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Sample records for case-matched lesion approach

  1. Case-matched comparison of the retroperitoneal approach with laparotomy for necrotizing pancreatitis

    NARCIS (Netherlands)

    van Santvoort, Hjalmar C.; Besselink, Marc G.; Bollen, Thomas L.; Buskens, Erik; van Ramshorst, Bert; Gooszen, Hein G.

    2007-01-01

    BACKGROUND: Minimally invasive necrosectomy through a retroperitoneal approach is gaining popularity for the treatment of necrotizing pancreatitis. There is, however, no substantial evidence from comparative studies in favor of this technique over laparotomy. The aim of this case-matched study was

  2. The benefits of a laparoscopic approach in ileal pouch anal anastomosis formation: a single institutional retrospective case-matched experience.

    LENUS (Irish Health Repository)

    Kelly, J

    2010-06-01

    A laparoscopic approach to ileoanal pouch formation is novel. By using prospectively gathered data, laparoscopic and open restorative proctocolectomy procedures in mucosal ulcerative colitis (UC) and familial adenomatous polyposis (FAP) patients were compared using a case-matched design.

  3. Bone marrow lesions: A systematic diagnostic approach

    Directory of Open Access Journals (Sweden)

    Filippo Del Grande

    2014-01-01

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

  4. Video-assisted thoracic surgery lobectomy does not offer any functional recovery advantage in comparison to the open approach 3 months after the operation: a case matched analysis†.

    Science.gov (United States)

    Salati, Michele; Brunelli, Alessandro; Xiumè, Francesco; Monteverde, Marco; Sabbatini, Armando; Tiberi, Michela; Pompili, Cecilia; Palloni, Roberto; Refai, Majed

    2017-06-01

    The objective of the present study was to compare functional loss [forced expiratory volume in one second to forced vital capacity ratio (FEV1), DLCO and VO2max reduction] after VATS versus open lobectomies. We performed a prospective observational study on 195 patients who had a pulmonary lobectomy from June 2010 to November 2014 and who were able to complete a 3-months functional evaluation follow-up program. Since the VATS technique was our first choice for performing lobectomies from January 2012, we divided the patients into two groups: the OPEN group (112 patients) and the VATS group (83 patients). The open approach was intended as a muscle sparing/nerve sparing lateral thoracotomy. Fourteen baseline factors were used to construct a propensity score to match the VATS-group patients with their OPEN-group counterparts. These two matched groups were then compared in terms of reduction of FEV1, DLCO and VO2max (Mann-Whitney test). The propensity score analysis yielded 83 well-matched pairs of OPEN and VATS patients. In both groups, 3 months postoperatively, we found a reduction in FEV1, DLCO and VO2max values (OPEN patients: FEV1-10%, DLCO -11.9%, VO2max - 5.5%; VATS patients: FEV1-7.2%, DLCO-10.6%, VO2max-6.9%). The reductions in FEV1, DLCO and VO2max were similar to those in the two matched groups, with a Cohen effect size offer any advantages in terms of FEV1, DLCO and exercise capacity recovery in comparison to the muscle-sparing thoracotomy approach. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  5. Transfrontoethmoidal approach to medial intraconal lesions.

    Science.gov (United States)

    Jittapiromsak, Pakrit; Deshmukh, Pushpa; Nakaji, Peter; Spetzler, Robert F; Preul, Mark C

    2009-12-01

    Object The standard superior craniotomy approach through the orbital roof is obstructed by numerous muscles, nerves, and vessels. Accessing the medial intraconal space also involves considerable brain retraction. The authors present a modified approach through the frontal sinus that overcomes these limitations. Methods Seven fixed silicone-injected cadaveric specimens were dissected bilaterally. In addition to the superior orbital wall, the ethmoidal sinuses and medial orbital wall were removed. The anatomical relationships between the major neurovascular complexes in the medial intraconal space and the optic nerve were observed. Results Intraconally, working space was created both in a "superior window" between the superior oblique and levator palpebrae muscle and in a "medial window" between the superior oblique and medial rectus muscle. The superior window mainly created an ipsilateral trajectory to the deep target. The medial window, which created a contralateral trajectory, provided a more inferior view of the medial intraconal space. Removal of the medial orbital wall further widened the exposure obtained from the superior window. The combination of these working windows makes the medial surface of the optic nerve available for exploration from multiple angles. Most of the major neurovascular complexes of the posterior orbit can be retracted safely without impinging on the optic nerve. Conclusions This novel extradural transfrontoethmoidal approach affords a direct view to the medial posterior orbit without major conflicts with intraconal neurovascular structures and requires minimal brain manipulation. The approach appears to offer advantages for medially located intraconal lesions.

  6. Ovarian cystic lesions: a current approach to diagnosis and management.

    Science.gov (United States)

    Ackerman, Susan; Irshad, Abid; Lewis, Madelene; Anis, Munazza

    2013-11-01

    The primary imaging modality for evaluation of ovarian cystic lesions is pelvic ultrasonography. Most ovarian cysts are benign and demonstrate typical sonographic features that support benignity. However, some ovarian cystic lesions have indeterminate imaging features, and the approach to management varies. This article discusses how to recognize and diagnose different types of ovarian cystic lesions, including an approach to management. The learning objective is to recognize imaging features of ovarian cystic lesions. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Minimally invasive approach for lesions involving the frontal sinus ...

    African Journals Online (AJOL)

    Background: Traditional open surgery for frontal sinus pathology and cerebrospinal fluid (CSF) leaks is complex and involves a craniotomy. Minimally invasive options offer an alternate solution. We describe and assess the outcome of a minimally invasive approach for lesions and defects involving the frontal sinus.

  8. How to approach breast lesions in children and adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Yiming, E-mail: yiminggao@gmail.com [New York University Langone Medical Center, 221 Lexington Ave., New York, NY 10016 (United States); Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 (United States); Saksena, Mansi A.; Brachtel, Elena F.; Meulen, Deborah C. ter; Rafferty, Elizabeth A. [Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 (United States)

    2015-07-15

    Highlights: • Recognize why the diagnostic approach to the developing breast differs from that to the adult breast. • Review of embryology, early breast development, and later pubescent breast development. • Learn the spectrum of common and uncommon pediatric breast lesions. • Develop an algorithm for diagnostic evaluation and management of pediatric breast lesions. - Abstract: Assessment of a pediatric breast lesion always starts with clinical evaluation. When imaging of a pediatric breast is indicated, ultrasound is the mainstay. The vast majority of pediatric breast complaints are of benign etiology, therefore the diagnostic/management approach emphasizes “first do no harm”. Correlation with age and clinical history helps to direct diagnosis. It is essential to be familiar with the imaging appearance of the normal developing breast at various Tanner stages, in order to diagnose physiologic breast findings and to minimize unnecessary biopsies in young breasts vulnerable to injury. Normal anatomic structures, developmental conditions, benign neoplastic and non-neoplastic lesions are common causes of breast complaints in children. Uncommon benign masses and rarely, secondary more than primary malignancies may present in a pediatric breast. Chest wall masses such as Ewing's sarcoma or rhabdomyosarcoma occur in children and may involve the breast via contiguous growth or locoregional metastasis. In addition, special attention should be given to any breast lesion in a child with risk factors predisposing to breast cancer, such as known extramammary malignancy, genetic mutations, prior mantle irradiation, or strong family history of breast cancer, which usually requires biopsy to exclude the possibility of malignancy. Conclusion: The developing breast is vulnerable to injury, and because breast malignancy is uncommon in children, diagnostic and management approach emphasizes “first do no harm”. Understanding normal breast development and the

  9. How to approach breast lesions in children and adolescents

    International Nuclear Information System (INIS)

    Gao, Yiming; Saksena, Mansi A.; Brachtel, Elena F.; Meulen, Deborah C. ter; Rafferty, Elizabeth A.

    2015-01-01

    Highlights: • Recognize why the diagnostic approach to the developing breast differs from that to the adult breast. • Review of embryology, early breast development, and later pubescent breast development. • Learn the spectrum of common and uncommon pediatric breast lesions. • Develop an algorithm for diagnostic evaluation and management of pediatric breast lesions. - Abstract: Assessment of a pediatric breast lesion always starts with clinical evaluation. When imaging of a pediatric breast is indicated, ultrasound is the mainstay. The vast majority of pediatric breast complaints are of benign etiology, therefore the diagnostic/management approach emphasizes “first do no harm”. Correlation with age and clinical history helps to direct diagnosis. It is essential to be familiar with the imaging appearance of the normal developing breast at various Tanner stages, in order to diagnose physiologic breast findings and to minimize unnecessary biopsies in young breasts vulnerable to injury. Normal anatomic structures, developmental conditions, benign neoplastic and non-neoplastic lesions are common causes of breast complaints in children. Uncommon benign masses and rarely, secondary more than primary malignancies may present in a pediatric breast. Chest wall masses such as Ewing's sarcoma or rhabdomyosarcoma occur in children and may involve the breast via contiguous growth or locoregional metastasis. In addition, special attention should be given to any breast lesion in a child with risk factors predisposing to breast cancer, such as known extramammary malignancy, genetic mutations, prior mantle irradiation, or strong family history of breast cancer, which usually requires biopsy to exclude the possibility of malignancy. Conclusion: The developing breast is vulnerable to injury, and because breast malignancy is uncommon in children, diagnostic and management approach emphasizes “first do no harm”. Understanding normal breast development and the

  10. The anterior interhemispheric approach: a safe and effective approach to anterior skull base lesions.

    Science.gov (United States)

    Mielke, Dorothee; Mayfrank, Lothar; Psychogios, Marios Nikos; Rohde, Veit

    2014-04-01

    Many approaches to the anterior skull base have been reported. Frequently used are the pterional, the unilateral or bilateral frontobasal, the supraorbital and the frontolateral approach. Recently, endoscopic transnasal approaches have become more popular. The benefits of each approach has to be weighted against its complications and limitations. The aim of this study was to investigate if the anterior interhemispheric approach (AIA) could be a safe and effective alternative approach to tumorous and non-tumorous lesions of the anterior skull base. We screened the operative records of all patients with an anterior skull base lesion undergoing transcranial surgery. We have used the AIA in 61 patients. These were exclusively patients with either olfactory groove meningioma (OGM) (n = 43), ethmoidal dural arteriovenous fistula (dAVF) ( n = 6) or frontobasal fractures of the anterior midline with cerebrospinal fluid (CSF) leakage ( n = 12). Patient records were evaluated concerning accessibility of the lesion, realization of surgical aims (complete tumor removal, dAVF obliteration, closure of the dural tear), and approach related complications. The use of the AIA exclusively in OGMs, ethmoidal dAVFs and midline frontobasal fractures indicated that we considered lateralized frontobasal lesions not suitable to be treated successfully. If restricted to these three pathologies, the AIA is highly effective and safe. The surgical aim (complete tumor removal, complete dAVF occlusion, no rhinorrhea) was achieved in all patients. The complication rate was 11.5 % (wound infection (n = 2; 3.2 %), contusion of the genu of the corpus callosum, subdural hygroma, epileptic seizure, anosmia and asymptomatic bleed into the tumor cavity (n = 1 each). Only the contusion of the corpus callosum was directly related to the approach (1.6 %). Olfaction, if present before surgery, was preserved in all patients, except one (1.6 %). The AIA is an effective and a safe approach

  11. The European approach to in-transit melanoma lesions

    NARCIS (Netherlands)

    Hoekstra, H. J.

    The biological behavior of melanoma is unpredictable. Three to five per cent of melanoma patients will develop in-transit lesions and the median time to recurrence ranges between 13-16 months. At the time of recurrence the risk of occult nodal metastasis, with clinically negative regional lymph

  12. The effectiveness of shock wave lithotripters: a case matched comparison.

    Science.gov (United States)

    Alanee, Shaheen; Ugarte, Roland; Monga, Manoj

    2010-12-01

    We compared the results of shock wave lithotripsy with a newer electromagnetic lithotripter to those of an electrohydraulic lithotripter using identical treatment and followup criteria. We performed a case matched comparison of 8,565 patients treated from 2003 to 2007 using the Medstone STS™ and the Modulith® SLX machines, matching for stone size, location and patient body mass index. The outcome of interest was treatment success in producing stone-free status. We report treatment characteristics, such as stone site and size, gating and final stone-free rate. Significance was considered at pModulith SLX and Medstone STS stone-free rates were equivalent (61.1% and 64.5%, respectively, p=0.0664). Matching and logistic regression results showed that differences in the stone-free rate were insignificant for all stones (p>0.7592), lower pole kidney stones (p=0.9659) and ureteral stones (p=0.6409). Medstone STS performed better than Modulith SLX only for distal ureteral stones (83.63% vs 66.67%, p=0.0154). The rate of post-lithotripsy secondary procedures was equivalent (p=0.2079). The difference was insignificant for harder stones (p=0.2988). Shock wave lithotripsy is equally effective using Medstone STS and Modulith SLX for different stone sizes and most stone sites. Shock wave lithotripsy is more successful for lower ureteral stones using the Medstone STS. To our knowledge this is the first study comparing these 2 commonly used lithotripters. Copyright © 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  13. An ensemble deep learning based approach for red lesion detection in fundus images.

    Science.gov (United States)

    Orlando, José Ignacio; Prokofyeva, Elena; Del Fresno, Mariana; Blaschko, Matthew B

    2018-01-01

    Diabetic retinopathy (DR) is one of the leading causes of preventable blindness in the world. Its earliest sign are red lesions, a general term that groups both microaneurysms (MAs) and hemorrhages (HEs). In daily clinical practice, these lesions are manually detected by physicians using fundus photographs. However, this task is tedious and time consuming, and requires an intensive effort due to the small size of the lesions and their lack of contrast. Computer-assisted diagnosis of DR based on red lesion detection is being actively explored due to its improvement effects both in clinicians consistency and accuracy. Moreover, it provides comprehensive feedback that is easy to assess by the physicians. Several methods for detecting red lesions have been proposed in the literature, most of them based on characterizing lesion candidates using hand crafted features, and classifying them into true or false positive detections. Deep learning based approaches, by contrast, are scarce in this domain due to the high expense of annotating the lesions manually. In this paper we propose a novel method for red lesion detection based on combining both deep learned and domain knowledge. Features learned by a convolutional neural network (CNN) are augmented by incorporating hand crafted features. Such ensemble vector of descriptors is used afterwards to identify true lesion candidates using a Random Forest classifier. We empirically observed that combining both sources of information significantly improve results with respect to using each approach separately. Furthermore, our method reported the highest performance on a per-lesion basis on DIARETDB1 and e-ophtha, and for screening and need for referral on MESSIDOR compared to a second human expert. Results highlight the fact that integrating manually engineered approaches with deep learned features is relevant to improve results when the networks are trained from lesion-level annotated data. An open source implementation of our

  14. Transthoracic approach for lesions involving the anterior dorsal spine: A multidisciplinary approach with good outcomes

    Directory of Open Access Journals (Sweden)

    Srikant Balasubramaniam

    2016-01-01

    Materials and Methods: A total of 16 patients were operated for varying lesions of body of dorsal vertebra by the transthoracic approach. The study was for a period of 5 years from January 2011 to December 2015. Patients age ranged from 25 to 61 years with an average of 36.4 yrs. There were 7 males and 9 females. In our series 9 patients had Kochs spine, 4 patients were traumatic fracture spine and 3 had neoplastic lesion. Majority of patients had multiple symptoms with backache being present in all patients. Results: There was one post operative mortality which was unrelated to surgery. One patient had post operative delayed kyphosis. Remaining patients improved in their symptoms following surgery. Conclusion: With careful coordination by thoracic surgeons, neurospinal surgeons and anaesthetists, the anterior spine approach for dorsal spine is safe and effective. Adequate preoperative evaluation should stratify the risk and institute measures to reduce it. Accurate surgical planning and careful surgical technique are the key to yield a good outcome and to reduce the risk of complications.

  15. An alternative management approach to paranasal sinus fibro-osseous lesions.

    Science.gov (United States)

    Ooi, Eng H; Glicksman, Jordan T; Vescan, Allan D; Witterick, Ian J

    2011-01-01

    Fibro-osseous lesions of the paranasal sinuses are an uncommon heterogeneous group of lesions with variable clinical presentation. It is unclear whether these lesions directly cause symptoms or secondarily obstruct the sinuses with resultant rhinosinusitis. We have used an expectant management approach in selected patients that includes observation with serial scans or endoscopic sinus surgery (ESS) to improve the outflow tract of the affected sinus without resection of the lesion. The purpose of this work is to review our experience with management of paranasal sinus fibro-osseous lesions. Retrospective chart review from 1997 to 2009. A total of 44 patients were identified in this study. There were 19 (43%) osteoma and 25 (57%) fibrous dysplasia cases. The presenting symptoms were mainly sinonasal with headaches (36%), pain/pressure (19%), and nasal obstruction (17%). Two patients (4.5%) presented with proptosis and diplopia. Five (11%) patients had associated nasal polyps. The diagnosis was an incidental finding in seventeen (38%) cases. Twenty-two (50%) patients were managed conservatively with serial computed tomography (CT) scans to monitor for interval growth over a mean interval of 41.8 months (range, 13-130 months). There were 2 patients in the observation group with CT scan evidence of interval growth with an increase in size of 1 mm and 9 mm over 130 and 36 months, respectively. Twelve symptomatic patients (27%) underwent ESS without resection of the lesion, with symptomatic improvement in 11 patients (92%). Four patients (9%) underwent endoscopic biopsy to attain histological diagnosis. Six (13%) patients in this study had resection of their lesion with 5 of the patients having symptomatic improvement following resection. In patients with fibro-osseous lesions, we support an expectant management approach of asymptomatic patients with observation and serial imaging, treating selected symptomatic patients with ESS and resection of the lesion in patients

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

    Science.gov (United States)

    McInnes, E F; Scudamore, C L

    2014-08-17

    Pathological evaluation of lesions caused directly by xenobiotic treatment must always take into account the recognition of background (incidental) findings. Background lesions can be congenital or hereditary, histological variations, changes related to trauma or normal aging and physiologic or hormonal changes. This review focuses on the importance and correct approach to recording of background changes and includes discussion on sources of variability in background changes, the correct use of terminology, the concept of thresholds, historical control data, diagnostic drift, blind reading of slides, scoring and artifacts. The review is illustrated with background lesions in Sprague Dawley and Wistar rats. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. [Extradural temporopolar approach for surgical management of paraclinoid lesions].

    Science.gov (United States)

    Otani, Naoki; Wada, Kojiro; Kobayashi, Yasushi; Kumagai, Kohsuke; Ueno, Hideaki; Osada, Hideo; Nakao, Yasuaki; Yamamoto, Takuji; Mori, Kentaro

    2014-10-01

    Surgical treatment of paraclinoid tumors adjacent to important anatomical structures, such as the optic nerve, optic chiasm, pituitary stalk, and internal carotid artery, should emphasize maximum resection and preservation of visual function. Thus, early localization and exposure of the optic nerve, and complete mobilization and decompression of the optic nerve and internal carotid artery, are necessary in order to prevent intraoperative neurovascular injuries. However, this technique requires wide exposure of the optic-carotid space through the interpeduncular cistern. We have developed an extradural temporopolar approach for resection of paraclinoid tumors, which can also allow early devascularization of arteries that feed the tumors. We evaluated the surgical outcomes of this approach, paying special attention to clinical and visual outcomes. Thirteen patients(4 men, 9 women;24-78 years, mean age 54 years), underwent tumor removal using an extradural temporopolar approach between March 2000 and April 2013. We retrospectively reviewed medical charts, radiological findings, intensive care unit flow sheets, and surgical records. Histological diagnoses included craniopharyngioma(4 cases), pituitary adenoma(3 cases), medial sphenoid ridge meningioma(2 cases), tuberculum sellae meningioma(2 cases), trigeminal neurinoma(1 case), and malignant epidermoid(1 case). Tumors were 1.5-6.0cm in length(mean 3.2cm). Tumors were cystic in all 4 craniopharyngiomas and solid in the other 9 cases. Preoperative neurological deficits included visual disturbance in 10 patients, double vision caused by oculomotor nerve palsy in 2 patients, and vertigo in 1 patient. Additional orbitozygomatic craniotomies were performed in 8 patients. Total tumor removal was performed in 7 patients and subtotal removal performed in 6. The pituitary stalk was microscopically preserved in all patients. Postoperative complications included transient diabetes insipidus in 2 patients, chronic subdural

  18. New Perspectives on the Brain Lesion Approach - Implications for Theoretical Models of Human Memory.

    Science.gov (United States)

    Irish, Muireann; van Kesteren, Marlieke T R

    2018-03-15

    Human lesion studies represent the cornerstone of modern day neuropsychology and provide an important adjunct to functional neuroimaging methods. The study of human lesion groups with damage to distinct regions of the brain permits the identification of underlying mechanisms and structures not only associated with, but essential for, complex cognitive processes. Here, we consider a recent review by McCormick et al., 2018 in which the power of the lesion model approach is elegantly presented with respect to a host of sophisticated cognitive endeavors, including autobiographical memory, future thinking, spatial navigation, and decision-making. By comparing profiles of loss and sparing in hippocampal (HC) and ventromedial prefrontal cortex (vmPFC) lesion groups, the authors provide new insights into the underlying neuroarchitecture of these diverse cognitive functions. Building on this framework, we consider how vmPFC and HC degeneration, in the context of large-scale network dysfunction in dementia, impacts discrete facets of memory and social cognition. Notably, we find remarkable concordance between the available evidence in dementia and that of the HC and vmPFC lesion literature. We further assess the role of the prefrontal cortex in modulating aspects of spatial navigation and discuss the role of schema-related processing in the service of memory more broadly. Far from being obsolete, we contend that human lesion work occupies a crucial position in cognitive neuroscience and offers an array of exciting areas for future study within this field. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

  19. A new approach to the detection of lesions in mammography using fuzzy clustering.

    Science.gov (United States)

    Wang, Y; Shi, H; Ma, S

    2011-01-01

    Breast cancer is a leading cause of female mortality and its early detection is an important means of reducing this. The present study investigated an approach, based on fuzzy clustering, to detect small lesions, such as microcalcifications and other masses, that are hard to recognize in breast cancer screening. A total of 180 mammograms were analysed and classified by radiologists into three groups (n = 60 per group): those with microcalcifications; those with tumours; and those with no lesions. Twenty mammograms were taken as training data sets from each of the groups. The algorithm was then applied to the data not taken for training. Analysis by fuzzy clustering achieved a mean accuracy of 99.7% compared with the radiologists' findings. It was concluded that the fuzzy clustering algorithm allowed for more efficient and accurate detection of breast lesions and may improve the early detection of breast tumours.

  20. Contrast-Enhanced Ultrasound Guided Biopsy of Undetermined Abdominal Lesions: A Multidisciplinary Decision-Making Approach

    Directory of Open Access Journals (Sweden)

    Feng Mao

    2017-01-01

    Full Text Available Aim. To investigate the value of contrast-enhanced ultrasound (CEUS guided biopsy of undetermined abdominal lesions in multidisciplinary treatment (MDT decision-making approach. Methods. Between Jan 2012 and Dec 2015, 60 consecutive patients (male, 37; female, 23; mean age, 51.3 years ± 14.6 who presented with undetermined abdominal lesions were included. CEUS and core needle percutaneous biopsy was performed under real-time CEUS guidance in all lesions. Data were recorded and compared with conventional ultrasound (US guidance group (n=75. All CEUS findings and clinical data were evaluated in MDT. Results. CEUS enabled the delimitation of more (88.3% versus 41.3% and larger (14.1 ± 10.7 mm versus 32.3 ± 18.5 mm nonenhanced necrotic areas. More inner (20.0% versus 6.7% and surrounding (18.3% versus 2.7% major vessels were visualized and avoided during biopsies. CEUS-guided biopsy increased the diagnostic accuracy from 93.3% to 98.3%, with correct diagnosis in 57 of 60 lesions (95.0%. The therapeutic plan was influenced by CEUS guided biopsies findings in the majority of patients (98.3%. Conclusion. The combination of CEUS guided biopsy and MDT decision-making approach is useful in the diagnostic work-up and therapeutic management.

  1. Seeing the Invisible: Revealing Atrial Ablation Lesions Using Hyperspectral Imaging Approach.

    Directory of Open Access Journals (Sweden)

    Narine Muselimyan

    Full Text Available Currently, there are limited means for high-resolution monitoring of tissue injury during radiofrequency ablation procedures.To develop the next generation of visualization catheters that can reveal irreversible atrial muscle damage caused by ablation and identify viability gaps between the lesions.Radiofrequency lesions were placed on the endocardial surfaces of excised human and bovine atria and left ventricles of blood perfused rat hearts. Tissue was illuminated with 365nm light and a series of images were acquired from individual spectral bands within 420-720nm range. By extracting spectral profiles of individual pixels and spectral unmixing, the relative contribution of ablated and unablated spectra to each pixel was then displayed. Results of spectral unmixing were compared to lesion pathology.RF ablation caused significant changes in the tissue autofluorescence profile. The magnitude of these spectral changes in human left atrium was relatively small (< 10% of peak fluorescence value, yet highly significant. Spectral unmixing of hyperspectral datasets enabled high spatial resolution, in-situ delineation of radiofrequency lesion boundaries without the need for exogenous markers. Lesion dimensions derived from hyperspectral imaging approach strongly correlated with histological outcomes. Presence of blood within the myocardium decreased the amplitude of the autofluorescence spectra while having minimal effect on their overall shapes. As a result, the ability of hyperspectral imaging to delineate ablation lesions in vivo was not affected.Hyperspectral imaging greatly increases the contrast between ablated and unablated tissue enabling visualization of viability gaps at clinically relevant locations. Data supports the possibility for developing percutaneous hyperspectral catheters for high-resolution ablation guidance.

  2. Surgical procedure "simplified retrosigmoid approach" for C-P angle lesions.

    Science.gov (United States)

    Yamashima, Tetsumori; Lee, Joung H; Tobias, Samuel; Kim, Chang-Hyun; Chang, Jong Hee; Kwon, Jeong-Taik

    2004-02-01

    Previously, we reported surgical results of the simplified retrosigmoid approach for vestibular nerve sectioning in the cases with intractable vertigo. Here, we introduce in details surgical procedures of the simplified retrosigmoid (also called "subasterional" here for simplification) approach developed by one of the authors (J.H.L.). This approach is to operate cerebello-pontine (C-P) angle lesions through a small upper lateral window below the transverse-sigmoid junction. The retroauricular 4-5 cm skin incision, triangular craniectomy 2 cm in width, dural opening and closure, special considerations, and reconstruction of the skull defect were outlined. The bony landmarks for triangle craniectomy below asterion were described in detail. The C-P angle was appropriately approached for microvascular decompression, removal of C-P angle tumors, and vestibular nerve resection. This subasterional approach was characterized by short operation time of 1-3 h and less postoperative discomforts compared to the conventional retrosigmoid approach.

  3. Transthoracic fine needle aspiration biopsy of subcarinal lesion: oblique approach using biplane fluoroscopic guidance

    International Nuclear Information System (INIS)

    Kim, Sung Tae; Jeon, Seok Chol; Choi, Yo Won; Seo, Heung Suk; Hahm, Chang Kok

    1995-01-01

    To evaluate effectiveness of oblique approach under biplane fluoroscopic guidance in transthoracic fine needle aspiration biopsy. Fourteen consecutive patients underwent transthoracic fine needle aspiration biopsy for subcarinal lesions. Subcarina was the only accessible biopsy site in 13 patients. Subcarinal biopsy was performed to determine the presence of metastasis in an enlarged subcarinal lymph node in the remaining one patient. Before biopsy, we evaluated the size and location of the lesion on preliminary plain chest X-ray film and CT scan. Under dual projection fluoroscopic guidance, biopsy was performed through right posterior intercostal space with the patient prone by using oblique approach. On 15 degree LAO projection the needle was directed to the area anterior to the spine and advanced to the line extending through the posterior wall of the main bronchus. Cytologic diagnosis was made in 12 out of 14 patients(accuracy 85.7%). The final diagnosis consisted of 5 squamous cell carcinoma, 5 small cell carcinoma, 1 adenocarcinoma and 1 adenosquamous carcinoma. Pneumothorax developed in 2 patients(14%) and was managed by chest tube drainage. Mild hemoptysis was observed in 2. Transthoracic fine needle aspiration biopsy using oblique approach under biplane fluoroscopic guidance is a relatively safe and sensitive method for the histologic diagnosis of subcarinal lesion

  4. Minimally invasive approach for small ventrally located intradural lesions of the craniovertebral junction.

    Science.gov (United States)

    Eicker, Sven O; Mende, Klaus Christian; Dührsen, Lasse; Schmidt, Nils Ole

    2015-04-01

    The surgical management of lesions ventral to the neuraxis at the level of the craniovertebral junction (CVJ) and upper cervical spine is challenging. Here, the authors describe a minimally invasive dorsal approach for small ventrally located intradural lesions at the CVJ as an alternative for the more extensive classic transoral approach or variants of suboccipital approaches. Between 2012 and 2014, 6 symptomatic patients with a small lesion of the ventral aspect at the CVJ level were treated using a minimally invasive dorsal approach at the University Medical Center in Hamburg-Eppendorf, Germany. The anatomical distance between the posterior atlantooccipital membrane and the posterior atlantoaxial ligament, as determined by CT images, was assessed in the treated patients and in 100 untreated persons. The authors treated 6 patients (mean age 54.7 years) who had a clinical presentation of mild neurological symptoms that disappeared after resection. Minimally invasive surgical dorsal access was achieved by using tubular systems and using the natural space between the occiput (C-0) and C-1, and in 1 case between C-1 and C-2, without having to remove bony structures. The postoperative course in each of the 6 patients was uneventful. The neuropatho-logical findings confirmed a meningotheliomatous meningioma (WHO Grade I) in 5 cases and an extramedullary cavernous hemangioma in 1 case. MRI confirmed complete resection of all the lesions. The atlantooccipital distances ranged from 3 to 17 mm (mean 8.98 mm) in the supine neutral position, and the atlantoaxial distances ranged from 5 to 17 mm (mean 10.56 mm). There were no significant differences between women and men (atlantooccipital p = 0.14; atlantoaxial p = 0.72). The results of this study demonstrate that the minimally invasive dorsal approach using the space between C-0 and C-1 or C-1 and C-2 provides direct and sufficient exposure for the safe surgical resection of small ventrally located intradural lesions at the

  5. A hybrid approach based on logistic classification and iterative contrast enhancement algorithm for hyperintense multiple sclerosis lesion segmentation.

    Science.gov (United States)

    da Silva Senra Filho, Antonio Carlos

    2017-11-18

    Multiple sclerosis (MS) is a neurodegenerative disease with increasing importance in recent years, in which the T2 weighted with fluid attenuation inversion recovery (FLAIR) MRI imaging technique has been addressed for the hyperintense MS lesion assessment. Many automatic lesion segmentation approaches have been proposed in the literature in order to assist health professionals. In this study, a new hybrid lesion segmentation approach based on logistic classification (LC) and the iterative contrast enhancement (ICE) method is proposed (LC+ICE). T1 and FLAIR MRI images from 32 secondary progressive MS (SPMS) patients were used in the LC+ICE method, in which manual segmentation was used as the ground truth lesion segmentation. The DICE, Sensitivity, Specificity, Area under the ROC curve (AUC), and Volume Similarity measures showed that the LC+ICE method is able to provide a precise and robust lesion segmentation estimate, which was compared with two recent FLAIR lesion segmentation approaches. In addition, the proposed method also showed a stable segmentation among lesion loads, showing a wide applicability to different disease stages. The LC+ICE procedure is a suitable alternative to assist the manual FLAIR hyperintense MS lesion segmentation task.

  6. [Transgastric laparo-endoscopic approach for difficult access lesions. Experimental mode].

    Science.gov (United States)

    Tapia-Vega, Marcel Adalid; Morales-Chávez, Carlos Ernesto; Aguirre-Olmedo, Itzé; Cuendis-Velázquez, Adolfo; Rojano-Rodríguez, Martín Edgardo; Cárdenas-Lailson, Luis Eduardo

    2014-01-01

    Gastric neoplasms can be treated by laparoscopy in a safe and efficient way. Some lesions are not accessible to laparoscopic surgery due to their location. A transgastric approach is proposed as an alternative. Show the results with the application of an endoscopic laparotomy in an animal model that maintains functional anatomy, to resect the posterior gastric neoplasms of the stomach wall, close to the cardia and pre-pyloric region. The laparo-endoscopic technique for resection of gastric neoplasms located in the posterior wall was developed in twelve pigs at the Hospital General Gea González from May to December 2011. An endoscopy was performed to establish the site of insertion of intragastric trocars. Three gastrotomies were made in the anterior wall; under endoscopic and laparoscopic vision the trocars were inserted. The stomach was insufflated with CO2. The lesion was resected maintaining a 20 mm circumferencial margin. The gastrotomies were sutured. The statistic analysis was made with t Student and exact Fisher tests. One-hundred percent of resections were achieved in an average time of 102.33 minutes (± 4.50). Two complications and no transoperatory deceases occurred. The technique we describe allows an appropriate approach to gastric lesions located in the posterior wall, those near to the esophagogastric juntion and the prepiloric region, due to the excellent exposure managed by working inside the stomach with a laparoscopic vision and the two intragastric movile ports. The laparoscopic transgastric approach is feasible and safe for the resection of gastric neoplasms located in the posterior wall, those close to the esophago-gastric junction, and the pre-pyloric region.

  7. Laparoscopic versus open liver resection for benign and malignant solid liver tumors: a case-matched study.

    Science.gov (United States)

    Fallahzadeh, Mohammad Kazem; Zibari, Gazi B; Hamidian Jahromi, Alireza; Chu, Quyen; Shi, Runhua; Shokouh-Amiri, Hosein

    2013-11-01

    Laparoscopic liver resection (LLR) is proposed as an alternative to open liver resection (OLR) for treatment of liver tumors. The aim of this study was to compare the surgical and oncological outcomes of LLR versus OLR in benign and malignant solid liver tumors. In this case-matched study, charts of 497 patients with liver lesions who had LLR or OLR in our center were retrospectively reviewed. Among them, 54 consecutive patients with benign or malignant solid liver tumors who had LLR were matched with a similar number of patients with OLR based on the pathology and extent of liver resection. Additionally, the surgical and oncological outcomes such as operating room time, amount of blood transfusion requirement, free resection margin rate, length of hospital stay, complication rate, perioperative mortality, and survival were compared between the two groups. Demographics, pathological characteristics of the tumor, and extent of liver resection were similar between the two groups. Twenty-nine (54%) patients in each group had malignant lesions. There were no statistically significant differences between the two groups in terms of operating room time, amount of blood transfusion requirement, free resection margin, or postoperative complication rate or survival. However, hospital stay was significantly shorter in the laparoscopic group (5.9 versus 9 days, P=.006). Although no perioperative mortality was observed in patients with benign tumors, among the patients with malignant tumors, 2 died perioperatively in each group. Our results in accordance with previous studies demonstrated that although the oncological outcomes of LLR and OLR were comparable, LLR patients had a shorter hospital stay.

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

    Directory of Open Access Journals (Sweden)

    Merli Saare

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

  9. Characterization of Adrenal Lesions on Unenhanced MRI Using Texture Analysis: A Machine-Learning Approach.

    Science.gov (United States)

    Romeo, Valeria; Maurea, Simone; Cuocolo, Renato; Petretta, Mario; Mainenti, Pier Paolo; Verde, Francesco; Coppola, Milena; Dell'Aversana, Serena; Brunetti, Arturo

    2018-01-17

    Adrenal adenomas (AA) are the most common benign adrenal lesions, often characterized based on intralesional fat content as either lipid-rich (LRA) or lipid-poor (LPA). The differentiation of AA, particularly LPA, from nonadenoma adrenal lesions (NAL) may be challenging. Texture analysis (TA) can extract quantitative parameters from MR images. Machine learning is a technique for recognizing patterns that can be applied to medical images by identifying the best combination of TA features to create a predictive model for the diagnosis of interest. To assess the diagnostic efficacy of TA-derived parameters extracted from MR images in characterizing LRA, LPA, and NAL using a machine-learning approach. Retrospective, observational study. Sixty MR examinations, including 20 LRA, 20 LPA, and 20 NAL. Unenhanced T 1 -weighted in-phase (IP) and out-of-phase (OP) as well as T 2 -weighted (T 2 -w) MR images acquired at 3T. Adrenal lesions were manually segmented, placing a spherical volume of interest on IP, OP, and T 2 -w images. Different selection methods were trained and tested using the J48 machine-learning classifiers. The feature selection method that obtained the highest diagnostic performance using the J48 classifier was identified; the diagnostic performance was also compared with that of a senior radiologist by means of McNemar's test. A total of 138 TA-derived features were extracted; among these, four features were selected, extracted from the IP (Short_Run_High_Gray_Level_Emphasis), OP (Mean_Intensity and Maximum_3D_Diameter), and T 2 -w (Standard_Deviation) images; the J48 classifier obtained a diagnostic accuracy of 80%. The expert radiologist obtained a diagnostic accuracy of 73%. McNemar's test did not show significant differences in terms of diagnostic performance between the J48 classifier and the expert radiologist. Machine learning conducted on MR TA-derived features is a potential tool to characterize adrenal lesions. 4 Technical Efficacy: Stage 2 J

  10. Lesion focused stereotactic thermo-coagulation of focal cortical dysplasia IIB: a new approach to epilepsy surgery?

    Science.gov (United States)

    Wellmer, Jörg; Kopitzki, Klaus; Voges, Jürgen

    2014-06-01

    Over the last few decades, preferred epilepsy surgical approaches have developed from standard lobectomies to individually tailored resections. Yet, it remains uncertain how small surgical interventions can be without compromising the success of the surgery. Particularly in patients with epileptogenic lesions identified by magnetic resonance imaging (MRI), it is unresolved whether resection or destruction of the lesion suffices to eliminate the epileptogenic zone. We present a minimally invasive surgical approach that may provide insight into this issue. Two patients with pharmacoresistant epilepsy due to focal cortical dysplasia type IIB demonstrated by 3 Tesla MRI were treated with lesion-focused stereotactic radio-frequency thermo-coagulation. In both patients, pathognomonic epileptic discharges were recorded from the lesion via a stimulation device prior to coagulation. In one patient, the suspected proximity of the lesion to the pyramidal tract was verified by eliciting motor evoked potentials from the depths of the lesion. Following complete and near complete lesion destruction, seizures (several per day or per week, respectively) ceased in patients A and B, with no seizures for 12 months and 5 months, respectively, at the time of this publication. Neither patient acquired persistent postoperative neurological deficits. The fact that seizure activity stopped after destruction of small bottom-of-sulcus dysplasias implies that in these cases, the epileptogenic zone and the epileptogenic lesion may overlap. If future studies can replicate this finding, focused lesion destruction could be a further development of individually tailored epilepsy surgery. The technique described here is especially suited for high-precision surgery close to eloquent brain structures. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  11. Orbital cortical approach to lesions around the frontal horn of the lateral ventricle: indication and surgical parameters.

    Science.gov (United States)

    Goel, Atul; Shah, Abhidha; Ramdasi, Raghvendra; Patni, Neeraj

    2014-04-01

    An orbital cortical approach to lesions in the region of the frontal horn is described on the basis of surgical experience with five cases and dissections of three cadaveric brain specimens. The approach involves cortical incision over the orbital surface of the frontal brain and directing the surgical trajectory superiorly. The possible indications of the approach and the critical surgical parameters are described. To assess the landmarks that could be used to employ the approach, three formalin-fixed frozen cadaveric brains were appropriately dissected. A number of parameters were analysed to identify the safe entry points and the trajectory to approach the frontal horn. Five lesions located in the region of the frontal horn were operated upon by employing the discussed approach. The frontal horn is located at the depth of approximately 18 mm (range, 17-20 mm) from the orbital surface of the frontal brain. In a lateral perspective, the tip of the frontal horn is in line with the tip of the temporal pole. Wide opening of the Sylvian fissure, relaxation of the brain and lateral basal frontal exposure can be used effectively to obtain a suitable angulation for conduct of surgery. Avoidance of olfactory tracts and Heubner's perforating artery at the site of medial orbital gyrus cortical incision and appropriately directing the corticectomy that avoids the association fibre tracts, caudate head and internal capsule can lead to a safe exposure of the frontal horn. The approach is suitable for lesions involving or in the vicinity of the inferior aspect of the frontal horn and in the region of the caudate head. Neuronavigation can be of assistance during surgery and avoid critical misdirection. All the five lesions were treated without consequence. For selected indications, an inferior frontal or orbital cortical approach can be used effectively and safely to approach lesions in relation to the frontal horn. The approach needs to be precise to avoid injury to vital

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

    OpenAIRE

    SungEun Yang; HyeJin Lee; Sung-Ho Jin

    2016-01-01

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

  13. Simultaneously anterior decompression and posterior instrumentation by extrapleural retroperitoneal approach in thoracolumbar lesions

    Directory of Open Access Journals (Sweden)

    Jain Anil

    2010-01-01

    Full Text Available Background: Anterior decompression with posterior instrumentation when indicated in thoracolumbar spinal lesions if performed simultaneously in single-stage expedites rehabilitation and recovery. Transthoracic, transdiaphragmatic approach to access the thoracolumbar junction is associated with significant morbidity, as it violates thoracic cavity; requires cutting of diaphragm and a separate approach, for posterior instrumentation. We evaluated the clinical outcome morbidity and feasibility of extrapleural retroperitoneal approach to perform anterior decompression and posterior instrumentation simultaneously by single "T" incision outcome in thoracolumbar spinal trauma and tuberculosis. Patients and Methods: Forty-eight cases of tubercular spine (n = 25 and fracture of the spine (n = 23 were included in the study of which 29 were male and 19 female. The mean age of patients was 29.1 years. All patients underwent single-stage anterior decompression, fusion, and posterior instrumentation (except two old traumatic cases via extrapleural retroperitoneal approach by single "T" incision. Tuberculosis cases were operated in lateral position as they were stabilized with Hartshill instrumentation. For traumatic spine initially posterior pedicle screw fixation was performed in prone position and then turned to right lateral position for anterior decompression by same incision and approach. They were evaluated for blood loss, duration of surgery, superficial and deep infection of incision site, flap necrosis, correction of the kyphotic deformity, and restoration of anterior and posterior vertebral body height. Results: In traumatic spine group the mean duration of surgery was 269 minutes (range 215-315 minutes including the change over time from prone to lateral position. The mean intraoperative blood loss was 918 ml (range 550-1100 ml. The preoperative mean ASIA motor, pin prick and light touch score improved from 63.3 to 74.4, 86 to 94.4 and 86 to 96 at

  14. [Choice of surgical approaches for salvage surgery of primary lesion recurrence and residual cases of nasopharyngeal carcinoma].

    Science.gov (United States)

    Tao, Zhong-Qiang; Si, Yong-Feng; Lan, Sheng-Yong; Zhang, Zheng; Deng, Zhuo-Xia; Huang, Bo; Zhou, Ri-Jing; Lu, Jin-Long

    2011-02-01

    The choice of surgical approaches for salvage surgery based on the location and invasion of recurrent and residual lesions of nasopharyngeal carcinoma (NPC), surgical results, complications, and survival were assessed. Thirty-seven cases with recurrent and residual lesions of NPC underwent salvage surgery between March 1991 and January 2005 were analysed retrospectively. Of 37 patients, 23 were men and 14 women, with a median age of 46.5 years (26 - 57 years); 4 were at stage I, 10 at stage II, 14 at stage III, and 9 at stage IV; 5 cases were with cervical metastasis, including 3 cases of N1 and 2 cases N2. All recurrent and residual lesions of NPC were determined by biopsy. On the location and invasion of recurrent and residual lesions of NPC, 8 cases underwent endoscopic resection of lesions, 12 cases of the palate nasopharyngectomy, 5 cases of maxillary swing, 4 cases of maxillary swing plus prerenal approach, 2 cases of lateral rhinotomy plus coronal flap approach, and 6 cases transfacial plus nasal pyramid swing approach. Five cases with cervical metastasis received neck dissection in addition to the operations for recurrent and residual lesions of NPC. Postoperatively 31 cases received radiotherapy with dosage of 60 Gy, among them 15 cases with concurrent chemoradiation therapy, and 6 cases with clear surgical margin did not received radiotherapy or chemotherapy. The cases were followed up for 12 - 72 months, with a median of 45 months. Total resection for the recurrent and residual lesions of NPC accounted for 91.8% (34/37) and subtotal resection for 8.2% (3/37). The accident of perioperative complications was 24.3% (9/37). The 3- and 5-year overall disease-free survival rates (DFSR) were 62.1% and 43.3%, respectively. The 3- and 5-year overall survival rates (OSR) were 72.9% and 51.3%, respectively. The 5 year DFSR of cases at stage I-IV were 100%, 40%, 28% and 11% (χ(2) = 10.0, P < 0.01), respectively. The 5 year OSR were 100%, 70%, 35% and 28% (χ(2

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

    Science.gov (United States)

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

    2016-03-01

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

  16. New Perspectives on the Brain Lesion Approach - Implications for Theoretical Models of Human Memory.

    NARCIS (Netherlands)

    Irish, Muireann; van Kesteren, M.T.R.

