonographic features and patterns of cystic renal carcinomas. Methods. Thirteen cases of cystic renal carcinoma confirmed by operation and pathology were examined by ultrasonography, and the cystic walls, septa and solid mural nodules were studied. Results. Solid mural nodules of some cases and irregular thickening of the cystic walls and septa were characteristic findings for the ultrasonic diagnosis of cystic renal carcinomas. According to their pathologic mechanisms and sonographic features, cystic renal carcinomas were classified into 3 patterns: unilocular cystic mass, multiloculated cystic mass and cystic-solid mass. Conclusions. Typical cystic renal carcinomas can be well diagnosed, while atypical cases may be misdiagnosed as benign renal cysts by ultrasonography. Color Doppler ultrasonography and needle aspiration guided by ultrasonography are helpful in the diagnosis of these atypical cases.

  10. Idiopathic pulmonary hemorrhage: morphology and differential diagnosis. Case report

    OpenAIRE

    Eduardo Cambruzzi; Karla Lais Pêgas; Túlio Vedana

    2013-01-01

    Idiopathic pulmonary hemorrhage (IPH) is a rare cause of alveolar hemorrhage (AH) with unknown etiology that primarily affects children. The process has a variable clinical progression, and its diagnosis is established after excluding all causes of AH. Herein, the authors report a case of IPH in an adult male patient referring cough and hemoptysis. The conventional radiography computed tomography imaging identified zones of consolidation and areas of ground-glass attenuation in the lower lobe...

  11. Somatostatinoma syndrome: a challenging differential diagnosis among pancreatic tumors

    Directory of Open Access Journals (Sweden)

    Paula Martinez Vianna

    2013-03-01

    Full Text Available Among the neuroendocrine neoplasia, the pancreatic somatostatin-producing tumors are very rare. Usually functional, these tumors produce the somatostatinoma syndrome, which encompasses diabetes mellitus, diarrhea/steatorrhoea, and cholelithiasis. Other symptoms may include dyspepsia, weight loss, anemia, and hypochlorhydria. All theses symptoms are explained by the inhibitory actions of the somatostatin released by tumoral cells originated from pancreatic delta cells or endocrine cells of the digestive tract. The diagnosis is easy to overlook since these symptoms are commonly observed in other more common syndromes. Besides the clinical features, diagnosis is based on serum determination of somatostatin, and imaging exams, such as ultrasound, computer tomography and positron emission tomography. Pathologic examination is characterized by the positivity of immunohistochemical reaction for synaptophysin, chromogranin, and somatostatin. These tumors can be classified according to tumor size, mitotic index, neural or vascular invasion, and distant metastases. The authors describe the case of a 61-year-old female patient who sought medical care because of a 6-month history of watery diarrhea, weight loss, and depression. She was diagnosed with diabetes mellitus 3 years ago. Imaging examination revealed a tumoral mass of 4 cm in its longest axis in the topography of the head of the pancreas and calculous cholecistopathy. The patient’s clinical status was unfavorable for a surgical approach. She died after 20 days of hospitalization. The definitive diagnosis was achieved with the autopsy findings, which disclosed a pancreatic somatostatinoma.

  12. Computerized tomography in the differential diagnosis of extremity edema

    International Nuclear Information System (INIS)

    Computerized tomography provides valuable information for differentiating some cases of extremity edemas of acute and chronic venostatic origin and lymphedema - primary and secondary, in malignant processes. Graphic representation of individual kinds of changes and observed densities in 33 patients are presented. (author). 9 figs., 1 tab., 6 refs

  13. Vestibular papillomatosis: An important differential diagnosis of vulvar papillomas.

    Science.gov (United States)

    Ozkur, Ezgi; Falay, Tugba; Turgut Erdemir, Asli Vefa; Gurel, Mehmet Salih; Leblebici, Cem

    2016-01-01

    Most authors believe that vestibular papillomatosis (VP) is an anatomical variant of the vestibular mucosa. But VP is sometimes misdiagnosed as genital warts and this can lead to aggressive investigations, therapy, and anxiety in patients. We present a patient with VP. Dermoscopy and reflectance confocal microscopy (RCM) were performed to differentiate VP from other papilomatous diseases of the vulva. PMID:27136629

  14. Differential Diagnosis of Children with Suspected Childhood Apraxia of Speech

    Science.gov (United States)

    Murray, Elizabeth; McCabe, Patricia; Heard, Robert; Ballard, Kirrie J.

    2015-01-01

    Purpose: The gold standard for diagnosing childhood apraxia of speech (CAS) is expert judgment of perceptual features. The aim of this study was to identify a set of objective measures that differentiate CAS from other speech disorders. Method: Seventy-two children (4-12 years of age) diagnosed with suspected CAS by community speech-language…

  15. Application of 18F-FDG PET for the diagnosis and differential diagnosis of Alzheimer's disease and Lewy body dementia

    International Nuclear Information System (INIS)

    Alzheimer's disease and Lewy body dementia are the two most frequent disorders among degenerative dementias. Their clinical identification and differential diagnosis are often difficult in the early stages when, on the other hand treatment is most effective. FDG-PET assessment of region brain metabolism is a proven method and its application demented patients ensures a higher diagnostic accuracy even at the preclinical stage. It helps resolving cases with difficult differential diagnosis as well. In this paper we discuss the application of the method in Alzheimer's disease and Lev body dementia; we present typical cases of both disorder which were assessed by FDG-PET for the first time in Bulgaria highlighting the methodology and the characteristic imaging findings

  16. Patient exposure in the basic science classroom enhances differential diagnosis formation and clinical decision-making

    Directory of Open Access Journals (Sweden)

    Justin G. Peacock

    2015-02-01

    Full Text Available Purpose. The authors proposed that introducing real patients into a pathology classroom early in medical education would help integrate fundamental principles and disease pathology with clinical presentation and medical history. Methods. Three patients with different pathologies described their history and presentation without revealing their diagnosis. Students were required to submit a differential diagnosis in writing, and then were able to ask questions to arrive at the correct diagnosis. Students were surveyed on the efficacy of patient-based learning. Results. Average student scores on the differential diagnosis assignments significantly improved 32% during the course. From the survey, 72% of students felt that patient encounters should be included in the pathology course next year. Seventy-four percent felt that the differential diagnosis assignments helped them develop clinical decision-making skills. Seventy-three percent felt that the experience helped them know what questions to ask patients. Eighty-six percent felt that they obtained a better understanding of patients’ social and emotional challenges. Discussion. Having students work through the process of differential diagnosis formulation when encountering a real patient and their clinical presentation improved clinical decision-making skills and integrated fundamental concepts with disease pathology during a basic science pathology course.

  17. Septic Bursitis in an 8-Year-Old Boy

    OpenAIRE

    Panagiotis Kratimenos; Ioannis Koutroulis; Dante Marconi; Jennifer Ding; Christos Plakas; Margaret Fisher

    2014-01-01

    Background. The prepatellar bursa can become inflamed owing to repeated trauma. Prepatellar bursitis is extremely rare in children. Methods. We report the case of an 8-year-old boy who was treated for an erythematous, swollen, and severely painful right knee, fever, inability to bear weight on the leg, and purulent material draining from a puncture wound. We describe the differential diagnosis for tender swollen knee, including infection, gout, rheumatoid arthritis, and osteoarthritis. If unt...

  18. Differential diagnosis of multiple vertebral compression: butterfly vertebrae.

    Science.gov (United States)

    Ozaras, Nihal; Gumussu, Kevser; Demir, Saliha Eroglu; Rezvani, Aylin

    2015-11-01

    [Purpose] A butterfly vertebra is a rare congenital anomaly resulting from a symmetric fusion defect. Only a few cases of butterfly vertebra have been described. This anomaly may be isolated or associated with Pfeiffer, Jarcho-Levins, Crouzon, or Alagille syndrome. [Subject and Methods] We herein describe a 38-year-old man who presented with neck and low back pain and was found to have butterfly vertebrae at the T9 and L3 levels. He also had Behçet's disease and psoriasis. [Results] The patient's symptoms improved with analgesics and physiotherapy. [Conclusion] To our knowledge, butterfly vertebrae at two levels have never been reported. Butterfly vertebrae may be confused with vertebral fractures in lateral radiographs, and awareness of this anomaly is important for a correct diagnosis. PMID:26696746

  19. [Vocal cord dysfunction. An important differential diagnosis to bronchial asthma].

    Science.gov (United States)

    Kothe, C; Schade, G; Fleischer, S; Hess, M

    2004-03-01

    Vocal cord dysfunction (VCD) is described as a functional disorder of the vocal folds which leads to an intermittent, inspiratory 'paradoxical' glottal closure. We report on three women with frequent repetitive shortness of breath attacks caused by VCD. This was diagnosed by transnasal videofiberendoscopy, with glottal closure being seen during inspiration. Because of the different etiologies, one of the patients was treated with breathing and speech therapy, another received Omeprazol for laryngopharyngeal reflux, and the third was treated by intralaryngeal botulinum toxin injections. All three patients showed a reduction in attacks. Clinically, VCD seems to mimic asthma. However, with a thorough patient history and diagnostics, especially with transnasal laryngoscopy during a (triggered) attack, a precise diagnosis seems possible. PMID:15007522

  20. Spectrophotometric intracutaneous analysis for differential diagnosis of pigmented skin lesions

    Directory of Open Access Journals (Sweden)

    Е. V. Filonenko

    2013-01-01

    Full Text Available The non-invasive diagnosis of pigmented skin lesions by spectrophotometric intracutaneous analysis (SIA-scopy using device for dermatoscopy (SIAscope V by Astron Clinica, Ltd was approved in P.A.Herzen Moscow Cancer Research Institute. The method is based on analysis of light interaction with wavelength of 440–960 nm anf human skin, which is recorded by change of image on scan. The comparative analysis of SIA-scopy and histological data in 327 pigmented skin lesions in 147 patients showed, that SIA had high diagnostic efficiency for cutaneous melanoma: the sensitivity was 96%, specifity – 94%, diagnostic accuracy – 94%. For study of malignant potential of pigmented lesions by SIA-scopy the most informative capacity was obtained for assessment of melanin in papillary dermis, status of blood vessels and collagen fibres (SIA-scans 3, 4, 5.

  1. [The Interesting Case No. 42. Differential diagnosis of epistaxis].

    Science.gov (United States)

    Koch, O; Jecker, P; Maurer, J

    2001-02-01

    Epistaxis is a symptom and one of the most frequent medical emergencies. In most cases haemorrhages concern the anterior parts of the septum, in particular the Locus Kiesselbachi. Thus they are harmless and therapy is easy to handle. We report a case of a 55-year-old lady with relapsing epistaxis due to a pseudoaneurysm after surgery of a meningioma of the sphenoid bone. This type of epistaxis is rare and may culminate into a life-threatening event. The case demonstrates the importance of an exact differential diagnostic evaluation by use of modern imaging techniques for severe and life-threatening symptomatic nose-bleeding. PMID:11253565

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

    Science.gov (United States)

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

    2016-01-01

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

  3. A Case of Patch Stage of Kaposi’s Sarcoma and Discussion of the Differential Diagnosis

    Science.gov (United States)

    Kak, Ipshita; Salama, Samih; Gohla, Gabriella; Naqvi, Asghar; Alowami, Salem

    2016-01-01

    A 55 year old HIV positive male had a skin lesion biopsy which showed atypical vascular proliferation within the superficial and deep dermis with mild atypia of lining endothelial cells. A sparse lymphoplasmacytic infiltrate surrounding the irregular vascular channels was noted. Immunohistochemistry highlighted the atypical blood vessels with the vascular markers CD31, CD34 and Factor VIII. The differential diagnosis included unusual vascular or lymphatic proliferations, stasis dermatitis, kaposiform hemangioendothelioma, progressive lymphangioma and angiosarcoma with focal Kaposi’s sarcoma features. Characteristic human herpes virus-8 positive staining helped support the diagnosis of patch stage of Kaposi’s sarcoma. Herein, we discuss the case findings, differential diagnosis and characteristic histological findings associated with the patch stage of Kaposi’s sarcoma which can be an elusive diagnosis. PMID:27134709

  4. Improving the Differential Diagnosis of Chronic Obstructive Pulmonary Disease in Primary Care

    OpenAIRE

    Price, David B.; Yawn, Barbara P; Rupert C M Jones

    2010-01-01

    Chronic obstructive pulmonary disease (COPD) and asthma represent a substantial portion of primary care practice. In adults, differentiating asthma from COPD can be difficult but is important because of the marked differences in treatment, disease progression, and outcomes between the 2 conditions. Currently, clinical COPD is often misdiagnosed or undiagnosed until late in the disease. Earlier diagnosis could markedly reduce morbidity and improve quality of life. Establishing a diagnosis of C...

  5. Lung ultrasound: a valid help in the differential diagnosis between pneumothorax and pulmonary blebs

    OpenAIRE

    Francesca Sandionigi; Francesca Cortellaro; Elisa Forni; Daniele Coen

    2013-01-01

    Spontaneous pneumothorax is a relatively common disease but its radiological diagnosis can be difficult because of the insufficient sensitivity of chest X-rays. This is even more so when bullous emphysema and acute pneumothorax co-exist. There is evidence that lung ultrasound is a valid instrument to detect a pneumothorax and a valid help in the differential diagnosis between pneumothorax and pulmonary blebs. We present a case which suggests the potential superiority of lung ultrasound on che...

  6. Differential diagnosis of pediatric tumors of the nasal cavity and paranasal sinuses: a 45-year multi-institutional review.

    Science.gov (United States)

    Holsinger, F Christopher; Hafemeister, Adam C; Hicks, M John; Sulek, Marcelle; Huh, Winston W; Friedman, Ellen M

    2010-11-01

    We conducted a retrospective case-series review to identify the various diagnoses of neoplasms of the nasal cavity and paranasal sinuses in a pediatric population. Our study group was made up of 54 children-23 boys and 31 girls, aged 8 months to 16 years (mean: 9 yr). All patients had been diagnosed with a tumor of the nasal cavity or paranasal sinuses between Jan. 1, 1955, and Dec. 31, 1999, at one of four university-based, tertiary care referral centers. We compiled data on tumoral characteristics (location, size, and histopathology), morbidity and mortality, and rates of recurrence. Lesions included adnexal neoplasm, ameloblastic fibro-odontoma, basal cell carcinoma, benign fibrous histiocytoma, blue nevus, chondrosarcoma, compound nevus, epithelioma adenoides cysticum, esthesioneuroblastoma, Ewing sarcoma, fibrosarcoma, giant cell granuloma, granulocytic sarcoma, hemangioma, hemangiopericytoma, Langerhans cell histiocytosis, lymphangioma, lymphoma, melanoma, neuroblastoma, neurofibroma, ossifying osteofibroma, osteochondroma, osteosarcoma, port wine stain, rhabdomyosarcoma, Spitz nevus, and xanthogranuloma. To the best of our knowledge, this is the largest such study of its kind to date. We believe that the large size of this study and the data on disease incidence will allow clinicians to be better informed of the differential diagnosis of neoplasms of the nasal cavity and paranasal sinuses in the pediatric population.

  7. Infectious spondylitis and its differential diagnosis; Spondylitis und ihre Differenzialdiagnosen

    Energy Technology Data Exchange (ETDEWEB)

    Erlemann, Rainer [Helios St. Johannes Klinik, Duisburg (Germany). Inst. fuer Radiologie; Hoogeveen, Anja [AKH Viersen (Germany)

    2012-06-15

    Infectious spondylitis can be diagnosed early and reliably by MRI, given that the most important diagnostic criteria are present. These criteria are bone marrow edema adjacent to two contiguous vertebral end plates, disk space of high signal intensity and enhancement of bone adjacent to two contiguous vertebral end plates and of the disk space. If not all of these criteria are present, diagnostic accuracy decreases. Erosive osteochondritis, spondylarthritis, osteoporotic fractures of two contiguous vertebral end plates, active Schmorl's nodes as well as neuropathic spine may mimic an infectious spondylitis. This paper presents typical and atypical morphologic patterns of infectious spondylitis as well as the differentiation criteria from the above mentioned diseases. (orig.)

  8. Observational constraints and differential diagnosis for cosmic evolutionary models

    CERN Document Server

    Wang, Deng

    2016-01-01

    In this paper, we have proposed a plotting method based on the " natural plotting rule " (NPR) which can be used to distinguish different cosmological scenarios more efficiently and obtain more useful information. By using the NPR, we have avoided the blindness to use different diagnostics when discovering that some scenarios can be hardly differentiated from each other, and develop a logical line to adopt different diagnostics. As a concrete instance, we take this method based on the NPR to distinguish several Cardassian scenarios from the base cosmology scenario, and one from the other. We place constraints on three Cardassian cosmological scenarios and their flat versions by utilizing the Type Ia supernovae (SNe Ia), baryonic acoustic oscillations (BAO), cosmic microwave background (CMB) radiation, observational Hubble parameter (OHD) data-sets as well as the single data point from the newest event GW150914, and discover that our results are more stringent than previous results for constraining the cosmolo...

  9. Overactive bladder, differential diagnosis, and clinical utility of fesoterodine

    Directory of Open Access Journals (Sweden)

    Wyndaele J-J

    2012-11-01

    Full Text Available Jean-Jacques WyndaeleDepartment of Urology, Antwerp University, Antwerp, BelgiumAbstract: Overactive bladder is a symptom syndrome with urgency, frequency and, in many cases, nocturia. Urge incontinence is not present in all. There is no direct correlation with detrusor overactivity, an objective finding during urodynamic testing where involuntary contractions can be noticed. In the pathophysiology, much more attention has been given to the afferent/sensory arm of the micturition reflex in the last decade. Anatomical and infectious causes have to be diagnosed or ruled out. Diagnosis of overactive bladder is made mostly by history-taking, but other tests can be necessary in specific patients. Treatment consists of behavioral measures, a good explanation of the condition, training, and pelvic floor physiotherapy. Drugs are often used. Until recently, antimuscarinic drugs have been the mainstay of pharmacological therapy. Fesoterodine is a newer antimuscarinic agent which is more pharmacodynamically stable then tolterodine. Fesoterodine has been extensively researched using different dosages and compared with placebo and tolterodine, in different age groups, and under different conditions. Fesoterodine is superior to placebo and to tolterodine in the short term and long term. Its safety is very acceptable.Keywords: overactive bladder, fesoterodine, incontinence, urgency, lower urinary tract

  10. The lung in systemic vasculitis: radiological patterns and differential diagnosis.

    Science.gov (United States)

    Feragalli, Beatrice; Mantini, Cesare; Sperandeo, Marco; Galluzzo, Michele; Belcaro, Giovanni; Tartaro, Armando; Cotroneo, Antonio R

    2016-01-01

    The respiratory system may be involved in all systemic vasculitides, although with a variable frequency. The aim of our review is to describe radiographic and high-resolution CT (HRCT) findings of pulmonary vasculitides and to correlate radiological findings with pathological results. Lung disease is a common feature of antineutrophil cytoplasmic autoantibody-associated small-vessel vasculitides, including granulomatosis with polyangiitis (Wegener's), eosinophilic granulomatosis with polyangiitis (Churg-Strauss) and microscopic polyangiitis. Pulmonary involvement is less frequent in immune-complex-mediated small-vessel vasculitides, such as Behçet's disease and Goodpasture's syndrome. Pulmonary involvement associated to large-vessel (gigantocellular arteritis and Takayasu's disease) or medium-vessel (nodose polyarteritis and Kawasaki's disease) vasculitides is extremely rare. The present review describes the main clinical and radiological features of pulmonary vasculitides with major purpose to correlate HRCT findings (solitary or multiple nodules, cavitary lesions, micronodules with centrilobular or peribronchial distribution, airspace consolidations, "crazy paving", tracheobronchial involvement, interstitial disease) with pathological results paying particular attention to the description of acute life-threatening manifestations. A thorough medical history, careful clinical examination and the knowledge of radiological patterns are mandatory for a correct and early diagnosis. PMID:26876879

  11. Balloon Cell Urethral Melanoma: Differential Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    M. McComiskey

    2015-01-01

    Full Text Available Introduction. Primary malignant melanoma of the urethra is a rare tumour (0.2% of all melanomas that most commonly affects the meatus and distal urethra and is three times more common in women than men. Case. A 76-year-old lady presented with vaginal pain and discharge. On examination, a 4 cm mass was noted in the vagina and biopsy confirmed melanoma of a balloon type. Preoperative CT showed no distant metastases and an MRI scan of the pelvis demonstrated no associated lymphadenopathy. She underwent anterior exenterative surgery and vaginectomy also. Histology confirmed a urethral nodular malignant melanoma. Discussion. First-line treatment of melanoma is often surgical. Adjuvant treatment including chemotherapy, radiotherapy, or immunotherapy has also been reported. Even with aggressive management, malignant melanoma of the urogenital tract generally has a poor prognosis. Recurrence rates are high and the mean period between diagnosis and recurrence is 12.5 months. A 5-year survival rate of less than 20% has been reported in balloon cell melanomas along with nearly 20% developing local recurrence. Conclusion. To the best of our knowledge, this case is the first report of balloon cell melanoma arising in the urethra. The presentation and surgical management has been described and a literature review provided.

  12. Magnetic resonance imaging and bone scintigraphy in the differential diagnosis of unclassified arthritis

    DEFF Research Database (Denmark)

    Duer, Anne; Østergaard, M; Hørslev-Petersen, K;

    2008-01-01

    OBJECTIVES: To investigate the value in clinical practice of hand magnetic resonance imaging (MRI) and whole body bone scintigraphy in the differential diagnosis of patients with unclassified arthritis. METHODS: 41 patients with arthritis (> or = 2 swollen joints, > 6 months' duration) which...... joints of the most symptomatic hand and whole body bone scintigraphy were performed. Two rheumatologists agreed on the most likely diagnosis and the patients were treated accordingly. A final diagnosis was made by another specialist review 2 years later. RESULTS: Tentative diagnoses after MRI and bone...

  13. Differential diagnosis of sexual pain in women (La diagnosi differenziale del dolore sessuale nella donna

    Directory of Open Access Journals (Sweden)

    Giancarlo Carli, MD

    2013-09-01

    Full Text Available Dyspareunia, a pain that occurs in response to an attempted vaginalentry or to a sexual intercourse, is a clinical entity that recognizes multifactorial etiology. It may be due to organic diseases or to functional disorders suchas Hypoactive Syndrome Desire Disease (HSDD, vaginismus and provoked vulvodynia (PVD. A full history is fundamental for the diagnosis of functional syndromes. For PVD diagnosis, the gynaecologist must also have experience of syndromes of chronic widespread pain of unknownetiology such as fibromyalgia since these syndromes are frequently associated. In PVD local and diffuse hyperalgesia is associated with mechanismsof central sensitization. In PVD there is evidence suggesting local mechanisms of neuropathic nature, although local symptoms consist only in light erythema and oedema.

  14. Gastric-Type Extremely Well-Differentiated Adenocarcinoma of the Stomach: A Challenge for Preoperative Diagnosis

    OpenAIRE

    Joo, Mee; Han, Song Hee

    2015-01-01

    Gastric-type extremely well-differentiated adenocarcinoma (EWDA) is a rare type of gastric adenocarcinoma characterized by infiltration of well-formed mucinous glands with little or no nuclear atypia, which resemble foveolar epithelium or pyloric glands. Because of its high degree of differentiation, preoperative biopsy diagnosis of gastric-type EWDA is very difficult. We encountered a case of gastric-type EWDA, manifesting as a Borrmann type 4 lesion, in a 47-year-old man. Despite four repea...

  15. Differential diagnosis of structural changes in the pubic bone in children and adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Appell, R.G.; Willich, E.

    1983-02-01

    Structural changes in the pubic bone often are difficult to interpret. The radiologic appearance is very different. The differentiation between inflammatory and malignant processes is hardly to distinguish. We report of ten patients with osseous changes in the os pubic (4 Ewing's sarcoma, 1 osteosarcoma, 1 Morbus Hodgkin, 1 osteochondronecrosis, 2 osteochondritis, 1 subchronic osteomyelitis). Two patients with Ewing's sarcoma who were initially treated for osteomyelitis are described in detail. Differential diagnosis and previous literature are reviewed.

  16. Differential Diagnosis and Intervention of Proximal Median Nerve Entrapment: A Resident's Case Problem.

    Science.gov (United States)

    Bair, Marcus R; Gross, Michael T; Cooke, Jennifer R; Hill, Carla H

    2016-09-01

    Study Design Resident's case problem. Background Entrapment neuropathies represent a diagnostic challenge and require a comprehensive understanding of the nerve's path and the anatomical structures that may cause compression of the nerve. This resident's case problem details the evaluation and differential diagnosis process for median nerve entrapment resulting from forceful and repetitive pronation/supination motions. Diagnosis Median nerve compression syndromes include pronator syndrome, anterior interosseous nerve syndrome, and carpal tunnel syndrome. A cluster of clinical special tests were performed to determine the anatomical site of median nerve entrapment. Based on the patient's history and clinical test results, a diagnosis of pronator syndrome was determined. Provocation testing specific to pronator syndrome assisted with further localizing the site of entrapment to the pronator teres muscle, which guided effective management strategies. Discussion This resident's case problem illustrates the importance of detailed anatomical knowledge and a differential diagnostic process when evaluating a patient with signs and symptoms of an entrapment neuropathy of the median nerve. Electrodiagnostic studies are useful in ruling out carpal tunnel and anterior interosseous nerve syndromes, but are often inconclusive in cases of pronator syndrome. Therefore, a diagnosis of pronator syndrome in this case problem was based on a detailed understanding of median nerve anatomy, potential sites of compression, and unique clinical features associated with this condition. Level of Evidence Differential diagnosis, level 4. J Orthop Sports Phys Ther 2016;46(9):800-808. Epub 5 Aug 2016. doi:10.2519/jospt.2016.6723. PMID:27494058

  17. [The morphology and differential diagnosis of neuroglial heterotopias and related tumors].

    Science.gov (United States)

    Shelekhova, K V; Sokolova, I A; Kazakov, D V; Michal, M

    2009-01-01

    The paper reviews the data available in the literature and a clinicomorphological analysis of 15 cases of neuroglial heteropias and related tumors retrieved from the joint databases of Sikl's Department of Pathology, Pilsen, Czech Republic, and the Department of Pathology, Petrov Oncology Institute, with emphasis on the histological, immunohistochemical and ultrastructural features, as well as differential diagnosis.

  18. Cerebrospinal fluid P-tau(181P) : biomarker for improved differential dementia diagnosis

    NARCIS (Netherlands)

    Struyfs, Hanne; Niemantsverdriet, Ellis; Goossens, Joery; Fransen, Erik; Martin, Jean-Jacques; De Deyn, Peter P.; Engelborghs, Sebastiaan

    2015-01-01

    The goal of this study is to investigate the value of tau phosphorylated at threonine 181 (P-tau(181p)) in the Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarker panel for differential dementia diagnosis in autopsy confirmed AD and non-AD patients. The study population consisted of 140 aut

  19. COMPUTED-TOMOGRAPHY IN DIFFERENTIAL-DIAGNOSIS OF TEMPOROMANDIBULAR-JOINT DISORDERS

    NARCIS (Netherlands)

    DEBONT, LGM; VANDERKUIJL, B; STEGENGA, B; VENCKEN, LM; BOERING, G

    1993-01-01

    Computed tomography (CT) has great potential for imaging intra- and extracapsular hard-tissue abnormality of the temporomandibular joint (TMJ). CT is not the best method of imaging disk position and form. For differential diagnosis of TMJ disorders, CT is especially successful in bony lesions. The s

  20. Postpartum post-dural puncture headache: is your differential diagnosis complete?

    NARCIS (Netherlands)

    Bleeker, C.P.; Hendriks, I.M.; Booij, L.H.D.J.

    2004-01-01

    We describe a patient with an intracerebral haemorrhage following an accidental dural puncture during an attempted epidural for pain relief in labour. Anaesthetists need to include intracerebral haemorrhage in the differential diagnosis of post-dural puncture headache in the puerperium.

  1. Differential diagnosis in the pediatric radiology; Differenzialdiagnosen in der paediatrischen Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Rijn, Rick R. van [Academic Medical Center Amsterdam (Netherlands). Dept. of Radiology; Blickmann, Johan G. (eds.) [Univ. of Rocherster Medical Center, NY (United States). Dept. of Imaging Sciences URMC

    2012-11-01

    The book on differential diagnosis in the pediatric radiology covers the following issues: (1) Thorax, mediastinum, heart ad large blood vessels. (2) Abdomen and gastrointestinal tract. (3) Urogenital tract. (4) Skull, intracranial space and spinal cord. (5) Skeleton, bone joints and soft tissue. (6) Normative values.

  2. Mixed solid and cystic acoustic neuroma: MR features and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Denys, A. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France); Duvoisin, B. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France)]|[Dept. of Radiodiagnosis, University Hospital, Lausanne (Switzerland); Fernandes, J.G. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France); Doyon, D. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France)

    1991-11-01

    We present a very rare case of combined cystic and solid acoustic neuroma investigated by magnetic resonance imaging (MRI). This case illustrates the value of MRI in the characterization of tumours in the posterior cranial fossa, particularly acoustic neuromas, and its diagnostic impact in unusual situations. The differential diagnosis of cystic and mixed lesions in the cerebellopontine angle is discussed. (orig.)

  3. [S3 Guideline. Part 1: Diagnosis and Differential Diagnosis of Non-Traumatic Adult Femoral Head Necrosis].

    Science.gov (United States)

    Bohndorf, K; Beckmann, J; Jäger, M; Kenn, W; Maus, U; Nöth, U; Peters, K M; Rader, C; Reppenhagen, S; Roth, A

    2015-08-01

    Non-traumatic femoral head necrosis (FHN) is primarily a disease of the middle-aged adult. Early diagnosis, at a time with lacking or minimal clinical symptoms, is mandatory to consider conservative therapy or joint preserving operations as a therapeutic option. The new German S3 guideline about diagnosis and therapy of FHN is a cooperative effort of five professional medical societies, overall headed by the Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC). This review (part I/III) cites and explains the statements of the S3 guideline as agreed on the use of imaging methods for diagnosis of FHN. A diagnostic algorithm is presented. FHN clinically has to be considered in case of equivocal pain of a hip joint with a minimum of 6 weeks duration, when risk factors can be revealed, groin pain at clinical investigation, limping, pain or limitation of movement in case of load, and no obvious differential diagnoses. Is an FHN clinically suspected, primarily radiographs of the pelvis ap and a Lauenstein projection of the hip involved should be carried out. When the radiographs are normal, an MRI of the hips should follow routinely. MRI allows the diagnosis of FNH with high accuracy. Furthermore, MRI reveals the site and the size of the necrotic area involved and evaluates the integrity of the joint surface and subchondral fractures. When ARCO stage II (ARCO: Association Research Circulation Osseous) is diagnosed and MRI does not allow one to determine the joint surface with certainty, a CT of the hip joints should be performed. The S3 guideline explains and recommends the use of the ARCO classification. Although, this classification of 1993 is still largely based on radiographs, the pragmatic use of an "extended" version seems reasonable. Today, classical radiographic criteria like impression of the joint surface and subchondral fractures ("crescent sign") are better to be evaluated by MRI, in cases of subtle findings MRI is even surpassed by CT

  4. [Tularemia lymphadenitis. An emerging differential diagnosis of necrotizing granulomatous cervical lymphadenitis].

    Science.gov (United States)

    Strehl, J; Schoerner, C; Hartmann, A; Agaimy, A

    2014-03-01

    Tularemia is emerging as an important differential diagnosis of necrotizing granulomatous lymphadenitis, particularly in the head and neck region. The causal organism, Francisella tularensis is a Gram-negative coccoid bacterium. Tularemia usually presents with necrotizing granulomatous purulent lymphadenitis featuring multiple mostly small granulomas with geographic necrosis bordered by palisades of histiocytes. Diagnosis is mainly based on these characteristic but non-pathognomonic histological features in conjunction with negative tests for mycobacterial infections and serological confirmation of tularemia-specific antibodies or detection by polymerase chain reaction (PCR). This article describes our experiences with five patients with tularemia lymphadenitis and gives an overview of the diverse histopathological features and the differential diagnosis of this uncommon but possibly underrecognized disease.

  5. The use of expert systems on the differential diagnosis of urinary incontinence.

    Science.gov (United States)

    Lopes, Maria Helena Baena de Moraes; Marin, Heimar de Fátima; Ortega, Neli Regina Siqueira

    2009-09-01

    The differential diagnosis of urinary incontinence classes is sometimes difficult to establish. As a rule, only the results of urodynamic testing allow an accurate diagnosis. However, this exam is not always feasible, because it requires special equipment, and also trained personnel to lead and interpret the exam. Some expert systems have been developed to assist health professionals in this field. Therefore, the aims of this paper are to present the definition of Artificial Intelligence; to explain what expert system and system for decision support are and its application in the field of health and to discuss some expert systems for differential diagnosis of urinary incontinence. It is concluded that expert systems may be useful not only for teaching purposes, but also as decision support in daily clinical practice. Despite this, for several reasons, health professionals usually hesitate to use the computer expert system to support their decision making process.

  6. Extraskeletal Ewing’s sarcoma in a great toe of a young boy

    OpenAIRE

    Cypel, Tatiana Karine Simon; Meilik, Benjamin; Zuker, Ronald Melvin

    2007-01-01

    Extraskeletal Ewing’s sarcoma (EES) is a rare, soft tissue, malignant neoplasm histologically similar to skeletal Ewing’s sarcoma. It occurs mainly in adolescents and young adults, and affects extremities in 36% of cases and central locations (commonly paravertebral regions) in the remainder. The differential diagnosis includes other small, blue, round cell tumours. A clinical case of EES involving a great toe in a young boy is reported. EES diagnosis was confirmed by features of histological...

  7. [Lung cavities caused by Nocardia cyriacigeorgica in an immunosuppressed boy].

    Science.gov (United States)

    Berring, Dahlia Caroline; Nygaard, Ulrikka

    2014-09-29

    The identification of nodules and/or cavitations in the chest X-ray of a chronically or acute ill patient will rise the suspicion of tuberculosis. However, it is important to be aware of pulmonary nocardiosis as a rare but important differential diagnosis, especially in case of no hilar adenitis. In this case report, we describe a six-year-old boy receiving prednisolone due to nephrotic syndrome, who developed pneumothorax because of pulmonal nocardiosis. The prognosis is good in case of early diagnosis and antibiotic treatment. PMID:25294520

  8. The Potential of Gait Analysis to Contribute to Differential Diagnosis of Early Stage Dementia: Current Research and Future Directions

    Science.gov (United States)

    Morgan, Debra; Funk, Melanie; Crossley, Margaret; Basran, Jenny; Kirk, Andrew; Bello-Haas, Vanina Dal

    2007-01-01

    Early differential diagnosis of dementia is becoming increasingly important as new pharmacologic therapies are developed, as these treatments are not equally effective for all types of dementia. Early detection and differential diagnosis also facilitates informed family decision making and timely access to appropriate services. Information about…

  9. 病毒性心肌炎%Diagnosis and differential diagnosis of virus myocarditis

    Institute of Scientific and Technical Information of China (English)

    汪朝晖; 廖玉华

    2012-01-01

    病毒性心肌炎是指嗜心肌病毒感染引起的心肌非特异性炎症病变,在病毒流行感染期约5%的患者发生心肌炎,约有12.5%急性病毒性心肌炎可进展为扩张型心肌病.病毒性心肌炎临床表现多样,并且没有相关的特异性检查,因而临床上难以明确诊断.尽管国际上有Bolt等多个诊断版本,但迄今为止,没有一个公认的诊断标准.1999年全国心肌炎心肌病专题研讨会提出了成人急性病毒性心肌炎诊断参考标准,但在临床上往往因掌控不严而导致诊断过宽.另外,在诊断病毒性心肌炎时需除外一些疾病如冠心病、甲状腺功能异常、风湿性心肌炎等.%Viral myocarditis ( VMC) is a non-specific inflammatory disease caused by the infection of myocardial virus. Approximately 5% of patients get myocarditis in epizootic infection stage and the 12. 5% of acute VMC will evolve inlo dilated cardiomyopalhy. Clinical observations of VMC show its diversity and non-specific examinations, which explains to us lhat this disease can be diagnosed difficultly. Despile the above fact there are lots of diagnostic standards,such as Blot and other versions,so far we don't have a consistent recognition. In 1999, National Myocarditis Cardiomyopathy Symposium put forward a reference standard alxmt adult acute VMC,but often in clinical practice the diagnosis of this disease is loo wide which is caused by our poor control accuracy. Furthermore, in the process of diagnosis, we should rule out other diseases, such as coronary heart disease, ihvroid dysfunction,rheumatic myocarditis,etc.

  10. [Molecular diagnosis as a strategy for differential diagnosis and at early ages of neurofibromatosis type 1 (NF1)].

    Science.gov (United States)

    Gómez, Martha; Batista, Oriana

    2015-10-01

    Neurofibromatosis type 1 (NF1), is a haploinsufficient and multisystemic disease, caused by inherited or sporadic mutations in the NF1 gene. Its incidence is one in 2,500 to 3,000 individuals, it has an autosomal dominant pattern of inheritance, high clinical variability, complete penetrance and age-dependent complications. Neurofibromin is the product of the NF1 gene and is believed to act as a tumor suppressor since the loss of its function has been associated with benign and malignant tumors in neural crest-derived tissues. Only two correlations between clinical phenotype and mutant alleles in the NF1 gene have been observed. The established criteria for disease diagnosis are very efficient in adults and children older than 3 years of age, but not for children under this age. Mutational analysis is therefore recommended to confirm the disease in young children with a negative family history. A pathogenic mutation in the NF1 should be added to the list of diagnostic criteria. Mutational analysis is also recommended for differential diagnosis and for prenatal or pre-implantation genetic diagnosis, taking into consideration the family history and the type of method to be applied. Molecular studies of this disease using different complimentary molecular techniques and bioinformatics tools have characterized NF1 gene mutations at both the DNA and mRNA levels, increasing the mutational spectrum. Consequently, about 1,289 defects have been reported to date, mainly nonsense/missense mutations, deletions and splice site defects. PMID:26633276

  11. Second harmonic generation microscopy is a novel technique for differential diagnosis of breast fibroepithelial lesions.

    Science.gov (United States)

    Tan, Wai Jin; Yan, Jie; Xu, Shuoyu; Thike, Aye Aye; Bay, Boon Huat; Yu, Hanry; Tan, Min-Han; Tan, Puay Hoon

    2015-12-01

    Breast fibroepithelial lesions, including fibroadenomas and phyllodes tumours, are commonly encountered in clinical practice. As histological differences between these two related entities may be subtle, resulting in a challenging differential diagnosis, pathological techniques to assist the differential diagnosis of these two entities are of high interest. An accurate diagnosis at biopsy is important given corresponding implications for clinical decision-making including surgical extent and monitoring. Second harmonic generation (SHG) microscopy is a recently developed optical imaging technique capable of robust, powerful and unbiased label-free direct detection of collagen fibril structure in tissue without the use of antibodies. We constructed tissue microarrays emulating limited materials on biopsy to investigate quantitative collagen signal in fibroepithelial lesions using SHG microscopy. Archived formalin-fixed paraffin-embedded materials of 47 fibroepithelial lesions (14 fibroadenomas and 33 phyllodes tumours) were evaluated. Higher collagen signal on SHG microscopy was observed in fibroadenomas than phyllodes tumours on SHG imaging (pmicroscopy for fibroadenoma classification was 71.4% and 84.4%, respectively. To corroborate these findings, we performed immunohistochemistry on tissue array sections using collagen I and III primary antibodies. Both collagen I and III immunohistochemical expressions were also significantly higher in fibroadenomas than in phyllodes tumours (pmicroscopy is a novel imaging approach that can aid the differential diagnosis of fibroepithelial lesions.

  12. Compilation of a preliminary checklist for the differential diagnosis of neurogenic stuttering

    Directory of Open Access Journals (Sweden)

    Mariska Lundie

    2014-06-01

    Full Text Available Background: Neurogenic stuttering (NS is the most frequently occurring acquired form of stuttering in children and adults. This form of stuttering is primarily caused by neurological incidents. Owing to controversies with regard to similarities between developmental stuttering (DS and NS symptomatology, differential diagnosis is problematic. Differential diagnosis will guide the appropriate management of persons who stutter (PWS.Objectives: The aim of this study was to describe and highlight the characteristics of NS in order to compile a preliminary checklist for accurate diagnosis and intervention.Method: An explorative, applied mixed method, multiple case study research design was followed. Purposive sampling was used to select four participants. A comprehensive assessment battery was compiled for data collection.Results: The results revealed a distinct pattern of core stuttering behaviours in NS, although discrepancies existed regarding stuttering severity and frequency. It was also found that DS and NS can co-occur. The case history and the core stuttering pattern are important considerations during differential diagnosis, as these are the only consistent characteristics in people with NS.Conclusion: It is unlikely that all the symptoms of NS are present in an individual. The researchers scrutinised the findings of this study and the findings of previous literature to compile a potentially workable checklist.

  13. Differential diagnosis of Alzheimer-type dementia and vascular dementia based on neuroimaging study

    International Nuclear Information System (INIS)

    A new method for differential diagnosis of Alzheimer-type dementia (AD) and vascular dementia (VD) based on neuroimaging studies was developed by Hayashi's quantification theory II. Fifty-five patients with AD and 36 patients with VD underwent both SPECT and MRI studies. Both images in each subject were scored according to the extent of hypoperfusion in areas including frontal and temporoparietal regions and the severity of deep white matter lesions and medial temporal lobe atrophy. The scores of AD and VD patients were significantly different, and this difference was considered to contribute most to the differential diagnosis of AD and VD. The weight of each score of SPECT and MRI items was computed, and the sum of the weights was calculated as a score for each subject to best distinguish AD from VD patients. This method was designed to simplify the calculation of the sample scores, and the sum of the weights was established so that a positive score (0≤) indicated the probability of AD, while a negative score (<0) indicated the probability of VD. The correct diagnosis rate was 91% (50/55) for AD and 89% (32/36) for VD, for an overall discrimination of 90%. The present method seemed to be practically useful in the differential diagnosis of AD and VD. (author)

  14. Thyroid spindle epithelial tumor with thymus-like differentiation (SETTLE): is cytopathological diagnosis possible?

    Science.gov (United States)

    Kloboves-Prevodnik, Veronika; Jazbec, Janez; Us-Krasovec, Marija; Lamovec, Janez

    2002-05-01

    Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a rare tumor of the thyroid gland which occurs predominantly in children, adolescents, and young adults. It usually presents as a painless neck or thyroid mass and only exceptionally as a diffusely enlarged thyroid gland, without metastatic disease at diagnosis. We report on the case of 12-yr-old girl who had diffusely enlarged thyroid gland for about 1 yr and was initially treated for thyroiditis. Fine-needle aspiration biopsy (FNAB) was performed 8 mo after the first admission. Cytological examination of smears showed unusual morphological features. FNAB smears were cellular, with dissociated cells, naked oval nuclei, aggregates, and groups. Three main cell types were observed: spindle, epithelioid, and epithelial. These cells were uniform, cytologically bland, with few mitotic figures. The distinction between these cells was not always unequivocal. In the background of the smears abundant red extracellular material in the form of fine, dust-like granules and irregular patches were present. It was also observed in some aggregates and groups of tumor cells. Spindle and epithelioid cells were immunocytochemically diffusely pan-cytokeratin-positive. In the differential diagnosis, medullary thyroid carcinoma and SETTLE were suggested. The final histological diagnosis was SETTLE. In cases of SETTLE presented as a diffuse thyromegaly the correct diagnosis may be delayed because clinically and ultrasonographically thyroiditis is suspected. To avoid such a delay, FNAB should be used preoperatively. It can provide specific cytological diagnosis based on morphological features and certain immunocytochemical characteristics of the tumor.

  15. CT-Guided Pancreatic Percutaneous Fine-Needle Biopsy in Differential Diagnosis between Pancreatic Cancer and Chronic Pancreatitis

    OpenAIRE

    Michele Carlucci; Alessandro Zerbi; Danilo Parolini; Sandro Sironi; Angelo Vanzulli; Carlo Staudacher; Agostino Faravelli; Paola Garancini; Alessandro del Maschio; Valerio di Carlo

    1989-01-01

    Differential diagnosis between pancreatic cancer and chronic pancreatitis is still difficult to establish. In 63 patients with suspected pancreatic neoplasm we performed: serum CA 19-9 assessment, abdominal ultrasound, CT scan and CT-guided pancreatic percutaneous fine-needle biopsy. The conclusive diagnosis was pancreatic cancer in 40 patients and chronic pancreatitis in 23 patients. With regard to the differential diagnosis, sensitivity and specificity were respectively 80% and ...

  16. Diagnosis and differential diagnosis of Graves' orbitopathy in MRI; Diagnose und Differenzialdiagnose der endokrinen Orbitopathie in der MRT

    Energy Technology Data Exchange (ETDEWEB)

    Daubner, D.; Spieth, S.; Engellandt, K.; Kummer, R. von [Universitaetsklinikum Carl Gustav Carus, Technische Universitaet Dresden, Abteilung Neuroradiologie, Institut und Poliklinik fuer Radiologische Diagnostik, Dresden (Germany)

    2012-06-15

    Imaging of Graves' orbitopathy (GO) includes radiological and nuclear medicine procedures. Depending on the method used they provide information about the distribution and activity of the disease. Magnetic resonance imaging (MRI) is not only a helpful tool for making the diagnosis it also enables differentiation of the active and inactive forms of GO due to intramuscular edema. The modality is therefore appropriate to evaluate the disease activity and the course of therapy. The disease leads to the typical enlargement of the muscle bodies of the extraocular muscles. The inferior rectus, medial rectus and levator palpebrae muscles are mostly involved. Signal changes of the intraconal and extraconal fat tissue are possible and a bilateral manifestation is common. The differential diagnosis includes inflammatory diseases and tumors, of which orbital pseudotumor (idiopathic, unspecific orbital inflammation), ocular myositis and orbital lymphoma are the most important. The specific patterns (localization, involvement of orbital structures and signal changes) can be differentiated by MRI. (orig.) [German] Die Bildgebung der endokrinen Orbitopathie (EO) umfasst radiologische und nuklearmedizinische Verfahren, die je nach Methode Aussagen zur Verteilung und Aktivitaet der Erkrankung liefern. Die Magnetresonanztomographie (MRT) ist nicht nur zur Diagnosestellung hilfreich, sondern auch in der Lage, die aktive von der inaktiven Form anhand des intramuskulaeren Oedems zu unterscheiden. Das Verfahren eignet sich deshalb auch zur Aktivitaetsbeurteilung und zur Bewertung einer Therapie im Verlauf. Die Erkrankung fuehrt zu einer typischen Verdickung des Muskelbauchs der extraokulaeren Augenmuskeln, wobei die Mm. rectus inferior, rectus medialis und levator palpebrae am haeufigsten betroffen sind. Signalveraenderungen des intra- und extrakonalen Fettgewebes sind moeglich, und eine bilaterale Manifestation ist haeufig. Die Differenzialdiagnose umfasst neben anderen

  17. Foreign Body Granuloma: A Diagnosis Not to Forget

    Directory of Open Access Journals (Sweden)

    I. El Bouchti

    2012-01-01

    The differential diagnosis for bony reaction to an unrecognised organic foreign body includes osteoid osteoma, chronic and acute osteomyelitis, tuberculosis granuloma, bone cyst, aneurysmal bone cyst, cortical fibrous defect, and neoplasm. We report the case of a boy suffering from a thorn inducing a lytic lesion of the fifth metatarsal that demonstrates the diagnosis difficulties of foreign body granuloma.

  18. Unilateral Intraparotid Swelling: A Case Report of Kimura’s Disease and Review of Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    N. W. Savage

    2013-01-01

    Full Text Available An interesting case of Kimura's disease was described in the 42-year-old patient manifesting itself as a unilateral parotid swelling, albeit the disease usually affects both parotid glands. Furthermore, first pathohistological finding was not suggestive of the disease, revealing only fatty tissue, but on the repeated biopsy together with CT the correct diagnosis was established. It should be emphasized that Kimura's disease has to be taken into account while making differential diagnosis in parotid gland swellings, especially in people of Oriental origin.

  19. Lung ultrasound: a valid help in the differential diagnosis between pneumothorax and pulmonary blebs

    Directory of Open Access Journals (Sweden)

    Francesca Sandionigi

    2013-06-01

    Full Text Available Spontaneous pneumothorax is a relatively common disease but its radiological diagnosis can be difficult because of the insufficient sensitivity of chest X-rays. This is even more so when bullous emphysema and acute pneumothorax co-exist. There is evidence that lung ultrasound is a valid instrument to detect a pneumothorax and a valid help in the differential diagnosis between pneumothorax and pulmonary blebs. We present a case which suggests the potential superiority of lung ultrasound on chest radiography in distinguishing free air (pneumothorax from apical blebs, particularly when these are located in the posterior regions and may be easily confused with pneumothorax.

  20. MDCT evaluation of congenital mitral-aortic intervalvular fibrosa aneurysm: implications for the aetiology and differential diagnosis

    International Nuclear Information System (INIS)

    Mitral-aortic intervalvular fibrosa aneurysm is a rare disease whose aetiology remains a matter of debate. Here we present the youngest reported patient with the disease, a 6-month-old boy, without a history of infection, which supports a congenital origin as initially proposed. Multidetector-row CT (MDCT) surpassed echocardiography in delineating the intracardiac anatomical details with high spatial resolution, confirming the important problem-solving role of MDCT in the diagnosis of congenital heart disease. (orig.)