    2017-01-01

    Human lesion studies represent the cornerstone of modern day neuropsychology and provide an important adjunct to functional neuroimaging methods. The study of human lesion groups with damage to distinct regions of the brain permits the identification of underlying mechanisms and structures not only

  17. Successful nonsurgical management of periapical lesions of endodontic origin: A conservative orthograde approach

    Directory of Open Access Journals (Sweden)

    J V Karunakaran

    2017-01-01

    Full Text Available Periapical lesions of endodontic origin are common pathological conditions affecting periradicular tissues. Microbial infection of pulpal tissues is primarily responsible for initiation and progression of apical periodontitis. The primary objective of endodontic therapy should be to restore involved teeth to a state of normalcy nonsurgically. Different nonsurgical management techniques, namely, conservative root canal therapy, decompression technique, method using calcium hydroxide, aspiration-irrigation technique, lesion sterilization and tissue repair therapy, active nonsurgical decompression technique, and the apexum procedure have been advocated. New techniques which use drug-loaded injectable scaffolds, simvastatin, and epigallocatechin-3-gallate have been tried. Surgical option should be considered when intra- or extra-radicular infections are persistent. Incidence of nonendodontic periapical lesions has also been reported. An accurate diagnosis of the periapical lesion whether it is of endodontic or nonendodontic origin has to be made. Surgical methods have many disadvantages, and hence should be considered as an option only in the case of failure of nonsurgical techniques. Assessment of healing of periapical lesions has to be done periodically which necessitates a long-term follow-up. Even large periapical lesions and retreatment cases where the lesion is of endodontic origin have been successfully managed nonsurgically with orthograde endodontic therapy.

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

    Directory of Open Access Journals (Sweden)

    SungEun Yang

    2016-08-01

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

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

    Science.gov (United States)

    Yang, SungEun; Lee, HyeJin; Jin, Sung-Ho

    2016-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Firoozeh Nilchian

    2012-01-01

    Conclusion: Preliminary data suggest that there are strong evidence regarding the incidence of child abuse relating orofacial lesions which dentists should be aware of them. Future trials may draw on these useful baseline data to help their study design.

  1. A Novel Fuzzy Topological Approach to the Detection of Mammographic Lesions and Quantification of Parenchymal Density

    National Research Council Canada - National Science Library

    Udupa, Jayaram

    2001-01-01

    .... During this project period, the following have been accomplished: The development and validation of a new method of lesion and density detection based on fuzzy connectedness that utilizes the relative strength of connectedness among objects...

  2. Mass lesions in chronic pancreatitis: benign or malignant? An "evidence-based practice" approach.

    LENUS (Irish Health Repository)

    Gerstenmaier, Jan F

    2012-02-01

    The diagnosis of a pancreatic mass lesion in the presence of chronic pancreatitis can be extremely challenging. At the same time, a high level of certainty about the diagnosis is necessary for appropriate management planning. The aim of this study was to establish current best evidence about which imaging methods reliably differentiate a benign from a malignant lesion, and show how that evidence is best applied. A diagnostic algorithm based on Bayesian analysis is proposed.

  3. LESIONS OF THE MANDIBLE - A PATTERN BASED APPROACH TO DIAGNOSIS BY OPG

    Directory of Open Access Journals (Sweden)

    Anil Govind

    2015-12-01

    Full Text Available The present study of 95 orthopentograms focused on importance of OPG as a first line of investigation in the diagnosis of mandibular lesions and establish its role beyond doubt in some the conditions due to its pathognomonic appearance. It also narrows down the list of differential diagnosis. INTRODUCTION Mandibular lesions cause a variety of problems ranging from swelling, tooth mobility, displacement of adjacent teeth, mild sensitivity, root deformation of developing permanent teeth and potential to expand the bone causing fractures. Some of these mandibular lesions are silent in their progression and pose a challenge in early diagnosis for clinicians. Radiographic characteristics such as location, margin, density, relation to tooth, along with clinical notes is the first step in interpreting mandibular pathologies. Orthopentogram is a simple, accurate and cost effective technique commonly employed for diagnosing dental and maxillofacial lesions. We retrospectively evaluated spectrum of mandibular lesions from a database of groundwork diagnostic OPGs. METHODS We reviewed a total of 2690 orthopentograms of patients with tooth ache and/or swelling, referred to the radiologist for the preliminary diagnosis. All osteolytic lesions more than 10 mm. and having characteristics of root abscess were included for evaluation. OPG taken for orthodontic work up, showing dental abscess less than 10 mm and OPG of patients with Gingival and T.M. joint pathologies were excluded. RESULTS In our study, we found 0.35% (95/2690 of patients were having a spectrum of mandibular lesions. The frequency of appearance of mandibular lesions on OPG was buccal-neoplasm>dentigerous-cysts>dental-cyst>neoplastic=traumatic-bone-cyst= osteomyelitis >kerato-cyst. The most frequent sites of these lesions were 80/103(77.6% molars, 14/103(13.6% incisors, and 9/103(8.7% angle of mandibles. No lesions were found on condyles. CONCLUSION The present study proves that OPG is a first

  4. Three-Year Outcomes of Revisional Laparoscopic Gastric Bypass after Failed Laparoscopic Sleeve Gastrectomy: a Case-Matched Analysis.

    Science.gov (United States)

    Malinka, Thomas; Zerkowski, Jens; Katharina, Itskovich; Borbèly, Yves Michael; Nett, Philipp; Kröll, Dino

    2017-09-01

    While previous studies suggest laparoscopic Roux-en-Y gastric bypass (LRYGB) as a reasonable treatment approach to address weight loss failure after laparoscopic sleeve gastrectomy (LSG), data focusing on long-term outcomes are still lacking. The purpose of this study was to evaluate weight and comorbidity outcomes comparing revisional LRYGB (rLRYGB) with primary LRYGB (pLRYGB). Retrospective single-centre case-matched analysis was conducted at a bariatric tertiary referral centre. Between January 2009 and July 2013, 239 patients were entered into a prospective database, and 32 patients undergoing rLRYGB (cases) were matched with 32 patients undergoing pLRYGB (controls) for sex, age and BMI. The end point was data at 3 years of follow-up. Thirty-one patients (12.9%) were lost to follow-up during the study period. There were no significant differences in patient demographics or median BMI (kg/m 2 ) for pLRYGB or rLRYGB (42.8 ± 12.1 vs. 42.3 ± 11.5, respectively; p = 0.748). Coexisting comorbidities were rated similarly in both groups. At 3 years, the percentage of excess weight loss (74.4 ± 23.3 vs 52.0 ± 26, respectively; p = 0.007) was higher for pLRYGB than rLRYGB, while similar improvements of coexisting comorbidities could be observed. rLRYGB is a feasible and practical surgical approach that allows effective weight loss at 3 years of follow-up and alleviates refractory reflux symptoms. Although weight loss is lower compared to pLRYGB, resolution or improvement of coexisting comorbidities appears similar. Therefore, rLRYGB seems to be a reliable procedure to address failure after LSG.

  5. Segmenting Multiple Sclerosis Lesions using a Spatially Constrained K-Nearest Neighbour approach

    DEFF Research Database (Denmark)

    Lyksborg, Mark; Larsen, Rasmus; Sørensen, Per Soelberg

    2012-01-01

    We propose a method for the segmentation of Multiple Sclerosis lesions. The method is based on probability maps derived from a K-Nearest Neighbours classication. These are used as a non parametric likelihood in a Bayesian formulation with a prior that assumes connectivity of neighbouring voxels. ...

  6. Sorting out the clinical consequences of ischemic lesions in brain aging: a clinicopathological approach.

    Science.gov (United States)

    Gold, Gabriel; Kovari, Enikö; Hof, Patrick R; Bouras, Constantin; Giannakopoulos, Panteleimon

    2007-06-15

    Vascular lesions are particularly common in the aged brain. However, it is still unclear whether all such lesions affect cognition. To better explore relationships between specific characteristics of vascular lesions (type, size and location) and cognitive status. We performed a review of currently available neuroimaging and post-mortem studies taking into account several recent clinicopathological reports in elderly individuals with varying levels of cognitive impairment. New data reveals the significant impact of cortical microinfarcts on intellectual function, in contrast to focal cortical and white matter gliosis which are not significantly associated with cognitive status. Structural neuroimaging studies show inconsistent data regarding the cognitive consequences of WML. Neuropathological analyses reveal that both periventricular and subcortical demyelination are associated with cognitive status in the absence of macrovascular pathology. When lacunes are present, these microvascular lesions have no independent effect on intellectual impairment. The relationship between lacunes and cognition is highly dependent on localization. Basal ganglia and thalamic lacunes correlate with cognitive decline but not lacunes in the frontal, temporal and parietal deep white matter. Recent studies suggest that some cases of dementia might be misclassified: 1. Cases with typical Alzheimer course and moderate lacunes in subcortical white matter should probably be considered pure Alzheimer's disease. 2. The presence of microscopic infarcts can markedly impact cognition but is not detectable by currently available neuroimaging techniques and the vascular component of such mixed cases may go undiagnosed. The development of urgently needed new criteria for vascular dementia should take into account the relative contribution of various types of vascular lesions that can impact cognitive function.

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

    Science.gov (United States)

    Asgary, Saeed; Fazlyab, Mahta

    2014-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Saeed Asgary

    2014-05-01

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

  9. An intraoperative multimodal neurophysiologic approach to successful resection of precentral gyrus epileptogenic lesions.

    Science.gov (United States)

    Simon, Mirela V; Cole, Andrew J; Chang, Eric C; Buchbinder, Bradley R; Stufflebeam, Steve M; Nozari, Ala; Stemmer-Rachamimov, Anat O; Eskandar, Emad N

    2012-04-01

    Cortical dysplasias (CDs) are highly epileptogenic lesions with a good prognosis of seizure freedom, if totally resected. However, their accurate delineation and resection can be difficult, and depend on the extent of pathology and lesion location. Intraoperative neurophysiologic assessments are valuable in these situations. We present an illustrative case of intractable epilepsy where judicious use of intraoperative neurophysiologic-techniques guided resection of precentral CD, under general anesthesia and in the absence of preoperative electrophysiologic mapping data. Ictal onset was accurately delineated using electrocorticography (ECoG). Phase reversal of the median somatosensory-evoked potentials (MSSEPs) localized the central sulcus (CS). Motor evoked potentials (MEPs) triggered by high-frequency monopolar anodal electrical cortical stimulation at the primary motor cortex (PMC) threshold delineated the PMC. Using this technique, PMC and the corticospinal tract (CST) were continuously monitored during resection. No changes in MEPs from the preresection baseline were seen; no residual abnormal activity was present in the postresection ECoG. The patient emerged from surgery without deficits and has been seizure free during a 10-month follow-up. Staged multimodal intraoperative neurophysiology can be used successfully under general anesthesia to guide resection of epileptogenic lesions within the precentral gyrus, as an add-on or, in certain situations, as a viable alternative to preoperative electrophysiologic mapping. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.

  10. Seeing the Invisible: Revealing Atrial Ablation Lesions Using Hyperspectral Imaging Approach.

    Science.gov (United States)

    Muselimyan, Narine; Swift, Luther M; Asfour, Huda; Chahbazian, Tigran; Mazhari, Ramesh; Mercader, Marco A; Sarvazyan, Narine A

    2016-01-01

    Currently, there are limited means for high-resolution monitoring of tissue injury during radiofrequency ablation procedures. To develop the next generation of visualization catheters that can reveal irreversible atrial muscle damage caused by ablation and identify viability gaps between the lesions. Radiofrequency lesions were placed on the endocardial surfaces of excised human and bovine atria and left ventricles of blood perfused rat hearts. Tissue was illuminated with 365nm light and a series of images were acquired from individual spectral bands within 420-720nm range. By extracting spectral profiles of individual pixels and spectral unmixing, the relative contribution of ablated and unablated spectra to each pixel was then displayed. Results of spectral unmixing were compared to lesion pathology. RF ablation caused significant changes in the tissue autofluorescence profile. The magnitude of these spectral changes in human left atrium was relatively small (gaps at clinically relevant locations. Data supports the possibility for developing percutaneous hyperspectral catheters for high-resolution ablation guidance.

  11. An Optimized Clustering Approach for Automated Detection of White Matter Lesions in MRI Brain Images

    Directory of Open Access Journals (Sweden)

    M. Anitha

    2012-04-01

    Full Text Available Settings White Matter lesions (WMLs are small areas of dead cells found in parts of the brain. In general, it is difficult for medical experts to accurately quantify the WMLs due to decreased contrast between White Matter (WM and Grey Matter (GM. The aim of this paper is to
    automatically detect the White Matter Lesions which is present in the brains of elderly people. WML detection process includes the following stages: 1. Image preprocessing, 2. Clustering (Fuzzy c-means clustering, Geostatistical Possibilistic clustering and Geostatistical Fuzzy clustering and 3.Optimization using Particle Swarm Optimization (PSO. The proposed system is tested on a database of 208 MRI images. GFCM yields high sensitivity of 89%, specificity of 94% and overall accuracy of 93% over FCM and GPC. The clustered brain images are then subjected to Particle Swarm Optimization (PSO. The optimized result obtained from GFCM-PSO provides sensitivity of 90%, specificity of 94% and accuracy of 95%. The detection results reveals that GFCM and GFCMPSO better localizes the large regions of lesions and gives less false positive rate when compared to GPC and GPC-PSO which captures the largest loads of WMLs only in the upper ventral horns of the brain.

  12. Repair of model compounds of photoinduced lesions in DNA. Electrochemical approaches

    International Nuclear Information System (INIS)

    Boussicault, F.

    2006-09-01

    The goal of this work is to better understand the repair mechanism of photoinduced lesions in DNA (cyclobutane dimers and pyrimidine (6-4) pyrimidone adducts) by photolyase redox enzymes, using tools and concepts of molecular electrochemistry. Thanks to the study of model compounds of cyclobutane lesions by cyclic voltametry, we have been able to mimic the key step of the enzymatic repair (dissociative electron transfer) and to monitor the repair of model compounds by Escherichia coli DNA photolyase. From these results, we have discussed the repair mechanism, especially the stepwise or concerted character of the process. Repair mechanism of (6-4) adducts is not known now, but a possible pathway implies an electron transfer coupled to the cleavage of two bonds in the closed form of the lesions (oxetanes). Voltammetric study of reduction and oxidation of model oxetanes and their repair by E. coli DNA photolyase gave some experimental evidence confirming the proposed mechanism and allowing a better understanding of it. (author)

  13. Lesiones torácicas graves y el enfoque del control de daños Severe thoracic lesions and the damage control approach

    Directory of Open Access Journals (Sweden)

    Mario Miguel Morales Wong

    2008-03-01

    Full Text Available En los últimos años se han desarrollado nuevas estrategias para el tratamiento del trauma grave con lesiones exanguinantes o sin ellas, pero son estas últimas las que más requieren un cambio de la forma de actuar en aras de mejorar la supervivencia. Tales estrategias quirúrgicas se han denominado cirugía de control de daños, que en esencia evita complicaciones como la tríada letal de acidosis, hipotermia y coagulopatía. A diferencia del control de daños en el abdomen, existen lesiones torácicas que requieren una reparación inicial durante el acto quirúrgico, pero pueden hallarse otras cuya reparación puede ser secundaria. El método de control de daños en las lesiones torácicas debe llevarse a cabo con procedimientos que sean técnicamente rápidos y simples, para postergar el tratamiento definitivo de las lesiones que no requieran una reparación inmediata en pacientes in extremisNew strategies have been developed in the last years to treat severe trauma with exsanguinating lesions or without them. The latter demand more changes in the way of acting in order to improve survival. Such surgical strategies have been called damage control surgery that in essence prevent complications such as the lethal triad of acidosis, hypothermia and coagulopathy. Unlike the control of abdomen damage, there are thoracic lesions requiring an initial repair during surgery, but there may be found others, whose repair is secondary. The damage control method in the thoracic lesions should be conducted with technically fast and simple procedures to postpone the definitive treatment of the lesions that do not require an immediate repair in patients in extremis

  14. Stereotactic biopsy for brainstem lesion: Comparison of approaches and reports of 10 cases

    Directory of Open Access Journals (Sweden)

    Se-Yi Chen

    2011-03-01

    Conclusion: A number of approaches are available for stereotactic brainstem biopsy. Surgical approach should be tailored, according to the location neurological function, with special concern for the patients’ safety. In selected condition, frameless stereotaxy biopsy also provides competed diagnostic yield.

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

    Science.gov (United States)

    Premaladha, J; Ravichandran, K S

    2016-04-01

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

  16. A cell pattern approach to interpretation of fine needle aspiration cytology of thyroid lesions: A cyto-histomorphological study

    Directory of Open Access Journals (Sweden)

    Bommanahalli Basavaraj

    2010-01-01

    Full Text Available Aim: Our study aimed at a cell pattern approach to interpret thyroid cytology and to demonstrate diagnostic accuracy of fine needle aspiration cytology (FNAC with an emphasis on diagnostic pitfalls. Materials and Methods: A total number of 218 goitre cases, from the year 2000 to 2004, were reviewed retrospectively from the cytology files, without considering the previous cytological diagnosis. Four cases with inadequate aspirate were excluded. The predominant cell pattern, such as macro/normofollicular, microfollicular, papillary, syncytial, dispersed and cystic pattern, was noted in each case. The final diagnosis was arrived by observing the cellular details and background elements. Cytological diagnosis was correlated with histopathology in 75 cases. The sensitivity and specificity were computed. Results: Normo/macrofollicular pattern was seen in 71.96% of nodular goitre and 6.9% of follicular neoplasms. Around 86.2% of follicular neoplasms and 17.6% of papillary carcinoma had microfollicular pattern. The papillary pattern was seen in 47% of papillary carcinoma. Syncytial pattern was noticed in 72.3% of chronic lymphocytic thyroiditis and 29.4% of papillary carcinoma. Cytological diagnosis was concordant with histopathological diagnosis in 65 cases. Overall sensitivity and specificity of FNAC in diagnosing neoplastic lesions of thyroid were 83.33 and 95.55%, respectively. Conclusion: FNAC is more sensitive and specific in triaging neoplastic from non-neoplastic thyroid lesions. Identification of the predominant cell pattern would be complementary to analysis of cell morphology and background details in cytological diagnosis of thyroid lesions. This approach helps to diagnose follicular neoplasm and follicular variant of papillary thyroid carcinoma.

  17. A posterolateral approach to occipitoatlantoaxial ventral lesions: a report of the long-term follow-up of 23 cases.

    Science.gov (United States)

    Limin, Liu; Chunguang, Zhou; Yueming, Song; Siqing, Huang; Hao, Liu; Quan, Gong; Tao, Li; Jiancheng, Zeng; Faming, Luo

    2013-07-01

    A retrospective study of consecutive patient series. To report a technique of odontoidectomy using a transoccipitocervical posterolateral approach for occipitoatlantoaxial ventral lesions in a long-term follow-up study. Occipitoatlantoaxial malformation and old traumatic dislocation usually cause compression of the high cervical spinal cord from a variety of different directions and angles, leading to high morbidity. The main objective of treatment is to relieve the anteroposterior compression and to restore the stability of the occipitocervical region. Currently, there are 2 approaches to perform the surgical procedure: (1) posterior decompression by suboccipital and occipitocervical fusion and internal fixation; and (2) decompression by a transoral approach to an odontoid resection. However, there are some short points, which need to be changed, such as the incomplete decompression (the former), narrow view, cerebrospinal fluid leakage, and the high infection rates. From 1999 to 2006, 23 patients with occipitoatlantoaxial ventral lesions were treated using a transoccipitocervical posterolateral approach for decompression. The procedure included an expansion of the foramen magnum, a resection of the posterior arch of atlas, a lateral occipitocervical epidural exposure to the odontoid and the C2 vertebra, and an excision of the odontoid. Thus, an anteroposterior decompression and occipitocervical spinal fusion was achieved. Neurological function, daily living ability, and the work ability of patients were assessed in a follow-up study. A 28-year-old woman died of respiratory and circulatory failure 10 hours after operation. The remaining patients survived without postoperative infection. The neurological injury in 17 patients did not deteriorate, whereas 5 patients had decreased sensation in the upper limbs, and the elbow flexor muscle strength in 2 patients declined by 1 grade on the operation side. Short-term follow-up (3-6 mo, 22 cases) indicated that 19

  18. Lesiones torácicas graves y el enfoque del control de daños Severe thoracic lesions and the damage control approach

    OpenAIRE

    Mario Miguel Morales Wong; Mario Michel Gómez Hernández; Alexander Ramos Godines; Rolando González Folch

    2008-01-01

    En los últimos años se han desarrollado nuevas estrategias para el tratamiento del trauma grave con lesiones exanguinantes o sin ellas, pero son estas últimas las que más requieren un cambio de la forma de actuar en aras de mejorar la supervivencia. Tales estrategias quirúrgicas se han denominado cirugía de control de daños, que en esencia evita complicaciones como la tríada letal de acidosis, hipotermia y coagulopatía. A diferencia del control de daños en el abdomen, existen lesiones torácic...

  19. Trans-zygomatic middle cranial fossa approach to access lesions around the cavernous sinus and anterior parahippocampus: a minimally invasive skull base approach.

    Science.gov (United States)

    Melamed, Itay; Tubbs, R Shane; Payner, Troy D; Cohen-Gadol, Aaron A

    2009-08-01

    Exposure of the cavernous sinus or anterior parahippocampus often involves a wide exposure of the temporal lobe and mobilization of the temporalis muscle associated with temporal lobe retraction. The authors present a cadaveric study to illustrate the feasibility, advantages and landmarks necessary to perform a trans-zygomatic middle fossa approach to lesions around the cavernous sinus and anterior parahippocampus. The authors performed bilateral trans-zygomatic middle fossae exposures to reach the cavernous sinus and parahippocampus in five cadavers (10 sides). We assessed the morbidity associated with this procedure and compared the indications, advantages, and disadvantages of this method versus more extensive skull base approaches. A vertical linear incision along the middle portion of the zygomatic arch was extended one finger breadth inferior to the inferior edge of the zygomatic arch. Careful dissection inferior to the arch allowed preservation of facial nerve branches. A zygomatic osteotomy was followed via a linear incision through the temporalis muscle and exposure of the middle cranial fossa floor. A craniotomy along the inferolateral temporal bone and middle fossa floor allowed extradural dissection along the middle fossa floor and exposure of the cavernous sinus including all three divisions of the trigeminal nerve. Intradural inspection demonstrated adequate exposure of the parahippocampus. Exposure of the latter required minimal or no retraction of the temporal lobe. The trans-zygomatic middle fossa approach is a simplified skull base exposure using a linear incision, which may avoid the invasivity of more extensive skull base approaches while providing an adequate corridor for resection of cavernous sinus and parahippocampus lesions. The advantages of this approach include its efficiency, ease, minimalism, preservation of the temporalis muscle, and minimal retraction of the temporal lobe.

  20. Repair of model compounds of photoinduced lesions in DNA. Electrochemical approaches; Reparation de modeles de lesions photoinduites de l'ADN. Approches electrochimiques

    Energy Technology Data Exchange (ETDEWEB)

    Boussicault, F

    2006-09-15

    The goal of this work is to better understand the repair mechanism of photoinduced lesions in DNA (cyclobutane dimers and pyrimidine (6-4) pyrimidone adducts) by photolyase redox enzymes, using tools and concepts of molecular electrochemistry. Thanks to the study of model compounds of cyclobutane lesions by cyclic voltametry, we have been able to mimic the key step of the enzymatic repair (dissociative electron transfer) and to monitor the repair of model compounds by Escherichia coli DNA photolyase. From these results, we have discussed the repair mechanism, especially the stepwise or concerted character of the process. Repair mechanism of (6-4) adducts is not known now, but a possible pathway implies an electron transfer coupled to the cleavage of two bonds in the closed form of the lesions (oxetanes). Voltammetric study of reduction and oxidation of model oxetanes and their repair by E. coli DNA photolyase gave some experimental evidence confirming the proposed mechanism and allowing a better understanding of it. (author)

  1. Nyvad Criteria for Caries Lesion Activity and Severity Assessment: A Validated Approach for Clinical Management and Research.

    Science.gov (United States)

    Nyvad, Bente; Baelum, Vibeke

    2018-03-05

    The Nyvad classification is a visual-tactile caries classification system devised to enable the detection of the activity and severity of caries lesions with special focus on low-caries populations. The criteria behind the classification reflect the entire continuum of caries, ranging from clinically sound surfaces through noncavitated and microcavitated caries lesions in enamel, to frank cavitation into the dentin. Lesion activity at each severity stage is discriminated by differences in surface topography and lesion texture. The reliability of the Nyvad criteria is high to excellent when used by trained examiners in the primary and permanent dentitions. The Nyvad criteria have construct validity for lesion activity assessments because of their ability to reflect the well-known caries-controlling effect of fluoride. Predictive validity was demonstrated by showing that active noncavitated lesions are at higher risk of progressing to a cavity or filled state than do inactive noncavitated lesions. Lesion activity assessment performed successfully as a screening tool to identify individuals with a poor caries prognosis. Because of their predictive validity, the Nyvad criteria are superior to other current caries lesion descriptors for the detection of changes in the lesion activity status over time. The Nyvad criteria fulfill all the formal requirements for a robust caries lesion classification and are recommended for evidence-based caries management in clinical practice and in research. © 2018 S. Karger AG, Basel.

  2. Study protocol for an approach based on diagnosis and therapy of cutaneous radiation induced lesions

    International Nuclear Information System (INIS)

    Di Giorgio, Marina; Vallerga, Maria B.; Radl, Analia; Portas, Mercedes

    2008-01-01

    Full text: In the frame of an agreement between the 'Hospital de Quemados del Gobierno de la Ciudad de Buenos Aires'-Burn Center- (a reference hospital of the Medical Radiological Emergency Response Network of Argentina) and the Nuclear Regulatory Authority, a research project for diagnostic and therapeutic approach of cutaneous radiation syndrome (CRS) is in progress. Sixty seven persons, which developed acute and/or late CRS, were included in this protocol from 1997 to 2007, treated with an equivalent therapeutic scheme and evaluated through clinical follow-up, serial photographic record and complementary tests (tele-thermography and high frequency ultrasonography). There exist individual variations that could condition the response to ionizing radiation (IR) in not only accidental but also planned exposures (such as radiotherapy and interventional radiology). Deficiencies in DNA repair mechanisms would be involved on hypersensitivity to deterministic effects of IR. Consequently, the characterization of DNA repair capacity in lymphocytes through cytokinesis blocked micronucleus (MN) and alkaline single-cell microgel electrophoresis (comet) assays could be suitable approaches to evaluate in vitro individual radiosensitivity. Under this context, individual radiosensitivity assessment was conducted in patients included in this research protocol that showed acute and/or late cutaneous reactions with grades 3 and 4 of the Toxicity Criteria of the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer. DNA repair capacity was evaluated through MN and comet assay for initial damage and after specific times of repair (0-120 minutes). DNA damage and repair capacity were quantified by the Olive tail moment. Previous own studies have identified three subpopulations, characterized by the mean values of their repair mean half-time: healthy controls (2.6 ± 0.3 minutes), average-reactor cancer patients (4.7 ± 2.9 minutes) and over

  3. A case matched study examining the reliability of using ImPACT to assess effects of multiple concussions.

    Science.gov (United States)

    Barker, Trevor; Russo, Stephen A; Barker, Gaytri; Rice, Mark A; Jeffrey, Mary G; Broderick, Gordon; Craddock, Travis J A

    2017-04-28

    Approximately 3.8 million sport and recreational concussions occur per year, creating a need for accurate diagnosis and management of concussions. Researchers and clinicians are exploring the potential dose-response cumulative effects of concussive injuries using computerized neuropsychological exams, however, results have been mixed and/or contradictory. This study starts with a large adolescent population and applies strict inclusion criteria to examine how previous mild traumatic brain injuries affect symptom reports and neurocognitive performance on the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) computerized tool. After applying exclusion criteria and case matching, 204 male and 99 female participants remained. These participants were grouped according to sex and the number of previous self-reported concussions and examined for overall differences on symptoms reported and scores obtained on the ImPACT neurocognitive battery composites. In an effort to further reduce confounding factors due to the varying group sizes, participants were then case matched on age, sex, and body mass index and analyzed for differences on symptoms reported and scores obtained on the ImPACT neurocognitive battery composites. Case matched analysis demonstrated males with concussions experience significantly higher rates of dizziness (p = .027, η 2  = .035), fogginess (p = .038, η 2  = .032), memory problems (p = .003, η 2  = .055), and concentration problems (p = .009, η 2  = .046) than males with no reported previous concussions. No significant effects were found for females, although females reporting two concussions demonstrated a slight trend for experiencing higher numbers of symptoms than females reporting no previous concussions. The results suggest that male adolescent athletes reporting multiple concussions have lingering concussive symptoms well after the last concussive event; however, these symptoms were found to

  4. Does Evidence Support a Combined Restorative Surgical Approach for the Treatment of Gingival Recessions Associated With Noncarious Cervical Lesions?

    Science.gov (United States)

    Agossa, Kevimy; Godel, Guillaume; Dubar, Marie; S Y, Kadiatou; Behin, Pascal; Delcourt-Debruyne, Elisabeth

    2017-09-01

    Gingival recessions are frequently associated with noncarious cervical lesions. Combined restorative surgical approaches have been suggested for the management of these combined defects. The aim of this review was to analyze the current evidence on the effectiveness of these combined restorative surgical approaches. A systematic review of randomized controlled studies published from January 2006 to June 2016 was performed. Ten articles comparing combined restorative surgical approaches to surgery alone were included. Both the procedures showed similar outcomes in term of root coverage but the combined restorative surgical approach achieved better result in the reduction of dentin hypersensitivity. In combined restorative surgical treatments, resin-modified glass ionomers showed better antimicrobial properties but poorer esthetic outcome than resin composites. Data to support or refute definitely the interest of combined approaches for the treatment of gingival recessions associated with noncarious cervical lesions are limited. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. A class discovery and class prediction approach to histopathological classification of mammographic screen detected columnar cell lesions of the breast.

    Science.gov (United States)

    Pathmanathan, Nirmala; Salisbury, Elizabeth L; Provan, Pamela J; Bilous, A Michael; Byth, Karen; Milliken, Jane S; Clarke, Christine L; Balleine, Rosemary L

    2010-01-01

    Columnar cell lesions (CCLs) of the breast have been increasingly recognised in biopsies taken to investigate mammographic screen detected microcalcification. The aim of this study was to identify distinct CCL subtypes by systematic analysis of histopathology. Hierarchical cluster analysis was performed based on the profile of histopathological features in 102 screen detected CCLs. Features assessed included nuclear morphology, acinar dilatation, epithelial cell hyperplasia, cell crowding, apical snout formation and intraluminal secretion. The stability of this classification was tested in an independent cohort of 32 cases. The histopathology of screen detected CCLs was extremely variable. Hierarchical cluster analysis identified two subclasses: Class 1 (34/102, 33%) characterised by absence of nuclear atypia and less pronounced hyperplasia; and Class 2 (68/102, 67%) that were generally more atypical. Ki-67 scores were significantly lower for Class 1 CCLs (p Class 1 cases were clearly distinguished from Class 2, indicating that these were stable phenotypes amongst screen detected CCLs. The histopathological features of CCLs diagnosed at screening are extremely heterogeneous. Using a systematic approach, we have devised a broad classification system that delineates a category of less atypical CCLs that could form a basis for future studies.

  6. Improving B mode ultrasound evaluation of breast lesions with real-time ultrasound elastography--a clinical approach.

    Science.gov (United States)

    Tan, S M; Teh, H S; Mancer, J F Kent; Poh, W T

    2008-06-01

    Ultrasound elastography using the extended combined auto-correlation method of tissue elasticity allows for real-time strain image visualisation using a free-hand probe with concurrent conventional B mode imaging. Four hundred and fifteen consecutive women with 550 breast lesions confirmed on B mode ultrasound were assessed with elastography using the elasticity score. There were 119 malignant and 431 benign lesions. The elastography sensitivity was 78.0%, specificity was 98.5% and overall accuracy was 93.8%. The median score for malignancy was 5 and that for benign lesions was 2. There was good correlation with B mode BIRADS category. 98.6% of lesions with an elasticity score of 2 or below (95%CI=96.8-99.4) were benign. BIRADS 3 lesions with an elasticity score of 2 or below may be re-classified as BIRADS 2 lesions. We found that 15.3% of BIRADS 2 and 3 lesions with an elasticity score of 3 were malignant. Real-time ultrasound elastography is user-friendly with a high accuracy rate, thereby improving B mode ultrasound assessment.

  7. MALDI imaging mass spectrometry analysis-A new approach for protein mapping in multiple sclerosis brain lesions.

    Science.gov (United States)

    Maccarrone, Giuseppina; Nischwitz, Sandra; Deininger, Sören-Oliver; Hornung, Joachim; König, Fatima Barbara; Stadelmann, Christine; Turck, Christoph W; Weber, Frank

    2017-03-15

    Multiple sclerosis is a disease of the central nervous system characterized by recurrent inflammatory demyelinating lesions in the early disease stage. Lesion formation and mechanisms leading to lesion remyelination are not fully understood. Matrix Assisted Laser Desorption Ionisation Mass Spectrometry imaging (MALDI-IMS) is a technology which analyses proteins and peptides in tissue, preserves their spatial localization, and generates molecular maps within the tissue section. In a pilot study we employed MALDI imaging mass spectrometry to profile and identify peptides and proteins expressed in normal-appearing white matter, grey matter and multiple sclerosis brain lesions with different extents of remyelination. The unsupervised clustering analysis of the mass spectra generated images which reflected the tissue section morphology in luxol fast blue stain and in myelin basic protein immunohistochemistry. Lesions with low remyelination extent were defined by compounds with molecular weight smaller than 5300Da, while more completely remyelinated lesions showed compounds with molecular weights greater than 15,200Da. An in-depth analysis of the mass spectra enabled the detection of cortical lesions which were not seen by routine luxol fast blue histology. An ion mass, mainly distributed at the rim of multiple sclerosis lesions, was identified by liquid chromatography and tandem mass spectrometry as thymosin beta-4, a protein known to be involved in cell migration and in restorative processes. The ion mass of thymosin beta-4 was profiled by MALDI imaging mass spectrometry in brain slides of 12 multiple sclerosis patients and validated by immunohistochemical analysis. In summary, our results demonstrate the ability of the MALDI-IMS technology to map proteins within the brain parenchyma and multiple sclerosis lesions and to identify potential markers involved in multiple sclerosis pathogenesis and/or remyelination. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Surgical approach for minimal breast lesions in the material of the center, using preoperative insertion of metal identification wire

    International Nuclear Information System (INIS)

    Waltzer, I; Kroupa, K.; Cierny, R.; Palacka, P.; Puskarova, E.; Torok, A.; Osifova, O.; Laukova, T.; Bella, V.; Simova, A.

    2006-01-01

    In the pursuit of the detection of early subclinical forms of breast cancer, and with regard to the advancement in screening programs, the wire-guided excision is irreplaceable in the diagnostic and therapy of benign and malignant breast lesions. In the 15-year period (1. 1. 1991 - 31. 12. 2005) we have performed surgery on 21 826 patients. 7 845 (35,9 %) of them were surgically treated for breast disease, including patients (311 cases) with other operation (secondary suture, surgery for infection, debridement...). 3 383 patients were treated for benign, 4 151 for malignant lesions. Out of the total of 7 534 patients, 6 332 (84,0 %) were treated for palpable lesions, 1 202 (16,0 %) for non-palpable lesions, with the localization needle. In this article we present the analysis of clinical material of the Clinic of surgery of the National Oncological Institute (NOU). (author)

  9. Evaluation of colonic lesions and pitfalls in CT colonography: A systematic approach based on morphology, attenuation and mobility

    International Nuclear Information System (INIS)

    Mang, Thomas; Gryspeerdt, Stefaan; Schima, Wolfgang; Lefere, Philippe

    2013-01-01

    Computed tomographic colonography is a reliable technique for the detection and classification of neoplastic and non-neoplastic lesions of the colon. It is based on a thin-section CT dataset of the cleansed and air-distended colon, acquired in prone and supine position. Two-dimensional and 3D projections are used in combination for image interpretation. The evaluation of CT colonography datasets is based on two steps, lesion perception to detect a polyp candidate and image interpretation to correctly characterize colonic filling defects. A thorough knowledge of the morphologic and attenuation characteristics of common colonic lesions and artifacts facilitates characterization of the findings. The purpose of this review article is to give an overview of the key CT colonographic imaging criteria to correctly characterize common colorectal lesions and to identify typical pitfalls and pseudolesions

  10. Blue lesions.

    Science.gov (United States)

    Longo, Caterina; Scope, Alon; Lallas, Aimilios; Zalaudek, Iris; Moscarella, Elvira; Gardini, Stefano; Argenziano, Giuseppe; Pellacani, Giovanni

    2013-10-01

    Blue color is found in a wide range of malignant and benign melanocytic and nonmelanocytic lesions and in lesions that result from penetration of exogenous materials, such as radiation or amalgam tattoo or traumatic penetration of particles. Discriminating between different diagnostic entities that display blue color relies on careful patient examination and lesion assessment. Dermoscopically, the extent, distribution, and patterns created by blue color can help diagnose lesions with specificity and differentiate between benign and malignant entities. This article provides an overview of the main diagnoses whereby blue color can be found, providing simple management rules for these lesions. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Robot-assisted total mesorectal excision for rectal cancer: case-matched comparison of short-term surgical and functional outcomes between the da Vinci Xi and Si.

    Science.gov (United States)

    Morelli, Luca; Di Franco, Gregorio; Guadagni, Simone; Rossi, Leonardo; Palmeri, Matteo; Furbetta, Niccolò; Gianardi, Desirée; Bianchini, Matteo; Caprili, Giovanni; D'Isidoro, Cristiano; Mosca, Franco; Moglia, Andrea; Cuschieri, Alfred

    2018-02-01

    Robotic rectal resection with da Vinci Si has some technical limitations, which could be overcome by the new da Vinci Xi. We compare short-term surgical and functional outcomes following robotic rectal resection with total mesorectal excision for cancer, with the da Vinci Xi (Xi-RobTME group) and the da Vinci Si (Si-RobTME group). The first consecutive 30 Xi-RobTME were compared with a Si-RobTME control group of 30 patients, selected using a one-to-one case-matched methodology from our prospectively collected Institutional database, comprising all cases performed between April 2010 and September 2016 by a single surgeon. Perioperative outcomes were compared. The impact of minimally invasive TME on autonomic function and quality of life was analyzed with specific questionnaires. The docking and overall operative time were shorter in the Xi-RobTME group (p  25 kg/m 2 was necessary in ten patients (45 vs. 0%, p < 0.001) and in six patients (37 vs. 0%, p < 0.05), in the Si-RobTME and Xi-RobTME groups, respectively. There were no differences in conversion rate, mean hospital stay, pathological data, and in functional outcomes between the two groups before and at 1 year after surgery. The technical advantages offered by the da Vinci Xi seem to be mainly associated with a shorter docking and operative time and with superior ability to perform a fully-robotic approach. Clinical and functional outcomes seem not to be improved, with the introduction of the new Xi platform.

  12. Length of stay variations between rural and urban patients with acute myeloid leukemia: a case-matched study.

    Science.gov (United States)

    Heinz, Sean J; Milliken, Sam

    2013-06-01

    Keeping patients in hospital longer than medically necessary is costly and occupies resources that could be better utilised. If patients from regional areas remain in hospital longer because of logistical issues such as transport and accommodation, then there is an argument for establishing or expanding appropriate medical services for rural areas. However, if the length of stay (LOS) for rural and urban patients is similar, it could be surmised that current logistic services appropriately meet demand. This study reviews the cases of 40 patients with acute myeloid leukemia. This disease was selected as patients are generally required to travel to a metropolitan hospital for treatment, regardless of location. Twenty patients resided within the Sydney metropolitan area and 20 lived in rural New South Wales. Each of the 20 metropolitan patients were case-matched (1:1) with 20 rural patients with reference to sex, specific acute myeloid leukemia subtype (by World Health Organisation ICD-10 classification), and age. Following statistical non-parametric (t-test) analysis, rural and urban medians were found to be very similar with a high t-value and small mean (urban median=29, rural median=29.5, t-value=0.722, m=-0.95, s.d.=15.236, two-tailed P=0.789, 95% CI=-7.89, 5.99). This demonstrates that there was no statistically significant difference between mean LOS for rural or urban patients after case-matching, a conclusion supported by qualitative analysis of the data. Logistical issues are therefore unlikely to keep rural patients with AML in hospital beyond their immediate medical treatment. What is known about this topic? A United States-based study found that LOS in hospital for rural patients with human immunodeficiency virus was one-third longer than for urban patients across each of the 6 years analysed (from 1998 to 2003). However it was noted that after adjusting for covariates such as age and sex, differences between LOS for rural and urban residents were not of

  13. Comparing oncoplastic breast conserving surgery with mastectomy and immediate breast reconstruction: Case-matched patient reported outcomes.

    Science.gov (United States)

    Kelsall, Jennett E; McCulley, Stephen J; Brock, Lisa; Akerlund, Malin T E; Macmillan, R Douglas

    2017-10-01

    Oncoplastic breast conserving surgery (OBCS) allows women who may otherwise have mastectomy and immediate reconstruction (MxIR) the choice to conserve their breast yet avoid deformity. We compared the outcome of these options. Two cohorts meeting study criteria were identified from prospectively audited series of women undergoing OBCS or MxIR. After case matching for age, tumour size and date of surgery, stratification by breast size and controlling for radiotherapy; body image scale (BIS) scores of psychosocial function and patient reported outcome measures (PROMs) for breast appearance and return to function were analysed. A total of 567 women (286 treated by OBCS and 281 by MxIR) fulfilled inclusion criteria. Demographics were similar between the two unmatched cohorts, except for radiotherapy, age and tumour size (all p breast appearance, return to work and function (all p breasts treated by OBCS reported better BIS scores (mean 3.30 vs. 5.37, p = 0.011) and self-rated breast appearance score (p breasts. BIS and appearance favoured OBCS, regardless of whether radiotherapy would have been avoided if treated by MxIR. OBCS offers suitable women the option to avoid MxIR while providing faster recovery. Better psychosocial and self-rated satisfaction with breast appearance is achieved for OBCS in all groups, regardless of the need for radiotherapy, apart from those women with smaller breasts for whom the results are comparable. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. A purely functional Imaging based approach for transcortical resection of lesion involving the dominant atrium: Towards safer, imaging-guided, tailored cortico-leucotomies.

    Science.gov (United States)

    Frati, Alessandro; Pesce, Alessandro; D'Andrea, Giancarlo; Fraschetti, Flavia; Salvati, Maurizio; Cimatti, Marco; Esposito, Vincenzo; Raco, Antonino

    2018-04-01

    The Dominant Atrium (DA) is a crossroad of eloquent white matter bundles difficult to preserve with a standard "anatomical" approach. The aim of this work is to evaluate the results of a cohort of patients who underwent surgery with the aid of a purely functional MRI and DTI-based approach. 43 patients suffering from lesions involving the DA have been included in the final cohort and studied in regards to quality of life (KPS); a special attention was lent on the incidence of new or worsening of preexisting neurological deficits, with a focus on motor, visual and speech disturbances after the surgical treatment. Patient, surgery and lesion-related data were recorded to identify the relationships with outcome. Eloquent areas fMRI and the course of Arcuate Fasciculus (AF), Inferior frontooccipital fasciculus (IFOF), Optic radiation (OR) and corticospinal tract (CST) have been investigated with preoperative MRI sequences and DTI reconstruction. The final cohort consisted of 43 patients, 19 males and 24 females; average age was 56.8 years. We recorded 9 transient and 3 permanent postoperative deficits, only one of those was caused by an edema interference with DTI reconstruction. Preoperative functional status, histology and volume of the lesion proved to be independent factors affecting results. A purely functional surgical approach to the DA provided promising preliminary results. A direct DTI-fMRI visualization of the eloquent structures proximal to DA allows surgeon to conceive an ultra-precise and "tailored" cortico-leucotomy for an optimal exposure of the lesion. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Segmentation of Brain Lesions in MRI and CT Scan Images: A Hybrid Approach Using k-Means Clustering and Image Morphology

    Science.gov (United States)

    Agrawal, Ritu; Sharma, Manisha; Singh, Bikesh Kumar

    2018-01-01

    Manual segmentation and analysis of lesions in medical images is time consuming and subjected to human errors. Automated segmentation has thus gained significant attention in recent years. This article presents a hybrid approach for brain lesion segmentation in different imaging modalities by combining median filter, k means clustering, Sobel edge detection and morphological operations. Median filter is an essential pre-processing step and is used to remove impulsive noise from the acquired brain images followed by k-means segmentation, Sobel edge detection and morphological processing. The performance of proposed automated system is tested on standard datasets using performance measures such as segmentation accuracy and execution time. The proposed method achieves a high accuracy of 94% when compared with manual delineation performed by an expert radiologist. Furthermore, the statistical significance test between lesion segmented using automated approach and that by expert delineation using ANOVA and correlation coefficient achieved high significance values of 0.986 and 1 respectively. The experimental results obtained are discussed in lieu of some recently reported studies.

  16. Segmentation of Brain Lesions in MRI and CT Scan Images: A Hybrid Approach Using k-Means Clustering and Image Morphology

    Science.gov (United States)

    Agrawal, Ritu; Sharma, Manisha; Singh, Bikesh Kumar

    2018-04-01

    Manual segmentation and analysis of lesions in medical images is time consuming and subjected to human errors. Automated segmentation has thus gained significant attention in recent years. This article presents a hybrid approach for brain lesion segmentation in different imaging modalities by combining median filter, k means clustering, Sobel edge detection and morphological operations. Median filter is an essential pre-processing step and is used to remove impulsive noise from the acquired brain images followed by k-means segmentation, Sobel edge detection and morphological processing. The performance of proposed automated system is tested on standard datasets using performance measures such as segmentation accuracy and execution time. The proposed method achieves a high accuracy of 94% when compared with manual delineation performed by an expert radiologist. Furthermore, the statistical significance test between lesion segmented using automated approach and that by expert delineation using ANOVA and correlation coefficient achieved high significance values of 0.986 and 1 respectively. The experimental results obtained are discussed in lieu of some recently reported studies.

  17. Conduction of reparative dentin: A pulp protecting approach by indirect pulp capping in deep carious lesion with biodentine

    Directory of Open Access Journals (Sweden)

    Rafeza Sultana

    2016-12-01

    Full Text Available This case report represents, the treatment of deep carious lesion in a male was done by using indirect pulp capping with biodentine. The clinical and radiological outcomes were evaluated. The patient was presented with mild to moderate sensitivity on thermal (cold stimulation and discomfort associated with eating in the left mandibular first molar. The clinico–radiographical examination revealed a disto–occlusal carious lesion, very close to the pulp, absence of radiolucencies in the periapical region and no periodontal space widening. Pulp sensitivity was confirmed by thermal pulp vitality test. Indirect pulp capping treatment was performed with biodentine. Following 6 months of the treatment, the clinical symptoms were resolved and a calcific bridge was found at the dentin over the pulp and biodentine interface that was indicative the evidence of reparative dentin formation.

  18. Surgical approaches to complex vascular lesions: the use of virtual reality and stereoscopic analysis as a tool for resident and student education.

    Science.gov (United States)

    Agarwal, Nitin; Schmitt, Paul J; Sukul, Vishad; Prestigiacomo, Charles J

    2012-08-01

    Virtual reality training for complex tasks has been shown to be of benefit in fields involving highly technical and demanding skill sets. The use of a stereoscopic three-dimensional (3D) virtual reality environment to teach a patient-specific analysis of the microsurgical treatment modalities of a complex basilar aneurysm is presented. Three different surgical approaches were evaluated in a virtual environment and then compared to elucidate the best surgical approach. These approaches were assessed with regard to the line-of-sight, skull base anatomy and visualisation of the relevant anatomy at the level of the basilar artery and surrounding structures. Overall, the stereoscopic 3D virtual reality environment with fusion of multimodality imaging affords an excellent teaching tool for residents and medical students to learn surgical approaches to vascular lesions. Future studies will assess the educational benefits of this modality and develop a series of metrics for student assessments.

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Javier Benezet

    2016-01-01

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

  1. Axillary nerve lesions after open reduction and internal fixation of proximal humeral fractures through an extended lateral deltoid-split approach: electrophysiological findings.

    Science.gov (United States)

    Westphal, Thomas; Woischnik, Stephan; Adolf, Daniela; Feistner, Helmut; Piatek, Stefan

    2017-03-01

    Axillary nerve injuries after shoulder surgery are rare. In most studies, the frequency of injury is usually determined using clinical examinations, but results from intraoperative neuromonitoring studies have revealed higher than expected rates. Few studies have investigated this topic. Our aim was to determine the frequency of axillary nerve lesions after open reduction and internal fixation of proximal humeral fractures by using electrophysiological assessments and to provide a review of the relevant literature. This was a retrospective cohort study of 76 consecutive patients who received open reduction and internal fixation of a proximal humeral fracture using a locking plate through a deltoid-splitting approach. We performed a clinical and electrophysiological examination at a minimum follow-up time of 12 months. Functional results were assessed according to the Constant-Murley and Disabilities of the Arm, Shoulder and Hand scores. Electrophysiological examinations comprised electromyography, electroneurography, and motor and somatosensory evoked potentials. The main outcome was the frequency of axillary nerve lesions. Forty patients were monitored for an average of 28 months. The mean raw Constant-Murley score was 61 points, the age- and gender-adjusted score was 71%, and the mean Disabilities of the Arm, Shoulder and Hand score was 33 points. Neurapraxia occurred in 1 patient, axonotmesis with incomplete reinnervation occurred in 3, and complete reinnervation occurred in 3. The latter group was classified as having a temporary axillary nerve lesion. The 10% rate of permanent axillary nerve lesions in our cohort is higher than expected based on the clinical examination. Electrophysiological assessment is therefore more appropriate to detect axillary nerve injuries. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  2. Pink lesions.

    Science.gov (United States)

    Giacomel, Jason; Zalaudek, Iris

    2013-10-01

    Dermoscopy (dermatoscopy or surface microscopy) is an ancillary dermatologic tool that in experienced hands can improve the accuracy of diagnosis of a variety of benign and malignant pigmented skin tumors. The early and more accurate diagnosis of nonpigmented, or pink, tumors can also be assisted by dermoscopy. This review focuses on the dermoscopic diagnosis of pink lesions, with emphasis on blood vessel morphology and pattern. A 3-step algorithm is presented, which facilitates the timely and more accurate diagnosis of pink tumors and subsequently guides the management for such lesions. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. The Aortic Bifurcation Angle as a Factor in Application of the Outback for Femoropopliteal Lesions in Ipsilateral Versus Contralateral Approaches.

    Science.gov (United States)

    Raskin, Daniel; Khaitovich, Boris; Balan, Shmuel; Silverberg, Daniel; Halak, Moshe; Rimon, Uri

    2018-01-01

    To assess the technical success of the Outback reentry device in contralateral versus ipsilateral approaches for femoropopliteal arterial occlusion. A retrospective review of patients treated for critical limb ischemia (CLI) using the Outback between January 2013 and July 2016 was performed. Age, gender, length and site of the occlusion, approach site, aortic bifurcation angle, and reentry site were recorded. Calcification score was assigned at both aortic bifurcation and reentry site. Technical success was assessed. During the study period, a total of 1300 endovascular procedures were performed on 489 patients for CLI. The Outback was applied on 50 femoropopliteal chronic total occlusions. Thirty-nine contralateral and 11 ipsilateral antegrade femoral were accessed. The device was used successfully in 41 patients (82%). There were nine failures, all in the contralateral approach group. Six due to inability to deliver the device due to acute aortic bifurcation angle and three due to failure to achieve luminal reentry. Procedural success was significantly affected by the aortic bifurcation angle (p = 0.013). The Outback has high technical success rates in treatment of femoropopliteal occlusion, when applied from either an ipsi- or contralateral approach. When applied in contralateral access, acute aortic bifurcation angle predicts procedural failure.

  4. Convergence of interoception, emotion, and social cognition: A twofold fMRI meta-analysis and lesion approach.

    Science.gov (United States)

    Adolfi, Federico; Couto, Blas; Richter, Fabian; Decety, Jean; Lopez, Jessica; Sigman, Mariano; Manes, Facundo; Ibáñez, Agustín

    2017-03-01

    Guided by indirect evidence, recent approaches propose a tripartite crosstalk among interoceptive signaling, emotional regulation, and low-level social cognition. Here we examined the neurocognitive convergence of such domains. First, we performed three meta-analyses of functional magnetic resonance imaging studies to identify which areas are consistently coactivated by these three systems. Multi-level Kernel Density Analysis (MKDA) revealed major overlaps in the right anterior insular and frontotemporal regions (viz., the orbitofrontal and inferior frontal gyri, the amygdala, and mid temporal lobe/subcortical structures). Second, we explored such domains in patients with fronto-insulo-temporal damage. Relative to controls, the patients showed behavioral impairments of interoception, emotional processing, and social cognition, with preservation of other cognitive functions. Convergent results from both studies offer direct support for a model of insular-frontotemporal regions integrating interoception, emotion, and social cognition. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Canadian Optically-guided approach for Oral Lesions Surgical (COOLS trial: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Poh Catherine F

    2011-10-01

    Full Text Available Abstract Background Oral cancer is a major health problem worldwide. The 5-year survival rate ranges from 30-60%, and has remained unchanged in the past few decades. This is mainly due to late diagnosis and high recurrence of the disease. Of the patients who receive treatment, up to one third suffer from a recurrence or a second primary tumor. It is apparent that one major cause of disease recurrence is clinically unrecognized field changes which extend beyond the visible tumor boundary. We have previously developed an approach using fluorescence visualization (FV technology to improve the recognition of the field at risk surrounding a visible oral cancer that needs to be removed and preliminary results have shown a significant reduction in recurrence rates. Method/Design This paper describes the study design of a randomized, multi-centre, double blind, controlled surgical trial, the COOLS trial. Nine institutions across Canada will recruit a total of 400 patients with oral severe dysplasia or carcinoma in situ (N = 160 and invasive squamous cell carcinoma (N = 240. Patients will be stratified by participating institution and histology grade and randomized equally into FV-guided surgery (experimental arm or white light-guided surgery (control arm. The primary endpoint is a composite of recurrence at or 1 cm within the previous surgery site with 1 the same or higher grade histology compared to the initial diagnosis (i.e., the diagnosis used for randomization; or 2 further treatment due to the presence of severe dysplasia or higher degree of change at follow-up. This is the first randomized, multi-centre trial to validate the effectiveness of the FV-guided surgery. Discussion In this paper we described the strategies, novelty, and challenges of this unique trial involving a surgical approach guided by the FV technology. The success of the trial requires training, coordination, and quality assurance across multiple sites within Canada. The COOLS

  6. Canadian Optically-guided approach for Oral Lesions Surgical (COOLS) trial: study protocol for a randomized controlled trial

    International Nuclear Information System (INIS)

    Poh, Catherine F; Durham, J Scott; Brasher, Penelope M; Anderson, Donald W; Berean, Kenneth W; MacAulay, Calum E; Lee, J Jack; Rosin, Miriam P

    2011-01-01

    Oral cancer is a major health problem worldwide. The 5-year survival rate ranges from 30-60%, and has remained unchanged in the past few decades. This is mainly due to late diagnosis and high recurrence of the disease. Of the patients who receive treatment, up to one third suffer from a recurrence or a second primary tumor. It is apparent that one major cause of disease recurrence is clinically unrecognized field changes which extend beyond the visible tumor boundary. We have previously developed an approach using fluorescence visualization (FV) technology to improve the recognition of the field at risk surrounding a visible oral cancer that needs to be removed and preliminary results have shown a significant reduction in recurrence rates. This paper describes the study design of a randomized, multi-centre, double blind, controlled surgical trial, the COOLS trial. Nine institutions across Canada will recruit a total of 400 patients with oral severe dysplasia or carcinoma in situ (N = 160) and invasive squamous cell carcinoma (N = 240). Patients will be stratified by participating institution and histology grade and randomized equally into FV-guided surgery (experimental arm) or white light-guided surgery (control arm). The primary endpoint is a composite of recurrence at or 1 cm within the previous surgery site with 1) the same or higher grade histology compared to the initial diagnosis (i.e., the diagnosis used for randomization); or 2) further treatment due to the presence of severe dysplasia or higher degree of change at follow-up. This is the first randomized, multi-centre trial to validate the effectiveness of the FV-guided surgery. In this paper we described the strategies, novelty, and challenges of this unique trial involving a surgical approach guided by the FV technology. The success of the trial requires training, coordination, and quality assurance across multiple sites within Canada. The COOLS trial, an example of translational research, may result in

  7. EMD-DWT based transform domain feature reduction approach for quantitative multi-class classification of breast lesions.

    Science.gov (United States)

    Ara, Sharmin R; Bashar, Syed Khairul; Alam, Farzana; Hasan, Md Kamrul

    2017-09-01

    Using a large set of ultrasound features does not necessarily ensure improved quantitative classification of breast tumors; rather, it often degrades the performance of a classifier. In this paper, we propose an effective feature reduction approach in the transform domain for improved multi-class classification of breast tumors. Feature transformation methods, such as empirical mode decomposition (EMD) and discrete wavelet transform (DWT), followed by a filter- or wrapper-based subset selection scheme are used to extract a set of non-redundant and more potential transform domain features through decorrelation of an optimally ordered sequence of N ultrasonic bi-modal (i.e., quantitative ultrasound and elastography) features. The proposed transform domain bi-modal reduced feature set with different conventional classifiers will classify 201 breast tumors into benign-malignant as well as BI-RADS⩽3, 4, and 5 categories. For the latter case, an inadmissible error probability is defined for the subset selection using a wrapper/filter. The classifiers use train truth from histopathology/cytology for binary (i.e., benign-malignant) separation of tumors and then bi-modal BI-RADS scores from the radiologists for separating malignant tumors into BI-RADS category 4 and 5. A comparative performance analysis of several widely used conventional classifiers is also presented to assess their efficacy for the proposed transform domain reduced feature set for classification of breast tumors. The results show that our transform domain bimodal reduced feature set achieves improvement of 5.35%, 3.45%, and 3.98%, respectively, in sensitivity, specificity, and accuracy as compared to that of the original domain optimal feature set for benign-malignant classification of breast tumors. In quantitative classification of breast tumors into BI-RADS categories⩽3, 4, and 5, the proposed transform domain reduced feature set attains improvement of 3.49%, 9.07%, and 3.06%, respectively, in

  8. Accurate Depth of Radiofrequency-Induced Lesions in Renal Sympathetic Denervation Based on a Fine Histological Sectioning Approach in a Porcine Model.

    Science.gov (United States)

    Sakaoka, Atsushi; Terao, Hisako; Nakamura, Shintaro; Hagiwara, Hitomi; Furukawa, Toshihito; Matsumura, Kiyoshi; Sakakura, Kenichi

    2018-02-01

    Ablation lesion depth caused by radiofrequency-based renal denervation (RDN) was limited to radiofrequency-RDN cannot ablate a substantial percentage of renal sympathetic nerves. We aimed to define the true lesion depth achieved with radiofrequency-RDN using a fine sectioning method and to investigate biophysical parameters that could predict lesion depth. Radiofrequency was delivered to 87 sites in 14 renal arteries from 9 farm pigs at various ablation settings: 2, 4, 6, and 9 W for 60 seconds and 6 W for 120 seconds. Electric impedance and electrode temperature were recorded during ablation. At 7 days, 2470 histological sections were obtained from the treated arteries. Maximum lesion depth increased at 2 to 6 W, peaking at 6.53 (95% confidence interval, 4.27-8.78) mm under the 6 W/60 s condition. It was not augmented by greater power (9 W) or longer duration (120 seconds). There were statistically significant tendencies at 6 and 9 W, with higher injury scores in the media, nerves, arterioles, and fat. Maximum lesion depth was positively correlated with impedance reduction and peak electrode temperature (Pearson correlation coefficients were 0.59 and 0.53, respectively). Lesion depth was 6.5 mm for radiofrequency-RDN at 6 W/60 s. The impedance reduction and peak electrode temperature during ablation were closely associated with lesion depth. Hence, these biophysical parameters could provide prompt feedback during radiofrequency-RDN procedures in the clinical setting. © 2018 The Authors.

  9. Outcomes and prognostic factors for squamous cell carcinoma of the oral tongue in young adults: a single-institution case-matched analysis.

    Science.gov (United States)

    Blanchard, Pierre; Belkhir, Farid; Temam, Stéphane; El Khoury, Clément; De Felice, Francesca; Casiraghi, Odile; Patrikidou, Anna; Mirghani, Haitham; Levy, Antonin; Even, Caroline; Gorphe, Philippe; Nguyen, France; Janot, François; Tao, Yungan

    2017-03-01

    There is controversy regarding prognosis and treatment of young patients with oral cavity cancer compared to their older counterparts. We conducted a retrospective case-matched analysis of all adult patients younger than 40 years and treated at our institution for a squamous cell carcinoma of the oral cavity. Only non-metastatic adult patients (age >18) with oral tongue cancer were eventually included and matched 1:1 with patients over 40 years of age, at least 20 years older than the cases, with same T and N category and treatment period. Sixty-three patients younger than 40 had an oral cavity squamous cell cancer out of which 57 had an oral tongue primary during the period 1999-2012, and 50 could be matched with an older control. No difference could be seen between younger and older patients with regard to overall, cancer-specific, or progression-free survival. The patterns of failure were similar, although in young patients, almost all failures occurred during the first 2 years following treatment. Although overall survival shows a trend toward lower survival in older patients, cancer-specific survival and analysis of pattern failure suggest that disease prognosis is similar between young and older adults with oral tongue cancer. Further work is needed to identify the younger patients with poorer prognosis who overwhelmingly fail during the first year after treatment and could benefit from treatment intensification. Until then, young adults ought to be treated using standard guidelines.

  10. Should fine needle aspiration biopsy be the first pathological investigation in the diagnosis of a bone lesion? An algorithmic approach with review of literature

    Directory of Open Access Journals (Sweden)

    Mehrotra Ravi

    2007-01-01

    Full Text Available Abstract Background Fine needle aspiration biopsy (FNAB is gaining increasing popularity in the diagnosis of musculoskeletal lesions; and in many patients, a definitive diagnosis can be rendered from aspiration smears alone. Its applicability in bone pathology, however, has been controversial due to a high percentage of inadequate smears, difficulty in evaluation of tissue architecture and nonspecific results in the diagnosis of primary bone lesions. In this study, the value of aspiration as the first pathological investigation in the diagnosis of a bone lesion was evaluated. Methods 91 cases of clinically suspected cases of bone lesions were aspirated over a period of two years. Direct or cytospin smears were fixed in 95% alcohol and stained by Hematoxylin and Eosin or air-dried and later fixed in methanol for May Grŭnwald Giemsa staining. Results Of the 91 patients who were subjected to FNAB, 81 were considered satisfactory and 10.9 % (10 were inadequateinconclusive for diagnosis. Cyto-histological concordance was obtained in 78.5 % (51/65 patients. Positive and negative predictive values were 87.5% and 97.2 % respectively. Sensitivity as a preliminary diagnostic technique was 93.3%, whereas specificity was 94.5 %. Overall, diagnostic accuracy was 94.2 %. Metastatic lesions were detected with 100% accuracy. Two cases were reported as false positive and one case as false negative. Conclusion Cytology provides valuable information to the clinician to make an informed decision regarding appropriate therapy. We conclude that time-consuming and costly investigations may be reduced by choosing FNAB as the initial pathological diagnostic method for skeletal lesions of unknown origin. The choice of radiological examinations, laboratory tests and surgical biopsies can be determined after the FNAB diagnosis.

  11. Self-Inflicted Lesions in Dermatology: A Management and Therapeutic Approach - A Position Paper From the European Society for Dermatology and Psychiatry

    NARCIS (Netherlands)

    Tomas-Aragones, Lucia; Consoli, Silla M.; Consoli, Sylvie G.; Poot, Francoise; Taube, Klaus-Michael; Linder, M. Dennis; Jemec, Gregor B. E.; Szepietowski, Jacek C.; de Korte, John; Lvov, Andrey; Gieler, Uwe

    2017-01-01

    The classification of self-inflicted skin lesions proposed by the European Society for Dermatology and Psychiatry (ESDaP) group generated questions with regard to specific treatments that could be recommended for such cases. The therapeutic guidelines in the current paper integrate new

  12. Self-Inflicted Lesions in Dermatology: A Management and TherapeuticApproach - A Position Paper From the European Society for Derma-tology and Psychiatry.

    Science.gov (United States)

    Tomas-Aragones, Lucía; Consoli, Silla M; Consoli, Sylvie G; Poot, Francoise; Taube, Klaus-Michael; Linder, M Dennis; Jemec, Gregor B E; Szepietowski, Jacek C; de Korte, John; Lvov, Andrey N; Gieler, Uwe

    2017-02-08

    The classification of self-inflicted skin lesions proposed by the European Society for Dermatology and Psychiatry (ESDaP) group generated questions with regard to specific treatments that could be recommended for such cases. The therapeutic guidelines in the current paper integrate new psychotherapies and psychotropic drugs without forgetting the most important relational characteristics required for dealing with people with these disorders. The management of self-inflicted skin lesions necessitates empathy and a doctor-patient relationship based on trust and confidence. Cognitive behavioural therapy and/or psychodynamic and psychoanalytic psychotherapy (alone, or combined with the careful use of psychotropic drugs) seem to achieve the best results in the most difficult cases. Relatively new therapeutic techniques, such as habit reversal and mentalization-based psychotherapy, may be beneficial in the treatment of skin picking syndromes.

  13. Mesenchymal breast lesions

    International Nuclear Information System (INIS)

    Schickman, R.; Leibman, A.J.; Handa, P.; Kornmehl, A.; Abadi, M.

    2015-01-01

    Mesenchymal breast lesions encompass a variety of breast diseases. Many of these lesions are rare with only a few case reports in the literature. This article reviews the imaging findings of selected mesenchymal breast lesions, their clinical presentations and method of diagnosis. Mesenchymal lesions are diverse and include haemangioma, granular cell tumour, myofibroblastoma, fibromatosis, pseudoangiomatous stromal hyperplasia, and malignant fibrous histiocytoma. It is important for radiologists to be aware of these lesions as some of them may have malignant potential or demonstrate imaging features that overlap with other malignant lesions

  14. Detection of tumoral lesions in the posterior fossa, in brain computerized tomography scans for various conditions of acquiring a preliminary approach

    International Nuclear Information System (INIS)

    Perez, M.; Carvalho-Filho, A. E.; Khoury, H. J.; Casas, M. C.; Andrade, M. E.; Paz, J. E.

    2010-01-01

    The present work performs a study over 13 tomographic images, using an anthropomorphic head phantom. It contains small lesions in the posterior fossas. Tube current (I [mA]), slice thickness (E [mm], were the parameters changed among studies, looking for the best acquisition conditions, which permit good lesion detectability, and applying the lowest dose. Air Kerma in air [mGy] was calculated. Image quality was analyzed by both expert criterion and some merit figures. Two of them were global: contrasts to noise ratio (RCR [dB]) and signal to noise ratio (RSR). The rest of the measures used were relatives to the maximum dose condition: The gain in signal to noise ratio (SNR [dB]) and the maximum signal to noise ratio (PSNR [dB]), the normalized mean squared error (NMSE) and the structural similarity index (SSIM). Objective and subjective results were correlated. It is shown that it is possible to reduce the dose using lower values of mAs without affecting lesion detectability and keeping good image quality for the scanner used. An optimized protocol is also proposed for the technology used. (Author) 27 refs.

  15. Tumefactive demyelinating lesions

    International Nuclear Information System (INIS)

    Dagher, A.P.; Smirniotopoulos, J.; Armed Forces Inst. of Pathology, Washington, DC

    1996-01-01

    We studied 21 cases of pathologically confirmed tumefactive demyelinating lesions and reviewed the spectrum of tumefactive demyelinating lesions in the literature. Radiological features and clinical data were reviewed to characterize the lesions as consistent with a known demyelinating disease, most notably multiple sclerosis. Atypical clinical or radiological features (other than tumefaction) were noted. Most lesions were part of a clinical and/or radiological picture consistent with multiple sclerosis. No case strongly suggestive of variants or related diseases, such as Schilder's disease or Balo's concentric sclerosis, were found. There was one case suggestive of acute disseminated encephalomyelitis. Features which help distinguish the lesions from tumour are discussed. (orig.)

  16. Benign Jaw Lesions.

    Science.gov (United States)

    Gohel, Anita; Villa, Alessandro; Sakai, Osamu

    2016-01-01

    There are both odontogenic and nonodontogenic benign lesions in the maxilla and mandible. These lesions may have similar imaging features, and the key radiographic features are presented to help the clinician narrow the differential diagnosis and plan patient treatment. Both intraoral and panoramic radiographs and advanced imaging features are useful in assessing the benign lesions of the jaws. The location, margins, internal contents, and effects of the lesions on adjacent structures are important features in diagnosing the lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Tumefactive demyelinating lesions

    Energy Technology Data Exchange (ETDEWEB)

    Dagher, A.P. [Thomas Jefferson Univ. Hospital, Philadelphia, PA (United States). Div. of Neuroradiology; Smirniotopoulos, J. [Thomas Jefferson Univ. Hospital, Philadelphia, PA (United States). Div. of Neuroradiology]|[Armed Forces Inst. of Pathology, Washington, DC (United States). Dept. of Radiological Pathology

    1996-08-01

    We studied 21 cases of pathologically confirmed tumefactive demyelinating lesions and reviewed the spectrum of tumefactive demyelinating lesions in the literature. Radiological features and clinical data were reviewed to characterize the lesions as consistent with a known demyelinating disease, most notably multiple sclerosis. Atypical clinical or radiological features (other than tumefaction) were noted. Most lesions were part of a clinical and/or radiological picture consistent with multiple sclerosis. No case strongly suggestive of variants or related diseases, such as Schilder`s disease or Balo`s concentric sclerosis, were found. There was one case suggestive of acute disseminated encephalomyelitis. Features which help distinguish the lesions from tumour are discussed. (orig.)

  18. Periodontal bone lesions

    International Nuclear Information System (INIS)

    Linden, L.W.J. van der.

    1985-01-01

    In the course of life the periodontum is subject to changes which may be physiological or pathological. Intraoral radiographs give insight into the hard structures of the dentomaxillar region and provides information on lesions in the bone of the periodontum in that they show radiopacities and radiolucencies caused by such lesions. In this thesis the relation is investigated between the true shape and dimensions of periodontal bone lesions and their radiographic images. A method is developed and tested of making standardized and reproducible radiographs suitable for longitudinal studies of periodontal lesions. Also the possibility is demonstrated of an objective and reproducible interpretation of radiographic characteristics of periodontal bone lesions. (Auth.)

  19. Surgical approaches to complex vascular lesions: the use of virtual reality and stereoscopic analysis as a tool for resident and student education

    OpenAIRE

    Agarwal, Nitin; Schmitt, Paul J; Sukul, Vishad; Prestigiacomo, Charles J

    2012-01-01

    Virtual reality training for complex tasks has been shown to be of benefit in fields involving highly technical and demanding skill sets. The use of a stereoscopic three-dimensional (3D) virtual reality environment to teach a patient-specific analysis of the microsurgical treatment modalities of a complex basilar aneurysm is presented. Three different surgical approaches were evaluated in a virtual environment and then compared to elucidate the best surgical approach. These approaches were as...

  20. Lesion activity assessment

    DEFF Research Database (Denmark)

    Ekstrand, K R; Zero, D T; Martignon, S

    2009-01-01

    in response to cariogenic plaque as well as lesion arrest. Based on this understanding, different clinical scoring systems have been developed to assess the severity/depth and activity of lesions. A recent system has been devised by the International Caries Detection and Assessment System Committee......This chapter focusses on the probability of a caries lesion detected during a clinical examination being active (progressing) or arrested. Visual and tactile methods to assess primary coronal lesions and primary root lesions are considered. The evidence level is rated as low (R....... The literature suggests that there is a fair agreement between visual/tactile external scripts of caries and the severity/depth of the lesion. The reproducibility of the different systems is, in general, substantial. No single clinical predictor is able to reliably assess activity. However, a combination...

  1. Lesions of the Jaw.

    Science.gov (United States)

    Mosier, Kristine M

    2015-10-01

    Imaging of lesions within the maxilla and mandible is often fraught with difficulty owing to the similarity in the imaging appearance of a diverse array of pathological processes. Principally, lesions arise from either odontogenic sources or from primary bone lesions. The response of the cancellous and cortical bone to pathologic insult can be expressed either through an osteolytic or an osteoblastic response; thus the majority of lesions within the jaws can be classified as cystic or lytic appearing, sclerotic, or a mixture of the two. This article will review the imaging features of the most common cysts, fibro-osseous lesions, benign and malignant neoplasms, and highlight those features key to the differential diagnosis. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Associations between clinical outcome and navigated transcranial magnetic stimulation characteristics in patients with motor-eloquent brain lesions: a combined navigated transcranial magnetic stimulation-diffusion tensor imaging fiber tracking approach.

    Science.gov (United States)

    Sollmann, Nico; Wildschuetz, Noémie; Kelm, Anna; Conway, Neal; Moser, Tobias; Bulubas, Lucia; Kirschke, Jan S; Meyer, Bernhard; Krieg, Sandro M

    2018-03-01

    OBJECTIVE Navigated transcranial magnetic stimulation (nTMS) and diffusion tensor imaging fiber tracking (DTI FT) based on nTMS data are increasingly used for preoperative planning and resection guidance in patients suffering from motor-eloquent brain tumors. The present study explores whether nTMS-based DTI FT can also be used for individual preoperative risk assessment regarding surgery-related motor impairment. METHODS Data derived from preoperative nTMS motor mapping and subsequent nTMS-based tractography in 86 patients were analyzed. All patients suffered from high-grade glioma (HGG), low-grade glioma (LGG), or intracranial metastasis (MET). In this context, nTMS-based DTI FT of the corticospinal tract (CST) was performed at a range of fractional anisotropy (FA) levels based on an individualized FA threshold ([FAT]; tracking with 50%, 75%, and 100% FAT), which was defined as the highest FA value allowing for visualization of fibers (100% FAT). Minimum lesion-to-CST distances were measured, and fiber numbers of the reconstructed CST were assessed. These data were then correlated with the preoperative, postoperative, and follow-up status of motor function and the resting motor threshold (rMT). RESULTS At certain FA levels, a statistically significant difference in lesion-to-CST distances was observed between patients with HGG who had no impairment and those who developed surgery-related transient or permanent motor deficits (75% FAT: p = 0.0149; 100% FAT: p = 0.0233). In this context, no patient with a lesion-to-CST distance ≥ 12 mm suffered from any new surgery-related permanent paresis (50% FAT and 75% FAT). Furthermore, comparatively strong negative correlations were observed between the rMT and lesion-to-CST distances of patients with surgery-related transient paresis (Spearman correlation coefficient [r s ]; 50% FAT: r s = -0.8660; 75% FAT: r s = -0.8660) or surgery-related permanent paresis (50% FAT: r s = -0.7656; 75% FAT: r s = -0.6763). CONCLUSIONS

  3. Intraosseous osteolytic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Adler, C.P.; Wenz, W.

    1981-10-01

    Any pathological damage occurring in a bone will produce either an osteolytic or osteosclerotic lesion which can be seen in the macroscopic specimen as well as in the roentgenogram. Various bone lesions may lead to local destructions of the bone. An osteoma or osteoplastic osteosarcoma produces an osteosclerotic lesion showing a dense mass in the roentgenogram; a chondroblastoma or an osteoclastoma, on the other hand, induces an osteolytic focal lesion. This paper presents examples of different osteolytic lesions of the humerus. An osteolytic lesion seen in the roentgenogram may be either produced by an underlying non-ossifying fibroma of the bone, by fibrous dysplasia, osteomyelitis or Ewing's sarcoma. Differential diagnostic considerations based on the radiological picture include eosinophilic bone granuloma, juvenile or aneurysmal bone cyst, multiple myeloma or bone metastases. Serious differential diagnostic problems may be involved in case of osteolytic lesions occurring in the humerus. Cases of this type involving complications have been reported and include the presence of an teleangiectatic osteosarcoma as well as that of a hemangiosarcoma of the bone.

  4. Comparison of Laparoscopic versus Open Surgery after Insertion of Self-Expandable Metallic Stents in Acute Malignant Colorectal Obstruction: A Case-Matched Study

    Directory of Open Access Journals (Sweden)

    Chotirot Angkurawaranon

    2017-03-01

    Full Text Available Background: Self-expanding metallic stents (SEMS have been acknowledged in management of acute colorectal obstruction. The surgical approach after SEMS insertion varies from open approach to laparoscopic-assisted approach. The primary objective of this study was to compare the outcomes of laparoscopic approach and open approach after SEMS insertion. Methods: From January 2007 to December 2010, cross-sectional medical records reviewed a total of 76 patients who underwent colorectal stenting with SEMS. Patients and tumor characteristics, complications, morbidity and mortality were obtained. Results: Forty-three patients underwent SEMS placement as a bridge to surgery. Laparoscopic-assisted surgery (LS was performed in 24 patients (55.8%, and open surgery (OS was performed in 19 patients (44.2%. All clinicopathological parameters were matched. The technical success of SEMS was found in 42 patients (97.7%, and the clinical stent success was 100%. LS had a higher chance of primary anastomosis than OS (p=0.012; Odd ratio 2.717; 95%CI: 1.79-4.012. LS had a lower permanent ostomy rate (p=0.031; Odd ratio 0.385; 95%CI: 0.259-0.572 and lower estimated blood loss (p=0.024; Odd ratio 0.23; 95%CI: 0.006-0.086. The post-operative complications, mortality rate, recurrence rate, disease free status, and overall survival rates between the two groups were non-significant. Conclusion: Colonic stent is an effective treatment of acute malignant colonic obstruction. The authors suggest the advantage of laparoscopic approach resection after colonic stenting results in a higher primary anastomosis rate, and lower blood loss than open surgery.

  5. Diffuse cavitary lung lesions

    International Nuclear Information System (INIS)

    Grunzke, Mindy; Garrington, Timothy; Hayes, Kari; Bourland, Wendy

    2010-01-01

    An 11-year-old girl presented with a 2-month history of progressively worsening cough, daily fevers, and weight loss. A chest radiograph revealed multiple cystic cavitary lung lesions. An extensive infectious work-up was negative. Chest CT verified multiple cavitary lung lesions bilaterally, and [F-18]2-fluoro-2-deoxy-D-glucose ( 18 F-FDG) positron emission tomography with CT (PET/CT) showed increased uptake in the lung lesions as well as regional lymph nodes. Subsequent biopsy of an involved lymph node confirmed classical Hodgkin lymphoma, nodular sclerosis type. This case represents an unusual presentation for a child with Hodgkin lymphoma and demonstrates a role for 18 F-FDG PET/CT in evaluating a child with cavitary lung lesions. (orig.)

  6. Uterine Vascular Lesions

    Science.gov (United States)

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

    2013-01-01

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

  7. Petrous apex mass lesions

    International Nuclear Information System (INIS)

    Settanni, Flavio A.P.; Testa, Jose Ricardo Gurgel; Campos, Roberto Augusto de Carvalho; Goes Filho, Jose Francisco de; Guerrero, Andre Luiz; Nascimento, Luiz Augusto; Frazatto, Ricardo

    2000-01-01

    The authors discuss the difficulties in diagnosing lesions of the petrous apex. Petrous apex involvement remains silent until the disease reaches and advanced stage of development. Symptoms and signs related to these lesions are due to involvement of adjacent neurovascular structures and may be nonspecific early in the course of the disease. The diagnosis is based on a combined CT and MRI evaluation of the temporal bone region. CT and MRI findings are often sufficient for a confident preoperative differentiation and diagnosis. Characteristic imaging findings associated with their pattern of erosion and spreading can distinguish the types of expansive lesions arising from the petrous apex such as trigeminal schwannomas, cholesterol granulomas, cholesteatomas and aneurysms of the petrous portion of the internal carotid artery. However, an arteriographic evaluation should be performed if a vascular lesion is strongly suspected. (author)

  8. Managing Carious Lesions

    DEFF Research Database (Denmark)

    Schwendicke, F; Frencken, J E; Bjørndal, L

    2016-01-01

    The International Caries Consensus Collaboration undertook a consensus process and here presents clinical recommendations for carious tissue removal and managing cavitated carious lesions, including restoration, based on texture of demineralized dentine. Dentists should manage the disease dental...... caries and control activity of existing cavitated lesions to preserve hard tissues and retain teeth long-term. Entering the restorative cycle should be avoided as far as possible. Controlling the disease in cavitated carious lesions should be attempted using methods which are aimed at biofilm removal...... or control first. Only when cavitated carious lesions either are noncleansable or can no longer be sealed are restorative interventions indicated. When a restoration is indicated, the priorities are as follows: preserving healthy and remineralizable tissue, achieving a restorative seal, maintaining pulpal...

  9. Skin lesion of blastomycosis

    Science.gov (United States)

    ... infection. It is most often found in: Africa Canada, around the Great Lakes South central and north ... is diagnosed by identifying the fungus in a culture taken from a skin lesion. This usually requires ...

  10. Male breast lesions

    International Nuclear Information System (INIS)

    Matushita, J.P.K.; Andrade, L.G. de; Carregal, E.; Marimatsu, R.I.; Matushita, J.S.

    1989-01-01

    Roentgenographic examination of the male breast is an important aspect of the continued, intensive investigation of the radiologic morphology of the normal and diseased breast conducted in 17 cases examined at the Instituto Nacional do Cancer - RJ. It is purpose of this report to present the Roentgen appearance of various lesions of the male breast as they have been found in our practice and also to stress some of the difficulties in the differential diagnosis of these lesions. (author) [pt

  11. Benign fibroosseous lesions

    Directory of Open Access Journals (Sweden)

    Cansu Köseoğlu Seçgin

    2016-05-01

    Full Text Available Benign fibroosseous lesions represent a group of lesions that share the same basic evolutive mechanism and are characterized by replacement of normal bone with a fibrous connective tissue that gradually undergoes mineralization. These lesions are presented by a variety of diseases including developmental, reactive-dysplastic processes and neoplasms. Depending on the nature and amount of calcified tissue, they can be observed as radiolucent, mixed or radiopaque. Their radiographic features could be well-defined or indistinguishable from the surrounding bone tissue. They can be asymptomatic as in osseous dysplasias and can be detected incidentally on radiographs, or they can lead to expansion in the affected bone as in ossifying fibroma. All fibroosseous lesions seen in the jaws and face are variations of the same histological pattern. Therefore, detailed clinical and radiographic evaluation in differential diagnosis is important. In this review, fibroosseous benign lesions are classified as osseous dysplasia, fibrous dysplasia and fibroosseous tumors; and radiographic features and differential diagnosis of these lesions are reviewed taking into account this classification.

  12. Imaging of painful solitary lesions of the sacrum

    International Nuclear Information System (INIS)

    Peh, W. C. G.; Koh, W. L.; Kwek, J. W.; Htoo, M. M.; Tan, P. H.

    2007-01-01

    Full text: In patients with sacral pain, the painful symptoms may be caused by a variety of bony and soft tissue lesions. Benign lesions include giant cell tumour, neurogenic tumour, insufficiency fracture, infection and giant bone island. Malignant lesions include primary bone tumours, Ewing sarcoma, plasmacytoma, lymphoma and chordoma. Soft tissue tumours adjacent to or involving the sacrum may cause painful symptoms. A multimodality approach to imaging is required for full assessment of these lesions. This pictorial essay describes a range of common solitary sacral lesions that may cause pain, with emphasis on imaging features

  13. Sampling probability distributions of lesions in mammograms

    Science.gov (United States)

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

    2015-03-01

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

  14. Automated detection of multiple sclerosis lesions in serial brain MRI

    Energy Technology Data Exchange (ETDEWEB)

    Llado, Xavier; Ganiler, Onur; Oliver, Arnau; Marti, Robert; Freixenet, Jordi [University of Girona, Computer Vision and Robotics Group, Girona (Spain); Valls, Laia [Dr. Josep Trueta University Hospital, Department of Radiology, Girona (Spain); Vilanova, Joan C. [Girona Magnetic Resonance Center, Girona (Spain); Ramio-Torrenta, Lluis [Dr. Josep Trueta University Hospital, Institut d' Investigacio Biomedica de Girona, Multiple Sclerosis and Neuroimmunology Unit, Girona (Spain); Rovira, Alex [Vall d' Hebron University Hospital, Magnetic Resonance Unit, Department of Radiology, Barcelona (Spain)

    2012-08-15

    Multiple sclerosis (MS) is a serious disease typically occurring in the brain whose diagnosis and efficacy of treatment monitoring are vital. Magnetic resonance imaging (MRI) is frequently used in serial brain imaging due to the rich and detailed information provided. Time-series analysis of images is widely used for MS diagnosis and patient follow-up. However, conventional manual methods are time-consuming, subjective, and error-prone. Thus, the development of automated techniques for the detection and quantification of MS lesions is a major challenge. This paper presents an up-to-date review of the approaches which deal with the time-series analysis of brain MRI for detecting active MS lesions and quantifying lesion load change. We provide a comprehensive reference source for researchers in which several approaches to change detection and quantification of MS lesions are investigated and classified. We also analyze the results provided by the approaches, discuss open problems, and point out possible future trends. Lesion detection approaches are required for the detection of static lesions and for diagnostic purposes, while either quantification of detected lesions or change detection algorithms are needed to follow up MS patients. However, there is not yet a single approach that can emerge as a standard for the clinical practice, automatically providing an accurate MS lesion evolution quantification. Future trends will focus on combining the lesion detection in single studies with the analysis of the change detection in serial MRI. (orig.)

  15. Meniscal Ramp Lesions

    Science.gov (United States)

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

    2016-01-01

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

  16. Decoding Diffusivity in Multiple Sclerosis: Analysis of Optic Radiation Lesional and Non-Lesional White Matter

    Science.gov (United States)

    Klistorner, Alexander; Vootakuru, Nikitha; Wang, Chenyu; Yiannikas, Con; Graham, Stuart L.; Parratt, John; Garrick, Raymond; Levin, Netta; Masters, Lynette; Lagopoulos, Jim; Barnett, Michael H.

    2015-01-01

    Objectives Diffusion tensor imaging (DTI) has been suggested as a new promising tool in MS that may provide greater pathological specificity than conventional MRI, helping, therefore, to elucidate disease pathogenesis and monitor therapeutic efficacy. However, the pathological substrates that underpin alterations in brain tissue diffusivity are not yet fully delineated. Tract-specific DTI analysis has previously been proposed in an attempt to alleviate this problem. Here, we extended this approach by segmenting a single tract into areas bound by seemingly similar pathological processes, which may better delineate the potential association between DTI metrics and underlying tissue damage. Method Several compartments were segmented in optic radiation (OR) of 50 relapsing-remitting MS patients including T2 lesions, proximal and distal parts of fibers transected by lesion and fibers with no discernable pathology throughout the entire length of the OR. Results Asymmetry analysis between lesional and non-lesional fibers demonstrated a marked increase in Radial Diffusivity (RD), which was topographically limited to focal T2 lesions and potentially relates to the lesional myelin loss. A relative elevation of Axial Diffusivity (AD) in the distal part of the lesional fibers was observed in a distribution consistent with Wallerian degeneration, while diffusivity in the proximal portion of transected axons remained normal. A moderate, but significant elevation of RD in OR non-lesional fibers was strongly associated with the global (but not local) T2 lesion burden and is probably related to microscopic demyelination undetected by conventional MRI. Conclusion This study highlights the utility of the compartmentalization approach in elucidating the pathological substrates of diffusivity and demonstrates the presence of tissue-specific patterns of altered diffusivity in MS, providing further evidence that DTI is a sensitive marker of tissue damage in both lesions and NAWM. Our

  17. Decoding diffusivity in multiple sclerosis: analysis of optic radiation lesional and non-lesional white matter.

    Directory of Open Access Journals (Sweden)

    Alexander Klistorner

    Full Text Available Diffusion tensor imaging (DTI has been suggested as a new promising tool in MS that may provide greater pathological specificity than conventional MRI, helping, therefore, to elucidate disease pathogenesis and monitor therapeutic efficacy. However, the pathological substrates that underpin alterations in brain tissue diffusivity are not yet fully delineated. Tract-specific DTI analysis has previously been proposed in an attempt to alleviate this problem. Here, we extended this approach by segmenting a single tract into areas bound by seemingly similar pathological processes, which may better delineate the potential association between DTI metrics and underlying tissue damage.Several compartments were segmented in optic radiation (OR of 50 relapsing-remitting MS patients including T2 lesions, proximal and distal parts of fibers transected by lesion and fibers with no discernable pathology throughout the entire length of the OR.Asymmetry analysis between lesional and non-lesional fibers demonstrated a marked increase in Radial Diffusivity (RD, which was topographically limited to focal T2 lesions and potentially relates to the lesional myelin loss. A relative elevation of Axial Diffusivity (AD in the distal part of the lesional fibers was observed in a distribution consistent with Wallerian degeneration, while diffusivity in the proximal portion of transected axons remained normal. A moderate, but significant elevation of RD in OR non-lesional fibers was strongly associated with the global (but not local T2 lesion burden and is probably related to microscopic demyelination undetected by conventional MRI.This study highlights the utility of the compartmentalization approach in elucidating the pathological substrates of diffusivity and demonstrates the presence of tissue-specific patterns of altered diffusivity in MS, providing further evidence that DTI is a sensitive marker of tissue damage in both lesions and NAWM. Our results suggest that, at

  18. Common conjunctival lesions

    African Journals Online (AJOL)

    Conjunctival naevus (Fig. 11). Conjunctival naevi are common and are located in the interpalpebral bulbar conjunctiva close to the limbus or at the caruncle. The naevus is a discrete, flat or slightly elevated sessile lesion. The colour can be from pale to brown to a dark black. If present from birth to 6 months it is considered a ...