  1. Knowledge discovery in medical systems using differential diagnosis, LAMSTAR & k-NN.

    Science.gov (United States)

    Isola, Rahul; Carvalho, Rebeck; Tripathy, Amiya Kumar

    2012-11-01

    Medical data is an ever-growing source of information generated from the hospitals in the form of patient records. When mined properly the information hidden in these records is a huge resource bank for medical research. As of now, this data is mostly used only for clinical work. This data often contains hidden patterns and relationships, that can lead to better diagnosis, better medicines, better treatment and overall, a platform to better understand the mechanisms governing almost all aspects of the medical domain. Unfortunately, discovery of these hidden patterns and relationships often goes unexploited. However there is on-going research in medical diagnosis which can predict the diseases of the heart, lungs and various tumours based on the past data collected from the patients.They are mostly limited to domain specific systems that predict diseases restricted to their area of operation like heart, brain and various other domains. These are not applicable to the whole medical dataset. The system proposed in this paper uses this vast storage of information so that diagnosis based on this historical data can be made. It focuses on computing the probability of occurrence of a particular ailment from the medical data by mining it using a unique algorithm which increases accuracy of such diagnosis by combining the key points of Neural Networks, Large Memory Storage and Retrieval (LAMSTAR), k-NN and Differential Diagnosis all integrated into one single algorithm. The system uses a Service-Oriented Architecture wherein the system components of diagnosis, information portal and other miscellaneous services are provided.This algorithm can be used in solving a few common problems that are encountered in automated diagnosis these days, which include: diagnosis of multiple diseases showing similar symptoms, diagnosis of a person suffering from multiple diseases, receiving faster and more accurate second opinion and faster identification of trends present in the medical

  2. Fault detection and diagnosis in nonlinear systems a differential and algebraic viewpoint

    CERN Document Server

    Martinez-Guerra, Rafael

    2014-01-01

    The high reliability required in industrial processes has created the necessity of detecting abnormal conditions, called faults, while processes are operating. The term fault generically refers to any type of process degradation, or degradation in equipment performance because of changes in the process's physical characteristics, process inputs or environmental conditions. This book is about the fundamentals of fault detection and diagnosis in a variety of nonlinear systems which are represented by ordinary differential equations. The fault detection problem is approached from a differential algebraic viewpoint, using residual generators based upon high-gain nonlinear auxiliary systems (‘observers’). A prominent role is played by the type of mathematical tools that will be used, requiring knowledge of differential algebra and differential equations. Specific theorems tailored to the needs of the problem-solving procedures are developed and proved. Applications to real-world problems, both with constant an...

  3. Brain MR Contribution to the Differential Diagnosis of Parkinsonian Syndromes: An Update

    Science.gov (United States)

    De Blasi, Roberto; Grasso, Daniela; Savica, Rodolfo

    2016-01-01

    Brain magnetic resonance (MR) represents a useful and feasible tool for the differential diagnosis of Parkinson's disease. Conventional MR may reveal secondary forms of parkinsonism and may show peculiar brain alterations of atypical parkinsonian syndromes. Furthermore, advanced MR techniques, such as morphometric-volumetric analyses, diffusion-weighted imaging, diffusion tensor imaging, tractography, proton MR spectroscopy, and iron-content sensitive imaging, have been used to obtain quantitative parameters useful to increase the diagnostic accuracy. Currently, many MR studies have provided both qualitative and quantitative findings, reflecting the underlying neuropathological pattern of the different degenerative parkinsonian syndromes. Although the variability in the methods and results across the studies limits the conclusion about which technique is the best, specific radiologic phenotypes may be identified. Qualitative/quantitative MR changes in the substantia nigra do not discriminate between different parkinsonisms. In the absence of extranigral abnormalities, the diagnosis of PD is more probable, whereas basal ganglia changes (mainly in the putamen) suggest the diagnosis of an atypical parkinsonian syndrome. In this context, changes in pons, middle cerebellar peduncles, and cerebellum suggest the diagnosis of MSA, in midbrain and superior cerebellar peduncles the diagnosis of PSP, and in whole cerebral hemispheres (mainly in frontoparietal cortex with asymmetric distribution) the diagnosis of Corticobasal Syndrome. PMID:27774334

  4. Cystic lymph node enlargement of the neck: filariasis as a rare differential diagnosis in MRI

    Energy Technology Data Exchange (ETDEWEB)

    Schick, Christoph; Thalhammer, Axel; Balzer, Joern O.; Abolmaali, Nasreddin; Vogl, Thomas J. [Department of Diagnostic and Interventional Radiology, University of Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt/Main (Germany)

    2002-09-01

    Cervical lymph node enlargement is a common feature of most inflammatory and neoplastic entities of the head and neck. Filariasis can lead to lymphangiectasis resembling lymph node enlargement; however, this is a rare differential diagnosis in European patients. As ethnic minorities are increasing throughout Europe and personal mobility, e.g. during holidays, is increasing, such rare differential diagnoses have to be taken into consideration. We present the case of an Iraqi patient referred to as for a suspected cystic lymph node mass that was verified histologically by open MRI biopsy and proved to be a cystic manifestation of filariasis. (orig.)

  5. The role of Tc-99m RBC scintigraphy in the differential diagnosis of orbital cavernous hemangioma.

    Science.gov (United States)

    Sayit, E; Durak, I; Capakaya, G; Yilmaz, M; Durak, H

    2001-04-01

    The cavernous hemangioma is the most common benign orbital tumor in adults. Its presentation is during the forth to fifth decades with a slowly progressive unilateral proptosis. Intraconal cavernous hemangiomas may be difficult to differentiate from other intraconal lesions such as schwannomas, meningiomas and hemangiopericytomas. We report a case of orbital cavernous hemangioma diagnosed by Tc-99m RBC scintigraphy. Tc-99m RBC scintigraphy revealed a typical scintigraphic pattern in which there is intense focally increased uptake on the delayed image. We conclude that Tc-99m RBC scintigraphy can be a useful method in the differential diagnosis of orbital cavernous hemangioma as in hepatic hemangioma. PMID:11448074

  6. A differential diagnosis of inherited endocrine tumors and their tumor counterparts

    Directory of Open Access Journals (Sweden)

    Sergio P. A. Toledo

    2013-07-01

    Full Text Available Inherited endocrine tumors have been increasingly recognized in clinical practice, although some difficulties still exist in differentiating these conditions from their sporadic endocrine tumor counterparts. Here, we list the 12 main topics that could add helpful information and clues for performing an early differential diagnosis to distinguish between these conditions. The early diagnosis of patients with inherited endocrine tumors may be performed either clinically or by mutation analysis in at-risk individuals. Early detection usually has a large impact in tumor management, allowing preventive clinical or surgical therapy in most cases. Advice for the clinical and surgical management of inherited endocrine tumors is also discussed. In addition, recent clinical and genetic advances for 17 different forms of inherited endocrine tumors are briefly reviewed.

  7. Common recessive limb girdle muscular dystrophies differential diagnosis: why and how?

    Directory of Open Access Journals (Sweden)

    Ana Cotta

    2014-09-01

    Full Text Available Limb girdle muscular dystrophies are heterogeneous autosomal hereditary neuromuscular disorders. They produce dystrophic changes on muscle biopsy and they are associated with mutations in several genes involved in muscular structure and function. Detailed clinical, laboratorial, imaging, diagnostic flowchart, photographs, tables, and illustrated diagrams are presented for the differential diagnosis of common autosomal recessive limb girdle muscular dystrophy subtypes diagnosed nowadays at one reference center in Brazil. Preoperative image studies guide muscle biopsy site selection. Muscle involvement image pattern differs depending on the limb girdle muscular dystrophy subtype. Muscle involvement is conspicuous at the posterior thigh in calpainopathy and fukutin-related proteinopathy; anterior thigh in sarcoglycanopathy; whole thigh in dysferlinopathy, and telethoninopathy. The precise differential diagnosis of limb girdle muscular dystrophies is important for genetic counseling, prognostic orientation, cardiac and respiratory management. Besides that, it may probably, in the future, provide specific genetic therapies for each subtype.

  8. Advances of imaging on differential diagnosis between recurrence of glioma and radiation-induced brain injury

    International Nuclear Information System (INIS)

    Differentiating recurrence of glioma from radiation-induced brain injury is a central challenge in neuro-oncology. The 2 very different outcomes after brain tumor treatment often appear similar on traditional imaging studies. They may even manifest with similar clinical symptoms. Distinguishing treatment injury from tumor recurrence is crucial for diagnosis and treatment planning. In this article, we reviewed the latest developments and key findings from research studies exploring the efficacy of structural and functional imaging modalities in differentiating treatment injury from tumor recurrence with DWI, MRS, DCE-MR, DSC-MR, PET, and SPECT. And we discussed the advantages and disadvantages of each approach to provide useful information for making proper diagnosis and treatment planning. (authors)

  9. Schnitzler's Disease as an Important Differential Diagnosis of Chronic Recurrent Multifocal Osteomyelitis: A Case Report

    Directory of Open Access Journals (Sweden)

    Kathrin Schrödl

    2012-01-01

    Full Text Available Introduction. At first sight, chronic recurrent multifocal osteomyelitis (CRMO and Schnitzler's disease are diagnoses of exclusion and can be similar in their manifestation. Methods. In this paper we present the reevaluation of the 13-year-old diagnosis of chronic recurrent osteomyelitis of a 58-year-old man with chronic ostealgia, night sweat, and pruritic urticarial lesions on the extremities and trunk. For further examination, we performed blood analysis, bone and skin biopsies, CT scans, and magnetic resonance imaging. Results. Laboratory findings showed increased inflammation parameters. Magnetic resonance imaging (MRI revealed a diffuse bone marrow infiltration. A bone and skin biopsy showed a sclerotic bone marrow involvement and a superficial dermal and perivascular infiltrate of neutrophils. Based on these findings, the diagnosis of Schnitzler’s disease was made. Conclusion. Here, we want to present Schnitzler's disease as an important differential diagnosis to CRMO in adults presenting with signs suggestive of CRMO.

  10. MANAGEMENT OF ENDOCRINE DISEASE: Pituitary 'incidentaloma': neuroradiological assessment and differential diagnosis.

    Science.gov (United States)

    Vasilev, Vladimir; Rostomyan, Liliya; Daly, Adrian F; Potorac, Iulia; Zacharieva, Sabina; Bonneville, Jean-François; Beckers, Albert

    2016-10-01

    Pituitary incidentalomas are a by-product of modern imaging technology. The term 'incidentaloma' is neither a distinct diagnosis nor a pathological entity. Rather, it is a collective designation for different entities that are discovered fortuitously, requiring a working diagnosis based on the input of the radiologist, endocrinologist and often a neurosurgeon. In addition to pathological conditions affecting the pituitary gland, a thorough knowledge of the radiological characteristics of normal variants and technical artifacts is required to arrive at an accurate differential diagnosis. After careful radiological and hormonal evaluation, the vast majority of pituitary incidentalomas turn out to be non-functioning pituitary microadenomas and Rathke's cleft cysts (RCCs). Based on the low growth potential of non-functioning pituitary microadenomas and RCCs, periodic MRI surveillance is currently considered the optimal management strategy. Stricter follow-up is required for macroadenomas, as increases in size occur more frequently. PMID:27068689

  11. [Biphasic pulmonary blastoma with germ cell differentiation: a challenge in diagnosis and treatment].

    Science.gov (United States)

    Teixeira, Alexandra; Vieira, Claúdia; Sousa, Nuno; Begonha, Rosa; Afonso, Mariana; Amaro, Teresina; Maurício, Joaquina

    2011-12-01

    Serviço de Oncologia Médica. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal. A 27-year-old man, smoker, presented with three months history of fever. A left pulmonary mass inseparable from the heart was identified and serum alpha-fetoprotein was 4160 ng/ml. The morphologic aspects and immunohistochemistry of the biopsy specimen, in conjunction with the clinical findings were compatible with a diagnosis of pulmonary blastoma with germ cell differentiation. The tumour was considered unresectable. The patient was submitted to two cycles of primary chemotherapy with bleomycin, etoposide and cisplatin. Despite a reduction in serum alpha-fetoprotein, the tumor did not regress. Second line chemotherapy (with paclitaxel, ifosfamide and cisplatin) was instituted, but progressive disease was identified after 2 cycles. Six months after the diagnosis cerebral metastases were found and the patient died. This case illustrates a rare situation of difficult diagnosis and treatment.

  12. Prolactinoma in a Diabetic Dialysis Patient with Erectile Dysfunction: A Difficult Differential Diagnosis

    OpenAIRE

    Piccoli, Giorgina B.; Bermont, Francesca; Magnano, Andrea; Soragna, Giorgio; Terzolo, Massimo

    2006-01-01

    Dialysis patients often suffer from erectile dysfunction. The prevalence of this symptom in the context of dialysis is as high as 90%. Diabetes, diffuse vascular disease and pharmacological therapy are attendant causes of this condition, severely impairing the quality of life. Due to the high frequency of erectile dysfunction in uremic patients, minimalist diagnostic approaches are often used. Nevertheless, a careful differential diagnosis is also warranted in well dialyzed patients to identi...

  13. Late presentation of hyperandrogenism in pregnancy: clinical features and differential diagnosis

    OpenAIRE

    Das, Gautam; Eligar, Vinay S; Govindan, Jyothish; Rees, D. Aled

    2013-01-01

    Summary Background Hyperandrogenic states in pregnancy are rare but arise most commonly due to new-onset ovarian pathology in pregnancy. We describe the case of a young woman who presented in the latter half of her pregnancy with features of hyperandrogenism. We review the biochemical and imaging findings and discuss the differential diagnosis. Case presentation A 26-year-old woman presented in the later part of her pregnancy with widespread hirsutism. Biochemical testing confirmed hyperandro...

  14. Mucocele of the upper lip: case report of an uncommon presentation and its differential diagnosis.

    Science.gov (United States)

    Mustapha, Indra Z; Boucree, Stanley A

    2004-05-01

    This report describes a lesion of the upper lip that was definitively diagnosed by histologic examination as a mucocele or mucus retention phenomenon. The usual location of mucoceles is the lower lip. This case illustrates an uncommon presentation of mucocele with respect to symptoms, location and duration. The features of a variety of oral lesions are discussed and compared, to help clinicians in establishing an appropriate differential diagnosis. PMID:15132815

  15. Imaging of bronchiectasis: the great value of high-resolution CT in differential diagnosis

    International Nuclear Information System (INIS)

    Bronchiectasis is defined as localized irreversible dilatation of the bronchial tree. Brochiectasis has been associated with a wide variety of causes, but it is mostly caused by acute, chronic or recurrent infections. This paper should give a review about the manifestation of bronchiectasis and bronchioloectasis in HR-CT and discuss the causing entities. However, integration of bronchiectasis and other HR-CT findings may enable a narrower differential diagnosis, in some cases it is possible to give the correct diagnose directly. (orig.)

  16. Pyoderma Gangrenosum and Full-Thickness Burns: is there a Problem of Differential Diagnosis?

    OpenAIRE

    Napoli, B.; D’Arpa, N.; F. Conte

    2006-01-01

    A case is presented of pyoderma gangrenosum, describing its characteristic features with particular reference to the phenomenon of pathergy, which considerably limits the surgical approach to the disease. After an account of the numerous skin ulcerations that have to be taken into consideration in order to make a differential diagnosis, it is noted that pyoderma gangrenosum can only on rare occasions be confused with a full-thickness granulating burn.

  17. Modern diagnosis of celiac disease and relevant differential diagnoses in the case of cereal intolerance

    OpenAIRE

    Hahn, Markus; Hagel, Alexander F; Hirschmann, Simon; Bechthold, Caroline; Konturek, Peter; Neurath, Markus; Raithel, Martin

    2014-01-01

    Summary At an incidence of 1:500, celiac disease (formerly sprue) is an important differential diagnosis in patients with malabsorption, abdominal discomfort, diarrhea and food intolerances. Celiac disease can induce a broad spectrum of both gastrointestinal and extraintestinal symptoms, e.g. dermatitis herpetiformis (Duhring’s disease). A variety of oligo- and asymptomatic courses (e.g. anemia, osteoporosis, depression) through to refractory collagenic celiac disease are seen. In HLA-DQ2 and...

  18. Multiple Hypovascular Tumors in Kidney: A Rare Case Report and Differential Diagnosis

    OpenAIRE

    Pei-Yu Wu; Sheng-Fung Lin; Ping-Hsun Wu; Yi-Chun Tsai; Yu-Ting Kuo; Mei-Chuan Kuo; Hung-Chun Chen

    2013-01-01

    The most common malignant renal tumor is renal cell carcinoma and surgery is the standard treatment. The proportion of lymphoma with renal involvement is 2~15% and lymphoma could be cured by chemotherapy without nephrectomy. Sonography, computed tomography (CT), and magnetic resonance imaging (MRI) can detect and characterize a renal mass. We present a case of right renal hypovascular tumors and differential diagnosis of hypovascular tumors by image study. CT scan showed hypovascular tumors a...

  19. AB214. Application of ultrasonic measurement of epididymal width in differential diagnosis of azoospermia

    Science.gov (United States)

    Song, Yongsheng

    2016-01-01

    Objective To investigate the of epididymal width in identifying non obstructive azoospermia (NOA) and obstructive azoospermia (OA). Methods Using scrotal ultrasound to compare difference of epididymal width between OA (n=18) and NOA (n=10) patients. Results In the patients with OA average bilateral epididymal width is 0.7+0.1 cm, which is higher than the NOA patients (PNOA and OA, which is helpful for differential diagnosis of azoospermia.

  20. Differential diagnosis of polyuric/polydipsic syndromes with the aid of urinary vasopressin measurement in adults.

    OpenAIRE

    Eckmanns, Tim

    2010-01-01

    OBJECTIVE: A water deprivation test or a hypertonic saline infusion test with the measurement of plasma osmolality and plasma vasopressin are the gold standard tests in the differential diagnosis of polyuric syndromes. Because commercially available vasopressin kits are too insensitive for this approach, and the concentration of vasopressin in urine is much higher than in plasma, urinary vasopressin measurements may be an alternative to the more difficult plasma vasopressin measurement. DESIG...

  1. A Case of Senile Chorea: Considering Huntington’s Disease and Neuroacanthocytosis in differential diagnosis

    OpenAIRE

    Ayşe Deniz Elmalı; Ayşegül Gündüz; Zafer Başlar; Fatoş Sibel Ertan

    2015-01-01

    Sporadic chorea presenting after the age of 50 is called “senile chorea”. Senile chorea is a rare entity with a wide differential diagnosis list. Causes of senile chorea include vascular and metabolic diseases, adverse events related to medications, hematologic and immune system diseases, genetic and sporadic neurodegenerative syndromes, and paraneoplastic disorders. Although the most common etiologies are vascular and metabolic disorders, neuroacanthocytosis, Wilson and Huntington diseases a...

  2. Cognitive-style characteristics as criteria for differential diagnosis of delirium

    OpenAIRE

    I.V. Kuznetsov; Morozova, M. V.

    2014-01-01

    We present a psychological study of the relationship of cognitive styles with the development of delusional formations, overvalued ideas and simulative products in order to develop criteria of delirium differential diagnosis. We examined 118 men, ordered at forensic psychological and psychiatric examination, among them delusional symptoms were found in 68 people, and overvalued ideas in 26 people, 24 people simulated delirium. As a method of research, we used pathopsychological experiment and...

  3. Differential diagnosis of rheumatic illnesses. 4. compl. rev. and enl. ed.; Differenzialdiagnose rheumatischer Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Zeidler, Henning [Rheumatologikum Hannover (Germany); Michel, Beat [UniversitaetsSpital Zuerich, Zurich (Switzerland). Rheumaklinik und Inst. fuer Physikalische Medizin

    2009-07-01

    The number of the possible differential diagnosis of rheumatic illnesses is extraordinarily high. This circumstance makes the diagnostics a difficult field with numerous pitfalls. The correct and complete diagnosis however is a condition for the correct therapy. This book facilitates this way from the symptom to the diagnosis for the reader: A detailed representation of the fundamentals (anamnesis, investigation findings, laboratory diagnostics and imaging) a detailed description of all important differential diagnosis follows. The meanwhile fourth edition of this standard work was completely revised and updated. An indispensable guide book for all persons which treat patients with rheumatic illnesses. [German] Die Zahl der moeglichen Differenzialdiagnosen rheumatischer Erkrankungen ist ausserordentlich hoch. Dieser Umstand macht die Diagnostik zu einem schwierigen Feld mit zahlreichen Fallstricken. Die korrekte und vollstaendige Diagnose ist aber Voraussetzung fuer die richtige Therapie. Dieses Buch erleichtert dem Leser diesen Weg vom Symptom zur Diagnose: Einer ausfuehrlichen Darstellung der Grundlagen (Anamnese, Untersuchungsbefund, Labordiagnostik und Bildgebung) folgt eine detaillierte Beschreibung aller wichtigen Differenzialdiagnosen. Die mittlerweile vierte Auflage dieses Standardwerks wurde komplett ueberarbeitet und aktualisiert. Ein unverzichtbarer Ratgeber fuer alle, die Patienten mit Erkrankungen aus dem rheumatologischen Formenkreis behandeln. (orig.)

  4. Cd138 Expression in Renal Tumors and Its Usage in the Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Ayhan ÖZCAN

    2011-05-01

    Full Text Available Objective: The differential diagnosis of kidney tumors, especially those with eosinophilic cytoplasms, can be problematic due to overlapping morphologic features. CD138 is primarily a plasma cell marker but is known to be expressed in the proximal renal tubular epithelium as well. This study aims to investigate the possible contribution of CD138 expression in the differential diagnosis of kidney tumors with eosinophilic cytoplasm.Material and Method: The case series consisted of 15 chromophobe (ChRCC, 5 eosinophilic variant (EoRCC, 10 clear cell (CCRCC and 9 papillary (PRCC renal cell carcinomas, and 13 oncocytomas. Sections obtained from representative paraffin blocks were stained against CD138 antibody.Results: All CCRCC and PRCC showed membranous CD138 expression. In some of the other eosinophilic renal tumors, cytoplasmic CD138 labeling in varying degrees was detected. In CCRCC cases, CD138 expression was especially observed in low grade areas and areas showing cystic and pseudopapillary growth patterns. A similar pattern of cytoplasmic staining was seen in 3 of the EoRCC and the most of the PRCC cases (6/9.Conclusion: Our findings suggest that CD138 may contribute to the differential diagnosis of renal tumors because of the membranous staining pattern in CCRCC and EoRCC cases and the cytoplasmic staining in CHRCC and oncocytoma cases. Its contributory role may be improved by combined usage with markers like Cytokeratin 7 and RCC marker.

  5. Clustering and switching during a semantic verbal fluency test contribute to differential diagnosis of cognitive impairment

    Institute of Scientific and Technical Information of China (English)

    Qianhua Zhao; Qihao Guo; Zhen Hong

    2013-01-01

    The verbal fluency test (VFT) can be dissociated into "clustering" (generating words within subcategories)and "switching" (shifting between clusters),which may be valuable in differential diagnosis.In the current study,we investigated the validity of VFT in the differential diagnosis of Alzheimer's disease (AD,n=65),vascular dementia (VaD,n =65),mild cognitive impairment (MCI,n =92),and vascular cognitive impairment without dementia (VCIND,n =76) relative to cognitively normal senior controls (NC,n =374).We found that in the NC group,the total correct score was significantly correlated with age and education; males generated more subcategories; cluster size increased with education,and subcategory and switching decreased with age.A significantly progressive advantage was observed in VFT scores in the sequence NC > MCINCIND > ADNaD,and this significantly discriminated dementia patients from the other groups.AD patients performed better in all four VFT scores than VaD patients.Subcategory and switching scores significantly distinguished AD from VaD patients (AD > VaD; mean difference,0.50 for subcategory,P <0.05; 0.71 for switching,P <0.05).MCI patients scored higher than VCIND patients,but the difference did not reach statistical significance.These results suggest that semantic VFT is useful for the detection of MCI and VCIND,and in the differential diagnosis of cognitive impairment.

  6. Multiple biomarkers of colorectal tumor in a differential diagnosis model :A quantitative study

    Institute of Scientific and Technical Information of China (English)

    Wen Jin; Mei-Qin Gao; Zhi-Wu Lin; Dai-Xing Yang

    2004-01-01

    AIM: To evaluate the multiple biomarkers of colorectal tumor and their potential usage in early diagnosis of colorectal Cancers.METHODS: Multiple biomarkers (DNA contents, AgNOR,PCNA, p53, c-erbB-2) in 10 normal colorectal mucosae, 37 colorectal adenomas and 55 colorectal cancers were analyzed quantitatively in the computed processing imaging system.Discrimination patterns were employed to evaluate the significance of single and multiple indices in diagnosis of colorectal cancers.RESULTS: The mean values of the analyzed parameters increased in order of the normal mucosa, adenoma and adenocareinoma, and this tendency reflected the progression of colorectal malignancy. The parameters including DNA index, positive rates, densities of AgNOR, c-erbB-2, and p53,shape and density of nucleus were relatively valuable for diagnoses. Then a diagnostic discrimination model was established. The samples were confirmed with the model,the sensitivity rates in cancer group and adenoma group were 96.36% and 89.19%, respectively. The value of proliferating cell nuclear antigen (PCNA) in early diagnosis of colorectal cancers was uncertain.CONCLUSION: The quantitative evaluation of some parameters for colorectal tumor can provide reproducible data for differential diagnosis. The established diagnostic discrimination model may be of clinicopathological value,and can make the early diagnosis of colorectal cancer possible.

  7. Noninvasive differential diagnosis of dental periapical lesions in cone-beam CT scans

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Kazunori, E-mail: kazokada@sfsu.edu [Department of Computer Science, San Francisco State University, San Francisco, California 94132 (United States); Rysavy, Steven [Biomedical and Health Informatics Program, University of Washington, Seattle, Washington 98195 (United States); Flores, Arturo [Computer Science and Engineering, University of California, San Diego, California 92093 (United States); Linguraru, Marius George [Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Medical Center, Washington, DC 20010 and Departments of Radiology and Pediatrics, George Washington University, Washington, DC 20037 (United States)

    2015-04-15

    Purpose: This paper proposes a novel application of computer-aided diagnosis (CAD) to an everyday clinical dental challenge: the noninvasive differential diagnosis of periapical lesions between periapical cysts and granulomas. A histological biopsy is the most reliable method currently available for this differential diagnosis; however, this invasive procedure prevents the lesions from healing noninvasively despite a report that they may heal without surgical treatment. A CAD using cone-beam computed tomography (CBCT) offers an alternative noninvasive diagnostic tool which helps to avoid potentially unnecessary surgery and to investigate the unknown healing process and rate for the lesions. Methods: The proposed semiautomatic solution combines graph-based random walks segmentation with machine learning-based boosted classifiers and offers a robust clinical tool with minimal user interaction. As part of this CAD framework, the authors provide two novel technical contributions: (1) probabilistic extension of the random walks segmentation with likelihood ratio test and (2) LDA-AdaBoost: a new integration of weighted linear discriminant analysis to AdaBoost. Results: A dataset of 28 CBCT scans is used to validate the approach and compare it with other popular segmentation and classification methods. The results show the effectiveness of the proposed method with 94.1% correct classification rate and an improvement of the performance by comparison with the Simon’s state-of-the-art method by 17.6%. The authors also compare classification performances with two independent ground-truth sets from the histopathology and CBCT diagnoses provided by endodontic experts. Conclusions: Experimental results of the authors show that the proposed CAD system behaves in clearer agreement with the CBCT ground-truth than with histopathology, supporting the Simon’s conjecture that CBCT diagnosis can be as accurate as histopathology for differentiating the periapical lesions.

  8. Value of assessing adrenocorticotropic hormone (ACTH levels in differential diagnosis of hypercorticism

    Directory of Open Access Journals (Sweden)

    Penezić Zorana

    2004-01-01

    Full Text Available Diagnosis and differential diagnosis of Cushing's syndrome remains a challenge in clinical endocrinology. The aim of this study was to establish the value of assessing adrenocorticotropic hormone (ACTH levels in differential diagnosis of hypercorticism using receiver operating characteristic (ROC curve. We have evaluated 114 patients with Cushing's syndrome testing the value of pathohistological examination and postoperative testing. The control group consisted of 53 obese healthy persons. ACTH level was determined using a commercial RIA (CIS, France. ACTH secreting pituitary adenoma was found in 56.14% examinees, ectopic secretion in 6.14%, cortisol secreting adrenal adenoma in 37.57%, and adrenal carcinoma in 6.14% of all patients with Cushing's syndrome. Basal ACTH level for pituitary adenoma was 107.29±75.69 pg/mL; for ectopic secretion 181.63±149.84 pg/mL; for adrenal adenoma 4.22±2.32 pg/mL; for adrenal carcinoma 5.50 ±7.72 pg/mL; and 34.76 ±10.07 pg/mL in control group. Testing the value of assessing ACTH the area under ROC curve was 0.9965±0.0071. Test sensitivity was 99.89% and test specificity was 97%. For ACTH cut-off level of 8 pg/mL, test sensitivity was 88.50%, with specificity of 99%. For ACTH cut-off level of 22 pg/mL, test sensitivity was 99.30%, with specificity of 98%. Our intermediate zone from 8 to 22 pg/mL confirms that assessment of ACTH level is a reliable tool in differential diagnosis of Cushing's syndrome.

  9. Noninvasive differential diagnosis of dental periapical lesions in cone-beam CT scans

    International Nuclear Information System (INIS)

    Purpose: This paper proposes a novel application of computer-aided diagnosis (CAD) to an everyday clinical dental challenge: the noninvasive differential diagnosis of periapical lesions between periapical cysts and granulomas. A histological biopsy is the most reliable method currently available for this differential diagnosis; however, this invasive procedure prevents the lesions from healing noninvasively despite a report that they may heal without surgical treatment. A CAD using cone-beam computed tomography (CBCT) offers an alternative noninvasive diagnostic tool which helps to avoid potentially unnecessary surgery and to investigate the unknown healing process and rate for the lesions. Methods: The proposed semiautomatic solution combines graph-based random walks segmentation with machine learning-based boosted classifiers and offers a robust clinical tool with minimal user interaction. As part of this CAD framework, the authors provide two novel technical contributions: (1) probabilistic extension of the random walks segmentation with likelihood ratio test and (2) LDA-AdaBoost: a new integration of weighted linear discriminant analysis to AdaBoost. Results: A dataset of 28 CBCT scans is used to validate the approach and compare it with other popular segmentation and classification methods. The results show the effectiveness of the proposed method with 94.1% correct classification rate and an improvement of the performance by comparison with the Simon’s state-of-the-art method by 17.6%. The authors also compare classification performances with two independent ground-truth sets from the histopathology and CBCT diagnoses provided by endodontic experts. Conclusions: Experimental results of the authors show that the proposed CAD system behaves in clearer agreement with the CBCT ground-truth than with histopathology, supporting the Simon’s conjecture that CBCT diagnosis can be as accurate as histopathology for differentiating the periapical lesions

  10. History of the infantile hepatic hemangioma: From imaging to generating a differential diagnosis.

    Science.gov (United States)

    Gnarra, Maria; Behr, Gerald; Kitajewski, Alison; Wu, June K; Anupindi, Sudha A; Shawber, Carrie J; Zavras, Nick; Schizas, Dimitrios; Salakos, Chris; Economopoulos, Konstantinos P

    2016-08-01

    We aim to provide an up-to-date summary of infantile hepatic hemangioma (IHH) and its misnomers and to dialectically present the differential diagnosis of these rare entities of the liver. Eligible peer-reviewed articles on hepatic infantile hemangiomas, published between 2000 and 2015, were reviewed for this study. IHH is the most common hepatic vascular tumor in children. Once a liver mass is identified in an infant, the differential diagnosis ranges from vascular malformations to benign and malignant tumors including mesenchymal hamartoma, hepatoblastoma, metastatic neuroblastoma, so careful physical examination, imaging studies, and, if indicated, tumor markers and biopsy, are of pivotal importance to ascertain the correct diagnosis. Despite the benign nature of IHHs, some of these lesions may demand medical and/or surgical intervention, especially for multiple and diffuse IHH. Complications can include hepatomegaly, hypothyroidism and cardiac failure. Therefore, a close follow-up is required until complete involution of the lesions. We propose an algorithm to guide the physicians towards the proper management of hepatic lesions. PMID:27610342

  11. HE4 in the Differential Diagnosis of a Pelvic Mass: A Case Report

    Directory of Open Access Journals (Sweden)

    Luigi Frati

    2011-01-01

    Full Text Available Neoplasms of the ovary present an increasing challenge to the physician. Neoplastic ovarian cysts can resemble endometriomas in ultrasound imaging and need to be carefully considered in the differential diagnosis. We report the case of a woman with a strong family history of hereditary breast and ovarian cancer, who presented with a pelvic mass. The young girl refused oncogenetic counseling and genetic testing, even though she had a 50% a priori probability of being a BRCA1 mutation carrier. Pelvic magnetic resonance imaging (MRI and a comparative analysis of the serum concentration of HE-4 and CA125 biomarkers provided accuracy and sensitivity in the diagnosis of a benign ovarian pathology. Based on this experience, we propose that the sensitivity of a screening program based on a HE4 and CA125 assay and MRI in high risk patients with mutations in the BRCA1 and BRCA2 genes may be considered a useful pre-operative tool for the differential diagnosis of pelvic masses.

  12. [Differential diagnosis between Schizotypal Personality Disorder and Autism Spectrum Disorders: a case report].

    Science.gov (United States)

    Ünver, Buket; Öner, Özgür; Yurtbaşı, Pınar

    2015-01-01

    Schizotypal personality disorder is characterized by social and interpersonal deficits marked by discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior. Inappropriate or constricted affect, reduced capacity for relationships, lack of close friends and reduced capacity for social life are the symptoms that overlap both schizotypal personality disorder and autism spectrum disorders. The making of differential diagnosis may be difficult since several symptoms are similar between these disorders. In this study, we discussed the differential diagnosis issues on the basis of an adolescent case. Odd appearance, magical thoughts, reference thoughts suggests Schizotypal Personality Disorder whereas lack of eye contact at 2 years old, a preference to be isolated and play alone and referral to a child psychiatrist at 4 years old suggest Autism Spectrum Disorders. Based on the results of psychological assessment, Wechsler Intelligence Scale for Children-Revised (WISC-R) profile is compatible with autistic children's profiles. Based on Schizotypal Personality Questionnaire, the patient's anxiety, lack of close friends, constricted affect symptoms which take place in the category of interpersonal schizotypy seems to overlap with lack of communication of Autism Spectrum Disorders. This case report indicates that, separation of autism and schizophrenia, a very important historical breakthrough in autism research, may be blurred in cases with less typical clinical pictures representing autistic and schizophrenic "spectrum" diagnosis.

  13. The use of differential scintigraphy in the clinical diagnosis of osseous and soft tissue changes affecting the diabetic foot

    Energy Technology Data Exchange (ETDEWEB)

    Visser, H.J.; Jacobs, A.M.; Oloff, L.; Drago, J.J.

    Prompt recognition of cellulitis, osteomyelitis, diabetic osteolysis, Charcot neuroarthropathy, septic synovitis, and deep plantar abscesses in the diabetic foot is essential because the therapy is drastically different. Differential diagnosis has been greatly facilitated by recently developed scanning techniques.

  14. Differential Diagnosis of the pancreatic disease : significance of perivascular changes at celiac trunk and superior mesenteric artery on CT

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Ryang; Kim, Ki Whang; Yu, Jeong Sik; Kim, Ji Hyung; Kim, Dong Guk; Lee, Sung Il; Ahn, Chang Soo; Oh, Sei Jung [Yonsei Univ., Seoul (Korea, Republic of). Coll. of Medicine; Kim, Young Hwan [Sanggye Paik Hospital, Seoul (Korea, Republic of)

    1998-03-01

    The purpose of this paper is to classify perivascular change in the celiac trunk and SMA occurring in pancreatic disease and to evaluate its significance in differential diagnosis. In 73 patients with pancreatic disease (42, acute pancreatitis; 14, chronic pancreatitis; 17, pancreatic cancer) abdominal CT findings were retrospectively reviewed. We defined infiltration as linear or irregular density and thickening as presence of a soft tissue mantle surrounding the vessel, and statistically evaluated the usefulness of these factors for the differential diagnosis of pancreatic diseases. Thickening of the celiac trunk and SMA is a valuable finding in the differential diagnosis of pancreatic inflammatory disease and pancreatic cancer. When applied to the differential diagnosis of pancreatic disease, perivascular change should be classified as either infiltration or thickening. (author). 10 refs., 1 tab., 2 figs.

  15. CLCA2 as a Novel Immunohistochemical Marker for Differential Diagnosis of Squamous Cell Carcinoma from Adenocarcinoma of the Lung

    OpenAIRE

    Kazuya Shinmura; Hisaki Igarashi; Hisami Kato; Yuichi Kawanishi; Yusuke Inoue; Satoki Nakamura; Hiroshi Ogawa; Takashi Yamashita; Akikazu Kawase; Kazuhito Funai; Haruhiko Sugimura

    2014-01-01

    Recent progress in targeted therapy for lung cancer has revealed that accurate differential diagnosis between squamous cell carcinoma (SCC) and adenocarcinoma (ADC) of the lung is essential. To identify a novel immunohistochemical marker useful for differential diagnosis between the two subtypes of lung cancer, we first selected 24 SCC-specific genes and 6 ADC-specific genes using data (case number, 980) from the Cancer Genome Atlas (TCGA) database. Among the genes, we chose the CLCA2 gene,...

  16. Differentiation of Pancreatic Cancer and Chronic Pancreatitis Using Computer-Aided Diagnosis of Endoscopic Ultrasound (EUS) Images: A Diagnostic Test

    OpenAIRE

    Maoling Zhu; Can Xu; Jianguo Yu; Yijun Wu; Chunguang Li; Minmin Zhang; Zhendong Jin; Zhaoshen Li

    2013-01-01

    BACKGROUND: Differentiating pancreatic cancer (PC) from normal tissue by computer-aided diagnosis of EUS images were quite useful. The current study was designed to investigate the feasibility of using computer-aided diagnostic (CAD) techniques to extract EUS image parameters for the differential diagnosis of PC and chronic pancreatitis (CP). METHODOLOGY/PRINCIPAL FINDINGS: This study recruited 262 patients with PC and 126 patients with CP. Typical EUS images were selected from the sample set...

  17. Multiparametric MR imaging in diagnosis of chronic prostatitis and its differentiation from prostate cancer

    Directory of Open Access Journals (Sweden)

    Vivek Kumar Sah

    2015-03-01

    Full Text Available Chronic prostatitis is a heterogeneous condition with high prevalence rate. Chronic prostatitis has overlap in clinical presentation with other prostate disorders and is one of the causes of high serum prostate specific antigen (PSA level. Chronic prostatitis, unlike acute prostatitis, is difficult to diagnose reliably and accurately on the clinical grounds alone. Not only this, it is also challenging to differentiate chronic prostatitis from prostate cancer with imaging modalities like TRUS and conventional MR Imaging, as the findings can mimic those of prostate cancer. Even biopsy doesn't play promising role in the diagnosis of chronic prostatitis as it has limited sensitivity and specificity. As a result of this, chronic prostatitis may be misdiagnosed as a malignant condition and end up in aggressive surgical management resulting in increased morbidity. This warrants the need of reliable diagnostic tool which has ability not only to diagnose it reliably but also to differentiate it from the prostate cancer. Recently, it is suggested that multiparametric MR Imaging of the prostate could improve the diagnostic accuracy of the prostate cancer. This review is based on the critically published literature and aims to provide an overview of multiparamateric MRI techniques in the diagnosis of chronic prostatitis and its differentiation from prostate cancer.

  18. Morphometry in the differential diagnosis of granulosa-cell tumors of the ovary.

    Science.gov (United States)

    Sassen, R J; Baak, J P

    1986-09-01

    Although the diagnosis of granulosa-cell tumors of the ovary is usually consistent and reproducible, in some cases the differentiation from poorly differentiated adenocarcinomas can be difficult. To investigate our subjective impression of the similarity of nuclei in both types of tumors, seven granulosa-cell tumors and eight poorly differentiated adenocarcinomas were studied with morphometry, with a variety of nuclear parameters measured in 100 nuclei per case. The findings showed that, in general, granulosa-cell tumors have a slightly higher mean nuclear contour index (NCI), which is a measure of the nuclear indentation or grooving, and a somewhat lower mean nuclear area than do adenocarcinomas. There is considerable overlap, however, with the nuclear patterns of the two types of tumors forming a morphologic continuum. Multivariate analysis gave a better discrimination but did not entirely eliminate the overlap. The maximum NCI was the best single discriminator. While only one of the granulosa-cell tumors had a maximum NCI less than 5.11, none of the adenocarcinomas exceeded this value. The only granulosa-cell tumor with a maximum NCI below the threshold was in a case with a much less favorable clinical course. The results of this study indicate that objective morphometric nuclear criteria are useful in the diagnosis of granulosa-cell tumors and possibly have some prognostic value. PMID:3778617

  19. Histopathological Differential Diagnosis of Psoriasis and Seborrheic Dermatitis of the Scalp

    Science.gov (United States)

    Park, Ji-Hye; Park, Young Joon; Kim, Sue Kyoung; Kwon, Ji Eun; Kang, Hee Young; Lee, Eun-So; Choi, Jee Ho

    2016-01-01

    Background The differential diagnosis of psoriasis and seborrheic dermatitis can be difficult when both conditions are localized to the scalp without the involvement of other skin sites. Objective We aimed to evaluate the histopathological differences between psoriasis and seborrheic dermatitis on the scalp and identify favorable criteria for their differential diagnosis. Methods We evaluated 15 cases of psoriasis and 20 cases of seborrheic dermatitis of the scalp that had been clinicopathologically diagnosed. Skin biopsy sections stained with H&E were examined. Additional immunohistochemistry was performed, including Ki-67, keratin 10, caspase-5, and GLUT-1. Results On histopathological examination, mounds of parakeratosis with neutrophils, spongiform micropustules of Kogoj, and clubbed and evenly elongated rete ridges were significantly more frequently observed in psoriasis. Follicular plugging, shoulder parakeratosis and prominent lymphocytic exocytosis were significantly more common in seborrheic dermatitis. Moreover, significantly higher mitotic figures were observed in psoriatic lesions than in seborrheic dermatitis. Immunohistochemistry did not show any difference between psoriasis and seborrheic dermatitis. Conclusion Histopathological features favoring psoriasis include mounds of parakeratosis with neutrophils, spongiform micropustules of Kogoj, clubbed and evenly elongated rete ridges, and increased mitotic figures (≥6/high-powered field). Features indicating seborrheic dermatitis are follicular plugging, shoulder parakeratosis and prominent lymphocytic exocytosis. Immunohistochemistry was not helpful in differentiating psoriasis from seborrheic dermatitis. PMID:27489423

  20. Using the Disease State Fingerprint Tool for Differential Diagnosis of Frontotemporal Dementia and Alzheimer's Disease

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    Miguel Ángel Muñoz-Ruiz

    2016-07-01

    Full Text Available Background: Disease State Index (DSI and its visualization, Disease State Fingerprint (DSF, form a computer-assisted clinical decision making tool that combines patient data and compares them with cases with known outcomes. Aims: To investigate the ability of the DSI to diagnose frontotemporal dementia (FTD and Alzheimer's disease (AD. Methods: The study cohort consisted of 38 patients with FTD, 57 with AD and 22 controls. Autopsy verification of FTD with TDP-43 positive pathology was available for 14 and AD pathology for 12 cases. We utilized data from neuropsychological tests, volumetric magnetic resonance imaging, single-photon emission tomography, cerebrospinal fluid biomarkers and the APOE genotype. The DSI classification results were calculated with a combination of leave-one-out cross-validation and bootstrapping. A DSF visualization of a FTD patient is presented as an example. Results: The DSI distinguishes controls from FTD (area under the receiver-operator curve, AUC = 0.99 and AD (AUC = 1.00 very well and achieves a good differential diagnosis between AD and FTD (AUC = 0.89. In subsamples of autopsy-confirmed cases (AUC = 0.97 and clinically diagnosed cases (AUC = 0.94, differential diagnosis of AD and FTD performs very well. Conclusions: DSI is a promising computer-assisted biomarker approach for aiding in the diagnostic process of dementing diseases. Here, DSI separates controls from dementia and differentiates between AD and FTD.

  1. Technetium-99m hexamethylpropylene amine oxime leucocyte scintigraphy in the differential diagnosis of cerebral abscesses.

    Science.gov (United States)

    Spinelli, F; Sara, R; Milella, M; Ruffini, L; Sterzi, R; Causarano, I R; Sberna, M

    2000-01-01

    The diagnosis of brain abscess is often difficult, as the clinical symptoms are not specific. Computed tomography (CT) and magnetic resonance imaging (MRI) are highly sensitive, but different cerebral lesions, especially neoplasms, can have the same ring-like contrast enhancement. Brain abscess is a severe illness requiring rapid diagnosis to choose the most appropriate therapy. Technetium-99m hexamethylpropylene amine oxime (HMPAO)-labelled leucocyte scintigraphy is commonly used to detect an inflammatory process. The aim of this study was to present the results obtained with leucocyte scintigraphy in 65 patients with intracranial mass lesions and clinical findings compatible to or suggestive of brain abscess. The final diagnosis, based on surgery, clinical findings and stereotatic puncture, was brain abscess in 17 patients, primary brain neoplasm in 22, brain metastasis in 16, lymphoma in 2, cysticercosis in 2, hematoma in 2 and cerebral infarction in 4. 99mTc-HMPAO leucocyte scintigraphy was positive in all abscess cases. The scan was negative in the rest of the patients examined, with the exception of one lesion, which was finally diagnosed as a tumour (1 false-positive). All patients who did not have false-negative scans were treated with steroids. The sensitivity, specificity and diagnostic accuracy of leucocyte scintigraphy was 100%, 97.8% and 98.4%, respectively. In conclusion, in our experience, leucocyte scintigraphy is a valuable aid in the differential diagnosis between abscess and neoplasm. PMID:10654146

  2. Technetium-99m hexamethylpropylene amine oxime leucocyte scintigraphy in the differential diagnosis of cerebral abscesses

    International Nuclear Information System (INIS)

    The diagnosis of brain abscess is often difficult, as the clinical symptoms are not specific. Computed tomography (CT) and magnetic resonance imaging (MRI) are highly sensitive, but different cerebral lesions, especially neoplasms, can have the same ring-like contrast enhancement. Brain abscess is a severe illness requiring rapid diagnosis to choose the most appropriate therapy. Technetium-99m hexamethylpropylene amine oxime (HMPAO)-labelled leucocyte scintigraphy is commonly used to detect an inflammatory process. The aim of this study was to present the results obtained with leucocyte scintigraphy in 65 patients with intracranial mass lesions and clinical findings compatible to or suggestive of brain abscess. The final diagnosis, based on surgery, clinical findings and stereotatic puncture, was brain abscess in 17 patients, primary brain neoplasm in 22, brain metastasis in 16, lymphoma in 2, cysticercosis in 2, hematoma in 2 and cerebral infarction in 4. 99mTc-HMPAO leucocyte scintigraphy was positive in all abscess cases. The scan was negative in the rest of the patients examined, with the exception of one lesion, which was finally diagnosed as a tumour (1 false-positive). All patients who did not have false-negative scans were treated with steroids. The sensitivity, specificity and diagnostic accuracy of leucocyte scintigraphy was 100%, 97.8% and 98.4%, respectively. In conclusion, in our experience, leucocyte scintigraphy is a valuable aid in the differential diagnosis between abscess and neoplasm. (orig.)

  3. Technetium-99m hexamethylpropylene amine oxime leucocyte scintigraphy in the differential diagnosis of cerebral abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Spinelli, F.; Sara, R.; Milella, M.; Ruffini, L. [Dept. of Nuclear Medicine, Niguarda Ca' Granda Hospital, Milan (Italy); Sterzi, R.; Causarano, I.R. [Dept. of Neurology, Niguarda Ca' Granda Hospital, Milan (Italy); Sberna, M. [Dept. of Neuroradiology, Niguarda Ca' Granda Hospital, Milan (Italy)

    2000-01-01

    The diagnosis of brain abscess is often difficult, as the clinical symptoms are not specific. Computed tomography (CT) and magnetic resonance imaging (MRI) are highly sensitive, but different cerebral lesions, especially neoplasms, can have the same ring-like contrast enhancement. Brain abscess is a severe illness requiring rapid diagnosis to choose the most appropriate therapy. Technetium-99m hexamethylpropylene amine oxime (HMPAO)-labelled leucocyte scintigraphy is commonly used to detect an inflammatory process. The aim of this study was to present the results obtained with leucocyte scintigraphy in 65 patients with intracranial mass lesions and clinical findings compatible to or suggestive of brain abscess. The final diagnosis, based on surgery, clinical findings and stereotatic puncture, was brain abscess in 17 patients, primary brain neoplasm in 22, brain metastasis in 16, lymphoma in 2, cysticercosis in 2, hematoma in 2 and cerebral infarction in 4. {sup 99m}Tc-HMPAO leucocyte scintigraphy was positive in all abscess cases. The scan was negative in the rest of the patients examined, with the exception of one lesion, which was finally diagnosed as a tumour (1 false-positive). All patients who did not have false-negative scans were treated with steroids. The sensitivity, specificity and diagnostic accuracy of leucocyte scintigraphy was 100%, 97.8% and 98.4%, respectively. In conclusion, in our experience, leucocyte scintigraphy is a valuable aid in the differential diagnosis between abscess and neoplasm. (orig.)

  4. Synovial hemangioma: imaging features in eight histologically proven cases, review of the literature, and differential diagnosis

    International Nuclear Information System (INIS)

    This study was undertaken to describe the imaging characteristics of synovial hemangioma, with the goal of improving the disappointing rate (22%) of clinical diagnosis of this condition. A review of the literature and the differential diagnosis of intra-articular lesions, including synovial osteochondromatosis and pigmented villonodular synovitis, are also presented. Plain radiographs showed a soft tissue density suggesting either joint effusion or a mass in all patients. Phleboliths and bone erosions on plain films in four patients with extra-articular soft tissue involvement pointed to the correct diagnosis. Angiography, showing fine-caliber, smooth-walled vessels, contrast pooling indilated vascular spaces, and early visualization of venous structures, was diagnostic in two patients. Neither arthrography nor CT yielded specific enough findings. MRI was consistently effective in allowing the correct diagnosis to be made preoperatively, showing an intra-articular or juxta-articular mass of intermediate signal intensity on T1-weighted images and of high signal intensity on T2- or T2'-weighted images with low-signal channels or septa within it. A fluid-fluid level was found in two patients with a cavernous-type lesion. Despite the limited nature of this study, it shows clearly that MRI is the procedure of choice. (orig./MG)

  5. Sclerosing cholangitis: Clinicopathologic features, imaging spectrum, and systemic approach to differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Ni Eun [Dept. of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, So Yeon; Lee, Seung Soo; Byun, Jae Ho; Kim, Hyoung Jung; Kim, Jin Hee; Lee, Moon Gyu [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2016-02-15

    Sclerosing cholangitis is a spectrum of chronic progressive cholestatic liver disease characterized by inflammation, fibrosis, and stricture of the bile ducts, which can be classified as primary and secondary sclerosing cholangitis. Primary sclerosing cholangitis is a chronic progressive liver disease of unknown cause. On the other hand, secondary sclerosing cholangitis has identifiable causes that include immunoglobulin G4-related sclerosing disease, recurrent pyogenic cholangitis, ischemic cholangitis, acquired immunodeficiency syndrome-related cholangitis, and eosinophilic cholangitis. In this review, we suggest a systemic approach to the differential diagnosis of sclerosing cholangitis based on the clinical and laboratory findings, as well as the typical imaging features on computed tomography and magnetic resonance (MR) imaging with MR cholangiography. Familiarity with various etiologies of sclerosing cholangitis and awareness of their typical clinical and imaging findings are essential for an accurate diagnosis and appropriate management.

  6. Use of procalcitonin for the differential diagnosis of fever in cancer patients: an observational study

    Directory of Open Access Journals (Sweden)

    Daria Macchioni

    2013-09-01

    Full Text Available Fever often occurs in cancer patients and the possibility of having a reliable marker for the differential etiological diagnosis is desirable. The aim of this study was to investigate the eligibility of the use of procalcitonin (PCT in hemato-oncological patients for the differential diagnosis of fever. We prospectively enrolled 98 cancer patients and divided them into two groups: those with active disease and those with non-active disease. Procalcitonin was dosed at Time 0 (recruitment and at the onset of fever. On enrollment, PCT values were 0.1 ng/mL in 83% patients with active disease, and lower than 0.5 ng/mL in 23%, which is usually considered not suggestive of bacterial infection. Four percent of patients had values over 0.5 ng/mL and these were mainly patients with neuroendocrine tumors or affiliates. On enrollment, there were also no statistically significant differences in PCT values between the two groups of patients. This showed that active cancer is unable by itself to change PCT levels. In the active disease group, 21 episodes of fever due to bacterial infection were registered, and in all of them an increase in PCT values was observed. This demonstrates the ability of PCT to detect an infection-induced fever in cancer patients. Procalcitonin concentrations are not significantly altered by active neoplastic disease. On the contrary, in the course of fever due to a bacterial infection, PCT values increase and can, therefore, be considered a useful tool in the differential diagnosis between infection-induced fever and drug-related or tumor associated-fever. Procalcitonin may be a useful marker of bacterial infection even in cancer patients.

  7. Differential diagnosis of isolated calf muscle vein thrombosis and gastrocnemius hematoma by high-frequency ultrasound

    Institute of Scientific and Technical Information of China (English)

    SU Li-ya; GUO Fa-jin; XU Guang; HAN Xiu-jie; SUN Chang-kun; ZHANG Zheng; JING Qing-hong

    2013-01-01

    Background Differential diagnosis of isolated calf muscle vein thrombosis (ICMVT) and gastrocnemius hematoma is essential for early identification of deep vein thrombosis (DVT).This study aimed to investigate the diagnostic value of high-frequency color Doppler ultrasound for differential diagnosis of ICMVT and gastrocnemius hematoma.Methods A retrospective case series of 35 ICMVT (M∶F,21∶14; mean age (64.5±10.6) years) and 23 gastrocnemius hematoma (M∶F,16∶7; mean age (75.4±11.8) years) patients with bilateral/unilateral lower limb pain was conducted between January 2006 and September 2012.Characteristics and the morphology of high-frequency color Doppler ultrasonography of the lower limb deep vein,great saphenous vein,calf muscles,skin,and soft tissue were examined.Results ICMVT hypoechoic signals were characterized by long,tube-like masses on longitudinal sections and oval masses on transverse sections,with apparent muscle thrombosis boundaries,distal and proximal venous connections,and,often,lower limb DVT.Gastrocnemius hematoma hypoechoic signals were characterized by large volumes,enhanced posterior hematoma echo,hyperechoic muscle boundaries,no hematoma blood flow,and no DVT,and clear differences in trauma/exercise-and oral anticoagulant-induced hematomas were readily apparent.According to the measurement,the ratio of long diameter/transverse diameter (D/T) in ICMVT patients was about less than 2.0,whereas in gastrocnemius hematoma patients the ratio was more than 2.0.Early stage isoechoic and hypoechoic signals were detected with gradually increasing ovular anechoic areas.Partial muscle fibers in the hematoma due to muscle fractures were apparent.Conclusion High-frequency color Doppler ultrasound was found to be a sensitive and reliable method for differential diagnosis of ICMVT and gastrocnemius hematoma due to trauma and exercise or prolonged oral anticoagulant use.

  8. Naked patients in the general hospital: differential diagnosis and management strategies.

    Science.gov (United States)

    Maytal, Guy; Smith, Felicia A; Stern, Theodore A

    2006-01-01

    Physicians and patients are frequently concerned, and, at times, distressed, by nakedness during clinical encounters. When nakedness appears, clinicians should attempt to establish the reason for it and determine whether it is appropriate for the situation. Establishing the etiology of nudity can facilitate care by hospital staff and help to modulate their countertransference reactions and behavior. The authors present and discuss three cases involving nudity at times other than during the physical examination, within the context of differential diagnosis and treatment alternatives. PMID:17116949

  9. Wound healing and treating wounds: Differential diagnosis and evaluation of chronic wounds.

    Science.gov (United States)

    Morton, Laurel M; Phillips, Tania J

    2016-04-01

    Wounds are an excellent example of how the field of dermatology represents a cross-section of many medical disciplines. For instance, wounds may be caused by trauma, vascular insufficiency, and underlying medical conditions, such as diabetes, hypertension, and rheumatologic and inflammatory disease. This continuing medical education article provides an overview of wound healing and the pathophysiology of chronic wounds and reviews the broad differential diagnosis of chronic wounds. It also describes the initial steps necessary in evaluating a chronic wound and determining its underlying etiology.

  10. The derivation and validation of a prediction rule for differential diagnosis of thyroid nodules

    Institute of Scientific and Technical Information of China (English)

    李拓

    2013-01-01

    Objective To set up a prediction rule for the pro-operative differential diagnosis of thyroid nodules and evaluate its clinical value.Methods All patients of thyroid nodules undergoing thyroid operations in Changzheng hospital from June,1997 to July,2012 were included in this study.They were randomly divided into the derivation cohort (2/3) and the validation cohort (1/3) .A prediction rule was developed based on the logistic regression model and the scoring system was established in accordance with assigning of the value of each variableβ

  11. [The differential diagnosis of the types of trauma caused by wheeled tractors].

    Science.gov (United States)

    Zaval'niuk, A Kh

    1993-01-01

    Examinations of 23 corpses and study of 282 expert conclusions concerning the deaths of subjects aged 6 to 78 dead because of wheeled tractor injuries under agricultural conditions helped detect the specific characteristic signs of tractor injury types. Mathematical method of analysis of the characteristic features' quantitative parameters permitted the author to find statistically reliable criteria for differential diagnosis of the types of injuries inflicted by wheeled tractors. The possibility of correct conclusions of an expert using this method is at least 95%. PMID:7940629

  12. Nevus of ota with rare palatal involvement: a case report with emphasis on differential diagnosis.

    Science.gov (United States)

    Sharma, Gaurav; Nagpal, Archna

    2011-01-01

    Nevus of Ota, a dermal melanocytic nevus, is rare in the Indian subcontinent. It presents as a brown, blue, or gray patch on the face and is within the distribution of the ophthalmic and maxillary branches of the trigeminal nerve. The oral cavity is infrequently involved in nevus of Ota. Only 11 cases have been documented in the English literature. We report a rare case of intraoral nevus of Ota in a 22-year-old male patient. This paper focuses on the differential diagnosis of oral manifestations of nevus of Ota to assist in proper followup to avert malignant transformation.

  13. Nevus of Ota with Rare Palatal Involvement: A Case Report with Emphasis on Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Gaurav Sharma

    2011-01-01

    Full Text Available Nevus of Ota, a dermal melanocytic nevus, is rare in the Indian subcontinent. It presents as a brown, blue, or gray patch on the face and is within the distribution of the ophthalmic and maxillary branches of the trigeminal nerve. The oral cavity is infrequently involved in nevus of Ota. Only 11 cases have been documented in the English literature. We report a rare case of intraoral nevus of Ota in a 22-year-old male patient. This paper focuses on the differential diagnosis of oral manifestations of nevus of Ota to assist in proper followup to avert malignant transformation.

  14. Differential diagnosis of infections in a patient with Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Paolo Ghiringhelli

    2008-12-01

    Full Text Available We describe a case of a 65-years-old patient with Chronic Obstructive Pulmonary Disease (COPD, receiving oxygen therapy and resistant to antibiotic therapy. He was admitted with high fever, productive cough, marked leukocytosis, and chest X-ray findings of infiltration and fluid levels within lung cysts. A differential diagnosis was essential to start an adequate treatment and avoid the rapid worsening of patients respiratory status. In patients with chronic pulmonary diseases under immunotherapy, micotic infections should be considered. Aspergillus fumigatus was cultured from bronchial washing fluid and we diagnosed chronic necrotizing pulmonary aspergillosis (CNPA. Oral itraconazole was started and his symptoms and laboratory data markedly improved.

  15. Differential diagnosis of a cavitary lung lesion in 45-year old man

    Directory of Open Access Journals (Sweden)

    Tanseli Gönlügür

    2011-03-01

    Full Text Available Pulmonary cavity has infectious and non-infectious aetiologies. A 41-year old man was hospitalized with a 1-week history of productive cough, and pleuritic chest pain. A chest CT scan showed a cavitary lesion in left upper lobe. An open lung biopsy revealed the presence of connective tissue within alveolar ducts and bronchioles. In conclusion, cryptogenic organising pneumonia which is a rare cause of pulmonary cavitary lesion was diagnosed. The case was presented in order to emphasize such rare causes of cavitary lung lesions in the differential diagnosis of tuberculosis.

  16. The differential diagnosis of inflammatory joint disease in maternal-fetal microchimerism

    Directory of Open Access Journals (Sweden)

    Seme Youssef Reda

    2013-12-01

    Full Text Available This study aimed at making the differential diagnosis of joint disease in a case of genetic chimerism in a female multiparous donor from the Regional Blood Bank of Guarapuava-PR (Hemocentro Regional de Guarapuava-PR, who had had three pregnancies of male fetuses. The patient showed joint pain prior to the last donation. It was possible to identify fetal cells remaining in circulation 20 years after her last pregnancy. Laboratory tests for acute phase proteins revealed possible termination of immune tolerance to circulating fetal cells. Thus, a hypothesis of graft-versus-host disease was formulated to explain the joint disease manifested by the donor.

  17. Eruptive dermal clear cell desmo-plastic mesenchymal tumors with perivascular myoid differentiation in a young boy. A clinical, histopathologic, immunohistochemical and electron microscopy study of 17 lesions.

    Science.gov (United States)

    Tomasini, Carlo; Metze, Dieter; Osella-Abate, Simona; Novelli, Mauro; Kutzner, Heinz

    2014-02-01

    Clear cell tumors of the skin are observed in a wide variety of benign and malignant conditions with different histogenesis, sharing the presence of cells with abundant clear cytoplasm. Herein, we report the clinicopathologic features of a healthy young patient affected by asymptomatic, eruptive and disseminated, benign clear cell dermal tumors since early infancy. Neither family history nor genetic testing and counseling provided further useful information. The lesions were mostly confined to the face and lower left extremity with pink teleangiectatic papules and small nodules. Over a 4-year period, a total of 16 different cutaneous lesions were biopsied and histopathologic and immunohistochemical studies carried out; an additional lesion was also removed for electron microscopy examination. Histopathology evidenced multiple perivascular growths of spindle to oval and round cells intermingled with clear/granular cells throughout the dermis, with prominent desmoplasia and numerous capillary-like vessels with focal hemangiopericytoma-like features. Immunohistochemical neoplastic cells were uniformly positive for h-caldesmon and focally smooth muscle α-actin and CD13 indicating myoid differentiation whereas the consistent diffuse cytoplasmic staining for lysosome antigen, such as CD68PG-M1 and NKI/C3 along with the ultrastructural findings supported the view of a lysosome-mediated apoptotic process. The differential diagnosis with other clear cell cutaneous neoplasms is discussed.

  18. Brachyury: A Diagnostic Marker for the Differential Diagnosis of Chordoma and Hemangioblastoma versus Neoplastic Histological Mimickers

    Science.gov (United States)

    Ieni, Antonio; Branca, Giovanni

    2014-01-01

    Brachyury is a transcription factor which is required for posterior mesoderm formation and differentiation as well as for notochord development during embryogenesis. Due to its expression in the neoplastic cells of chordoma, a malignant tumour deriving from notochordal remnants, but not in tumors showing a similar histology, brachyury has been proposed as a diagnostic marker of this neoplasia. Though commonly considered a hallmark of chordoma, the expression of brachyury has been also documented in the stromal cells of hemangioblastoma (HBL), a slow growing tumor which may involve the central nervous system (CNS) and, rarely, the kidney. Herein we review the role of brachyury immunohistochemical detection in the identification and differential diagnosis of chordoma and HBL towards histological mimickers and suggest that brachyury is added to the panel of immunohistochemical markers for the recognition of HBL in routinary practice, principally in unusual sites. PMID:24591762

  19. Brachyury: A Diagnostic Marker for the Differential Diagnosis of Chordoma and Hemangioblastoma versus Neoplastic Histological Mimickers

    Directory of Open Access Journals (Sweden)

    Valeria Barresi

    2014-01-01

    Full Text Available Brachyury is a transcription factor which is required for posterior mesoderm formation and differentiation as well as for notochord development during embryogenesis. Due to its expression in the neoplastic cells of chordoma, a malignant tumour deriving from notochordal remnants, but not in tumors showing a similar histology, brachyury has been proposed as a diagnostic marker of this neoplasia. Though commonly considered a hallmark of chordoma, the expression of brachyury has been also documented in the stromal cells of hemangioblastoma (HBL, a slow growing tumor which may involve the central nervous system (CNS and, rarely, the kidney. Herein we review the role of brachyury immunohistochemical detection in the identification and differential diagnosis of chordoma and HBL towards histological mimickers and suggest that brachyury is added to the panel of immunohistochemical markers for the recognition of HBL in routinary practice, principally in unusual sites.

  20. Features of the differential diagnosis of persons with gender identity disorders

    Directory of Open Access Journals (Sweden)

    Z.D. Novikova

    2013-10-01

    Full Text Available We presented a study of the features of gender identity in people undergoing gender, psychological and psychiatric examination to address the issue of gender reassignment. We analyze the specifics of gender identity, levels of masculinity and femininity, the similarities and differentiation within four nosological groups, which include persons with gender identity disorders (GID with transsexualism, personality disorders, diseases of the schizophrenia spectrum, and with organic mental disorders. We address the question of the differential diagnosis in the process of psychological screening of people with transsexualism and other types of GID. The analytical description of the four algorithms and their comparison are psychologically specific, qualitative research, almost impossible using statistical method of data processing. The data presented may be useful to specialists involved in the study of persons with gender identity disorders

  1. [Non-suicidal self-injury and suicide attempts: grounding of differential diagnosis].

    Science.gov (United States)

    Nitkowski, D; Petermann, F

    2010-01-01

    Three criteria for differential diagnosis of non-suicidal self-injury and suicide attempts were validated by means of more recent empirical studies. Criteria concerning motives (functions), methods of self-injury (medical severity), lifetime frequency and lifetime number of episodes were investigated. Literature research showed only a few studies concentrated on a direct comparison of non-suicidal self-injury and suicide attempts. Therefore, studies examing the relationship of suicide intent to the relevant features, are considered, too. Empirical results concerning motives (functions), methods (medical severity), lifetime frequency and number of episodes were compared to the three criteria. Except for lifetime frequency, studies support the criteria. However, in the case of motives, a more differentiated examination is needed to distinguish between non-suicidal self-injury and suicide attempts. To optimize the assessment, guidelines should be slightly modified. Because of the phenomenological overlap of non-suicidal self-injury and suicide attempts, a dimensional assessment can be helpful.

  2. The Value of D-Dimer in Diagnosis of Acute Mesenteric Ischemia and Differential Diagnosis from Acute Pancreatitis and Acute Cholecystitis

    OpenAIRE

    Semih Hot; Nüvit Duraker; Ayhan Sarı; Kenan Çetin

    2016-01-01

    Objective: Because of its poor prognosis and high mor­tality rate, early diagnosis of acute mesenteric ischemia (AMI) is a challenge. The value of serum markers in the diagnosis of AMI is limited and the studies related with the D-dimer test carried out in recent years. In this prospec­tive study we investigated the value of the level of plasma D-dimer in the diagnosis of AMI and the differential diag­nosis from acute pancreatitis and acute cholecystitis. Methods: We included 89 patients w...

  3. The differential diagnosis of children with joint hypermobility: a review of the literature

    Directory of Open Access Journals (Sweden)

    Elliott Elizabeth J

    2009-01-01

    Full Text Available Abstract Background In this study we aimed to identify and review publications relating to the diagnosis of joint hypermobility and instability and develop an evidence based approach to the diagnosis of children presenting with joint hypermobility and related symptoms. Methods We searched Medline for papers with an emphasis on the diagnosis of joint hypermobility, including Heritable Disorders of Connective Tissue (HDCT. Results 3330 papers were identified: 1534 pertained to instability of a particular joint; 1666 related to the diagnosis of Ehlers Danlos syndromes and 330 related to joint hypermobility. There are inconsistencies in the literature on joint hypermobility and how it relates to and overlaps with milder forms of HDCT. There is no reliable method of differentiating between Joint Hypermobility Syndrome, familial articular hypermobility and Ehlers-Danlos syndrome (hypermobile type, suggesting these three disorders may be different manifestations of the same spectrum of disorders. We describe our approach to children presenting with joint hypermobility and the published evidence and expert opinion on which this is based. Conclusion There is value in identifying both the underlying genetic cause of joint hypermobility in an individual child and those hypermobile children who have symptoms such as pain and fatigue and might benefit from multidisciplinary rehabilitation management. Every effort should be made to diagnose the underlying disorder responsible for joint hypermobility which may only become apparent over time. We recommend that the term "Joint Hypermobility Syndrome" is used for children with symptomatic joint hypermobility resulting from any underlying HDCT and that these children are best described using both the term Joint Hypermobility Syndrome and their HDCT diagnosis.

  4. Imaging-based differential diagnosis between multiple system atrophy and Parkinson's disease.

    Science.gov (United States)

    Sako, Wataru; Abe, Takashi; Murakami, Nagahisa; Miyazaki, Yoshimichi; Izumi, Yuishin; Harada, Masafumi; Kaji, Ryuji

    2016-09-15

    There are many tools for differentiating between multiple system atrophy with predominant parkinsonian features (MSA-P) and Parkinson's disease (PD). These include middle cerebellar peduncle (MCP) width, apparent diffusion coefficient (ADC) value of the putamen and cerebellum, and (123)I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy images. We aimed to directly compare the above-mentioned methods, and to determine the optimal tool for differential diagnosis. Eleven patients with MSA-P and 36 patients with PD were enrolled. Of these, 7 patients with MSA-P and 14 patients with PD were chosen as background-matched subjects. We measured MCP width, ADC value of the putamen and cerebellum, and MIBG myocardial scintigraphy images. Area under curve (AUC) of receiver operating characteristic (ROC) was assessed to compare the above-mentioned methods. MCP width and ADC value of the putamen may be helpful for differentiating between MSA-P and PD relative to other methods in background-matched patients (MCP, AUC=0.95; putamen ADC, AUC=0.88; cerebellar ADC, AUC=0.70; MIBG, AUC=0.78). Similar AUCs were seen in all patients with different backgrounds. Our findings suggested that MCP width and ADC value of the putamen could be superior to ADC value of the cerebellum and MIBG uptake for differentiating between MSA-P and PD. PMID:27538610

  5. Differential diagnosis of pancreatic cancer from other solid tumours arising from the periampullary area on MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Suk Ki [Bundang Jesaeng General Hospital, Departments of Radiology, Daejin Medical Center, Seognam-si, Gyeonggi-do (Korea, Republic of); Kim, Jung Hoon; Joo, Ijin; Jeon, Ju Hyun; Han, Joon Koo; Choi, Byung Ihn [Seoul National University College of Medicine, Department of Radiology and Institute of Radiation Medicine, Chongno-gu, Seoul (Korea, Republic of); Shin, Kyung Sook [Chungnam National University School of Medicine, Department of Radiology, 266 Munhwa-ro, Jung-gu, Daejeon (Korea, Republic of)

    2015-10-15

    To investigate CT features and differential diagnosis of pancreatic adenocarcinoma compared to other solid tumours arising in the periampullary area. One hundred and ninety-five patients with pathologically proven, solid periampullary tumours, including pancreatic adenocarcinoma (n = 98), neuroendocrine tumours (n = 52), gastrointestinal stromal tumours (n = 31), and solid pseudopapillary neoplasms (n = 14), underwent preoperative CT. Two radiologists reviewed CT features and rated the possibility of pancreatic adenocarcinoma. Statistically common findings for pancreatic adenocarcinoma included: patient age >50 years; ill-defined margin; completely solid mass; homogeneous enhancement; hypoenhancement on arterial and venous phases; atrophy; and duct dilatation. Statistically common findings for GIST included: heterogeneous enhancement; hyperenhancement on arterial and venous phases; rim enhancement; and prominent feeding arteries. The hyperenhancement on arterial and venous phases is statistically common in NET, and heterogeneous enhancement, hypoenhancement on the arterial and venous phases are statistically common in SPN. Diagnostic performance of CT for differentiating pancreatic adenocarcinomas from other solid periampullary tumours was 0.962 and 0.977 with excellent interobserver agreement (κ = 0.824). CT is useful not only for differentiating pancreatic adenocarcinoma form other solid tumours but also for differentiating between other solid tumours, including NET, SPN, and GIST, arising in the periampullary area. (orig.)

  6. Differential diagnosis of pancreatic cancer from other solid tumours arising from the periampullary area on MDCT

    International Nuclear Information System (INIS)

    To investigate CT features and differential diagnosis of pancreatic adenocarcinoma compared to other solid tumours arising in the periampullary area. One hundred and ninety-five patients with pathologically proven, solid periampullary tumours, including pancreatic adenocarcinoma (n = 98), neuroendocrine tumours (n = 52), gastrointestinal stromal tumours (n = 31), and solid pseudopapillary neoplasms (n = 14), underwent preoperative CT. Two radiologists reviewed CT features and rated the possibility of pancreatic adenocarcinoma. Statistically common findings for pancreatic adenocarcinoma included: patient age >50 years; ill-defined margin; completely solid mass; homogeneous enhancement; hypoenhancement on arterial and venous phases; atrophy; and duct dilatation. Statistically common findings for GIST included: heterogeneous enhancement; hyperenhancement on arterial and venous phases; rim enhancement; and prominent feeding arteries. The hyperenhancement on arterial and venous phases is statistically common in NET, and heterogeneous enhancement, hypoenhancement on the arterial and venous phases are statistically common in SPN. Diagnostic performance of CT for differentiating pancreatic adenocarcinomas from other solid periampullary tumours was 0.962 and 0.977 with excellent interobserver agreement (κ = 0.824). CT is useful not only for differentiating pancreatic adenocarcinoma form other solid tumours but also for differentiating between other solid tumours, including NET, SPN, and GIST, arising in the periampullary area. (orig.)

  7. Best practices in the differential diagnosis and reporting of acute transfusion reactions

    Directory of Open Access Journals (Sweden)

    Hillis CM

    2016-01-01

    Full Text Available Christopher M Hillis,1–3,* Andrew W Shih,1,3,* Nancy M Heddle1,3,4 1Department of Medicine, 2Department of Oncology, 3McMaster Transfusion Research Program, McMaster University, Hamilton, 4Centre for Innovation, Canadian Blood Services, Ottawa, ON, Canada  *These authors contributed equally to this work Abstract: An acute transfusion reaction (ATR is any reaction to blood, blood components, or plasma derivatives that occurs within 24 hours of a transfusion. The frequencies of ATRs and the associated symptoms, reported by the sentinel sites of the Ontario Transfusion Transmitted Injuries Surveillance System from 2008 to 2012, illustrate an overlap in presenting symptoms. Despite this complexity, the differential diagnosis of an ATR can be determined by considering predominant signs or symptoms, such as fever, dyspnea, rash, and/or hypotension, as these signs and symptoms guide further investigations and management. Reporting of ATRs locally and to hemovigilance systems enhances the safety of the blood supply. Challenges to the development of an international transfusion reaction reporting system are discussed, including the issue of jurisdiction and issues of standardization for definitions, investigations, and reporting requirements. This review discusses a symptom-guided approach to the differential diagnosis of ATRs, the evolution of hemovigilance systems, an overview of the current Canadian system, and proposes a best practice model for hemovigilance based on a World Health Organization patient safety framework. Keywords: blood transfusion, blood components, hemovigilance

  8. KatG protein: A novel marker for differential diagnosis of Myobacterium avium complex infection

    Directory of Open Access Journals (Sweden)

    Gupta K

    2010-01-01

    Full Text Available Purpose: Biochemical or nucleic acid based diagnostic techniques for MAC infection are unsatisfactory. This study aims to identify and evaluate M. avium secretory protein(s of diagnostic potential, so as to develop a rapid and simple method for diagnosis of MAC infection. Material and Methods: Initially, a specific protein band of ~80-85 kDa was recognised by differential immunoblotting; which was subjected to anion exchange column chromatography for purification of proteins. After fractionisation using SDS-PAGE and electroelution, blast search was carried out. Further immunoreactivity studies were done with M. avium and Mtb infected mice sera. Clinical utilisation of separated protein was evaluated by conducting indirect ELISA with serum samples from mycobacterial infected patients. Results: A specific 81.6 kDa protein, shown to be catalase-peroxidase protein (KatG by blast search was separated. Immunoreactivity studies of purified KatG proteins with mice sera confirmed it to be specific for M. avium infection. Indirect ELISA with patient samples further confirmed it to be M. avium infection specific. Conclusion: KatG protein is specifically recognised by MAC patients and can be used as a marker for simple and rapid ELISA based tests for differential diagnosis of M. avium infection.

  9. Differential diagnosis of groove pancreatic carcinomas vs. groove pancreatitis: Usefulness of the portal venous phase

    Energy Technology Data Exchange (ETDEWEB)

    Ishigami, Kousei, E-mail: Ishigamikousei@aol.co [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan); Tajima, Tsuyoshi; Nishie, Akihiro; Kakihara, Daisuke [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan); Fujita, Nobuhiro [Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Asayama, Yoshiki; Ushijima, Yasuhiro; Irie, Hiroyuki [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan); Nakamura, Masafumi; Takahata, Shunichi [Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Ito, Tetsuhide [Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Honda, Hiroshi [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan)

    2010-06-15

    Purpose: To clarify if the portal venous phase is helpful for the differential diagnosis of groove pancreatic carcinomas and groove pancreatitis. Materials and methods: MDCT and MRI of groove pancreatic carcinomas (n = 7) and groove pancreatitis (n = 15) were retrospectively reviewed by two radiologists independently. The signal intensity on T2-weighted images was subjectively assessed. The presence or absence of common bile duct (CBD) and main pancreatic duct (MPD) strictures, calcifications, and cystic lesions was evaluated. Additionally, the appearance of groove pancreatic carcinoma and that of groove pancreatitis in the portal venous phase on dynamic MDCT and MRI were compared. Results: There were no significant differences in the signal intensity on T2-weighted images and in the presence or absence of CBD and MPD strictures, calcifications, and cystic lesions between groove pancreatic carcinomas and groove pancreatitis. However, patchy focal enhancement in the portal venous phase was more commonly observed in groove pancreatitis than groove pancreatic carcinoma (Reviewers 1 and 2: 14/15 [93.3%] vs. 1/7 [14.3%], P < 0.0001). In addition, peripheral enhancement was only seen in groove pancreatic carcinomas (Reviewer 1: 4/7 [57.1%] vs. 0/15 [0%], P < 0.005, and Reviewer 2: 3/7 [42.9%] vs. 0/15 [0%], P < 0.05). Conclusion: The portal venous phase may be helpful for the differential diagnosis of groove pancreatic carcinomas and groove pancreatitis.

  10. In vitro differential diagnosis of clavus and verruca by a predictive model generated from electrical impedance.

    Directory of Open Access Journals (Sweden)

    Chien-Ya Hung

    Full Text Available BACKGROUND: Similar clinical appearances prevent accurate diagnosis of two common skin diseases, clavus and verruca. In this study, electrical impedance is employed as a novel tool to generate a predictive model for differentiating these two diseases. MATERIALS AND METHODS: We used 29 clavus and 28 verruca lesions. To obtain impedance parameters, a LCR-meter system was applied to measure capacitance (C, resistance (Re, impedance magnitude (Z, and phase angle (θ. These values were combined with lesion thickness (d to characterize the tissue specimens. The results from clavus and verruca were then fitted to a univariate logistic regression model with the generalized estimating equations (GEE method. In model generation, log ZSD and θSD were formulated as predictors by fitting a multiple logistic regression model with the same GEE method. The potential nonlinear effects of covariates were detected by fitting generalized additive models (GAM. Moreover, the model was validated by the goodness-of-fit (GOF assessments. RESULTS: Significant mean differences of the index d, Re, Z, and θ are found between clavus and verruca (p0.7, the adjusted generalized R2 is 0.512 (>0.3, and the p value of the Hosmer-Lemeshow GOF test is 0.350 (>0.05. CONCLUSIONS: This technique promises to provide an approved model for differential diagnosis of clavus and verruca. It could provide a rapid, relatively low-cost, safe and non-invasive screening tool in clinic use.

  11. Multimodal EEG-MRI in the differential diagnosis of Alzheimer's disease and dementia with Lewy bodies

    Science.gov (United States)

    Colloby, Sean J.; Cromarty, Ruth A.; Peraza, Luis R.; Johnsen, Kristinn; Jóhannesson, Gísli; Bonanni, Laura; Onofrj, Marco; Barber, Robert; O'Brien, John T.; Taylor, John-Paul

    2016-01-01

    Differential diagnosis of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) remains challenging; currently the best discriminator is striatal dopaminergic imaging. However this modality fails to identify 15–20% of DLB cases and thus other biomarkers may be useful. It is recognised electroencephalography (EEG) slowing and relative medial temporal lobe preservation are supportive features of DLB, although individually they lack diagnostic accuracy. Therefore, we investigated whether combined EEG and MRI indices could assist in the differential diagnosis of AD and DLB. Seventy two participants (21 Controls, 30 AD, 21 DLB) underwent resting EEG and 3 T MR imaging. Six EEG classifiers previously generated using support vector machine algorithms were applied to the present dataset. MRI index was derived from medial temporal atrophy (MTA) ratings. Logistic regression analysis identified EEG predictors of AD and DLB. A combined EEG-MRI model was then generated to examine whether there was an improvement in classification compared to individual modalities. For EEG, two classifiers predicted AD and DLB (model: χ2 = 22.1, df = 2, p EEG-MRI model showed greater prediction in AD and DLB (model: χ2 = 31.1, df = 3, p EEG and MRI, and may represent an alternative to dopaminergic imaging. PMID:27060340

  12. Neuroimaging in Parkinsonism: a study with magnetic resonance and spectroscopy as tools in the differential diagnosis

    International Nuclear Information System (INIS)

    The differential diagnosis of Parkinsonism based on clinical features, sometimes may be difficult. Diagnostic tests in these cases might be useful, especially magnetic resonance imaging, a noninvasive exam, not as expensive as positron emission tomography, and provides a good basis for anatomical analysis. The magnetic resonance spectroscopy analyzes cerebral metabolism, yielding inconsistent results in parkinsonian disorders. We selected 40 individuals for magnetic resonance imaging and spectroscopy analysis, 12 with Parkinson's disease, 11 with progressive supranuclear palsy, 7 with multiple system atrophy (parkinsonian type), and 10 individuals without any psychiatric or neurological disorders (controls). Clinical scales included Hoenh and Yahr, unified Parkinson's disease rating scale and mini mental status examination. The results showed that patients with Parkinson's disease and controls presented the same aspects on neuroimaging, with few or absence of abnormalities, and supranuclear progressive palsy and multiple system atrophy showed abnormalities, some of which statistically significant. Thus, magnetic resonance imaging and spectroscopy could be useful as a tool in differential diagnosis of Parkinsonism. (author)

  13. Prostatic Cancer: Diagnosis and Differentiation by Dynamic Contrast-Enhanced MRI

    Institute of Scientific and Technical Information of China (English)

    SHIHao; DINGHongyu; ZHANGGuangying; YANGZhenzhen

    2005-01-01

    Objective: To assess the role of dynamic contrast-enhanced MRI (DCE-MRI) in the diagnosis and differentiation of prostatic cancer (PC). Methods: Five volunteers, 36 patients with benign prostatic hyperplasia (BPH) and 13 patients with biopsy-proven prostate cancer underwent conventional MRI, DCE-MR1 and delayed enhancement MRI. The value of the signal intensity in DCE-MRI was measured and calculated to draw the time-signal intensity curve of the normal peripheral zone (PZ), the prostate cancer and the benign prostatic hyperplasia. Results: In DCE-MRI, the normal peripheral zone was enhanced mildly and slowly and the peak value was located in late phase. The enhancement of the lesions in 36 patients with the benign prostatic hyperplasia was obvious in early phase and strengthened gradually, and then turned to decrease in late phase after peak value. The lesions in 9 of 13 cases with prostate cancer were enhanced obviously in early phase and washed out rapidly, and the peak value was located in early phase, but the peak value was in mediate and late phase in the other 4 cases with diffuse lesion in the prostate on T2WI. Conclusion: In DCE-MRI, the enhancement patterns of the normal peripheral zone,the prostate cancer and the benign prostatic hyperplasia were significantly different. DCE-MRI was very useful in the diagnosis and differentiation of prostate cancer.

  14. Neuroimaging in Parkinsonism: a study with magnetic resonance and spectroscopy as tools in the differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Vasconcellos, Luiz Felipe Rocha [1Hospital dos Servidores do Estado, Rio de Janeiro RJ (Brazil)], e-mail: luizneurol@terra.com.br; Novis, Sergio A. Pereira; Rosso, Ana Lucia Z. [Hospital Universitario Clementino Fraga Filho (HUCFF), Rio de Janeiro, RJ (Brazil); Moreira, Denise Madeira [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Inst. de Neurologia Deolindo Couto; Leite, Ana Claudia C.B. [Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ (Brazil)

    2009-03-15

    The differential diagnosis of Parkinsonism based on clinical features, sometimes may be difficult. Diagnostic tests in these cases might be useful, especially magnetic resonance imaging, a noninvasive exam, not as expensive as positron emission tomography, and provides a good basis for anatomical analysis. The magnetic resonance spectroscopy analyzes cerebral metabolism, yielding inconsistent results in parkinsonian disorders. We selected 40 individuals for magnetic resonance imaging and spectroscopy analysis, 12 with Parkinson's disease, 11 with progressive supranuclear palsy, 7 with multiple system atrophy (parkinsonian type), and 10 individuals without any psychiatric or neurological disorders (controls). Clinical scales included Hoenh and Yahr, unified Parkinson's disease rating scale and mini mental status examination. The results showed that patients with Parkinson's disease and controls presented the same aspects on neuroimaging, with few or absence of abnormalities, and supranuclear progressive palsy and multiple system atrophy showed abnormalities, some of which statistically significant. Thus, magnetic resonance imaging and spectroscopy could be useful as a tool in differential diagnosis of Parkinsonism. (author)

  15. Differential diagnosis of regional cerebral hyperfixation of TC-99m HMPAO on SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Shirazi, P.; Konopka, L.; Crayton, J.W. [Loyola Univ. Medical Center, Maywood, IL (United States)] [and others

    1994-05-01

    Accurate diagnostic evaluation of patients with neurologic and neuropsychiatric disease is important because early treatment may halt disease progression and prevent impairment or disability. Cerebral hyperfixation of HMPAO has been ascribed to luxury perfusion following ischemic infarction. The present study sought to identify other conditions that also display radiotracer hyperfixation in order to develop a differential diagnosis of this finding on SPECT imaging. Two hundred fifty (n=250) successive cerebral SPECT images were reviewed for evidence of HMPAO hyperfixation. Hyperfixation was defined as enhanced focal perfusion surrounded by a zone of diminished or normal cerebral perfusion. All patients were scanned after intravenous injection of 25 mCi Tc-99m HMPAO. Volume-rendered and oblique images were obtained with a Trionix triple-head SPECT system using ultra high resolution fan beam collimators. Thirteen (13/250; 5%) of the patients exhibited regions of HMPAO hyperfixation. CT or MRI abnormalities were detected in 6/13 cases. Clinical diagnoses in these patients included intractable psychosis, post-traumatic stress disorder, alcohol and narcotic dependence, major depression, acute closed-head trauma, hypothyroidism, as well as subacute ischemic infarction. A wide variety of conditions may be associated with cerebral hyperfixation of HMPAO. These conditions include neurologic and psychiatric diagnoses, and extend the consideration of hyperfixation beyond ischemic infarction. Consequently, a differential diagnosis of HMPAO hyperfixation may be broader than originally considered, and this may suggest a fundamental role for local cerebral hyperperfusion. Elucidation of the fundamental mechanism(s) for cerebral hyperperfusion requires further investigation.

  16. MR Cholangiography and Dynamic Examination of Duodenal Fluid in the Differential Diagnosis between Extrahepatic Biliary Atresia and Infantile Hepatitis Syndrome

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    In order to evaluate the value of magnetic resonance cholangiography (MRC) and dynamic examination of duodenal fluid in the differential diagnosis between extrahepatic biliary atresia (EHBA) and infantile hepatitis syndrome (IHS), 52 pa tients with infantile cholestatic jaundice were examined by MRC and duodenal fluid examination. Original interpretations were compared with clinical outcome. Calculated sensitivity of duodenal fluid examination in diagnosis of EHBA was 100%, and specificity was 91.1%. Sensitivity of MRC in the diagnosis of EHBA was 94.4 % and specificity 88.24 %. The sensitivity of MRC and examination of duodenal fluid combined in diagnosis of EHBA was 94.4 % and specificity 97.06 %. We are led to conclude that MRC and dynamic examination of duodenal fluid are useful in the differential diagnosis between IHS and EHBA and the combined use of the two techniques yield better resutls.

  17. Differential diagnosis of usual interstitial pneumonia: when is it truly idiopathic?

    Directory of Open Access Journals (Sweden)

    Wim A. Wuyts

    2014-09-01

    Full Text Available Idiopathic pulmonary fibrosis (IPF, the most common and lethal of the idiopathic interstitial pneumonias, is defined by a radiological and/or pathological pattern of usual interstitial pneumonia (UIP. However, UIP is not synonymous with IPF as other clinical conditions may be associated with UIP, including chronic hypersensitivity pneumonitis, collagen vascular disease, drug toxicity, asbestosis, familial IPF and Hermansky–Pudlak syndrome. Differentiating IPF (“idiopathic UIP” from conditions that mimic IPF (“secondary UIP” has substantial therapeutic and prognostic implications. A number of radiological and histological clues may help distinguish IPF from other conditions with a UIP pattern of fibrosis, but their appreciation requires extensive expertise in interstitial lung disease as well as an integrated multidisciplinary approach involving pulmonologists, radiologists and pathologists. In addition, multidisciplinary discussions may decrease the time to initial IPF diagnosis and, thus, enable more timely management. This concept was strongly emphasised by the 2011 ATS/ERS/JRS/ALAT guidelines. This article highlights, with the aid of a clinical case, the difficulties in making a diagnosis of IPF in clinical practice. Yet, an accurate diagnosis is critical, particularly given the availability of drugs that may reduce the pace of functional decline and disease progression in IPF.

  18. Ground-glass opacity at high resolution CT: an approach for differential diagnosis

    International Nuclear Information System (INIS)

    Purpose: To evaluate the Ground-Glass Opacity in high resolution computed tomography (HRCT) with its underlying abnormality and anatomic distribution and its correlation with different etiologies. Methods: A 38 patients series, (32 men, 16 women, mean age 54,6 years, range 20-28) was retrospectively analyzed. They were evaluated with high resolution computed tomography, 2 mm thick sections and 10 mm of interval. Contrast intravenous iodinated contrast (no-ionic) was injected in 11 patients. The final diagnosis was made with sputum analysis, bronchioalveolar lavage, trans bronchial biopsy and open lung biopsy. Results: The differential diagnosis of ground glass opacity is based on analyzing their anatomic resolution and the underlying pathology in the lung parenchyma. Centrilobular distribution indicated early air-spaces pathology produced in our series by 21 infections, 4 pulmonary hemorrhages, 1 hypersensitivity pneumonitis and 1 descamative interstitial pneumonitis. Panlobular distribution, alveolar proteinosis (1 case) sarcoidosis (1 case) drug toxicity 1 case and one case of pneumocystis carinii. Peripherical distribution typical of early idiopathic fibrosis (1). Bronchiolitis obliterans with organizing pneumonia (1). Structural alterations of the lung parenchyma with bronchiectasias was seen in 16 cases, cystic lesions in 3 cases, sub pleural linear opacities 4 cases, peribronchovascular interstitial thickening or nodularity and emphysema in 10 cases. Conclusion: HRCT is useful to evaluate ground glass opacities pattern with the anatomic distribution and the underlying structural pathology. These findings under some clinical circumstances can suggest a specific diagnosis in most cases, indicating a potentially treatable disease. (author)

  19. A bilobed testicle diagnosed with ultrasound in an 18-year-old boy

    Directory of Open Access Journals (Sweden)

    Farzaneh Hekmatnia

    2016-01-01

    Full Text Available Bilobed testicle is a very rare congenital malformation with an unknown etiology. Herein, we report an 18-year-old boy presented with a right-bilobed testicle mimicking a testicular tumor. The present case highlights the importance of considering bilobed testicle as a valuable differential diagnosis of testicular mass to prevent unnecessary surgery. Furthermore, the case could provide more information about presentation and management of bilobed testicle.

  20. Evidence for juvenile disc herniation in a Homo erectus boy skeleton

    OpenAIRE

    Häusler, Martin; Schiess, Regula; Böni, Thomas

    2013-01-01

    Study Design: An analysis and differential diagnosis of bony alterations in the lower lumbar vertebrae of a Homo erectus boy skeleton. Objective: To analyze low back problems during early human evolution. Summary of Background Data: Back problems in modern humans are often attributed to our upright, bipedal locomotion that is thought to place huge mechanical stresses on the vertebral column. However, little is known of this situation during the course of human evolution. Methods: We analyzed ...

  1. An Investigation of Narrative Ability in Boys with Autism and Fragile X Syndrome

    OpenAIRE

    Hogan-Brown, Abigail L; Losh, Molly; Martin, Gary E.; Mueffelmann, Deborah J.

    2013-01-01

    Whereas pragmatic language difficulties are characteristic of both autism and Fragile X syndrome, it is unclear whether such deficits are qualitatively similar or whether certain skills are differentially affected. This study compared narrative competence in boys with autism, Fragile X syndrome, Down syndrome, and typical development. Results revealed that an interaction between diagnosis and nonverbal mental age predicted narrative microstructure (e.g., complex syntax) but not macrostructure...

  2. Differential MRI Diagnosis Between Brain Abscess and Necrotic or Cystic Brain Tumors Using Diffusion Weighted Images

    Directory of Open Access Journals (Sweden)

    Zinat Miabi

    2009-01-01

    Full Text Available "nIntroduction: Differentiating brain abscesses from cystic or necrotic tumors by CT or MR imaging can be difficult. Difficulties in the diagnosis of intracranial abscess are mainly due to the combination of often unspecified clinical findings and similarities in the morphologic appearance of some intracranial mass lesions, such as cystic gliomas, metastases, and brain abscesses. Diffusion-weighted imaging provides a way to evaluate the diffusion properties of water molecules in tissue and has been used for diseases such as ischemia, tumors, epilepsy, and white matter disorders. The goal of this study was to evaluate the diagnostic utility of diffusion MRI to differentiate between brain abscesses and necrotic or cystic brain tumors. "nMaterials and Methods: MRI was performed in 17 patients (12 men and five women; age range, 19–74 years [mean, 55 years] with necrotic lesions and MR imaging evidence of ring-shaped enhancement after the injection of contrast material .In addition to standard MR sequences diffusion weighted MRI with apparent coefficient (ADC maps. "nResults: Eleven patients had tumors, and six had pyogenic abscesses. The tumors were glioblastomas (five patients, anaplastic astrocytoma (three patients, metastases (three patients, and primary malignancy, including lung (2 and breast (1 cancer. Surgical or stereotactic biopsies were obtained, and histologic studies were performed in all except one case (case 5. In the cases of abscess, bacteriologic analysis was also conducted. None of these lesions appeared hemorrhagic on T1-weighted images. "nConclusion: Diffusion-weighted imaging is useful for differentiating brain abscess from cystic or necrotic brain tumor, which is often difficult with conventional MR imaging. Diffusion-weighted imaging is useful as an additional imaging technique for establishing the differential diagnosis between brain abscesses and cystic or necrotic brain tumors. It requires less imaging time and is more

  3. Differential sialylation of serpin A1 in the early diagnosis of Parkinson's disease dementia.

    Directory of Open Access Journals (Sweden)

    Sarah Jesse

    Full Text Available The prevalence of Parkinson's disease (PD increases with age. Up to 50% of PD show cognitive decline in terms of a mild cognitive impairment already in early stages that predict the development of dementia, which can occur in up to 80% of PD patients over the long term, called Parkinson's disease dementia (PDD. So far, diagnosis of PD/PDD is made according to clinical and neuropsychological examinations while laboratory data is only used for exclusion of other diseases. The aim of this study was the identification of possible biomarkers in cerebrospinal fluid (CSF of PD, PDD and controls (CON which predict the development of dementia in PD. For this, a proteomic approach optimized for CSF was performed using 18 clinically well characterized patients in a first step with subsequent validation using 84 patients. Here, we detected differentially sialylated isoforms of Serpin A1 as marker for differentiation of PD versus PDD in CSF. Performing 2D-immunoblots, all PDD patients could be identified correctly (sensitivity 100%. Ten out of 24 PD patients showed Serpin A1 isoforms in a similar pattern like PDD, indicating a specificity of 58% for the test-procedure. In control samples, no additional isoform was detected. On the basis of these results, we conclude that differentially sialylated products of Serpin A1 are an interesting biomarker to indicate the development of a dementia during the course of PD.

  4. The Value of D-Dimer in Diagnosis of Acute Mesenteric Ischemia and Differential Diagnosis from Acute Pancreatitis and Acute Cholecystitis

    Directory of Open Access Journals (Sweden)

    Semih Hot

    2016-03-01

    Full Text Available Objective: Because of its poor prognosis and high mor­tality rate, early diagnosis of acute mesenteric ischemia (AMI is a challenge. The value of serum markers in the diagnosis of AMI is limited and the studies related with the D-dimer test carried out in recent years. In this prospec­tive study we investigated the value of the level of plasma D-dimer in the diagnosis of AMI and the differential diag­nosis from acute pancreatitis and acute cholecystitis. Methods: We included 89 patients who admitted to our emergency department with abdominal pain. The number and the diagnosis of the patients were 17 AMI, 42 acute pancreatitis and 30 acute cholecystitis, respectively. We measured the levels of plasma D-dimer of all patients by using a latex agglutination ‘immunoassay’ method. Even­tually we calculated the sensitivity and specificity of D-dimer test in the diagnosis of AMI. Results: We determined the specificity of the D-dimer test in the differential diagnosis of AMI as 50% from acute pancreatitis, 70% from acute cholecystitis, 58.3% from all the control group and the sensitivity was 100%. Conclusion: The measurement of plasma D-dimer con­centration may be useful in the differential diagnosis of AMI from acute pancreatitis and acute cholecystitis. How­ever, to reveal the diagnostic value of D-dimer test more clearly, further studies with larger series are needed, where cut-off value is highly defined, and other patients with acute abdominal pain are added into the control group.