  19. Ocular Lesions in Psoriatics

    Directory of Open Access Journals (Sweden)

    Vijay K Jain

    1987-01-01

    Full Text Available Ninety psoriasis patients without arthropathy were subjected to complete ocular e tion, to determine, the incidence of eye symptoms. Various ocular lesions observed included,trachoma 32.(35.5%, squamous blephritis 18 (20% and cataract 7 (7.7%.

  20. Mallory-Weiss lesions

    DEFF Research Database (Denmark)

    Lange, J.; Jensen, Lone Susanne

    2010-01-01

    Introduction: Malory-Weiss syndrome (MW) has been known since 1929. Only few studies exist which focus on the prognosis of the lesion. No Danish MW data are available. The purpose of the study was to describe the demographics of patients admitted with an MW to a Danish surgical unit during a 5-year...

  1. Skin lesion removal

    Science.gov (United States)

    ... likely to be done when there is a concern about a skin cancer. Most often, an area the shape of an ellipse is removed, as this makes it easier to close with stitches. The entire lesion is removed, going as deep as the fat, if needed, to ...

  2. Theory of pairwise lesion interaction

    International Nuclear Information System (INIS)

    Harder, Dietrich; Virsik-Peuckert, Patricia; Bartels, Ernst

    1992-01-01

    A comparison between repair time constants measured both at the molecular and cellular levels has shown that the DNA double strand break is the molecular change of key importance in the causation of cellular effects such as chromosome aberrations and cell inactivation. Cell fusion experiments provided the evidence that it needs the pairwise interaction between two double strand breaks - or more exactly between the two ''repair sites'' arising from them in the course of enzymatic repair - to provide the faulty chromatin crosslink which leads to cytogenetic and cytolethal effects. These modern experiments have confirmed the classical assumption of pairwise lesion interaction (PLI) on which the models of Lea and Neary were based. It seems worthwhile to continue and complete the mathematical treatment of their proposed mechanism in order to show in quantitative terms that the well-known fractionation, protraction and linear energy transfer (LET) irradiation effects are consequences of or can at least be partly attributed to PLI. Arithmetic treatment of PLI - a second order reaction - has also the advantage of providing a prerequisite for further investigations into the stages of development of misrepair products such as chromatin crosslinks. It has been possible to formulate a completely arithmetic theory of PLI by consequently applying three biophysically permitted approximations - pure first order lesion repair kinetics, dose-independent repair time constants and low yield of the ionization/lesion conversion. The mathematical approach will be summarized here, including several formulae not elaborated at the time of previous publications. We will also study an application which sheds light on the chain of events involved in PLI. (author)

  3. Lesiones en el deporte

    Directory of Open Access Journals (Sweden)

    Rubio Gimeno, Silvio

    2000-02-01

    Full Text Available Not available

    El incremento de la actividad física y del deporte, en las sociedades llamadas desarrolladas, ha traído consigo beneficios claros para la salud, reflejados en diferentes indicadores de salud. Simultáneamente, el deporte de competición obliga a una dedicación diaria a intensidad de entrenamiento, con objeto de obtener los elevados requerimientos físicos que exige la competición. Todo ello ha traído consigo la aparición de numerosas lesiones, fundamentalmente del sistema músculo- esquelético.
    Se exponen en este trabajo consideraciones históricas, la epidemiología de la lesión deportiva y se describen, concisamente, algunas de las lesiones más habituales y significativas que afectan a músculos, tendones y sistema esquelético.

  4. MANAGEMENT OF TRAUMATIC LIVER LESIONS.

    Science.gov (United States)

    Timofte, D; Hutanu, I; Livadariu, Roxana Maria; Soroceanu, R P; Munteanu, Iulia; Diaconu, C; Ionescu, Lidia

    2015-01-01

    To determine the correct therapeutic approach to the different grades of liver trauma. The study is based on a retrospective analysis of treatment outcomes in 56 patients with abdominal trauma admitted over a 9-year period to in the IIIrd Surgical Clinic of the Iasi "Sf. Spiridon" Hospital. It is focused on operative or non-operative management of liver trauma, surgical technique used, morbidity and postoperative mortality. Data were collected from electronic medical records and observation sheets and processed and interpreted using Microsoft Excel statistical functions. In the interval May 26, 2005-April 19, 2013 56 cases of abdominal trauma were recorded, 31 (55.35%) residing in urban areas, and 25 (44.64%) in rural areas. The mean age was 39 years, range 18-83 years old. The male/female ratio was 2.5/1 and the group consisted of 40 (71.42%) male patients and 16 (28.57%) female patients. The causes of abdominal trauma were: car accident in 29 (51%) cases, fall from different heights in 6 (10%) patients, workplace-related accidents in 8 patients (14%) and direct hit injury in 12 patients (12%). In our cohort, 51 (91%) patients with abdominal trauma have been emergency admitted, 3 patients (5%) were transferred from different medical units, and 2 patients (4%) were referred by a specialist doctor. Two or more simultaneous lesions were diagnosed in 53 (96%) cases. Of the 45 patients with traumatic liver injuries diagnosed on admission, 32 (71%) required surgical intervention. In the remaining 13 (29%) patients, the therapeutic management was conservative. Hepatic traumas are often severe, and frequently associated with multiple injuries. The non-operative management is indicated in liver lesions grade I, II and III according to the American Association for the Surgery of Trauma (AAST), if abdominal cavity organs are not injured. Higher grade liver lesions (over IV) in which the hemorrhagic risk persists or reappears require surgical intervention as soon as possible

  5. White matter lesion progression

    DEFF Research Database (Denmark)

    Hofer, Edith; Cavalieri, Margherita; Bis, Joshua C

    2015-01-01

    BACKGROUND AND PURPOSE: White matter lesion (WML) progression on magnetic resonance imaging is related to cognitive decline and stroke, but its determinants besides baseline WML burden are largely unknown. Here, we estimated heritability of WML progression, and sought common genetic variants...... and previous association studies. RESULTS: A total of 1085 subjects showed WML progression. The heritability estimate for WML progression was low at 6.5%, and no single-nucleotide polymorphisms achieved genome-wide significance (PFour loci were suggestive (P

  6. An unexpected lumbar lesion

    Directory of Open Access Journals (Sweden)

    Laura Beard

    2016-01-01

    Full Text Available This case report details an interesting case of suspected spinal bifida in an obstetric patient who presented for an elective cesarean section. A large scarred/dimpled area, surrounded by significant hair growth in the region of the lumbar spine had been missed in multiple antenatal and preoperative assessments and was recognized on the day of the surgery as the patient was being prepared for spinal anesthesia. The patient was uncertain regarding the pathology of the lesion, and all investigations relating to this had been undertaken in Pakistan where she lived as a child. General anesthesia was undertaken because magnetic resonance imaging had not been performed and tethering of the spinal cord could not be ruled out clinically. The patient suffered from significant blood loss intra and postoperatively, requiring a two unit blood transfusion. She was discharged after 5 days in the hospital. This case highlights the need for thorough examination in all obstetric patients presenting to the preoperative clinic, focusing on the airway, vascular access, and lumbar spine. Patients may not always disclose certain information due to a lack of understanding, embarrassment, forgetfulness, or language barriers. Significant aspects of their care may have been undertaken abroad and access to these notes is often limited. Preoperative detection of the lesion would have allowed further investigation and imaging of the lesion and enabled more comprehensive discussions with the patient regarding anesthetic options and risk.

  7. A Study on Oral Mucosal Lesions in 3500 Patients with ...

    African Journals Online (AJOL)

    Conclusion: The prevalence rate of oral mucosal lesions in patients with dermatological diseases was relatively low. However, predominant oral mucosal lesions observed in the study were autoimmune in origin with a high morbidity and mortality index. Hence, multidisciplinary approach will definitely help in the prognosis ...

  8. Morphological classifications of gastrointestinal lesions

    NARCIS (Netherlands)

    Vleugels, Jasper L. A.; Hazewinkel, Yark; Dekker, Evelien

    2017-01-01

    In the era of spreading adoption of gastrointestinal endoscopy screening worldwide, endoscopists encounter an increasing number of complex lesions in the gastrointestinal tract. For decision-making on optimal treatment, precise lesion characterization is crucial. Especially the assessment of

  9. Atypical idiopathic inflammatory demyelinating lesions

    DEFF Research Database (Denmark)

    Wallner-Blazek, Mirja; Rovira, Alex; Fillipp, Massimo

    2013-01-01

    Atypical lesions of a presumably idiopathic inflammatory demyelinating origin present quite variably and may pose diagnostic problems. The subsequent clinical course is also uncertain. We, therefore, wanted to clarify if atypical idiopathic inflammatory demyelinating lesions (AIIDLs) can be class...

  10. Acute periodontal lesions.

    Science.gov (United States)

    Herrera, David; Alonso, Bettina; de Arriba, Lorenzo; Santa Cruz, Isabel; Serrano, Cristina; Sanz, Mariano

    2014-06-01

    This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute

  11. Localization of lesions in aphasia

    International Nuclear Information System (INIS)

    Hojo, Kei; Watanabe, Shunzo; Tasaki, Hiroichi; Sato, Tokijiro; Metoki, Hirobumi.

    1984-01-01

    Using a microcomputer, the locus and extent of the lesions, as demonstrated by computed tomography for 127 cases with various types of aphasia were superimposed onto standardized marices. The relationship between the foci of the lesions and the types of aphasia was investigated. Broca aphasics (n=39) : Since the accumulated site of the lesions highly involved the deep structures of the lower part of the precentral gyrus as well as the insula and lenticular nucleus, only 60% of the Broca aphasics had lesions on these areas. This finding has proved to have little localizing value. Wernicke aphasics (n=23) : The size of the lesion was significantly smaller than Broca's aphasia. At least 70% of the patients had the superior temporal lesions involving Wernicke's area and subcortical lesions of the superior and middle temporal gyri. Amnestic aphasics (n=18) : The size of the lesion was smaller than any other types. While there was some concentration of the lesions (maximum 40%) in the area of the subcortical region of the anterior temporal gyrus adjacent to Wernicke's area and the lenticular nucleus, the lesions were distributed throughout the left hemisphere. Amnestic aphasia was thought to be the least localizable. Conduction aphasics (n=11) : The lesions were relatively small in size. Many patients had posterior speech area lesions involving at least partially Wernicke's area. In particular, more than 80% of the conduction aphasics had lesions of the supramarginal gyrus and it's adjacent deep structures. Global aphasics (n=36) : In general, the size of the lesion was very large and 70% of the global aphasics had extensive lesions involving both Broca's and Wernicke's areas. However, there were observations showing that the lesions can be small and confined. (J.P.N.)

  12. Benign breast lesions in Kano

    African Journals Online (AJOL)

    malignant breast diseases. But the prevalence of breast cancer is increasing especially in communities that hitherto reported low incidence; a recent report from Ibadan cancer registry, showed that ... Table Relative frequency of breast lesions in Kano. Histological No. % of breast % of benign breast diagnosis lesions lesions.

  13. A disappearing neonatal skin lesion.

    LENUS (Irish Health Repository)

    Hawkes, Colin Patrick

    2012-01-31

    A preterm baby girl was noted at birth to have a firm, raised, non-tender skin lesion located over her right hip. She developed three similar smaller lesions on her ear, buttock and right knee. All lesions had resolved by 2 months of age.

  14. Periapical implant lesion: A systematic review.

    Science.gov (United States)

    Blaya-Tárraga, J-A; Cervera-Ballester, J; Peñarrocha-Oltra, D; Peñarrocha-Diago, M

    2017-11-01

    The aim of this study was to systematically review the evidence for periapical implant lesion, which makes a patient more susceptible to the periapical lesion, frequency, symptoms, signs (including radiological findings) and possible treatment options. A systematic literature review and analysis of publications included in PubMed, Embase and Cochrane; articles published until March 2016; with a populations, exposures and outcomes (PEO) search strategy was performed, focused on the issue: "In patients with periapical lesion to the implant during the osseointegration, what symptoms, signs, and changes in complementary examination manifested, for according to that stage, be intervened with the appropriate approach?". The set criteria for inclusion were peer-reviewed articles. From a total of 212 papers identified, 36 studies were included in this systematic review, with 15461 implants evaluated and 183 periapical implant lesions. Which 8 papers included more than 5 cases and 28 included equal or less than 5 cases. Analysis of the papers revealed that periapical implant lesion is classified according to evolution stages into acute (non-suppurated and suppurated) and subacute (or suppurated-fistulized). In the acute stage and in the subacute if there is no loss of implant stability, the correct treatment approach is implant periapical surgery. In the subacute stage associated with implant mobility the implant must be removed. Evidence on the subject is very limited, there are few studies with small sample, without homogeneity of criteria for diagnosing the disease and without design of scientific evidence. Currently etiology lacks consensus. The early diagnosis of periapical implant periapical lesions during the osseointegration phase and early treatment, will lead to a higher survival rate of implants treated, hence preventing the need for implant extraction.

  15. Iliopsoas compartment lesions: a radiologic evaluation

    International Nuclear Information System (INIS)

    Leao, Alberto Ribeiro de Souza; Amaral, Raquel Portugal Guimaraes; Abud, Thiago Giansante; Demarchi, Guilherme Tadeu Sauaia; Freire Filho, Edison de Oliveira; Novack, Paulo Rogerio; Campos, Flavio do Amaral; Shigueoka, David Carlos; Fernandes, Artur da Rocha Correa; Szejnfeld, Jacob; D'Ippolito, Giuseppe

    2007-01-01

    The iliopsoas compartment, a posterior boundary of the retroperitoneum, is comprised of the psoas major, psoas minor and iliac muscles. The symptoms picture in patients presenting with pathological involvement of this compartment may show a wide range of nonspecific clinical presentations that may lead to delayed diagnosis. However, in the search of an etiological diagnosis, it is already known that inflammation, tumors, and hemorrhages account for almost all the lesions affecting the iliopsoas compartment. By means of a retrospective analysis of radiological studies in patients with iliopsoas compartment lesions whose diagnosis was confirmed by anatomopathological evaluation or clinical follow-up, we have reviewed its anatomy as well as the main forms of involvement, with the purpose of identifying radiological signs that may help to narrow down the potential differential diagnoses. As each lesion is approached we will discuss the main radiological findings such as presence of gas in pyogenic abscesses, bone destruction and other bone changes of vertebral bodies in lesions secondary to tuberculosis, involvement of fascial planes in cases of neoplasms, and differences in signal density and intensity of hematomas secondary to hemoglobin degradation, among others. So, we have tried to present cases depicting the most frequent lesions involving the iliopsoas compartment, with emphasis on those signs that can lead us to a more specific etiological diagnosis. (author)

  16. Iliopsoas compartment lesions: a radiologic evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Leao, Alberto Ribeiro de Souza; Amaral, Raquel Portugal Guimaraes; Abud, Thiago Giansante; Demarchi, Guilherme Tadeu Sauaia; Freire Filho, Edison de Oliveira; Novack, Paulo Rogerio; Campos, Flavio do Amaral; Shigueoka, David Carlos; Fernandes, Artur da Rocha Correa; Szejnfeld, Jacob; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: ar.leao@uol.com.br; Santos, Jose Eduardo Mourao [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil)

    2007-07-15

    The iliopsoas compartment, a posterior boundary of the retroperitoneum, is comprised of the psoas major, psoas minor and iliac muscles. The symptoms picture in patients presenting with pathological involvement of this compartment may show a wide range of nonspecific clinical presentations that may lead to delayed diagnosis. However, in the search of an etiological diagnosis, it is already known that inflammation, tumors, and hemorrhages account for almost all the lesions affecting the iliopsoas compartment. By means of a retrospective analysis of radiological studies in patients with iliopsoas compartment lesions whose diagnosis was confirmed by anatomopathological evaluation or clinical follow-up, we have reviewed its anatomy as well as the main forms of involvement, with the purpose of identifying radiological signs that may help to narrow down the potential differential diagnoses. As each lesion is approached we will discuss the main radiological findings such as presence of gas in pyogenic abscesses, bone destruction and other bone changes of vertebral bodies in lesions secondary to tuberculosis, involvement of fascial planes in cases of neoplasms, and differences in signal density and intensity of hematomas secondary to hemoglobin degradation, among others. So, we have tried to present cases depicting the most frequent lesions involving the iliopsoas compartment, with emphasis on those signs that can lead us to a more specific etiological diagnosis. (author)

  17. Petrous apex lesions outcome in 21 cases

    Directory of Open Access Journals (Sweden)

    Hekmatara M

    1997-09-01

    Full Text Available Petrous apex lesions of temporal bone progress slowly. Most of the time not only destruct this area but also involve neighbouring element. The symptoms of the neighbouring neuro-vasculare involvement we can recognize these lesions. The most common symptoms of involvement of the petrous apex are: headache, conductive hearing loss or sensorineural type, paresthesia and anesthesia of the trigeminal nerve, paresia and paralysis of the facial nerve, abducent nerve. In retrospective study which has been in the ENT and HNS wards of Amiralam hospital, 148 patients have been operated due to temporal bone tumor; from these numbers, 21 (13.6% patients had petrous apex lesions of temporal bone. Eleven (52.9% patients of these 21 persons were men and the remaining 10 (47-6% were women. The average age of the patients was 37 years. The common pathology of these patients were glomus jugulare tumors, hemangioma, schwannoma, meningioma, congenital cholesteatoma, giant cell granuloma. The kind of operations that have been done on these patients were: infratemporal, translabyrinthine and middle fossa approaches. The conclusion of this study shows that petrous apex area is an occult site. The symptoms of this lesion are not characteristic, meticulous attention to the history and physical examination are very helpful to recognition of these lesions and it's extention.

  18. Sports injuries Lesiones deportivas

    Directory of Open Access Journals (Sweden)

    Santiago Patiño Giraldo

    2007-04-01

    Full Text Available Stress generated by sports practice has increased the probability that athletes suffer from acute and chronic injuries. Worldwide, there have been many different investigations concerning the incidence of sport injuries. The different ways in which results have been presented makes it difficult to compare among them. Rates of sports injuries vary between 1.7 and 53 per 1.000 hours of sports practice; 0.8 and 90.9 per 1.000 hours of training; 3.1 and 54.8 per 1.000 hours of competition, and 6.1 and 10.9 per 100 games. The great variability among the incidence rates may be explained by differences among sports, countries, competitive levels, ages and methodology used in the studies. Sports injuries have been defined as those occurring when athletes are practicing sports and that result in tissue alterations or damages, affecting the operation of the corresponding structures. Contact sports such as soccer, rugby, martial arts, basketball, handball and hockey generate greater risk of injuries. The probability of lesions is higher during competition than in training. El estrés generado por la práctica deportiva ha originado una mayor probabilidad de que los atletas presenten lesiones agudas y crónicas. En el ámbito mundial existen diferentes investigaciones acerca de la incidencia de lesiones deportivas. La comparación de sus resultados es difícil por las diferencias en las características de la población y en la forma de reportar los datos, que varía ampliamente entre los estudios (proporciones o tasas de incidencia o tasas por cada 100 ó 1.000 participantes o tasas por horas de juego o por número de partidos jugados. Las tasas varían entre 1,7 y 53 lesiones por 1.000 horas de práctica deportiva, entre 0,8 y 90,9 por 1.000 horas de entrenamiento, entre 3,1 y 54,8 por 1.000 horas de competición y de 6,1 a 10,9 por 100 juegos. La gran variación entre las tasas de incidencia se explica por las diferencias existentes entre los deportes

  19. Analysis of pulmonary coin lesions

    International Nuclear Information System (INIS)

    Kim, O; Kim, K. H.; Oh, K. K.; Park, C. Y.

    1979-01-01

    For A long time the solitary pulmonary nodule has remained a difficult problem to solve and has attracted a great deal of attension in recent years. Circumscribed coin lesions of the lung were generally peripheral in location with respect to the pulmonary hilus. Because of this, important clinical problem in management and diagnosis arise. Such a lesion is discovered through roentgenologic examination. So the roentgenologists is the first be in a position to offer advise. This presentation is an attempt to correlate a useful diagnosis with roentgenologic findings of pulmonary coin lesion which enables us to get differential diagnosis of benign and malignant lesion. Histologically proven 120 cases of the pulmonary coin lesion during the period of 8 years were reviewed through plain film, tomogram, bronchoscopy, variable laboratory findings, and clinical history. The results are as follows: 1. Male to female sex ratio was 3 : 1. In age distribution, most of the malignant pulmonary coin lesion appeared in 6th decade (39%) and 5th decade (27%). In benign lesion, the most cases were in 3 rd decade. 2. Pathological cell type are as follows: Primary bronchogenic cancer 43.3%, tuberculoma 25.8%, inflammatory lesion 17.5%, benign tumor 10%, and bronchial adenoma, harmartoma, A.V. malformation, mesothelioma, are 1 case respectively. As a result benign and malignant lesion showed equal distribution (49.1% : 50.3%). 3. In symptom analysis ; cough is the most common (43.5%) symptom in malignant lesion, next follows hemoptysis (20.9%) and chest pain (14.5%). In benign lesion, most of the patient (32.7%) did not complain any symptom. 4. In malignant lesion, the most common nodular size was 4 cm (32.3%), and in benign lesion 2 cm sized coin was most common (39.3%). 5. In general, margin of nodule was very sharp and well demarcated in benign lesion (83.3%), and in malignant lesion that was less demarcated and poorly defined. 6. Most case of calcification (82.7%) was seen in benign

  20. Study of genital lesions

    Directory of Open Access Journals (Sweden)

    Anand Kumar B

    2003-03-01

    Full Text Available A total of one hundred patients (75 males and 25 females age ranged from 17-65 years with genital lesions attending the STD clinic of Bowring and LC Hospitals Bangalore constituted the study group. Based on clinical features, the study groups were classified as syphilis (39, chancroid (30, herpes genitolis (13, condylomato lato (9, LGV (7t condylomata acuminata (5, genital scabies (3, granuloma inguinole (2 and genital candidiasis (1. In 68% microbiological findings confirmed the clinical diagnosis. Of the 100 cases 13% and 2% were positive for HIV antibodies and HbsAg respectively.

  1. Minimally invasive trans-portal resection of deep intracranial lesions.

    NARCIS (Netherlands)

    Raza, S.M.; Recinos, P.F.; Avendano, J.; Adams, H.; Jallo, G.I.; Quinones-Hinojosa, A.

    2011-01-01

    BACKGROUND: The surgical management of deep intra-axial lesions still requires microsurgical approaches that utilize retraction of deep white matter to obtain adequate visualization. We report our experience with a new tubular retractor system, designed specifically for intracranial applications,

  2. Vascular lesions following radiation

    International Nuclear Information System (INIS)

    Fajardo, L.F.; Berthrong, M.

    1988-01-01

    The special radiation sensitivity of the vascular system is mainly linked to that of endothelial cells, which are perhaps the most radiation-vulnerable elements of mesenchymal tissues. Within the vascular tree, radiation injures most often capillaries, sinusoids, and small arteries, in that order. Lesions of veins are observed less often, but in certain tissues the veins are regularly damaged (e.g., intestine) or are the most affected structures (i.e., liver). Large arteries do suffer the least; however, when significant damage does occur in an elastic artery (e.g., thrombosis or rupture), it tends to be clinically significant and even fatal. Although not always demonstrable in human tissues, radiation vasculopathy generally is dose and time dependent. Like other radiation-induced lesions, the morphology in the vessels is not specific, but it is characteristic enough to be often recognizable. Vascular injury, especially by therapeutic radiation is not just a morphologic marker. It is a mediator of tissue damage; perhaps the most consistent pathogenetic mechanism in delayed radiation injury

  3. Oral lesions in lupus erythematosus: correlation with cutaneous lesions.

    Science.gov (United States)

    Nico, Marcello Menta Simonsen; Vilela, Maria Apparecida Constantino; Rivitti, Evandro Ararigbóia; Lourenço, Silvia Vanessa

    2008-01-01

    Oral lesions in the context of lupus erythematosus (LE) have long been described. However, definitive agreement on about the exact nature and correct classification of these manifestations is lacking in published studies. Controversy exists on the significance of oral LE lesions regarding patient outcome. In this article, medical and dental literature on clinical and histopathological aspects of oral LE lesions are reviewed and critically discussed. A clinico-pathological correlation of oral lesions (interface mucositis-lupus mucositis) with cutaneous lesions (interface dermatitis-lupus dermatitis) is established, for those represent the mucosal counterparts of cutaneous LE. Validity about widely used but imprecise terms such as "oral ulcers", "ulcerative plaques", and others, in the context of LE, is discussed, and the uncertain relationship of these alterations to systemic disease with a worse outcome is commented. Furthermore, insights about the nature, differential diagnosis, and prognosis of oral lesions in LE patients are presented.

  4. Management of Preinvasive Lesions.

    Science.gov (United States)

    Patrono, Maria G; Corzo, Camila; Iniesta, Maria; Ramirez, Pedro T

    2017-12-01

    Serous tubal intraepithelial carcinoma is considered the precursor lesion of high-grade serous carcinoma, and found in both low-risk and high-risk populations. Isolated serous tubal intraepithelial carcinomas in patients with BRCA1/2 mutations are detected in ∼2% of patients undergoing risk-reducing bilateral salpingo-oophorectomy and even with removal of the tubes and ovaries the rate of developing primary peritoneal carcinoma following remains up to 7.5%. Postoperative recommendations after finding incidental STICs remain unclear and surgical staging, adjuvant chemotherapy, or observation have been proposed. Discovery of STIC should prompt consideration of hereditary cancer program referral for BRCA1/2 mutation screening.

  5. Thalamic Lesions: A Radiological Review

    Science.gov (United States)

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

    2014-01-01

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

  6. Thalamic Lesions: A Radiological Review

    Directory of Open Access Journals (Sweden)

    Dimitri Renard

    2014-01-01

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

  7. Radio-induced brain lesions

    Directory of Open Access Journals (Sweden)

    Gorgan Mircea Radu

    2014-03-01

    Full Text Available Introduction : Radiotherapy, an important tool in multimodal oncologic treatment, can cause radio-induced brain lesion development after a long period of time following irradiation.

  8. Intertriginous lesions in pityriasis versicolor.

    Science.gov (United States)

    Aljabre, S H M

    2003-11-01

    The well-recognized sites of involvement in pityriasis versicolor are the upper part of the trunk, the neck and the upper arms. There is little documentation regarding pityriasis versicolor lesions in flexural areas. To study the occurrence and morphology of lesions of pityriasis versicolor in flexural areas. One hundred and ten cases of pityriasis versicolor were studied. Sites of lesions and other clinical features were determined. Flexural lesions in pityriasis versicolor were not uncommon. They were not correlated to age, sex, duration or relapses of the infection. Thorough inspection and examination of the skin by Wood's light before establishing treatment is prudent in cases of pityriasis versicolor located in typical sites.

  9. MALIGNANCY IN LARGE COLORECTAL LESIONS

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Oliveira dos SANTOS

    2014-09-01

    Full Text Available Context The size of colorectal lesions, besides a risk factor for malignancy, is a predictor for deeper invasion Objectives To evaluate the malignancy of colorectal lesions ≥20 mm. Methods Between 2007 and 2011, 76 neoplasms ≥20 mm in 70 patients were analyzed Results The mean age of the patients was 67.4 years, and 41 were women. Mean lesion size was 24.7 mm ± 6.2 mm (range: 20 to 50 mm. Half of the neoplasms were polypoid and the other half were non-polypoid. Forty-two (55.3% lesions were located in the left colon, and 34 in the right colon. There was a high prevalence of III L (39.5% and IV (53.9% pit patterns. There were 72 adenomas and 4 adenocarcinomas. Malignancy was observed in 5.3% of the lesions. Thirty-three lesions presented advanced histology (adenomas with high-grade dysplasia or early adenocarcinoma, with no difference in morphology and site. Only one lesion (1.3% invaded the submucosa. Lesions larger than 30 mm had advanced histology (P = 0.001. The primary treatment was endoscopic resection, and invasive carcinoma was referred to surgery. Recurrence rate was 10.6%. Conclusions Large colorectal neoplasms showed a low rate of malignancy. Endoscopic treatment is an effective therapy for these lesions.

  10. Possible association of first and high birth order of pregnant women with the risk of isolated congenital abnormalities in Hungary - a population-based case-matched control study.

    Science.gov (United States)

    Csermely, Gyula; Susánszky, Éva; Czeizel, Andrew E; Veszprémi, Béla

    2014-08-01

    In epidemiological studies at the estimation of risk factors in the origin of specified congenital abnormalities in general birth order (parity) is considered as confounder. The aim of this study was to analyze the possible association of first and high (four or more) birth order with the risk of congenital abnormalities in a population-based case-matched control data set. The large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities included 21,494 cases with different isolated congenital abnormality and their 34,311 matched controls. First the distribution of birth order was compared of 24 congenital abnormality groups and their matched controls. In the second step the possible association of first and high birth order with the risk of congenital abnormalities was estimated. Finally some subgroups of neural-tube defects, congenital heart defects and abdominal wall's defects were evaluated separately. A higher risk of spina bifida aperta/cystica, esophageal atresia/stenosis and clubfoot was observed in the offspring of primiparous mothers. Of 24 congenital abnormality groups, 14 had mothers with larger proportion of high birth order. Ear defects, congenital heart defects, cleft lip± palate and obstructive defects of urinary tract had a linear trend from a lower proportion of first born cases to the larger proportion of high birth order. Birth order showed U-shaped distribution of neural-tube defects and clubfoot, i.e. both first and high birth order had a larger proportion in cases than in their matched controls. Birth order is a contributing factor in the origin of some isolated congenital abnormalities. The higher risk of certain congenital abnormalities in pregnant women with first or high birth order is worth considering in the clinical practice, e.g. ultrasound scanning. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Detection of tumoral lesions in the posterior fossa, in brain computerized tomography scans for various conditions of acquiring a preliminary approach; Deteccion de lesiones tumorales en fosa posterior en imagenes de Tomografia Computarizada cerebral para diversas condiciones de adquisicion: un enfoque preliminar

    Energy Technology Data Exchange (ETDEWEB)

    Perez, M.; Carvalho-Filho, A. E.; Khoury, H. J.; Casas, M. C.; Andrade, M. E.; Paz, J. E.

    2010-07-01

    The present work performs a study over 13 tomographic images, using an anthropomorphic head phantom. It contains small lesions in the posterior fossa. Tube current (I [mA]), slice thickness (E [mm]), were the parameters changed among studies, looking for the best acquisition conditions, which permit good lesion detectability, and applying the lowest dose. Air Kerma in air [mGy] was calculated. Image quality was analyzed by both expert criterion and some merit figures. Two of them were global: contrasts to noise ratio (RCR [dB]) and signal to noise ratio (RSR). The rest of the measures used were relatives to the maximum dose condition: The gain in signal to noise ratio (SNR [dB]) and the maximum signal to noise ratio (PSNR [dB]), the normalized mean squared error (NMSE) and the structural similarity index (SSIM). Objective and subjective results were correlated. It is shown that it is possible to reduce the dose using lower values of mAs without affecting lesion detectability and keeping good image quality for the scanner used. An optimized protocol is also proposed for the technology used. (Author) 27 refs.

  12. SLAP lesions: Anatomy, clinical presentation, MR imaging diagnosis and characterization

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Debra [University of California San Diego, Department of Radiology, 200 W. Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States); MedRay Imaging and Fraser Health Authority, Vancouver, BC (Canada)], E-mail: cbchung@ucsd.edu; Mohana-Borges, Aurea; Borso, Maya; Chung, Christine B. [University of California San Diego, Department of Radiology, 200 W. Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States)

    2008-10-15

    ABSTRACT: Superior labral anterior posterior (SLAP) tears are an abnormality of the superior labrum usually centered on the attachment of the long head of the biceps tendon. Tears are commonly caused by repetitive overhead motion or fall on an outstretched arm. SLAP lesions can lead to shoulder pain and instability. Clinical diagnosis is difficult thus imaging plays a key diagnostic role. The normal anatomic variability of the capsulolabral complex can make SLAP lesions a diagnostic challenge. Concurrent shoulder injuries are often present including rotator cuff tears, cystic changes or marrow edema in the humeral head, capsular laxity, Hill-Sachs or Bankart lesion. The relevant anatomy, capsulolabral anatomic variants, primary and secondary findings of SLAP tears including MR arthrography findings, types of SLAP lesions and a practical approach to labral lesions are reviewed.

  13. Clinicopathologic Study of Intra- Osseous Lesions of the Jaws in Southern Iranian Population

    OpenAIRE

    Jaafari-Ashkavandi, Zohreh; Akbari, Behrooz

    2017-01-01

    Statement of the Problem: It is necessary for surgeons and practitioners to know about relative incidence and clinicopathologic features of lesions for accurate diagnosis and approach of pathologic lesions. Data are limited about overall incidence of intra-osseous lesions of the jaws in Iranian patients. Purpose: This study evaluated the clinicopathologic features of intra- osseous lesions of the jaws in an Iranian population, in a 22-year period. Materials and Method: In this cross- sectiona...

  14. Automated detection of Lupus white matter lesions in MRI

    Directory of Open Access Journals (Sweden)

    Eloy Roura Perez

    2016-08-01

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

  15. Stereotactic biopsy of cerebellar lesions: straight versus oblique frame positioning.

    Science.gov (United States)

    Quick-Weller, Johanna; Brawanski, Nina; Dinc, Nazife; Behmanesh, Bedjahn; Kammerer, Sara; Dubinski, Daniel; Seifert, Volker; Marquardt, Gerhard; Weise, Lutz

    2017-10-26

    Biospies of brain lesions with unknown entity are an everyday procedure among many neurosurgical departments. Biopsies can be performed frame-guided or frameless. However, cerebellar lesions are a special entity with a more complex approach. All biopsies in this study were performed stereotactically frame guided. Therefore, only biopsies of cerebellar lesions were included in this study. We compared whether the frame was attached straight versus oblique and we focused on diagnostic yield and complication rate. We evaluated 20 patients who underwent the procedure between 2009 and 2017. Median age was 56.5 years. 12 (60%) Patients showed a left sided lesion, 6 (30%) showed a lesion in the right cerebellum and 2 (10%) patients showed a midline lesion. The stereotactic frame was mounted oblique in 12 (60%) patients and straight in 8 (40%) patients. Postoperative CT scan showed small, clinically silent blood collection in two (10%) of the patients, one (5%) patient showed haemorrhage, which caused a hydrocephalus. He received an external ventricular drain. In both patients with small haemorrhage the frame was positioned straight, while in the patient who showed a larger haemorrhage the frame was mounted oblique. In all patients a final histopathological diagnosis was established. Cerebellar lesions of unknown entity can be accessed transcerebellar either with the stereotactic frame mounted straight or oblique. Also for cerebellar lesions the procedure shows a high diagnostic yield with a low rate of severe complications, which need further treatment.

  16. A toolbox for multiple sclerosis lesion segmentation

    International Nuclear Information System (INIS)

    Roura, Eloy; Oliver, Arnau; Valverde, Sergi; Llado, Xavier; Cabezas, Mariano; Pareto, Deborah; Rovira, Alex; Vilanova, Joan C.; Ramio-Torrenta, Lluis

    2015-01-01

    Lesion segmentation plays an important role in the diagnosis and follow-up of multiple sclerosis (MS). This task is very time-consuming and subject to intra- and inter-rater variability. In this paper, we present a new tool for automated MS lesion segmentation using T1w and fluid-attenuated inversion recovery (FLAIR) images. Our approach is based on two main steps, initial brain tissue segmentation according to the gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) performed in T1w images, followed by a second step where the lesions are segmented as outliers to the normal apparent GM brain tissue on the FLAIR image. The tool has been validated using data from more than 100 MS patients acquired with different scanners and at different magnetic field strengths. Quantitative evaluation provided a better performance in terms of precision while maintaining similar results on sensitivity and Dice similarity measures compared with those of other approaches. Our tool is implemented as a publicly available SPM8/12 extension that can be used by both the medical and research communities. (orig.)

  17. A toolbox for multiple sclerosis lesion segmentation

    Energy Technology Data Exchange (ETDEWEB)

    Roura, Eloy; Oliver, Arnau; Valverde, Sergi; Llado, Xavier [University of Girona, Computer Vision and Robotics Group, Girona (Spain); Cabezas, Mariano; Pareto, Deborah; Rovira, Alex [Vall d' Hebron University Hospital, Magnetic Resonance Unit, Dept. of Radiology, Barcelona (Spain); Vilanova, Joan C. [Girona Magnetic Resonance Center, Girona (Spain); Ramio-Torrenta, Lluis [Dr. Josep Trueta University Hospital, Institut d' Investigacio Biomedica de Girona, Multiple Sclerosis and Neuroimmunology Unit, Girona (Spain)

    2015-10-15

    Lesion segmentation plays an important role in the diagnosis and follow-up of multiple sclerosis (MS). This task is very time-consuming and subject to intra- and inter-rater variability. In this paper, we present a new tool for automated MS lesion segmentation using T1w and fluid-attenuated inversion recovery (FLAIR) images. Our approach is based on two main steps, initial brain tissue segmentation according to the gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) performed in T1w images, followed by a second step where the lesions are segmented as outliers to the normal apparent GM brain tissue on the FLAIR image. The tool has been validated using data from more than 100 MS patients acquired with different scanners and at different magnetic field strengths. Quantitative evaluation provided a better performance in terms of precision while maintaining similar results on sensitivity and Dice similarity measures compared with those of other approaches. Our tool is implemented as a publicly available SPM8/12 extension that can be used by both the medical and research communities. (orig.)

  18. [Mallory-Weiss lesions].

    Science.gov (United States)

    Lange, Jeppe; Jensen, Lone S

    2010-02-15

    Mallory-Weiss syndrome (MW) has been know since 1929. Only few studies exist which focus on the prognosis of the lesion. No Danish MW data are available. The purpose of the study was to describe the demographics of patients admitted with an MW to a Danish surgical unit during a 5-year period and to investigate the prognosis of these patients. Data from the patient records of 49 patients with endoscopically verified MW admitted through a five-year period were analysed. At follow-up, 35 patients were alive and contacted. A total of 29 responded. The mean time to follow-up from admittance was 42.7 months (range: 10.1-77.1). Haemostasis was achieved in all 49 patients. Sixteen received active therapy during the endoscopic procedure. Haemoglobin at admittance was lower (p = 0.008), the presence of bleeding stigmata higher (p < 0.0001) and the number of patients receiving blood transfusion higher (p = 0.01) among those receiving active therapy than among the group receiving no therapy at the time of their endoscopy. At follow-up, 50% of those receiving active therapy were dead (eight of 16) compared with 18% (six of 33) in the no-therapy group (p = 0.02). In the follow-up period, 10% of the patients admitted with an MW were re-admitted for a new gastrointestinal bleeding. Our data suggests that an attitude change is needed toward MW with bleeding stigmata. The course of the disease may not be as benign as generally believed. Further prospective studies designed to resolve this matter are needed.

  19. Imaging techniques in the study of lipomatous neck lesions

    International Nuclear Information System (INIS)

    Munoz, M. M.; Herrero, C.; Garcia, M. J.; Sanchez-Lafuente, J.

    2001-01-01

    Lipomas of the neck are uncommon lesions. Those situated in deep locations and diffuse lipomatosis of the neck can be clinically mis diagnosed. We reviewed the 20 lipomatous neck lesions treated in our hospital over a 15-year period (1985-1999). Computed tomography was diagnostic in nearly 100% of cases and, this, is the method of choice for the detection and characterization of lipomatous tumors. It also provides data that aid in planning the surgical approach and enables the follow-up of clinically stable lesions that do not require surgical treatment. (Author) 11 refs

  20. Imaging of the adrenal gland lesions

    Directory of Open Access Journals (Sweden)

    Keith Herr

    2014-08-01

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

  1. Cavity lining after excavating caries lesions

    DEFF Research Database (Denmark)

    Schwendicke, Falk; Göstemeyer, Gerd; Gluud, Christian

    2015-01-01

    OBJECTIVES: After removal of dentin caries lesions, cavity lining has been advocated. Non-clinical data support this approach, but clinical data are sparse and ambiguous. We aimed at evaluating the benefits and harms of cavity lining using meta-analysis and Trial Sequential Analysis. DATA: We...... included randomized clinical trials comparing restorations without versus with cavity lining for treating primary caries lesions. Only trials reporting failure (defined as need to re-retreat) after ≥1 year follow-up were included. Trial selection, data extraction, and risk of bias assessment were conducted....... STUDY SELECTION: From 128 studies, three randomized trials (89/130 patients or teeth), all treating primary teeth, were included. The trials had high risk of bias. All trials compared no lining versus calcium hydroxide lining after selective caries removal followed by adhesive restoration. Follow...

  2. Imaging of the adrenal gland lesions

    Energy Technology Data Exchange (ETDEWEB)

    Herr, Keith [Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA (United States); Muglia, Valdair F. [Universidade de Sao Paulo (FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina; Koff, Walter Jose [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil). Faculdade de Medicina. Dept. de Cirurgia; Westphalen, Antonio Carlos, E-mail: antonio.westphalen@ucsf.edu [Departments of Radiology and Biomedical Imaging and Urology, School of Medicine, University of California, San Francisco, CA (United States)

    2014-07-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Baiyu; Leng, Shuai; Yu, Lifeng; Yu, Zhicong; Ma, Chi; McCollough, Cynthia, E-mail: mccollough.cynthia@mayo.edu [Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905 (United States)

    2015-12-15

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  6. Unsupervised detection of liver lesions in CT images.

    Science.gov (United States)

    Afifi, Ahmed; Nakaguchi, Toshiya

    2015-01-01

    This work presents an automatic approach for liver lesions detection in CT images. In this approach, liver is first segmented using fast and reliable semi-automatic technique. After liver segmentation, lesion detection is formulated as an unsupervised segmentation approach to alleviate tedious user interaction or prior learning requirements. The Meanshift clustering technique is utilized to separate different liver tissues in each CT slice. Consequently, a rule-based system is proposed to automatically and dynamically estimate healthy and unhealthy tissues distributions, and produces initial estimation of defected tissue. Finally, the graph cuts algorithm is employed to refine the initial detection and produces the finial lesions. Validation of the proposed approach using 15 patients' CT data shows high detection rate of 93%, which makes it an efficient initial opinion in the diagnosis process.

  7. Differential diagnosis of sacral lesions

    International Nuclear Information System (INIS)

    Mesgarzadeh, M.; Rodman, M.S.; Bonakdarpour, A.; Mahboubi, S.

    1987-01-01

    The authors reviewed the teaching files of Temple University Hospital and Children's Hospital of Philadelphia and selected the best representative cases of various lesions of the sacrum. They selected the following lesions: metastasis, chondrosarcoma, chrodoma, plasmacytoma, giant cell tumor, osteogenic sarcoma, Ewing sarcoma, neuroblastoma, neurofibrosarcoma, hemangiopericytoma, osteoblastoma, ossifying fibroma, eosinophilic granuloma, aneurysmal bone cyst, sacrococcygeal teratoma, anterior meningocele, endodermal sinus tumor, and stress fracture. The authors illustrate, for each lesion, the likely age range, sights of predilection, likelihood of occurrence in the sacrum, and radiographic findings helpful in limiting the differential diagnosis. They demonstrate the value of bone scintigraphy in detecting, and CT in confirming, stress fractures of the sacrum

  8. Automated delineation of stroke lesions using brain CT images

    Directory of Open Access Journals (Sweden)

    Céline R. Gillebert

    2014-01-01

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

  9. Quantitative characterization and micro-CT mineral mapping of natural fissural enamel lesions.

    Science.gov (United States)

    Shahmoradi, Mahdi; Swain, Michael V

    2016-03-01

    The aim of this study was to characterize the mineral distribution pattern of natural fissural enamel lesions and to quantify structural parameters and mineral density of these lesions in comparison to proximal white spot enamel lesions. Imaging was undertaken using a high-resolution desktop micro-computed tomography system. A calibration equation was used to transform the grey level values of images into true mineral density values. The value of lesion parameters including the mineral density and the thickness of the surface layer of the enamel lesion were extracted from mineral density profiles. The thickness of the surface layer showed variation among different lesions and it ranged from 0-90 μm in proximal lesions and 0-137 μm in fissural lesions. The average thickness of surface layer in fissural lesions was significantly higher than smooth surface proximal lesions. Sound fissural enamel showed lower mineral density compared to proximal enamel. Micro-CT and the suggested de-noising and visualization method provide an efficient high-resolution approach for non-destructive evaluation of fissural lesions. Using these methods, the current study revealed the exclusive pattern and structure of fissural enamel lesions which may provide a basis for future studies on prevention and remineralization of these lesions. The common demineralization pattern of fissural lesions, which indicates the extension of the lesion in two directions towards the pulp horns, may explain the early inflammation and symptoms of the pulp in fissural lesions even when the lesion base appears far from the pulp roof in normal radiographs. In addition, the presence of the surface layer, indicates that vigorous probing of the occlusal fissures may lead to breakage and cavitation of the enamel lesions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Nodular lesions in renal tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Mizunuma, Kimiyoshi; Toyoda, Keiko; Tada, Shimpei; Kaneko, Kenji; Yamaguchi, Manabu [Jikei Univ., Tokyo (Japan). School of Medicine

    1994-11-01

    We retrospectively studied the CT findings of rental tuberculosis in 27 cases (32 kidneys). As a characteristic CT findings, nodular lesions were recognized in 20 kidneys. Low density nodules were found in three kidneys, isodensity nodules in seven, and high density nodules in 10. In a case examined by follow-up five years later, the low and isodensity nodules changed to high density nodules with decreasing volume. Ultrasound demonstrated the high density nodules as low-echo mass lesions. These nodular lesions corresponded with the localized foci in the renal parenchyma and/or pyocalyx. We consider that the density differences in nodular lesions reflect the process of water absorption from the caseous necrotizing materials of tuberculosis. (author).