  5. Laser Raman detection of platelet as a non-invasive approach for early and differential diagnosis of Alzheimer's disease

    International Nuclear Information System (INIS)

    Early and differential diagnosis of Alzheimer's disease (AD) is a problem that puzzled many doctors. Reliable markers in easy-assembling samples are of considerable clinical diagnostic value. In this work, laser Raman spectroscopy (LRS) was developed a new method that potentially allows early and differential diagnosis of AD from the platelet sample. Raman spectra of platelets isolated from different ages of AD transgenic mice and non-transgenic controls were collected and analyzed. Multilayer perceptron networks (MLP) classification method was used to classify spectra and establish the diagnostic models. For differential diagnosis, spectra of platelets isolated from AD, Parkinson's disease (PD) and vascular dementia (VD) mice were also discriminated. Two notable spectral differences at 740 and 1654 cm-1 were revealed in the mean spectrum of platelets isolated from AD transgenic mice and the controls. MLP displayed a powerful ability in the classifying of early, advanced AD and the control group, and in differential diagnosis of PD and advanced AD, as well as VD and advanced AD. The results suggest that platelet detecting by LRS coupled with MLP analysis appears to be an easy and accurate method for early and differential diagnosis of AD. This technique could be rapidly promoted from laboratory to the hospital

  6. Brucellosis: unusual presentations in two adolescent boys

    International Nuclear Information System (INIS)

    Two boys presented with variable signs and symptoms of infectious disease that challenged diagnosis. One of the two patients had aortic valve vegetations and lower extremity aneurysms, and the other had calvarial osteomyelitis, epidural abscess, pleural effusions, and pulmonary nodules. Only after a battery of bacterial and fungal agglutination tests was the unsuspected diagnosis made in each of brucellosis from Brucella canis. (orig.)

  7. Brucellosis: unusual presentations in two adolescent boys

    Energy Technology Data Exchange (ETDEWEB)

    Piampiano, P.; McLeary, M.; Young, L.W. [Dept. of Radiology, Division of Pediatric Radiology, Loma Linda University Children' s Hospital, Loma Linda, CA (United States); Janner, D. [Div. of Pediatric Infectious Disease, Loma Linda University Medical Center and Children' s Hospital, Loma Linda, CA (United States)

    2000-05-01

    Two boys presented with variable signs and symptoms of infectious disease that challenged diagnosis. One of the two patients had aortic valve vegetations and lower extremity aneurysms, and the other had calvarial osteomyelitis, epidural abscess, pleural effusions, and pulmonary nodules. Only after a battery of bacterial and fungal agglutination tests was the unsuspected diagnosis made in each of brucellosis from Brucella canis. (orig.)

  8. Differential Diagnosis Knowledge Building by Using CUC-C4.5 Framework

    Directory of Open Access Journals (Sweden)

    Kusrini

    2010-01-01

    Full Text Available Problem statement: The Case Based Reasoning (CBR method can be implemented in differential diagnosis analysis. C4.5 algorithm has been commonly used to help the method's knowledge building process. This process is completed by constructing decision tree from previously handled cases data. The C4.5 algorithm itself can be used with an assumption that all the cases has an exact and equal truth value thus have an exact contribution in decision tree building process. However, the decision makers sometimes not sure about the truth of the cases in the cases database, therefore the confidence value can be different for case by case. Besides that, the C4.5 algorithm can only handle cases that are stored in a flat table with data in form of categorized text or in discrete class. This algorithm has not yet explained about how is decision tree building mechanism in situation when the data are stored in relational tables. It also has not yet explained about the process of knowledge building when the data are in the form of number in continuous class. Meanwhile, the observed objects in this research, that is medical record data, are mostly stored in a complex relational database and have common form of categorized text, discrete number, continuous number and image. Therefore, the C4.5 is needed to be improved so it can handle decision building for cases database of medical record. Approach: We develop a knowledge building framework that can handle confidence level difference of cases in cases database. The framework we build also allows the data are stored in relational database. Moreover, our framework can process data in the form of categorized text, discrete number, continuous number and image. This framework is named CUC-C4.5, abbreviated from Complex Uncertain Case C4.5 as it is the improvement from C4.5 algorithm. Results: The CUC-C4.5 framework has been applied on the case of differential diagnosis knowledge building in a group decision support system

  9. Can Quantitative Muscle Strength and Functional Motor Ability Differentiate the Influence of Age and Corticosteroids in Ambulatory Boys with Duchenne Muscular Dystrophy?

    Science.gov (United States)

    Buckon, Cathleen; Sienko, Susan; Bagley, Anita; Sison-Williamson, Mitell; Fowler, Eileen; Staudt, Loretta; Heberer, Kent; McDonald, Craig M.; Sussman, Michael

    2016-01-01

    Background: In the absence of a curative treatment for Duchenne Muscular Dystrophy (DMD), corticosteroid therapy (prednisone, deflazacort) has been adopted as the standard of care, as it slows the progression of muscle weakness and enables longer retention of functional mobility. The ongoing development of novel pharmacological agents that target the genetic defect underlying DMD offer hope for a significant alteration in disease progression; however, substantiation of therapeutic efficacy has proved challenging. Identifying functional outcomes sensitive to the early, subtle changes in muscle function has confounded clinical trials. Additionally, the alterations in disease progression secondary to corticosteroid therapy are not well described making it difficult to ascertain the benefits of novel agents, often taken concurrently with corticosteroids. Objective: The purpose of this study was to examine outcome responsiveness to corticosteroid therapy and age at the onset of a natural history study of ambulatory boys with DMD. Methods: Eighty-five ambulatory boys with DMD (mean age 93 mo, range 49 to 180 mo) were recruited into this study. Fifty participants were on corticosteroid therapy, while 33 were corticosteroid naïve at the baseline assessment. Within each treatment group boys were divided in two age groups, 4 to 7 years and 8 and greater years of age. The Biodex System 3 Pro isokinetic dynamometer was used to assess muscle strength. Motor skills were assessed using the upper two dimensions (standing/walking, running & jumping) of the Gross Motor Function Measure (GMFM 88) and Timed Motor Tests (TMTs) (10-meter run, sit to stand, supine to stand, climb 4-stairs). Two way analysis of variance and Pearson correlations were used for analysis. Results: A main effect for age was seen in select lower extremity muscle groups (hip flexors, knee extensors and ankle dorsiflexors), standing dimension skills, and all TMTs with significantly greater weakness and loss of

  10. Differential protein profiling as a potential multi-marker approach for TSE diagnosis

    Directory of Open Access Journals (Sweden)

    Hogarth Caroline

    2009-11-01

    Full Text Available Abstract Background Transmissible spongiform encephalopathy describes a family of diseases affecting both man and animals. Current tests for the diagnosis of these diseases are based on the detection of an abnormal misfolded form of the host protein PrP which is found within the central nervous and lymphoreticular systems of affected animals. Recently, concern that this marker may not be as reliable as previously thought, coupled with an urgentneed for a pre-clinical live animal test, has led to the search for alternative assays for the detection of TSE disease. Methods This "proof of concept" study, examines the use of differential protein expression profiling using surface enhanced laser desorption and ionisationtime of flight mass spectrometry (SELDI-TOF for the diagnosis of TSE disease. Spectral output from all proteins selectively captured from individual murine brain homogenate samples, are compared as "profiles" in groups of infected and non-infected animals. Differential protein expression between groups is thus highlighted and statistically significant protein "peaks" used to construct a panel of disease specific markers. Studies at both terminal stages of disease and throughout the time course of disease have shown a disease specific protein profile or "disease fingerprint" which could be used to distinguish between groups of TSE infected and uninfected animals at an early time point of disease. Results Our results show many differentially expressed proteins in diseased and control animals, some at early stages of disease. Three proteins identified by SELDI-TOF analysis were verified by immunohistochemistry in brain tissue sections. We demonstrate that by combining the most statistically significant changes in expression, a panel of markers can be constructed that can distinguish between TSE diseased and normal animals. Conclusion Differential protein expression profiling has the potential to be used for the detection of disease in TSE

  11. Recurrent eccrine hidradenoma of the breast in a male patient: problems in differential diagnosis

    Directory of Open Access Journals (Sweden)

    Maria Orsaria

    2013-04-01

    Full Text Available Introduction: Hidradenoma is an uncommon usually benign tumor of the skin that grows slowly.Case presentation: We describe a case of a 39 patient with a breast mass. Physical examination revealed a solitary, well-circumscribed tumor, measuring 1 cm by 0.7 cm. No other skin abnormalities were found. A total surgical excision was performed and histologic examination concluded to an eccrine hidradenoma with clear cells.Conclusion: Here we discuss problems in the differentiate this tumor, mainly in this not common location, from a breast primary (ductal carcinoma or adenomyoepitelioma, from a metastatic clear cell carcinoma and from other types of skin tumors. Moreover, this patient presented with a recurrence of the tumor in the same location, suggesting a locally aggressive form of this neoplasia; few reports in the literature are described as at low malignant potential, but definite criteria for this diagnosis are not well defined.

  12. Clear cell myoepithelioma of palate with emphasis on clinical and histological differential diagnosis.

    Science.gov (United States)

    Nair, Bindu J; Vivek, Velayudhannair; Sivakumar, Trivandrum T; Joseph, Anna P; Varun, Babyamma Raghavanpillai; Mony, Vinod

    2014-03-27

    Myoepitheliomas account for less than 1% of all salivary gland tumors and mostly occur in the parotid gland and palate. A 58-year old male patient reported to the Outpatient Department of PMS College of Dental Science and Research (Kerala, India) with a slow growing painless swelling on the palate for 4 years. Pleomorphic adenoma, basal cell adenoma, myoepithelioma, cyst adenoma, lipoma, neurofibroma, neurilemmoma and leiomyoma were considered. Histopathology revealed a thinly encapsulated tumor composed mainly of sheets of clear cells mixed with cells having eosinophilic cytoplasm. Histopathological differential diagnosis included pleomorphic adenoma, oncocytoma, oncocytic hyperplasia, sebaceous adenoma, malignant salivary gland neoplasms and metastatic lesions from kidney and thyroid. Myoepitheliomas mostly occur in the parotid gland and palatal region and various histological types of myoepithelioma are described. Myoepitheliomas of the palate are rare with clear cell variant even rarer.

  13. Differential diagnosis of dumbbell lesions associated with spinal neural foraminal widening: Imaging features

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    Kivrak, Ali Sami [Selcuk University, Meram Medical Faculty, Department of Radiology, 42080 Konya (Turkey)], E-mail: alisamikivrak@hotmail.com; Koc, Osman; Emlik, Dilek; Kiresi, Demet; Odev, Kemal [Selcuk University, Meram Medical Faculty, Department of Radiology, 42080 Konya (Turkey); Kalkan, Erdal [Selcuk University, Meram Medical Faculty, Department of Neurosurgery, Konya (Turkey)

    2009-07-15

    Computed tomography (CT) and magnetic resonance imaging (MRI) reliably demonstrate typical features of schwannomas or neurofibromas in the vast majority of dumbbell lesions responsible for neural foraminal widening. However, a large variety of unusual lesions which are causes of neural foraminal widening can also be encountered in the spinal neural foramen. Radiologic findings can be helpful in differential diagnosis of lesions of spinal neural foramen including neoplastic lesions such as benign/malign peripheral nerve sheath tumors (PNSTs), solitary bone plasmacytoma (SBP), chondroid chordoma, superior sulcus tumor, metastasis and non-neoplastic lesions such as infectious process (tuberculosis, hydatid cyst), aneurysmal bone cyst (ABC), synovial cyst, traumatic pseudomeningocele, arachnoid cyst, vertebral artery tortuosity. In this article, we discuss CT and MRI findings of dumbbell lesions which are causes of neural foraminal widening.

  14. [Chondromyxoid fibroma. Morphological variations, site, incidence, radiologic criteria and differential diagnosis].

    Science.gov (United States)

    Engels, C; Priemel, M; Möller, G; Werner, M; Delling, G

    1999-07-01

    Chondromyxoid fibroma is a rare benign bone tumor, accounting for less than 1% of all bone tumors. The peak age incidence is the second and third decade of life. Chondromyxoid fibrom occurs in the metaphyseal parts of the major tubular bones, predominantly of the lower extremity. Roentgenograms show, in most cases, a well-demarcated radiolucent lesion. The classic histological feature of a chondromyxoid fibroma is stellate or spindle-shaped cells arranged in lobules in a myxoid or chondroid background. Analysis of 40 chondromyxoid fibromas demonstrates the morphological variation of this tumor. Cases were examined for age distribution, localization, and radiological and histological features. In 85% we found the typical histomorphological pattern. Recurrence rate was 12.5%. In four cases the appearance was uncharacteristic and differentiation from other tumors such as chondroblastoma or chondrosarcoma was quite difficult. By adhering to strict histomorphological criteria, definite diagnosis of chondromyxoid fibroma can be made in most cases. PMID:10478364

  15. Polymerase chain reaction (PCR) for rapid diagnosis and differentiation of parapoxvirus and orthopoxvirus infections in camels

    International Nuclear Information System (INIS)

    Rapid identification and differentiation of camel pox (CMP) and camel contagious ecthyma (CCE) were achieved by polymerase chain reaction (PCR) with primers that distinguish Orthopoxvirus (OPV) and Parapovirus (PPV). Forty scab specimens collected from sick camels and sheep were treated by 3 different DNA extraction procedures and examined by PCR. The sensitivity of the PCR was compared with that of electron microscopy and virus isolation in cell culture. Procedure 1, in which viral DNA was extracted directly from scab specimens followed by PCR, proved to be superior and more sensitive. Procedure 2 enables a fast specific diagnosis of PPV and OPV infections directly from scab materials without the need for DNA extraction. These assays provide a rapid and feasible alternative to electron microscopy and virus isolation. (author)

  16. Maxillary sinusitis as a differential diagnosis in temporomandibular joint pain-dysfunction syndrome.

    Science.gov (United States)

    Rihani, A

    1985-01-01

    Maxillary sinusitis may be diagnosed incorrectly as TMJ pain-dysfunction syndrome because of a similarity of signs and symptoms. Both conditions can manifest with headache, facial pain radiating to the ear and the maxillary teeth, preauricular pain, and pain in the buccal vestibule posterior and superior to the maxillary tuberosity. It can be concluded that (1) more consideration should be given to sinus disturbances as a differential diagnosis in TMJ pain-dysfunction syndrome, (2) it may be preferable to refer some patients with TMJ pain to a medical center where specialists in dentistry, otolaryngology, neurology, rheumatology, and psychiatry can evaluate the patient, and (3) TMJ pain-dysfunction syndrome should be evaluated and treated by a dentist experienced in management of this disorder. PMID:3856028

  17. Role of nuclear medicine imaging in differential diagnosis of accessory spleens in patients after splenectomy

    International Nuclear Information System (INIS)

    More than 10% of healthy population has one or more accessory spleens. The most common location is the hilum of the spleen or area near the tail of the pancreas. The radiological appearance of accessory spleens in oncologic patients who underwent splenectomy can be misinterpreted as a recurrence, especially in the case of compensatory growth of an accessory spleen in successive radiological examinations. We present the cases of three patients who underwent splenectomy for gastric carcinoid, gastric adenocarcinoma and cancer of the left adrenal gland, respectively. CT examination and/or PET-CT scan revealed suspicious findings in the left upper abdomen. In one patient, the dimensional increase of this finding in successive examinations was initially considered suggestive for cancer recurrence. Scintigraphy with 99mTc-nanocolloid was able to confirm the presence of an accessory spleen in all these patients. Splenic scintigraphy is an economical, accessible and accurate tool in differential diagnosis of accessory spleens in patients after splenectomy

  18. Differential diagnosis of breast cancer using quantitative, label-free and molecular vibrational imaging.

    Science.gov (United States)

    Yang, Yaliang; Li, Fuhai; Gao, Liang; Wang, Zhiyong; Thrall, Michael J; Shen, Steven S; Wong, Kelvin K; Wong, Stephen T C

    2011-08-01

    We present a label-free, chemically-selective, quantitative imaging strategy to identify breast cancer and differentiate its subtypes using coherent anti-Stokes Raman scattering (CARS) microscopy. Human normal breast tissue, benign proliferative, as well as in situ and invasive carcinomas, were imaged ex vivo. Simply by visualizing cellular and tissue features appearing on CARS images, cancerous lesions can be readily separated from normal tissue and benign proliferative lesion. To further distinguish cancer subtypes, quantitative disease-related features, describing the geometry and distribution of cancer cell nuclei, were extracted and applied to a computerized classification system. The results show that in situ carcinoma was successfully distinguished from invasive carcinoma, while invasive ductal carcinoma (IDC) and invasive lobular carcinoma were also distinguished from each other. Furthermore, 80% of intermediate-grade IDC and 85% of high-grade IDC were correctly distinguished from each other. The proposed quantitative CARS imaging method has the potential to enable rapid diagnosis of breast cancer.

  19. Spontaneous subarachnoid hemorrhage as a differential diagnosis of pre-hospital cardiac arrest

    Directory of Open Access Journals (Sweden)

    Sohil Pothiawala

    2012-01-01

    Full Text Available Spontaneous subarachnoid hemorrhage is the most common neurological disorder leading to pre-hospital cardiac arrest. ECG changes in SAH may mimic myocardial infarction or ischemia, and thus lead to delayed treatment of the primary problem. Early identification of SAH-induced cardiac arrest with the use of computed tomography scan of the brain obtained immediately after resuscitation will aid emergency physicians make further decisions. The overall prognosis of patients who are resuscitated is extremely poor. But, prompt neurosurgical referral and multidisciplinary intensive care management can improve the survival rate and the functional outcome. Thus, physicians should consider SAH as a differential diagnosis in patients presenting with pre-hospital cardiac arrest.

  20. Capillaroscopy in Psoriatic and Rheumatoid Arthritis: A Useful Tool for Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Dario Graceffa

    2013-01-01

    Full Text Available Impairment of capillaries permeability and changes of microcirculation are associated with inflammatory arthritis. In order to demonstrate microvascular differences between psoriatic arthritis (PsA and rheumatoid arthritis (RA we analyzed capillaroscopic abnormalities such as megacapillaries, haemorrhages, ramifications, and avascular areas in patients affected by these two rheumatic disorders. Moreover to identify specific capillaroscopy patterns we analyzed the following parameters: venous limb diameter, arterial limb diameter, capillary loop diameter, amplitude of the capillary loop, linear density of capillaries (on 2 mm, and number of twisted capillaries (on 4 mm. Through a comparative morphometric analysis of capillaroscopy, our study demonstrated the presence of specific microvascular differences between PsA and RA providing an additional diagnostic tool for the differential diagnosis. We also suggest that capillaries structural abnormalities might reflect endothelial injury due to systemic inflammation during chronic arthritis.

  1. Immunohistochemistry applied to the differential diagnosis between ductal and lobular carcinoma of the breast.

    Science.gov (United States)

    de Deus Moura, Rafael; Wludarski, Sheila C L; Carvalho, Filomena M; Bacchi, Carlos E

    2013-01-01

    The distinction between classic lobular and ductal carcinoma, both in situ and invasive, has important therapeutic and management implications. Most ductal and lobular carcinomas are distinguished readily on hematoxylin-eosin-stained sections because of distinct histomorphologic features. In cases with ambiguous morphologic features, however, categorization in one or another type can be a challenge. Several immunohistochemical markers, including epithelial cadherin, p120, β-catenin, and low-molecular-weight and high-molecular-weight cytokeratins among others, have been introduced to help better discriminate between lobular neoplasia and ductal carcinoma. In this critical review of the literature, we comment about the usefulness and the limitations of these markers to improve the accuracy in the differential diagnosis of breast pathology.

  2. A rare differential diagnosis to occupational neck pain: bilateral stylohyoid syndrome

    Directory of Open Access Journals (Sweden)

    Vogel Tobias

    2006-06-01

    Full Text Available Abstract Chronic neck pain is widely prevalent and a common source of disability in the working-age population. Etiology of chronic neck pain includes neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain as well as pain due to degenerative changes. We report the case of a 42 year old secretary, complaining about a longer history of neck pain and limited movement of the cervical spine. Surprisingly, the adequate radiologic examination revealed a bilateral ossification of the stylohyoid ligament complex. Her symptoms remained intractable from conservative treatment consisting of anti-inflammatory medication as well as physical therapy. Hence the patient was admitted to surgical resection of the ossified stylohyoid ligament complex. Afterwards she was free of any complaints and went back to work. Therefore, ossification of the stylohyoid ligament complex causing severe neck pain and movement disorder should be regarded as a rare differential diagnosis of occupational related neck pain.

  3. A rare differential diagnosis to occupational neck pain: bilateral stylohyoid syndrome.

    Science.gov (United States)

    Kirchhoff, Gertrud; Kirchhoff, Chlodwig; Buhmann, Sonja; Kanz, Karl-Georg; Lenz, Miriam; Vogel, Tobias; Kichhoff, Rainer Maria

    2006-06-26

    Chronic neck pain is widely prevalent and a common source of disability in the working-age population. Etiology of chronic neck pain includes neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain as well as pain due to degenerative changes. We report the case of a 42 year old secretary, complaining about a longer history of neck pain and limited movement of the cervical spine. Surprisingly, the adequate radiologic examination revealed a bilateral ossification of the stylohyoid ligament complex. Her symptoms remained intractable from conservative treatment consisting of anti-inflammatory medication as well as physical therapy. Hence the patient was admitted to surgical resection of the ossified stylohyoid ligament complex. Afterwards she was free of any complaints and went back to work. Therefore, ossification of the stylohyoid ligament complex causing severe neck pain and movement disorder should be regarded as a rare differential diagnosis of occupational related neck pain.

  4. Differential diagnosis of orf viruses by a single-step PCR.

    Science.gov (United States)

    Chan, Kun-Wei; Hsu, Wei-Li; Wang, Chi-Young; Yang, Cheng-Hsiung; Lin, Fong-Yuan; Chulakasian, Songkhla; Wong, Min-Liang

    2009-09-01

    The complete nucleotide sequence of the A32L gene (named after vaccinia virus, corresponding with open reading frame 108 of the orf virus and encoding an ATPase) of the orf virus was studied using samples of orf virus from infected goats, which were collected from six outbreaks in central Taiwan. DNA sequence analysis of the A32L genes of these and isolates from other countries showed sequence heterogeneity (base pair variation and deletion) in the 3'-terminal regions. This finding led to the development of a polymerase chain reaction (PCR) method for the rapid differential diagnosis of orf virus infections, and the results demonstrated that this was an easy and reliable method for genotyping of orf viruses.

  5. Multimodal EEG-MRI in the differential diagnosis of Alzheimer's disease and dementia with Lewy bodies.

    Science.gov (United States)

    Colloby, Sean J; Cromarty, Ruth A; Peraza, Luis R; Johnsen, Kristinn; Jóhannesson, Gísli; Bonanni, Laura; Onofrj, Marco; Barber, Robert; O'Brien, John T; Taylor, John-Paul

    2016-07-01

    Differential diagnosis of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) remains challenging; currently the best discriminator is striatal dopaminergic imaging. However this modality fails to identify 15-20% of DLB cases and thus other biomarkers may be useful. It is recognised electroencephalography (EEG) slowing and relative medial temporal lobe preservation are supportive features of DLB, although individually they lack diagnostic accuracy. Therefore, we investigated whether combined EEG and MRI indices could assist in the differential diagnosis of AD and DLB. Seventy two participants (21 Controls, 30 AD, 21 DLB) underwent resting EEG and 3 T MR imaging. Six EEG classifiers previously generated using support vector machine algorithms were applied to the present dataset. MRI index was derived from medial temporal atrophy (MTA) ratings. Logistic regression analysis identified EEG predictors of AD and DLB. A combined EEG-MRI model was then generated to examine whether there was an improvement in classification compared to individual modalities. For EEG, two classifiers predicted AD and DLB (model: χ(2) = 22.1, df = 2, p < 0.001, Nagelkerke R(2) = 0.47, classification = 77% (AD 87%, DLB 62%)). For MRI, MTA also predicted AD and DLB (model: χ(2) = 6.5, df = 1, p = 0.01, Nagelkerke R(2) = 0.16, classification = 67% (77% AD, 52% DLB). However, a combined EEG-MRI model showed greater prediction in AD and DLB (model: χ(2) = 31.1, df = 3, p < 0.001, Nagelkerke R(2) = 0.62, classification = 90% (93% AD, 86% DLB)). While suggestive and requiring validation, diagnostic performance could be improved by combining EEG and MRI, and may represent an alternative to dopaminergic imaging. PMID:27060340

  6. Differential diagnosis between Alzheimer's disease and dementia with Lewy bodies with DaTSCAN SPECT

    International Nuclear Information System (INIS)

    Aim. Dementia with Lewy bodies (DLB) is the second commonest cause of neuro degenerative dementia after dementia of the Alzheimer's type (DAT). Clinical misdiagnosis between the 2 diseases are frequent. Therefore we tested the hypothesis proposed by Walker Costa et al. that specific D2 dopaminergic degeneration in DLB could be demonstrated by SPECT imaging to make this differential diagnosis. We used DaTSCAN (123I-Ioflupane). Materials and methods. We prospectively currently included 7 patients. MMSE scores range from 18 to 24 (mean 21). DAT diagnosis was made on DSMIV criteria and DLB on international consensus criteria 96-97 (Mc Keith et al.). All patients underwent the following tests: UPDRS, Grober and Buschke memory test, one day fluctuation assessment and NPI scoring. Four patients were diagnosed as DLB and 3 as DAT. They underwent MRI and DaTSCAN SPECT. SPECT acquisition were performed 4 to 5 hours after the injection of 185 MBq of 123I-Ioflupane. We used a 3 headed Prism 3000 XP camera equipped with very high resolution low energy fan beam collimators. Images were evaluated visually and by measurement of the binding potential (BP). BP was measured by regions of interest: one (9x9 pixels) was placed on the caudate nucleus (CN) and the other (34 x 34 pixels) over the occipital area (OC) (unspecific binding). BP was calculated as BP= (CN-OC)/OC. Results. All 3 DAT patients had visually normal DaTSCAN striatal uptake and BP values ranged from 4,1 to 5,1. In all DLB patients, striatal uptake was significantly reduced with visually dramatic reduction of putamen uptake. BP values ranged from 1,4 to 2,9. Conclusion. On these preliminary results we obtained a clear separation, with no overlap, between DAT and DLB patients. These data confirm that DaTSCAN SPECT is able to demonstrate in vivo specific dopaminergic degeneration in DLB. It can be used to differentiate DLB from DAT

  7. The usefulness of diffusion weighted imaging in the differential diagnosis of various intracranial cystic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ihn, Yon Kwon; Jun, Jeong Su; Hwang, Seong Su; Baik, Jun Hyun; Park, Young Ha [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2004-06-01

    The purpose of this study was to evaluate the usefulness of diffusion-weighted imaging (DWI) for the differential diagnosis of various intracranial cystic lesions. This study included 19 patients (13 males, 6 females) with a mean age of 42.5 years. The final histopathological diagnoses for 14 patients were pyogenic brain abscess (n=3), glioblastoma (n=3), ependymoma (n=1), anaplastic astrocytoma (n=1), pilocytic astrocytoma (n=1), hemangioblastoma (n=2), arachnoid cyst (n=1), epidermoid (n=1) and schwannoma (n=1). The other cases of metastasis (n=4) and arachnoid cyst (n=2) were diagnosed on the basis of clinical, laboratory and imaging data. DWI imaging studies were performed with a 1.5 T MR system. A single shot spin echo EPI pulse sequence was applied. B values were set at 0 and 1000 sec/mm{sup 2}. The apparent diffusion coefficient (ADC) were calculated from the ADC map of 10 different cystic brain lesions. Conventional MR imaging included T2WI, T1WI, FLAIR and contrast enhanced T1WI. We analyzed the location, nature, signal intensity on DWI, and the enhancement pattern of the lesions. All of the 3 cases of brain abscess, 1 of 4 cases of metastasis and 1 case of epidermoid showed hyperintensity on DWI. The mean ADC value of brain abscess (2 cases) was less than 1.15 (0.13x10{sup -3} mm{sup 2}/s). The mean ADC values of the other cystic lesions (8 cases) were variable, ranging from 2.840.66 to 3.100.16 (10{sup -3} mm{sup 2}/sec). DWI and ADC values were useful in the differential diagnosis of various intracranial cystic lesions, but some metastatic tumors may mimic a brain abscess on DWI. Therefore, a clinical correlation is mandatory.

  8. Multimodal EEG-MRI in the differential diagnosis of Alzheimer's disease and dementia with Lewy bodies

    Science.gov (United States)

    Colloby, Sean J.; Cromarty, Ruth A.; Peraza, Luis R.; Johnsen, Kristinn; Jóhannesson, Gísli; Bonanni, Laura; Onofrj, Marco; Barber, Robert; O'Brien, John T.; Taylor, John-Paul

    2016-01-01

    Differential diagnosis of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) remains challenging; currently the best discriminator is striatal dopaminergic imaging. However this modality fails to identify 15–20% of DLB cases and thus other biomarkers may be useful. It is recognised electroencephalography (EEG) slowing and relative medial temporal lobe preservation are supportive features of DLB, although individually they lack diagnostic accuracy. Therefore, we investigated whether combined EEG and MRI indices could assist in the differential diagnosis of AD and DLB. Seventy two participants (21 Controls, 30 AD, 21 DLB) underwent resting EEG and 3 T MR imaging. Six EEG classifiers previously generated using support vector machine algorithms were applied to the present dataset. MRI index was derived from medial temporal atrophy (MTA) ratings. Logistic regression analysis identified EEG predictors of AD and DLB. A combined EEG-MRI model was then generated to examine whether there was an improvement in classification compared to individual modalities. For EEG, two classifiers predicted AD and DLB (model: χ2 = 22.1, df = 2, p MTA also predicted AD and DLB (model: χ2 = 6.5, df = 1, p = 0.01, Nagelkerke R2 = 0.16, classification = 67% (77% AD, 52% DLB). However, a combined EEG-MRI model showed greater prediction in AD and DLB (model: χ2 = 31.1, df = 3, p < 0.001, Nagelkerke R2 = 0.62, classification = 90% (93% AD, 86% DLB)). While suggestive and requiring validation, diagnostic performance could be improved by combining EEG and MRI, and may represent an alternative to dopaminergic imaging. PMID:27060340

  9. [Differential diagnosis in "undifferentiated" inflammatory diseases and dyskinesias of the large intestine].

    Science.gov (United States)

    Peleshchuk, A P; Revenok, K M

    2001-01-01

    The majority of foreign gastroenterologists have their doubts whether there exist "undifferentiated" colitisis. They consider these to be a variant of the irritable bowel syndrome. We have examined 173 patients. Of these, 67 percent were less than 45 years of age with significant intestinal disorders caused by chronic colitis. Diagnosis of Crohn's disease and nonspecific ulcerative colitis had been excluded. The main complaints of the patients were constipations alternated sometimes with short-time diarrhea (61%), diarrhea (13%), spasmodic pains in the inferior parts of the abdomen (20%), abdominal distention, and rumbling (74%). In 79% there was tenderness in the sygmoid colon and caecum and spasm thereof. Rectoromanoscopy (RRS) revealed normal mucosa of the rectum and sygmoid colon in 70%, proctosygmoiditis (predominantly catarrhal) in 30 percent of cases. In proctosygmoiditis (vs the normal mucosa) motor dysfunctions, disorders of the contrast mass passage through the intestine, gaustrations were more often seen but the relief of the mucosa was intact. Results of morphological investigations of biopsy specimens of rectal and sygmoidal mucosas were compared with endoscopy findings. No histological changes were revealed in 23% patients with proctosygmoiditis whereas in cases of endoscopically normal mucosa moderate inflammation was rarely detectable. Inflammatory changes in the mucosa were to be seen more frequently by cytologic analysis than by biopsy but more rarely than by RRS. In this way, 25% patients with endoscopical diagnosis of proctosygmoiditis had normal cytological picture. The increased amount of intestinal enzymes (enterokynase, alkaline phosphatase) in stools does not permit differentiating the functional and organic types of the disease, but it significantly contributes to endoscopical, morphological, cytological, and clinical data. Our investigations show that "undifferentiated" colitis is a rarity and that one finds difficulty in differentiating

  10. A controlled study of positron-emission-tomography and positron-emission-tomography/computed tomography in differential diagnosis of solitary pulmonary nodules-report of 60 cases

    Institute of Scientific and Technical Information of China (English)

    DING Qi-yong; HUA Yan-qing; ZHANG Guo-zhen; ZHAO Jun; GUAN Yi-hui; GE Xiao-jun; MAO Ding-biao; ZUO Chuan-tao

    2005-01-01

    @@ The differential diagnosis of solitary pulmonary nodules (SPNs) remains a challenge. It is acknowledged that combining positron-emission tomography (PET) and computed tomography (CT) offers the most reliable noninvasive method for the diagnosis of SPNs.

  11. Radiological differential diagnosis of rheumatoid arthritis; Radiologische Differenzialdiagnose der rheumatoiden Arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Wick, M.C.; Klauser, A.S. [Medizinische Universitaet Innsbruck, Department Radiologie, Innsbruck (Austria)

    2012-02-15

    Establishing an early and reliable diagnosis of rheumatoid arthritis (RA) is of major importance but can be a great clinical challenge leading to direct therapeutic consequences. No single epidemiological, genetic, clinical, serological or radiological test exists which can exclusively diagnose RA. In general diagnosis of RA includes a case history, clinical signs, laboratory abnormalities and radiological examinations, viz. conventional radiography of the joints of the hands and feet. This review summarizes the most important radiological features of RA and the radiological findings of its closest differential diagnoses. (orig.) [German] Eine fruehe Diagnosestellung bei rheumatoider Arthritis (RA) stellt eine grosse klinische Herausforderung dar, da sich daraus unmittelbare therapeutische Konsequenzen ableiten. Es gibt keinen epidemiologischen, genetischen, klinischen, serologischen oder radiologischen Test, mit dessen alleiniger Anwendung die Diagnose der RA definitiv gestellt werden kann. Die Diagnose der RA erfolgt durch die Kombination von Patientenanamnese, klinischen Zeichen und serologischen Biomarkern in Zusammenschau mit der radiologischen Diagnostik, allen voran der Anwendung konventioneller Roentgenbilder der Haende und Fuesse. In diesem Uebersichtsartikel werden die wichtigsten radiologischen Merkmale zur Diagnose der RA und der diagnostisch haeufigsten Differenzialerkrankungen dargestellt. (orig.)

  12. Rare Solid Tumors of the Pancreas as Differential Diagnosis of Pancreatic Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Sabine Kersting

    2012-05-01

    Full Text Available Context Rare solid tumors of the pancreas can be misinterpreted as primary pancreatic cancer. Objective The aim of this study was to report our experience in the treatment of patients with rare tumor lesions of the pancreas and to discuss clinical and pathological characteristics in the context of the role of surgery. Design Data from patients of our prospective data-base with rare benign and malignant tumors of the pancreas, treated in our division from January 2004 to August 2010, were analyzed retrospectively. Results One-thousand and ninety-eight patients with solid tumors of the pancreas underwent pancreatic surgery. In 19 patients (10 women, 9 men with a mean age of 57 years (range: 20-74 years rare pancreatic tumors (metastasis, solid pseudopapillary tumor, teratoma, hemangioma, accessory spleen, lymphoepithelial cyst, hamartoma, sarcoidosis, yolk sac tumor were the reason for surgical intervention. Conclusion If rare benign and malignant pancreatic tumors, intrapancreatic metastasis, as well as pancreatic malformations or other abnormalities, present themselves as solid masses of the pancreas, they constitute an important differential diagnosis to primary pancreatic neoplasia, e.g. pancreatic ductal adenocarcinoma. Clinical imaging techniques cannot always rule out malignancy, thus operative exploration often remains the treatment of choice to provide the correct diagnosis and initiate adequate surgical therapy.

  13. Value of ultrasound examination in differential diagnosis of pancreatic lymphoma and pancreatic cancer

    Institute of Scientific and Technical Information of China (English)

    Li Qiu; Yan Luo; Yu-Lan Peng

    2008-01-01

    AIM:To investigate the value of clinical manifestations and ultrasound examination in the differential diagnosis of pancreatic lymphoma and pancreatic cancer.METHODS:The clinical and ultrasonic characteristics of 12 cases of pancreatic lymphoma and 30 cases of pancreatic cancer were retrospectively analyzed.RESULTS:Statistically significant differences were found in the course of disease,back pain,jaundice,carcino-embryonic antigen (CEA) and CA19-9 increase,palpable abdominal lump,superficial lymph node enlargement,fever and night sweats,lesion size,bile duct expansion,pancreatic duct expansion,vascular involvement,retroperitoneal (below the renal vein level)lymph node enlargement,and intrahepatic metastasis between pancreatic lymphoma and pancreatic cancer.There were no significant differences in age of onset,gender ratio,weight loss,nausea and vomiting,lesion position,the echo of the lesion,and the blood flow of the lesion.CONCLUSION:Pancreatic lymphoma should be considered for patients with long lasting symptoms,superficial lymph node enlargement,palpable abdominal lump,fever and night sweats,relatively large lesions,and retroperitoneal (below the level of the renal vein) lymph node enlargement.A diagnosis of pancreatic cancer should be considered more likely in the patients with relatively short disease course,jaundice,back pain,CEA and CA19-9 increase,relatively small lesions,bile duct expansion,obvious pancreatic duct expansion,peripheral vascular wrapping and involvement,or intrahepatic metastases.

  14. Lymph Node Thyroglobulin Measurement in Diagnosis of Neck Metastases of Differentiated Thyroid Carcinoma

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    Luca Giovanella

    2011-01-01

    Full Text Available Aim. Enlarged cervical lymph nodes (LNs in patients with thyroid cancer are usually assessed by fine-needle aspiration cytology (FNAC. Thyroglobulin (Tg is frequently elevated in malignant FNAC needle wash specimens (FNAC-Tg. The objectives of the study were to (1 determine an appropriate diagnostic cut-off for FNAC-Tg levels (2 compare FNAC and FNAC-Tg results in a group of 108 patients affected by differentiated thyroid carcinoma (DTC. Methods. A total of 126 consecutive FNACs were performed on enlarged LNs and the final diagnosis was confirmed by surgical pathology examination or clinical follow-up. The best FNAC-Tg cut-off level was selected by receiver operating curve analysis, and diagnostic performances of FNAC and FNAC-Tg were compared. Results. The rate of FNAC samples adequate for cytological examination was 77% in contrast FNAC-Tg available in 100% of aspirates (<.01. The sensitivity, specificity, and accuracy of FNAC were 71%, 80%, 74%, 100%, 80%, and 94%, respectively. The most appropriate cut-off value for the diagnosis of thyroid cancer metastatic LN was 1.1 ng/mL (sensitivity 100%, specificity 100%. Conclusions. The diagnostic performance of needle washout FNAC-Tg measurement with a cut-off of 1.1 ng/mL compared favorably with cytology in detecting DTC node metastases.

  15. Differential diagnosis of white matter diseases in the tropics: An overview

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    Pandit Lekha

    2009-01-01

    Full Text Available In hospitals in the tropics, the availability of magnetic resonance imaging (MRI facilities in urban areas and especially in teaching institutions have resulted in white matter diseases being frequently reported in a variety of clinical settings. Unlike the west where multiple sclerosis (MS is the commonest white matter disease encountered, in the tropics, there are myriad causes for the same. Infectious and post infectious disorders probably account for the vast majority of these diseases. Human immunodeficiency virus (HIV infection tops the list of infective conditions. Central nervous system (CNS tuberculosis occasionally presents with patchy parenchymal lesions unaccompanied by meningeal involvement. Human T cell leukemia virus (HTLV infection and cystic inflammatory lesions such as neurocysticercosis are important causes to be considered in the differential diagnosis. Diagnosing post infectious demyelinating disorders is equally challenging since more than a third of cases seen in the tropics do not present with history of past infection or vaccinations. Metabolic and deficiency disorders such as Wernicke′s encephalopathy, osmotic demyelinating syndrome associated with extra pontine lesions and Vitamin B12 deficiency states can occassionaly cause confusion in diagnosis. This review considers a few important disorders which manifest with white matter changes on MRI and create diagnostic difficulties in a population in the tropics.

  16. Tendinitis of the Temporalis muscle: Differential diagnosis and treatment. A Case Report.

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    Veronica Iturriaga.

    2016-03-01

    Full Text Available Introduction: The temporalis muscle plays an essential role in mastication and is actively involved in the mandibular closing movement. It is covered by a fibroelastic fascia that forms its tendon. Tendinitis is a degenerative and inflammatory process, which originates in the tendon-bone junction. Signs and symptoms such as swelling, pain, tenderness on palpation, limitation of movement and mouth opening are frequently associated with other temporomandibular disorders and not with tendinitis as a causal factor. Objective: To describe a clinical case identifying the diagnostic process and management of tendinitis of the temporalis muscle. Case report: A 30-year old male patient who sought treatment after continuous squeezing pain in the zygomatic and bilateral temporal regions with increased pain during mouth opening and mandibular function. The patient referred pain in the insertion region of the tendon of the temporalis muscle. Pain was removed after using anesthesia, consequently confirming the diagnosis of tendinitis of the temporalis muscle. Primary management measures were performed and then peritendinous corticosteroids were administered. The patient did not refer spontaneous or functional pain during check-up. Conclusion: Tendinitis of the temporalis muscle is a common condition, although frequently underdiagnosed. A good differential diagnosis must be performed to avoid confusion with other common conditions such as odontogenic pain, sinusitis, arthralgia, myofascial pain and migraine. Management depends on the type of tendinitis. It usually occurs in conjunction with other types of TMD or facial pain, so it is important to know the different clinical characteristics of pathologies with similar manifestations.

  17. Leptin levels in the differential diagnosis between benign and malignant ascites

    Institute of Scientific and Technical Information of China (English)

    Mehmet Buyukberber; Mehmet Koruk; M Cemil Savas; Murat T Gulsen; Yavuz Pehlivan; Rukiye Deveci; Alper Sevinc; Serdar Gergerlioglu

    2007-01-01

    AIM: To evaluate the role of leptin levels in the differential diagnosis of ascites.METHODS: Ascitic leptin, TNFα and serum leptin levels were measured in 77 patients with ascites (35 with malignancies, 30 cirrhosis and 12 tuberculosis). Control serum samples were obtained from 20 healthy subjects.Leptin and TNFα levels were measured by ELISA. Body mass index (BMI) and percentage of body fat (BFM) by skin fold measurement were calculated for all patients and control groups. Peritoneal biopsy, ascites cytology and cultures or biochemical values were used for the diagnosis of patients.RESULTS: In patients with malignancies, the mean serum and ascites leptin levels and their ratios were significantly decreased compared to the other patient groups and controls. In tuberculosis peritonitis, ascitic fluid TNFα levels were significantly higher than malignant ascites and cirrhotic sterile ascites. BMI and BFM values did not distinguish between patients and controls.CONCLUSION: In patients with malignant ascites,levels of leptin and TNFα were significantly lower than in patients with tuberculous ascites.

  18. The role and rationale of nuclear medicine procedures in the differential diagnosis of renovascular hypertension

    International Nuclear Information System (INIS)

    The use of radionuclides in the differential diagnosis of renovascular hypertension has gone through many periods of enthusiasm and of disappointment. Regardless of the problems with the routine renogram, the availability of gamma camera renal evaluation makes possible meaningful preintervention of screening. The use of the test as a follow-up procedure is an extremely important but often overlooked application of radionuclides in the evaluation of renovascular hypertension. The radionuclide technique is a sensitive and accurate method of evaluating the results of percutaneous angioplasty or surgery or renal function in the affected kidney of patients with renovascular disease. A major change in our approach to the nuclear medicine diagnosis of renovascular hypertension has been the introduction of captopril renography. Although there is still a great deal of work to be done and many investigators are actively studying captopril renography, the potential of the test is clear. Captopril renography should include a baseline renogram, followed by the administration of 25 mg of captopril and a repeat study. Specificity and sensitivity data on this test probably will not be available for several years, but preliminary results are encouraging enough to justify routine use at this time in clinics in which screening for renovascular hypertension is carried out. (author)

  19. Infantile Myofibroma Eroding into the Frontal Bone: A Case Report and Review of Its Histopathologic Differential Diagnosis

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    Aatish Thennavan

    2012-01-01

    Full Text Available Infantile myofibroma is a rare and benign tumour of children presenting in the head and neck region. Rendering a final diagnosis of infantile myofibroma can be challenging in the light of nonspecific clinical, radiological findings and its histopathological similarities with a number of neoplasms especially spindle cell tumours. In this paper we discuss a case of infantile myofibroma in a 2-month-old infant, enumerating the various differential entities that have to be eliminated in reaching its specific diagnosis and highlighting the importance of immunopositivity to vimentin and smooth muscle actin (SMA in establishing its myofibroblastic differentiation.

  20. Significance of ambulatory electroencephalography for differential diagnosis of epilepsy and syncope

    Institute of Scientific and Technical Information of China (English)

    Xueling Zhang; Lingli Zhang; Deyun Zhu; Lan Wei; Xuehong Wang

    2008-01-01

    BACKGROUND: Twenty-four hour ambulatory electroencephalography (AEEG) provides advantages for continuous electroencephalogram, monitoring brief loss of consciousness complicated by suspect or mild limb spasm. OBJECTIVE: To explore the significance of AEEG for differentially diagnosing epilepsy and syncope, compared to EEG. DESIGN, TIME AND SETTING: Sixty patients with brief loss of consciousness, complicated by suspect or mild limb spasm, were selected from Suqian People's Hospital between January 2006 and June 2007. PARTICIPANTS: Sixty participants comprised 34 males and 26 females, aged 13-64 years. According to clinical symptoms prior to the study, 36 patients were initially diagnosed with epilepsy and 24 with syncope. METHODS AND MAIN OUTCOME MEASURES: Abnormalities and epileptiform discharge were detected using EEG and AEEG, and the diagnostic value of the two methods for epilepsy and syncope was compared. RESULTS: A total of sixty patients were included in the final analysis. Abnormal AEEGs were observed in 37 cases (62%) and epilcptitorm discharge AEEGs in 23 cases (38%), both of which were significantly greater than EEGs [37% (22/60), 18% ( 11/60), respectively, P < 0.01, 0.05]. The detection rate of abnormal AEEG and epileptiform discharge in the epilepsy group [75% (27/36), 47% (17/36), respectively] was significantly greater than in the syncope group [42% (10/24), 25% (6/24), respectively, P < 0.01, 0.05 ]. CONCLUSION: AEEG can improve detection probability of epileptiform discharge and exhibits significant differences in the differential diagnosis of epilepsy and syncope.

  1. Pancreatic neuroendocrine tumor and solid-pseudopapillary neoplasm: Key immunohistochemical profiles for differential diagnosis

    Science.gov (United States)

    Ohara, Yusuke; Oda, Tatsuya; Hashimoto, Shinji; Akashi, Yoshimasa; Miyamoto, Ryoichi; Enomoto, Tsuyoshi; Satomi, Kaishi; Morishita, Yukio; Ohkohchi, Nobuhiro

    2016-01-01

    AIM To reveal better diagnostic markers for differentiating neuroendocrine tumor (NET) from solid-pseudopapillary neoplasm (SPN), focusing primarily on immunohistochemical analysis. METHODS We reviewed 30 pancreatic surgical specimens of NET (24 cases) and SPN (6 cases). We carried out comprehensive immunohistochemical profiling using 9 markers: Synaptophysin, chromogranin A, pan-cytokeratin, E-cadherin, progesterone receptor, vimentin, α-1-antitrypsin, CD10, and β-catenin. RESULTS E-cadherin staining in NETs, and nuclear labeling of β-catenin in SPNs were the most sensitive and specific markers. Dot-like staining of chromogranin A might indicate the possibility of SPNs rather than NETs. The other six markers were not useful because their expression overlapped widely between NETs and SPNs. Moreover, two cases that had been initially diagnosed as NETs on the basis of their morphological features, demonstrated SPN-like immunohistochemical profiles. Careful diagnosis is crucial as we actually found two confusing cases showing disagreement between the tumor morphology and immunohistochemical profiles. CONCLUSION E-cadherin, chromogranin A, and β-catenin were the most useful markers which should be employed for differentiating between NET and SPN.

  2. Dynamic MR imaging of neurohypophyseal germ cell tumors for differential diagnosis of infundibular diseases

    International Nuclear Information System (INIS)

    To investigate the MR dynamic patterns of neurohypophyseal germ cell tumors (GCTs) for differential diagnosis of infundibular diseases affecting young people. Material and Methods: Eleven patients with neurohypophyseal GCTs underwent dynamic MR studies with T1-weighted spin-echo (SE) or turbo SE techniques. Other infundibular lesions, including adenohypophysitis (n=3), Langerhans' cell histiocytosis (LCH, n=2), and 1 hemangioblastoma from von Hippel-Lindau disease, were also evaluated. Serial images were obtained every 15 s (turbo SE) or 30 s (SE technique) for 240 s after rapid injection of contrast medium. The dynamic patterns were analyzed quantitatively with the contrast medium enhancement ratio. Results: On dynamic MR images, GCTs typically showed a gradual enhancement increase with a peak between 105 s and 180 s, while two showed a relatively rapid increase. LCH and hemangioblastoma showed a dynamic pattern similar to GCTs, while adenohypophysitis demonstrated a sharp rise and a steeper wash-out with an obvious peak before 90 s. Conclusion: Typical dynamic pattern of GCTs was the gradual enhancement increase without wash-out. Dynamic MR imaging can distinguish GCTs from adenohypophysitis, but is not useful for differentiation from LCH

  3. Dynamic MR imaging of neurohypophyseal germ cell tumors for differential diagnosis of infundibular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Liang, L.; Korogi, Y.; Sugahara, T.; Ikushima, I.; Shigematsu, Y.; Okuda, T.; Takahashi, M. [Kumamoto Univ. School of Medicine (Japan). Radiology Dept.

    2000-11-01

    To investigate the MR dynamic patterns of neurohypophyseal germ cell tumors (GCTs) for differential diagnosis of infundibular diseases affecting young people. Material and Methods: Eleven patients with neurohypophyseal GCTs underwent dynamic MR studies with T1-weighted spin-echo (SE) or turbo SE techniques. Other infundibular lesions, including adenohypophysitis (n=3), Langerhans' cell histiocytosis (LCH, n=2), and 1 hemangioblastoma from von Hippel-Lindau disease, were also evaluated. Serial images were obtained every 15 s (turbo SE) or 30 s (SE technique) for 240 s after rapid injection of contrast medium. The dynamic patterns were analyzed quantitatively with the contrast medium enhancement ratio. Results: On dynamic MR images, GCTs typically showed a gradual enhancement increase with a peak between 105 s and 180 s, while two showed a relatively rapid increase. LCH and hemangioblastoma showed a dynamic pattern similar to GCTs, while adenohypophysitis demonstrated a sharp rise and a steeper wash-out with an obvious peak before 90 s. Conclusion: Typical dynamic pattern of GCTs was the gradual enhancement increase without wash-out. Dynamic MR imaging can distinguish GCTs from adenohypophysitis, but is not useful for differentiation from LCH.

  4. A case with oto-spondylo-mega-epiphyseal-dysplasia (OSMED): the clinical recognition and differential diagnosis.

    Science.gov (United States)

    Karaer, Kadri; Rosti, Rasim Ozgür; Torun, Deniz; Sanal, Hatice Tuba; Bahçe, Muhterem; Güran, Sefik

    2011-01-01

    The oto-spondylo-mega-epiphyseal-dysplasia (OSMED) phenotype is an autosomal recessive trait that is a skeletal dysplasia with the hallmark findings of limb shortening, multiple skeletal and radiological abnormalities, mid-face hypoplasia with a flat nasal bridge, small upturned nasal tip, and sensorineural hearing loss. A 3.5-year-old girl born to consanguineous Turkish parents had characteristic facial features at birth: mid-face hypoplasia, mild hypertelorism, upslanting palpebral fissures, prominent supraorbital ridges, depressed nasal bridge, small upturned nasal tip, long philtrum, and micrognathia. Radiological examination at three years of age revealed large flaring metaphyses and wide flat epiphyses. The humerus and femur showed the characteristic dumbbell shape. She had bilateral hearing loss with no ophthalmologic findings. There is continuing debate over the clinical overlap and differential diagnosis of OSMED syndrome. The patient was examined considering Weissenbacher-Zweymuller, Stickler type 3, Marshall syndrome, and Kniest dysplasia as possible differential diagnoses. We believe that the presented patient clinically manifested features of OSMED syndrome. We would like to point out that the management of OSMED calls for a coordinated multidisciplinary approach. PMID:21980822

  5. Differential Diagnosis of Thyroid Nodules Using Gray-Scale and Color Doppler Ultrasonography

    International Nuclear Information System (INIS)

    To assess the differential points between benign and malignant thyroid nodules, we retrospectively analysed the gray-scale and color Doppler ultrasovograms, radioisotope(RI) scans, and thyroid function tests of lO4 cases. The pathology of the lesion was confirmed as benign in 80 cases and malignant in 24 case, either at operation orby fine needle aspiration biopsy. Gray-scale ultrasonographic findings were analysed in terms of lymphadenopathy,size, and multiplicity. Color Doppler ultrasonography was performed in 40 case, and color singals were graded from type 0 to type III according to color flow distributions. There were no statistically significant differences inperipheral halo, size, multiplicity, color Doppler ultrasonograms, and findings at RI scan and thyriod functiontest between benign and malignant nodules(Chi-square test : P>0.05). However, internal punctate calcification,solid and hypoechoic pattern, cervical lymphadenopathy, irregular and illdefined outer margin, male gender weremore common in malignant thyroid nodules, while smooth and well-defined outer margin, complex echogenicity weremore common in benign nodules(P<0.05). Although color Doppler examination did not contribute to the differentialdiagnosis of benign and malignant nodules, complete halo in grat-scale ultrasonographt and color signal type II (prominent color flow at the periphery of the nodules; color 'halo' sihn) showed statistically significantcorrelation. In conclusion, gray-scale ultrasonography is a useful imaging modality for differential diagnosis of thyroid nodules, and further studies may be requires to clarify the availability of color Doppler ultrasonography

  6. [The amylase-creatinine clearance ratio in the differential diagnosis of pancreatitis and gastroduodenal ulcer with hyperamylasemia].

    Science.gov (United States)

    Pezzangora, V; Della Dora, R; Pagliarini, A; Dell'Olivo, I

    1978-04-01

    The Authors followed 29 patients, hospitaled with a diagnosis of pancreatitis. They all presented the same sympotomatology and a considerable increase of the serum amylase ad urinary amylase. The examination of the ratio between the clearance of amylasis and creatinine permitted to make a differential diagnosis for 8 cases (4rd group) that were nothing but peptic ulcera. Such a diagnosis was confirmed by the radiological contrastographic examination or by the intraoperative report. So if the ratio between the clearance of amylase and creatinine is normal we must think about a pathological situation were the iperamylasemia has a pathogenetic cause different from pancreatitis.

  7. Herlyn-werner-wunderlich syndrome: MRI findings, radiological guide (two cases and literature review), and differential diagnosis

    International Nuclear Information System (INIS)

    Herlyn-Werner-Wunderlich (HWW) syndrome is a very rare congenital anomaly of the urogenital tract involving Müllerian ducts and Wolffian structures, and it is characterized by the triad of didelphys uterus, obstructed hemivagina and ipsilateral renal agenesis. It generally occurs at puberty and exhibits non-specific and variable symptoms with acute or pelvic pain shortly following menarche, causing a delay in the diagnosis. Moreover, the diagnosis is complicated by the infrequency of this syndrome, because Müllerian duct anomalies (MDA) are infrequently encountered in a routine clinical setting. two cases of HWW syndrome in adolescents and a differential diagnosis for one case of a different MDA, and the impact of magnetic resonance (MR) imaging technology to achieve the correct diagnosis. MR imaging is a very suitable diagnostic tool in order to perform the correct diagnosis of HWW syndrome

  8. Herlyn-werner-wunderlich syndrome: MRI findings, radiological guide (two cases and literature review, and differential diagnosis

    Directory of Open Access Journals (Sweden)

    Del Vescovo Riccardo

    2012-03-01

    Full Text Available Abstract Background Herlyn-Werner-Wunderlich (HWW syndrome is a very rare congenital anomaly of the urogenital tract involving Müllerian ducts and Wolffian structures, and it is characterized by the triad of didelphys uterus, obstructed hemivagina and ipsilateral renal agenesis. It generally occurs at puberty and exhibits non-specific and variable symptoms with acute or pelvic pain shortly following menarche, causing a delay in the diagnosis. Moreover, the diagnosis is complicated by the infrequency of this syndrome, because Müllerian duct anomalies (MDA are infrequently encountered in a routine clinical setting. Cases presentation two cases of HWW syndrome in adolescents and a differential diagnosis for one case of a different MDA, and the impact of magnetic resonance (MR imaging technology to achieve the correct diagnosis. Conclusions MR imaging is a very suitable diagnostic tool in order to perform the correct diagnosis of HWW syndrome.

  9. Supporting Boys as Readers

    Science.gov (United States)

    Serafini, Frank

    2013-01-01

    The challenges associated with boys and reading are focused on such factors as society's lack of focus on literacy skills, parents failings to inspire reading in boys, and internal motivational factors rather than looking at the environments created for reading in and out of school. In this column, several ideas for helping boys develop a…

  10. MR imaging findings of pineal germinoma: focus on differential diagnosis from other germ cell tumors

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    Kim, Hyun Jin; Lee, Ho Kyu; Kim, Jae Kyun; Shin, Ji Hoon; Choi, Choong Gon; Lee, Myung Jun; Ham, Soo Youn; Lee, Jong Hwa; Suh, Dae Chul [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-10-01

    To determine the characteristic MR imaging findings of pineal germinoma, and differential diagnosis from other germ cell tumors. MR images of patients with histopathologically proven pineal germinoma(n=3D14) and other pineal germ cell tumors(n=3D10) were retrospectively analyzed with regard to size, signal intensity and homogeneity, enhancing features, cyst formation, and multiplicity of lesions. Other pineal germ cell tumors were the mixed germ cell tumors (n=3D4), malignant teratomas (n=3D3), choriocarcinoma(n=3D1), embryonal carcinoma(n=3D1), and endodermal sinus tumor(n=3D1). Tumor markers were evaluated. On T1-weighted images, germinomas showed homogeneous(86%) or iso signal intensity (93%), while other germ cell tumors showed inhomogeneous(70%) or iso signal intensity(70%). On T2-weighted images, germinomas showed homogeneous(64%) or iso signal intensity(57%), while other germ cell tumors showed inhomogeneous(70%) or high signal intensity(80%). On Gd-DTPA enhanced images, germinomas showed homogeneous (93%) or strong enhancement (64%), while other germ cell tumors showed homogeneous(60%) or strong enhancement (70%). Cyst formation was noted in ten Patients (71%) with germinoma and in six (60%) with other germ cell tumors. Invasion on surrounding structures was seen in 11 patients (79%) with germinoma and in five (50%) with other germ cell tumors. Lesions were multiple in three patients(21%) with germinoma. Thirteen of 14 patients with germinoma had normal serum {alpha}-FP(tetoprotein) and {beta}-HCG(human chononic gonafotrophin) levels. Two of four patients with mixed germ cell tumors had elevated serum {beta}-FP and {alpha}-HCG levels; in the ther two, elevated serum {alpha}-FP or {beta}-HCG levels were noted. In the malignant teratoma and embryonal carcinoma patients, serum {alpha}-FP and {beta}-HCG levels were normal. The patient with choriocarcinoma had an elevated serum {beta}-HCG level. On T1W1, the only significant differential point (p<0.01) between

  11. Differential diagnosis of Parkinsonism using dual phase F 18 FP CIT PET imaging

    International Nuclear Information System (INIS)

    Dopamine transporter (DAT) imaging can demonstrate presynaptic dopaminergic neuronal loss in Parkinson's disease (PD). However, differentiating atypical parkinsonism (APD) from PD is often difficult. We investigated the usefulness of dual phase F 18 FP CIT positron emission tomography (PET) imaging in the differential diagnosis of parkinsonism. Ninety eight subjects [five normal, seven drug induced parkinsonism (DIP), five essential tremor (ET), 24 PD, 20 multiple system atrophy parkinson type (MSA-P), 13 multiple system atrophy cerebellar type (MSA-C), 13 progressive supranuclear palsy (PSP), and 11 dementia with Lewy bodies(DLB)] underwent F 18 FP CIT PET. PET images were acquired at 5 min (early phase) and 3 h (late phase) after F 18 FP CIT administration (185MBq). Regional uptake pattern of cerebral and cerebellar hemispheres was assessed on early phase images, using visual, quantitative, and statistical parametric mapping (SPM) analyses. Striatal DAT binding was normal in normal, ET, DIP, and MSA C groups, but abnormal in PD, MSA P PSP, and DLB groups. No difference was found in regional uptake on early phase images among normal DAT binding groups, except in the MSA C group. Abnormal DAT binding groups showed different regional uptake pattern on early phase images compared with PD in SPM analysis (FDR<0.05). When discriminating APD from PD, visual interpretation of the early phase image showed high diagnostic sensitivity and specificity (75.4% and 100%, respectively). Regarding the ability to distinguish specific APD, sensitivities were 81% for MSA P, 77% for MSA C, 23% for PSP, and 54.5% for DLB. Dual phase F 18 FP CIT PET imaging is useful in demonstrating striatal DAT loss in neurodegenerative parkinsonism, and also in differentiating APD, particularly MSA, from PD

  12. Differential diagnosis of Parkinsonism using dual phase F 18 FP CIT PET imaging

    Energy Technology Data Exchange (ETDEWEB)

    Jin, So Young; Oh, Min Young; Ok, Seung Jun; Oh, Jung Su; Lee, Sang Ju; Chung, Sun Ju; Lee, Chong Sik; Kim, Jae Seung [Univ. of Ulsan, Seoul (Korea, Republic of)

    2012-03-15

    Dopamine transporter (DAT) imaging can demonstrate presynaptic dopaminergic neuronal loss in Parkinson's disease (PD). However, differentiating atypical parkinsonism (APD) from PD is often difficult. We investigated the usefulness of dual phase F 18 FP CIT positron emission tomography (PET) imaging in the differential diagnosis of parkinsonism. Ninety eight subjects [five normal, seven drug induced parkinsonism (DIP), five essential tremor (ET), 24 PD, 20 multiple system atrophy parkinson type (MSA-P), 13 multiple system atrophy cerebellar type (MSA-C), 13 progressive supranuclear palsy (PSP), and 11 dementia with Lewy bodies(DLB)] underwent F 18 FP CIT PET. PET images were acquired at 5 min (early phase) and 3 h (late phase) after F 18 FP CIT administration (185MBq). Regional uptake pattern of cerebral and cerebellar hemispheres was assessed on early phase images, using visual, quantitative, and statistical parametric mapping (SPM) analyses. Striatal DAT binding was normal in normal, ET, DIP, and MSA C groups, but abnormal in PD, MSA P PSP, and DLB groups. No difference was found in regional uptake on early phase images among normal DAT binding groups, except in the MSA C group. Abnormal DAT binding groups showed different regional uptake pattern on early phase images compared with PD in SPM analysis (FDR<0.05). When discriminating APD from PD, visual interpretation of the early phase image showed high diagnostic sensitivity and specificity (75.4% and 100%, respectively). Regarding the ability to distinguish specific APD, sensitivities were 81% for MSA P, 77% for MSA C, 23% for PSP, and 54.5% for DLB. Dual phase F 18 FP CIT PET imaging is useful in demonstrating striatal DAT loss in neurodegenerative parkinsonism, and also in differentiating APD, particularly MSA, from PD.

  13. Doppler ultrasound in the diagnosis and follow-up of the muscle rupture and an arteriovenous fistula of the thigh in 12 year boy

    International Nuclear Information System (INIS)

    Background. With this case report the authors wish to present the accuracy of non-invasive vascular imaging methods, especially Doppler ultrasound, in the evaluation of the muscular trauma and periskeletal soft tissue vascular anomalies. Case report. Twelve year-old boy has been admitted with the right femoral quadriceps muscle traumatic rupture. Postoperative B-mod sonography (US) visualised recidivuous haematoma and Power Doppler depicted hypervascularized area, suspected vascular malformation (angioma). Doppler findings obtained on the right thigh vasculature gave us reasons to think about posttraumatic arteriovenous fistula. Doppler has been repeated in the specialized paediatric institution with the same results. Digital subtraction angiography, 8 months after trauma, did not confirm suspicions reported in US findings. Spiral computed tomographic angiography (CTA) performed 11 months after trauma clearly depicted a lesion which had been repeatedly described in US findings. Fourteen months after trauma the vascular surgeon performed the deep femoral artery muscular branches ligation, but in the official report only arteriovenous fistula was mentioned. After the surgery the patient was clinically better. The aetiology of the right femoral arteriovenous fistula and hypervascularized structure remains unclear. Conclusions. Every inadequately behaving, recidivous posttraumatic haematoma should be evaluated with Doppler ultrasound. CTA can be performed if it is needed to clarify US findings. (author)

  14. Application of dual phase imaging of 11C-acetate positron emission tomography on differential diagnosis of small hepatic lesions.

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    Li Huo

    Full Text Available OBJECTIVE: Previously we observed that dual phase 11C-acetate positron emission tomography (AC-PET could be employed for differential diagnosis of liver malignancies. In this study, we prospectively evaluated the effect of dual phase AC-PET on differential diagnosis of primary hepatic lesions of 1-3 cm in size. METHODS: 33 patients having primary hepatic lesions with size of 1-3 cm in diameter undertook dual phase AC-PET scans. Procedure included an early upper-abdomen scan immediately after tracer injection and a conventional scan in 11-18 min. The standardized uptake value (SUV was calculated for tumor (SUVT and normal tissue (SUVB, from which 11C-acetate uptake ratio (as lesion against normal liver tissue, SUVT/SUVB in early imaging (R1, conventional imaging (R2, and variance between R2 and R1 (ΔR were derived. Diagnoses based on AC-PET data and histology were compared. Statistical analysis was performed with SPSS 19.0. RESULTS: 20 patients were found to have HCC and 13 patients had benign tumors. Using ΔR>0 as criterion for malignancy, the accuracy and specificity were significantly increased comparing with conventional method. The area under ROC curve (AUC for R1, R2, and ΔR were 0.417, 0.683 and 0.831 respectively. Differential diagnosis between well-differentiated HCCs and benign lesions of FNHs and hemangiomas achieved 100% correct. Strong positive correlation was also found between R1 and R2 in HCC (r2 = 0.55, P<0.001. CONCLUSIONS: Dual phase AC-PET scan is a useful procedure for differential diagnosis of well-differentiated hepatocellular carcinoma and benign lesions. The dynamic changes of 11C-acetate uptake in dual phase imaging provided key information for final diagnosis.

  15. Extraskeletal Ewing’s sarcoma in a great toe of a young boy

    Science.gov (United States)

    Cypel, Tatiana Karine Simon; Meilik, Benjamin; Zuker, Ronald Melvin

    2007-01-01

    Extraskeletal Ewing’s sarcoma (EES) is a rare, soft tissue, malignant neoplasm histologically similar to skeletal Ewing’s sarcoma. It occurs mainly in adolescents and young adults, and affects extremities in 36% of cases and central locations (commonly paravertebral regions) in the remainder. The differential diagnosis includes other small, blue, round cell tumours. A clinical case of EES involving a great toe in a young boy is reported. EES diagnosis was confirmed by features of histological analysis and immunohistochemistry, and by the presence of the t(11;22) chromosomal translocation. PMID:19554151

  16. Berardinelli-Seip syndrome in a 6-year-old boy

    Directory of Open Access Journals (Sweden)

    Babu Priya

    2008-01-01

    Full Text Available A 6-year-old boy presented with abnormal habitus since birth, delayed language development, history of frequent falls since 9 months, and fever since 1 week. He was found to have hyperandrogenic features, generalized paucity of fat, generalized muscular overdevelopment, and brownish pigmentation over the flexural creases. Skin biopsy demonstrated features suggestive of acanthosis nigricans with an absence of subcutaneous tissue. After further investigation, a diagnosis of Berardinelli-Seip syndrome with bilateral pneumonia and generalized tonic clonic seizures was made. Clinical features, histopathology, differential diagnosis, and prognosis of this rare disorder have been discussed.

  17. Clinical value of diascopy and other non-invasive techniques on differential diagnosis algorithms of oral pigmentations: A systematic review

    Science.gov (United States)

    Pena-Cristóbal, Maite; Otero-Rey, Eva-María; Tomás, Inmaculada; Blanco-Carrión, Andrés

    2016-01-01

    Objectives To determine the diagnostic value of diascopy and other non-invasive clinical aids on recent differential diagnosis algorithms of oral mucosal pigmentations affecting subjects of any age. Material and Methods Data Sources: this systematic review was conducted by searching PubMed, Scopus, Dentistry & Oral Sciences Source and the Cochrane Library (2000-2015); Study Selection: two reviewers independently selected all types of English articles describing differential diagnosis algorithms of oral pigmentations and checked the references of finally included papers; Data Extraction: one reviewer performed the data extraction and quality assessment based on previously defined fields while the other reviewer checked their validity. Results Data Synthesis: eight narrative reviews and one single case report met the inclusion criteria. Diascopy was used on six algorithms (66.67%) and X-ray was included once (11.11%; 44.44% with text mentions); these were considered helpful tools in the diagnosis of intravascular and exogenous pigmentations, respectively. Surface rubbing was described once in the text (11.11%). Conclusions Diascopy was the most applied method followed by X-ray and surface rubbing. The limited scope of these procedures only makes them useful when a positive result is obtained, turning biopsy into the most recommended technique when diagnosis cannot be established on clinical grounds alone. Key words:Algorithm, differential diagnosis, flow chart, oral mucosa, oral pigmentation, systematic review. PMID:27703615

  18. Peak systolic velocity of superior thyroid artery for the differential diagnosis of thyrotoxicosis.

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    Xiaolong Zhao

    Full Text Available AIM: The differentiation of destruction-induced thyrotoxicosis and Graves' disease (GD is of great importance for selection of proper therapy. Radioactive iodine uptake (RAIU is the gold standard for differentiating these two conditions but its application has remained somewhat limited. Thyroid color Doppler flow sonography (CDFS is a potential alternative of RAIU but more supporting evidence is warranted. In the present study, a standard operative procedure was developed to measure the mean peak systolic velocity of superior thyroid artery (STA-PSV and evaluate its role in the differential diagnosis of thyrotoxicosis. METHODS: A total of 135 patients with untreated thyrotoxicosis were enrolled into one retrospective study (GD, n = 103; thyroiditis, n = 32 and another prospective study recruited 169 patients (GD, n = 118; thyroiditis, n = 51. Thirty normal controls were also enrolled. Thyroid function, anti-TSH-receptor antibody (TRAb, RAIU, CFDS of thyroid and STA-PSV were performed for each patient. Receiver operator curve (ROC was used to evaluate the diagnostic value of STA-PSV in a retrospective study so as to seek the optimal cutoff point. Then the cutoff point value was used to validate its diagnostic value in a prospective study and in another thyrotoxicosis population. RESULTS: STA-PSV of GD was significantly higher than that of thyroiditis in both retrospective and prospective studies. The area under the ROC curve of mean STA-PSV was 0.8799 and 0.9447 in the retrospective and prospective studies respectively. If a mean STA-PSV cutoff point of 50.5 cm/s was set from the retrospective analysis for the prospective study, the sensitivity and specificity in distinguishing GD from thyroiditis were 81.04% and 96.08% respectively. Mean STA-PSV and TRAb had similar area under ROC. The coefficients of variation in STA-PSV measurement were lower than 10% for the euthyroid, thyroiditis and GD groups. CONCLUSIONS: STA-PSV is a feasible supplement

  19. The Asperger personality - psychopathology, personality structure, and differential diagnosis of adults with autism spectrum disorder without accompanying intellectual impairment

    OpenAIRE

    Strunz, Sandra

    2015-01-01

    Introduction: Autism Spectrum Disorders (ASD) are classified as pervasive developmental disorders and are characterised by impairments in social interaction and communication and by repetitive stereotyped pattern of behaviour and restricted interests. Individuals with ASD without accompanying intellectual impairment often already reached adulthood before an ASD diagnosis is made. Diagnosing ASD in adults is challenging, especially because of difficulties in differentiating ASD from personalit...

  20. CONDENSING OSTEITIS OF THE CLAVICLE - MAGNETIC-RESONANCE-IMAGING AS AN ADJUNCT METHOD FOR DIFFERENTIAL-DIAGNOSIS

    NARCIS (Netherlands)

    VIERBOOM, MAC; STEINBERG, JDJ; MOOYAART, EL; VANRIJSWIJK, MH

    1992-01-01

    Condensing osteitis of the clavicle is a benign disorder leading to osteosclerosis of the medial end of the clavicle. The differential diagnosis between condensing osteitis of the clavicle and ischaemic necrosis of the medial clavicular epiphysis (Friedrich's disease), osteoid osteoma, and low grade

  1. Genome sequences of three live attenuated vaccine strains of Brucella species and implications for pathogenesis and differential diagnosis.

    Science.gov (United States)

    Wang, Yufei; Ke, Yuehua; Wang, Zhoujia; Yuan, Xitong; Qiu, Yefeng; Zhen, Qing; Xu, Jie; Li, Tiefeng; Wang, Dali; Huang, Liuyu; Chen, Zeliang

    2012-11-01

    Live attenuated vaccines play essential roles in the prevention of brucellosis. Here, we report the draft genome sequences of three vaccine strains, Brucella melitensis M5-10, B. suis S2-30, and B. abortus 104M. Primary genome sequence analysis identified mutations, deletions, and insertions which have implications for attenuation and signatures for differential diagnosis. PMID:23045513

  2. Genome Sequences of Three Live Attenuated Vaccine Strains of Brucella Species and Implications for Pathogenesis and Differential Diagnosis

    OpenAIRE

    Wang, Yufei; Ke, Yuehua; Wang, Zhoujia; Yuan, Xitong; Qiu, Yefeng; Zhen, Qing; Xu, Jie; Li, Tiefeng; Wang, Dali; Huang, Liuyu; Chen, Zeliang

    2012-01-01

    Live attenuated vaccines play essential roles in the prevention of brucellosis. Here, we report the draft genome sequences of three vaccine strains, Brucella melitensis M5-10, B. suis S2-30, and B. abortus 104M. Primary genome sequence analysis identified mutations, deletions, and insertions which have implications for attenuation and signatures for differential diagnosis.

  3. The radiological and histopathological differential diagnosis of chordoid neoplasms in skull base

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    PAN Bin-cai

    2013-07-01

    Full Text Available Background Chordoid neoplasms refer to tumors appearing to have histological features of embryonic notochord, which is characterized by cords and lobules of neoplastic cells arranged within myxoid matrix. Because of radiological and histological similarities with myxoid matrix and overlapping immunohistochemical profile, chordoma, chordoid meningioma, chordoid glioma, and rare extraskeletal myxoid chondrosarcoma enter in the radiological and histological differential diagnosis at the site of skull base. However, there is always a great challenge for histopathologists to make an accurate diagnosis when encountering a chordoid neoplasm within or near the central nervous system. The aim of this study is to investigate and summarize the radiological, histological features and immunohistochemical profiles of chordoid neoplasms in skull base, and to find a judicious panel of immunostains to unquestionably help in diagnostically challenging cases. Methods A total of 23 cases of chordoid neoplasms in skull base, including 10 chordomas, 5 chordoid meningiomas, 3 chordoid gliomas and 5 extraskeletal myxoid chondrosarcomas, were collected from the First Affiliated Hospital, Sun Yat-sen University and Guangdong Tongjiang Hospital. MRI examination was performed on the patients before surgical treatment. Microscopical examination and immunohistochemical staining study using vimentin (Vim, pan-cytokeratin (PCK, epithelial membrane antigen (EMA, S?100 protein (S-100, glial fibrillary acidic protein (GFAP, D2-40, Galectin-3, CD3, CD20, Ki-67 were performed on the samples of cases. The clinicopathological data of the patients was also analyzed retrospectively. Results Most of chordomas were localized in the clivus with heterogeneous hyperintensity on T2WI scanning. The breakage of clivus was observed in most cases. Histologically, the tumor cells of chordoma exhibited bland nuclear features and some contained abundant vacuolated cytoplasm (the so

  4. Spectral CT imaging in differential diagnosis of pancreatic serous oligocystic adenoma and mucinous cystic neoplasms

    International Nuclear Information System (INIS)

    Objective: To investigate the CT spectral imaging features of pancreatic serous oligocystic adenoma and mucinous cystic neoplasms and to assess the value of spectral CT in differentiating between pancreatic serous oligocystic adenoma and mucinous cystic neoplasms. Methods: From Feb. 2010 to Dec. 2010, 27 patients with cystic neoplasms of the pancreas (group one with 15 serous oligocystic adenomas and group two with 12 mucinous cystic neoplasms) underwent dual-phase CT spectral imaging followed by surgery. Quantitative values (age, tumor size, CT value change as function of photon energy, effective-Z, iodine-water concentration, and calcium-water concentration) were compared with independent samples t test and Mann-Whitney test and non-quantitative parameters (gender, symptom, and tumor location) were compared with Chi-square test (Fisher exact). The parameters with significant differences between two groups were analyzed further and the performance of multiple parameters for joint differential diagnosis was evaluated with discriminant analysis. Results: Compared to patients with mucinous cystic neoplasms, patients with serous oligocystic adenoma had younger age, lower frequency of being symptomatic and smaller tumor size. The CT values on 40 keV to 60 keV (with 10 keV increment) in late arterial phase [(36±13) HU vs. (62±23) HU, (26±8) HU vs. (40±15) HU, and (19±6) HU vs. (27±10) HU respectively] and 40 keV to 50 keV (with 10 keV increment) in portal venous phase [(43±14) HU vs. (61±25) HU and (30±10) HU vs. (40±16) HU respectively], effective-Z (late arterial phase 7.80± 0.16 vs. 8.05±0.21, and portal venous phase 7.87±0.15 vs 8.02±0.22), concentration of calcium (water) [late arterial phase (5±3) g/L vs. (11±4) g/L, t=-3.836, P=0.001 and portal venous phase (7±3) g/L vs. (10±5) g/L, t=-2.071, P=0.049] and iodine (water) [late arterial phase (0.38±0.24) g/L vs. (0.78±0.32) g/L, t=-3.755, P=0.001 and portal venous phase (0.48± 0.24) g/L vs. (0

  5. Vibration Sensor-Based Bearing Fault Diagnosis Using Ellipsoid-ARTMAP and Differential Evolution Algorithms

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    Chang Liu

    2014-06-01

    Full Text Available Effective fault classification of rolling element bearings provides an important basis for ensuring safe operation of rotating machinery. In this paper, a novel vibration sensor-based fault diagnosis method using an Ellipsoid-ARTMAP network (EAM and a differential evolution (DE algorithm is proposed. The original features are firstly extracted from vibration signals based on wavelet packet decomposition. Then, a minimum-redundancy maximum-relevancy algorithm is introduced to select the most prominent features so as to decrease feature dimensions. Finally, a DE-based EAM (DE-EAM classifier is constructed to realize the fault diagnosis. The major characteristic of EAM is that the sample distribution of each category is realized by using a hyper-ellipsoid node and smoothing operation algorithm. Therefore, it can depict the decision boundary of disperse samples accurately and effectively avoid over-fitting phenomena. To optimize EAM network parameters, the DE algorithm is presented and two objectives, including both classification accuracy and nodes number, are simultaneously introduced as the fitness functions. Meanwhile, an exponential criterion is proposed to realize final selection of the optimal parameters. To prove the effectiveness of the proposed method, the vibration signals of four types of rolling element bearings under different loads were collected. Moreover, to improve the robustness of the classifier evaluation, a two-fold cross validation scheme is adopted and the order of feature samples is randomly arranged ten times within each fold. The results show that DE-EAM classifier can recognize the fault categories of the rolling element bearings reliably and accurately.

  6. Radiographic features of Mycoplasma pneumoniae pneumonia: differential diagnosis and performance timing

    International Nuclear Information System (INIS)

    The Japanese Respiratory Society guidelines propose a differential diagnosis for atypical pneumonia and bacterial pneumonia using a scoring system for the selection of appropriate antibiotic. In order to improve this scoring system, the guidelines are seeking new specific parameter. The purpose of this study was to clarify the pattern of abnormalities with Mycoplasma pneumoniae pneumonia on chest computed tomography (CT) and whether the radiographic findings could distinguish M. pneumoniae pneumonia from Streptococcus pneumoniae pneumonia. A retrospective review was performed of the CT findings of 64 cases and 68 cases where M. pneumoniae and S. pneumoniae, respectively, were the only pathogen identified by the panel of diagnostic tests used. Of the 64 patients with M. pneumoniae pneumonia, bronchial wall thickening was observed most frequently (81%), followed by centrilobular nodules (78%), ground-glass attenuation (78%), and consolidation (61%). Bronchial wall thickening and centrilobular nodules were observed more often in M. pneumoniae patients than in S. pneumoniae patients (p < 0.0001). The presence of bilateral bronchial wall thickening or centrilobular nodules was only seen in patients with M. pneumoniae pneumonia. Using the scoring system of the Japanese Respiratory Society guidelines and chest CT findings, 97% of M. pneumoniae patients were suspected to be M. pneumoniae pneumonia without serology. When comparing the CT findings between early stage and progressed stage in the same patients with severe pneumonia, the radiographic features of early stage M. pneumoniae pneumonia were not observed clearly in the progressed stage. The present results indicate that the diagnosis of M. pneumoniae pneumonia would appear to be reliable when found with a combination of bronchial wall thickening and centrilobular nodules in the CT findings. However, these CT findings are not observed in progressed severe M. pneumoniae pneumonia patients

  7. Diagnostic value of CD117 in differential diagnosis of acute leukemias.

    Science.gov (United States)

    Ahmadi, Abbas; Poorfathollah, Ali-Akbar; Aghaiipour, Mahnaz; Rezaei, Mansour; Nikoo-ghoftar, Mahin; Abdi, Mohammad; Gharib, Alireza; Amini, Amir

    2014-07-01

    C-kit receptor (CD117) and its ligand, stem cell factor, play a key role in normal hematopoiesis. It has been demonstrated that its expression extremely increases in leukemias with myeloid commitment. We analyzed findings on CD117 expression together with other myeloid related markers in 203 de novo acute leukemias, referred to Iranian immunophenotyping centers: Iranian Blood Transfusion Organization (IBTO) and Baghiatallah Hospital (BH). All cases were characterized based on the French American British cooperative group (FAB) and European Group for Immunological Classification of Leukemias (EGIL). The cases comprised of 111 acute myeloblastic leukemia (AML), 86 acute lymphoblastic leukemia (ALL), and 6 acute undifferentiated leukemia (AUL). CD117 was positive in 75 % of AML and 50 % of AUL, whereas none of the ALL cases was positive for this marker. Although CD117 was positive in 100 % of M5a cases, no M5b positive was found (p = 0.036). The calculated specificity for myeloid involvement was 100 % for CD117 and CD33, and 98 % for CD13 and CD15 (p < 0.001). The calculated sensitivity for myeloid involvement was 83, 76, 64, and 41 % for CD13, CD117, CD33, and CD15, respectively (p < 0.001). We concluded that CD117 expression is a specific and rather sensitive marker for differential diagnosis between AML and ALL, and except for M5 subtypes, it fails to determine FAB subtypes; lack of expression in M5 can identify M5b. Therefore, it should be included in the routine primary panel for diagnosis of acute leukemias. PMID:24722823

  8. 131I-metaiodobenzylguanidine as an aid in the differential diagnosis af small and round cell tumors

    International Nuclear Information System (INIS)

    131I-MIBG scintigraphy has proven to be highly sensitive (>90%) and specific (almost 100%) in locating neuroblastoma (NB). This may be useful in staging and restaging NB. Another possible value of MIBG scintigraphy is demonstrated: small and round cell tumors (especially in childhood) can present difficult diagnostic problems. NB belongs to this histologic group. Differential diagnosis also includes EWING's sarcoma, rhabdomyosarcoma and malignant lymphoma. Since MIBG is known to concentrate only in NB, this radiopharmaceutical may narrow down the differential diagnosis. This could be demonstrated in four cases: in one of these, the diagnosis of NB was established, in the other three, NB was ruled out; further pathologic work-up in these cases revealed an ALL, a rhabdomyosarcoma and a NHL, respectively. (orig.)

  9. Determining level of endogenous serum erythropoietin for differential diagnosis of polycythemia vera and symptomatic polycythemia

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    Kostyukevych O.M.

    2013-06-01

    Full Text Available The article deals with determining possibility of the assessment of the level of endogenous serum erythropoietin (EPO for differential diagnosis of polycythemia vera (PV and secondary erythrocytosis (SE. The determination of subnormal level of this cytokine for the diagnosis of PV has been detected. The relation between the level of endogenous erythropoietin and iron metabolism also has been analyzed. The study involved 88 patients with PV and 119 patients with SE. Statistically significant decrease in EPO concentration level has been detected in PV patients. The mean EPO level was equal to 6.38 ± 0.84 mIU/mL and 17.98 ±2.48 mIU/mL in PV and SE patients respectively. In control group of individuals EPO concentration was equal to 9,81 ±0,58 mIU/mL, the significant difference was found between all studied groups (р<0.01. According to our data, EPO was increased in 28 SE patients (23.53%, it was not observed in control group and in group of PV patients (φ*emp = 4.355, р<0.01. The decrease of EPO level in PV patients has been detected more often than in SE patients (84.09% versus 11.76% , φ*emp = 5.218, р<0.01, it has not been observed in control group. Only 14 (15.91% PV patients had normal EPO level, in contrast 77 (64.71% SE patients demonstrated normal EPO level (φ*emp = 4.578, р<0.01. The average level of ferritin was equal to 57.41 ± 9.74 ng/mL in PV patients and 199.77 ± 14.32 ng/mL in SE patients (р<0.01. Significantly more patients with PV demonstrated decrease of ferritin level (31.81% versus 7.56%, φ*emp = 4.438, р<0.01. Patients with SE more often had raised level of EPO than PV patients (15.12% versus 4.54%, φ*emp = 2.453, р<0.01. The sensitivity of test with detecting of the reduced level of EPO for the diagnosis of PV was 84.1%, specificity - 87.4%, positive predictive value - 83.1%, negative predictive value - 88.1%. Normal range of EPO significantly (rs = 0,5494 correlated with decreased levels of serum ferritin in

  10. Kallmann综合征1例%Ultrasonography in differential diagnosis of precocious puberty in girls

    Institute of Scientific and Technical Information of China (English)

    邓大同; 朱晖; 孙莉; 章秋; 杨明功

    2011-01-01

    @@ Kallmann综合征是先天性遗传性疾病,又称为"男性特发性低促性腺激素性腺功能减退症(idiopathic hypogonadotropic hypogonadism,IHH)",发病率男性为1/l万,女性为1/5万,笔者于2010年7月27日发现1例,报道如下. 1 临床资料 患者男性,20岁.因"睾丸、阴茎小,男性第二性征不发育"入住我院.患者自幼出现嗅觉障碍,无法辨识出水与酒精的气味,无法辨识香、臭味,但可辨别水与食醋气味差别.父母非近亲结婚,两个妹妹生长发育正常.%Aim To investigate the differential diagnostic value of ulrasound with precocious puberty. Methods The uterine,ovarian follicles were measured by ultrasound. Then these indexes were compared with the normal control groups in the same age. Results The uterine indexes of girls with true-precocious puberty and pseudo-precocious puberty were significantly larger than the normal girls (P < 0.05). The volume of ovary and the largest follicle diameter, a section of the largest number of follictes in true-precocious puberty are larger than the normal girls (P < 0.05). The volume of ovary and the largest follicle diameter, a section of the largest number of follicles in pseudo-precocious puberty are similar to the normal girls(P <0.05). Conclusion Ultrasonography has great value on differential diagnosis of precocious puberty in girls.

  11. Radiographic differential diagnosis between ameloblastoma and odontogenic keratocyst: with emphasis on CT

    International Nuclear Information System (INIS)

    To evaluate clinical and radiographic differential diagnosis between ameloblastoma and odontogenic keratocyst (OKC) using clinical data, plain radiographs, and CT. 25 cases of ameloblastoma and 44 cases of OKC diagnosed in biopsy, were selected from the files stored in Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital from 1999 to 2001, and evaluated using following criteria: sex and age, location, shape, border to normal bone tissue, effect to adjacent tissues, homogeneity in the lumen of the lesion, response of the cortical bone, long-to-short length (L/S) ratio of the lesion, and expansion angle of the cortex. Ameloblastoma and OKC were seen most frequently in third decades and no statistical significance was noted between both sexes. Ameloblastoma occurred most frequently in mandibular angle and ramus area (68%) and OKC at the maxillary molar (34.1%), and mandibular angle and ramus area (43.2%). The root resorption of the adjacent teeth, mandibular canal displacement, and the impaction of teeth were seen more frequently in ameloblastoma than in OKC. The L/S ratio measured in CT was largest in maxillary OKC cases, followed by mandibular ameloblastoma, and mandibular OKC (1.2, 1.8 and 2.4 respectively). The expansion angle of the cortex shows a statistically significant difference between ameloblastoma (48.8 .deg. C) and OKC (31.5 .deg. C). The numeric morphology (L/S ratio) and expansion angle of the cortical bone of the lesion measured in computed tomography can be used to differentiate the ameloblastoma and odontogenic keratocyst.

  12. Differential diagnosis of truly suprasellar space-occupying masses: synopsis of clinical findings, CT, and MRI

    International Nuclear Information System (INIS)

    This review demonstrates the features of truly suprasellar masses in modern imaging based on the clinical, CT, and MRI findings of 42 patients with suprasellar masses in correlation to the histologic findings. The radiologic examinations were evaluated retrospectively to determine if diagnosis can be made based on specific imaging patterns. The most frequent clinical findings of space-occupying suprasellar masses were visual disturbances, diabetes insipidus, and symptoms and signs of occlusive hydrocephalus. There were no clinical features specific for any of the observed masses. Craniopharyngiomas were the most frequent tumors. They appeared in two different forms, as cystic and as solid enhancing masses. The cystic tumors could not be differentiated from cystic hamartomas or cystic gliomas by CT or MRI. The solid craniopharyngiomas were similar to meningiomas and hamartomas. In craniopharyngiomas of adults calcifications were not common. In CT and especially in MRI gliomas were characterized by the diffuse infiltration of the adjacent brain tissue or optic nerve. Except for meningiomas, all lesions were highly variable in appearance, making a reliable characterization by CT and MRI difficult in many cases. However, administration of contrast media in some cases resulted in a better tumor delineation. Compared with unenhanced MRI the enhanced scans did not increase diagnostic efficacy for neoplasms, but were helpful in the differentiation from inflammatory diseases. The MRI technique was superior to CT in demonstrating the anatomic relationships, thus facilitating evaluation of origin and extent of the lesions. The CT technique, of course, was more reliable in the detection of calcifications. Both CT and MRI are not tissue-specific, however, and suprasellar tumors as well as many other neoplasms cannot be classified using only one of these imaging techniques. (orig.)

  13. Differential diagnosis of parotid gland tumours: which magnetic resonance findings should be taken in account?

    Science.gov (United States)

    Tartaglione, T; Botto, A; Sciandra, M; Gaudino, S; Danieli, L; Parrilla, C; Paludetti, G; Colosimo, C

    2015-10-01

    Our aim was to define typical magnetic resonance (MRI) findings in malignant and benign parotid tumours. This study is based on retrospective evaluation of pre-surgical MRI of 94 patients with parotid gland tumours. Histology results were available for all tumours. There were 69 cases of benign (73%) and 25 cases of malignant (27%) tumours, including 44 pleomorphic adenomas, 18 Warthin's tumours, 7 various benign tumours, 6 squamous cell carcinomas, 3 carcinoma ex pleomorphic adenomas, 2 mucoepidermoid carcinomas, 1 adenoid cystic carcinoma and 13 various malignant tumours. The following MRI parameters were evaluated: shape, site, size, margins, signal intensity (SI) on T1w and T2w images, contrast enhancement, signal of cystic content, presence or absence of a capsule, perineural spread, extraglandular growth pattern and cervical adenopathy. Statistical analysis was performed to identify the MRI findings most suggestive of malignancy, and to define the most typical MRI pattern of the most common histologies. Ill-defined margins (p parotid inferior process (p < 0.001) and mild or incomplete contrast enhancement (p = 0.01). SI on T1w and T2w images and contrast enhancement enables differential diagnosis between pleomorphic adenoma and Warthin's tumour. PMID:26824912

  14. Primary Synovial Sarcoma of Kidney: A Rare Differential Diagnosis of Renomegaly

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    Gaurang Modi

    2014-01-01

    Full Text Available Synovial sarcomas (SS are classified as subgroup of soft tissue sarcomas affecting mainly extremities of young adults. Primary SS of kidney are very rare tumours with poor prognosis. Though they have characteristic histology and immunohistochemistry (IHC due to rarity of incidence it is difficult to diagnose them. Sometimes chromosomal rearrangement studies are required to confirm the diagnosis. We are presenting a case of 41-year-old male who was referred to our cancer centre for evaluation of left renal mass. CT scan of abdomen revealed a large left renal mass encasing the aorta. Biopsy of renal mass revealed poorly differentiated sarcoma and IHC was positive for vimentin, CD99, and BCL2 and negative for AE1, epithelial membrane antigen, and leukocyte common antigen. The patient was clinically inoperable as renal mass was encasing the aorta. So he was subsequently offered palliative chemotherapy in form of ifosfamide and adriamycin. CT abdomen shows partial response after 3 cycles of chemotherapy according to RECIST criteria.

  15. Differential diagnosis of thyroid nodules with virtual touch tissue imaging of ARFI elastography

    Science.gov (United States)

    Li, Tao; Zhou, Pei; Ding, Mingyue; Mi, Yongwei; Li, Yiyong; Zhang, Ji

    2016-04-01

    The aim of this study was to evaluate the diagnostic performance of virtual touch tissue imaging (VTI) based on ARFI elastography technique for differentiating malignant from benign thyroid nodules. One hundred pathologically proven thyroid nodules (80 benign, 20 malignant) in 76 participants were recruited in this study. The likelihood of malignancy in the light of VTI features was scored into 6 levels by one experienced sonogist who was blinded to pathological results. In addition, the mean gray value within the thyroid nodule (mGVTN) derived from VTI image was calculated for quantitative analysis. Receiver-operating characteristic curve (ROC) analyses were performed to assess the diagnostic performance of VTI score and mGVTN. The frequency of malignant nodules (11/20) classified between VTI levels 4 to 6 was more than that of benign nodules (6/80) (p thyroid nodules. The diagnosis performance of mGVTN was almost consistent with that of VTI score, which indicated that the mGVTN as a quantitative parameter might facilitate doctors diagnosing malignant thyroid nodules by VTI.

  16. Clinical Relevance of Compression Elastography in Differential Diagnosis of Pancreatic Cystic Masses

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    Morozova Т.G.

    2014-06-01

    Full Text Available The aim of the investigation was to assess the capabilities of compression elastography in differential diagnosis of pancreatic cystic tumors. Materials and Methods. 15 patients with pancreatic cystic masses were examined. There were the following clinical forms: pancreatic pseudocysts in chronic pancreatitis — 9 (60%, pancreatic cystadenocarcinoma — 4 cases (26.7%, pancreatic cyst in intraductal papillary-mucinous adenoma — 2 cases (13.3%. The patients underwent pancreatic and hepatic sonography, fibrogastroduodenoscopy and compression elastography with endosonography. Referential techniques were helical computed tomography and ultrasound-guided pancreatic paracenthesis. The patients were operated on within 3–4 months, the diagnoses were histologically verified. Compression elastographic strain ratio (SR was calculated by the program in ultrasonic apparatus, i.e.: the image was fixed in “an interest area” (a focal lesion, from two to three measuring points were established using a special cursor, and the program calculated SR. Results. We determined optimal threshold values of compression elastography indices, when diagnostic sensitivity, specificity and accuracy of the technique were maximum; and showed significant clinical capabilities and prospects of compression elastography applied in endosonography. SR in cystadenocarcinoma was 34.1–42.5 RU, in solid pseudopapillary tumor — from 44.7 RU, in postnecrotic cysts — from 13 to 25 RU. Conclusion. The data analysis showed that the application of compression elastography in endosonography enabled to increase the informative value of clinical laboratory examination of patients with pancreatic cystic masses.

  17. Non-functioning parathyroid adenoma: a rare differential diagnosis for vocal-cord paralysis.

    Science.gov (United States)

    Kamali, D; Sharpe, A; Nagarajan, S; Elsaify, W

    2016-07-01

    Introduction Adenomas of the parathyroid gland typically present with symptoms of hyperparathyroidism, manifested by fatigue, bone pain, abdominal pain, weakness, dyspepsia, nephrolithiasis and skeletal bone disease. Here, we describe, for the first time, a case of a non-functioning benign tumour of the parathyroid gland presenting as vocal-cord paralysis. Case History A 49-year-old male presented with a 10-week history of dysphonia and the feeling of having 'something stuck in my throat'. History-taking elicited no other associated symptoms. Flexible nasal endoscopy demonstrated paralysis of the left vocal cord. Computed tomography of the neck revealed a cystic lesion, 18mm in diameter adjacent to the oesophagus. After more rigorous tests, a neck exploration, left hemithyroidectomy, excision of the left paratracheal mass and level-VI neck dissection was undertaken, without incident to the patient or surgical team. Histology was consistent with a parathyroid adenoma. Conclusions This case emphasises the importance of including adenomatous disease of the parathyroid gland in the differential diagnosis despite normal parathyroid status as a cause of vocal cord palsy. PMID:27055408

  18. Dynamic automated synovial imaging (DASI) for differential diagnosis of rheumatoid arthritis

    Science.gov (United States)

    Grisan, E.; Raffeiner, B.; Coran, A.; Rizzo, G.; Ciprian, L.; Stramare, R.

    2014-03-01

    Inflammatory rheumatic diseases are leading causes of disability and constitute a frequent medical disorder, leading to inability to work, high comorbidity and increased mortality. The gold-standard for diagnosing and differentiating arthritis is based on patient conditions and radiographic findings, as joint erosions or decalcification. However, early signs of arthritis are joint effusion, hypervascularization and synovial hypertrophy. In particular, vascularization has been shown to correlate with arthritis' destructive behavior, more than clinical assessment. Contrast Enhanced Ultrasound (CEUS) examination of the small joints is emerging as a sensitive tool for assessing vascularization and disease activity. The evaluation of perfusion pattern rely on subjective semiquantitative scales, that are able to capture the macroscopic degree of vascularization, but are unable to detect the subtler differences in kinetics perfusion parameters that might lead to a deeper understanding of disease progression and a better management of patients. We show that after a kinetic analysis of contrast agent appearance, providing the quantitative features characterizing the perfusion pattern of the joint, it is possible to accurately discriminate RA from PSA by building a random forest classifier on the computed features. We compare its accuracy with the assessment performed by expert radiologist blinded of the diagnosis.

  19. Focal adenomyosis (intramural endometriotic cyst) in a very young patient - differential diagnosis with uterine fibromatosis.