  11. Post-radiotherapeutic heart lesions

    International Nuclear Information System (INIS)

    Testart, F.M.

    1979-05-01

    Heart structures have traditionally been considered radioresistant. In fact all tissues subjected to radiotherapy can develop lesions. Possible damage includes: - pericardiac fibrosis, the commonest and best individualized, associated with a constriction this leads to a stoppage pattern usually occurring late, around the 18th month. Its frequency depends directly on the total radiation dose; - fibrous myocarditis by direct damage to the heart muscle; - stenosis type lesions of the large coronary trunks; - in exceptional cases lesions of the aorta: hyperplastic degenerescence of the intima and adventitia or of the aortic sigmoid valvules and the mitral valves. Three observations are reported, concerning a coronary, a pericardiac and a coronary, myocardiac and pericardiac lesion. Following this account the irradiation techniques and main experimental data are reviewed and the prophylactic and therapeutic consequences to be derived from our observations and those of the literature are examined [fr

  12. Ocular lesions in irradiated beagles

    International Nuclear Information System (INIS)

    Benjamin, S.A.; Lee, A.C.; Schweitzer, D.J.; Phemister, R.D.

    1981-01-01

    Both Segment II and Segment III dogs exposed at 28 or 55 days postcoitus (dpc) or at 2 days postpartum (dpp), when the retina is still developing, were evaluated clinically and histopathologically for the presence of retinal lesions. The Segment II dogs received 0 to 355 rads and were sacrificed at 70 days or 2 to 4 years of age. The Segment III experimental groups received 0, 16 or 83 rads and were sacrificed at 5 years of age. Findings in the Segment II irradiated dogs included retinal dysplasia and progressive retinal atrophy accompanied by retinal vascular attenuation. The severity and extent of the lesions increased with dose. The localization of the lesions in the retina was dependent on the age at irradiation, hence, the state of differentiation of the developing retina. No clear evidence of radiation-induced retinal lesions was seen in Segment III dogs sacrificed at 5 years of age

  13. MRI atlas of MS lesions

    Energy Technology Data Exchange (ETDEWEB)

    Sahraian, Mohammad Ali [Tehran Univ. of Medical Sciences Sina Hospital (Iran). Dept. of Neurology; Radue, Ernst-Wilhelm [Univ. Hospital Basel (Switzerland). Dept. of Neuroradiology

    2008-07-01

    MRI has become the main paraclinical test in the diagnosis and management of multiple sclerosis. We have demonstrated more than 400 pictures of different typical and atypical MS lesions in this atlas. Each image has a teaching point. New diagnostic criteria and differential diagnosis are discussed and the book is supported by a teaching DVD where the reader can see MS lesions in different slices and sequences. (orig.)

  14. Apraxia in deep cerebral lesions.

    OpenAIRE

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

    1983-01-01

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

  15. Rosacea with extensive extrafacial lesions

    OpenAIRE

    Pereira, TM; Vieira, AP; Sousa-Basto, A

    2008-01-01

    Rosacea is a very common skin disorder in the clinical practice that primarily affects the convex areas of the face. Extrafacial rosacea lesions have occasionally been described, but extensive involvement is exceptional. In the absence of its typical clinical or histological features, the diagnosis of extrafacial rosacea may be problematic. We describe an unusual case of rosacea with very exuberant extrafacial lesions, when compared with the limited involvement of the face.

  16. Unusual lesions of the mediastinum

    Directory of Open Access Journals (Sweden)

    Fatima Shamsuddin

    2015-01-01

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

  17. Premalignant Lesions in the Kidney

    Directory of Open Access Journals (Sweden)

    Ziva Kirkali

    2001-01-01

    Full Text Available Renal cell carcinoma (RCC is the most malignant urologic disease. Different lesions, such as dysplasia in the tubules adjacent to RCC, atypical hyperplasia in the cyst epithelium of von Hippel-Lindau syndrome, and adenoma have been described for a number of years as possible premalignant changes or precursor lesions of RCC. In two recent papers, kidneys adjacent to RCC or removed from other causes were analyzed, and dysplastic lesions were identified and defined in detail. Currently renal intraepithelial neoplasia (RIN is the proposed term for classification. The criteria for a lesion to be defined as premalignant are (1 morphological similarity; (2 spatial association; (3 development of microinvasive carcinoma; (4 higher frequency, severity, and extent then invasive carcinoma; (5 progression to invasive cancer; and (6 similar genetic alterations. RIN resembles the neoplastic cells of RCC. There is spatial association. Progression to invasive carcinoma is described in experimental cancer models, and in some human renal tumors. Similar molecular alterations are found in some putative premalignant changes. The treatment for RCC is radical or partial nephrectomy. Preneoplastic lesions may remain in the renal remnant in patients treated by partial nephrectomy and may be the source of local recurrences. RIN seems to be a biologic precursor of some RCCs and warrants further investigation. Interpretation and reporting of these lesions would reveal important resources for the biological nature and clinical significance. The management of RIN diagnosed in a renal biopsy and partial nephrectomy needs to be answered.

  18. Managing Carious Lesions

    DEFF Research Database (Denmark)

    Innes, N P T; Frencken, J E; Bjørndal, L

    2016-01-01

    manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm...... words used in the literature for caries removal techniques, and 2) agreed terms and definitions, explaining how these were decided.Dental cariesis the name of the disease, and thecarious lesionis the consequence and manifestation of the disease-the signs or symptoms of the disease. The termdental caries...... dentine; 2)stepwise removal-including stage 1,selective removal to soft dentine, and stage 2,selective removal to firm dentine6 to 12 mo later; and 3)nonselective removal to hard dentine-formerly known ascomplete caries removal(technique no longer recommended). Adoption of these terms, around managing...

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

    Science.gov (United States)

    Storm, Andrew C; Lee, Linda S

    2016-10-21

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

  20. Fast semi-automated lesion demarcation in stroke

    Directory of Open Access Journals (Sweden)

    Bianca de Haan

    2015-01-01

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

  1. Lesions of anogenital mammary-like glands: an update.

    Science.gov (United States)

    Kazakov, Dmitry V; Spagnolo, Dominic V; Kacerovska, Denisa; Michal, Michal

    2011-01-01

    Long considered to be ectopic breast tissue representing the caudal remnants of the milk ridges, anogenital mammary-like glands are nowadays thought to represent a normal constituent of the anogenital area. Lesions involving these glands, benign or malignant, epithelial or stromal manifest a striking similarity to their mammary counterparts. This review addresses the recent literature on lesions of anogenital mammary-like glands and our personal experience with various lesions related to these structures. Discussed are the normal anatomy and histology of these glands as well as the clinical presentation, histopathological and immunohistochemical features, molecular biological aspects, and differential diagnosis of various lesions involving anogenital mammary-like glands, including lactating adenoma, hidradenoma papilliferum, hidradenocarcinoma papilliferum, fibroadenomas, phyllodes tumor, pseudoangiomatous stromal hyperplasia, extramammary Paget disease, and other carcinomas. In addition, "nonspecific" epithelial or stromal changes some of which can be likened to similar changes occurring in a range of benign breast disease, including sclerosing adenosis, columnar cell lesions, ductal lesions and various metaplastic changes affecting epithelium and myoepithelium are discussed. Although lesions of anogenital mammary-like glands are often discussed in many dermatopathology textbooks in the context of cutaneous adnexal neoplasms we advocate that the best approach to the diagnosis of these lesions is to relate them to analogous well recognized lesions occurring in the breast, that is, through the eyes of a breast pathologist. This will enable their recognition, precise classification and should introduce greater uniformity in how they are reported in the literature so that more meaningful clinicopathological comparisons and correlations may be made.

  2. MRI of the stener lesion

    International Nuclear Information System (INIS)

    Haramati, N.; Hiller, N.; Dowdle, J.; Jacobson, M.; Barax, C.N.; Lieberfarb, R.I.; Lester, B.; Kulick, R.G.

    1995-01-01

    Six cadaver thumbs had ulnar collateral ligament (UCL) tears created surgically. MR examinations (2D STIR and 3D GRASS) were performed identically on all specimens both before displacement (non-Stener) and after displacement (Stener lesion) of the UCL. The MR images were then randomly numbered. Each image was evaluated separately in blinded fashion by four musculoskeletal radiologists for the presence or absence of a Stener lesion. Each radiologist reinterpreted the images after an interval of several days. The interpretation was based on previously published criteria for Stener lesion diagnosis by MR. The sensitivity of GRASS ranged from 0.17 to 0.67 with the most experienced reader scoring the lowest. The specificity of GRASS ranged from 0.33 to 1.0 (most experienced reader 0.67, 0.83). STIR had a sensitivity of 0.00-0.17 and a specificity of 0.53-0.83. The K values for inter- and intraobserver agreement were measured. The intraobserver K for GRASS was 0.27-0.75 (most experienced reader 0.75). 2D imaging is probably inadequate for the evaluation of Stener lesions. The most likely reason is that the STIR slice thickness of 3 mm limits resolution of small UCLs. The poor sensitivity and specificity of GRASS as well as poor interobserver agreement suggest that MR may not be sufficiently accurate for Stener lesion evaluation. (orig./MG)

  3. Abordagem estereotáxica guiada por imagem de lesões do sistema nervoso central: precisão diagnóstica, morbidade, mortalidade Image guided stereotactic approach of central nervous system lesions: accuracy, morbidity, mortality

    Directory of Open Access Journals (Sweden)

    MARCELO KEN-ITI HISATUGO

    1999-09-01

    Full Text Available Analisamos 75 pacientes com lesões do sistema nervoso central submetidos a biópsia estereotáxica no período de março de 1993 a dezembro de 1998 na Universidade Federal de São Paulo - Escola Paulista de Medicina. As três lesões mais frequentes foram: metástase, astrocitoma de baixo grau e glioblastoma multiforme. O índice de morbidade foi 2,66% decorrente de: infecção de ferida operatória em uma paciente portadora de cisto talâmico; e de um paciente com linfoma que apresentou crise convulsiva parcial motora durante a cirurgia. A mortalidade foi 1,33% decorrente de piora intensa de edema perilesional, falecendo o paciente após uma semana. O índice de diagnóstico foi 89,33%.We studied seventy-five patients with brain lesions biopsied by stereotaxis from March 1993 to December 1998 at Universidade Federal de São Paulo - Escola Paulista de Medicina. The three most frequent lesions were: metastasis, low grade astrocytomas and glioblastoma multiforme. The morbidity rate was 2.66% due to: one case of scalp infection in a patient with thalamic cyst; and a partial seizure during surgery in a patient with lynphoma. The mortality rate was 1.33% due to increasing of cerebral edema after biopsy and the patient died after one week. The diagnostic accuracy was 89.33%.

  4. The skull base: tumoral lesions

    International Nuclear Information System (INIS)

    Casselman, Jan W.

    2005-01-01

    Many lesions occur in the anterior, central and posterior skull base. In order to detect and characterise them, one has to apply the best imaging technique. Today MR is the preferred technique, and the use of CT is more and more restricted to evaluate the presence of calcifications and involvement of thin bony walls, foramina and fissures. However, MR is only superior when the right sequences and imaging planes are used. Many lesions can be characterised by their specific signal intensity on different sequences and by their location. Nevertheless some lesions can only be characterised after biopsy. The purpose of imaging in skull base tumours remains in the first place the evaluation of the exact tumour extent, and this is again best achieved with MR. In this paper the imaging technique and the most frequent skull base tumours are discussed. (orig.)

  5. Classification of multiple sclerosis lesions using adaptive dictionary learning.

    Science.gov (United States)

    Deshpande, Hrishikesh; Maurel, Pierre; Barillot, Christian

    2015-12-01

    This paper presents a sparse representation and an adaptive dictionary learning based method for automated classification of multiple sclerosis (MS) lesions in magnetic resonance (MR) images. Manual delineation of MS lesions is a time-consuming task, requiring neuroradiology experts to analyze huge volume of MR data. This, in addition to the high intra- and inter-observer variability necessitates the requirement of automated MS lesion classification methods. Among many image representation models and classification methods that can be used for such purpose, we investigate the use of sparse modeling. In the recent years, sparse representation has evolved as a tool in modeling data using a few basis elements of an over-complete dictionary and has found applications in many image processing tasks including classification. We propose a supervised classification approach by learning dictionaries specific to the lesions and individual healthy brain tissues, which include white matter (WM), gray matter (GM) and cerebrospinal fluid (CSF). The size of the dictionaries learned for each class plays a major role in data representation but it is an even more crucial element in the case of competitive classification. Our approach adapts the size of the dictionary for each class, depending on the complexity of the underlying data. The algorithm is validated using 52 multi-sequence MR images acquired from 13 MS patients. The results demonstrate the effectiveness of our approach in MS lesion classification. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Lesiones frecuentes en atletas profesionales

    OpenAIRE

    Doyel, Crevecoer

    2015-01-01

    Durante la práctica del atletismo frecuentemente ocurren lesiones, afectando principalmente a los miembros inferiores. Las causas que las originan son muy diversas y tienen diferentes características de acuerdo al tipo de modalidad realizada dentro del atletismo. Objetivo: Analizar las características de las lesiones más frecuentes en miembros inferiores, en atletas corredores profesionales, de diferentes distancias, de ambos sexos, de entre 18 y 40 años de edad, que practican atletismo en...

  7. Dynamic MRI of orbital lesions

    Energy Technology Data Exchange (ETDEWEB)

    Sawada, Akihiro; Matsumoto, Hiroko (Kochi Medical School, Nangoku (Japan))

    1991-04-01

    Study of time intensity curves was performed for 15 orbital lesions. Inflammatory lesions (2 chronic dacryoadenitis, 1 chalazion, 1 inflammatory pseudotumor), 1 meningioma, and 4 pseudolymphoma showed rapid increase with run off. They showed peak formations within 2 minutes. Tumors except for meningioma (3 malignant lymphoma, 2 retinoblastoma, 1 pleomorphic adenoma of lacrimal gland) showed gradual increase without peak formation. No difference between benign and malignancy was detected. Dynamic MRI would be useful for differential diagnosis between pseudotumor and malignant lymphoma, that has been difficult for imaging diagnosis so far. (author).

  8. Pediatric Knee Osteochondritis Dissecans Lesions.

    Science.gov (United States)

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

    2016-10-01

    Osteochondritis dissecans (OCD) can cause knee pain and dysfunction in children. The etiology of OCD remains unclear; theories on causes include inflammation, ischemia, ossification abnormalities, genetic factors, and repetitive microtrauma. Most OCD lesions in skeletally immature patients will heal with nonoperative treatment. The success of nonoperative treatment decreases once patients reach skeletal maturity. The goals of surgical treatment include maintenance of articular cartilage congruity, rigid fixation of unstable fragments, and repair of osteochondral defects with cells or tissues that can adequately replace lost or deficient cartilage. Unsalvageable OCD lesions can be treated with various surgical techniques. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Similar but Different: How Reflectance Confocal Microscopy May Help in the Diagnosis of Pink Lesions.

    Science.gov (United States)

    Ferrari, Federica; Bassoli, Sara; Pellacani, Giovanni; Argenziano, Giuseppe; Cesinaro, Anna Maria; Longo, Caterina

    2017-01-01

    Among skin neoplasms, solitary pink tumors represent challenging lesions in clinical practice since they can mimic melanocytic and nonmelanocytic lesions or even inflammatory ones. In this case series we described dermoscopic and confocal features of 2 couples of similar lesions in order to achieve the correct diagnosis and the best therapeutic approach. During clinical routine practice, 2 couples of clinically and dermoscopically similar lesions were examined by means of confocal microscopy. All lesions revealed no clear-cut diagnostic features on dermoscopy. However, confocal microscopy revealed tumor islands with palisading cells and a dark clefting at the periphery in basal cell carcinomas. In the other "false twin" lesions, atypical cells and elongated junctional nests were observed and the diagnosis of amelanotic melanomas was rendered. In the current case series, the combined use of dermoscopy and reflectance confocal microscopy was an optimal workup for difficult-to-diagnose lesions such as pink tumors. © 2017 S. Karger AG, Basel.

  10. Disseminated paracoccidioidomycosis diagnosis based on oral lesions

    Directory of Open Access Journals (Sweden)

    Liana Preto Webber

    2014-01-01

    Full Text Available Paracoccidioidomycosis (PCM is a deep mycosis with primary lung manifestations that may present cutaneous and oral lesions. Oral lesions mimic other infectious diseases or even squamous cell carcinoma, clinically and microscopically. Sometimes, the dentist is the first to detect the disease, because lung lesions are asymptomatic, or even misdiagnosed. An unusual case of PCM with 5 months of evolution presenting pulmonary, oral, and cutaneous lesions that was diagnosed by the dentist based on oral lesions is presented and discussed.

  11. Imaging inflammatory acne: lesion detection and tracking

    Science.gov (United States)

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

    2010-02-01

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

  12. Focal lesions of the patella

    Energy Technology Data Exchange (ETDEWEB)

    Hedayati, B. [Royal national Orthopaedic Hospital Stanmore, Brockley Hill Stanmore, Department of Radiology, Middlesex (United Kingdom); Lewisham Hospital NHS Trust, Department of Radiology, London (United Kingdom); Saifuddin, A. [Royal national Orthopaedic Hospital Stanmore, Brockley Hill Stanmore, Department of Radiology, Middlesex (United Kingdom)

    2009-08-15

    Focal lesions of the patella may be identified during the investigation of anterior knee pain or as an incidental finding on radiological images. This pictorial review describes the radiographic appearances of a wide range of conditions that have been seen in this sesamoid bone. Where appropriate, computed tomography and magnetic resonance features have been included. (orig.)

  13. Cystic Lesions in Autoimmune Pancreatitis

    Directory of Open Access Journals (Sweden)

    Macarena Gompertz

    2015-11-01

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

  14. Self-inflicted skin lesions

    DEFF Research Database (Denmark)

    Ring, Hans Christian; Smith, Matthias Nybro; Jemec, Gregor B E

    2014-01-01

    The current literature on the management of self-inflicted skin lesions points to an overall paucity of treatments with a high level of evidence (randomized controlled trials, controlled trials, or meta-analyses). In order to improve the communication between dermatologists and mental health...

  15. Stereotactic lesioning for mental illness.

    Science.gov (United States)

    Kim, M-C; Lee, T-K

    2008-01-01

    The authors report stereotactically created lesioning by radiofrequency or Cyberknife radiosurgery for patients with mental illness. Since 1993, thirty-eight patients have undergone stereotactic psychosurgery for medically intractable mental illnesses. Two patients had aggressive behavior. Twenty-five patients suffered from Obsessive-Compulsive Disorder (OCD) and ten patients had depression. Another patient suffered from atypical psychosis. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior. Limbic leucotomy or anterior cingulotomy was done for OCD and subcaudate tractotomy with or without cingulotomy was done for depression. In twenty-three patients, the lesions were made by a radiofrequency (RF) lesion generator. In fifteen cases, the lesions were made with CyberKnife Radiosurgery (CKRS). The Overt Aggression Scale (OAS) declined from 8 to 2 with clinical improvement during follow up period. With long-term follow up (meaning 57 months) in 25 OCDs, the mean Yale Brown Obsessive Compulsive Score (YBOCS) declined from 34 to 13 (n = 25). The Hamilton Depression scale (HAMD) for ten patients with depression declined from 38.5 to 10.5 (n = 10). There was no operative mortality and no significant morbidity except one case with transient urinary incontinence. Authors suggest that stereotactic psychosurgery by RF and CKRS could be a safe and effective means of treating some medically intractable mental illnesses.

  16. Odontogenic lesions in pediatric patients.

    Science.gov (United States)

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

    2014-05-01

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

  17. Direct surgery for brainstem lesions

    Energy Technology Data Exchange (ETDEWEB)

    Sakai, Noboru [Gifu Univ. (Japan). School of Medicine

    1997-09-01

    Direct surgery for intrinsic lesions of the brainstem has been considered a hazardous procedure. During the past 10 years, 32 cases of symptomatic lesions involving the brainstem were operated on. Magnetic resonance (MR) imaging is of greatest value in the diagnosis and for surgical indications. Almost all cases were treated by radical extirpation. Namely, 9 cavernous angiomas and 2 hemangioblastomas resulted in radical extirpation. The preoperative neurological deficits improved after surgery. Also, 2 ependymomas, 4 medulloblastomas, 4 plexus papillomas, and 1 epidermoid were successfully extirpated, and the surgical treatment for them allowed favorable outcome. Therefore, those brainstem lesions were considered to be more favorable indications for direct surgery. On the other hand, 4 astrocytomas and 6 glioblastomas were either subtotally or partially resected, in which a small incision in the fourth ventricle floor and the surface of the brainstem was made when the lesion was intramedullary. Consequently, there were neither mortality in surgery nor aggravation of the focal neurological symptoms. High-grade glioma in 6 cases was removed as much as possible, but almost all of the cases nevertheless expired due to prompt recurrence under 2 years after onset of symptoms and surgery. (author)

  18. Stereotactic lesioning for mental illness

    International Nuclear Information System (INIS)

    Kim, M.-C.; Lee, T.-K.

    2008-01-01

    The authors report stereotactically created lesioning by radiofrequency or Cyberknife radiosurgery for patients with mental illness. Since 1993, thirty-eight patients have undergone stereotactic psychosurgery for medically intractable mental illnesses. Two patients had aggressive behavior. Twenty-five patients suffered from Obsessive-Compulsive Disorder (OCD) and ten patients had depression. Another patient suffered from atypical psychosis. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior. Limbic leucotomy or anterior cingulotomy was done for CCD and subcaudate tractotomy with or without cingulotomy was done for depression. In twenty-three patients, the lesions were made by a radiofrequency (RF) lesion generator. In fifteen cases, the lesions were made with Cyberknife Radiosurgery (CKRS). The Overt Aggression Scale (OAS) declined from 8 to 2 with clinical improvement during follow up period. With long-term follow up (meaning 57 months) in 25 OCDs, the mean Yale Brown Obsessive Compulsive Score (YBOCS) declined from 34 to 13 (n = 25). The Hamilton Depression scale (HAMD) for ten patients with depression declined from 38.5 to 10.5 (n = 10). There was no operative mortality and no significant morbidity except one case with transient urinary incontinence. Authors suggest that stereotactic psychosurgery by RF and CKRS could be a safe and effective means of treating some medically intractable mental illnesses. (author)

  19. Restorative treatment for initial, cavitated and gross coronal carious lesions.

    Science.gov (United States)

    Brennan, D S; Balasubramanian, M; Spencer, A J

    2016-09-01

    Treatment patterns for caries have been shown to reflect high rates of restorative services. The objective of this study was to investigate types of restorative treatment provided to patients with a main diagnosis of coronal caries in relation to the severity of the caries lesion. A random sample of Australian dentists was surveyed by mailed questionnaires in 2009-2010 (response rate 67%). Data on types of restorative treatment, patient characteristics and main diagnosis were collected from a service log. Models of service rates adjusted for age, gender, insurance status and reason for visit showed that compared to the reference category of initial caries lesions, there were lower rates [Rate Ratio, 95% CI] of adhesive anterior restorative services [0.57, 0.34-0.95] and lower rates of adhesive posterior restorations [0.56, 0.40-0.79] for gross lesions. Treatment of coronal caries was characterized by high rates of adhesive posterior restorative services, but gross lesions had lower rates of both anterior and posterior adhesive restorations. Types of restorative treatment for coronal caries were similar between initial and cavitated lesions. This could indicate scope for the adoption of more minimum intervention approaches to the management of initial carious lesions. © 2015 Australian Dental Association.

  20. A promising split-lesion technique for rapid tattoo removal using a novel sequential approach of a single sitting of pulsed CO(2) followed by Q-switched Nd: YAG laser (1064 nm).

    Science.gov (United States)

    Sardana, Kabir; Garg, Vijay K; Bansal, Shivani; Goel, Khushbu

    2013-12-01

    Laser tattoo removal conventionally uses Q-switched (QS) lasers, but they require multiple sittings, and the end results depend largely on the type of tattoo treated. In pigmented skin, due to the competing epidermal pigment results, laser results in tattoo are slow and inadequate. To evaluate the efficacy of a combined use of ultrapulse CO2 and QS Nd:YAG (1064 nm) laser in the treatment of tattoos in Indian skin. A split-lesion trial was carried out in five patients, with the left side of tattoos receiving the QS Nd:YAG (1064 nm) and the right side, a sequential combination of Up CO2 and QS Nd: YAG at 6 weeks interval with a maximum of six sittings. Outcome assessment was carried out by a blinded assessor using standardized photography. An assessment of physician improvement score, side-effects score, and patient satisfaction score was taken during and at the end of the study. There was a statistically significant improvement on the combination side(physician improvement score -3.7 vs. 1.87: P = 0.0019) which occurred earlier with fewer sittings (1.7 vs. 6). There was no statistically significant difference in the side effects. A combination of an Up CO2 laser with QS Nd: YAG laser is a promising tool for rapid and effective removal of blue-black/blue amateur tattoo in pigmented skin. © 2013 Wiley Periodicals, Inc.

  1. CT-based needle marking of superficial intracranial lesions for minimal invasive neurosurgery

    International Nuclear Information System (INIS)

    Marquardt, G.; Wolff, R.; Schick, U.; Lorenz, R.

    2000-01-01

    A CT-based method of marking superficial intracranial lesions with a needle is presented. This form of neuronavigation can be applied in every neurosurgical centre. Owing to its rapid application it is also suitable for cases of emergency. The neurosurgical approach can be centred precisely over this lesion providing for a minimally invasive operation. The method has proved its efficacy in numerous cases of haematomas and cystic lesions. (author)

  2. Surgical management of metastatic lesions at the cervicothoracic junction

    Directory of Open Access Journals (Sweden)

    Joseph F Baker

    2015-01-01

    Full Text Available Purpose: The cervicothoracic junction (CTJ represents a transition from the semirigid thoracic spine to the mobile subaxial cervical spine. Pathologic lesions are prone to kyphotic deformity. The aim of this study was to review our experience with surgical stabilization of metastatic lesions affecting the CTJ (C7-T2. Materials and Methods: We reviewed all surgical stabilizations of metastatic spine lesions over the preceding 4 years in our institution. A total of 14 patients with CTJ lesions were identified. Case notes and radiology were reviewed to determine the presentation, outcomes, and specific complications. Results: The mean survival was 405 days (standard deviation [s.d.] 352. 8/14 died at a mean time from surgery of 193 days (s.d. 306. Most cases were a result of either lung or breast primary tumors. Half were stabilized with an anterior only approach and two had staged anterior-posterior. There were no cases of neurologic deterioration in this cohort as a result of surgery. There were two cases of deep surgical site infection and two documented cases of pulmonary embolus. There were no reported construct failures over the follow-up period. Conclusion: Patients with cervicothoracic metastatic lesions can be treated with either anterior or posterior approaches or a combination after considering each individual′s potential instability and disease burden.

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

    Science.gov (United States)

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

    2015-01-01

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

  4. Saliency-Based Lesion Segmentation Via Background Detection in Dermoscopic Images.

    Science.gov (United States)

    Ahn, Euijoon; Kim, Jinman; Bi, Lei; Kumar, Ashnil; Li, Changyang; Fulham, Michael; Feng, David Dagan

    2017-11-01

    The segmentation of skin lesions in dermoscopic images is a fundamental step in automated computer-aided diagnosis of melanoma. Conventional segmentation methods, however, have difficulties when the lesion borders are indistinct and when contrast between the lesion and the surrounding skin is low. They also perform poorly when there is a heterogeneous background or a lesion that touches the image boundaries; this then results in under- and oversegmentation of the skin lesion. We suggest that saliency detection using the reconstruction errors derived from a sparse representation model coupled with a novel background detection can more accurately discriminate the lesion from surrounding regions. We further propose a Bayesian framework that better delineates the shape and boundaries of the lesion. We also evaluated our approach on two public datasets comprising 1100 dermoscopic images and compared it to other conventional and state-of-the-art unsupervised (i.e., no training required) lesion segmentation methods, as well as the state-of-the-art unsupervised saliency detection methods. Our results show that our approach is more accurate and robust in segmenting lesions compared to other methods. We also discuss the general extension of our framework as a saliency optimization algorithm for lesion segmentation.

  5. Petrous apex lesions in the pediatric population

    Energy Technology Data Exchange (ETDEWEB)

    Radhakrishnan, Rupa [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Son, Hwa Jung [University of Cincinnati College of Medicine, Department of Otolaryngology-Head and Neck Surgery, Cincinnati, OH (United States); Koch, Bernadette L. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2014-03-15

    A variety of abnormal imaging findings of the petrous apex are encountered in children. Many petrous apex lesions are identified incidentally while images of the brain or head and neck are being obtained for indications unrelated to the temporal bone. Differential considerations of petrous apex lesions in children include ''leave me alone'' lesions, infectious or inflammatory lesions, fibro-osseous lesions, neoplasms and neoplasm-like lesions, as well as a few rare miscellaneous conditions. Some lesions are similar to those encountered in adults, and some are unique to children. Langerhans cell histiocytosis (LCH) and primary and metastatic pediatric malignancies such as neuroblastoma, rhabomyosarcoma and Ewing sarcoma are more likely to be encountered in children. Lesions such as petrous apex cholesterol granuloma, cholesteatoma and chondrosarcoma are more common in adults and are rarely a diagnostic consideration in children. We present a comprehensive pictorial review of CT and MRI appearances of pediatric petrous apex lesions. (orig.)

  6. Imaging review of lipomatous musculoskeletal lesions

    Directory of Open Access Journals (Sweden)

    Burt Ashley M.

    2017-01-01

    Full Text Available Lipomatous lesions are common musculoskeletal lesions that can arise within the soft tissues, bone, neurovascular structures, and synovium. The majority of these lesions are benign, and many of the benign lesions can be diagnosed by radiologic evaluation. However, radiologic differences between benign and malignant lipomatous lesions may be subtle and pathologic correlation is often needed. The use of sonography, computed tomography (CT, and magnetic resonance imaging (MRI is useful not only in portraying fat within the lesion, but also for evaluating the presence and extent of soft tissue components. Lipomas make up most soft tissue lipomatous lesions, but careful evaluation must be performed to distinguish these lesions from a low-grade liposarcoma. In addition to the imaging appearance, the location of the lesion and the patient demographics can be utilized to help diagnose other soft tissue lipomatous lesions, such as elastofibroma dorsi, angiolipoma, lipoblastoma, and hibernoma. Osseous lipomatous lesions such as a parosteal lipoma and intraosseous lipoma occur less commonly as their soft tissue counterpart, but are also benign. Neurovascular and synovial lipomatous lesions are much rarer lesions but demonstrate more classic radiologic findings, particularly on MRI. A review of the clinical, radiologic, and pathologic characteristics of these lesions is presented.

  7. Neurosurgical Management of Nonmissile Penetrating Cranial Lesions.

    Science.gov (United States)

    de Holanda, Luciano Ferreira; Pereira, Benedito Jamilson A; Holanda, Rafael Rodrigues; Neto, José Targino; de Holanda, Carlos Vanderlei M; Giudicissi Filho, Miguel; de Oliveira, Nathalia Ribeiro Cunha; de Oliveira, Jean G

    2016-06-01

    The objective of this study is to present a case series of nonmissile penetrating (NMP) injuries and to establish a workflow for an uncommon mechanism of traumatic head injury through the analysis of each case, classification of the type of lesion, management, and outcome score at follow-up. From January 1991 to December 2008, 36,000 patients presenting with traumatic brain injury (TBI) were admitted in the Department of Neurosurgery, Hospital Antônio Targino, Campina Grande-PB, Brazil. From these patients, 11 presenting with lesions caused by NMP objects were selected. Among the 11 patients, 9 were men and 2 were women. Their ages ranged from 7 to 74 years old (mean age ± SD, 29.1 ± 22.99 years). All patients underwent neuroradiologic evaluation. The entry point was classified as natural (orbit) or artificial (skull transfixation), and we also divided the patients presenting with secondary parenchymal or vascular damage from those presenting with only lesions caused by the primary penetration into the cranium and meninges. All patients were neurosurgically treated with removal of the foreign body through craniotomy, except the patient whose object (pen) was removed without craniotomy with local anesthesia. Glasgow Coma Scale (GCS) score on admission was a statistically significant factor on prognosis, and any patient who presented with a GCS score of 15 evolved satisfactorily, and there were no deaths in this group of patients (P = 0.04). TBIs caused by NMP objects are unusual and caused by aggression, self-inflicted harm (in the case of psychiatric patients), and accident. The foreign body may enter into the skull through a natural hole (orbit, nose, mouth, or ear) or crosses the skull, causing a fracture and creating an artificial hole. Preoperative neuroradiologic assessment is paramount for the correct neurosurgical approach. The main prognostic factor for these patients is the GCS score at admission. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Skin Lesions in Swine with Decompression Sickness: Clinical Appearance and Pathogenesis

    Directory of Open Access Journals (Sweden)

    Long Qing

    2017-07-01

    Full Text Available Skin lesions are visual clinical manifestations of decompression sickness (DCS. Comprehensive knowledge of skin lesions would give simple but strong clinical evidence to help diagnose DCS. The aim of this study was to systematically depict skin lesions and explore their pathophysiological basis in a swine DCS model. Thirteen Bama swine underwent simulated diving in a hyperbaric animal chamber with the profile of 40 msw-35 min exposure, followed by decompression in 11 min. After decompression, chronological changes in the appearance of skin lesions, skin ultrasound, temperature, tissue nitric oxide (NO levels, and histopathology were studied. Meanwhile bubbles and central nervous system (CNS function were monitored. All animals developed skin lesions and two died abruptly possibly due to cardiopulmonary failure. A staging approach was developed to divide the appearance into six consecutive stages, which could help diagnosing the progress of skin lesions. Bubbles were only seen in right but not left heart chambers. There were strong correlations between bubble load, lesion area, latency to lesion appearance and existence of cutaneous lesions (P = 0.007, P = 0.002, P = 0.004, respectively. Even though local skin temperature did not change significantly, skin thickness increased, NO elevated and histological changes were observed. Increased vessel echo-reflectors in lesion areas were detected ultrasonically. No CNS dysfunction was detected by treadmill walking and evoked potential. The present results suggest skin lesions mainly result from local bubbles and not CNS injuries or arterial bubbles.

  9. Adaptive lesion formation using dual mode ultrasound array system

    Science.gov (United States)

    Liu, Dalong; Casper, Andrew; Haritonova, Alyona; Ebbini, Emad S.

    2017-03-01

    We present the results from an ultrasound-guided focused ultrasound platform designed to perform real-time monitoring and control of lesion formation. Real-time signal processing of echogenicity changes during lesion formation allows for identification of signature events indicative of tissue damage. The detection of these events triggers the cessation or the reduction of the exposure (intensity and/or time) to prevent overexposure. A dual mode ultrasound array (DMUA) is used for forming single- and multiple-focus patterns in a variety of tissues. The DMUA approach allows for inherent registration between the therapeutic and imaging coordinate systems providing instantaneous, spatially-accurate feedback on lesion formation dynamics. The beamformed RF data has been shown to have high sensitivity and specificity to tissue changes during lesion formation, including in vivo. In particular, the beamformed echo data from the DMUA is very sensitive to cavitation activity in response to HIFU in a variety of modes, e.g. boiling cavitation. This form of feedback is characterized by sudden increase in echogenicity that could occur within milliseconds of the application of HIFU (see http://youtu.be/No2wh-ceTLs for an example). The real-time beamforming and signal processing allowing the adaptive control of lesion formation is enabled by a high performance GPU platform (response time within 10 msec). We present results from a series of experiments in bovine cardiac tissue demonstrating the robustness and increased speed of volumetric lesion formation for a range of clinically-relevant exposures. Gross histology demonstrate clearly that adaptive lesion formation results in tissue damage consistent with the size of the focal spot and the raster scan in 3 dimensions. In contrast, uncontrolled volumetric lesions exhibit significant pre-focal buildup due to excessive exposure from multiple full-exposure HIFU shots. Stopping or reducing the HIFU exposure upon the detection of such an

  10. Local lesions and induced resistance.

    Science.gov (United States)

    Loebenstein, G

    2009-01-01

    The local lesion phenomenon is one of the most notable resistance mechanisms where virus after multiplying in several hundred cells around the point of entry, does not continue to spread and remains in a local infection. Several types of local lesions are known, inter alia, necrotic, chlorotic, and starch lesions. Cells inside the lesion generally contain much less virus than cells in a systemic infection. Cytopathic changes accompany the local lesion development. Proteases that may have properties similar to caspases, which promote programmed cell death (PCD) in animals, seem to participate in PCD during the hypersensitive response. Salicylic acid seems to be associated with the HR and may play a role in localizing the virus. The functions and properties of the N gene of Nicotiana, which was the first plant virus resistance gene to be isolated by transposon tagging, are discussed and compared with other plant genes for disease resistance. The Inhibitor of Virus Replication (IVR) associated with the local lesion response is mainly a tetratricopeptide repeat (TPR) protein. TPR motifs are also present in inducible interferons found in animal cells. Transformation of N. tabacum cv. Samsun nn, in which Tobacco mosaic virus (TMV) spreads systemically, with the NC330 gene sequence, encoding an IVR-like protein, resulted in a number of transgenic plant lines, expressing variable resistance to TMV and the fungal pathogen Botrytis cinerea. Transformation of tomato plants with the IVR gene became also partially resistant to B. cinerea (Loebenstein et al., in press). IVR-like compounds were found in the interspecific hybrid of N. glutinosa x N. debneyi that is highly resistant to TMV, and in the "green island" tissue of tobacco, cv. Xanthi-nc, infected with Cucumber mosaic virus (CMV). Infection in one part of the plant often induces resistance in other non-invaded tissues. Local (LAR) or systemic (SAR) acquired resistance can be activated by viruses, bacterial, and fungal

  11. CT-Guided Percutaneous Biopsy of Intrathoracic Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Lai, Hira; Neyaz, Zafar; Nath, Alok; Borah, Samudra [Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow (India)

    2012-03-15

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

  12. Imaging of Benign Odontogenic Lesions.

    Science.gov (United States)

    Scarfe, William C; Toghyani, Shiva; Azevedo, Bruno

    2018-01-01

    Numerous benign cysts or solid tumors may present in the jaws. These arise from tooth-forming tissues in the dental alveolus or from nonodontogenic tissues in the basal bone of the mandible and maxilla. Radiologists provide 2 deliverables to assist in diagnosis and management: (1) appropriately formatted images demonstrating the location and extent of the lesion and (2) interpretive reports highlighting specific radiologic findings and an impression providing a radiologic differential diagnosis. This article provides guidance on essential image protocols for planning treatments, a radiologic differential diagnostic algorithm based on location and pattern recognition, and a summary of the main features of benign odontogenic lesions. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. [HIV-associated periodontal lesions].

    Science.gov (United States)

    Langford, A

    1990-05-01

    During HIV infection different lesions may occur in the area of the gingiva and/or the periodontium. An increased frequency and severity of periodontal diseases has been observed. Different forms of Candida albicans infection have been clinically characterized as pseudomembranous, erythematous (atrophic) or hyperplastic form or as papillary variant. While infection with Candida albicans may occur frequently in other areas of the oral mucosa, candidiasis of the gingiva seems to be quite rare. Due to the underlying immunodeficiency, HIV-infected patients are prone to infection with and/or reactivation of different viruses, which may cause oral lesions as well. Recurrent progressive ulcerations may occur due to herpes simplex virus 1/2, while ulcerations with a punched-out appearance may result from disseminated CMV infection. Oral Kaposi's sarcoma may clinically present as bluish or red spots, which may increase into exophytic tumors during the progress of the disease.

  14. Hemimegalencephaly, hemihypertrophy and vascular lesions.

    Science.gov (United States)

    Cristaldi, A; Vigevano, F; Antoniazzi, G; di Capua, M; Andreuzzi, A; Morselli, G; Iorio, F; Fariello, G; Trasimeni, G; Gualdi, G F

    1995-02-01

    We report on two children with hemihypertrophy and ipsilateral hemimegalencephaly. Vascular lesions in one were consistent with a diagnosis of the Klippel-Trénaunay-Weber Syndrome. MRI performed in the first days of life and at 1 month of age revealed the presence of the neuronal anomaly. The occurrence of hemimegalencephaly in our patients indicates that hemihypertrophy and vascular dysplasia are pathogenetically related phenomena of a continuous spectrum in which this brain disorder may appear.

  15. Factitial pemphigus-like lesions

    OpenAIRE

    Zonuz, Ali Taghavi; Treister, Nathaniel; Mehdipour, Fahimeh; Farahani, Ramin Mostofi Zadeh; Tubbs, R. Shane; Shoja, Mohammadali Mohajel

    2007-01-01

    The maxillofacial region is rarely subjected to self-inflicted conditions such as factitious disease. Nasal ulceration, facial emphysema, periorbital ecchymosis, mandibular subluxation, gingival and mucosal ulceration, dental and salivary gland pain and glossopharyngeal neuralgia have been reported as possible manifestations of factitious disease. We report a case of a young woman who presented with unilateral bullous and ulcerative oral and erythematous facial lesions that were initially...

  16. Understanding posterior meniscal roots lesions: from basic science to treatment

    Directory of Open Access Journals (Sweden)

    Raphael Serra Cruz

    Full Text Available ABSTRACT The variability of symptoms and the fact that they are not easily recognized in imaging studies make the diagnosis and treatment of posterior meniscal roots lesions a challenging task to the orthopedist. In recent years, a more precise understanding of the anatomy and biomechanical impair of the knee joint in these cases has enabled great advances in therapeutic approaches. Well-documented studies have shown that the repair of these lesions presents superior functional and clinical improvement when compared with meniscectomy. However, the progression of degenerative joint changes in the long-term still exhibits conflicting results.

  17. Eye lesions in pet birds.

    Science.gov (United States)

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

    1993-03-01

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

  18. Automatic segmentation of psoriasis lesions

    Science.gov (United States)

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

    2014-10-01

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

  19. NEOPLASTIC LESIONS OF THE APPENDIX

    Directory of Open Access Journals (Sweden)

    Piotr Bryk

    2013-11-01

    Full Text Available The aim of the research was to present the clinical observations of neoplastic lesions of the appendix (one carcinoid and two mucous cysts and to discuss various manners of treatment and prognosis. Material and methods: The authors of the following paper present a description of three cases of appendix tumours, two patients with a mucous cyst and a patient with carcinoid, against the background of all the appendectomies performed at the Clinical Department of General, Endocrine and Oncological Surgery of the Provincial Polyclinical Hospital in Kielce in the years 2005–2011. Results : Within the 7-year period, a total of 11 719 surgical operations have been performed, where 834 (7.1% were that of appendectomy. Among all of the removed vermiform appendixes, neoplastic lesions occurred in three cases constituting a mere 0.3% of all of the appendectomies performed within that period. In two of the cases there was a suspicion of mucous cysts before the surgical operation. In none of the above-mentioned cases was is possible to ultimately establish the diagnosis before the operation. The patients were subjected to a simple appendectomy. The patients are in good clinical health, with no signs of relapse. Conclusions : The presented cases of patients with appendix tumours illustrate the difficulty of preoperative detection of a neoplastic lesion. This is mainly due to a scantily symptomatic course or symptoms typical of appendicitis. In light of this, histopathological examination of each appendix should be treated as obligatory.