    Science.gov (United States)

    Manta, L; Suciu, N; Constantin, A; Toader, O; Popa, F

    2016-01-01

    Introduction. Adenomyosis is a widespread disease usually affecting the late reproductive years of the women's life, which has a great impact on their fertility. The most common form is diffuse adenomyosis, while focal adenomyosis, a cystic variant, is very rare, particularly in patients younger than 30 years old. Materials and methods. We reported a rare case of a 20-year-old Caucasian woman with cystic adenomyosis who was admitted in our service with severe chronic pelvic pain, dysmenorrhea, and menorrhagia, who had received conservative surgical treatment to preserve fertility and improve her obstetrical prognosis. Results and Discussions. Although the necrobiosis of a uterine fibroid was suspected preoperatively, the extemporaneous histopathological exam revealed adenomyosis associated with fibroleiomyoma with hyaline dystrophy and multiple foci of endometriosis of cystic formation in the wall of a young woman without any risk factors. Conclusion. Although a rare lesion in young patients, cystic adenomyosis should be considered when chronic pelvic pain is exacerbated during menstruation and is associated with a uterine tumor. In young patients, the differential diagnosis should be made with uterine malformations (hematometra), necrobiosis of uterine fibroids, pelvic endometriosis. The surgical treatment should be conservative with the excision of the lesion, always taking into account fertility preservation in young patients. PMID:27453751

  20. Residual Salivary Secretion Ability May Be a Useful Marker for Differential Diagnosis in Autoimmune Diseases

    Directory of Open Access Journals (Sweden)

    Etsuko Maeshima

    2014-01-01

    Full Text Available Background. We have elucidated decreased resting salivary flow in approximately 60% of patients with autoimmune diseases not complicated by Sjögren syndrome (SjS. In this study, salivary stimulation tests using capsaicin were performed to examine residual salivary secretion ability in patients with autoimmune diseases. Materials and Methods. Fifty-eight patients were divided into three groups: patients with primary or secondary SjS (SjS group, patients with systemic sclerosis not complicated by SjS (SSc group, and patients with other autoimmune diseases (non-SjS/non-SSc group. Simple filter paper and filter paper containing capsaicin were used to evaluate salivary flow rates. Results. Resting salivary flow rates were significantly lower in the SjS and SSc groups than in the non-SjS/non-SSc group but did not differ significantly between the SjS and SSc groups. Capsaicin-stimulated salivary flow rates were significantly lower in the SjS and SSc groups than in the non-SjS/non-SSc group, but not significantly different between the SjS and SSc groups. In the non-SjS/non-SSc group, salivary flow rates increased after capsaicin stimulation to the threshold level for determination of salivary gland dysfunction, whereas no improvement was observed in the SjS and SSc groups. Conclusion. Residual salivary secretion ability may be a useful marker for differential diagnosis in autoimmune diseases.

  1. Chronic pulmonary embolism - radiological imaging and differential diagnosis; Chronische Lungenembolie - Radiologische Bildmorphologie und Differenzialdiagnose

    Energy Technology Data Exchange (ETDEWEB)

    Coppenrath, E.; Herzog, P.; Attenberger, U.; Reiser, M. [Klinikum Innenstadt der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany)

    2007-08-15

    In chronic pulmonary embolism branches of the pulmonary arterial tree remain partially or totally occluded. This may lead to pulmonary hypertension with the development of right ventricular hypertrophy as well as structural changes of pulmonary arteries. Imaging of chronic pulmonary embolism should prove vessel occlusions (pulmonary angiography, MSCT, MRI) and reduction of regional lung perfusion (lung scanning, MSCT, MRI). According to current guidelines ventilation-perfusion lung scanning and pulmonary angiography are still recommended as the methods of choice. MSCT and MRI provide technical alternatives which are helpful in differential diagnosis versus other types of pulmonary hypertension. In spite of medical and surgical measures (in rare cases pulmonary thromboendarterectomy) the prognosis of chronic pulmonary embolism remains unfavourable. (orig.) [German] Bei der chronischen Lungenembolie sind Abschnitte der arteriellen Lungenstrombahn dauerhaft verschlossen. Dies kann zu einer Erhoehung des pulmonal-arteriellen Drucks mit den Folgen einer Rechtsherzbelastung und strukturellen Veraenderungen der Pulmonalarterien fuehren. Bildmorphologisch nachzuweisen sind Gefaessverschluesse (Pulmonalisangiographie, MSCT, MRT) und die Minderperfusion des Lungenparenchyms (Szintigraphie, MSCT, MRT). Nach den bisherigen Empfehlungen gelten fuer die Diagnostik der chronischen Lungenembolie die Lungenszintigraphie (Ventilation/Perfusion) und die Pulmonalisangiographie als Methoden der ersten Wahl. Die MSCT und MRT (Angiographie/Perfusion) stellen technische Alternativen dar. Differenzialdiagnostisch sind andere Formen der pulmonalen Hypertonie abzugrenzen. Trotz medikamentoeser und chirurgischer Therapiemassnahmen (z. B. pulmonale Thrombendarterektomie) bleibt die Prognose der chronischen Lungenembolie unguenstig. (orig.)

  2. Most frequent causes, complications and differential diagnosis of neonatal respiratory distress in chest X-ray

    Energy Technology Data Exchange (ETDEWEB)

    Ponhold, W. (Vienna Univ. (Austria). Kinderklinik)

    1982-01-01

    The radiologic changes of the chest X-ray of 270 newborns with respiratory distress were analyzed. In cases of Hyaline Membranes the chest X-Ray showed finely granular evenly disseminated structures combined with signs of hypoventilation. Localized, patchy, streaky, homogenous and reticulonodular shadows were found in cases of pneumonia and hemorrhage. Hyperinflation were an additional sign for an inflammatory disease. This symptom was also demonstrated in pulmonary bleeding, but was less common. The bilateral interstitial augmentation of the pulmonary structure in combination with cardiomegaly was mainly a symptom for cardial insufficiency and transient tachypnea. The differentiation between fine granular and reticulo-nodular structures should create no problem if the chest X-ray is of good quality. Extrapulmonary air collections were found in a high percentage in the course of artificial ventilation as a consequence of the 'baro-trauma'. The radiologic diagnosis of BPD was no problem. The value of the chest X-ray lies in the demonstration of a pulmonary cause for the respiratory distress, in the demonstration of complications and in the radiological observation of the disease.

  3. CT characterization of bile duct dilatation: Differential diagnosis of obstructive jaundice

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Jae Hoon; Yoon, Hyp; Ko, Young Tae; Lee, Dong Ho; Yang, Ik [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1992-07-15

    Each disease affecting the bile ducts tends to produce characteristic pattern of biliary dilatation: recurrent pyogenic cholangitis causes dilatation and straightening of the larger (central) intrahepatic ducts: clonorchiasis causes dilatation of the smaller (peripheral) intrahepatic ducts; and carcinoma along the extrahepatic ducts causes (proportional) dilatation and tortuosity of both larger and smaller intrahepatic ducts. To evaluate the specificity of the pattern and morphology of the dilated biliary tree on CT scans (CT characterization) three independent radiologists who were unifamiliar with the cases were asked to classify 62 CT scans in patients with obstructive jaundice. The case population consisted of 14 cases with recurrent pyogenic cholangitis, 18 cases with clonorchiasis and 30 cases with carcinoma along the extrahepatic ducts, which were intermixed randomly. Classification was made only on the basis of CT characterization: those scans showing primary lesions, i.t., stone , aggregate of flukes, or tumor mass were excluded or masked. All the scans of every cases showing the extrahepatic bile duct were masked . Radiologists correctly classified 54 of the 62 cases (87%): ten of the 14 patients with recurrent pyogenic cholangitis (71%). 17 of the 18 patients with clonorchiasis (94%) and 27 of the 30 patients with carcinoma along the extrahepatic bile ducts (90%). We believe that CT characterization of bile dust dilatation is useful in the differential diagnosis of obstructive jaundice, especially when a primary pathologic lesion is not depicted in CT scans.

  4. Pitt-Hopkins Syndrome and Differential Diagnosis: A Molecular and Clinical Challenge.

    Science.gov (United States)

    Marangi, Giuseppe; Zollino, Marcella

    2015-09-01

    Pitt-Hopkins syndrome is an emerging neurodevelopmental disorder caused by haploinsufficiency of the TCF4 gene on chromosome 18q21. It is characterized by severe intellectual disability, seizures, microcephaly, constipation and a distinctive facial gestalt. Although the overlapping phenotype of microcephaly, epilepsy, absent speech and constipation represents a challenge for the differential diagnosis with Angelman syndrome, Rett syndrome and Mowat-Wilson syndrome, distinctive of Pitt-Hopkins syndrome are breathing abnormalities, that can occur as either hyperventilation episodes or apnea crises, and a typical facial dysmorphism, including bitemporal narrowing, squared forehead, deep-set eyes, peculiar nose conformation, with broad nasal bridge, down-turned nasal tip and flaring nostrils, typical shape of the mouth, with a tented and M shaped upper lip, and widely spaced teeth. The occurrence of these signs in variable association of uncoordinated movements, microcephaly of postnatal onset, eye abnormalities, constipation, epilepsy and subtle brain abnormalities is highly predictive of a TCF4 mutation, making it possible to plan a genetic test of choice among severe encephalopathies. Angelman syndrome represents the nosological condition closest to Pitt-Hopkins syndrome. PMID:27617128

  5. Differential diagnosis and prognosis of T1-weighted post-gadolinium intralabyrinthine hyperintensities

    Energy Technology Data Exchange (ETDEWEB)

    Dubrulle, F.; Puech, P.; Ernst, O. [University Nord of France, Department of Radiology, CHU Lille, Huriez Hospital INSERM, Lille (France); Kohler, R. [CHU Lille, Huriez Hospital, Department of Radiology, Lille (France); Vincent, C. [CHU Lille, Department of Otology and Oto-neurosurgery, Lille (France)

    2010-11-15

    The aim of this longitudinal study is to describe the different intralabyrinthine lesions yielding high signal intensity on T1-weighted (T1W) images after intravenous gadolinium and then to analyze the follow-up of these patients. Thirty-seven patients were included and followed clinically and radiologically. A precise analysis of MR labyrinthine signals allowed exact depiction of the different lesions. Special interest is focused on the intralabyrinthine fluid signal on 3D high-resolution T2W images. The enhanced T1W labyrinthine hyperintensities correspond to two different categories: intralabyrinthine enhancement (15 intralabyrinthine schwannomas, 13 labyrinthitis, 1 inflammatory granuloma) and spontaneous T1W hyperintensities (8 intralabyrinthine hemorrhages). Hemorrhagic lesions show a substantial decrease of the intralabyrinthine fluid signal on the 3D HRT2 that evolves to ossification. In labyrinthitis, the importance of the initial labyrinthine fluid signal decrease on the 3D HRT2 is well correlated with the hearing prognosis. A meticulous analysis of inner ear lesions allows various intralabyrinthine lesions, in particular schwannomas, to be differentiated from labyrinthitis. T1W imaging without gadolinium is essential for the correct diagnosis of rapidly evolving hearing loss. In labyrinthitis and intralabyrinthine hemorrhage, 3D HRT2 brings an interesting prognostic factor for the chance of hearing recovery. (orig.)

  6. Differential diagnosis in patients with ring-like thallium-201 uptake in brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kinuya, Keiko; Ohashi, Masahiro; Itoh, Syotaro [Tonami General Hospital, Toyama (Japan)] (and others)

    2002-09-01

    This study was performed to investigate lesions with ring-like thallium-201 ({sup 201}Tl) uptake and to determine whether SPECT provides any information in differential diagnosis. A total of 244 {sup 201}Tl SPECT images were reviewed. In each study, early (15 min postinjection) and late (3 hr) brain SPECT images were obtained with 111 MBq of {sup 201}Tl. The early uptake ratio (ER; lesion to normal brain average count ratio) and the late uptake ratio (LR) and the L/E ratio (ratio of LR to ER) were calculated. Ring-like uptake was observed in pre-therapeutic 26 SPECT images, including ten glioblastoma multiformes (ER, 3.45{+-}0.64; LR, 2.74{+-}0.54; L/E ratio 0.80{+-}0.13), five meningiomas (6.48{+-}2.34; 4.41{+-}1.41; 0.72{+-}0.19), four metastatic lung cancers (3.47{+-}1.23; 2.40{+-}0.98; 0.70{+-}0.14), four brain abscesses (2.48{+-}1.06; 1.59{+-}0.30; 0.78{+-}0.15), one invasive lesion of squamous cell carcinoma from the ethmoid sinus (1.54; 1.52; 0.99), one medulloblastoma (3.53; 3.52; 1.00) and one hematoma (3.32; 2.36; 0.71). The ER of meningioma was significantly higher than those of glioblastoma multiforme (p<0.0005), metastatic lung cancer (p<0.005) and brain abscess (p<0.0005). There were no significant differences among these three entities. The LR of meningioma was significantly higher than those of glioblastoma multiforme (p<0.005), metastatic lung cancer (p<0.005) and brain abscess (p<0.0001). The LR of brain abscess was significantly lower than that of glioblastoma multiforme (p<0.05). The L/E ratio could not differentiate these four entities. High ER and high LR in a lesion with ring-like uptake is likely an indicator of meningioma. The LR of brain abscess was significantly lower than that of glioblastoma multiforme, but {sup 201}Tl SPECT has still difficulty in differentiating abscess from brain tumor. (author)

  7. Evaluation of elastic fibers pattern with orcein staining in differential diagnosis of lichen planopilaris and discoid lupus erythematosus.

    Directory of Open Access Journals (Sweden)

    Zahra Farzaneh Asadi Kani

    2014-03-01

    Full Text Available Differential diagnosis of lichen planopilaris and discoid lupus erythematosus especially in late stages is a problem for clinicians and pathologists. Our aim was to find discriminator histopathologic findings that help us to achieve definite diagnosis without using immunofluorescence study. The histopathologic findings in 77 cases of lichen planopilaris were compared with those of 26 cases of discoid lupus erythematosus with Hematoxylin & Eosin and especially staining (Alcian blue pH 2.5, Periodic Acid Shiff, Orcein. Final histopathologic diagnosis was based on histologic findings, clinicopathological correlation, past medical history and immunofluorescence studies if were applied before. Then elastic fibers pattern in dermis and follicular sheath with orcein staining were described without having information about final diagnosis. New and subtle presentations of histologic changes were assessed. We compared all histopathologic finding for each staining method. Some histologic changes such as hypergranulosis, epidermal atrophy, mucin deposition, diffuse scar and some other patterns were not specific for any diagnosis. A setting of histopathologic findings and clinicopathological correlation were needed for accurate diagnosis. We had only one specimen for the vertical section, and we had no horizontal sections. Description of elastic fibers pattern in orcein staining may be helpful in achieving a specific diagnosis, but this is not completely reliable, and we had overlap features. Finally, immunofluorescence study may be recommended for suspicious cases.

  8. 眩晕的诊断与鉴别诊断%The diagnosis and differential diagnosis of vertigo

    Institute of Scientific and Technical Information of China (English)

    潘婕; 罗本燕

    2011-01-01

    Summary: Vertigo refers to an illusion of motion between the body and the surroundings, which is one of the common chief complainsin clinies of neurology.This study shed light on the diagnosis and diferential diagnosis of vertigo based on the authors'clinical experience and new advances in vertigo studies during the recent years.%眩晕是指发生于自身与周围物体之间的运动幻觉,是神经内科门诊常见主诉之一.文章将以临床经验为基础,结合近年来的研究进展,将眩晕的诊断与鉴别诊断做一概述.

  9. Prenatal Diagnosis of Treacher-Collins Syndrome Using Three-Dimensional Ultrasonography and Differential Diagnosis with Other Acrofacial Dysostosis Syndromes

    OpenAIRE

    Daniela Cardoso Pereira; Luiz Claudio de Silva Bussamra; Edward Araujo Júnior; Carolina Leite Drummond; Luciano Marcondes Machado Nardozza; Antonio Fernandes Moron; José Mendes Aldrighi

    2013-01-01

    Treacher-Collins syndrome (TCS) is a rare dominant autosomal anomaly resulting from malformation or disruption of the development of the first and second branchial arches. It is characterized by micrognathia, malar hypoplasia, and malformations of the eyes and ears. The prenatal diagnosis using two-dimensional ultrasonography (2DUS) is characterized by identification of facial malformations together with polyhydramnios. Three-dimensional ultrasonography (3DUS) has the capacity to spatially di...

  10. Some boys' problems in education

    DEFF Research Database (Denmark)

    Jørgensen, Christian Helms

    2015-01-01

    The last two decades have seen an increasing political concern in the high dropout rates and low performance in education of boys compared to girls – at times in the form of a ‘moral panic’. This has also been the case in Denmark where ‘the boy problem’ in education now is placed high on the agenda...... have in VET. Secondly, it explores the role of VET for students at risk of dropping out based on individual qualitative interviews with 106 students, two-thirds male, attending vocational schools in Denmark. The analyses show that most students experience the dual system of VET as a valuable...... alternative to general education, but social and institutional processes of differentiation in the vocational schools place a significant group of students in a position where they have little chance of completing the programme. In the conclusion, some reflections are made on the effect of a recent reform of...

  11. MAGNETIC RESONANCE IMAGING OF THE SACROILIAC JOINT IN DIFFERENTIAL DIAGNOSIS OF EARLY POLYARTICULAR PSORIATIC AND RHEUMATOID ARTHRITIS (STUDY DATA REMARKA)

    OpenAIRE

    Elena Yu Loginova; T. V. Korotaeva; E L Luchihina; Smirnov, A. V.; A A Glazkov; D E Karateev

    2014-01-01

    Diagnosis of lesions of the spine and sacroiliac joints may be helpful in discrimination between early psoriatic arthritis (ePsA) and early rheumatoid arthritis (eRA).Objective. To assess the significance of inflammatory back pain (IBP), HLA-B27, and active sacroiliitis (ASI) confirmed by magnetic resonance imaging (MRI) for differential diagnosis of polyarticular ePsA and eRA.Materials and Methods. The study included 29 patients with ePsA (13 males and 16 females, mean age 36.52 ± 11.27 year...

  12. Granulomatous slack skin T-cell lymphoma: an important differential diagnosis with giant cell tumor of soft tissue.

    Science.gov (United States)

    Adriano, André Ricardo; Lima, Tiago Silveira; Battistella, Maxime; Bagot, Martine

    2015-01-01

    Granulomatous slack skin is an indolent T-cell lymphoma, considered to be a variant of mycosis fungoides. Clinically it is characterized by areas of redundant skin, wrinkled, inelastic, with variable erythema and infiltration besides a poikilodermic surface. A differential diagnosis unknown to most dermatologists is the giant cell tumor of soft tissue, which is an extremely rare low-grade sarcoma. The authors report a patient who had undergone extensive surgery because of a primary diagnosis of giant cell tumor of soft tissue, but which proved to be granulomatous slack skin after a second interventional procedure with confirmatory histopathology. PMID:26734874

  13. Granulomatous slack skin T-cell lymphoma: an important differential diagnosis with giant cell tumor of soft tissue*

    Science.gov (United States)

    Adriano, André Ricardo; Lima, Tiago Silveira; Battistella, Maxime; Bagot, Martine

    2015-01-01

    Granulomatous slack skin is an indolent T-cell lymphoma, considered to be a variant of mycosis fungoides. Clinically it is characterized by areas of redundant skin, wrinkled, inelastic, with variable erythema and infiltration besides a poikilodermic surface. A differential diagnosis unknown to most dermatologists is the giant cell tumor of soft tissue, which is an extremely rare low-grade sarcoma. The authors report a patient who had undergone extensive surgery because of a primary diagnosis of giant cell tumor of soft tissue, but which proved to be granulomatous slack skin after a second interventional procedure with confirmatory histopathology. PMID:26734874

  14. Prenatal Diagnosis of Treacher-Collins Syndrome Using Three-Dimensional Ultrasonography and Differential Diagnosis with Other Acrofacial Dysostosis Syndromes

    Directory of Open Access Journals (Sweden)

    Daniela Cardoso Pereira

    2013-01-01

    Full Text Available Treacher-Collins syndrome (TCS is a rare dominant autosomal anomaly resulting from malformation or disruption of the development of the first and second branchial arches. It is characterized by micrognathia, malar hypoplasia, and malformations of the eyes and ears. The prenatal diagnosis using two-dimensional ultrasonography (2DUS is characterized by identification of facial malformations together with polyhydramnios. Three-dimensional ultrasonography (3DUS has the capacity to spatially display these facial malformations, thus making it easy for the parents to understand them. We present a case of TCS diagnosed in the 33rd week using 3DUS, with postnatal confirmation using cranial computed tomography and anatomopathological analysis.

  15. Cerebrospinal fluid P-tau181P: biomarker for improved differential dementia diagnosis

    Directory of Open Access Journals (Sweden)

    Hanne eStruyfs

    2015-06-01

    Full Text Available The goal of this study is to investigate the value of tau phosphorylated at threonine 181 (P-tau181P in the Alzheimer’s disease (AD cerebrospinal fluid (CSF biomarker panel for differential dementia diagnosis in autopsy confirmed AD and non-AD patients.The study population consisted of 140 autopsy confirmed AD and 77 autopsy confirmed non-AD dementia patients. CSF concentrations of Aβ1-42, T-tau, and P-tau181P were determined with single analyte ELISA-kits (INNOTEST®, Fujirebio, Ghent, Belgium. Diagnostic accuracy was assessed through receiver operating characteristic (ROC curve analyses to obtain area under the curve (AUC values and to define optimal cutoff values to discriminate AD from pooled and individual non-AD groups. ROC curve analyses were only performed on biomarkers and ratios that differed significantly between the groups. Pairwise comparison of AUC values was performed by means of DeLong tests.The Aβ1-42/P-tau181P ratio (AUC=0.770 performed significantly better than Aβ1-42 (AUC=0.677, P=0.004, T-tau (AUC=0.592, P<0.001, and Aβ1-42/T-tau (AUC=0.678, P=0.001, while P-tau181P (AUC=0.720 performed significantly better than T-tau (AUC=0.592, P<0.001 to discriminate between AD and the pooled non-AD group. When comparing AD and the individual non-AD diagnoses, Aβ1-42/P-tau181P (AUC=0.894 discriminated AD from frontotemporal dementia significantly better than Aβ1-42 (AUC=0.776, P=0.020 and T-tau (AUC=0.746, P=0.004, while P-tau181P/T-tau (AUC=0.958 significantly improved the differentiation between AD and Creutzfeldt-Jakob disease as compared to Aβ1-42 (AUC=0.688, P=0.004, T-tau (AUC=0.874, P=0.040, and Aβ1-42/P-tau181P (AUC=0.760, P=0.003.In conclusion, this study demonstrates P-tau181P is an essential component of the AD CSF biomarker panel and combined assessment of Aβ1-42, T-tau, and P-tau181P renders, to present date, the highest diagnostic power to discriminate between AD and non-AD dementias.

  16. Neuro-Spect and neuropsychological test in the differential diagnosis of dementia

    International Nuclear Information System (INIS)

    differential diagnosis of dementia. However, these are preliminary results that needed to be confirmed in larger number of patients

  17. The Role of Computer-aided Detection and Diagnosis System in the Differential Diagnosis of Thyroid Lesions in Ultrasonography

    Directory of Open Access Journals (Sweden)

    Tien-Chun Chang

    2015-12-01

    Full Text Available To avoid abuse of fine-needle aspiration cytology (FNAC and to save the time of a learning curve, a computer-aided detection and diagnosis (CAD system to detect suspicious lesions for FNAC from thyroid ultrasonography has been developed by the Department of Industrial Engineering, cooperative with the Department of Surgery at the National Taiwan University, Taipei, Taiwan. The purposes of this article are to introduce how to utilize the CAD system in thyroid ultrasonography, and to outline the real role of the CAD system. After marking the apparently transverse (extending across axis and longitudinal axis of the nodule appearing by ultrasonography, four parameters are calculated and displayed by the computer system automatically, which include microcalcifications, hypoechoic lesion, heterogeneity, and indistinct margin. The results are displayed by the pointers in the semilunar figures. The necessity of FNAC is dependent on the size and numbers of positive findings (pointers displayed in the right side. This CAD system is objective and easy to use. It may supply an easy method to determine the necessity for FNAC, but what we must keep in mind is that this method can reduce the necessity of FNAC, not replace FNAC for the diagnosis of thyroid cancer.

  18. Efficacy of thyroid ultrasound elastography in differential diagnosis of small thyroid nodules

    International Nuclear Information System (INIS)

    Objective: To explore the efficacy of thyroid ultrasound (US) elastography in differential diagnosis of small thyroid nodules. Methods: This HIPAA-compliant study was approved by the Institutional Review Board and all patients provided written informed consent. Thirty-five patients with 38 small thyroid nodules as seen on transverse ultrasound image formed our study population. An US examination and a separate thyroid elastography examination with pulsation from the carotid artery used as the compression source were performed before fine-needle aspiration. Baseband US data were acquired for off-line elastography processing, where a semi-quantitative index for each nodule was calculated. The Kruskal–Wallis nonparametric rank sum test was used to assess equality of population means among the different types of thyroid nodules. Maximum likelihood estimation of the curve parameters for a binomial receiver operating characteristic (ROC) curve was performed. Results: Elasticity contrast index calculated with elastography was effective in distinguishing between small papillary thyroid carcinomas (PTMC, n = 8) and other lesions (n = 30) in small thyroid nodules (p = 0.0036). The area under the ROC curve for diagnosing PTMCs was 0.812 with a 95% confidence interval of 0.653–0.920. The cut-off value of ECI of 3.6 led to a sensitivity of 100% and a specificity of 60% for detecting PTMCs. Conclusion: Noninvasive evaluation of small thyroid nodules is possible using thyroid US elastography with in vivo compression to pick out the most suspicious thyroid nodules for fine-needle aspiration (FNA) and avoid FNA in benign nodules

  19. Efficacy of thyroid ultrasound elastography in differential diagnosis of small thyroid nodules

    Energy Technology Data Exchange (ETDEWEB)

    Dighe, Manjiri, E-mail: dighe@u.washington.edu [Department of Radiology, Box 357115, 1959 NE Pacific Street, University of Washington, Seattle, WA 98195 (United States); Luo, Si [Department of Bioengineering, University of Washington, William H. Foege Building, N510B, 3720 15th Ave NE, Seattle, WA 98195-5061 (United States); Cuevas, Carlos, E-mail: cuevas@u.washington.edu [Department of Radiology, Box 357115, 1959 NE Pacific Street, University of Washington, Seattle, WA 98195 (United States); Kim, Yongmin, E-mail: ykim@u.washington.edu [Department of Bioengineering, University of Washington, Box 355061, Seattle, WA 98195-5061 (United States)

    2013-06-15

    Objective: To explore the efficacy of thyroid ultrasound (US) elastography in differential diagnosis of small thyroid nodules. Methods: This HIPAA-compliant study was approved by the Institutional Review Board and all patients provided written informed consent. Thirty-five patients with 38 small thyroid nodules as seen on transverse ultrasound image formed our study population. An US examination and a separate thyroid elastography examination with pulsation from the carotid artery used as the compression source were performed before fine-needle aspiration. Baseband US data were acquired for off-line elastography processing, where a semi-quantitative index for each nodule was calculated. The Kruskal–Wallis nonparametric rank sum test was used to assess equality of population means among the different types of thyroid nodules. Maximum likelihood estimation of the curve parameters for a binomial receiver operating characteristic (ROC) curve was performed. Results: Elasticity contrast index calculated with elastography was effective in distinguishing between small papillary thyroid carcinomas (PTMC, n = 8) and other lesions (n = 30) in small thyroid nodules (p = 0.0036). The area under the ROC curve for diagnosing PTMCs was 0.812 with a 95% confidence interval of 0.653–0.920. The cut-off value of ECI of 3.6 led to a sensitivity of 100% and a specificity of 60% for detecting PTMCs. Conclusion: Noninvasive evaluation of small thyroid nodules is possible using thyroid US elastography with in vivo compression to pick out the most suspicious thyroid nodules for fine-needle aspiration (FNA) and avoid FNA in benign nodules.

  20. Voxel-based moprhometry in the differential diagnosis of posttraumatic cognitive impairments

    Directory of Open Access Journals (Sweden)

    M.M. Odinak

    2014-01-01

    Full Text Available Brain injury (BI is a major cause of cognitive impairments (CI in young people. However, many aspects of their development remain unstudied. In particular, the role of neurodegenerative and vascular processes in the occurrence of posttraumatic disorders of higher cortical functions is still unclear. Voxel-based morphometry is one of the current neuroimaging techniques. Objective: to comprehensively study a change in the volume indicators of a number of brain structures in patients with posttraumatic, vascular, and amnestic CI.Patients and methods. The investigation enrolled 123 patients who were divided into 5 groups: 1 20 examinees without CI (a control group; 2 22 patients with mild and moderate CI and a history of mild recurrent CI; 3 19 patients with moderate posttraumatic CI after severe brain contusion; 4 41 patients with moderate vascular CI; 5 21 patients with moderate amnestic CI. Before divided into the groups, all the patients underwent comprehensive neuropsychological testing, which enabled different aspects of cognitive performance to be assessed.Results. Atrophic changes were ascertained to be uncharacteristic for the patients who had sustained mild recurrent BI. At the same time, the patients with severe consequences of BI showed a significant decrease in the volume of brain regions, primarily in that of frontal and temporal lobes. A combined comprehensive assessment of the results obtained in the group analysis using SPM8 and calculating absolute volume values using MRICroN allowed one to more accurately understand the nature of neurodegenerative changes. Comparative assessment of the data obtained in the posttraumatic, vascular, and amnestic CI groups identified a number of differences in both the distribution of atrophic changes and their level, which can be of great importance for the differential diagnosis of these conditions.

  1. Clinical Significance of Auditory Target P300 Subcomponents in Psychosis: Differential Diagnosis, Symptom Profiles, and Course

    Science.gov (United States)

    Perlman, Greg; Foti, Dan; Jackson, Felicia; Kotov, Roman; Constantino, Eduardo; Hajcak, Greg

    2015-01-01

    Background Reduced auditory target P300 amplitude is a leading biomarker for psychotic disorders, although its relevance for differential diagnosis and link to specific clinical features (symptom profiles, functional impairment, and course) is unclear. This study aims to clarify the clinical significance of auditory target P300 using concurrent and retrospective clinical data from a longitudinal cohort with psychosis. Methods 92 cases from an epidemiological study of first-admission psychosis were assessed using an auditory oddball paradigm at 15-year follow-up along with 44 never-psychotic adults. Subcomponents of auditory target P300 amplitude (i.e., a central positive P3a, a parietal positive P3b, and a frontal negative slow wave) were isolated using temporal-spatial principal components analysis. Results P3a amplitude was blunted across psychotic disorders relative to non-psychotic adults. P3b amplitude was reduced in schizophrenia specifically, including cases initially misclassified at baseline. The frontal negative slow wave did not distinguish among groups. P3b amplitude reduction was associated with several clinical features at the concurrent assessment, as well as previous time points, including recovery from psychosis even 5 years earlier and functioning even 15 years earlier. Conclusions Auditory target P300 amplitude yields both a schizophrenia-specific component (i.e., P3b) and a transdiagnostic psychosis component (i.e., P3a). The P3b component may also shed light on prognosis, real-world functioning, and course, as well as help to reduce misdiagnosis of psychotic disorders. Prospective studies are needed to test whether P3b tracks or predicts clinical status. PMID:25934167

  2. Use of a stable copper isotope (65Cu) in the differential diagnosis of Wilson's disease.

    Science.gov (United States)

    Lyon, T D; Fell, G S; Gaffney, D; McGaw, B A; Russell, R I; Park, R H; Beattie, A D; Curry, G; Crofton, R J; Gunn, I

    1995-06-01

    1. 65Cu/63Cu stable-isotope ratios have been measured in blood serum after oral administration of the stable isotope 65Cu. The incorporation of the isotope into the plasma protein pool was followed at various times for up to 3 days. The resulting patterns of enrichment in healthy control subjects, in Wilson's disease patients and in heterozygotes for the Wilson's disease gene, were similar in appearance to those found by others using copper radioactive isotopes. After an initially high enrichment at 2 h after dosage, the Wilson's disease cases, in contrast to the control subjects, did not show a secondary rise in isotope enrichment of the plasma pool after 72 h, demonstrating a failure to incorporate copper into caeruloplasmin. The Wilson's disease heterozygotes had variable degrees of impairment of isotope incorporation, not always distinguished from those of control subjects. 2. The stability of the isotope also permits the copper tracer to be followed for a longer period. Ten healthy subjects were studied for over 40 days, allowing the biological half-time of an oral dose of copper to be determined (median 18.5 days, 95% confidence interval 14-26 days). Known heterozygotes for the Wilson's disease gene were found to have a significantly increased biological half-time for removal of copper from the plasma pool (median 43 days, 95% confidence interval 32-77 days). 3. The incorporation of 65 Cu in patients with diseases of the liver (other than Wilson's disease) was found to be similar to that in control subjects, aiding differential diagnosis.

  3. Contrast-enhanced sonography versus biopsy for the differential diagnosis of thrombosis in hepatocellular carcinoma patients

    Institute of Scientific and Technical Information of China (English)

    Paolo Sorrentino; Salvatore D'Angelo; Luciano Tarantino; Umberto Ferbo; Alessandra Bracigliano; Raffaela Vecchione

    2009-01-01

    AIM: To clarify which method has accuracy: 2nd generation contrast-enhanced ultrasound or biopsy of portal vein thrombus in the differential diagnosis of portal vein thrombosis. METHODS: One hundred and eighty-six patients with hepatocellular carcinoma and portal vein thrombosis underwent in blinded fashion a 2nd generation contrastenhanced ultrasound and biopsy of portal vein thrombus; both results were examined on the basis of the follow-up of patients compared to reference-standard. RESULTS: One hundred and eight patients completed the study. Benign thrombosis on 2nd generation contrast- enhanced ultrasound was characterised by progressive hypoenhancing of the thrombus; in malignant portal vein thrombosis there was a precocious homogeneous enhancement of the thrombus. On follow-up there were 50 of 108 patients with benign thrombosis: all were correctly diagnosed by both methods. There were 58 of 108 patients with malignant thrombosis: amongst these, 52 were correctly diagnosed by both methods, the remainder did not present malignant cells on portal vein thrombus biopsy and showed on 2nd generation contrast-enhanced ultrasound an inhomogeneous enhancement pattern. A new biopsy during the follow-up, guided to the area of thrombus that showed up on 2nd generation contrast-enhanced ultrasound, demonstrated an enhancing pattern indicating malignant cells. CONCLUSION: In patients with hepatocellular carcinoma complicated by portal vein thrombosis, 2nd generation contrast-enhanced ultrasound of portal vein thrombus is very useful in assessing the benign or malignant nature of the thrombus. Puncture biopsy of thrombus is usually accurate but presents some sampling errors, so, when pathological results are required, 2nd generation contrast-enhanced ultrasound could guide the sampling needle to the correct area of the thrombus.

  4. Differential Diagnosis of a Severe Late Onset Ovarian Hyperstimulation Syndrome Associated with Prolonged Ascites Production – a Case Report

    Directory of Open Access Journals (Sweden)

    Ujvari E

    2005-01-01

    Full Text Available Capsule: A case of severe late onset ovarian hyperstimulation syndrome (OHSS with prolonged ascites production. Difficulties of differential diagnosis and management. Objective: This report describes a case of extremely prolonged, severe ovarian hyperstimulation syndrome. Results: 17 litres of ascites have been removed from the abdominal cavity by repeated paracenteses until the 25th week of pregnancy, which progressed after the complete resolution of symptoms to the 34th week, when cesarean section was done. Conclusion: Severe ovarian hyperstimulation syndrome can occasionally follow an unusually prolonged course. Chronic formation of abundant ascites, the presence of ovarian enlargement and elevated levels of certain tumour markers might raise the probability of ovarian cancer. Adequate differential diagnosis and management resulted in delivery of a healthy newborn.

  5. National Boy Scout Jamboree

    Science.gov (United States)

    1989-01-01

    This video looks at a NASA sponsored exhibit at the National Boy Scout Jamboree in Fredricksburg, VA. Boy Scouts are shown interacting with NASA researchers and astronauts and touring mockups of Space Station Freedom and Apollo 11. NASA's program to encourage the researchers of tomorrow is detailed.

  6. Boys With Long Hair

    Institute of Scientific and Technical Information of China (English)

    孙利英

    2005-01-01

    Long hair is popular among the young people.Even the boy students in high school join in this group.Some boy students would rather wear long hair,some even change their hair's color into golden,red,brown and pink.Why?

  7. Application of T2* measurement on gradient echo T2*-weighted imaging in differential diagnosis of intracranial hemorrhage and calcification

    Institute of Scientific and Technical Information of China (English)

    LIU Lan-xiang; YI Hui-ling; HAN Hong-bin; QI Xi-ming

    2012-01-01

    Background Differential diagnosis of intracranial hemorrhage and calcification is a common problem encountered in clinical imaging diagnosis.The purpose of this study was to investigate the feasibility of T2* measurement on gradient echo (GRE) T2*-weighted imaging (T2*WI) in differential diagnosis of intracranial hemorrhage and calcification.Methods Thirty-eight hemorrhagic foci in 18 patients and 11 calcification foci in seven patients were included in this study.The diagnosis of hemorrhage and calcification was confirmed in all cases with enhanced T2* weighted angiography (ESWAN) magnetic resonance imaging (MRI) and CT respectively.The significance for the difference of T2* value between the central and peripheral areas of hemorrhage and calcification lesions was tested with univariate analysis of variance.Results The detection rate of GRE T2*WI on intracranial hemorrhage was 1.9-fold higher than that of CT,especially for the hemorrhage in the brainstem and cerebellum.However,GRE T2*WI was far less sensitive to calcification than CT.There was a significant difference in the T2* value between the central area of hemorrhage and calcification (P <0.001),though no difference in the T2* value was obtained between the peripheral area of hemorrhage and calcification (P>0.05).Conclusions Quantitative measurement of T2* value on GRE T2*WI with a single MRI examination provides a fast,convenient,and effective means in differential diagnosis between intracranial hemorrhage and calcification,which may thus reduce the medical cost and save precious time for clinical management.

  8. Differential Diagnosis of Patients with Inconclusive Parkinsonian Features Using [{sup 18}F]FP-CIT PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Park, Eunkyung; Hwang, Yu Mi; Lee, Channyoung; Oh, Sun Young; Kim, Young Chul; Choe, Jae Gol; Park, Kun Woo [Korea Univ., Seoul (Korea, Republic of); Kim, Sujin [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2014-06-15

    It is often difficult to differentiate parkinsonism, especially when patients show uncertain parkinsonian features. We investigated the usefulness of dopamine transporter (DAT) imaging for the differential diagnosis of inconclusive parkinsonism using [{sup 18}F]FP-CIT PET. Twenty-four patients with inconclusive parkinsonian features at initial clinical evaluation and nine healthy controls were studied. Patients consisted of three subgroups: nine patients whose diagnoses were unclear concerning whether they had idiopathic Parkinson's disease or drug-induced parkinsonism ('PD/DIP'), nine patients who fulfilled neither the diagnostic criteria of PD nor of essential tremor ('PD/ET'), and six patients who were alleged to have either PD or atypical parkinsonian syndrome ('PD/APS'). Brain PET images were obtained 120 min after injection of 185 MBq [{sup 18}F]FP-CIT. Imaging results were quantified and compared with follow-up clinical diagnoses. Overall, 11 of 24 patients demonstrated abnormally decreased DAT availability on the PET scans, whereas 13 were normal. PET results could diagnose PD/DIP and PD/ET patients as having PD in six patients, DIP in seven, and ET in five; however, the diagnoses of all six PD/APS patients remained inconclusive. Among 15 patients who obtained a final follow-up diagnosis, the image-based diagnosis was congruent with the follow-up diagnosis in 11 patients. Four unsolved cases had normal DAT availability, but clinically progressed to PD during the follow-up period. [{sup 18}F]FP-CIT PET imaging is useful in the differential diagnosis of patients with inconclusive parkinsonian features, except in patients who show atypical features or who eventually progress to PD.

  9. [Endocrine diagnosis in puberty--pathophysiologic bases].

    Science.gov (United States)

    Girard, J

    1994-05-01

    Puberty is characterized by activation of the maturing gonads and by the thus started increased secretion of sexual steroids. Consequences are the appearance of secondary signs of puberty sensu strictori, i. e. the development of breasts in girls, the increase of testicle volume in boys, often followed by growing pubic hair, axillary hair, menarche or laryngeal growth (puberty vocal change) respectively. The most important accompanying symptom is the spurt of growth starting around 12 to 18 months after the onset of the development of the secondary pubertal signs. From the time sequence of the development and the possible delays, valuable diagnostic hints can be gained, giving rise to a more precise analysis of the hormonal phenomena of adolescence. In cases of pubertas tarda a primary malfunction must be differentiated from secondary hypogonadotropic functional defect. The syndromes should be classified correctly according to their etiology. The most frequent diagnosis is that of a simply delayed puberty. Acne, hypertrichosis, hirsutism are concomitant phenomena of puberty development which can indicate a hormonal imbalance (differential diagnosis AGS, ovarian hyperandrogeny). The swelling of breasts in boys (gynecomastia) is a common transitory phenomenon in male adolescence (DD, tumor of the gonads or Klinefelter syndrome). Interesting considerations of differential diagnosis apply also to the assessment of the enlargement of the thyroid gland in puberty, which affects more often girls than boys. PMID:8016754

  10. CT-stereotactic biopsy for differential diagnosis of deep localized intracerebral hematoma

    International Nuclear Information System (INIS)

    The diagnosis of intracerebral haematomas, especially of those which are relatively small, occupy little space and are deeply situated, presents considerable problems. The problem is even greater when the expected acute case history and the acute beginning of the symptoms do not occur and unusual localisations are found. The consequences of this are false diagnoses and the treatment of these patients within the framework of blanket diagnosis ''intracerebral tumours'' or ''space occupying processes'' without any confirmation of the histological diagnosis. Using a sample of 26 patients where the histological diagnosis of non-recent intracerebral hemorrhages had been confirmed (out of a series of 818 CT-stereotactically biopsied patients punctured by us from the beginning of 1983 until the end of 1984), the problem of establishing a diagnosis is exposed. A histological diagnosis should in any case be confirmed before any thorough and depp-reaching therapy is begun, since false diagnoses and misinterpretations can cause serious consequences for the patient. (orig.)

  11. An Evaluation on the Importance of Phosphotungstic Acid Haematoxyiin (PTAH) Staining in Differential Diagnosis of Salivary Gland Neoplasms

    OpenAIRE

    E Yazdi; F Baghaie Naeini; M Seyed Majidi

    2003-01-01

    The differential diagnosis between pleomorphic adenoma, the most common salivary gland neoplasm, microscopically, and two other common salivary gland neoplasms, meaning adenoid cystic carcinoma and mucoepidermoid carcinoma, is difficut.The purpose of this study was to determine the differences between pleomorphic adenoma, adenoid cystic carcinoma and mucoepidermoid carcinoma regarding the staining intensity with PTAH and H&E and also to investigate the relationship between staining intensity ...

  12. Trigeminal Electrophysiology: a 2 × 2 matrix model for differential diagnosis between temporomandibular disorders and orofacial pain

    OpenAIRE

    Chessa Giacomo; Frisardi Gianni; Sau Gianfranco; Frisardi Flavio

    2010-01-01

    Background Pain due to temporomandibular disorders (TMDs) often has the same clinical symptoms and signs as other types of orofacial pain (OP). The possible presence of serious neurological and/or systemic organic pathologies makes differential diagnosis difficult, especially in early disease stages. In the present study, we performed a qualitative and quantitative electrophysiological evaluation of the neuromuscular responses of the trigeminal nervous system. Using the jaw jerk reflex (JJ...

  13. Impact of d-Dimers on the Differential Diagnosis of Acute Chest Pain: Current Aspects Besides the Widely Known

    OpenAIRE

    Hahne, Kathrin; Lebiedz, Pia; Breuckmann, Frank

    2014-01-01

    d-dimers are cleavage products of fibrin that occur during plasmin-mediated fibrinolysis of blood clots. In the emergency department, d-dimer measurement represents a valuable and cost-effective tool in the differential diagnosis of acute chest pain including the main life-threatening entities: acute coronary syndrome, pulmonary embolism, and acute aortic syndrome. Whereas the diagnostic and prognostic values of d-dimer testing in acute coronary syndrome is of less priority, increases of d-di...

  14. Procalcitonin for the differential diagnosis of infectious and non-infectious systemic inflammatory response syndrome after cardiac surgery

    OpenAIRE

    Zhao, Dong; Zhou, Jianxin; Haraguchi, Go; Arai, Hirokuni; Mitaka, Chieko

    2014-01-01

    Background This study was performed to assess the value of procalcitonin (PCT) for the differential diagnosis between infectious and non-infectious systemic inflammatory response syndrome (SIRS) after cardiac surgery. Methods Patients diagnosed with SIRS after cardiac surgery between April 1, 2011 and March 31, 2013 were retrospectively studied. A total of 142 patients with SIRS, infectious (n = 47) or non-infectious (n = 95), were included. The patients with infectious SIRS included 11 with ...

  15. Disease profile and differential diagnosis of hereditary transthyretin-related amyloidosis with exclusively cardiac phenotype: An Italian perspective

    OpenAIRE

    Rapezzi, Claudio; Quarta, Candida Cristina; Obici, Laura; Perfetto, Federico; Longhi, Simone; Salvi, Fabrizio; Biagini, Elena; Lorenzini, Massimiliano; Grigioni, Francesco; Leone, Ornella; Cappelli, Francesco; Palladini, Giovanni; Rimessi, Paola; Ferlini, Alessandra; Arpesella, Giorgio

    2013-01-01

    AIMS: Hereditary transthyretin (TTR)-related amyloidosis (ATTR) is mainly considered a neurologic disease. We assessed the phenotypic and genotypic spectra of ATTR in a Caucasian area and evaluated the prevalence, genetic background, and disease profile of cases with an exclusively cardiac phenotype, highlighting possible hints for the differential diagnosis with hypertrophic cardiomyopathy (HCM) and senile systemic amyloidosis (SSA). METHODS AND RESULTS: In this Italian multicentr...

  16. The differential diagnosis of children with joint hypermobility: a review of the literature

    OpenAIRE

    Elliott Elizabeth J; Tofts Louise J; Munns Craig; Pacey Verity; Sillence David O

    2009-01-01

    Abstract Background In this study we aimed to identify and review publications relating to the diagnosis of joint hypermobility and instability and develop an evidence based approach to the diagnosis of children presenting with joint hypermobility and related symptoms. Methods We searched Medline for papers with an emphasis on the diagnosis of joint hypermobility, including Heritable Disorders of Connective Tissue (HDCT). Results 3330 papers were identified: 1534 pertained to instability of a...

  17. Prenatal diagnosis by isoenzymic differentiation of Treacher Collins' syndrome induced by retinoids in rats

    DEFF Research Database (Denmark)

    Granström, G; Kirkeby, S

    1990-01-01

    ear ossicles, short cochleas, defectively differentiated Meckel's cartilages, micrognathia, rudimentary malar bones, lateral facial clefts, fistulas and skin tags, all of which were similar to Treacher Collins' syndrome in man. The defects were accompanied by a pathological differentiation pattern...

  18. The specific case: cardiac amyloidosis as differential diagnosis in case of restricted cardiac pump function

    International Nuclear Information System (INIS)

    The NMR imaging data in combination with clinical characterization and echocardiography are consistent with the diagnosis of a cardiac amyloidosis. The article describes disease pattern and diagnosis based on contrast agent accumulation and diastolic functional disturbances. CT was performed to exclude pulmonary embolism.

  19. Neoplastic lesions of the temporomandibular joint (TMJ): diagnosis, differential diagnosis and intervention; Neoplasien des Temporomandibulargelenks (TMG). Diagnostik, Differenzialdiagnostik und Intervention

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Abolmaali, N.; Schedel, H.; Bergh, B. [Frankfurt Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Maeurer, J. [Radiologische Praxis am Prinzregentenplatz, Muenchen (Germany)

    2001-09-01

    Purpose. To evaluate the effectiveness of diagnostic and interventional radiological techniques for neoplastic lesions of the temporomandibular joint (TMJ). Material and methods. Modern diagnosis of the TMJ is based on the clinical use of conventional X-ray techniques, computed tomography (CT), magnetic resonance imaging (MRI) and interventional techniques like biopsies, vascular occlusion and ablation. Results. Conventional X-ray still forms the basic diagnostic procedure applied in open and closed mouth position. CT improves the diagnostic information and serves as the standard diagnostical instrument for cartaliganeous or osseous neoplastic lesions. MRI evaluates soft tissue infiltration in multiplanar techniques and high spatial resolution. Interventional vascular and ablative techniques improve the treatment of neoplastic disorders. (orig.) [German] Zielsetzung. Vorstellung der Wertigkeit bildgebender Verfahren fuer die diagnostische und interventionelle Radiologie des Temporomandibulargelenks (TMG). Material und Methodik. Die moderne Radiologie des TMG basiert auf dem Einsatz der konventionellen Roentgendiagnostik, der Computertomographie (CT) und der Magnetresonanztomographie (MRT), sowie interventioneller Verfahren wie der Biopsie, vaskulaerer Embolisationsverfahren und tumorablativer Verfahren. Ergebnisse. Als Basisdiagnostik dient die konventionelle Diagnostik in offener und geschlossener Mundposition der Erfassung von Funktionsstoerungen sowie ossaerer Destruktionen. Die CT erweitert das diagnostische Spektrum und verbessert die Differenzialdiagnostik fuer ossifizierende Prozesse. Der Einsatz der MRT erlaubt die Erfassung der Weichteilinfiltration sowie der Gelenkstrukturen. Vaskulaere interventionelle Verfahren dienen der praetherapeutischen Okklusion bzw. der palliativen Tumortherapie in Form der okklusiven Embolisation, der Chemoembolisation, oder auch der Tumorablation. (orig.)

  20. Atitudes maternas diferenciais para com meninos e meninas de quatro e cinco anos Differential maternal attitudes toward four- and five-year-old boys and girls

    Directory of Open Access Journals (Sweden)

    Ebenézer A. de Oliveira

    2000-01-01

    Full Text Available Foram examinados os efeitos do sexo e da idade da criança pré-escolar sobre três atitudes maternas consideradas psicopatogênicas na literatura: irritabilidade, rejeição e intrusão. A amostra contou com 53 mães e suas crianças pré-escolares de 51 a 70 meses de idade, de níveis sócio-econômicos (NSE médio e baixo. As mães preencheram uma versão em Português do Parent Attitude Research Instrument-PARI. Correlações de ordem zero e regressões múltiplas indicaram que as mães tendem a relatar menor irritabilidade e rejeição quanto maior for a idade da criança; contudo, o mesmo não ocorreu para a intrusão materna. Independentemente da idade da criança, as mães dos meninos relataram maior intrusão do que as mães das meninas. Esses resultados se mantiveram mesmo após a inclusão do NSE na equação de regressão. Análises bivariadas também mostraram uma tendência marginal para as mães dos meninos relatarem maior rejeição do que as mães das meninas. Os resultados são discutidos à luz da literatura vigente sobre a socialização da criança pré-escolar, ressaltando elementos cognitivos e interacionais.This study examined the effects of the preschool child’s sex and age on three maternal attitudes regarded as pathogenic in the literature: Irritability, rejection, and intrusion. The sample had 53 mothers and their preschool children from 51 through 70 months of age, of both middle and low socioeconomic statuses (SES. The mothers filled out a Portuguese version of the Parent Attitude Research Instrument-PARI. Zero-order correlations and multiple regressions indicated that the older the child, the lower the levels of irritability and rejection reported by the mother; however, the same did not happen to maternal intrusion. Regardless of the child’s age, the mothers of boys reported higher intrusion than the mothers of girls. These results held even after introducing SES in the regression equation. Bivariate analyses

  1. Validity of multiplex biomarker model of 6 genes for the differential diagnosis of thyroid nodules

    Directory of Open Access Journals (Sweden)

    Ducena Kristine

    2011-06-01

    Full Text Available Abstract Background Currently the cytological examination of fine needle aspiration (FNA biopsies is the standard technique for the pre-operative differential diagnosis of thyroid nodules. However, the results may be non-informative in ~20% of cases due to an inadequate sampling and the lack of highly specific, measurable cytological criteria, therefore ancillary biomarkers that could aid in these cases are clearly needed. The aim of our study was to evaluate the mRNA expression levels of 8 candidate marker genes as the diagnostic biomarkers for the discrimination of benign and malignant thyroid nodules and to find a combination of biomarkers with the highest diagnostic value. Materials and methods mRNA expression levels of eight candidate marker genes - BIRC5, CCND1, CDH1, CITED1, DPP4, LGALS3, MET and TFF3 was measured by real-time RT-PCR in paired nodular and surrounding normal thyroid tissue specimens of 105 consecutive patients undergoing thyroid surgery and compared between different types of thyroid lesions. Results Significant differences in the mRNA expression levels between the normal and malignant thyroid tissues and between benign and malignant nodules were found for BIRC5, CCND1, CITED1, DPP4, LGALS3, MET and TFF3, but not CDH1. On a single gene basis, relative quantity (RQ of LGALS3 had the highest diagnostic value for the discrimination of malignant and benign thyroid nodules (AUC = 0.832, P LGALS3 was RQ sum of LGALS3 and BIRC5 (AUC = 0.841, P LGALS3, BIRC5, TFF3, CCND1, MET and CITED1 that had considerably higher specificity than a single marker or two marker gene-based models (AUC = 0.895, P Conclusions This study confirmed that mRNA expression levels of 7 out of 8 candidate genes analysed have a diagnostic value for the distinction of benign and malignant thyroid nodules. The multiplex biomarker model based on 6 genes outperformed a single marker or two marker-based models and warrants feasibility studies on FNA biopsies and

  2. [Tuberculosis and tularemia as part of the differential diagnosis in cervical lymphadenitis].

    Science.gov (United States)

    Karagöz, Ergenekon; Ulçay, Asım; Hatipoğlu, Mustafa; Turhan, Vedat

    2014-10-01

    We have read with interest the recently published article entitled "Investigation of the presence of Mycobacterium tuberculosis in the lymph node aspirates of the suspected tularemia lymphadenitis cases" by Albayrak et al. published in Mikrobiyol Bul 2014; 48(1): 129-34. They concluded that tuberculous lymphadenitis (TCL) should be kept in mind in suspected tularemia cases and those patients should also be investigated simultaneously for the presence of TCL. With reference to data provided by the Ministry of Health in Turkey, the number of reported cases of pulmonary tuberculosis in comparison to previous years is currently on decline whereas a gradual increase in extra-pulmonary (specifically cervical TCL) cases has been observed. Besides, as one of the most common causes of cervical lymphadenitis, we are witnessing a marked increase in granulomatous infections which have been part of the evaluated cases of oropharyngeal tularemia in Turkey. In fact, differentiation of the two types of lymphadenitis can be confusing on the basis of clinical and histopathological findings. Thus, investigating the presence of M.tuberculosis in cervical lymph node aspirates of tularemia suspected cases is a vital contribution, specifically in a geographical region that is considered endemic for both diseases. We would therefore like to note the importance of this study and thank the authors for their comprehensive contribution. Contrary to what is noted in the study, cervical lymphadenitis due to acute tonsillopharyngitis unresponsive to penicillin and its derivatives, has been regarded as cervical TCL due to their histopathological appearance and have been treated unnecessarily with long-term antituberculous drugs. There are some publications from Turkey indicating the detection of Francisella tularensis antibodies and nucleic acids in the patients who were histologically diagnosed as TCL. In situations where the exact etiology of cervical lymphadenitis is not determined, treatment

  3. Cerebrospinal Fluid P-Tau181P: Biomarker for Improved Differential Dementia Diagnosis.

    Science.gov (United States)

    Struyfs, Hanne; Niemantsverdriet, Ellis; Goossens, Joery; Fransen, Erik; Martin, Jean-Jacques; De Deyn, Peter P; Engelborghs, Sebastiaan

    2015-01-01

    The goal of this study is to investigate the value of tau phosphorylated at threonine 181 (P-tau181P) in the Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarker panel for differential dementia diagnosis in autopsy confirmed AD and non-AD patients. The study population consisted of 140 autopsy confirmed AD and 77 autopsy confirmed non-AD dementia patients. CSF concentrations of amyloid-β peptide of 42 amino acids (Aβ1-42), total tau protein (T-tau), and P-tau181P were determined with single analyte ELISA-kits (INNOTEST(®), Fujirebio, Ghent, Belgium). Diagnostic accuracy was assessed through receiver operating characteristic (ROC) curve analyses to obtain area under the curve (AUC) values and to define optimal cutoff values to discriminate AD from pooled and individual non-AD groups. ROC curve analyses were only performed on biomarkers and ratios that differed significantly between the groups. Pairwise comparison of AUC values was performed by means of DeLong tests. The Aβ1-42/P-tau181P ratio (AUC = 0.770) performed significantly better than Aβ1-42 (AUC = 0.677, P = 0.004), T-tau (AUC = 0.592, P < 0.001), and Aβ1-42/T-tau (AUC = 0.678, P = 0.001), while P-tau181P (AUC = 0.720) performed significantly better than T-tau (AUC = 0.592, P < 0.001) to discriminate between AD and the pooled non-AD group. When comparing AD and the individual non-AD diagnoses, Aβ1-42/P-tau181P (AUC = 0.894) discriminated AD from frontotemporal dementia significantly better than Aβ1-42 (AUC = 0.776, P = 0.020) and T-tau (AUC = 0.746, P = 0.004), while P-tau181P/T-tau (AUC = 0.958) significantly improved the differentiation between AD and Creutzfeldt-Jakob disease as compared to Aβ1-42 (AUC = 0.688, P = 0.004), T-tau (AUC = 0.874, P = 0.040), and Aβ1-42/P-tau181P (AUC = 0.760, P = 0.003). In conclusion, this study demonstrates P-tau181P is an essential component of the AD CSF biomarker

  4. Ductal adenocarcinoma and unusual differential diagnosis; Duktales Adenokarzinom und ungewoehnliche Differenzialdiagnosen

    Energy Technology Data Exchange (ETDEWEB)

    Haage, P.; Schwartz, C.A.; Scharwaechter, C. [Universitaet Witten/Herdecke, Zentrum fuer Radiologie HELIOS Universitaetsklinikum Wuppertal, Wuppertal (Germany)

    2016-04-15

    Ductal pancreatic adenocarcinoma is by far the most common solid tumor of the pancreas. It has a very poor prognosis, especially in the more advanced stages which are no longer locally confined. Due to mostly unspecific symptoms, imaging is key in the diagnostic process. Because of the widespread use of imaging techniques, incidental findings are to a greater extent discovered in the pancreas, which subsequently entail further work-up. Ductal pancreatic adenocarcinoma can be mimicked by a large number of different lesions, such as anatomical variants, peripancreatic structures and tumors, rarer primary solid pancreatic tumors, cystic tumors, metastases or different variants of pancreatitis. Additionally, a number of precursor lesions can be differentiated. The correct classification is thus important as an early diagnosis of ductal pancreatic adenocarcinoma is relevant for the prognosis and because the possibly avoidable treatment is very invasive. All major imaging techniques are principally suitable for pancreatic imaging. In addition to sonography of the abdomen, usually the baseline diagnostic tool, computed tomography (CT) with its superior spatial resolution, magnetic resonance imaging (MRI) with its good soft tissue differentiation capabilities, possibly in combination with MR cholangiopancreatography (MRCP), endosonography with its extraordinary spatial resolution, conceivably with additional endoscopic retrograde CP or the option of direct biopsy and finally positron emission tomography CT (PET-CT) as a molecular imaging tool are all particularly useful modalities. The various techniques all have its advantages and disadvantages; depending on the individual situation they may need to be combined. (orig.) [German] Das duktale Adenokarzinom ist der weitaus haeufigste solide Tumor des Pankreas. Die Prognose ist sehr schlecht, insbesondere bei fortgeschrittenen, nicht mehr lokal begrenzten Tumoren. Bei meist unspezifischen geringen Beschwerden kommt der

  5. 下咽癌的CT诊断与鉴别%CT diagnosis and differential diagnosis of hypopharyngeal carcinoma

    Institute of Scientific and Technical Information of China (English)

    李必强; 黄显龙; 张名均; 杨健; 王新玉; 陈修燕; 唐茁月

    2012-01-01

    Objective:To explore the computed tomography (CT) feature of hypopharyngeal carcinoma and investigate its differentiation from other hypopharyngeal diseases. Methods ;CT findings of 21 cases of hypopharyngeal carcinoma and other hypopharyngeal diseases which are necessary to differentiate from hypopharyngeal carcinoma were retrospectively analyzed,all of which were confirmed by surgery or pathology. Results;Of 21 cases, there were 13 cases of hypopharyngeal carcinoma,5 cases of hypopharynx inflammation, 1 case of hypopharyngeal cyst, 1 case of hypopharyngeal lymphoma and 1 case of hypopharyngeal polyp. Of the 13 cases of hypopharyngeal carcinoma,CT found location at pyriform sinus in 10 cases,at posterior wall of hypopharynx in 2 cases,at postcricoid in 1 case. The main manifestations of hypopharyngeal carcinoma were soft tissue density mass located at one side of pyriform sinus or retropharynx or postcricoid,thickening of retropharyngeal soft tissue,inhomogeneous enhancement,usually widening of cricoid cartilage-vertebra or arytenoid cartilage-vertebra distance( ≥ 1 cm) involving larynx and neighboring structures,parapharyngeal structures and adjacent cervical soft tissue,destructed faryngeal cartilage,invaded esophagus and metastasis of cervical lymph nodes. Conclusion; CT is useful for observing the site, shape, size and invasive extent of hypopharyngeal carcinoma as well as lymph node metastases.The widening of cricoid cartilage-vertebra or arytenoid cartilage-vertebra distance is the characteristic feature of hypopharyngeal carcinoma and necessary to differentiate from other hypopharyngeal diseases.%目的:探讨下咽癌的CT特点并与其它下咽部病变进行鉴别.方法:对21例下咽癌和需要与其鉴别的下咽部病变CT表现进行回顾性分析,所有病例都经手术或活检病理证实.结果:下咽癌13例,其中梨状窝癌10例,咽后壁癌2例,环后区癌1例.下咽部炎症5例;下咽部囊肿、下咽部淋

  6. Combined detection of serum tumor markers for differential diagnosis of solid lesions located at the pancreatic head

    Institute of Scientific and Technical Information of China (English)

    Quan Liao; Yu-Pei Zhao; Ying-Chi Yang; Li-Jun Li; Xiao Long; Shao-Mei Han

    2007-01-01

    BACKGROUND:The differential diagnosis of solid lesions located at the pancreatic head is very important for choosing therapies and setting up surgical tactics. This study was designed to evaluate the clinical signiifcance of combined measurement of multiple serum tumor markers and the application of the receiver-operating characteristic (ROC) curves in the differential diagnosis of solid lesions located at the pancreatic head. METHODS:The serum levels of CA19-9, CA242, CA50 and carcinoembryonic antigen (CEA) in 112 patients with carcinoma of the pancreatic head and 38 patients with focal chronic pancreatitis in the pancreatic head were measured with ELISA. The sensitivity, speciifcity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR) of the four serum tumor markers were calculated. The ROC curves for the four serum tumor markers were constructed and the area under the curve (AUC) was calculated. RESULTS:The AUCs of CA19-9, CA242, CA50 and CEA were 0.805, 0.749, 0.738 and 0.705; the PLRs were 1.91, 3.43, 5.09 and 5.46; and the NLRs were 0.41, 0.56, 0.59 and 0.71, respectively. Combined measurements increased the diagnostic speciifcity, and parallel combined testing increased the diagnostic sensitivity. CONCLUSIONS:Combined measurement of serum tumor markers CA19-9, CA242, CA50 and CEA is valuable in differential diagnosis of solid lesions located at the pancreatic head, and CA19-9 has the best diagnostic ability. Combined measurements can increase the speciifcity of diagnosis. Evaluation with the ROC curve is better than the sensitivity or speciifcity alone and the results are more integrated and objective.

  7. Cross-validation of biomarkers for the early differential diagnosis and prognosis of dementia in a clinical setting

    Energy Technology Data Exchange (ETDEWEB)

    Perani, Daniela [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, Nuclear Medicine Unit, Milan (Italy); Cerami, Chiara [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, Clinical Neuroscience Department, Milan (Italy); Caminiti, Silvia Paola [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); Santangelo, Roberto; Coppi, Elisabetta; Ferrari, Laura; Magnani, Giuseppe [San Raffaele Hospital, Department of Neurology, Milan (Italy); Pinto, Patrizia [Papa Giovanni XXIII Hospital, Department of Neurology, Bergamo (Italy); Passerini, Gabriella [Servizio di Medicina di Laboratorio OSR, Milan (Italy); Falini, Andrea [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, CERMAC - Department of Neuroradiology, Milan (Italy); Iannaccone, Sandro [San Raffaele Hospital, Clinical Neuroscience Department, Milan (Italy); Cappa, Stefano Francesco [San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); IUSS Pavia, Pavia (Italy); Comi, Giancarlo [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Hospital, Department of Neurology, Milan (Italy); Gianolli, Luigi [San Raffaele Hospital, Nuclear Medicine Unit, Milan (Italy)

    2016-03-15

    The aim of this study was to evaluate the supportive role of molecular and structural biomarkers (CSF protein levels, FDG PET and MRI) in the early differential diagnosis of dementia in a large sample of patients with neurodegenerative dementia, and in determining the risk of disease progression in subjects with mild cognitive impairment (MCI). We evaluated the supportive role of CSF Aβ{sub 42}, t-Tau, p-Tau levels, conventional brain MRI and visual assessment of FDG PET SPM t-maps in the early diagnosis of dementia and the evaluation of MCI progression. Diagnosis based on molecular biomarkers showed the best fit with the final diagnosis at a long follow-up. FDG PET SPM t-maps had the highest diagnostic accuracy in Alzheimer's disease and in the differential diagnosis of non-Alzheimer's disease dementias. The p-tau/Aβ{sub 42} ratio was the only CSF biomarker providing a significant classification rate for Alzheimer's disease. An Alzheimer's disease-positive metabolic pattern as shown by FDG PET SPM in MCI was the best predictor of conversion to Alzheimer's disease. In this clinical setting, FDG PET SPM t-maps and the p-tau/Aβ{sub 42} ratio improved clinical diagnostic accuracy, supporting the importance of these biomarkers in the emerging diagnostic criteria for Alzheimer's disease dementia. FDG PET using SPM t-maps had the highest predictive value by identifying hypometabolic patterns in different neurodegenerative dementias and normal brain metabolism in MCI, confirming its additional crucial exclusionary role. (orig.)

  8. Cross-validation of biomarkers for the early differential diagnosis and prognosis of dementia in a clinical setting

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the supportive role of molecular and structural biomarkers (CSF protein levels, FDG PET and MRI) in the early differential diagnosis of dementia in a large sample of patients with neurodegenerative dementia, and in determining the risk of disease progression in subjects with mild cognitive impairment (MCI). We evaluated the supportive role of CSF Aβ42, t-Tau, p-Tau levels, conventional brain MRI and visual assessment of FDG PET SPM t-maps in the early diagnosis of dementia and the evaluation of MCI progression. Diagnosis based on molecular biomarkers showed the best fit with the final diagnosis at a long follow-up. FDG PET SPM t-maps had the highest diagnostic accuracy in Alzheimer's disease and in the differential diagnosis of non-Alzheimer's disease dementias. The p-tau/Aβ42 ratio was the only CSF biomarker providing a significant classification rate for Alzheimer's disease. An Alzheimer's disease-positive metabolic pattern as shown by FDG PET SPM in MCI was the best predictor of conversion to Alzheimer's disease. In this clinical setting, FDG PET SPM t-maps and the p-tau/Aβ42 ratio improved clinical diagnostic accuracy, supporting the importance of these biomarkers in the emerging diagnostic criteria for Alzheimer's disease dementia. FDG PET using SPM t-maps had the highest predictive value by identifying hypometabolic patterns in different neurodegenerative dementias and normal brain metabolism in MCI, confirming its additional crucial exclusionary role. (orig.)

  9. Assessing significance of peripheral blood indicators for differential diagnosis and prognosis of thrombotic complications in polycythemia vera and secondary erythrocytosis

    Directory of Open Access Journals (Sweden)

    Kostiukevych O.M.

    2014-03-01

    Full Text Available The aim of the study – determining of changes in peripheral blood (PB in patients with secondary erythrocytosis (SE and polycythemia vera (PV, detection of discriminatory parameters levels of PB indicators and analyzing of their operating characteristics for differentiation of erythrocytosis and predicting of thrombotic events in patients with PV. Materials and methods. The material for the study was the results of clinical trials of 210 patients with erythrocytosis who underwent differential diagnosis between PV and SE. Results and discussion. The optimal threshold for differential diagnosis of red blood cells content between PV and SE is >6.08•1012/ L, the diagnostic value of the marker equals to the level of a good diagnostic marker (AUC=0.82; 95% CI=0.77-0.87, p 57.5% with its capacity – 0.72 (0.66-0.78, p 8.9•109/L, and the boundary of marker is consistent with a good level of efficiency (AUC=0.79, 95% CI=0.72-0.84, p287•109 /L" to differentiate erythrocytosis is 0.90 (0.86-0.94, p 55%" and "WBC >12.3•109 /L", according to the AUC (AUC=0.65; 95% CI=0.52-0.79, p=0.021 and AUC=0.66; 95% CI=0.55-0.77, p=0.003, respectively, corresponds to the average power level. Conclusion. Hemoglobin has not confirmed its value for the differential diagnosis between PV and SE. Using other parameters of PB with the aim of differentiating PV and SE is rational, but their discriminatory power levels greatly depend on the group erythrocytosis. In our cohort were obtained the following most appropriate criteria for inclusion of patients in the group of patients with PV: "WBC >8.9•109/L", "red blood cells >6.08•1012/L" and "hematocrit >57.5%". The most significant marker of general clinical blood test to differentiate between PV and SE is "platelets >287•109/L". Hematocrit over 55% and WBC over 12.3•109/L are valuable prognostic markers of thrombosis in PV patients, but their use is appropriate only in a cohort of patients with PV without

  10. Ureteritis Cystica: Important Consideration in the Differential Diagnosis of Acute Renal Colic

    OpenAIRE

    Padilla-Fernández, B.; FJ. Díaz-Alférez; M. Herrero-Polo; M. Martín-Izquierdo; JM. Silva-Abuín; MF. Lorenzo-Gómez

    2012-01-01

    Ureteritis cystica is an uncommon cause of acute renal pain. The aetiology remains unclear and the diagnosis may be difficult to establish. We report the case of a 29 year old woman with a history of repeated urinary tract infections presenting with acute renal colic in the absence of lithiasis. We review the diagnostic tools available to make the diagnosis and the recent pertinent literature.

  11. The Diagnostic and Differential Diagnosis Utility of Cerebrospinal Fluid α -Synuclein Levels in Parkinson's Disease: A Meta-Analysis.

    Science.gov (United States)

    Zhou, Bo; Wen, Min; Yu, Wen-Feng; Zhang, Chun-Lin; Jiao, Ling

    2015-01-01

    Several recent studies showed that α-syn might be a potential diagnostic biomarker for PD in human cerebrospinal fluid (CSF), but the results were inconsistent. The purpose of this meta-analysis was to investigate the diagnostic and differential diagnosis efficacy of CSF α-syn in PD. Studies which measured CSF α-syn or α-syn oligomers in patients with PD and met the inclusion criteria were included in the analysis. Results of the meta-analysis indicated that mean concentration of CSF α-syn was significantly lower in PD compared to controls and significantly higher in PD compared to multiple system atrophy (MSA). No significant difference in mean concentration of CSF α-syn was found between PD and dementia with Lewy bodies (DLB). Mean concentration of CSF α-syn was slightly decreased in PD compared to progressive supranuclear palsy (PSP). Mean concentration of CSF α-syn oligomers was significantly higher in PD than control. These results support the findings that CSF α-syn may be a potential diagnostic and differential diagnosis biomarker in PD compared to control and MSA but not DLB. Furthermore, α-syn oligomer may represent a better biomarker for diagnosis of PD.

  12. Differential diagnosis in pediatric radiology. Vol. 1. Skull, spine, skeleton; Differentialdiagnostik in der paediatrischen Radiologie. Bd. 1. Schaedel, Wirbelsaeule, Skelett

    Energy Technology Data Exchange (ETDEWEB)

    Ebel, K.D. [ed.; Willich, E. [ed.; Richter, E. [ed.; Benz-Bohm, G.; Bliesener-Harzheim, J.A.; Ebel, K.D.; Oestreich, A.E.; Reinwein, H.; Schaper, J.; Schumacher, R.; Stoever, B.

    1995-06-01

    The book presents in-depth material covering the full scope of tasks and problems of differential diagnostic radiology in children. The particular approach chosen by the authors provides information that will solve even the most difficult cases, guiding the reader on his way from radiographic findings to appropriate diagnosis. All radiographic findings have been characterized and classified and put into a tabulated system relating them to the relevant differential diagnosis. The system of reference adopted specifies a given lesion or disease by reference to the most significant diagnostic keywords obtained from anamnesis, clinical data, and further diagnostic evaluation. The tentative diagnosis is taken as the basis for further specification illustrated by the characteristic X-ray pictures and full-text descriptions. Almost all diagnoses are accompanied by a comprehensive image documentation obtained by all currently available imaging methods. (MG) [Deutsch] Das vorliegende Buch gibt einen kompletten Ueberblick ueeber die gesamte Bandbreite der Differentialdiagnostik in der Paediatrischen Radiologie und soll so auch in schwierigen Faeellen den Weg vom Roentgensymptom zur Diagnose ermoeglichen. Alle relevanten Roentgensymptome werden systematisch charakterisiert und die entsprechenden Differentialdiagnosen tabellarisch zusammengestellt. Jede Erkrankung wird durch Verweise auf die wichtigsten differentialdiagnostischen Stichworte aus Anamnese, Klinik und weiterfuehrende Diagnostik naeher eingegrenzt. Ausgehend von der Verdachtsdiagnose werden wegweisende Roentgenbefunde in Wort und Bild dargestellt. Fast alle erwaehnten Befunde werden durch Abbildungen unter Beruecksichtigung aller moderner bildgebenden Verfahren dokumentiert. (MG)

  13. Septic Bursitis in an 8-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Panagiotis Kratimenos

    2014-01-01

    Full Text Available Background. The prepatellar bursa can become inflamed owing to repeated trauma. Prepatellar bursitis is extremely rare in children. Methods. We report the case of an 8-year-old boy who was treated for an erythematous, swollen, and severely painful right knee, fever, inability to bear weight on the leg, and purulent material draining from a puncture wound. We describe the differential diagnosis for tender swollen knee, including infection, gout, rheumatoid arthritis, and osteoarthritis. If untreated, prepatellar bursitis can progress to patellar osteomyelitis. Results. Wound cultures grew Streptococcus pyogenes, with the infection resolving with amoxicillin. Conclusions. A high index of suspicion is necessary in children presenting with prepatellar bursitis to prevent potentially devastating sequelae of infection of the septic joint.

  14. Myeloid cell nuclear differentiation antigen is expressed in a subset of marginal zone lymphomas and is useful in the differential diagnosis with follicular lymphoma.

    Science.gov (United States)

    Metcalf, Ryan A; Monabati, Ahmad; Vyas, Monika; Roncador, Giovanna; Gualco, Gabriela; Bacchi, Carlos E; Younes, Sheren F; Natkunam, Yasodha; Freud, Aharon G

    2014-08-01

    The diagnosis of marginal zone lymphomas (MZL) is challenged by the lack of specific markers that distinguish them from other low-grade non-Hodgkin B-cell lymphomas. Myeloid cell nuclear differentiation antigen (MNDA) is a nuclear protein that labels myelomonocytic cells as well as B lymphocytes that localize to the marginal zone areas of splenic white pulp. We evaluated MNDA expression in a large series of B-cell lymphomas to assess the sensitivity and specificity of this antigen for the characterization of MZL. A total of 440 tissue sections containing extramedullary B-cell lymphomas and 216 bone marrow biopsies containing atypical or neoplastic lymphoid infiltrates were stained for MNDA by immunohistochemistry. Among the extramedullary lymphoma cases, approximately 67% of nodal MZL, 61% of extranodal MZL, and 24% of splenic MZL expressed MNDA. MNDA was also infrequently expressed in other B-cell neoplasms including mantle cell lymphoma (6%), chronic lymphocytic leukemia/small lymphocytic lymphoma (13%), follicular lymphoma (FL) (4%), lymphoplasmacytic lymphoma (25%), and diffuse large B-cell lymphoma (3%). In contrast, MNDA was only expressed in 2.3% of all bone marrow biopsies involved by lymphoid infiltrates, including 2 cases of FL and one case of MZL. Collectively, these data support the inclusion of MNDA in the diagnostic evaluation of extramedullary B-cell lymphomas, particularly those in which the differential diagnosis is between low-grade FL and MZL.

  15. CLCA2 as a Novel Immunohistochemical Marker for Differential Diagnosis of Squamous Cell Carcinoma from Adenocarcinoma of the Lung

    Directory of Open Access Journals (Sweden)

    Kazuya Shinmura

    2014-01-01

    Full Text Available Recent progress in targeted therapy for lung cancer has revealed that accurate differential diagnosis between squamous cell carcinoma (SCC and adenocarcinoma (ADC of the lung is essential. To identify a novel immunohistochemical marker useful for differential diagnosis between the two subtypes of lung cancer, we first selected 24 SCC-specific genes and 6 ADC-specific genes using data (case number, 980 from the Cancer Genome Atlas (TCGA database. Among the genes, we chose the CLCA2 gene, which is involved in chloride conductance and whose protein expression in lung cancer is yet to be characterized, and evaluated its protein expression status in 396 cases of primary lung cancer at Hamamatsu University Hospital. Immunohistochemical analysis revealed a significantly higher CLCA2 expression level in the SCCs than in the ADCs (P<0.0001 and also a significantly higher frequency of CLCA2 protein expression in the SCCs (104/161, 64.6% as compared with that in the ADCs (2/235, 0.9% (P<0.0001; sensitivity 64.6%, specificity 99.1%. The CLCA2 protein expression status was associated with the histological tumor grade in the SCCs. These results suggest that CLCA2 might be a novel excellent immunohistochemical marker for differentiating between primary SCC and primary ADC of the lung.

  16. Validation of Standard and New Criteria for the Differential Diagnosis of Narrow QRS Tachycardia in Children and Adolescents.

    Science.gov (United States)

    Deutsch, Karol; Stec, Sebastian; Kukla, Piotr; Morka, Aleksandra; Jastrzebski, Marek; Baszko, Artur; Pitak, Maciej; Sledz, Janusz; Fijorek, Kamil; Mazij, Mariusz; Ludwik, Bartosz; Gubaro, Marcin; Szydlowski, Leslaw

    2015-12-01

    To establish an appropriate treatment strategy and determine if ablation is indicated for patients with narrow QRS complex supraventricular tachycardia (SVT), analysis of a standard 12-lead electrocardiogram (ECG) is required, which can differentiate between the 2 most common mechanisms underlying SVT: atrioventricular nodal reentry tachycardia (AVNRT) and orthodromic atrioventricular reentry tachycardia (OAVRT). Recently, new, highly accurate electrocardiographic criteria for the differential diagnosis of SVT in adults were proposed; however, those criteria have not yet been validated in a pediatric population.All ECGs were recorded during invasive electrophysiology study of pediatric patients (n = 212; age: 13.2 ± 3.5, range: 1-18; girls: 48%). We assessed the diagnostic value of the 2 new and 7 standard criteria for differentiating AVNRT from OAVRT in a pediatric population.Two of the standard criteria were found significantly more often in ECGs from the OAVRT group than from the AVNRT group (retrograde P waves [63% vs 11%, P ECGs from the AVNRT group than from the OAVRT group (pseudo r' wave in V1 lead [39% vs 10%, P ECG parameters may predict a final diagnosis with better accuracy. PMID:26705217

  17. Acute inflammatory bowel disease of the small intestine in adult: MDCT findings and criteria for differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Stefania [Department of Diagnostic Imaging, A.Cardarelli Hospital, Naples (Italy)], E-mail: stefromano@libero.it; Russo, Anna [Institute of Radiology, Second University of Naples, Naples (Italy); Daniele, Stefania; Tortora, Giovanni [Department of Diagnostic Imaging, A.Cardarelli Hospital, Naples (Italy); Maisto, Francesco [Institute of Radiology, Second University of Naples, Naples (Italy); Romano, Luigia

    2009-03-15

    Inflammatory changes of the intestine leading to acute abdomen could represent a frequent diagnostic challenge for radiologists actively involved in the emergency area. MDCT imaging findings needs to be evaluated considering the clinical history and symptoms and other abdominal findings that could be of help in differential diagnosis. Several protocols have been suggested and indicated in the imaging of patient with acute intestine. However, a CT protocol in which the precontrast scanning of the abdomen is followed by i.v. administration of contrast medium using the 45-55 s delay could be effective for an optimal visualization of the bowel wall. It is important to learn to recognize how the intestine reacts to the injury and how it 'talks', in order to become aware of the different patterns of disease manifestation related to an acute intestinal condition, for an effective diagnosis of active and acute inflammatory bowel disease.

  18. CONTRIBUTION OF THE AUDIOLOGICAL AND VESTIBULAR ASSESSMENT TO THE DIFFERENTIAL AND ETIOLOGICAL DIAGNOSIS OF PERIPHERIC VESTIBULAR SYNDROMES

    Directory of Open Access Journals (Sweden)

    Loreta Ungureanu

    2012-09-01

    Full Text Available Scope of the study: Vestibular pathology is a complex one, requiring a minute clinical evaluation, as well as numerous paraclinical investigations. The present study analyzes the contribution of the modern methods of vestibular and auditive investigation to the diagnosis of dizziness. Materials and method: The results of the investigations performed on 84 patients with peripheric vestibular syndrome, on whom a complete audiological and vestibular assessment had been also made, have been retrospectively analyzed. Results: Anamnestic data and the results of evaluation permitted classification of peripheric vestibular pathology according to topo-lesional and etiological criteria. The most frequently diagnosed diseases were: benign paroxysmal positional vertigo, Ménière syndrome and vestibular neuronitis. Conclusions: Testing of the vestibulo-ocular and vestibulo-spinal reflexes through videonystagmoscopy and, respectively, computerized dynamic posturography, besides tonal vocal audiometry and precocious auditive potentials, is especially important for a positive diagnosis and etiological differentiation of vestibular syndromes.

  19. Differential diagnosis of tumors of the mandible and maxilla: radiological aspects; Diagnostico diferencial dos tumores da manbibula e maxila

    Energy Technology Data Exchange (ETDEWEB)

    Isberner, Rony Klaus; Nagazava, Marcio M.; Chiang, Jeng Tyng; Goncalves, Marcelo [Hospital do Cancer de Sao Paulo, SP (Brazil). Dept. de Imagem; Dib, Luciano L. [Hospital do cancer de Sao Paulo, SP (Brazil). Dept. de Estomatologia

    1999-06-01

    The radiolucent lesions of the maxilla and jaw can present similar features, such as location, proximity or dental inclusion, insufflative character and density. They are so alike that those signs frequently are not enough for the diagnosis. Among those lesions, we present follicular cysts, ameloblastomas, odontogenic keratocysts, central giant cell lesion, neurofibroma, mucoepydermoid carcinoma and hemangioma, examined with panoramic X-rays, computed tomography and in a specific case, a SPECT for the jaw, with red blood cells-{sup 99m} Tc. The objective of this work is to demonstrate in a illustrative way, the radiographic features of some of the radiolucent lesions of the maxilla and jaw, whose differential diagnosis becomes sometimes very difficult, but can be achieved through signs that are more compatible with certain lesions. (author)

  20. The diagnosis and differential diagnosis of granulocytic sarcoma%探讨粒细胞肉瘤的诊断与鉴别诊断

    Institute of Scientific and Technical Information of China (English)

    Xiaoli Feng; Jianming Ying; C. Cameron Yin; Ling Li; Susheng Shi; Hongtu Zhang; Yuntian Sun

    2008-01-01

    Objective: To discuss the diagnosis and differential diagnosis of granulocytic sarcoma (GS). Methods: Six cases were reported in this paper. They were assessed by pathologists. Immunohistochemistry (IHC) stain and routine hematoxylin and eosin (H&E) stain were applied. Results:All patients involved in different anatomic sites respectively including skin, lymph node, soft tissue, breast, cervix and penis. All cases were previously error diagnoses. Three of them were initially diagnosed as non-Hodgkin lymphoma (NHL). One case of cervical lymph node lesion was first considered as metastasized carcinoma by clinician. One biopsied skin sample was initially reported as Karposi's sarcoma. And one breast case was suspicious of the Iobular carcinoma with the frozen samples without antecedent clinical history information. GS was accompanied with acute myeloid leukemia (AML) in one case and with acute lymphocytic leukemia (ALL) in one case. Histopathologically, blastic, immature and differentiated variants were found in four, one and one, respectively. Immunohistochemistry (IHC) showed that myeloperoxidase (MPO) and lysozyme were both found to be positive in all cases, CD43 was found in 5 of 6 cases. Three of six cases were CD68, CD15 and LCA positive. CD34 and CD117 were positive in 1/5 and 1/6 cases, respectively. However, CD20 and CD3 were negative in all cases. Conclusion: GS was uncommon and it may be misdiagnosed easily in routine practice. Each area had its own character, but they had the common features too. It can be correctly diagnosed by combination of H&E stain, IHC stain, peripheral blood and bone marrow. MPO and Lysozyme were necessary for the nature of granulocytes. In addition, CD43, CD68 and CD15 were very helpful.

  1. HR 3 tesla MRI for the diagnosis of endolymphatic hydrops and differential diagnosis of inner ear tumors. Demonstrated by two cases with similar symptoms

    International Nuclear Information System (INIS)

    The synchronous appearance of different inner ear pathologies with a nearly equivalent clinical manifestation such as Meniere's disease and vestibular schwannoma is very rare but leads to a relevant dilemma concerning therapy options. MRI is the method of choice to detect intralabyrinthine tumors. Since endolymphatic hydrops is considered the morphological equivalent of Meniere's disease, magnetic resonance imaging including hT2w-FLAIR sequences 4 h after i.v. administration of gadolinium-based contrast agents (GBCA) allows the diagnosis and grading of endolymphatic hydrops in vivo synchronous to diagnosis and monitoring of ILT. To this day, only a few cases of intralabyrinthine schwannoma could be shown to appear simultaneously with endolymphatic hydrops by MRI, but to our knowledge the dedicated distinction of endolymphatic space has not been previously demonstrated. The aim of this work was not only to detect the coincidence of endolymphatic hydrops and vestibular schwannoma, but also to differentiate tumor tissue from endolymphatic space by 3 Tesla MRI. This enables therapy options that are originally indicated for Meniere's disease. The aim of this work was to describe the feasibility and usefulness of endolymphatic hydrops MRI on intralabyrinthal tumors in a special case of intravestibular schwannoma to demonstrate the high clinical relevance and impact in therapeutic decision-making for the synchronous appearance of endolymphatic hydrops and intralabyrinthine tumors. Therefore, we present a typical case of Meniere's disease in contrast to a patient with an intralabyrinthine schwannoma and Meniere's-like symptoms. (orig.)

  2. Primary renal undifferentiated sarcoma as an infiltrative mass in a 12 year old boy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Hee; Kim, Myung Joon; Lee, Mi Jung [Dept. of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Se Hwa [Dept. of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-09-15

    Undifferentiated sarcomas are rare tumors not classified into any sarcoma subtype. Due to their rarity, imaging findings of undifferentiated sarcomas are poorly characterized. The purpose of this report was to present imaging findings of a pathologically confirmed undifferentiated sarcoma originated from the left kidney of a 12-year-old boy. The mass was infiltrative involving the renal pelvis. It mimicked massive hilar lymphadenopathy with a preserved renal contour visible by both ultrasonography and CT. Renal vein thrombosis was also observed. Although undifferentiated sarcomas are rare, they should be considered in differential diagnosis of infiltrative renal masses with renal pelvis invasion in children.

  3. Intrascrotal lipoblastoma in a ten year old boy: case report and review of literature

    Directory of Open Access Journals (Sweden)

    Ghassan Nakib

    2013-02-01

    Full Text Available Lipoblastoma is a rare benign soft tissue tumor encountered almost exclusively in infancy and early childhood. The location of tumors varies, but most occur in the extremities, trunk, head and neck. Less frequently, lipoblastomas have been reported in the mediastinum, the retroperitoneum and the inguinal region. Only 7 cases of lipoblastoma in the scrotum have been reported so far in the English literature, with none of the patients older than 8. We report an intrascrotal lipoblastoma in a 10 year-old boy. The differential diagnosis is discussed with reference to the literature.

  4. Primary renal undifferentiated sarcoma as an infiltrative mass in a 12 year old boy

    International Nuclear Information System (INIS)

    Undifferentiated sarcomas are rare tumors not classified into any sarcoma subtype. Due to their rarity, imaging findings of undifferentiated sarcomas are poorly characterized. The purpose of this report was to present imaging findings of a pathologically confirmed undifferentiated sarcoma originated from the left kidney of a 12-year-old boy. The mass was infiltrative involving the renal pelvis. It mimicked massive hilar lymphadenopathy with a preserved renal contour visible by both ultrasonography and CT. Renal vein thrombosis was also observed. Although undifferentiated sarcomas are rare, they should be considered in differential diagnosis of infiltrative renal masses with renal pelvis invasion in children

  5. Acute disseminated encephalomyelitis in children: differential diagnosis from multiple sclerosis on the basis of clinical course

    Directory of Open Access Journals (Sweden)

    Yun Jin Lee

    2011-06-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM is a demyelinating disease of the central nervous system (CNS that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalopathy. ADEM is considered an autoimmune disorder that is triggered by an environmental stimulus in genetically susceptible individuals. The diagnosis of ADEM is based on clinical and radiological features. Most children with ADEM initially present with fever, meningeal signs, and acute encephalopathy. The level of consciousness ranges from lethargy to frank coma. Deep and subcortical white-matter lesions and gray-matter lesions such as thalami and basal ganglia on magnetic resonance imaging (MRI are associated with ADEM. In a child who presents with signs of encephalitis, bacterial and viral meningitis or encephalitis must be ruled out. Sequential MRI is required to confirm the diagnosis of ADEM, as relapses with the appearance of new lesions on MRI may suggest either multiphasic ADEM or multiple sclerosis (MS. Pediatric MS, defined as onset of MS before the age of 16, is being increasingly recognized. MS is characterized by recurrent episodes of demyelination in the CNS separated in space and time. The McDonald criteria for diagnosis of MS include evidence from MRI and allow the clinician to make a diagnosis of clinically definite MS on the basis of the interval preceding the development of new white matter lesions, even in the absence of new clinical findings. The most important alternative diagnosis to MS is ADEM. At the initial presentation, the 2 disorders cannot be distinguished with certainty. Therefore, prolonged follow-up is needed to establish a diagnosis.

  6. On differential diagnosis of dyskinesia and inflammatory processes of biliary tract in children according to the cholecystography data

    International Nuclear Information System (INIS)

    Children with diseases of biliferous system were examined. Cholecystograms were used to study the following characteristics: girth and log of bile cyst before and after reception of yolks, the volume of bile cyst before and after reception of yolks, the volume of residual bile, the degree of girth and log reduction before and after reception of yolks, the difference of ratios of girth to log of bile cyst before and after reception of yolks. The distinguished characteristics were summarized in the tables, which are recommended to use in infantile gastroenterological departments during differential diagnosis of dyskinesia and inflammatory processes of biliary tract

  7. Histopathology and TB-PCR kit analysis in differentiating the diagnosis of intestinal tuberculosis and Crohn’s disease

    Institute of Scientific and Technical Information of China (English)

    Joon; Mee; Kim; Hyung; Kil; Kim; Lucia; Kim; Suk; Jin; Choi

    2010-01-01

    AIM: To compare the histopathologic features of intestinal tuberculosis (ITB) and Crohn’s disease (CD) and to identify whether polymerase chain reaction for Mycobacterium tuberculosis (TB-PCR) would be helpful for differential diagnosis between ITB and CD.METHODS: We selected 97 patients with established diagnoses (55 cases of ITB and 42 cases of CD) who underwent colonoscopic biopsies.Microscopic features of ITB and CD were reviewed,and eight pathologic parameters were evaluated.Nine cases of acid fast bac...

  8. [Calcified portal vein thrombosis in the follow-up of surgical portocaval shunt: Sonographic findings and differential diagnosis].

    Science.gov (United States)

    Danse, E; Horsmans, Y

    2006-11-01

    The case of a patient with large hepatic calcifications along the portal vascular network caused by long-standing portal vein thrombosis is presented. These calcifications appeared in extended portal thrombosis and were confirmed in follow-up for a surgical portocaval shunt related to portal hypertension. The differential diagnosis should distinguish these from hyperechoic patterns observed along the periportal vascular network, including intraductal biliary stones, portal venous gas, gas in the biliary tract, biliary comet tail artifacts, periportal fibrosis in parasitosis, and calcifications of the hepatic arteries. PMID:17095965

  9. The expression of MDM2/CDK4 gene product in the differential diagnosis of well differentiated liposarcoma and large deep-seated lipoma

    Science.gov (United States)

    Pilotti, S; Torre, G Della; Mezzelani, A; Tamborini, E; Azzarelli, A; Sozzi, G; Pierotti, M A

    2000-01-01

    Ordinary lipomas are cytogenetically characterized by a variety of balanced rearrangements involving chromosome segment 12q13–15, whereas well differentiated liposarcomas (WDL) show supernumerary ring and giant marker chromosomes, known to contain amplified 12q sequences. The tight correlation between the presence of ring chromosomes and both amplification and overexpression of MDM2 and CDK4 genes suggests the exploration of the possibility that immunocytochemistry (ICC) might assist in the differential diagnosis of lipoma-like well differentiated liposarcomas (LL-WDL) and large deep-seated lipomas (LDSL). For this purpose, 21 cases of the former and 19 cases of the latter tumours were analysed by ICC and, according to the availability of material, by molecular and cytogenetic approaches. All lipomas displayed a null MDM2/CDK4 phenotype, whereas all LL-WDL showed MDM2/CDK4 or CDK4 phenotypes. Southern blot analysis performed on 16 suitable cases, complemented by fluorescence in situ hybridization and classical cytogenetic analysis in 11 cases, was consistent with, and further supported the immunophenotyping data. In conclusion, MDM2/CDK4 product-based immunophenotyping appears to represent a valuable method for the categorization of arguable LDSL. © 2000 Cancer Research Campaign PMID:10755400

  10. Congenital malaria in a neonate: case report with a comprehensive review on differential diagnosis, treatment and prevention in Indian perspective.

    Science.gov (United States)

    Rai, Preeti; Majumdar, Kaushik; Sharma, Sunita; Chauhan, Richa; Chandra, Jagdish

    2015-06-01

    Although malaria in pregnancy, lactation and congenital malaria can be a disease burden in the endemic zones of Africa and Indian sub-continent, it is still epidemiologically less investigated in India. As it may lead to considerable maternal and perinatal morbidity and mortality, awareness and timely intervention is necessary for desirable outcome and prevention of the condition. Very few reports of congenital malaria are available in the literature from an endemic country like India. Herein we describe a case of congenital malaria from north India in a 21-day neonate. Clinical presentation of this condition in the neonate may offer a considerable diagnostic challenge, and differentiation from vector borne malaria in infants may be important from the management point of view. Hence a review of the differential diagnosis, management and prevention of congenital malaria has been attempted in the Indian perspective. PMID:26064034

  11. The Bender-Gestalt Test in Differential Diagnosis of Adolescents with Learning Difficulties

    Science.gov (United States)

    Mordock, John B.; and others

    1968-01-01

    Attempt to assess efficiency of Haine and Koppitz scoring systems with Bender-Gestalt in ability to differentiate between brain-damaged and other young people in a residential treatment center did not prove useful. (Author/CJ)

  12. 壶腹周围癌早期诊断和鉴别诊断%Eady and differential diagnosis of periampullary cancer

    Institute of Scientific and Technical Information of China (English)

    赵玉沛

    2008-01-01

    Periampullary cancer is a kind of malignant cancer of digestive tract.It arises within 2 cm of the major duodenal papilla and eomprises cancers of the ampulla,distal comliiOll bile duct,pancreas and duodenum.Their clinical features and anatomic locations are similar,as are the therapeutic approaches.However,their long-term outcomes vary.Due to the bad prognosis,it is very important to make an early,accurate diagnosis and differential diagnosis of periampullary cancer.This article summarizes some basic methods and new developments of early and differential diagnosis of poriampullary cancer.

  13. Laryngeal neurinoma. Differential diagnosis of submucosal laryngeal tumors; Neurinoma laringeo. Diagnostico diferencial de tumoraciones submucosas laringeas

    Energy Technology Data Exchange (ETDEWEB)

    Higuera, A.; Palomo, V.; Munoz, R.; Sanchez, F.

    2002-07-01

    Laryngeal neurinoma is a rare benign tumor that appears as a submucosal mass, generally in the supraglottic region. We report the case of a patient with dysphonia of long evolution caused by a neurinoma. We discuss the radiological findings of the tumor and the value of computed tomography (CT) in the diagnosis of this and other submucosal laryngeal lesions. (Author) 16 refs.

  14. Pompe disease is a differential diagnosis in case of reduced physical capacity and abnormal muscular fatigue

    DEFF Research Database (Denmark)

    Hansen, Julie Schjødtz; Ellingsen, Anne R; Andreasen, Caroline M;

    2014-01-01

    Late-onset Pompe disease is an inherited metabolic myopathy with low activity of alpha glucosidase and variable clinical symptoms. In this case report we describe a woman with long standing muscular fatigue and malaise with the diagnosis initially established by pathologic findings in the muscle...

  15. Differential diagnosis of lung carcinoma with three-dimensional quantitative molecular vibrational imaging

    Science.gov (United States)

    Gao, Liang; Hammoudi, Ahmad A.; Li, Fuhai; Thrall, Michael J.; Cagle, Philip T.; Chen, Yuanxin; Yang, Jian; Xia, Xiaofeng; Fan, Yubo; Massoud, Yehia; Wang, Zhiyong; Wong, Stephen T. C.

    2012-06-01

    The advent of molecularly targeted therapies requires effective identification of the various cell types of non-small cell lung carcinomas (NSCLC). Currently, cell type diagnosis is performed using small biopsies or cytology specimens that are often insufficient for molecular testing after morphologic analysis. Thus, the ability to rapidly recognize different cancer cell types, with minimal tissue consumption, would accelerate diagnosis and preserve tissue samples for subsequent molecular testing in targeted therapy. We report a label-free molecular vibrational imaging framework enabling three-dimensional (3-D) image acquisition and quantitative analysis of cellular structures for identification of NSCLC cell types. This diagnostic imaging system employs superpixel-based 3-D nuclear segmentation for extracting such disease-related features as nuclear shape, volume, and cell-cell distance. These features are used to characterize cancer cell types using machine learning. Using fresh unstained tissue samples derived from cell lines grown in a mouse model, the platform showed greater than 97% accuracy for diagnosis of NSCLC cell types within a few minutes. As an adjunct to subsequent histology tests, our novel system would allow fast delineation of cancer cell types with minimum tissue consumption, potentially facilitating on-the-spot diagnosis, while preserving specimens for additional tests. Furthermore, 3-D measurements of cellular structure permit evaluation closer to the native state of cells, creating an alternative to traditional 2-D histology specimen evaluation, potentially increasing accuracy in diagnosing cell type of lung carcinomas.