  20. Incidental benign parotid lesions on FDG-PET: prevalence and clinico-pathologic findings

    International Nuclear Information System (INIS)

    Lim, Il Han; Lee, Won Woo; Chung, Jin Haeng; Park, So Yeon; Kim, Yu Kyeong; Kim, Sang Eun

    2007-01-01

    Incidental parotid lesions on F-18 FDG-PET can mimic distant metastasis of underlying malignancy. The prevalence and the clinico-pathologic findings of PET positive parotid lesions have not been known. We investigated how often incidental parotid lesions are found on clinical FDG-PET studies and what the clinico-pathologic characteristics of those parotid lesions are in the present study. We retrospectively reviewed 3, 344 cases of FDG-PET which had been obtained in our hospital from May 2003 to Dec 2006. The indications of FDG-PET were: evaluation of known/suspected cancer (n=3, 212) or screening of cancer in healthy subjects (n=132). Incidental parotid lesion on FDG-PET was defined as an un-expected FDG uptake in one of parotid glands which was not primary target lesion of current FDG-PET. FDG uptake was represented by maximum standardized uptake value (maxSUV). Final diagnosis was made by pathologic analysis or clinical follow-up assessment. Fifteen (0.45% = 15/3, 344) incidental parotid lesions were found and they were all benign lesions. The maxSUV ranged from 1.7 to 8.6 (means.d.=3.71.9). Final diagnoses of the incidental parotid lesions were; Warthin's tumor (n=2), pleomorphic adenoma (n=1), other un-specified benign lesion (n=1), and benign lesions under bases of imaging studies (n=3) and of clinical follow-up (n=8). All of incidentally found parotid lesions in clinical FDG-PET studies were confirmed as benign lesions with prevalence of 0.45%. Close follow up using PET or CT might be a reasonable approach for determining the nature of incidentally found parotid lesions

  1. The lesion in stereotactic suscaudate tractotomy.

    Science.gov (United States)

    Newcombe, R

    1975-05-01

    The anatomical distribution of 25 stereotactic tractotomy lesions is described. The posterior half of these lesions lie in a subcaudate position and the anterior half, for the most part, lies beneath the central segment of frontal white matter.

  2. Knowledge of nursing students on vasculogenic lesions

    Directory of Open Access Journals (Sweden)

    Raísa Leocádio Oliveira

    2016-01-01

    Full Text Available Objective: to assess the knowledge of nursing students on vasculogenic lesions. Methods: cross-sectional and descriptive study conducted in four higher education institutions. Researchers applied a questionnaire to 106 nursing students, which was composed of variables, such as school situation, prior contact and knowledge of students on the subject. Results: the mean score on the characteristics of vasculogenic lesions was higher among public institutions academic (33.0%, among those who reported having provided nursing care for patients with these lesions (37.7% and among those who claimed to know the difference between venous lesions and arterial lesions (25.5%. The higher amount of correct answers on venous lesions was related to the coloration in perilesional area (74.5%; and on arterial lesions, regarding habits and underlying diseases (67.0%. Conclusion: academics who have practical experience in the care of patients with vasculogenic lesions during undergraduate course had higher theoretical knowledge on the subject.

  3. Amalgam contact hypersensitivity lesion: an unusual presentation ...

    African Journals Online (AJOL)

    Amalgam or its components may cause Type IV hypersensitivity reactions on the oral mucosa. These amalgam contact hypersensitivity lesions (ACHL) present as white striae and plaques, erythematous, erosive, atrophic, or ulcerative lesions. Postinflammatory pigmentation in such lesions and pigmentation due to amalgam ...

  4. Lesion Contrast Enhancement in Medical Ultrasound Imaging

    DEFF Research Database (Denmark)

    Stetson, Paul F.; Sommer, F.G.; Macovski, A.

    1997-01-01

    Methods for improving the contrast-to-noise ratio (CNR) of low-contrast lesions in medical ultrasound imaging are described. Differences in the frequency spectra and amplitude distributions of the lesion and its surroundings can be used to increase the CNR of the lesion relative to the background...

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

    Science.gov (United States)

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

    2010-01-01

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

  6. Segmentation of multiple sclerosis lesions in MR images: a review

    Energy Technology Data Exchange (ETDEWEB)

    Mortazavi, Daryoush; Kouzani, Abbas Z. [Deakin University, School of Engineering, Geelong, Victoria (Australia); Soltanian-Zadeh, Hamid [Henry Ford Health System, Image Analysis Laboratory, Radiology Department, Detroit, MI (United States); University of Tehran, Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, Tehran (Iran, Islamic Republic of); School of Cognitive Sciences, Institute for Studies in Theoretical Physics and Mathematics (IPM), Tehran (Iran, Islamic Republic of)

    2012-04-15

    Multiple sclerosis (MS) is an inflammatory demyelinating disease that the parts of the nervous system through the lesions generated in the white matter of the brain. It brings about disabilities in different organs of the body such as eyes and muscles. Early detection of MS and estimation of its progression are critical for optimal treatment of the disease. For diagnosis and treatment evaluation of MS lesions, they may be detected and segmented in Magnetic Resonance Imaging (MRI) scans of the brain. However, due to the large amount of MRI data to be analyzed, manual segmentation of the lesions by clinical experts translates into a very cumbersome and time consuming task. In addition, manual segmentation is subjective and prone to human errors. Several groups have developed computerized methods to detect and segment MS lesions. These methods are not categorized and compared in the past. This paper reviews and compares various MS lesion segmentation methods proposed in recent years. It covers conventional methods like multilevel thresholding and region growing, as well as more recent Bayesian methods that require parameter estimation algorithms. It also covers parameter estimation methods like expectation maximization and adaptive mixture model which are among unsupervised techniques as well as kNN and Parzen window methods that are among supervised techniques. Integration of knowledge-based methods such as atlas-based approaches with Bayesian methods increases segmentation accuracy. In addition, employing intelligent classifiers like Fuzzy C-Means, Fuzzy Inference Systems, and Artificial Neural Networks reduces misclassified voxels. (orig.)

  7. Segmentation of multiple sclerosis lesions in MR images: a review

    International Nuclear Information System (INIS)

    Mortazavi, Daryoush; Kouzani, Abbas Z.; Soltanian-Zadeh, Hamid

    2012-01-01

    Multiple sclerosis (MS) is an inflammatory demyelinating disease that the parts of the nervous system through the lesions generated in the white matter of the brain. It brings about disabilities in different organs of the body such as eyes and muscles. Early detection of MS and estimation of its progression are critical for optimal treatment of the disease. For diagnosis and treatment evaluation of MS lesions, they may be detected and segmented in Magnetic Resonance Imaging (MRI) scans of the brain. However, due to the large amount of MRI data to be analyzed, manual segmentation of the lesions by clinical experts translates into a very cumbersome and time consuming task. In addition, manual segmentation is subjective and prone to human errors. Several groups have developed computerized methods to detect and segment MS lesions. These methods are not categorized and compared in the past. This paper reviews and compares various MS lesion segmentation methods proposed in recent years. It covers conventional methods like multilevel thresholding and region growing, as well as more recent Bayesian methods that require parameter estimation algorithms. It also covers parameter estimation methods like expectation maximization and adaptive mixture model which are among unsupervised techniques as well as kNN and Parzen window methods that are among supervised techniques. Integration of knowledge-based methods such as atlas-based approaches with Bayesian methods increases segmentation accuracy. In addition, employing intelligent classifiers like Fuzzy C-Means, Fuzzy Inference Systems, and Artificial Neural Networks reduces misclassified voxels. (orig.)

  8. Clinicopathologic Study of Intra- Osseous Lesions of the Jaws in Southern Iranian Population.

    Science.gov (United States)

    Jaafari-Ashkavandi, Zohreh; Akbari, Behrooz

    2017-12-01

    It is necessary for surgeons and practitioners to know about relative incidence and clinicopathologic features of lesions for accurate diagnosis and approach of pathologic lesions. Data are limited about overall incidence of intra-osseous lesions of the jaws in Iranian patients. This study evaluated the clinicopathologic features of intra- osseous lesions of the jaws in an Iranian population, in a 22-year period. In this cross- sectional retrospective analytical study, 4500 specimens in a 22- year period were reviewed. Baseline data of all patients with intra- osseous lesions including type and location of lesions as well as patients' age and gender, were collected and analyzed by SPSS software using descriptive analysis and Chi-square test. There were 1121 (25%) intra-osseous lesion. Odontogenic cysts and benign non- odontogenic bone lesions were the most common categories, respectively. The mean age of the patients was 30.1±16, the total male to female ratio was 1.1:1, and the most prevalent location of lesions was posterior of mandible. The results showed baseline information of intra-osseous lesions that were essentially similar to other populations; however, there were a few geographical differences. Further comprehensive studies in other parts of country are required to make a more reliable source of reference for clinicians and surgeons for evaluating and managing their patients more properly.

  9. Solitary lucent epiphyseal lesions in children

    Energy Technology Data Exchange (ETDEWEB)

    Gardner, D.J.; Azouz, E.M.

    1988-10-01

    We evaluated retrospectively the varying radiographic appearances of 15 solitary lucent epiphyseal lesions occurring in children. Imaging modalities used included plain films, conventional tomography, nuclear scintigraphy, and computed tomography. 40% of the lesions (6) were due to osteomyelitis. The remaining lesions included tuberculosis (1), foreign body granuloma (1), chondroblastoma (2), chondromyoxid fibroma (1), enchondroma (1), osteoid osteoma (2), and eosinophilic granuloma (1). Although the radiographic appearances of such lesions may be particularly characteristic, pathologic correlation is frequently necessary. The high incidence of osteomyelitis in our cases emphasizes its importance as a cause for a lucent epiphyseal lesion.

  10. Quantitative angiography methods for bifurcation lesions

    DEFF Research Database (Denmark)

    Collet, Carlos; Onuma, Yoshinobu; Cavalcante, Rafael

    2017-01-01

    Bifurcation lesions represent one of the most challenging lesion subsets in interventional cardiology. The European Bifurcation Club (EBC) is an academic consortium whose goal has been to assess and recommend the appropriate strategies to manage bifurcation lesions. The quantitative coronary...... angiography (QCA) methods for the evaluation of bifurcation lesions have been subject to extensive research. Single-vessel QCA has been shown to be inaccurate for the assessment of bifurcation lesion dimensions. For this reason, dedicated bifurcation software has been developed and validated. These software...

  11. JOURNAL CLUB: Evaluation of Diffusion Kurtosis Imaging of Stroke Lesion With Hemodynamic and Metabolic MRI in a Rodent Model of Acute Stroke.

    Science.gov (United States)

    Lu, Dongshuang; Jiang, Yinghua; Ji, Yang; Zhou, Iris Yuwen; Mandeville, Emiri; Lo, Eng H; Wang, Xiaoying; Sun, Phillip Zhe

    2018-02-22

    Diffusion kurtosis imaging (DKI) has emerged as a new acute stroke imaging approach, augmenting routine DWI. Although it has been shown that a diffusion lesion without kurtosis abnormality is more likely to recover after reperfusion, whereas a kurtosis lesion shows poor response, little is known about the underlying pathophysiologic profile of the kurtosis lesion versus the kurtosis lesion-diffusion lesion mismatch. We performed multiparametric MRI, including arterial spin labeling, pH-sensitive amide proton transfer, and DKI, in a rodent model of acute stroke caused by embolic middle cerebral artery occlusion. Diffusion and kurtosis lesions were semiautomatically segmented, and multiparametric MRI indexes were compared among the kurtosis lesion, diffusion lesion, kurtosis lesion-diffusion lesion mismatch, and the contralateral normal tissue area. We confirmed a significant difference between diffusion lesion and kurtosis lesion volumes (mean [± SD] volume, 151 ± 65 vs 125 ± 47 mm 3 ; p 0.05). Of importance, the pH of the kurtosis lesion was significantly lower than that of the lesion mismatch (mean pH, 6.81 ± 0.08 vs 6.89 ± 0.09; p < 0.01). The present study confirms that DKI provides an expedient approach for refining the heterogeneous DWI lesion that is associated with graded metabolic derangement, which is promising for improving the infarction core definition and ultimately helping to guide stroke treatment.

  12. Benign Eyelid Lesions: Six Months Study

    Directory of Open Access Journals (Sweden)

    E Abbasi Shavvazi

    2013-04-01

    Full Text Available Introduction: Benign eyelid lesions are classified to infectious, inflammatory and tumoral lesions. The various number of these lesions is due to unique eyelid anatomical structure. Some lesions are simple and do not need any treatment but sometimes patients refer to ophthalmologists due to beauty or problems such as pain, swelling. The aim of our study is to investigate and compare the relative frequency of benign eyelid lesions in Shahid Sadoughi eye clinic as well as the private offices. Methods: This cross sectional six month study was done on 247 patients who referred to Shahid Sadoughi eye clinic and the private offices in 2011. They were examined by direct observation and slit lamp regardless of the cause. The information was gleaned by a questionnaire and the research data was analyzed by SPSS (ver.16. Results: we studied 247 patients including 84(34% male and 163(6% female. The mean age of the patients was 42.7 years. 60.2% of lesions were in upper lid and 39.8% were in lower lid. 51.2% of lesions were in right eye and 48.8% were in left eye. The most common eyelid lesions were papilloma (32.9% nevus (21.9% and chalazion (14.1% respectively. Conclusion: Papilloma, nevus and chalazion are respectively the most common lesion in men and women. Benign lesions were more common in women located more in upper lid, though there was no statistically difference between right and left lid.

  13. Treatment of metastatic brain lesion

    Directory of Open Access Journals (Sweden)

    A. M. Zaytsev

    2015-01-01

    Full Text Available Objective. Increasing survival in patients with secondary brain damage, and identifying the factors of favorable and adverse prognosis.Material and method. In P. A. Hertsen Moscow Oncology Research Institute from 2007 to 2013 there were treated 268 patients with brain metastases. The mean age was 55.8 years (from 24 to 81 years. Metastases of colorectal cancer identified in 7.8%, cases of lung cancer in 34%, melanoma 9.3 %, breast cancer in 26%, kidney cancer in 11%, with non-identified primary tumor in 4.5%, other tumors accounted for 6.7%. Solitary metastasis was diagnosed in 164 (61,19% patients, oligometastasis (2-3 - 72 (26,87% patients with polymetastasis (more than 3 – 32 (11,94% patients. In 106 (39,55% of patients with brain metastases it was the only manifestation of the generalization process. To control the radical removal of the tumor in 93 (34,7% patients we used the method of fluorescence navigation (FN with the drug Alasens. In 66 (24,6% patients intraoperatively was held a session of photodynamic therapy (PDT. In 212 (79,1% cases, the removal of metastasis performed totally, 55 (20,9% patients stated Subtotal removal.Results. The observation period for the patients ranged from 3 to 79 months. Survival median among the entire group of patients with metastatic brain lesion was 12 months. Overall survival was significantly dependent on RPA class, the volume of postoperative treatment, histological type of primary tumor, number of intracerebral metastases and the timing of the relapse-free period.Conclusions. Factors that affects the overall survival are the features of the histology of the primary lesion, multiplicity of metastatic lesions, RPA class and the synchronous nature of the metastasis. The median of overall survival of patients who did not receive after surgical treatment of a particular type of therapy was only 4 months. If to use the combined treatment (surgical treatment with the irradiation of the whole brain median

  14. The prevalence of secondary dentinal lesions in cheek teeth from horses with clinical signs of pulpitis compared to controls.

    Science.gov (United States)

    Casey, M B; Tremaine, W H

    2010-01-01

    With the advent of detailed oral examination in horses using dental mirrors and rigid endoscopy, secondary dentinal lesions are observed more frequently. More information regarding the association of secondary dentinal defects with apical dental disease would improve the sensitivity of oral examination as a diagnostic aid for pulpitis. To assess prevalence and severity of secondary dentinal defects observed on examination of occlusal surfaces of cheek teeth (CT) from horses showing clinical signs of pulpitis compared to asymptomatic controls. Records from all cases of equine CT exodontia at the University of Bristol over a 4 year period were examined. Case selection criteria included the presence of clinical signs of pulpitis, an intact extracted tooth and availability of a complete history and follow up. Cases where coronal fracture or periodontal pocketing featured were excluded. CT from cadavers with no history of dental disease served as normal controls. Triadan positions and eruption ages of control teeth were matched with those of teeth extracted from cases. CT from selected cases and control teeth were examined occlusally. Secondary dentinal defects were identified and graded. Prevalence of occlusal lesions in CT with pulpitis and controls was compared. From the records of 120 horses where exodontia was performed, 40 cases matched selection criteria. Twenty-three mandibular and 21 maxillary CT were extracted from cases. The controls consisted of 60 mandibular and 60 maxillary CT from 7 cadaver skulls. Secondary dentinal defects were significantly over-represented in CT extracted from cases of pulpitis (P pulpitis in equine CT.

  15. Categorizing Cortical Dysplasia Lesions for Surgical Outcome Using Network Functional Connectivity

    Science.gov (United States)

    Bdaiwi, Abdullah Sarray

    Lesion-symptom mapping is a powerful and broadly applicable approach that is used for linking neurological symptoms to specific brain regions. Traditionally, it involves identifying overlap in lesion location across patients with similar symptoms. This approach has limitations when symptoms do not localize to a single region or when lesions do not tend to overlap. In this thesis, we show that we can expand the traditional approach of lesion mapping to incorporate network effects into symptom localization without the need for specialized neuroimaging of patients. Our approach involves assessing the functional connectivity of each lesion volume with the rest of the typical healthy brain using a database of healthy pediatric brain imaging data (C-MIND), available at CCHMC. Our study included 24 subjects that had cortical dysplasia lesions and underwent surgery for seizures that did not respond to drug therapy. We tested our approach using healthy brain imaging data across all ages (2-18 years old) and using age & gender specific groupings of data. The analysis sought categorization of lesion connectivity based on five subject characteristics: gender, cortical dysplasia pathology, epilepsy syndrome, scalp EEG pattern and surgical outcome. Our primary analysis focused on surgical outcome. The results showed that there are some substantial connectivity differences in the outcome analysis. Lesions with stronger connectivity to default mode and attention/motor networks tended to result in poorer surgical outcomes. This result could be expanded with a larger set of data with the ultimate goal of allowing examination of lesions of cortical dysplasia patients and predicting their seizure outcomes.

  16. Hexachlorophene lesions in newborn infants.

    Science.gov (United States)

    Gowdy, J M; Ulsamer, A G

    1976-03-01

    Vacuolization of the white matter of the brain is produced by a number of disease entities and chemicals, including hexachlorophene. Brains of 135 stillborn infants and infants dying in the neonatal period were examined for vacuole formation in the white matter to determine if any hexachlorophene-like lesions could be found. A nonsignificant excess of vaculoes was found in infants bathed in hexachlorophene at birth compared with infants not bathed in it. Analysis of 11 brains for hexachlorophene showed that detectable levels were present in five, all of which showed vacuolization. None was detected in the remaining six, three of which also showed vacuolization. In two of these there was no hexachlorophene exposure.

  17. Bacteriology of diabetic foot lesions

    Directory of Open Access Journals (Sweden)

    Anandi C

    2004-01-01

    Full Text Available Clinical grading and bacteriological study of 107 patients with diabetic foot lesions revealed polymicrobial aetiology in 69 (64.4% and single aetiology in 21 (19.6%. Among 107 patients 62 had ulcer. Of these 31 had mixed aerobes. Twenty six patients with cellulitis and 12 with gangrene had more than 5 types of aerobes and anaerobes such as E.coli, Klebsiella spp., Pseudomonas spp., Proteus spp., Enterobactor spp., Enterococci spp., Clostridium perfringens, Bacteroides spp., Prevotella spp. and Peptostreptococcus spp. It was noted that 50 out of 62 patients with ulcer, and all the patients with cellulitis and gangrene were given surgical management and treated with appropriate antibiotics based on antimicrobial susceptibility testing.

  18. Imaging of extradural spinal lesions

    International Nuclear Information System (INIS)

    Ahlhelm, F.; Schulte-Altedorneburg, G.; Naumann, N.; Reith, W.; Nabhan, A.

    2006-01-01

    There is a wide variety of spinal extradural tumors. In addition to real neoplasms, degenerative diseases, congenital abnormalities and inflammatory disorders can be causes of extradural masses. Due to the bony boundary of the spinal canal, both benign as well as malignant masses can cause progressive neurological deficits including paraplegia. Most of the spinal tumors are benign (hemangioma of the vertebral body, degenerative diseases). In younger patients congenital abnormalities and primary tumors of the spine have to be considered, whereas in adults the list of differential diagnoses should include secondary malignancies such as metastases and lymphomas as well as metabolic disorders such as osteoporotic vertebral compression fracture and Paget's disease. Cross-sectional imaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) of the spine often help to make a specific diagnosis of extradural spinal lesions and represent important tools for tumor staging and preoperative evaluation. (orig.) [de

  19. [Management of the meniscal lesion].

    Science.gov (United States)

    Baillon, B; Cermak, K; Vancabeke, M

    2011-01-01

    About 1,5 million arthroscopies are each year performed in the world, 50 % for meniscal affections. The menisci participate in the femoro-tibial load transmission and in the joint shock absorption; they contribute to the knee stability and play a role in the joint lubrication. The menisci are therefore important structures, and, in the case of a lesion, surgical abstention or repair should be favoured. When a meniscectomy has to be performed, it should be economical, preserving the meniscal wall. Meniscectomy is contra-indicated in the child and in the case of knee osteoarthrosis. Meniscal healing is compromised if the knee is unstable. If after total meniscectomy a patient presents symptomatic early osteoarthrosis, without marked loss of alignment, meniscal allografting is a therapeutic option, especially at the lateral compartment.

  20. 'Emotional Intelligence': Lessons from Lesions.

    Science.gov (United States)

    Hogeveen, J; Salvi, C; Grafman, J

    2016-10-01

    'Emotional intelligence' (EI) is one of the most highly used psychological terms in popular nomenclature, yet its construct, divergent, and predictive validities are contentiously debated. Despite this debate, the EI construct is composed of a set of emotional abilities - recognizing emotional states in the self and others, using emotions to guide thought and behavior, understanding how emotions shape behavior, and emotion regulation - that undoubtedly influence important social and personal outcomes. In this review, evidence from human lesion studies is reviewed in order to provide insight into the necessary brain regions for each of these core emotional abilities. Critically, we consider how this neuropsychological evidence might help to guide efforts to define and measure EI. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Automated Bayesian Segmentation of Microvascular White-Matter Lesions in the ACCORD-MIND Study

    International Nuclear Information System (INIS)

    Herskovits, E. H.; Bryan, R. N.; Yang, F.

    2008-01-01

    Purpose: Automatic brain-lesion segmentation has the potential to greatly expand the analysis of the relationships between brain function and lesion locations in large-scale epidemiologic studies, such as the ACCORD-MIND study. In this manuscript we describe the design and evaluation of a Bayesian lesion-segmentation method, with the expectation that our approach would segment white-matter brain lesions in MR images without user intervention. Materials and Methods: Each ACCORD-MIND subject has T1-weighted, T2-weighted, spin-density-weighted, and FLAIR sequences. The training portion of our algorithm first registers training images to a standard coordinate space; then, it collects statistics that capture signal-intensity information, and residual spatial variability of normal structures and lesions. The classification portion of our algorithm then uses these statistics to segment lesions in images from new subjects, without the need for user intervention. We evaluated this algorithm using 42 subjects with primarily white-matter lesions from the ACCORD-MIND project. Results: Our experiments demonstrated high classification accuracy, using an expert neuro radiologist as a standard. Conclusions: A Bayesian lesion-segmentation algorithm that collects multi-channel signal-intensity and spatial information from MR images of the brain shows potential for accurately segmenting brain lesions in images obtained from subjects not used in training. (authors)

  2. Panoramic and skull imaging may aid in the identification of multiple myeloma lesions

    Science.gov (United States)

    Faria, Karina-Morais; Brandão, Thais-Bianca; Silva, Wagner-Gomes; Pereira, Juliana; Neves, Frederico-Sampaio; Alves, Marcelo-Corrêa; Shintaku, Werner-Harumiti; Lopes, Marcio-Ajudarte; Ribeiro, Carolina-Prado; Migliorati, Cesar-Augusto; Santos-Silva, Alan-Roger

    2018-01-01

    Background The purpose of this study was to investigate the presence of punched-out lesions in craniofacial bones using three different radiographic protocols in a large cohort of patients. Material and Methods One hundred fifty-five MM patients were evaluated using panoramic and skull (frontal and lateral) radiographs, which were performed in all patients at the time of MM diagnosis. The diagnostic potential for detecting punched-out lesions was compared among the radiographic techniques. Results MM punched-out lesions were identified in 135 (87%) panoramic radiographs, 141 (91%) frontal and 144 (93%) lateral skull radiographs. Punched out-lesions were synchronously present in skull and jawbones in 129 (83.23 %) cases. The lesions were detected exclusively in skull in 18 (11.61%) cases and exclusively in jawbones in 6 (3.87%) cases. Punched out-lesion mainly affected the skull and the jawbones in a synchronous way (p<0.001) rather than separately. Conclusions All investigated radiographic techniques (panoramic, frontal and lateral skull approaches) demonstrated high detection rates for MM punched-out lesions in craniofacial bones. Panoramic radiography may aid to the radiographic protocols to identify multiple myeloma bone lesions. Key words:Multiple myeloma, osteolytic lesions, panoramic radiography. PMID:29274154

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Fränzle, Andrea; Hillengass, Jens; Bendl, Rolf

    2015-03-01

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

  5. Cutaneous lesions in new born

    Directory of Open Access Journals (Sweden)

    Sachdeva Meenakshi

    2002-11-01

    Full Text Available Five hundred unselected newborn babies delivered in the Department of Obstetrics and Gynaecology, Unit II of SGBT Hospital attached to Government Medical College, Amritsar during April 2000 to October 2000 were examined for cutaneous lesions daily for the first five days after birth. Different cutaneous lesions were seen in 474(94. 8% newborns. The physiological skin changes observed in order of frequency were Epstein pearls in 305(61%, Mongolian spot in 301(60. 2%, superficial cutaneous desquamation in 200(40%, icterus in 128(25. 6%, milia in 119(23. 8%, sebaceous gland hyperplasia in 107 (21. 4%, occipital alopecia in 94(18. 8%, lanugo in 72(14. 4%, peripheral cyanosis in 47(9. 4%, breast hypertrophy in 29(5. 8% and miniature puberty in 28(5. 6% newborns. Of the transient non-infective skin diseases, erythema toxicum neonatorum was observed most commonly in 105(21 %, followed by miliaria rubra in 103(20. 6% and acne neonatorum in 27(5. 4% newborns. The naevi and other developmental defects in the descending order were salmon patch in 69(13. 8%, congenital melanocytic noevi in 10(2%, accessory tragi in 3(0.6%, spina bifida in 2(0.4%, hydrocephalus in 1(0.2% and poliosis in 1(0.2% newborns. Cradle cap was the only dermatitis observed in 50(10% newborns. One (0.2% case each of Harlequin ichthyosis and labial cyst was seen.

  6. Subtraction radiography of interradicular bone lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kullendorf, B.; Groendahl, K.; Rohlin, M.; Nilsson, M. (Lund Univ., Malmoe (Sweden))

    1992-10-01

    Subtraction and conventional radiography were evaluated for their diagnostic potential to assess interradicular bone lesions in the mandibular premolar region. Both conventional radiographs and subtraction images were interpreted by 10 observers. The receiver-operating characteristic technique was used to compare the two techniques. The diagnostic validity was higher for the subtraction technique, both for lesions confined to cancellous bone and for lesions including the cortical bone, than for the conventional technique. For bone defects confined to cancellous bone the diagnostic accuracy was lower than those reported from periapical bone lesion irrespective of whether subtraction or conventional radiography was used. It is concluded that subtraction radiography improves the detectability of bone lesions, shallow ones in particular. Lesions in the interradicular bone are more difficult to detect than those in the periapical bone. 26 refs., 3 figs., 2 tabs.

  7. Subtraction radiography of interradicular bone lesions

    International Nuclear Information System (INIS)

    Kullendorf, B.; Groendahl, K.; Rohlin, M.; Nilsson, M.

    1992-01-01

    Subtraction and conventional radiography were evaluated for their diagnostic potential to assess interradicular bone lesions in the mandibular premolar region. Both conventional radiographs and subtraction images were interpreted by 10 observers. The receiver-operating characteristic technique was used to compare the two techniques. The diagnostic validity was higher for the subtraction technique, both for lesions confined to cancellous bone and for lesions including the cortical bone, than for the conventional technique. For bone defects confined to cancellous bone the diagnostic accuracy was lower than those reported from periapical bone lesion irrespective of whether subtraction or conventional radiography was used. It is concluded that subtraction radiography improves the detectability of bone lesions, shallow ones in particular. Lesions in the interradicular bone are more difficult to detect than those in the periapical bone. 26 refs., 3 figs., 2 tabs

  8. Acute stroke: automatic perfusion lesion outlining using level sets.

    Science.gov (United States)

    Mouridsen, Kim; Nagenthiraja, Kartheeban; Jónsdóttir, Kristjana Ýr; Ribe, Lars R; Neumann, Anders B; Hjort, Niels; Østergaard, Leif

    2013-11-01

    To develop a user-independent algorithm for the delineation of hypoperfused tissue on perfusion-weighted images and evaluate its performance relative to a standard threshold method in simulated data, as well as in acute stroke patients. The study was approved by the local ethics committee, and patients gave written informed consent prior to their inclusion in the study. The algorithm identifies hypoperfused tissue in mean transit time maps by simultaneously minimizing the mean square error between individual and mean perfusion values inside and outside a smooth boundary. In 14 acute stroke patients, volumetric agreement between automated outlines and manual outlines determined in consensus among four neuroradiologists was assessed with Bland-Altman analysis, while spatial agreement was quantified by using lesion overlap relative to mean lesion volume (Dice coefficient). Performance improvement relative to a standard threshold approach was tested with the Wilcoxon signed rank test. The mean difference in lesion volume between automated outlines and manual outlines was -9.0 mL ± 44.5 (standard deviation). The lowest mean volume difference for the threshold approach was -25.8 mL ± 88.2. A significantly higher Dice coefficient was observed with the algorithm (0.71; interquartile range [IQR], 0.42-0.75) compared with the threshold approach (0.50; IQR, 0.27- 0.57; P , .001). The corresponding agreement among experts was 0.79 (IQR, 0.69-0.83). The perfusion lesions outlined by the automated algorithm agreed well with those defined manually in consensus by four experts and were superior to those obtained by using the standard threshold approach. This user-independent algorithm may improve the assessment of perfusion images as part of acute stroke treatment. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.13121622/-/DC1. RSNA, 2013

  9. Artefactual skin lesions in children and adolescents

    DEFF Research Database (Denmark)

    Ring, Hans Christian; Miller, Iben M; Benfeldt, Eva

    2015-01-01

    ) with striking purpuric lesions diagnosed as factitious purpura. The clinical lesions were similar, but the underlying psychological problems differed significantly (depression and stress). The current state of knowledge of dermatitis artefacta in children and adolescents was reviewed. CONCLUSION: The presence...... of purpura in children and adolescents typically causes extensive intervention programs due to the possible serious pathological consequences. The two cases demonstrate a need for a high degree of attention to psychological disturbances, lesional evolution, and distribution once the suspicion is established....

  10. Isolated lytic bone lesion in tuberculosis

    Directory of Open Access Journals (Sweden)

    Mansoor C Abdulla

    2017-01-01

    Full Text Available Causes of lytic bone lesions include benign, malignant, and infectious processes. Lytic lesions due to tuberculosis (TB may closely mimic those due to tumors such as bone cyst, osteoblastoma, osteosarcoma, and metastatic bone disease radiologically. Histopathology and culture help in definitive diagnosis and prompt management. We describe an immunocompetent patient with isolated lytic bone lesion in the distal part of ulna due to TB to make the readers aware of such unusual presentations of TB.

  11. Solitary sternal lesions in breast cancer

    International Nuclear Information System (INIS)

    Morales, R.; Cano, R.; Mendoza, G.; Guzman, C.; Cotrina, M.; Aguilar, C.

    1993-01-01

    In a retrospective review of bone scans performed in 1740 patients with breast cancer from January 1988 to April 1993, twenty had a solitary sternal lesion. Etiology was found correlating this finding with pathology, x-rays and/or final outcome. Nineteen lesions were due to metastases and one to infection. This experience suggests that solitary sternal lesions in breast cancer patients are uncommon and are most frequently (95%) associated with malignant etiology. (Authors). 10 refs., 2 figs

  12. MR imaging of sacral and perisacral lesions

    International Nuclear Information System (INIS)

    Wetzel, L.H.; Levine, E.; Murphey, M.D.

    1987-01-01

    This exhibit demonstrates the utility of MR imaging in evaluating sacral and perisacral lesions. Thirty-two lesions were studied using a superconducting 1.0-T MR imager. Eleven primary and 13 metastatic tumors, four congenital lesions, and four arachnoid cysts were evaluated. MR did not usually enable a more specific histologic diagnosis than other imaging techniques. However, extraosseous and proximal spinal extent of tumors was well defined without use of oral or intravenous contrast material. MR imaging is an excellent noninvasive technique for evaluating most sacral and perisacral lesions and is particularly helpful when precise tumor extent must be determined for treatment planning

  13. Oncocytic lesions of the ophthalmic region

    DEFF Research Database (Denmark)

    Østergaard, Jens; Prause, Jan U; Heegaard, Steffen

    2011-01-01

    that required surgical intervention in the Danish population could be approximated to 0.3 lesions per million capita per year. Patient ages ranged from 45 years to 89 years, with a peak incidence in the eighth decade. Female patients were twice as common as male. Lesions were typically described as red......–brown, cystic and slow-growing. The antimitochondrial antibody MU213-UC produced a distinct and intense immunostaining of all oncocytic lesions and was found to be useful in substantiating oncocytic differentiation. Twenty-six of the lesions originated in the caruncle, three in the conjunctiva, two...

  14. Thermophysical lesions caused by HZE particles

    International Nuclear Information System (INIS)

    Tobias, C.A.; Malachowski, M.; Nelson, A.; Philpott, D.E.

    1980-01-01

    This paper deals with a type of damage caused by heavy particles that may occur in subcellular structures. These lesions are called thermophysical radiation injury and are similar to damage produced in solids by HZE particles. This chapter summarizes some of the experimental evidence for the presence of these lesions in certain mammalian tissues including the retina, brain, cornea, lens of mice and seeds of corn. Of all tissues examined, only the cornea exhibited a type of lesion which would fulfill the criteria of thermophysical lesions

  15. Obstructive Lesions of the Pediatric Subglottis

    OpenAIRE

    Ida, Jonathan B.; Guarisco, J. Lindhe; Rodriguez, Kimsey H.; Amedee, Ronald G.

    2008-01-01

    Purpose: To compile information regarding obstructive subglottic lesions in children, including anatomy, pathogenesis, prevention, evaluation, and treatment options, required for implementation of a multi-faceted treatment plan.

  16. Visible and occult microscopic lesions of endometriosis

    Directory of Open Access Journals (Sweden)

    Khaleque Newaz Khan

    2014-11-01

    Full Text Available Endometriosis is a multifactorial disease mostly affecting women of reproductive age and is associated with chronic pelvic pain and infertility. Even after 300 years, most of the literature claims that pathogenesis and/or pathophysiology of endometriosis is still elusive. Recurrence of pain and lesion continues to occur after effective medical or surgical therapies. Once generated within the pelvis due to retrograde entry of menstrual debris, peritoneal endometriotic lesions time-dependently change their color appearance resulting from certain biochemical change within lesions. A variable pattern of endometriotic lesions within the pelvis can be detected by laparoscopy as visible peritoneal endometriosis. It is generally believed that besides ovarian steroid hormones, the growth of endometriosis can be regulated by the innate immune system in the pelvic microenvironment by their interaction with endometrial cells and immune cells. Even with the careful eyes of an expert surgeon, we may sometimes miss detecting peritoneal lesion within the peritoneal cavity or deep into the peritoneum. In such a case, random collection of normal peritoneum may carry the possibility to identify some hidden endometriotic lesions by microscopy and these lesions can be named as occult (invisible microscopic endometriosis (OME. Here, we discuss the color appearance of peritoneal lesions and activity of these lesions by analysis of a panel of activity markers. Finally we discuss our recent findings on OME, their biological and clinical significance, and try to make a possible link in the origin between visible endometriosis and OME.

  17. Lesion localization in aphasia without hemiparesis

    International Nuclear Information System (INIS)

    Komatsu, Midori; Senoh, Yoko; Okamoto, Koichi; Morimatsu, Mitsunori; Hirai, Shunsaku

    1983-01-01

    The distribution of the lesions responsible for aphasia unassociated with right-sided hemiparesis was evaluated by cranial computed tomography (CT) among stroke patients. In the Broca aphasia group were observed atypical aphasic symptoms, and the lesions were far more localized than in ordinary Broca one. In the Wernicke aphasia group showed relatively large lesions in the left superior temporal gyrus, sometimes extending to supramarginal and angular gyri, which caused such additional symptoms as apraxia without motor paresis in some cases. In the Transcortical motor aphasia group showed the occlusion of the left internal carotid artery, though without obvious abnormality at CT. In another patient a circumscribed low density lesion was disclosed in the area anterior and superior to so-called Broca's area. In the Transcortical sensory aphasia group, the lesion involved the borderzone supplied by the left middle and posterior cerebral arteries. In the Amnestic aphasia group showed a lesion in the left parietal lobe, while in another no remarkable change was demonstrated. In the Global aphasia group, one had multiple isolated lesions in both anterior and posterior speech areas. Another showed a large lesion involving the whole territory of the left middle cerebral artery. In the remaining one a high density area was observed in the left superior temporal, supramarginal and angular gyri, not extending to the frontal lobe beyond with sylvian fissure. Therefore, in interpreting CTs of such aphasic patients we must take account of not only the extent of the lesion but also the severity of destruction. (J.P.N.)

  18. Lesion localization in aphasia without hemiparesis

    Energy Technology Data Exchange (ETDEWEB)

    Komatsu, Midori; Senoh, Yoko; Okamoto, Koichi; Morimatsu, Mitsunori; Hirai, Shunsaku (Gunma Univ., Maebashi (Japan). School of Medicine)

    1983-06-01

    The distribution of the lesions responsible for aphasia unassociated with right-sided hemiparesis was evaluated by cranial computed tomography (CT) among stroke patients. In the Broca aphasia group were observed atypical aphasic symptoms, and the lesions were far more localized than in ordinary Broca one. In the Wernicke aphasia group showed relatively large lesions in the left superior temporal gyrus, sometimes extending to supramarginal and angular gyri, which caused such additional symptoms as apraxia without motor paresis in some cases. In the Transcortical motor aphasia group showed the occlusion of the left internal carotid artery, though without obvious abnormality at CT. In another patient a circumscribed low density lesion was disclosed in the area anterior and superior to so-called Broca's area. In the Transcortical sensory aphasia group, the lesion involved the borderzone supplied by the left middle and posterior cerebral arteries. In the Amnestic aphasia group showed a lesion in the left parietal lobe, while in another no remarkable change was demonstrated. In the Global aphasia group, one had multiple isolated lesions in both anterior and posterior speech areas. Another showed a large lesion involving the whole territory of the left middle cerebral artery. In the remaining one a high density area was observed in the left superior temporal, supramarginal and angular gyri, not extending to the frontal lobe beyond with sylvian fissure. Therefore, in interpreting CTs of such aphasic patients we must take account of not only the extent of the lesion but also the severity of destruction.

  19. The Post-Ureteroscopic Lesion Scale (PULS)

    DEFF Research Database (Denmark)

    Schoenthaler, Martin; Buchholz, Noor; Farin, Erik

    2014-01-01

    The Post-Ureteroscopic Lesion Scale (PULS) offers a simple grading system for the description of ureteral lesions after ureteroscopy. In this article, we present the results of a video-based multicenter evaluation of the inter-rater reliability of clinically important PULS grades 0-3.......The Post-Ureteroscopic Lesion Scale (PULS) offers a simple grading system for the description of ureteral lesions after ureteroscopy. In this article, we present the results of a video-based multicenter evaluation of the inter-rater reliability of clinically important PULS grades 0-3....

  20. Metatranscriptomics reveals overall active bacterial composition in caries lesions

    Directory of Open Access Journals (Sweden)

    Aurea Simón-Soro

    2014-10-01

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

  1. Management of hypertrophied dural lesions: Is surgery a better option?

    Science.gov (United States)

    Ogiwara, Toshihiro; Nagm, Alhusain; Hanaoka, Yoshiki; Nishikawa, Akihiro; Goto, Tetsuya; Horiuchi, Tetsuyoshi; Hongo, Kazuhiro

    2017-10-15

    It is often difficult to definitively diagnose dural lesions with hypertrophy as they exhibit nonspecific imaging findings and clinical symptoms. Most cases require histopathological evaluation with surgical intervention (such as biopsy). However, complications related to surgical interventions remain as matter of concern. Herein, we analyzed and verified the significance of surgery in 39 patients with hypertrophic dural lesions who were histopathologically diagnosed with surgical interventions. Specimens of dural lesions were obtained successfully, and it was possible to make a definitive diagnosis for each case based on histopathological findings. All patients tolerate the procedures well, and there were no evidences of surgery-related complications during surgical approach to the dura mater. Preoperative and pathological diagnoses varied in eight cases. Our results indicate that histopathological evaluation is important for distinguishing diseases showing dural hypertrophy even if surgical invasiveness is concerned. Neurosurgeons should not hesitate to perform surgery for management of dural lesions with hypertrophy in order to achieve accurate diagnosis. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Production of lesions in rabbit spinal cord with microwave hyperthermia

    International Nuclear Information System (INIS)

    Sutton, C.H.; Popovic, P.

    1984-01-01

    The use of a variety of injury models in different species to produce spinal cord lesions by trauma or ischemia has often given rise to conflicting or inconclusive data. A new model has been developed in rabbits. Spinal cord lesions were produced in selected spinal cord segments of male New Zealand white rabbits by non-invasive irradiation with microwaves in the near field at 915 MHz. Graded injuries of predictable severity can be produced by the non-invasive induction of moderate hyperthermia in the thoracic spinal cord at precise dosage levels of temperature elevation and duration. Histological changes in microwave-induced hyperthermia closely parallel those seen in traumatic lesions of the human spinal cord, as well as those produced in animals with the classical weight-drop method of Allen. In addition to grading the spinal cord lesions with respect to residual neurological function, dose-response observations made with somatosensory evoked responses, blood-spinal cord barrier tracers, and neurohistological and enzyme histochemical preparations, suggest that it will be possible to use this approach to develop a standardized, calibrated model in rabbits to evaluate the efficacy of new therapeutic modalities for the treatment of spinal cord injury

  3. Management of dens invaginatus type III with large periradicular lesion.

    Science.gov (United States)

    Falcao, Luciana de Souza; de Freitas, Priscila Sousa; Marreiro, Raquel de Oliveira; Garrido, Angela Delfina Bittencourt

    2012-01-01

    This study describes a clinical case of type III dens invaginatus with an extensive periradicular lesion treated successfully. Dens invaginatus is a maldevelopment of the dental germ which occurs as a result of the invagination of the enamel organ. These cases may present difficulties with respect to its diagnosis and treatment because of canal morphology. The success of endodontic therapy requires a knowledge of dental anatomy and its anomalies. A 17-year-old female patient is reported presenting right maxillary lateral incisor (tooth no. 7) classified as type III dens invaginatus with necrotic pulp and presence of an extensive radiolucid lesion. Endodontic treatment was recommended for tooth. However, intracanal exudate was present, suggesting a resistant infection. Enucleation of the lesion was performed as a complementary approach. The root canal obturation was carried out by the gutta-percha thermoplastification technique with root canal sealer, followed by restoration of the tooth. Healing of the lesion with hard tissue formation was confirmed at follow-up. A combination of endodontic and surgical treatments were fundamental to the maintenance of the tooth. The treatment was considered successful. Root canal therapy of dens invaginatus should be based on a thorough clinical and radiographic evaluation. The knowledge of classification and anatomical variations of teeth with dens invaginatus are of great importance for correct treatment.

  4. Localization of lesions in aphasia, (2)

    International Nuclear Information System (INIS)

    Hojo, Kei; Watanabe, Shunzo; Tasaki, Hiroichi; Sato, Tokijiro; Metoki, Hirofumi.

    1985-01-01

    The relationship between the focus and the extent of the lesions and the various symptoms was investigated. 1. Broca aphasics: More than 80% of the group with obvious anarthric components had lesions of the third frontal gyrus involving Broca's area and the lower part of the precental gyrus as well as opercular and insular regions. The size of the lesions of this group was significantly larger than that of the group without marked anarthric components, and the latter was proved to have little localizing value. 2. Wernicke aphasics: The group with poor reading comprehension had cortical and/or subcortical lesions, involving posterior parts of both superior and middle temporal gyri as well as the supramarginal gyrus. On the other hand, lesions of the group with poor auditory comprehension were more anteriorly located and localized in the deep structures. Lesions of the group with poor Token test scores were large and scattered more anteriorly and/or posteriorly compared with those of the group with good Token test scores. 3. Amnestic aphaiscs: The group with poor naming scores had somewhat larger lesions than the group with good naming scores, and the lesions were scattered about the left hemisphere. The finding has proved that both groups had little localizing value. 4. Conduction aphasics: Lesions of the non-fluent type were significantly larger than those of the fluent type and distributed more anteriorly. However, highly involved lesions were located in the supramarginal gyrus and posterior parts of superior and/or middle temporal gyri. 5. Global aphasics: Lesions of the group with good articulation and prosody were observed to distribute more posteriorly in comparison with those of the other global aphasics. (J.P.N.)