  16. Opacification of the middle ear and mastoid: imaging findings and clues to differential diagnosis.

    Science.gov (United States)

    Lo, A C C; Nemec, S F

    2015-05-01

    Opacification of the middle ear and mastoid represents a spectrum of inflammatory, neoplastic, vascular, fibro-osseous, and traumatic changes. This article reviews the most important clinical and pathological characteristics, emphasizing CT and MRI findings. Knowledge of subtle patterns of middle ear and mastoid opacification at CT and MRI provide guidance towards the correct diagnosis. PMID:25573814

  17. Opacification of the middle ear and mastoid: imaging findings and clues to differential diagnosis

    International Nuclear Information System (INIS)

    Opacification of the middle ear and mastoid represents a spectrum of inflammatory, neoplastic, vascular, fibro-osseous, and traumatic changes. This article reviews the most important clinical and pathological characteristics, emphasizing CT and MRI findings. Knowledge of subtle patterns of middle ear and mastoid opacification at CT and MRI provide guidance towards the correct diagnosis

  18. Clinical significance of plasma lysophosphatidic acid levels in the differential diagnosis of ovarian cancer

    Directory of Open Access Journals (Sweden)

    Yun-Jie Zhang

    2015-01-01

    Full Text Available Objective: To investigate the value of lysophosphatidic acid (LPA in the diagnosis of ovarian cancer. Materials and Methods: We first performed a hospital-based, case-control study involving 123 ovarian cancer patients and 101 benign ovarian tumor patients, and then conducted a meta-analysis with 19 case-control studies to assess the correlation between ovarian cancer and plasma LPA levels. Results: The case-control study results demonstrated that ovarian cancer patients have increased LPA and cancer antigen (CA-125 levels compared to patients with benign ovarian tumor (LPA: Ovarian cancer vs benign ovarian tumor: 5.28 ± 1.52 vs 1.82 ± 0.77 μmol/L; CA-125: Ovarian cancer vs benign ovarian tumor: 87.17 ± 45.81 vs. 14.03 ± 10.14 U/mL, which showed statistically significant differences (both P < 0.05. LPA with advanced sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate of diagnosis excelled CA-125 in the diagnosis of ovarian cancer (both P < 0.05. The areas under the receiver operating characteristic (ROC curve in the diagnosis of ovarian cancer (LPA: 0.983; CA-125: 0.910 were statistically significant compared with the reference (both P < 0.001 and the difference of the areas of ROC curve between LPA and CA-125 in the diagnosis of ovarian cancer showed statistically significant difference (P < 0.05. The meta-analysis results suggested that plasma LPA levels were higher in ovarian cancer tissues than in benign tissues (standardized mean difference (SMD =2.36, 95% confidence interval (CI: 1.61-3.11, P < 0.001 and normal tissues (SMD = 2.32, 95% CI: 1.77-2.87, P < 0.001. Conclusion: LPA shows greater value in the diagnosis of ovarian cancer compared to CA-125 and may be employed as a biological index to diagnose ovarian cancer.

  19. Magnetic resonance (MR) imaging of chordoma and chondroma in the skull base; Differential diagnosis by IR sequence

    Energy Technology Data Exchange (ETDEWEB)

    Tashiro, Takahiko; Inoue, Yuichi; Nemoto, Yutaka (Osaka City Univ. (Japan). Faculty of Medicine) (and others)

    1992-05-01

    Differential diagnosis of chordoma and chondroma in the skull base is sometimes difficult. We retrospectively reviewed the MR images of 14 patients with skull base tumors (nine chordomas, four chondromas and one chondrosarcoma). MR imaging was performed with a 0.5 Tesla system (Picker International). Inversion recovery (IR) (2500-2100/600-500/40), T1-weighted spin echo (SE) (800-600/40), and T2-weighted SE (2500-1800/120) images were obtained. On IR images, seven of eight chordomas showed heterogeneous low signal intensity, and one chordoma and all chondromas showed markedly low signal intensity similar to that of CSF. Calcified or ossified portions of the chondromas were demonstrated as areas of moderately low intensity on IR images. Chondrosarcoma showed moderately low intensity similar to that of chordoma. T1-weighted SE images of chordoma and chondroma showed no difference in signal intensity. On T2-weighted SE images, six of nine chordomas and all chondromas showed markedly high signal intensity. Three chordomas and one chondrosarcoma showed moderately high signal intensity. In the diagnosis of skull base tumors, the IR sequence seems to be useful for differentiating chondroma from chordoma. (author).

  20. Differential Diagnosis of Japanese Encephalitis Virus Infections with the Inbios JE Detect™ and DEN Detect™ MAC-ELISA Kits

    Science.gov (United States)

    Johnson, Barbara W.; Goodman, Christin H.; Jee, Youngmee; Featherstone, David A.

    2016-01-01

    Japanese encephalitis virus (JEV) is the leading cause of pediatric viral neurological disease in Asia. The JEV-specific IgM antibody-capture enzyme-linked immunosorbent assay (MAC-ELISA) in cerebrospinal fluid (CSF) and serum is the recommended method of laboratory diagnosis, but specificity of JEV MAC-ELISA can be low due to cross-reactivity. To increase the specificity of the commercially available JE Detect™ MAC-ELISA (JE Detect), a differential testing algorithm was developed in which samples tested by JE Detect with positive results were subsequently tested by the DEN Detect™ MAC-ELISA (DEN Detect) kit, and results of both tests were used to make the final interpretation. The testing algorithm was evaluated with a reference panel of serum and CSF samples submitted for confirmatory testing. In serum, the false Japanese encephalitis (JE) positive rate was reduced, but sequential testing in CSF resulted in reduced JE specificity, as true JEV+ CSF samples had positive results by both JE Detect and DEN Detect and were classified as JE− (dengue virus [DENV]+). Differential diagnosis of JE by sequential testing with JE Detect and DEN Detect increased specificity for JE in serum, but more data with CSF is needed to make a final determination on the usefulness of this testing algorithm for CSF. PMID:26856911

  1. Differential Diagnosis of Japanese Encephalitis Virus Infections with the Inbios JE Detect™ and DEN Detect™ MAC-ELISA Kits.

    Science.gov (United States)

    Johnson, Barbara W; Goodman, Christin H; Jee, Youngmee; Featherstone, David A

    2016-04-01

    Japanese encephalitis virus (JEV) is the leading cause of pediatric viral neurological disease in Asia. The JEV-specific IgM antibody-capture enzyme-linked immunosorbent assay (MAC-ELISA) in cerebrospinal fluid (CSF) and serum is the recommended method of laboratory diagnosis, but specificity of JEV MAC-ELISA can be low due to cross-reactivity. To increase the specificity of the commercially available JEDetect(™)MAC-ELISA (JEDetect), a differential testing algorithm was developed in which samples tested by JEDetectwith positive results were subsequently tested by the DENDetect(™)MAC-ELISA (DENDetect) kit, and results of both tests were used to make the final interpretation. The testing algorithm was evaluated with a reference panel of serum and CSF samples submitted for confirmatory testing. In serum, the false Japanese encephalitis (JE) positive rate was reduced, but sequential testing in CSF resulted in reduced JE specificity, as true JEV+ CSF samples had positive results by both JEDetectand DENDetectand were classified as JE- (dengue virus [DENV]+). Differential diagnosis of JE by sequential testing with JEDetectand DENDetectincreased specificity for JE in serum, but more data with CSF is needed to make a final determination on the usefulness of this testing algorithm for CSF. PMID:26856911

  2. A Challenging Case of Metastatic Intra-Abdominal Synovial Sarcoma with Unusual Immunophenotype and Its Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Yi-Che Changchien

    2012-01-01

    Full Text Available The primary and metastatic gastrointestinal synovial sarcoma is rare with a wide differential diagnosis. It usually expresses cytokeratins EMA, BCL2 with an occasional CD99, and S100 positivity but not desmin. We present a case of metastatic synovial sarcoma with unusual immunophenotype causing diagnostic challenges. The tumor cells showed focal cytokeratin, EMA, and, unexpectedly, desmin positivity. Additional intranuclear TLE-1 positivity and negativity for CD34 and DOG-1 were also identified. A diagnosis of monophasic synovial sarcoma was confirmed by using FISH break-apart probe. RT-PCR revealed the SYT-SSX1 fusion gene. Intra-abdominal synovial sarcoma, either primary or metastatic, with unusual desmin positivity raises the diagnostic challenge, since a wide range of differential diagnoses could show a similar immunophenotype (leiomyosarcoma, desmoid tumor, myofibroblastic tumor, and rarely GIST etc.. Typical morphology and focal cytokeratin/EMA positivity should alert to this tumor, and FISH and RT-PCR remain the gold standard for the confirmation.

  3. Diagnosis and Differential Diagnosis of Spiral CT to Thyroid Tumor%螺旋CT对甲状腺肿瘤的诊断与鉴别价值

    Institute of Scientific and Technical Information of China (English)

    陈寅; 邹新农; 李威

    2011-01-01

    Objective:To evaluate spiral CT examination in the diagnosis of thyroid tumors and differential values.Methods:A retrospective analysis from January 2008 to April 2011 in our hospital,30 cases of thyroid cancer patients,their preoperative and postoperative CT examination pathological diagnosis and treatment diagnostic information to make comparisons,analyze their consistency. Results:The group of 30 cases of thyroid cancer patients,preoperative CT in 16 patients diagnosed with thyroid cancer,thyroid benign tumors in 14 patients,the diagnosis and postoperative pathologic diagnosis was consistent with rates of 94.1% and 92.9%.Appears on CT images of thyroid irregular margin,tumor-like nodules around the present peninsula,showing incomplete peritumoral capsule-like low density,sand-like calcification are characteristic of malignant thyroid tumors performance.Conclusion:Thyroid cancer patients using spiral CT scan for diagnosis,can be more accurately distinguish between the benign and malignant,particularly in the diagnosis of thyroid cancer is very accurate,and CT examination also clearly showed the tumor to the surrounding tissue and tumor metastasis violations,the development of treatment programs provide critical guidance.%目的:探讨螺旋CT检查对甲状腺良恶性肿瘤的诊断和鉴别价值.方法:回顾性分析2008年1月~2011年4月我院收治的30例甲状腺肿瘤患者,对其术前CT检查诊疗资料和术后病理组织诊断资料进行对比,分析两者的一致性.结果:本组30例甲状腺肿瘤患者中,术前CT诊断出16例患者为甲状腺癌、14例患者为甲状腺良性肿瘤,该诊断结果和术后病理组织诊断的符合率分别为94.1%和92.9%.CT图像上出现甲状腺边缘不规则、肿瘤周边呈现半岛样结节、瘤周呈现不完整包膜样低密度影、细沙样钙化,均是恶性甲状腺肿瘤的特征性表现.结论:甲状腺肿瘤患者采用螺旋CT扫描进行检查诊断,

  4. Clinicopathologic study of endolymphatic sac tumor (ELST) and differential diagnosis of papillary tumors located at the cerebellopontine angle.

    Science.gov (United States)

    Du, Jiang; Wang, Junmei; Cui, Yun; Zhang, Cuiping; Li, Guilin; Fang, Jingyi; Yue, Shenglin; Xu, Li

    2015-10-01

    We investigated the clinicopathologic features and immunophenotypes of 10 cases of endolymphatic sac tumor (ELST) and compared them with other papillary tumors, including eight cases of choroid plexus papilloma (CPP), three cases of atypical choroid plexus papilloma (ACPP), two cases of papillary ependymoma (PE), three cases of papillary meningioma (PM) and two cases of metastatic carcinoma (MC) the at cerebellopontine angle (CPA). The age at onset of ELST ranged from 13 to 39 years. The male-to-female ratio was 1:1. The clinical presentations were primarily ear-related symptoms. The temporal bones showed extensive destruction. Histologically, the important characteristics for differential diagnosis with CPP, which is most similar to ELST, include the quantity of blood vessels, the nuclei location at apical surface of the papillary, clear cytoplasm cells sometimes with visible vacuoles, psammoma bodies and dura or bone invasion. Immunohistochemistry stains for AE1/AE3, cytokeratin CK)5/6, epithelial membrane antigen, CK8/18, S-100, and synaptophysin are helpful in diagnosis of ELST. In ELST, ultrastructure of uniform 2 μm vesicles in cytoplasm was seen, and gene analysis also showed missense mutation in exon 3. This study indicates that the above histological features combined with immunohistochemistry findings are important for making the correct diagnosis. Gene analysis should be used in patients without medical history to exclude von Hippel-Lindau disease. PMID:25944396

  5. Gastrocnemius muscle herniation as a rare differential diagnosis of ankle sprain: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Bergmann Greta

    2012-03-01

    Full Text Available Abstract Background Muscle herniation of the leg is a rare clinical entity. Yet, knowing this condition is necessary to avoid misdiagnosis and delayed treatment. In the extremities, muscle herniation most commonly occurs as a result of an acquired fascial defect, often due to trauma. Different treatment options for symptomatic extremity muscle herniation in the extremities, including conservative treatment, fasciotomy and mesh repair have been described. Case presentation We present the case of a patient who presented with prolonged symptoms after an ankle sprain. The clinical picture showed a fascial insufficiency with muscle bulging under tension. Ultrasound and MRI imaging confirmed the diagnosis of muscle hernia of the medial gastrocnemius on the right leg. Conservative treatment did not lead to success. Therefore, the fascial defect was treated surgically by repairing the muscle herniation using a synthetic vicryl propylene patch. Conclusions Muscle hernias should be taken into consideration as a rare differential diagnosis whenever patients present with persisting pain or soft tissue swelling after ankle sprain. Diagnosis is mainly based on clinical aspect and physical examination, but can be confirmed by radiologic imaging techniques, including (dynamic ultrasound and MRI. If conservative treatment fails, we recommend the closure with mesh patches for large fascial defects.

  6. [Hepatic amyloidosis as a rare differential diagnosis of progressive liver failure].

    Science.gov (United States)

    Bettinger, Dominik; Lutz, Lisa; Schultheiß, Michael; Werner, Martin; Thimme, Robert; Neumann-Haefelin, Christoph

    2016-09-01

    Primary systemic amyloidosis is a rare disorder resulting in extracellular deposition of insoluble fibrils in different organs. Liver involvement has been reported. Since hepatic amyloidosis often presents clinically asymptomatic without specific laboratory or imaging hallmarks, diagnosis is challenging. However, cases of progressive hepatic failure due to liver amyloidosis have been reported. A 63 year old man presented with newly diagnosed ascites to our department. The patient reported occasional alcohol consumption. Viral hepatitis, genetic-metabolic causes as well as hepatic vascular disorders were excluded and ultrasound did not show any signs of liver cirrhosis or intraabdominal malignancy. Initially, alcoholic hepatitis was suspected. Due to the rapid deterioration of liver function, however, transjugular liver biopsy was performed showing light chain amyloidosis of kappa isotype. As diagnosis of hepatic amyloidosis is challenging, early liver biopsy is mandatory in patients with unexplained acute or chronic liver disease to exclude rare diseases with high mortality. PMID:27642740

  7. [Hepatic amyloidosis as a rare differential diagnosis of progressive liver failure].

    Science.gov (United States)

    Bettinger, Dominik; Lutz, Lisa; Schultheiß, Michael; Werner, Martin; Thimme, Robert; Neumann-Haefelin, Christoph

    2016-09-01

    Primary systemic amyloidosis is a rare disorder resulting in extracellular deposition of insoluble fibrils in different organs. Liver involvement has been reported. Since hepatic amyloidosis often presents clinically asymptomatic without specific laboratory or imaging hallmarks, diagnosis is challenging. However, cases of progressive hepatic failure due to liver amyloidosis have been reported. A 63 year old man presented with newly diagnosed ascites to our department. The patient reported occasional alcohol consumption. Viral hepatitis, genetic-metabolic causes as well as hepatic vascular disorders were excluded and ultrasound did not show any signs of liver cirrhosis or intraabdominal malignancy. Initially, alcoholic hepatitis was suspected. Due to the rapid deterioration of liver function, however, transjugular liver biopsy was performed showing light chain amyloidosis of kappa isotype. As diagnosis of hepatic amyloidosis is challenging, early liver biopsy is mandatory in patients with unexplained acute or chronic liver disease to exclude rare diseases with high mortality.

  8. Unusual primary intraosseous meningioma, mimicking cranial osteoid osteoma: A radiological clue to the differential diagnosis

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Izumo

    2014-01-01

    Full Text Available Primary intraosseous meningioma of the skull is rare. We report a patient who presented with a history of an enlarging scalp mass over 30 years. Noncontrast computed tomography demonstrated a densely calcified right frontal extra-axial mass lesion. Magnetic resonance imaging of the lesion demonstrated heterogeneous hypointensity on T1-and T2-wieghted images and without evidence of gadolinium contrast enhancement. And the mass showed heterogeneous isointensity on diffusion weighted image. Preoperative diagnosis for the lesion was osteoid osteoma of the right frontoparietal bone, and total excision of the tumor was carried out. Histological examination showed intraosseous meningothelial meningioma. We should be aware of the primary intraosseous meningioma showing the classical radiological findings of cranial osteoid osteoma. The radiological clue for the accurate diagnosis is discussed.

  9. The Problem With Boys

    Institute of Scientific and Technical Information of China (English)

    WANG HAIRONG

    2010-01-01

    @@ Pony,a 10-month-old boy,lost his first confrontation in life to a girl of the same age.The two babies'mothers met in a shopping mall recently and decided to let the two children play with each other.They put the babies down together on the floor.As soon as her feet were on the floor,the baby girl waddled toward Pony,stretching out her little hands to grab him.The boy,not yet strong enough to walk,cried at the aggressive girl.

  10. Oculopharyngeal muscular dystrophy as a rare differential diagnosis for unexplained dysphagia: a case report

    OpenAIRE

    Bumm, Klaus; Zenker, Martin; Bozzato, Alessandro

    2009-01-01

    Introduction We wish to report on a rare cause of dysphagia; oculopharyngeal muscular dystrophy (OPMD). It is a late adult onset autosomal dominant form of muscular dystrophy that constitutes as a rare diagnosis for any place outside of Canada and first case in southern Germany. Case presentation We report the medical odyssey of a 57-year old male Caucasian patient. He was referred at our hospital for further clarification of a progressive dysphagia, which, at first view, was thought to be tu...

  11. Problems in differential X-ray diagnosis of restrictive pneumothorax in young children

    International Nuclear Information System (INIS)

    To define X-ray signs of restrictive pneumothorax, the authors analyzed X-ray films of 225 newborns and babies of the first 3 months of life who were examined for respiratory disorders and acute respiratory diseases. Restrictive pneumothorax was detected in 19 . The processing X-ray films on the UAP-2 device enhanced the accuracy of restrictive pneumothorax diagnosis in infants and made it possible to do away an additional X-ray study, which reduced radiation loads

  12. CT differential diagnosis of tumour of the cranium with intracranial spread - a case report

    Energy Technology Data Exchange (ETDEWEB)

    Trittmacher, S.; Purmann, H.; Schmid, A.

    1988-01-01

    A report on patient presenting in the cranial computer tomogram with changes in the cranium in the left temporal region typical of a meningioma, as well as with changes in the floor of the middle cranial fossa. Correct diagnosis was obtained only by the overall assessment comprising anamnesis, laboratory findings and state of the skeletal structure: namely, a plasmacytoma involving the calotte of the cranium.

  13. Clinical efficacy of serum lipase subtype analysis for the differential diagnosis of pancreatic and non-pancreatic lipase elevation

    Science.gov (United States)

    Bang, Chang Seok; Kim, Jin Bong; Park, Sang Hyun; Baik, Gwang Ho; Su, Ki Tae; Yoon, Jai Hoon; Kim, Yeon Soo; Kim, Dong Joon

    2016-01-01

    Background/Aims: Non-pancreatic elevations of serum lipase have been reported, and differential diagnosis is necessary for clinical practice. This study aimed to evaluate the clinical efficacy of serum lipase subtype analysis for the differential diagnosis of pancreatic and non-pancreatic lipase elevation. Methods: Patients who were referred for the serum lipase elevation were prospectively enrolled. Clinical findings and serum lipase subtypes were analyzed and compared by dividing the patients into pancreatitis and non-pancreatitis groups. Results: A total of 34 patients (12 pancreatitis vs. 22 non-pancreatitis cases) were enrolled. In univariate analysis, the fraction of pancreatic lipase (FPL) in the total amount of serum lipase subtypes was statistically higher in patients with pancreatitis ([median, 0.004; interquartile range [IQR], 0.003 to 0.011] vs. [median, 0.002; IQR, 0.001 to 0.004], p = 0.04). Based on receiver operating characteristic curve analysis for the prediction of acute pancreatitis, FPL was the most valuable predictor (area under the receiver-operating characteristic curve [AUROC], 0.72; 95% confidence interval [CI], 0.54 to 0.86; sensitivity, 83.3%; specificity, 63.6%; positive predictive value, 55.6%; negative predictive value, 97.5%). In multivariate analysis, a cut-off value higher than 0.0027 for the FPL was associated with acute pancreatitis (odds ratio, 8.3; 95% CI, 1.3 to 51.7; p = 0.02). Conclusions: The results did not support that serum lipase subtype analysis could replace standard lipase measurement for the diagnosis of acute pancreatitis. However, the test demonstrated adequate sensitivity for use in triage or as an add-on test for serum lipase elevation. PMID:27243230

  14. A decision tree – based method for the differential diagnosis of Aortic Stenosis from Mitral Regurgitation using heart sounds

    Science.gov (United States)

    Pavlopoulos, Sotiris A; Stasis, Antonis CH; Loukis, Euripides N

    2004-01-01

    Background New technologies like echocardiography, color Doppler, CT, and MRI provide more direct and accurate evidence of heart disease than heart auscultation. However, these modalities are costly, large in size and operationally complex and therefore are not suitable for use in rural areas, in homecare and generally in primary healthcare set-ups. Furthermore the majority of internal medicine and cardiology training programs underestimate the value of cardiac auscultation and junior clinicians are not adequately trained in this field. Therefore efficient decision support systems would be very useful for supporting clinicians to make better heart sound diagnosis. In this study a rule-based method, based on decision trees, has been developed for differential diagnosis between "clear" Aortic Stenosis (AS) and "clear" Mitral Regurgitation (MR) using heart sounds. Methods For the purposes of our experiment we used a collection of 84 heart sound signals including 41 heart sound signals with "clear" AS systolic murmur and 43 with "clear" MR systolic murmur. Signals were initially preprocessed to detect 1st and 2nd heart sounds. Next a total of 100 features were determined for every heart sound signal and relevance to the differentiation between AS and MR was estimated. The performance of fully expanded decision tree classifiers and Pruned decision tree classifiers were studied based on various training and test datasets. Similarly, pruned decision tree classifiers were used to examine their differentiation capabilities. In order to build a generalized decision support system for heart sound diagnosis, we have divided the problem into sub problems, dealing with either one morphological characteristic of the heart-sound waveform or with difficult to distinguish cases. Results Relevance analysis on the different heart sound features demonstrated that the most relevant features are the frequency features and the morphological features that describe S1, S2 and the systolic

  15. A decision tree – based method for the differential diagnosis of Aortic Stenosis from Mitral Regurgitation using heart sounds

    Directory of Open Access Journals (Sweden)

    Loukis Euripides N

    2004-06-01

    Full Text Available Abstract Background New technologies like echocardiography, color Doppler, CT, and MRI provide more direct and accurate evidence of heart disease than heart auscultation. However, these modalities are costly, large in size and operationally complex and therefore are not suitable for use in rural areas, in homecare and generally in primary healthcare set-ups. Furthermore the majority of internal medicine and cardiology training programs underestimate the value of cardiac auscultation and junior clinicians are not adequately trained in this field. Therefore efficient decision support systems would be very useful for supporting clinicians to make better heart sound diagnosis. In this study a rule-based method, based on decision trees, has been developed for differential diagnosis between "clear" Aortic Stenosis (AS and "clear" Mitral Regurgitation (MR using heart sounds. Methods For the purposes of our experiment we used a collection of 84 heart sound signals including 41 heart sound signals with "clear" AS systolic murmur and 43 with "clear" MR systolic murmur. Signals were initially preprocessed to detect 1st and 2nd heart sounds. Next a total of 100 features were determined for every heart sound signal and relevance to the differentiation between AS and MR was estimated. The performance of fully expanded decision tree classifiers and Pruned decision tree classifiers were studied based on various training and test datasets. Similarly, pruned decision tree classifiers were used to examine their differentiation capabilities. In order to build a generalized decision support system for heart sound diagnosis, we have divided the problem into sub problems, dealing with either one morphological characteristic of the heart-sound waveform or with difficult to distinguish cases. Results Relevance analysis on the different heart sound features demonstrated that the most relevant features are the frequency features and the morphological features that

  16. Accuracy of endoscopic ultrasound elastography used for differential diagnosis of focal pancreatic masses

    DEFF Research Database (Denmark)

    Săftoiu, A; Vilmann, P; Gorunescu, F;

    2011-01-01

    Endoscopic ultrasound (EUS) elastography represents a new imaging procedure that might characterize the differences of hardness and strain between diseased tissue and normal tissue. The aim of this study was to assess the efficiency of EUS elastography for the differentiation of focal masses in...... chronic pancreatitis and pancreatic cancer....

  17. Is outcome of differentiated thyroid carcinoma influenced by tumor stage at diagnosis?

    NARCIS (Netherlands)

    Clement, S.C.; Kremer, L.C.; Links, T.P.; Mulder, R.L.; Ronckers, C.M.; Eck-Smit, B.L. van; Rijn, R.R. van; Pal, H.J. van der; Tissing, W.J.; Janssens, G.O.R.J.; Heuvel-Eibrink, M.M. van den; Neggers, S.J.; Dijkum, E.J. van; Peeters, R.P.; Santen, H.M. van

    2015-01-01

    BACKGROUND: There is no international consensus on surveillance strategies for differentiated thyroid carcinoma (DTC) after radiotherapy for childhood cancer. Ultrasonography could allow for early detection of DTC, however, its value is yet unclear since the prognosis of DTC is excellent. We address

  18. Is outcome of differentiated thyroid carcinoma influenced by tumor stage at diagnosis?

    NARCIS (Netherlands)

    Clement, S.C.; Kremer, L.C.M.; Links, T.P.; Mulder, R.L.; Ronckers, C.M.; van Eck-Smit, B.L.; van Rijn, R.R.; Pal van der, H.J.H.; Tissing, W.J.E.; Janssens, G.O.; van den Heuvel-Eibrink, M.M.; Neggers, S.J.; Nieveen van Dijkum, E.J.; Peeters, R.P.; van Santen, H.M.

    2015-01-01

    Background: There is no international consensus on surveillance strategies for differentiated thyroid carcinoma (DTC) after radiotherapy for childhood cancer. Ultrasonography could allow for early detection of DTC, however, its value is yet unclear since the prognosis of DTC is excellent. We address

  19. Differential diagnosis in cases of saddle-like impression of the fundus of the stomach

    Energy Technology Data Exchange (ETDEWEB)

    Hohenberg, G.; Deimer, E.; Schmidmeier, L.

    1984-01-01

    X-ray examination of the stomach sometimes shows a saddle-like impression of the region of the fundus. This phenomenon is without any clinical importance, but there are many diseases such as hiatal hernia, benign and malignant tumours, inflammatory diseases, and varices which are localised at the fundus. Differential diagnostic problems are discussed.

  20. Microarray Glycoprofiling of CA125 Improves Differential Diagnosis of Ovarian Cancer

    DEFF Research Database (Denmark)

    Chen, Kowa; Gentry-Maharaj, Aleksandra; Burnell, Matthew;

    2013-01-01

    neoplasms and endometriosis. Aberrant O-glycosylation is an inherent and specific property of cancer cells and could potentially aid in differentiating cancer from these benign conditions, thereby improving specificity of the assay. We report on the development of a novel microarray-based platform...

  1. Prospective study of differential diagnosis of hepatic tumors by pattern-based classification of contrast-enhanced sonography

    Institute of Scientific and Technical Information of China (English)

    Kazushi Numata; Tetsuo Isozaki; Manabu Morimoto; Kazuya Sugimori; Reiko Kunisaki; Toshio Morizane; Katsuaki Tanaka

    2006-01-01

    AIM: To prospectively evaluate the usefulness of a pattern-based classification of contrast-enhanced sonographic findings for differential diagnosis of hepatic tumors.METHODS: We evaluated the enhancement pattern of the contrast-enhanced sonography images in 586 patients with 586 hepatic lesions, consisting of 383 hepatocellular carcinomas, 89 metastases, and 114 hemangiomas. After injecting a galactose-palmitic acid contrast agent, lesions were scanned by contrastenhanced harmonic gray-scale sonography in three phases: arterial, portal, and late. The enhancement patterns of the initial 303 lesions were classified retrospectively, and multiple logistic regression analysis was used to identify enhancement patterns that allowed differentiation between hepatic tumors. We then used the pattern-based classification of enhancement we had retrospectively devised to prospectively diagnose 283 liver tumors.RESULTS: Seven enhancement patterns were found to be significant predictors of different hepatic tumors.The presence of homogeneous or heterogeneous enhancement both in the arterial and portal phase was the typical enhancement pattern for hepatocellular carcinoma, while the presence of peritumoral vessels in the arterial phase and ring enhancement or a perfusion defect in the portal phase was the typical enhancement pattern for metastases, and the presence of peripheral nodular enhancement both in the arterial and portal phase was the typical enhancement pattern for hemangioma. The sensitivity, specificity, and accuracy of prospective diagnosis based on the combinations of enhancement patterns, respectively, were 93.2%,96.2%, and 94.0% for hepatocellular carcinoma, 87.9%,99.6%, and 98.2% for metastasis, and 95.6%, 94.1%,and 94.3% for hemangioma.CONCLUSION: The pattern-based classification of the contrast-enhanced sonographic findings is useful for differentiating among hepatic tumors.

  2. HR 3 tesla MRI for the diagnosis of endolymphatic hydrops and differential diagnosis of inner ear tumors. Demonstrated by two cases with similar symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Homann, G.; Fahrendorf, D.; Niederstadt, T.; Nagelmann, N.; Heindel, W.; Vieth, V. [University Hospital Muenster (Germany). Dept. of Clinical Radiology; Luetkenhoener, B.; Boeckenfeld, Y.; Basel, T. [University Hospital Muenster (Germany). ENT Clinic

    2014-03-15

    The synchronous appearance of different inner ear pathologies with a nearly equivalent clinical manifestation such as Meniere's disease and vestibular schwannoma is very rare but leads to a relevant dilemma concerning therapy options. MRI is the method of choice to detect intralabyrinthine tumors. Since endolymphatic hydrops is considered the morphological equivalent of Meniere's disease, magnetic resonance imaging including hT2w-FLAIR sequences 4 h after i.v. administration of gadolinium-based contrast agents (GBCA) allows the diagnosis and grading of endolymphatic hydrops in vivo synchronous to diagnosis and monitoring of ILT. To this day, only a few cases of intralabyrinthine schwannoma could be shown to appear simultaneously with endolymphatic hydrops by MRI, but to our knowledge the dedicated distinction of endolymphatic space has not been previously demonstrated. The aim of this work was not only to detect the coincidence of endolymphatic hydrops and vestibular schwannoma, but also to differentiate tumor tissue from endolymphatic space by 3 Tesla MRI. This enables therapy options that are originally indicated for Meniere's disease. The aim of this work was to describe the feasibility and usefulness of endolymphatic hydrops MRI on intralabyrinthal tumors in a special case of intravestibular schwannoma to demonstrate the high clinical relevance and impact in therapeutic decision-making for the synchronous appearance of endolymphatic hydrops and intralabyrinthine tumors. Therefore, we present a typical case of Meniere's disease in contrast to a patient with an intralabyrinthine schwannoma and Meniere's-like symptoms. (orig.)

  3. Boys and Puberty

    Science.gov (United States)

    ... Erections? An erection is what happens when your penis fills up with blood and hardens. The penis will become bigger and stand out from the ... the fluid containing sperm) is discharged from the penis while a boy is asleep. Semen is released ...

  4. Parents' and boys' perceptions of boys' body size for average and high BMI boys.

    Science.gov (United States)

    Brann, Lynn S

    2011-07-01

    A study on 49 preadolescent boys and their parents was performed to determine if differences existed in boys' body esteem and body size perceptions and to determine how accurately parents perceive their sons' body size. The boys were grouped by their body mass index (BMI) into average and high BMI groups. The boys completed the Body Esteem Scale; the boys and the parents rated the boys' body size perceptions. No differences were found in the boys' body esteem. The boys in the high BMI group perceived themselves as bigger than the boys in the average BMI group, and the parents of the boys with a high BMI perceived their sons as bigger. The boys in the high BMI group rated their current figure as heavier than their ideal figure. The results supported that the boys and the parents were aware of the boys' current body size. However, the parents of the boys with high BMI were more accepting of a larger ideal body figure. PMID:21689273

  5. Fascioliasis - a contribution to the differential diagnosis of focal liver lesions

    Energy Technology Data Exchange (ETDEWEB)

    Schleppi, V.; Neufang, O.; Scheerer, W.; Lossnitzer, K.

    1987-02-01

    The case of a 60 years old patient with a rare parasitosis, fascioliasis hepatica, is presented. The clinical, parasitologic, radiologic and histologic findings are discussed with reference to the literature. The diagnosis was established by examination of the faeces of the patient. The radiologic examinations document the extent of the organic involvement, in the presented case that of the liver. The finding of circumscribed hypodense liver lesions can be decisive for the further diagnostic proceedings only in the light of an appropriate history and typical laboratory findings.

  6. [Chronic lupoid leishmaniasis. A rare differential diagnosis in Germany for erythematous infiltrative facial plaques].

    Science.gov (United States)

    Herrmann, A; Wohlrab, J; Sudeck, H; Burchard, G-D; Marsch, W C

    2007-03-01

    Lupoid leishmaniasis is a unique form of cutaneous leishmaniasis characterized by unusual clinical features and a chronic relapsing course. Clinically and histologically it is similar to lupus vulgaris, which is thus the most important differential diagnostic consideration. All patients with granulomatous facial lesions coming from endemic areas or with a positive travel history should be suspected of having leishmaniasis. We describe a 59-year-old woman with facial lupoid leishmaniasis. PMID:16670926

  7. Differential diagnosis of tumorous lesions in the iliac bone in children

    International Nuclear Information System (INIS)

    The radioilogic appearance of inflammatory and tumorous lesions in the iliac bone is characterized by destructive alterations and consolidations simultaneously. This pattern is nonspecific. The value of plain films of this area is compromised by the anatomy of the iliac bone and by overlying structures. Therefore tomography, computertomography and bone scans are necessary. Difficulties in differentiation between benign and malignant lesions are discussed and case reports are given. The importance of histologic examination is stressed. (orig.)

  8. PAS staining of bronchoalveolar lavage cells for differential diagnosis of interstital lung disease

    OpenAIRE

    Zabel Peter; Hauber Hans P

    2009-01-01

    Abstract Bronchoalveolar lavage (BAL) is a useful diagnostic tool in interstitial lunge diseases (ILD). However, differential cell counts are often non specific and immunocytochemistry is time consuming. Staining of glyoproteins by periodic acid Schiff (PAS) reaction may help in discriminating different forms of ILD. In addition, PAS staining is easy to perform. BAL cells from patients with idiopathic pulmonary fibrosis (IPF) (n = 8), sarcoidosis (n = 9), and extrinsic allergic alveolitis (EA...

  9. Cysts, cavities, and honeycombing in multisystem disorders: differential diagnosis and findings on thin-section CT

    International Nuclear Information System (INIS)

    Pulmonary cysts, cavities, and honeycombing are seen in a number of systemic disorders. The purpose of this review is to discuss the findings on thin-section computed tomography (CT) in both congenital and acquired multisystem conditions that give rise to multiple cystic spaces in the lungs. Conditions discussed include lymphangioleiomyomatosis, Langerhan's cell histiocytosis, lymphocytic interstitial pneumonia, and Birt-Hogg-Dube syndrome, with reference to specific features that may be helpful in the differentiation of these conditions on CT

  10. Informatics in radiology: radiology gamuts ontology: differential diagnosis for the Semantic Web.

    Science.gov (United States)

    Budovec, Joseph J; Lam, Cesar A; Kahn, Charles E

    2014-01-01

    The Semantic Web is an effort to add semantics, or "meaning," to empower automated searching and processing of Web-based information. The overarching goal of the Semantic Web is to enable users to more easily find, share, and combine information. Critical to this vision are knowledge models called ontologies, which define a set of concepts and formalize the relations between them. Ontologies have been developed to manage and exploit the large and rapidly growing volume of information in biomedical domains. In diagnostic radiology, lists of differential diagnoses of imaging observations, called gamuts, provide an important source of knowledge. The Radiology Gamuts Ontology (RGO) is a formal knowledge model of differential diagnoses in radiology that includes 1674 differential diagnoses, 19,017 terms, and 52,976 links between terms. Its knowledge is used to provide an interactive, freely available online reference of radiology gamuts ( www.gamuts.net ). A Web service allows its content to be discovered and consumed by other information systems. The RGO integrates radiologic knowledge with other biomedical ontologies as part of the Semantic Web.

  11. Differential Diagnosis of Lymphadenopathy in the Neck Spaces in a CT Perfusion Study

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, Sun Jung; Hong, Hyun Sook; Lee, Eun Hye; Lee, Min Hee [Dept. of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Park, Jung Mi [Dept. of Nuclear Science, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2011-11-15

    To evaluate the CT perfusion parameters for differentiating between a benign and malignant lymphadenopathy in the neck spaces. Seventeen patients with cervical lymphadenopathy underwent perfusion CT. Perfusion parameters, including blood flow (BF), blood volume (BV), permeability index (PI), and mean transit time, were calculated at the regions of interest in the enlarged lymph nodes (LNs). The enlarged LNs were diagnosed by fine needle aspiration, surgical excision, and clinical follow-up. The LNs were classified as either reactive hyperplasia (n = 26), metastatic LNs (n = 11), or LNs of lymphoma (n = 14). Significant differences were found for BF, BV, and PI among the three groups (p < 0.05). Reactive hyperplasia had a significantly higher BF than metastatic LN (p < 0.0167). The LNs of lymphoma had a significantly lower BF, BV, and PI than reactive hyperplasia (p < 0.0167). No significant difference was observed between the metastatic LNs of the head and neck cancer and LNs of lymphoma for all perfusion parameters. In patients with head and neck cancer, perfusion CT is not useful for differentiating between metastatic LNs and inflammatory reactive hyperplasia. However, perfusion CT can be useful for differentiating between LNs of lymphoma and reactive hyperplasia.

  12. Differential diagnosis of infantile osteomyelitis - classification according to scintigraphic, radiologic and magnetic resonance tomographic findings

    International Nuclear Information System (INIS)

    We present a retrospective study on children with the final diagnosis osteomyelitis, who have been examined in Tuebingen from 1985 to 1991. The different types of infantile osteomyelitis were classified due to the causative organism and findings in 3-phase scintigraphy and X-ray films. For the chronic type of osteomyelitis the study was extended to the years from 1979 to 1991 and the results of an earlier report were included. We worked up 17 cases of acute/peracute osteomyelitis, including 5 cases of early infancy, 2 cases of tuberculosis, 2 Brodie's abscesses, 5 plasmacellular types, 2 cases of primary chronic multifocal osteomyelitis (PCMO), and 5 cases of unspecific chronic osteomyelitis. All cases were examined with scintigraphy, X-ray films and in part with magnetic resonance tomographic imaging. In 23 cases scintigrams and X-ray films were performed in the follow-up. We show the importance of scintigraphy for the early detection and localisation of osteomyelitis, the importance of findings on X-ray films for the specific diagnosis of osteomyelitis, and the importance of magnetic resonance tomography for high-resolution detection of the expansion of osteomyelitis. (orig.)

  13. Differential diagnosis of isolated myeloid sarcoma: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Patrick A. Hagen

    2015-06-01

    Full Text Available Myeloid sarcoma (MS is a rare disease entity identified as a variety of manifestations defined by the occurrence of extramedullary myeloid cell masses with or without bone marrow involvement. This case describes an unusual presentation of isolated MS in a 60-year-old otherwise healthy male, who initially presented to his primary care physician with vague abdominal pain. After extensive workup including three omental biopsies, umbilical core biopsy, and inguinal lymph node biopsy, he was ultimately diagnosed with isolated MS with extensive extramedullary tumor burden. Despite advanced extramedullary disease, peripheral cell counts were normal and bilateral bone marrow biopsies unremarkable with normal cellular lineages, morphology, and cytogenetics. The patient underwent induction chemotherapy and is now greater than 100 days post myeloablative unrelated donor marrow transplantation with no evidence of disease recurrence and 100% donor status with full chimerism. This case demonstrates that making a prompt diagnosis with rapid initiation of treatment in myeloid sarcoma can be challenging due to its varied clinical presentation, cytomorphology, cytochemistry, and cytogenetic overlap with other lymphoid malignancies. Once a diagnosis of MS has been made, moving quickly to induction therapy is important. Several studies have shown that improved overall survival is attained when MS is treated as acute myeloid leukemia and increased survival is noted for patients undergoing bone marrow transplantation. Further prospective studies are needed to elucidate the many remaining questions in regards to the natural history, prognosis, and optimal treatment strategies for this deadly disease.

  14. Update on celiac disease – etiology, differential diagnosis, drug targets, and management advances

    Directory of Open Access Journals (Sweden)

    Scanlon SA

    2011-12-01

    Full Text Available Samantha A Scanlon1, Joseph A Murray1,21Department of Internal Medicine, 2Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USAAbstract: Celiac disease (CD is an immune-mediated enteropathy triggered by exposure to wheat gluten and similar proteins found in rye and barley that affects genetically susceptible persons. This immune-mediated enteropathy is characterized by villous atrophy, intraepithelial lymphocytosis, and crypt hyperplasia. Once thought a disease that largely presented with malnourished children, the wide spectrum of disease activity is now better recognized and this has resulted in a shift in the presenting symptoms of most patients with CD. New advances in testing, both serologic and endoscopic, have dramatically increased the detection and diagnosis of CD. While the gluten-free diet is still the only treatment for CD, recent investigations have explored alternative approaches, including the use of altered nonimmunogenic wheat variants, enzymatic degradation of gluten, tissue transglutaminase inhibitors, induction of tolerance, and peptides to restore integrity to intestinal tight junctions.Keywords: immune-mediated enteropathy, gliadin, gluten, epidemiology, CD diagnosis, therapy

  15. C. T. criteria of the differential diagnosis in primary retroperitoneal masses

    Energy Technology Data Exchange (ETDEWEB)

    Pistolesi, G.F.; Procacci, C.; Caudana, R.; Bergamo Andreis, I.A.; Manera, V.; Recla, M.; Grasso, G.; Florio, C.

    1984-05-01

    This personal series of 44 primary retroperitoneal masses (P.R.P.M.) studied by C.T. is analyzed. The reliability of C.T. in the identification (44/44), characterization (43/44) and origin evaluation (41/44) of P.R.P.M. has been absolutely satisfactory. In particular, those criteria of C.T. diagnosis which may be utilized in the evaluation of the origin of upper abdominal masses are thoroughly described. The evaluation of the involvement (non invasive; invasive) of adjacent viscera has been achieved in 22/38 P.R.P.M. verified at operation. The evaluation of tumour resectability has been less reliable due to the high incidence of under-diagnosis (60% in our personal experience). C.T. may be used in addition as an aid to different diagnostic techniques (percutaneous guided needle biopsy) or to therapy (drainage of retroperitoneal abscesses). C.T. is absolutely necessary in the follow-up of P.R.P.M. after surgery, radiotherapy or chemotherapy.

  16. Miller Fisher Syndrome: A Case Report Highlighting Heterogeneity of Clinical Features and Focused Differential Diagnosis.

    Science.gov (United States)

    Yepishin, Ilya V; Allison, Randall Z; Kaminskas, David A; Zagorski, Natalia M; Liow, Kore K

    2016-07-01

    Miller Fisher Syndrome (MFS) is a rare variant of Guillain-Barré Syndrome (GBS) that has a geographically variable incidence. It is largely a clinical diagnosis based on the cardinal clinical features of ataxia, areflexia, and opthalmoplegia, however, other neurological signs and symptoms may also be present. Serological confirmation with the anti-GQ1b antibody is available and allows for greater diagnostic certainty in the face of confounding symptoms. A self-limiting course is typical of MFS. The following case report is that of a patient who presented with generalized weakness, somatic pain, inability to walk, and diplopia following an upper respiratory illness. The patient exhibited the classic triad of ataxia, areflexia, and opthalmoplegia characteristic of MFS, but also had less typical signs and symptoms making for a more challenging diagnostic workup. Our suspected diagnosis of MFS was serologically confirmed with positive anti-GQ1b antibody titer and the patient was successfully treated with Intravenous immune globulin (IVIG).

  17. Boys & Girls Clubs of America

    Science.gov (United States)

    ... National BGC Week Join Our Cause Donate Now Boys & Girls Clubs of America and the UPS Foundation ... the Dangers Faced When Behind-the-Wheel MORE» Boys & Girls Clubs of America Names Jocelyn Woods National ...

  18. Fragile site X chromosomes in mentally retarded boys.

    OpenAIRE

    Moon, H. R.; Moon, S. Y.

    1993-01-01

    The fragile X syndrome is a common X-linked mental retardation and autism, affecting females as well as males. The fragile site X chromosomes were studied in a series of 153 mentally retarded boys of unknown etiology to determine the frequency of fragile X syndrome, and to assess the feasibility of making a clinical diagnosis of the fragile X syndrome in young boys before cytogenetic results were known. The 10 boys (6.4%) were positive for fra (X) (q27). The phenotype of fra (X) (q27) positiv...

  19. The value of acoustic radiation force impulse (ARFI) in the differential diagnosis of thyroid nodules

    International Nuclear Information System (INIS)

    Objectives: The aim of this study was to investigate the value of shear wave velocity value (SWV) and shear wave velocity ratio (SWR) in differentiating between malignant and benign thyroid nodules using virtual touch tissue quantification (VTQ) of acoustic radiation force impulse (ARFI) technology. Methods: The SWV and SWR were analyzed in 155 thyroid nodules in 155 patients (93 benign and 62 malignant) and eighty normal thyroid glands. The diagnostic performance of SWV and SWR were compared. Results: The mean value of SWV of malignant nodules differed significantly from those of the benign nodules (6.34 ± 2.58 m/s vs. 2.15 ± 0.59 m/s, P < 0.05) and the normal thyroid (1.96 ± 0.31 m/s, P < 0.05). There was no statistically significant difference between the mean value of SWV of benign nodules and normal thyroid (P > 0.05). The mean value of SWR of malignant nodules differed significantly from those of the benign nodules (2.99 ± 1.45 vs. 1.07 ± 0.34, P < 0.05). The sensitivity, specificity, positive predictive values, negative predictive values and accuracy of SWV in differentiating between malignant and benign nodules were 96.80%, 95.70%, 93.75%, 97.80% and 96.13% respectively based on the cutoff point as 2.84 m/s. Those of SWR were 91.90%, 81.70%, 77.03%, 93.83% and 85.83% based on the cutoff point as 1.32. The diagnostic accuracy rate of SWV was statistically higher than that of SWR (P < 0.05). Conclusion: VTQ of ARFI technology provides the quantitative information of thyroid tissue elasticity and has high accuracy rate in differentiating between malignant and benign nodules. It is a useful complement for conventional ultrasonography

  20. Better differential diagnosis of iron deficiency anemia from beta-thalassemia trait

    Directory of Open Access Journals (Sweden)

    Fakher Rahim

    2009-09-01

    Full Text Available Objective: Iron deficiency anemia (IDA and beta-thalassemia trait (ß-TT are the most common forms of microcytic anemia. This study was conducted to compare the validity of various discrimination indices in differentiating β-TT from IDA by calculating their sensitivity, specificity and Youden's index.Methods: Totally 323 subjects (173 children and 150 adults with microcytic anemia were involved in this study. We calculated 10 discrimination indices in all patients with IDA and β-TT. We divided the patients into two different groups as younger or older than 10 years. Results: None of the indices showed sensitivity and specificity of 100% in the patients older than 10 years, and in the patients younger than 10 years, only Shine & Lal index showed sensitivity close to 90% and specificity of 100%. The most accurate discriminative index for patients younger than 10 years was Shine & Lal and for those older than 10 years it was RDW index. According to Youden's index, Shine & Lal and RBC count showed the greatest diagnostic value in patients younger than 10 years and RDW and RBC count indices in those older than 10 years. Conclusion: None of the indices was completely sensitive and specific in differentiation between β-TT and IDA. Mean and median mean cell Hb density (MCHD were very close to normal values in both IDA and β-TT patients, but in the case of mean density of Hb/liter (MDHL, we found that the mean and median were significantly higher than normal values in β-TT and lower than normal values in IDA patients. In our study, Youden's index of RBC and Shine & Lal were the highest and most reliable indices in differentiating β-TT from IDA in the patients younger than 10 years. For patients older than 10 years, the most reliable discrimination indices were RBC and RDW.