  5. Tractographic analysis of historical lesion surgery for depression.

    Science.gov (United States)

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

    2010-12-01

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

  6. Red Blood Cell Storage Lesion

    Directory of Open Access Journals (Sweden)

    Daryl J. Kor

    2009-10-01

    Full Text Available The past two decades have witnessed increased scrutiny regarding efficacy and risk of the once unquestioned therapy of red blood cell (RBC transfusion. Simultaneously, a variety of changes have been identified within the RBC and storage media during RBC preservation that are correlated with reduced tissue oxygenation and transfusion-associated adverse effects. These alterations are collectively termed the storage lesion and include extensive biochemical, biomechanical, and immunologic changes involving cells of diverse origin. Time-dependent falls is 2,3-diphosphoglycerate, intracellular RBC adenosine triphosphate, and nitric oxide have been shown to impact RBC deformability and delivery of oxygen to the end-organ. The accumulation of biologic response modifiers such as soluble CD40 ligand (sCD40L, lysophosphatidylcholine (lyso-PC, and Regulated on Activation, Normal T-cell Expressed and Secreted (RANTES have been associated with altered recipient immune function as well. This review will address the alterations occurring within the RBC and storage media during RBC preservation and will address the potential clinical consequence thereof.

  7. Evaluation of hepatic cystic lesions

    Science.gov (United States)

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

    2013-01-01

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

  8. Cerebral CT of ischaemic lesions

    International Nuclear Information System (INIS)

    Aulich, A.

    1981-01-01

    The diagnosis of stroke must first be established by clinical examination. CT has proved useful for confirmation of the diagnosis and provides a global intracranial picture of morphological changes in cerebral vascular diseases. A hemorrhage can be recognized with certainty at the first CT examination as the cause of the stroke, but in the detection of a lesion due to ischemia an important role is played by the correct choice of the time of examination, and in some cases also of the check-up with contrast medium. The differential diagnosis between infarct in the acute stage and encephalitis or gliomas of low-grade malignity can be difficult. A decision can often only be made after a series of examinations. Postmalacial conditions are often difficult to differentiate from defects due to other causes, such as hemorrhage, head injury, postoperative states and after encephalitis. A knowledge of the anamnesis and the clinical findings is indispensable for CT evaluation. In assessing the prognosis before vascular surgery on the extracranial brain-supplying vessels the performance of a CT examination should be advised. A warning is given against the use of CT as a screening method. (orig.) [de

  9. Association between subcortical vascular lesion location and cognition: a voxel-based and tract-based lesion-symptom mapping study. The SMART-MR study.

    Directory of Open Access Journals (Sweden)

    J Matthijs Biesbroek

    Full Text Available INTRODUCTION: Lacunar lesions (LLs and white matter lesions (WMLs affect cognition. We assessed whether lesions located in specific white matter tracts were associated with cognitive performance taking into account total lesion burden. METHODS: Within the Second Manifestations of ARTerial disease Magnetic Resonance (SMART-MR study, cross-sectional analyses were performed on 516 patients with manifest arterial disease. We applied an assumption-free voxel-based lesion-symptom mapping approach to investigate the relation between LL and WML locations on 1.5 Tesla brain MRI and compound scores of executive functioning, memory and processing speed. Secondly, a multivariable linear regression model was used to relate the regional volume of LLs and WMLs within specific white matter tracts to cognitive functioning. RESULTS: Voxel-based lesion-symptom mapping identified several clusters of voxels with a significant correlation between WMLs and executive functioning, mostly located within the superior longitudinal fasciculus and anterior thalamic radiation. In the multivariable linear regression model, a statistically significant association was found between regional LL volume within the superior longitudinal fasciculus and anterior thalamic radiation and executive functioning after adjustment for total LL and WML burden. CONCLUSION: These findings identify the superior longitudinal fasciculus and anterior thalamic radiation as key anatomical structures in executive functioning and emphasize the role of strategically located vascular lesions in vascular cognitive impairment.

  10. Is it Ethical to Withhold Restorative Dental Care From a Child with Occlusoproximal Caries Lesions Into Dentin of Primary Molars?

    Science.gov (United States)

    Nainar, S M Hashim

    2015-01-01

    Non-restorative caries treatment (NRCT) has been mentioned as a treatment option for occluso-proximal caries lesions into dentin of primary molars. The NRCT approach for occluso-proximal caries lesions in primary molars was considered from an ethical perspective. In summary, it is not ethical to withhold restorative dental care from a child with occluso-proximal caries lesions into dentin of primary molars.

  11. Ultrasonography and arthrography in rotator cuff lesions: algorithmic approach

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eui Jong; Ryu, Kyung Nam; Lee, Sun Wha; Lim, Jae Hoon; Rhee, Yong Girl [Kyung Hee University Hospital, Seoul (Korea, Republic of); Yu, Pil Mun [Dankuk University College of Medicine, Chenona (Korea, Republic of)

    1992-11-15

    Twenty-six patients with chief complaint of shoulder pain who underwent both ultrasonographic examination and arthrography of the shoulder were analyzed. Ten out of 12 cases with clinical impression of frozen shoulder, showed normal findings on the ultrasonographic examination of the shoulder. Among these ten cases, nine cases showed adhesive capsulitis and one case showed rotator cuff tear on arthrography. Among six cases with the clinical impression of rotator cuff tear, five cases showed rotator cuff tear and one case showed combined calcific tendinitis and adhesive capsulitis on ultrasonographic examination. In arthrography, four cases of rotator cuff tear, one case of calcific tendinitis and biceps tendinitis and one case of normal finding were diagnosed. For the remaining eight cases in the ultrasonographic examination, normal finding or biceps tendinitis were found and for the remaining of the cases in arthrography adhesive capsulitis were found. With the above results, we recommend that the shoulder ultrasonography as the first line diagnostic modality for a patient with chief complaint of shoulder pain.

  12. Ultrasonography and arthrography in rotator cuff lesions: algorithmic approach

    International Nuclear Information System (INIS)

    Kim, Eui Jong; Ryu, Kyung Nam; Lee, Sun Wha; Lim, Jae Hoon; Rhee, Yong Girl; Yu, Pil Mun

    1992-01-01

    Twenty-six patients with chief complaint of shoulder pain who underwent both ultrasonographic examination and arthrography of the shoulder were analyzed. Ten out of 12 cases with clinical impression of frozen shoulder, showed normal findings on the ultrasonographic examination of the shoulder. Among these ten cases, nine cases showed adhesive capsulitis and one case showed rotator cuff tear on arthrography. Among six cases with the clinical impression of rotator cuff tear, five cases showed rotator cuff tear and one case showed combined calcific tendinitis and adhesive capsulitis on ultrasonographic examination. In arthrography, four cases of rotator cuff tear, one case of calcific tendinitis and biceps tendinitis and one case of normal finding were diagnosed. For the remaining eight cases in the ultrasonographic examination, normal finding or biceps tendinitis were found and for the remaining of the cases in arthrography adhesive capsulitis were found. With the above results, we recommend that the shoulder ultrasonography as the first line diagnostic modality for a patient with chief complaint of shoulder pain

  13. Approach to systemic lupus erythematosus and skin lesions

    OpenAIRE

    Mullaaziz, Didem; Tınazlı, mehtap; kaptanoglu, aslı feride

    2015-01-01

    AbstractSystemic lupus erythematosus (SLE) is a chronic, autoimmune disease that involves a broad spectrum of symptoms. The underlying cause of LE is unknown but the etiology is thought to be multifactorial and polygenic. Although it can occur in both genders, it has a higher incidence in women, commonly around 30 years of age. The cutaneous manifestations of lupus are pleomorphic. Various cutaneous manifestations of LE are divided into LE-specific and LE-nonspecific skin diseases based on hi...

  14. Minimally invasive approach for lesions involving the frontal sinus

    African Journals Online (AJOL)

    best done using a small elevator. A diamond drill may be used at the fracture site to ensure all mucosa is adequately removed and to remove any irregular bony edges. If a CSF leak is present, this must be repaired first; abdominal fat, fascia or synthetic dura is placed through the fracture site as an underlay graft, similar to ...

  15. Orbitozygomatic Approach to Parasellar Lesions | El-Naggar ...

    African Journals Online (AJOL)

    CSF rhinorhea occurred in one patient and was complicated with bacterial meningitis. It was treated by repeated lumber puncture and antibiotics but it was not responding for a long period and yielded poor patient outcome. Outcome was classified into: excellent, if the patient has no neurological deficit; good if the patient ...

  16. A New Approach Regarding the Legal Contract Lesion

    Directory of Open Access Journals (Sweden)

    Sache Neculaescu

    2010-06-01

    Full Text Available Why not agreeing upon a contract based on misbalanced services: because the party benefiting from an excessive service unlawfully exploited the precarious situation of the other party as a result of whom came to accept an unfair contract, or because contractual balance must be an essential feature of which and every contract with clearly established services? Which of the two reasons mentioned above is more important in terms of current contractual discipline? These are two questions which, no matter what answers will get, will involve an important matter of choice, in relation to which it will be possible to assess correctly the solutions proposed by the new Romanian Civil Code, as well as by the main bills on Europeancodification of contract law. The present study upholds the idea of misbalanced services only if it constitutes rather a remedy for a contractual problem, if it is oriented towards the legitimate interests of the most vulnerable party of that contract and less interested in sanctioning the guilty conduct of the person who tookadvantage from an excessive service. As a consequence, we support the objective perspective in what misbalanced services are concerned, a reason for which we shall be making a few comments on some of thenew legal provisions, by referring to the main bills on the European codification of contract law, and stating later on a few de lege ferenda proposals, in terms of contracts based on misbalanced services.

  17. Hypervascular liver lesions in radiologically normal liver

    Energy Technology Data Exchange (ETDEWEB)

    Amico, Enio Campos; Alves, Jose Roberto; Souza, Dyego Leandro Bezerra de; Salviano, Fellipe Alexandre Macena; Joao, Samir Assi; Liguori, Adriano de Araujo Lima, E-mail: ecamic@uol.com.br [Hospital Universitario Onofre Lopes (HUOL/UFRN), Natal, RN (Brazil). Clinica Gastrocentro e Ambulatorios de Cirurgia do Aparelho Digestivo e de Cirurgia Hepatobiliopancreatica

    2017-09-01

    Background: The hypervascular liver lesions represent a diagnostic challenge. Aim: To identify risk factors for cancer in patients with non-hemangiomatous hypervascular hepatic lesions in radiologically normal liver. Method: This prospective study included patients with hypervascular liver lesions in radiologically normal liver. The diagnosis was made by biopsy or was presumed on the basis of radiologic stability in follow-up period of one year. Cirrhosis or patients with typical imaging characteristics of haemangioma were excluded. Results: Eighty eight patients were included. The average age was 42.4. The lesions were unique and were between 2-5 cm in size in most cases. Liver biopsy was performed in approximately 1/3 of cases. The lesions were benign or most likely benign in 81.8%, while cancer was diagnosed in 12.5% of cases. Univariate analysis showed that age >45 years (p< 0.001), personal history of cancer (p=0.020), presence of >3 nodules (p=0.003) and elevated alkaline phosphatase (p=0.013) were significant risk factors for cancer. Conclusion: It is safe to observe hypervascular liver lesions in normal liver in patients up to 45 years, normal alanine amino transaminase, up to three nodules and no personal history of cancer. Lesion biopsies are safe in patients with atypical lesions and define the treatment to be established for most of these patients. (author)

  18. Prevalence of Oral Lesions in the Elderly.

    Science.gov (United States)

    Minic, I; Pejcic, A; Kostic, M; Krunic, N; Mirkovic, D; Igic, M

    2016-02-09

    Geriatric dentistry refers to dealing with oral diseases including prevention and treatment in old individuals. The aim of this investigation was to examine the types and frequency of oral lesions in the elderly. The study involved 75 elderly persons. The clinical diagnosis was established by correlating the aetiological factor associated with the lesion and by systematic examination of the oral mucosa and classifying those alterations according to the epidemiological guidelines for the diagnosis of oral mucosal diseases. During the clinical examination, the following elements were analysed: features of the lesion, anatomical location, extension, aetiological factors or related factors, dental status, alcohol, tobacco, trauma, use of prosthesis and if such were well adapted. Sixty lesions were diagnosed in 75 patients. These were classified according to clinical, histopathological and microbiological diagnosis and were distributed into 15 different clinical entities. The more prevalent pathologies were inflammatory, reactive and associated with long-term use of prostheses or ill-adapted prostheses, since 67% of the patients with lesions were using prostheses. Of the lesions related to prosthesis use, denture stomatitis was the most common one, representing 20 cases (33.3%). The second most frequent lesion was erythematous candidiasis (10%). The other most frequent lesions in this study were lingua plicata, xerostomia and pseudomembranous candidiasis. Oral and perioral tissues undergo different functional and structural changes with ageing. The role of the dentist and stomatologist includes the management of systemic, nutritional and pharmacological oral manifestations in order to establish an early diagnosis and subsequent accurate treatment.

  19. Pediatric multifocal liver lesions evaluated by MRI

    Directory of Open Access Journals (Sweden)

    Majed Almotairi

    2015-01-01

    Full Text Available Objective: The purpose of this study is to present our experience with MRI evaluation of multifocal liver lesions in children and describe the MRI characteristics of these lesions. Patients and Methods: A retrospective review of consecutive MRI exams performed for the evaluation of multiple liver lesions between 1 January 2007 and 31 December 2012 was done to note the number of lesions, the size of the largest lesion, MR signal characteristics, and background liver. Final diagnosis was assigned to each case based on pathology in the available cases and a combination of clinical features, imaging features, and follow-up in the remaining cases. Results: A total of 48 children (22 boys, 26 girls; age between 3 months and 18 years with average age 10.58 years and median age 11 years were included in the study. Totally 51 lesion diagnoses were seen in 48 children that included 17 focal nodular hyperplasia (FNH, 8 hemangiomas, 7 metastases, 6 regenerative nodules, 3 adenomas, 3 abscesses, and one each of angiomyolipoma, epithelioid hemangioendothelioma, focal fatty infiltration, hepatocellular carcinoma, hepatic infarction, nodular regenerative hyperplasia, and hepatic cyst. Background liver was normal in 33, cirrhotic in 10, fatty in 3, and siderotic in 2 children. Most FNH, hemangiomas, and regenerative nodules showed characteristic MRI features, while metastases were variable in signal pattern. Conclusion: Many commonly seen multifocal liver lesions in children have characteristic MRI features. MRI can help to arrive at reasonable differential diagnoses for multifocal liver lesions in children and guide further investigation and management.

  20. Elementary lesions in dermatological semiology: literature review.

    Science.gov (United States)

    Cardili, Renata Nahas; Roselino, Ana Maria

    2016-01-01

    Discrepancies in the terminology of elementary lesions persist when texts from Dermatology and Semiology books are compared, which can cause some confusion in both the teaching of undergraduate medical students and the learning acquired by professionals in the field. This review aims to compare and clarify the differences in the description of elementary lesions by many authors, used as references for specialists in dermatology.

  1. Principal component analysis of psoriasis lesions images

    DEFF Research Database (Denmark)

    Maletti, Gabriela Mariel; Ersbøll, Bjarne Kjær

    2003-01-01

    A set of RGB images of psoriasis lesions is used. By visual examination of these images, there seem to be no common pattern that could be used to find and align the lesions within and between sessions. It is expected that the principal components of the original images could be useful during future...

  2. Hypervascular liver lesions in radiologically normal liver

    International Nuclear Information System (INIS)

    Amico, Enio Campos; Alves, Jose Roberto; Souza, Dyego Leandro Bezerra de; Salviano, Fellipe Alexandre Macena; Joao, Samir Assi; Liguori, Adriano de Araujo Lima

    2017-01-01

    Background: The hypervascular liver lesions represent a diagnostic challenge. Aim: To identify risk factors for cancer in patients with non-hemangiomatous hypervascular hepatic lesions in radiologically normal liver. Method: This prospective study included patients with hypervascular liver lesions in radiologically normal liver. The diagnosis was made by biopsy or was presumed on the basis of radiologic stability in follow-up period of one year. Cirrhosis or patients with typical imaging characteristics of haemangioma were excluded. Results: Eighty eight patients were included. The average age was 42.4. The lesions were unique and were between 2-5 cm in size in most cases. Liver biopsy was performed in approximately 1/3 of cases. The lesions were benign or most likely benign in 81.8%, while cancer was diagnosed in 12.5% of cases. Univariate analysis showed that age >45 years (p< 0.001), personal history of cancer (p=0.020), presence of >3 nodules (p=0.003) and elevated alkaline phosphatase (p=0.013) were significant risk factors for cancer. Conclusion: It is safe to observe hypervascular liver lesions in normal liver in patients up to 45 years, normal alanine amino transaminase, up to three nodules and no personal history of cancer. Lesion biopsies are safe in patients with atypical lesions and define the treatment to be established for most of these patients. (author)

  3. Rare ovarian lesion in an adolescent girl

    Directory of Open Access Journals (Sweden)

    Ramasamy Senthilnathan

    2008-01-01

    Full Text Available Large solid ovarian lesions are considered malignant in nature in pediatric and adolescent age group. We present an adolescent girl who had large solid ovarian lesion, with negative tumor markers. She underwent laparotomy and right oopherectomy. Histopathology revealed that the lesion was massive ovarian edema. This is an extremely rare lesion of ovary and is benign in nature. Very few case reports are available in English literature. Hence we suggest that massive ovarian edema should be considred as one of the differential diagnosis in all the patients having large solid ovarian lesions with ngative tumor marker assay. Ovarian preservation with the help of frozen section analysis should always be considred in these patients.

  4. Evaluation of ureteral lesions in ureterorenoscopy

    DEFF Research Database (Denmark)

    Lildal, Søren Kissow; Andreassen, Kim Hovgaard; Jung, Helene

    2018-01-01

    OBJECTIVE: The aim of this study was to evaluate the incidence of ureteral lesions in retrograde intrarenal surgery (RIRS) with and without the use of a 10/12 Fr ureteral access sheath (UAS). A further objective was to search for preoperative factors that could influence the risk of ureteral damage....... MATERIALS AND METHODS: Data were collected from a clinical database on 180 consecutive adult patients undergoing RIRS for kidney stones with or without a 10/12 Fr UAS. The primary outcome measure was ureteral lesions endoscopically identified at the end of surgery using the Post-Ureteroscopic Lesion Scale...... (PULS) classification system. RESULTS: The use of 10/12 Fr UASs resulted in less severe lesions than reported previously with larger diameter UASs. There was a higher risk of superficial lesions in the UAS group, with a calculated crude odds ratio (OR) of 1.84 [95% confidence interval (CI) 1...

  5. Bone scintigraphy in lesions of the skull

    International Nuclear Information System (INIS)

    Fischer, M.; Wasilewski, A.; Deitmer, T.

    1982-01-01

    The value of 3-phase-scintigraphy in bone lesions of the skull with a new seeking agent 99mTc-2,3-dicarboxypropane-1,1-diphosphonic acid (DPD) is studied. A high soft tissue-bone-ratio of DPD is emphasized. For this reason DPD is used for bone scintigraphy of the skull, because the mass of soft tissue in relation to bone is high and a higher clearance improves the interpretation of the images of the first two phases. An increased tracer uptake is found for skeletal neoplasms (malignant and benign lesions) and for acute osteomyelitis. By contrast, the chronic inflammatory bone lesions showed normal tracer uptake. This new bone seeking agent allows to localize and differentiate tumorous or acute inflammatory lesions and chronic inflammatory bone lesions of the skull

  6. Remoción de terceros molares mandibulares con asistencia endoscópica: Nota técnica de un nuevo procedimiento quirúrgico para prevenir lesiones del NAI y formación de defectos óseos Removal of mandibular third molars with endoscopic approach: Technical note of a new surgical procedure to avoid IAN damage and bone defect formation

    Directory of Open Access Journals (Sweden)

    R Fuentes

    2012-08-01

    Full Text Available La variada posición anatómica de los terceros molares mandibulares presenta importantes desafíos asociados a su profundidad y grado de inclinación. Las complicaciones más habituales del procedimiento quirúrgico convencional de extracción se relacionan con la extensa osteotomía y poca visualización del sitio quirúrgico, que pueden generar consecuencias post-quirúrgicas como inflamación, dolor, trismus, lesiones reversibles e irreversibles del nervio alveolar inferior (NAI o nervio lingual, riesgo de fractura y formación de defectos periodontales del segundo molar. La implementación de soportes rígidos en la óptica endoscópica ha permitido utilizar esta tecnología para realizar abordajes mínimamente invasivos para remover terceros molares mediante accesos flapless con una mínima osteotomía de la zona oclusal, conservando la pared bucal y lingual a través de la visualización directa y magnificada del sitio quirúrgico, adaptable a los movimientos del paciente durante la intervención. En este reporte se presenta un nuevo procedimiento quirúrgico mínimamente invasivo a través de asistencia endoscópica para la conservación ósea en la remoción de terceros molares mandibulares con riesgo de lesión del nervio alveolar inferior.Anatomic variability of the position of mandibular third molars represents significant challenges associated with its depth and angulation. The most common complications of conventional surgical procedure are related to extensive osteotomy and poor visualization, which can cause postsurgical effects such as inflammation, pain, trismus, reversible and irreversible lesions of the inferior alveolar nerve (IAN or lingual nerve, fracture risk and formation of a deep periodontal defect on the distal aspect of the second molar. The implementation of rigid endoscopy in optics has allowed to use this technology via a minimally invasive approach to remove third molars by a minimally occlusal flapless ostectomy

  7. Score 3 prostate lesions: a gray zone for PI-RADS v2.

    Science.gov (United States)

    Scialpi, Michele; Martorana, Eugenio; Aisa, Maria Cristina; Rondoni, Valeria; D'Andrea, Alfredo; Bianchi, Giampaolo

    2017-09-01

    Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) does not offer a precise guidance on the clinical management (biopsy or not biopsy) for PI-RADS v2 score 3 lesions. Lesion volume calculated on biparametric MRI (bpMRI) [T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI)] by introducing a cut-off of 0.5 mL, allows to distinguish the lesions assigned by the multiparametric MRI (mpMRI) to the category PI-RADS v2 score 3 in two subgroups: a) Indolent or low risk lesions with volume PI-RADS v2 score 3, we suggest the following management: 1) Subgroup a (low-risk lesion): Clinical surveillance (accurate evaluation of age and clinical informations, periodic monitoring of prostate specific antigen value and repeated bpMRI 1 year later); 2) Subgroup b (high-risk lesion): Targeted biopsy. The proposed management would reduce the use of unnecessary biopsies and increase the diagostic yield of significant prostate cancer of approximately 50% and 30% respectively. These approaches encourage the radiologist to adopt MRI lesion volume to improve PI-RADS v2 and to optimize the management of PI-RADS v2 score 3 lesions.

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

    Science.gov (United States)

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

    2012-01-01

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

  9. Endodontic procedures for retreatment of periapical lesions.

    Science.gov (United States)

    Del Fabbro, Massimo; Corbella, Stefano; Sequeira-Byron, Patrick; Tsesis, Igor; Rosen, Eyal; Lolato, Alessandra; Taschieri, Silvio

    2016-10-19

    use of low energy level laser therapy (LLLT) prevented postoperative pain (very low quality evidence). Available evidence does not provide clinicians with reliable guidelines for treating periapical lesions. Further research is necessary to understand the effects of surgical versus non-surgical approaches, and to determine which surgical procedures provide the best results for periapical lesion healing and postoperative quality of life. Future studies should use standardised techniques and success criteria, precisely defined outcomes and the participant as the unit of analysis.

  10. Bacteriology of diabetic foot lesions.

    Science.gov (United States)

    Yoga, R; Khairul, A; Sunita, K; Suresh, C

    2006-02-01

    Infection plays a pivotal role in enhancing a diabetic foot at risk toward amputation. Effective antibiotic therapy against the offending pathogens is an important component of treatment of diabetic foot infections. Recognition of the pathogen is always difficult as the representative deep tissue sample for culture is surrounded by ulcer surface harbouring colonies of organisms frequently labelled as skin commensals. The emergent of resistant strains represents a compounding problem standing against efforts to prevent amputation. This study was undertaken to identify the pathogens associated with diabetic foot infection in terms of their frequency and sensitivity against certain commonly used antibiotics. Forty-four consecutive patients with open diabetic foot infections had wound swab taken for culture and sensitivity testing. Cultures positive were observed in 89% of the cases with Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeroginosa encountered in 20%, 14% and 14% of cases respectively. Mixed growths were isolated in 6% of cultures. All Staphylcoccus aureus isolates were resistant to Penicillin but 80% were sensitive to Erythromycin and Co-trimoxazole. Klebsiella pneumoniae isolates were sensitive to Methicillin and Gentamycin in 80% and 60% of cases respectively, and resistant to Ampicillin and Ceftazidime in 83% and 50% respectively. All Pseudomonas aeroginosa isolates were sensitive to Amikacin and Ciprofloxacin but 50% were resistant to Gentamycin. There was no single antibiotic possessing good coverage for all common organisms isolated from diabetic foot lesions. Staphylococcus aureus remains the predominant cause of diabetic foot infections followed by Klebsiela pneumonia and Pseudomonas aeroginosa. Most infections are monomicrobial. The emergence of multiresistant organisms is a worrying feature in diabetic foot infections.

  11. Major similarities in the bacterial communities associated with lesioned and healthy Fungiidae corals

    KAUST Repository

    Apprill, Amy

    2013-03-21

    Cultivation-based studies have demonstrated that yellow-band disease (YBD), a lesion-producing ailment affecting diverse species of coral, is caused by a consortium of Vibrio spp. This study takes the first cultivation-independent approach to examine the whole bacterial community associated with YBD-like lesioned corals. Two species of Fungiidae corals, Ctenactis crassa and Herpolitha limax, displaying YBD-like lesions were examined across diverse reefs throughout the Red Sea. Using a pyrosequencing approach targeting the V1-V3 regions of the SSU rRNA gene, no major differences in bacterial community composition or diversity were identified between healthy and lesioned corals of either species. Indicator species analysis did not find Vibrio significantly associated with the lesioned corals. However, operational taxonomic units belonging to the Ruegeria genus of Alphaproteobacteria and NS9 marine group of Flavobacteria were significantly associated with the lesioned corals. The most striking trend of this dataset was that reef location was found to be the most significant influence on the coral-bacterial community. It is possible that more pronounced lesion-specific bacterial signatures might have been concealed by the strong influence of environmental conditions on coral-bacteria. Overall, this study demonstrates inconsistencies between cultivation-independent and cultivation-based studies regarding the role of specific bacteria in coral diseases. © 2013 John Wiley & Sons Ltd and Society for Applied Microbiology.

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

    Science.gov (United States)

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

    2013-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Mina D. Fahmy

    2016-01-01

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

  14. Hybrid radioguided occult lesion localization (hybrid ROLL) of (18)F-FDG-avid lesions using the hybrid tracer indocyanine green-(99m)Tc-nanocolloid.

    Science.gov (United States)

    KleinJan, G H; Brouwer, O R; Mathéron, H M; Rietbergen, D D D; Valdés Olmos, R A; Wouters, M W; van den Berg, N S; van Leeuwen, F W B

    2016-01-01

    To assess if combined fluorescence- and radio-guided occult lesion localization (hybrid ROLL) is feasible in patients scheduled for surgical resection of non-palpable (18)F-FDG-avid lesions on PET/CT. Four patients with (18)F-FDG-avid lesions on follow-up PET/CT that were not palpable during physical examination but were suspected to harbor metastasis were enrolled. Guided by ultrasound, the hybrid tracer indocyanine green (ICG)-(99m)Tc-nanocolloid was injected centrally in the target lesion. SPECT/CT imaging was used to confirm tracer deposition. Intraoperatively, lesions were localized using a hand-held gamma ray detection probe, a portable gamma camera, and a fluorescence camera. After excision, the gamma camera was used to check the wound bed for residual activity. A total of six (18)F-FDG-avid lymph nodes were identified and scheduled for hybrid ROLL. Comparison of the PET/CT images with the acquired SPECT/CT after hybrid tracer injection confirmed accurate tracer deposition. No side effects were observed. Combined radio- and fluorescence-guidance enabled localization and excision of the target lesion in all patients. Five of the six excised lesions proved tumor-positive at histopathology. The hybrid ROLL approach appears to be feasible and can facilitate the intraoperative localization and excision of non-palpable lesions suspected to harbor tumor metastases. In addition to the initial radioguided detection, the fluorescence component of the hybrid tracer enables high-resolution intraoperative visualization of the target lesion. The procedure needs further evaluation in a larger cohort and wider range of malignancies to substantiate these preliminary findings. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  15. Computerized detection of mass lesions in digital mammograms

    International Nuclear Information System (INIS)

    Yin, F.F.; Giger, M.L.; Doi, K.; Metz, C.E.; Vyborny, C.J.; Schmidt, R.A.

    1989-01-01

    Early detection of breast cancer from the periodic screening of asymptomatic women could reduce breast cancer mortality by at least 40%. The authors are developing a computerized scheme for the detection of mass lesions in digital mammograms as an aid to radiologists in such high volume screening programs. Based on left-right architectural symmetry and gray-level histogram analysis, bilateral subtraction of left and right breast images is performed. False-positive detections included in bilateral-difference images are reduced with various images feature-extraction techniques. The database involves clinical film mammograms digitized by a TV camera and analyzed on a Micro-VAX workstation. Among five different bilateral subtraction techniques investigated, a nonlinear approach provided superior lesion enhancement. Feature-extraction techniques reduced substantially the remaining false-positives. Preliminary results, for 32 pairs of clinical mammograms, yielded a true-positive rate of approximately 95% with a false-positive rate of about 2 per image

  16. Glycoproteomic analysis of serum from patients with gastric precancerous lesions

    DEFF Research Database (Denmark)

    Gomes, Catarina; Almeida, Andreia; Ferreira, José Alexandre

    2013-01-01

    the simple mucin-type carbohydrate antigens T and STn in the serum of patients with gastritis, IM (complete and incomplete subtypes), and control healthy individuals. The immunohistochemistry analysis of the gastric mucosa of these patients showed expression of T and STn antigens in gastric lesions, with STn...... of glycosylation changes in circulating serum proteins in patients with precursor lesions of gastric cancer is of high interest and represents a source of putative new biomarkers for early diagnosis and intervention. This study applies a glycoproteomic approach to identify altered glycoproteins expressing...... being expressed only in IM. The serum glycoproteomic analysis using 2D-gel electrophoresis, Western blot, and MALDI-TOF/TOF mass spectrometry led to the identification of circulating proteins carrying these altered glycans. One of the glycoproteins identified was plasminogen, a protein that has been...

  17. Sport lesions caused by athletics practice

    Directory of Open Access Journals (Sweden)

    José Ernandes Feitoza

    2008-06-01

    Full Text Available Being a highly physical demanding sports, athletics depends on efficient training to overcome all physical demands without lesions. The aim of the present study was to analyze the types of lesions and their causes. The sample was constituted by forty-three athletes, sixteen males and twenty-seven females, 23.2 years of average age. A questionnaire containing five open questions and five closed questions was used as an instrument to determine the major lesions caused by athletics practice. The results showed that 84% of the athletes had already had some kind of lesions: 77% of which occurred during training and 23% during contest. The most frequent lesions were distension, tendinitis, twisting, contraction and inflammation. Legs were the most affected parts: 85% for jumpers, 85% for runners and 60% for throwers. When the lesions occurred, 76% of the jumpers, 84% of the runners and 85% of the throwers had no other health problem, but 52.7% of the athletes were in a state of anxiety before the contest and 13.8% had difficulties in concentrating on the contest. As for treatment 55.5% went to see a physiotherapist, and 16.6% went to see the medical doctor and the physiotherapist. The consequences of the lesions for the athletes’ performance were the following: 75% missed important contest events and 70% missed training for several months while they recuperated from their lesions. The results led to the conclusion that the best means to prevent lesions is to use adequate sites and equipments, efficient and individualized training coached by qualified specialists.

  18. [Degenerative lesions of the peripheral retina].

    Science.gov (United States)

    Conart, J-B; Baron, D; Berrod, J-P

    2014-01-01

    Degenerative lesions of the peripheral retina are present from teenage years onwards and increase with age. These abnormabilities are frequent, some of them being benign while others predispose to retinal tears and detachment. In the latter case, the lesions are rhegmatogenous and may justify prophylactic treatment by laser photocoagulation. We distinguish congenital lesions of the peripheral retina and intraretinal, chorioretinal and vitreoretinal degenerations. The holes and tears observed in 2% of the population consist of round atrophic holes, "horseshoe" tears, oral dialyses and giant tears. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. Lesion Contrast Enhancement in Medical Ultrasound Imaging

    DEFF Research Database (Denmark)

    Stetson, Paul F.; Sommer, F.G.; Macovski, A.

    1997-01-01

    Methods for improving the contrast-to-noise ratio (CNR) of low-contrast lesions in medical ultrasound imaging are described. Differences in the frequency spectra and amplitude distributions of the lesion and its surroundings can be used to increase the CNR of the lesion relative to the background....... Automated graylevel mapping is used in combination with a contrast-weighted form of frequency-diversity speckle reduction. In clinical studies, the techniques have yielded mean CNR improvements of 3.2 dB above ordinary frequency-diversity imaging and 5.6 dB over sharper conventional images, with no post...

  20. Acquired CNS lesions in fetal MRI

    International Nuclear Information System (INIS)

    Reith, W.; Pogledic, I.

    2013-01-01

    Acquired central nervous system (CNS) lesions are often subtle; therefore, the prenatal diagnosis of these lesions is extremely important. The fetal ultrasound examination and magnetic resonance imaging (MRI) are two important imaging methods that give an insight into these types lesions. The method of choice during pregnancy is still fetal ultrasound; however, fetal MRI is important when there are certain pathologies, e.g. periventricular leukomalacia (PVL) or malformations of the vein of Galen. In this manner clinicians can plan further therapy after childbirth in advance (e.g. cerebral angiography or embolization). (orig.) [de

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

    Directory of Open Access Journals (Sweden)

    Leslie Burdett Hart

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

  2. Comparison of Subjective Assessment and Precise Quantitative Assessment of Lesion Distribution in Diabetic Retinopathy.

    Science.gov (United States)

    Sears, Connie Martin; Nittala, Muneeswar G; Jayadev, Chaitra; Verhoek, Michael; Fleming, Alan; van Hemert, Jano; Tsui, Irena; Sadda, SriniVas R

    2018-02-22

    Predominantly peripheral disease in eyes with nonproliferative diabetic retinopathy (DR) is suggested as a potential strong risk factor for progression to proliferative disease. However, the reliability and optimal method for the assessment of lesion distribution are still uncertain. To compare agreement between subjective assessment and precise quantification of lesion burden in ultrawidefield (UWF) images of eyes with DR. This multisite cross-sectional study examines UWF pseudocolor images acquired from DR screening clinic patients from December 20, 2014, through August 1, 2014. Of 104 cases, 161 eyes with DR were included. Data analysis was conducted from June 1, 2016, through December 1, 2016 at the Doheny Image Reading Center. Distribution of DR lesions in eyes was assessed subjectively and quantitatively, and eyes were classified as having predominantly central lesions (PCLs) or predominantly peripheral lesions (PPLs). The frequency and surface area (SA) of each lesion type were quantified. Intergrader and subjective vs quantitative classification were compared for level of agreement. Several methods of determining PPL distribution were also compared. On subjective frequency-based evaluation by graders, 133 eyes were classified as having PCL, and 28 eyes as having PPL. On exact quantification of lesion SA, 121 eyes were classified as PCL, and 40 eyes as having PPL. On SA-based quantification, 134 eyes were classified as having PCL, and 27 eyes as having PPL. There was a significant difference between qualitative and quantitative classification of DR lesion distribution for both frequency-based (mean difference [SD]: PCL, 6 [2]; PPL, 13 [6]; P difference [SD]: PCL, 6 [1]; PPL, 20 [7]; P quantitative agreement were higher with frequency-based classification. Subjective assessment of PPL DR lesions on UWF images differed in some cases from precise quantitative assessments, particularly when considering the area of lesions. These findings highlight the

  3. Lesion analysis for cingulotomy and limbic leucotomy: comparison and correlation with clinical outcomes.

    Science.gov (United States)

    Yang, Jimmy C; Ginat, Daniel T; Dougherty, Darin D; Makris, Nikos; Eskandar, Emad N

    2014-01-01

    Cingulotomy and limbic leucotomy are lesioning surgeries with demonstrated benefit for medically intractable psychiatric illnesses. They represent significant refinements of the prefrontal lobotomy used from the 1930s through the 1950s. However, the associations between anatomical characterization of these lesions and outcome data are not well understood. To elucidate these procedures and associations, the authors sought to define and compare the neuroanatomy of cingulotomy and limbic leucotomy and to test a method that uses neuroanatomical data and voxel-based lesion-symptom mapping (VLSM) to reveal potential refinements to modern psychiatric neurosurgical procedures. T1-weighted MR images of patients who had undergone cingulotomy and limbic leucotomy were segmented and registered onto the Montreal Neurological Institute T1-weighted template brain MNI152. Using an atlas-based approach, the authors calculated, by case, the percentage of each anatomical structure affected by the lesion. Because of the infrequency of modern lesion procedures and the requirement for higher-resolution clinical imaging, the sample size was small. The pilot study correlated cingulotomy and limbic leucotomy lesion characteristics with clinical outcomes for patients with obsessive-compulsive disorder. For this study, preoperative and postoperative Yale-Brown Obsessive Compulsive Scale scores for 11 cingulotomy patients and 8 limbic leucotomy patients were obtained, and lesion masks were defined and compared anatomically by using an atlas-based method. Statistically significant voxels were additionally calculated by using VLSM techniques that correlated lesion characteristics with postoperative scores. Mean lesion volumes were 13.3 ml for cingulotomy and 11.8 ml for limbic leucotomy. As expected, cingulotomy was isolated to the anterior cingulum. The subcaudate tractotomy portion of limbic leucotomy additionally affected Brodmann area 25, the medial orbitofrontal cortex, and the nucleus

  4. Basic dermoscopy of melanocytic lesions for beginners

    Directory of Open Access Journals (Sweden)

    Grażyna Kamińska-Winciorek

    2011-08-01

    Full Text Available Background. Dermoscopy is a safe, easy-to-repeat diagnostic method used especially in the diagnosis of melanocytic lesions and others. Performing dermoscopy for skin lesions on the whole body takes only one minute more than standard clinical examination. Therefore the knowledge of basic dermoscopy among multi-specialization doctors – from general practitioners, surgeons, oncologists to dermatologists – increases the possibility of detection of potential melanoma.Aim. To describe the basic aspects of dermoscopy of melanocytic lesions.Methods. Review of medical databases PubMed and Medline from the last 8 years and a retrospective analysis of own experience.Results. We report the fundamental principles of performing dermoscopy, basic dermoscopic features and diagnostic algorithms of selected melanocytic lesions. Conclusions. The knowledge base of dermoscopy is very important among doctors of many specializations. It increases melanoma detection in very early stages.

  5. PERONEAL TENDON LESIONS IN ATHLETES (REVIEW

    Directory of Open Access Journals (Sweden)

    E. E. Achkasov

    2016-01-01

    Full Text Available The authors analyzed scientific literature in respect of various issues in treatment of athletes with peroneal muscles lesions starting from 1987 till 2016. Key search and publications selection was made in PubMed and russian national electronic scientific library eLIBRARY. Peroneal tendons pathology is not the major but the underestimated cause of pain in lateral and hindfoot as well as of foot dysfunction which is difficult to distinguish from lesions of lateral ligaments of the ankle joint. Untreated lesions of peroneal tendons can result in chronic ankle pain and significant functional disorders. The purpose of the present paper is to improve the current comprehension of anatomy, to identify factors contributing to pathology, to perform diagnostic evaluation of peroneal tendons and to review current treatment options of such lesions.

  6. Keloidal granuloma faciale with extrafacial lesions

    Directory of Open Access Journals (Sweden)

    Verma Rajesh

    2005-01-01

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

  7. Tumors and tumor-like lesions

    International Nuclear Information System (INIS)

    Koesling, S.; Stoevesandt, D.; Knipping, S.

    2007-01-01

    Tumors and tumor-like lesions are rare diseases in the paranasal sinuses. There is a great variety of histological types, but only a small number of morphological patterns on imaging. Histology is an important point in therapeutic planning. In most cases it is obtained by sampling, which is not as difficult in the sinonasal area as in other regions of the body. The main task of imaging is an exact estimation of the extent and spread of a lesion. This article discusses the possibilities and limitations of CT and MRI in the assessment of the dignity and spread of paranasal tumors and tumor-like lesions in consideration of necessary therapeutic information. Additionally, an overview of features on imaging of different paranasal tumors and tumor-like lesions is given. (orig.)

  8. DIAGNOSTIC CRITERIA FOR PROLIFERATIVE THYROID LESIONS IN BONY FISHES

    Science.gov (United States)

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

  9. Focal lesions in the central nervous system

    International Nuclear Information System (INIS)

    Fabrikant, J.I.; Budinger, T.F.; Tobias, C.A.; Born, J.L.

    1980-01-01

    This report reviews the animal and human studies currently in progress at LBL with heavy-ion beams to induce focal lesions in the central nervous system, and discusses the potential future prospects of fundamental and applied brain research with heavy-ion beams. Methods are being developed for producing discrete focal lesions in the central nervous system using the Bragg ionization peak to investigate nerve pathways and neuroendocrine responses, and for treating pathological disorders of the brain

  10. Aspects of atypical degenerative lesions of vertebrae

    International Nuclear Information System (INIS)

    Battikha, J.G.; Garcia, J.F.; Wettstein, P.

    1981-01-01

    Over the last 20 years, several authors have reported aspects of degenerative disease of the vertebral column with irregularity and sclerosis of the margins of the vertebral bodies [2, 4, 7-9, 13, 15, 17]. Twenty cases of such atypical degenerative vertebral lesions have been studied over a two year period and their radiological characteristics have been compared with vertebral lesions of infective origin and in the rheumatoid disorders. (orig.)

  11. Elementary lesions in dermatological semiology: literature review*

    Science.gov (United States)

    Cardili, Renata Nahas; Roselino, Ana Maria

    2016-01-01

    Discrepancies in the terminology of elementary lesions persist when texts from Dermatology and Semiology books are compared, which can cause some confusion in both the teaching of undergraduate medical students and the learning acquired by professionals in the field. This review aims to compare and clarify the differences in the description of elementary lesions by many authors, used as references for specialists in dermatology. PMID:27828637

  12. Bone involvement pattern in hypervascular lesions

    International Nuclear Information System (INIS)

    Bjersand, A.J.

    1982-01-01

    The pattern of the focal bone lesion which consists partly or wholly of rounded holes with comparatively smooth edges is discussed. Twenty-two bone lesions were studied by angiography. The 'hypervascular pattern' occurred in five cases of widely different histology, all with strong intraosseous hypervascularity. Different pathogenic mechanisms in the creation of this pattern are discussed. It is probably the result of both destructive and reparative processes in the bone. (orig.)

  13. [Nondiscal sciatica without organic lesion].

    Science.gov (United States)

    Tadie, M; Debray, Q; Perse, J; Hirsch, J F

    1978-01-01

    Among 1 800 patients operated on for hernia of the disc, 2% were completely negative on surgical exploration. Since a psychiatric aetiology might be involved, these patients were again given physical examination, clinical psychiatric examination and a personality test (minimult). This psychometric examination yelded pathological results in 68% of these patients. A comparison with two control groups operated on for hernia of the disc permitted a distinction of statistically significant differences. The results are compared with similar studies by other authors on patients with lumbalgia and dorsalgia. A practical approach is defined.

  14. Traumatic lesions of the posterior urethra.

    Science.gov (United States)

    Velarde-Ramos, L; Gómez-Illanes, R; Campos-Juanatey, F; Portillo-Martín, J A

    2016-11-01

    The posterior urethral lesions are associated with pelvis fractures in 5-10% of cases. The posterior urethra is attached to the pelvis bone by puboprostatic ligaments and the perineal membrane, which explains why disruption of the pelvic ring can injure the urethra at this level. To identify suspected cases of posterior urethral trauma and to perform the diagnosis and its immediate or deferred management. Search in PubMed of articles related to traumatic posterior urethral lesions, written in English or Spanish. We reviewed the relevant publications including literature reviews and chapters from books related to the topic. With patients with pelvis fractures, we must always rule out posterior urethral lesions. The diagnostic examination of choice is retrograde urethrography, which, along with the severity of the condition, will determine the management in the acute phase and whether the treatment will be performed immediately or deferred. Early diagnosis and proper acute management decrease the associated complications, such as strictures, urinary incontinence and erectile dysfunction. Despite the classical association between posterior urethral lesions and pelvic fractures, the management of those lesions (whether immediate or deferred) remains controversial. Thanks to the growing interest in urethral disease, there are an increasing number of studies that help us achieve better management of these lesions. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Skin conditions: benign nodular skin lesions.

    Science.gov (United States)

    Nguyen, Tam; Zuniga, Ramiro

    2013-04-01

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

  16. [Management of purpura fulminans lesions in children].

    Science.gov (United States)

    Pasquesoone, L; Belkhou, A; Gottrand, L; Guerreschi, P; Duquennoy-Martinot, V

    2016-10-01

    Purpura fulminans is a pediatric life-threatening emergency with a significant mortality, combining: septic shock, extensive purpuric lesions and disseminated intravascular coagulation. The most frequent bacterial pathogen is the meningococcus. The medical management includes antibiotics, corticoids, vascular filling and catecholamines. Purpura fulminans is characterized by the extent of hemorrhagic and mainly thrombotic lesions, attributed to the alteration in the vascular endothelium functions. Damage of soft tissues combines large necrotic areas and more or less extensive distal ischemic lesions. Necrotic lesions can be deep, reaching skin, subcutaneous tissue, fascia, muscle and sometimes even the bone. The importance of the aesthetic and functional sequelae as well as future quality of life, depend on the quality of surgical management for these wide and deep lesions. Fasciotomy is sometimes urgently needed in the case of a clinical compartment syndrome, confirmed by a high-pressure measurement in the muscle compartments. Debridement of necrotic lesions and amputations are only performed after a clear delineation of necrotic areas, between 10 days and 3 weeks of evolution. If an amputation is necessary, it must focus on the residual bone length, considering the child's growth potential. The coverage of tissue loss uses all the plastic surgery techniques, more or less complex, in order to reduce scars to minimum for these children. Rehabilitation follow-up includes physical and psychological care, which are essential until adulthood. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Association of Malassezia species with psoriatic lesions.

    Science.gov (United States)

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

    2014-08-01

    The aetiology of psoriasis remains elusive. Among multiple factors hypothesised, association of Malassezia spp. is supported by response to topical antifungals. The objective of this study was to evaluate the association of Malassezia spp. with psoriatic lesion. The subjects included 50 consecutive patients with psoriasis, and 50 age- and sex-matched healthy controls. Samples were collected using scotch tape over one square inch area from the lesional and non-lesional sites. The isolated Malassezia spp. were identified by phenotypic methods and confirmed by ITS2 PCR-RFLP and sequencing of D1/D2 region of 26S rDNA. Psoriatic lesions were seen commonly on scalp (28%, 14), chest (22%, 11) and arms (16%, 8). Majority of cases presented with chronic plaque form (76%, 38; P Malassezia species was M. furfur (70.6%, 24), followed by M. japonica (11.8%, 4) and M. globosa (8.8%, 3). From healthy individuals M. furfur, M. sympodialis, mixture of M. furfur and M. globosa was isolated in 73.3%, 10% and 16.7% (22, 3 and 5) of cases respectively. The average number of colonies isolated from scalp lesions of the patients was significantly higher (P = 0.03) than healthy areas. Although no strong association of Malassezia species was formed with psoriatic lesion in general, the fungi may play a role in exacerbation of scalp psoriasis. © 2014 Blackwell Verlag GmbH.

  18. Immediate reconstruction of a large mandibular defect of locally invasive benign lesions (a new method).

    Science.gov (United States)

    Shirani, Gholamreza; Arshad, Mahnaz; Mohammadi, Farnoush

    2007-11-01

    Locally invasive benign tumor and large lesions such as ameloblastoma, giant cell granuloma, odontogenic keratocyst, and odontogenic myxoma are a benign, invasive, lesions of the jaws that predominantly affects the mandible. Despite the benign nature of these lesions, there is a high rate of local recurrence after curettage, which usually requires resection. The traditional surgical approach for resection of these lesions, via either mandibulotomy or mandibulectomy is extraoral approach which is associated with significant functional and esthetic sequelae. A case series is presented here in which less invasive and intraoral approach. An intraoral approach provides wide and fast access to the mandible. This approach represents a less invasive alternative that provides access to the mandible for curative resection of benign tumors with minimal postoperative sequelae. At 5 years follow-up, there were minimal functional and esthetic defects. We explored the use of the less invasive and more esthetic incision as an approach to resection and reconstruction of the mandible. It is our belief that these concerns have been best addressed by the minimally invasive procedure used in this report. This approach resulted in a minimal esthetic and functional defect even though a massive mandibular resection was performed.

  19. [Surgery of inferior vena cava-associated urological tumor lesions].

    Science.gov (United States)

    Weber, M; Meyer, F; Liehr, U B; Halloul, Z

    2013-10-01

    Tumor lesions of the inferior vena cava are extremely challenging with regard to adequate therapeutic management also in advanced malignant urological tumor lesions which can be caused by malignant adhesion, impression and tumor infiltration from the surrounding tissue. This can be the case with metastases from a seminoma or testicular carcinoma (differential diagnosis: primary vena cava leiomyosarcoma), tumor-associated growth into and within the inferior vena cava originating from renal cell carcinoma or carcinoma of the pararenal gland. The aim of this overview was to summarize current clinical and operative experiences in the treatment of inferior vena cava-associated urological tumor lesions, perioperative management, individual-specific and finding-adapted surgical technique and possible outcome, including prognostic considerations from clinical daily practice and representative data found in the literature. The primary aim of the surgical approach is to achieve R0 resection with reconstruction of the inferior vena cava lumen providing a reasonable risk-benefit ratio, which comprises i) complete resection and substitution of the inferior vena cava by a prosthesis along the previous extent of tumor growth, ii) partial resection of the vena cava wall with subsequent patch-plasty or tangential resection with primary suture or iii) removal of the vena cava thrombus after cavotomy. Particular attention should be paid to tumor thrombi reaching the right atrium which need to be extracted after sternotomy and atriotomy using an extracorporeal circulation (cardiac surgeon). For surgical planning, subdivision of the inferior vena cava into three segments, infracardiac, infrahepatic and infrarenal third, has been proven and tested. The current development status and advances in surgical approaches as well as advances in medical technology allow the successful approach to such advanced stage urological tumor manifestations. A deciding factor is the abdominal and

  20. Impact of Lesion Length on Functional Significance in Intermediate Coronary Lesions

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    Morteza Safi

    2017-07-01

    Full Text Available Introduction: The present study aimed at assessing the role of lesion length in predicting Fractional Flow Reserve (FFR value for physiological evaluation of intermediate coronary lesions.Methods: In the current study, 68 patients with 83 coronary lesions were enrolled. All of the patients in this study underwent routine coronary angiography, according to appropriate indications. To evaluate physiologically significant intermediate coronary stenosis (defined between 40% and 70% on visual estimation, the Fractional Flow Reserve (FFR study was performed and the Quantitative Coronary Angiography (QCA data were also assessed for measurement of lesion length. The correlation between QCA data and FFR values was also examined.Results: Eighty-three lesions were evaluated from 68 patients. Stenosis was considered physiologically significant when FFR was lower than 0.75. The FFR was significant in twelve lesions (14.5%. There was a negative correlation between FFR value and lesion length (r = -0.294 and P = 0.013. Moreover, lesion length in physiologically significant FFR group (21.07  ± 6.9 was greater than that of the non-significant FFR group (15.23 ± 6.5 (P value < 0.05. Furthermore, the correlation between QCA data and FFR values was also investigated, yet, there was only a positive correlation between FFR and Minimum Luminal Diameter (MLD values (r = 0.248 and P value = 0.04. The Receiver Operating Characteristic (ROC curve analysis for predicting the significant FFR value demonstrated that a lesion length greater than 17.5 mm was the best cut-off point for prediction of the significant FFR value with acceptable sensitivity and specificity of 83.3% and 68.8%, respectively.Conclusions: There is a negative correlation between lesion length and FFR value in intermediate coronary lesions. In addition, a lesion length greater than 17.5 mm is the best cut- off point for prediction of significant FFR values.

  1. Sneak Peek into Tobacco Habits and Associated Insidious Oral Lesions in an Odisha Sample Population.

    Science.gov (United States)

    Das, Shibani; Shenoy, Sadhana

    2015-01-01

    Tobacco use in various forms, including with Areca nut, causes several potentially malignant disorders. Many lesions may transform into oral squamous cell carcinoma. Although patients may be aware of the hazards of tobacco habits, the lesions by themselves are insidious in nature resulting in failure of patients to present to general dentists/specialists at early stages. Our aim was to study the types of habits prevalent in the region of Rourkela in Orissa and to assess the insidious nature of the lesions associated with these habits. Not many studies have been done from this part of India. A camp was conducted for habitual users of tobacco and its products, Areca nut and other mixed habit users. A thorough history was taken of the type, duration and frequency of habits, symptoms of patients along with clinical examination by a single examiner. The data was entered in detail into an excel sheet and analysed. 54.7% had lesions and 60.9 % of them were asymptomatic and rest had mild burning sensation while eating. There was a very low awareness of the presence of lesions among the patients. There is a need to spread the awareness of the ill effects of the tobacco and other associated habits far and wide and more importantly educate the general public on the appearance of associated lesions as these are almost always insidious in nature. The patients can self-examine, detect lesions early when present and approach the dentist at the earliest opportunity.

  2. Human brain lesion-deficit inference remapped.

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    Mah, Yee-Haur; Husain, Masud; Rees, Geraint; Nachev, Parashkev

    2014-09-01

    Our knowledge of the anatomical organization of the human brain in health and disease draws heavily on the study of patients with focal brain lesions. Historically the first method of mapping brain function, it is still potentially the most powerful, establishing the necessity of any putative neural substrate for a given function or deficit. Great inferential power, however, carries a crucial vulnerability: without stronger alternatives any consistent error cannot be easily detected. A hitherto unexamined source of such error is the structure of the high-dimensional distribution of patterns of focal damage, especially in ischaemic injury-the commonest aetiology in lesion-deficit studies-where the anatomy is naturally shaped by the architecture of the vascular tree. This distribution is so complex that analysis of lesion data sets of conventional size cannot illuminate its structure, leaving us in the dark about the presence or absence of such error. To examine this crucial question we assembled the largest known set of focal brain lesions (n = 581), derived from unselected patients with acute ischaemic injury (mean age = 62.3 years, standard deviation = 17.8, male:female ratio = 0.547), visualized with diffusion-weighted magnetic resonance imaging, and processed with validated automated lesion segmentation routines. High-dimensional analysis of this data revealed a hidden bias within the multivariate patterns of damage that will consistently distort lesion-deficit maps, displacing inferred critical regions from their true locations, in a manner opaque to replication. Quantifying the size of this mislocalization demonstrates that past lesion-deficit relationships estimated with conventional inferential methodology are likely to be significantly displaced, by a magnitude dependent on the unknown underlying lesion-deficit relationship itself. Past studies therefore cannot be retrospectively corrected, except by new knowledge that would render them redundant

  3. Cutaneous lesions as presentation form of mantle cell lymphoma

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    Nayra Merino de Paz

    2011-12-01

    Full Text Available Mantle cell lymphoma is a type of no-Hodgkin lymphoma that affects extranodal areas, especially, bone narrow, digestive tract and Waldeyer ring. Here we report a case of mantle cell lymphoma IV Ann Arbor stage with cutaneous lesions on nasal dorsum and gland as the first manifestations. Skin involvement is a very rare manifestation and less than 20 cases have been reported in the literature. The importance of stablishing multidisciplinary relationships for a global approach has been shown by this clinical case.

  4. Percutaneous computed tomography guided biopsy of spinal lesions

    International Nuclear Information System (INIS)

    Vakhnina-Vassila, O; Flokatoula, M.; Stamatakis, V.; Geroukis, I.; Vlachou, I.; Petinelli, A.; Stathopoulou, S.; Kokkinis, C.

    2012-01-01

    Full text: Introduction: The decision to undertake a spinal biopsy has to be based on a thorough risk benefit analysis. Objectives and tasks: The main purpose of this presentation is to review all the parameters and technical characteristics that must be taken under consideration for a proper planning and implementation of a percutaneous CT-guided biopsy of spinal lesions. Material and methods: The benefit of a CT-guided biopsy is determined by the assessment that the information received will affect the patient's clinical management and therapeutic decisions. Prerequisite in designing and conducting a CT-guided biopsy is the knowledge of : 1) The advantages and disadvantages against an open biopsy; 2) Its indications and counter-indications; 3)The complications that may occur; 4) Imaging tests that must be taken in before the procedure; 5)The exact position of the patient that must be chosen (prone, supine, lateral recumbent); 6)The needle's approach that is chosen (rear/front, through neck, costospinal, lateral); 7) Evaluation of the parameters for targeting the lesion (spin section, section of the vertebral, lesion section); 8)The advantages and limitations of each technique (thin needle biopsy and thick needle biopsy); 9)The limitations of the procedure. Results: CT-guided percutaneous biopsy, a technique of high diagnostic accuracy and low percentage of complications, is the method of choice for the pathoanatomical determination and accurate diagnosis of spinal lesions. Conclusion: Knowledge of the parameters that ensure its proper planning and execution settle the procedure as a valuable and secure tool that raise the diagnostic accuracy

  5. Automated tissue segmentation of MR brain images in the presence of white matter lesions.

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    Valverde, Sergi; Oliver, Arnau; Roura, Eloy; González-Villà, Sandra; Pareto, Deborah; Vilanova, Joan C; Ramió-Torrentà, Lluís; Rovira, Àlex; Lladó, Xavier

    2017-01-01

    Over the last few years, the increasing interest in brain tissue volume measurements on clinical settings has led to the development of a wide number of automated tissue segmentation methods. However, white matter lesions are known to reduce the performance of automated tissue segmentation methods, which requires manual annotation of the lesions and refilling them before segmentation, which is tedious and time-consuming. Here, we propose a new, fully automated T1-w/FLAIR tissue segmentation approach designed to deal with images in the presence of WM lesions. This approach integrates a robust partial volume tissue segmentation with WM outlier rejection and filling, combining intensity and probabilistic and morphological prior maps. We evaluate the performance of this method on the MRBrainS13 tissue segmentation challenge database, which contains images with vascular WM lesions, and also on a set of Multiple Sclerosis (MS) patient images. On both databases, we validate the performance of our method with other state-of-the-art techniques. On the MRBrainS13 data, the presented approach was at the time of submission the best ranked unsupervised intensity model method of the challenge (7th position) and clearly outperformed the other unsupervised pipelines such as FAST and SPM12. On MS data, the differences in tissue segmentation between the images segmented with our method and the same images where manual expert annotations were used to refill lesions on T1-w images before segmentation were lower or similar to the best state-of-the-art pipeline incorporating automated lesion segmentation and filling. Our results show that the proposed pipeline achieved very competitive results on both vascular and MS lesions. A public version of this approach is available to download for the neuro-imaging community. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Sensory cortex lesion triggers compensatory neuronal plasticity.

    Science.gov (United States)

    Depner, Manfred; Tziridis, Konstantin; Hess, Andreas; Schulze, Holger

    2014-05-01

    Lesions to the human brain often cause dramatic impairments in the life of patients because of the very limited capacity of the mammalian nervous system to regenerate. On the other hand, neuronal tissue has a high capacity to reorganize itself so that loss of function due to brain damage may be compensated through neuroplastic reorganization of undamaged tissue in brain regions adjacent or contralateral to the lesion site. In this study we investigated the effect of serial lesions of the auditory cortices (AC) in both hemispheres of Mongolian gerbils on discrimination performance for fast amplitude modulated tones (AM). Healthy animals were trained to discriminate two fast AM, an ability that has previously been shown to critically depend on cortical processing. Their ability to maintain significant discrimination performance was retested after unilateral AC lesion, and again after lesion of the contralateral AC, with 15 days of continuing training in between the two lesions. After bilateral cortical ablation of both AC and 45 days of training the animals show no change in pure tone detection threshold as measured with modulation of the acoustic startle reflex which has been shown to rely on subcortical structures. In contrast to simultaneous bilateral ablation of AC that results in complete loss of AM discrimination ability in this paradigm we found compensatory plasticity that seems to be triggered by unilateral cortical ablation with subsequent training and that is able to almost fully compensate for the lost cortical functions. Our results demonstrate that AM discrimination ability that normally depends on AC may be transferred to other brain regions when the brain has time to activate compensatory plasticity between the lesions of the two AC hemispheres. For this process to take place obviously one intact AC hemisphere is needed. This finding may open perspectives for new therapeutic strategies that may alleviate the impairments after multiple ischemic strokes.

  7. Benign breast lesions in Eastern Nigeria

    International Nuclear Information System (INIS)

    Anyikam, A.; Nzegwn, Martin A.; Olusina, Daniel B.; Okoye, I.; Ozumba, Ben C.

    2008-01-01

    Objective was to characterize benign breast diseases in Eastern Nigeria and to highlight the age variations of these lesions as base line data. The Department of Morbid Anatomy, University of Nigeria Teaching Hospital, Enugu caters for over 30 million African blacks and receives 2000 surgical pathology specimens yearly. Seven hundred and twenty-two benign breast specimens were analyzed over 5 years from Ist January 2000 to 31 December 2004, out of 1050 breast samples received. Of 1050 breast specimens received, 722 (68.8%) were benign. Fibroadenoma was the most common lesion with 318 cases (44%), occurring at a mean age of 16-32 years. Next were fibrocystic changes with 165 cases (22.9%) at a mean age of 23-45 years. Normal breast in the axillary tail region was seen in 32 cases (4.4%), represented as no pathology, with a mean presentation age of 20-46 years. Low grade Phyllodes tumor had 28 cases (3.9%), presenting at an average mean age of 17-32 years. Lactating adenoma had 19 (2.6%) cases. Other lesions made up less than 3% each. Benign breast lesions peaked at the 20-24 age range and then declined. Most were females. Benign breast lesions occur more frequently than malignant breast lesions with a ratio of 2.3:1 and were presented 20 years earlier than their malignant counterparts. Fibroadenoma was the most common benign lesions followed by fibrocystic disease, similar to the findings in Western Nigeria. In Northern Nigeria, fibrocystic breast disease was more common. (author)

  8. Management of a complex pancreaticoduodenal lesion following a suicidal attempt with a crossbow.

    Science.gov (United States)

    Benmohamed, Nadja; Abbassi, Ziad; Naiken, Surennaidoo P; Morel, Philippe; Platon, Alexandra; Poletti, Pierre-Alexandre; Toso, Christian

    2016-12-31

    Traumatic pancreaticoduodenal lesions are rare, often involve a challenging management, and have high rates of morbidity and mortality. A 43-year-old male patient committed a suicidal attempt by shooting an arrow with a crossbow into his upper abdomen. He was successfully treated with cautious multidisciplinary approach. Crossbow lesions demonstrate low kinetics. Sharp tips of arrows result in localized damage, likely to involve several organs. Pancreatic lesions are of particular interest because of their difficult surgery. Surgical exploration and drainage can allow an efficient management of pancreatic penetrating lesions, even in the presence of a complete pancreatic duct disruption. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2016.

  9. Intragastric laparoscopic surgery: An option for gastric lesions not resectable by endoscopy.

    Science.gov (United States)

    Manuel Vázquez, Alba; Hernández Matías, Alberto; Bertomeu García, Agustín; Ruiz de Adana Belbel, Juan Carlos

    2016-03-01

    Gastric mucosal and submucosal lesions can be resected by endoscopy, laparoscopy or open surgery. Operative methods have varied depending on the location, endophytic growth and size of the lesion. Interest in minimally invasive surgery has increased and many surgeons are attempting laparoscopic approaches, especially in lesions of the stomach near the esophagogastric junction not amendable to endoscopic removal, because conventional surgery can produce stenosis and distort the postoperative anatomy, and increase morbimortality. We report our experience with laparoscopic intragastric surgery in 3 consecutive patients, with no complications. Laparoscopic intragastric surgery extends the surgeons' armamentarium to resect complex gastric lesions, while offering patients the benefits of minimal access surgery. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Skin lesions of children and adolescents in process of physiotherapeutic rehabilitation

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    Iluska Borges Dias Lima

    2014-01-01

    Full Text Available Objective: To evaluate the skin lesions in children and adolescents with neurological diseases in a physical therapy rehabilitation process. Method: A retrospective descriptive study with a quantitative approach. The sample consists of 101 medical records of children and adolescents treated at a Rehabilitation Center in Teresina - Piaui, Brazil. The data were collected by means of form, evaluation sheet and the Likert scale and processed in SPSS, presented in tables and a descriptive statistical analysis performed. Results: The major lesions which affected patients were pityriasis versicolor - 25.7% and pediculosis -21.8%. Data from the Likert scale regarding the injury originated from dermatological lesions with patients undergoing rehabilitation, the option not agree totally accounted for 37.1%, the option indifferent accounted for 3.4%, partially agree representing 24.7% and completely agree 34 8%. Final Considerations: The skin lesions cause treatment interruptions harming children and adolescents in physical therapy rehabilitation.

  11. Opposed Left and Right Brain Hemisphere Contributions to Sexual Drive: A Multiple Lesion Case Analysis

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    Claude M. J. Braun

    2003-01-01

    Full Text Available Brain topographical studies of normal men have have shown that sexual excitation is asymmetric in the brain hemispheres. Group studies of patients with unilateral epileptic foci and other studies of patients with unilateral brain lesions have come to the same conclusion. The present study reviewed previously published single case reports of patients with frank hypo or hypersexuality subsequent to a unilateral brain lesion. Hyposexual patients tended to have left hemisphere lesions (primarily of the temporal lobe, and hypersexual patients tended to have right hemisphere lesions (primarily of the temporal lobe (p < 0.05. We interpret this double dissociation as part of a more general phenomenon of psychic tone similarly dissociated with regard to hemispheric control, including mood, psychomotor baseline, speech rate, and even immunity. The behavioral significance of this psychic tone is to modulate approach versus avoidance behavior.

  12. Radiologic appearance of primary jaw lesions in children.

    Science.gov (United States)

    Gupta, Malini; Kaste, Sue C; Hopkins, Kenneth P

    2002-03-01

    The jaw (an unusual site of primary tumors in children and adolescents) has lesions often found incidentally by dentists on routine panoramic radiographs or during examination of a child who has swelling or tooth pain. This pictorial seeks to familiarize pediatric radiologists with the radiographic appearance of a variety of primary jaw lesions. We retrospectively searched institutional records for cases of primary jaw lesions in children and adolescents. Jaw lesions were characterized as: I, well-circumscribed radiolucent lesions; II, lesions with mixed or variable appearance; III, poorly circumscribed radiolucent lesions; and IV, radiopaque lesions. Although most oral and maxillofacial lesions in children are benign, a broad spectrum of tumors was identified; lesions may occur in patients with unrelated prior malignancy. Because radiologic studies may identify jaw lesions and direct further care, familiarity with the appearance of these entities is prudent.

  13. Radiologic appearance of primary jaw lesions in children

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Malini; Kaste, Sue C. [Department of Diagnostic Imaging, St. Jude Children' s Research Hospital, Memphis, TN (United States); Hopkins, Kenneth P. [Department of Surgery, Division of Dentistry, St. Jude Children' s Research Hospital, Memphis, TN (United States)

    2002-03-01

    Background: The jaw (an unusual site of primary tumors in children and adolescents) has lesions often found incidentally by dentists on routine panoramic radiographs or during examination of a child who has swelling or tooth pain. Objective: This pictorial seeks to familiarize pediatric radiologists with the radiographic appearance of a variety of primary jaw lesions. Materials and methods: We retrospectively searched institutional records for cases of primary jaw lesions in children and adolescents. Jaw lesions were characterized as: I, well-circumscribed radiolucent lesions; II, lesions with mixed or variable appearance; III, poorly circumscribed radiolucent lesions; and IV, radiopaque lesions. Results: Although most oral and maxillofacial lesions in children are benign, a broad spectrum of tumors was identified; lesions may occur in patients with unrelated prior malignancy. Conclusion: Because radiologic studies may identify jaw lesions and direct further care, familiarity with the appearance of these entities is prudent. (orig.)

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

    Science.gov (United States)

    Freire, Paulo G L; Ferrari, Ricardo J

    2016-06-01

    Multiple sclerosis (MS) is a demyelinating autoimmune disease that attacks the central nervous system (CNS) and affects more than 2 million people worldwide. The segmentation of MS lesions in magnetic resonance imaging (MRI) is a very important task to assess how a patient is responding to treatment and how the disease is progressing. Computational approaches have been proposed over the years to segment MS lesions and reduce the amount of time spent on manual delineation and inter- and intra-rater variability and bias. However, fully-automatic segmentation of MS lesions still remains an open problem. In this work, we propose an iterative approach using Student's t mixture models and probabilistic anatomical atlases to automatically segment MS lesions in Fluid Attenuated Inversion Recovery (FLAIR) images. Our technique resembles a refinement approach by iteratively segmenting brain tissues into smaller classes until MS lesions are grouped as the most hyperintense one. To validate our technique we used 21 clinical images from the 2015 Longitudinal Multiple Sclerosis Lesion Segmentation Challenge dataset. Evaluation using Dice Similarity Coefficient (DSC), True Positive Ratio (TPR), False Positive Ratio (FPR), Volume Difference (VD) and Pearson's r coefficient shows that our technique has a good spatial and volumetric agreement with raters' manual delineations. Also, a comparison between our proposal and the state-of-the-art shows that our technique is comparable and, in some cases, better than some approaches, thus being a viable alternative for automatic MS lesion segmentation in MRI. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. A HISTOPATHOLOGICAL SPECTRUM OF NECK LESIONS IN A RURAL HOSPITAL

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    Shri Lakshmi Surapaneni

    2016-07-01

    Full Text Available BACKGROUND A multitude of lesions occur in the neck and patients come to hospital on account of morbidity associated with these lesions. Therefore a histopathological study of the spectrum of neck lesions was undertaken. MATERIALS AND METHODS All histologically diagnosed lesions of the neck from January 2014 to December 2015 were noted. Details of gender, age, location and diagnosis were recorded. The lesions were classified based on anatomic location, gross and histological features and clinically. Clinically, lesions were classified as congenital, inflammatory/infective and neoplastic. Incidence of age, gender and location of different lesions was calculated using percentage, and median. The findings were compared with other studies. RESULTS A total of 140 neck lesions were included in the current study. Neck lesions were predominant in females with 94 cases. The median age group involved was the 21-30 group. Anterior neck lesions were more common. Anterior midline lesions were 74 and mostly thyroid and thyroglossal duct origin. Lesions of the lymph node were greater in the posterior triangle. 122 lesions were solid and 18 were cystic. Histologically, there were 64 thyroid gland lesions, 40 lymph node lesions, 13 soft tissue tumours, 8 salivary lesions, 10 thyroglossal cysts and 5 skin/adnexal lesions. Clinically, congenital/developmental lesions were 11, inflammatory/infective lesions were 68 and neoplastic lesions were 61. Of the neoplastic lesions, 17 were malignant. CONCLUSION Non-neoplastic lesions of the neck were common in our study in accordance with findings in other studies. The most common malignancy was Papillary carcinoma of thyroid.

  16. Additional diagnostic value of MRI in patients with suspicious breast lesions based on ultrasound

    Science.gov (United States)

    Uluc, F

    2014-01-01

    Objective: Biopsy has long been the standard approach in Breast Imaging Reporting and Data System® (BI-RADS) 4 or BI-RADS 5 (American College of Radiology, Reston, VA) lesions despite a wide variation in reported incidence of malignancy in BI-RADS 4 lesions. This study examined the diagnostic value of breast MRI as well as its ability to decrease unnecessary biopsies in patients with solid breast lesions who had an indication for biopsy. Methods: In this retrospective study, 277 breast lesions with a documented histological diagnosis as established by ultrasound-guided biopsy were included. All patients were female, and biopsy was performed owing to a BI-RADS score of 4 or 5 on ultrasonography. In addition, all patients had undergone MRI before biopsy. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MRI in predicting malignancy were calculated. Results: When all lesions were analysed, sensitivity, specificity, NPV and PPV of MRI in detecting malignancy were 94.2%, 56.1%, 90.7% and 68.1%, respectively. When only ultrasonographic BI-RADS 4 lesions are considered, the corresponding figures were as follows: 90.9%, 56.7%, 93.8% and 46.4%, respectively. False-negative rate of MRI for the latter group of lesions was 2.6%. 42% of unnecessary biopsies were avoided in sonographic BI-RADS 4 lesions. Conclusion: Despite promising results obtained in this study, dynamic MRI currently does not seem to be effective in ruling out the need for biopsy in the assessment of sonographic BI-RADS 4 lesions. However, advanced MRI techniques may assist in improving possible benefits of MRI in this patient group. PMID:24983629

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

    Science.gov (United States)

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

    2012-03-01

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

  18. Evaluation of various hepatic lesions with PET

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    Han, Chul Ju

    2000-12-01

    When a liver lesion is found in a PET image, differential diagnosis and analysis of the lesion is very important. We tried to analyze hepatic lesions found in PET. 53 patients with focal liver lesions (13 patients with HCC, 8 patients with cholangiocarcinoma (CC), 20 patients with liver metastasis, 5 patients with hemangioma, 7 patients with liver abscess, including 1 patient with liver candidiasis) were examined. Definitely high FDG uptake pattern were observed in 54% (7/13) of HCC, 100% (8/8) of CC, 95% (19/20) of metastatic liver cancer and 100% (7/7) of liver abscess. Therefore, PET was partially useful in the diagnosis of HCC, but it was very useful in the diagnosis of CC or liver metastasis or liver abscess. The contrast between lesions and surrounding liver background was very conspicuous in PET images of CC or liver metastasis or liver abscess, which suggests that PET might be used for the follow up and assessment of treatment response of these diseases.

  19. Evaluation of various hepatic lesions with PET

    International Nuclear Information System (INIS)

    Han, Chul Ju

    2000-12-01

    When a liver lesion is found in a PET image, differential diagnosis and analysis of the lesion is very important. We tried to analyze hepatic lesions found in PET. 53 patients with focal liver lesions (13 patients with HCC, 8 patients with cholangiocarcinoma (CC), 20 patients with liver metastasis, 5 patients with hemangioma, 7 patients with liver abscess, including 1 patient with liver candidiasis) were examined. Definitely high FDG uptake pattern were observed in 54% (7/13) of HCC, 100% (8/8) of CC, 95% (19/20) of metastatic liver cancer and 100% (7/7) of liver abscess. Therefore, PET was partially useful in the diagnosis of HCC, but it was very useful in the diagnosis of CC or liver metastasis or liver abscess. The contrast between lesions and surrounding liver background was very conspicuous in PET images of CC or liver metastasis or liver abscess, which suggests that PET might be used for the follow up and assessment of treatment response of these diseases

  20. Producing Uniform Lesion Pattern in HIFU Ablation

    Science.gov (United States)

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

    2009-04-01

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

  1. MR in phenylketonuria-related brain lesions

    International Nuclear Information System (INIS)

    Dezortova, M.; Hajek, M.; Tintra, J.; Hejcmanova, L.; Sykova, E.

    2001-01-01

    Purpose: Phenylketonuria (PKU) patients were examined by different MR techniques to explain the pathological changes observed in periventricular white brain matter using conventional MR imaging. Material and Methods: Fifteen patients with treated classical PKU were examined by 1 H spectroscopy, relaxometry and diffusion imaging on a whole-body 1.5-T MR imager. Results: Known PKU lesions characterized by T2 enhancement in periventricular white matter were observed in all patients. The MR spectra from the lesioned areas showed a significant decrease in choline concentration. The mean ADC of water decreased and tortuosity increased in PKU lesions compared to control data. Conclusion: The results support the following hypothesis: The T2 increase in the PKU lesion reflects a raised concentration of free water molecules (about 15%) that have an increased trajectory between collisions compared to the same region in controls. The increase in water mobility might be explained by changes in extracellular space volume and myelin sheaths, which, presumably, have a different geometry with more hydrophobic sites in PKU patients. The changes result in increased tortuosity and may be confirmed by the loss of anisotropy in PKU lesions

  2. MR in phenylketonuria-related brain lesions

    Energy Technology Data Exchange (ETDEWEB)

    Dezortova, M.; Hajek, M.; Tintra, J. [Inst. for Clinical and Experimental Medicine, Prague (Czech Republic); Hejcmanova, L. [Charles University, Prague (Czech Republic). 3rd Medical Faculty; Sykova, E. [Charles University, Prague (Czech Republic). 2nd Medical Faculty

    2001-09-01

    Purpose: Phenylketonuria (PKU) patients were examined by different MR techniques to explain the pathological changes observed in periventricular white brain matter using conventional MR imaging. Material and Methods: Fifteen patients with treated classical PKU were examined by {sup 1}H spectroscopy, relaxometry and diffusion imaging on a whole-body 1.5-T MR imager. Results: Known PKU lesions characterized by T2 enhancement in periventricular white matter were observed in all patients. The MR spectra from the lesioned areas showed a significant decrease in choline concentration. The mean ADC of water decreased and tortuosity increased in PKU lesions compared to control data. Conclusion: The results support the following hypothesis: The T2 increase in the PKU lesion reflects a raised concentration of free water molecules (about 15%) that have an increased trajectory between collisions compared to the same region in controls. The increase in water mobility might be explained by changes in extracellular space volume and myelin sheaths, which, presumably, have a different geometry with more hydrophobic sites in PKU patients. The changes result in increased tortuosity and may be confirmed by the loss of anisotropy in PKU lesions.

  3. Traumatic lung lesions: computed tomography findings

    International Nuclear Information System (INIS)

    Melo, Alessandro Severo Alves de; Moreira, Luiza Beatriz Melo; Marchiori, Edson

    2003-01-01

    Traumatic lesions of the lung are common findings in patients with thoracic trauma. These lesions are increasingly diagnosed using computed tomography, mostly due to the fast acquisition time helical techniques that allow evaluation of critically ill patients and an efficient therapeutic management. The authors studied 150 patients with thoracic trauma submitted to computed tomography that demonstrated lung contusions, atelectasis, lacerations and hematomas. Lung contusions were the most frequent lesions appearing as consolidation or ground-glass attenuation areas. Atelectasis, in subsegmentar and compressive patterns, were the second most common lesions observed. Lacerations appeared as consolidations with air or liquid level. Lung hematomas, characterized by round opacities, were the most rare lung lesions seen in only five cases. In this study, blunt thoracic trauma accounted for the majority of 120 cases whereas penetrating trauma occurred in 30 cases. The causes of blunt trauma in de crescent order of frequency were motor vehicle accidents, pedestrian hit by car, falls, motorcycle accidents and trashing. Penetrating traumas were caused by bullets or knives. (author)

  4. Venocentric lesions: an MRI marker of MS?

    Directory of Open Access Journals (Sweden)

    Matthew P. Quinn

    2013-07-01

    Full Text Available From the earliest descriptions of MS, the venocentric characteristic of plaques was noted. Recently, numerous MRI studies have proposed this finding as a prospective biomarker for MS, which might aid in differentiating MS from other diseases with similar MRI findings. High field MRI studies have shown that penetrating veins can be detected in most MS lesions using T2* weighted or susceptibility weighted imaging. Future studies must address the feasibility of imaging such veins in a clinically practical context. The specificity of this biomarker has been studied only in a limited capacity. Results in microangiopathic lesions are conflicting, whereas asymptomatic white matter hyperintensities as well as lesions of NMO are less frequently venocentric compared to MS plaques. Prospective studies have shown that the presence of venocentric lesions at an early clinical presentation is highly predictive of future MS diagnosis. This is very promising, but work remains to be done to confirm or exclude lesions of common MS mimics, such as ADEM, as venocentric. A number of technical challenges must be addressed before the introduction of this technique as a complementary tool in current diagnostic procedures.

  5. Osteochondral lesions of the talus: Current concept.

    Science.gov (United States)

    Laffenêtre, O

    2010-09-01

    Osteochondral lesions of the talus (OTL) are among those injuries that we should not fail to recognize, especially following any type of hindfoot injury. They were thoroughly described 15 years ago in a round table session organized by Doré and Rosset for the Société orthopédique de l'Ouest. Their physiopathology has not yet been definitely determined, even though some of the pathogenic mechanisms are known. They are best characterized using the fractures, osteonecroses, geodes (FOG) radiological classification. Both their diagnosis and their surgical treatment remain a challenge to the orthopaedic surgeon: some basic surgical principles apply to all of the lesions, such as cartilage debridement and shaving of necrotic tissues, while others will be used depending on the location and size of the lesions as well as the surgeon's experience. Finally, no specific technique appears to be superior to the others. Arthroscopy appears to be the most effective procedure for lesions smaller than 1 cm(2), whereas larger lesions should be filled, either with cancellous bone or with an osteochondral graft or using autogenous chondrocyte implantation. The data available in the literature should also incite orthopaedists to consider the results of surgical management with some modesty, and conservative management should remain among the therapeutic options. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  6. Oral White Lesions: Presentation and Comparison of Oral Submucous Fibrosis with Other Lesions

    International Nuclear Information System (INIS)

    Maqsood, A.; Aman, N.

    2013-01-01

    Objective: To compare oral submucous fibrosis with other white oral lesions for presentation and associated factors. Study Design: Cross-sectional study. Place and Duration of Study: The Departments of Oral Medicine and Oral and Maxillofacial Surgery, Dr. Ishrat-ul-Ibad Institute of Oral Health Sciences (DIKIOHS), Karachi, from May 2008 to May 2009. Methodology: Patients presenting with oral white lesions were selected by consecutive non-purposive sampling and clinico-demographic data was collected. For patients with oral submucous fibrosis (OSF), additional information like duration of habits, maximal incisal opening (MIO), presence of any other associated lesion were noted. OSF was compared with other white lesions for any association between characteristic of subjects. Chi-square and independent t-tests for determining the statistical significance at p < 0.05. Results: OSF was present in 59.6% (n = 106) of the 178 patients; other white lesions were 40.4% (n = 72). The mean age of patients with OSF was 34 +- 12.7 years and 45.81 +- 16.2 years in patients with other white lesions, (p < 0.0001). Items containing areca nut were consumed more by patients with OSF, with a significant (p < 0.0001) compared to patients with other white lesions. Conclusion: OSF was the predominant white lesion in patients examined at DIKIOHS. Areca nut was found to be chewed more by patients with OSF and still longer by patients with SCC. (author)

  7. Silent ischemic brain lesions after transcatheter aortic valve replacement : lesion distribution and predictors

    NARCIS (Netherlands)

    Samim, Mariam; Hendrikse, Jeroen; van der Worp, H. Bart; Agostoni, Pierfrancesco; Nijhoff, Freek; Doevendans, Pieter A.; Stella, Pieter R.

    Silent ischemic brain lesions and ischemic stroke are known complications of transcatheter aortic valve replacement (TAVR). We aimed to investigate the occurrence and distribution of TAVR-related silent ischemic brain lesions using diffusion-weighted magnetic resonance imaging (DWI). Consecutive

  8. Morgellons Disease Presenting As an Eyelid Lesion.

    Science.gov (United States)

    Sandhu, Rasanamar K; Steele, Eric A

    2016-01-01

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

  9. Evaluation of bone lesions of lymphomas

    International Nuclear Information System (INIS)

    Marugg, S.; Berchtold, C.; Elke, M.

    1985-01-01

    Skeletal involvement of non-Hodgkin's lymphoma is found in 11-16%, in Hodgkin's disease in 7.6-34%. Primary lymphoma of bone has an incidence of 1-50% among all non-Hodgkin's lymphoma. The occurrence of skeletal lesions is higher in infants and children than in adults. Skeletal lesions caused by Hodgkin's and non-Hodgkin's lymphoma are mostly seen in the axial skeleton including the skull, whereas the primary lymphoma of bone seems to prefer a more peripheral site. The aggressiveness of the tumor growth can be measured by the method of Lodwick, by judging the edge characteristic, the penetration of the cortex, the periostal and scleotic reaction. 3 examples illustrate this method. Conventional radiographs need only be performed when there is reason to believe a lesion is located in an area of structural importance, such as the neck of the femur, and in cases of skeletal pain of unknown origin. (orig.) [de

  10. Visual attention capacity after right hemisphere lesions

    DEFF Research Database (Denmark)

    Habekost, Thomas; Rostrup, Egill

    2007-01-01

    Recently there has been a growing interest in visual short-term memory (VSTM) including the neural basis of the function. Processing speed, another main aspect of visual attention capacity, has received less investigation. For both cognitive functions human lesion studies are sparse. We used...... a whole report experiment for estimation of these two parameters in 22 patients with right side stroke. Psychophysical performance was analyzed using Bundesen's [Bundesen, C. (1990). A theory of visual attention. Psychological Review, 97, 523-547] Theory of Visual Attention (TVA) and compared...... statistically to lesion location and size measured by MRI. Visual processing speed was impaired in the contralesional hemifield for most patients, but typically preserved ipsilesionally, even after large cortico-subcortical lesions. When bilateral deficits in processing speed occurred, they were related...

  11. Laser treatment for pigmented lesions: a review.

    Science.gov (United States)

    Jones, Christina E; Nouri, Keyvan

    2006-03-01

    Just a few decades ago, before lasers were introduced into dermatologic practice, many cutaneous lesions were untreatable. Since the introduction of lasers in dermatology in the 1960s and its revolution by Anderson and Parrish in the 1980s based on the selective photothermolysis theory, lasers have become a main component of many dermatology practices. With the advent of these selective lasers and their constant technological advancements, many lesions can now be easily removed with a low incidence of complications, creating a high demand for laser surgery. Aims This paper will review current laser systems used for pigmented lesions. An English-language literature search and review through Medline from January 1994 to October 2004. Review of the latest techniques and lasers used in treating pigmentary disorders and possible future applications and treatment options. Laser technique and technology has greatly advanced producing more effacious treatment with minimal complications.

  12. Lesions in nerves and plexus after radiotherapy

    International Nuclear Information System (INIS)

    Vees, W.

    1978-01-01

    Apart from the typical, radiation-induced changes in the skin, common secondary findings were oedemas, radiation-induced ulceration, fibroses of the mediastinum and lungs, pleura adhesions, and osteoradionecroses. In one patient with radiogenic paresis of the plexus brachialis, irradiation of the spinal cord because of epidural metastases of a mammary carcinoma resulted in radiation myelopathy which was verified by laminectomy. Observations of radiogenic lesions of the plexus brachialis show that the usual site of the lesion in the vasomotoric nerve bundle is the axilla. The lesion is assumed to be caused mainly by an overlapping of the axillary, infraclavicular and supraclavicular fields of irradiation which results in a dose peak in the axilla. (orig./AJ) 891 AJ/orig.- 892 MKO [de

  13. Endoscopic resection of fibro-osseous lesions of the paranasal sinuses.

    Science.gov (United States)

    Brodish, B N; Morgan, C E; Sillers, M J

    1999-01-01

    Fibro-osseous tumors, including osteomas, ossifying fibromas, and fibrous dysplasia, are not uncommon benign lesions arising in the paranasal sinuses. Conventional wisdom advocates resection when these lesions are symptomatic, or when they exhibit rapid growth. Traditionally, resection has been performed via a variety of open approaches. With the advent of sinonasal endoscopy in the mid 1980s, and subsequent advances in technology and surgical techniques, endoscopic management of some of these lesions is now feasible. To date, a search of the literature reveals only three case reports of osteomas resected with endoscopic guidance. We present a series of 10 symptomatic fibro-osseous lesions (nine osteomas and one fibrous dysplasia) occurring in nine patients in which endoscopic techniques were used. Seven ethmoid and frontal recess osteomas were resected transnasally and one sphenoid sinus fibrous dysplasia was resected using a transseptal transsphenoidal approach with the assistance of direct endoscopic visualization. There were two anticipated CSF leaks that were recognized and repaired at the time of surgery. There were no other complications and no tumor recurrence. All patients noted improvement in preoperative symptoms. We discuss patient selection, operative techniques and strategies, and the advantages and disadvantages of the endoscopic approach in the management of paranasal sinus fibro-osseous lesions.

  14. Brain hubs in lesion models: Predicting functional network topology with lesion patterns in patients.

    Science.gov (United States)

    Yuan, Binke; Fang, Yuxing; Han, Zaizhu; Song, Luping; He, Yong; Bi, Yanchao

    2017-12-20

    Various important topological properties of healthy brain connectome have recently been identified. However, the manner in which brain lesion changes the functional network topology is unknown. We examined how critical specific brain areas are in the maintenance of network topology using multivariate support vector regression analysis on brain structural and resting-state functional imaging data in 96 patients with brain damages. Patients' cortical lesion distribution patterns could significantly predict the functional network topology and a set of regions with significant weights in the prediction models were identified as "lesion hubs". Intriguingly, we found two different types of lesion hubs, whose lesions associated with changes of network topology towards relatively different directions, being either more integrated (global) or more segregated (local), and correspond to hubs identified in healthy functional network in complex manners. Our results pose further important questions about the potential dynamics of the functional brain network after brain damage.

  15. Lesiones bucales relacionadas con las enfermedades digestivas

    Directory of Open Access Journals (Sweden)

    José A. Pacho Saavedra

    2006-09-01

    Full Text Available Muchas de las lesiones de la mucosa en la cavidad bucal están relacionadas con trastornos anatómicos y funcionales de los órganos del aparato digestivo; algunas forman parte del cuadro clínico de la entidad y otras aparecen como complicaciones de estas. Generalmente son de orígenes inmunológicos, nutricionales o carenciales. Estas lesiones son difíciles de tratar, por lo que es importante conocer las características clínicas que faciliten una adecuada interpretación y al mismo tiempo ofrecer una conducta terapéutica correcta. Se presenta una revisión actualizada de las características semiológicas de las lesiones bucales que forman parte del cuadro clínico de diversas enfermedades digestivas, con el fin de que los médicos generales, clínicos, estomatólogos y gastroenterólogos puedan diagnosticarlas y brindar mejor orientación y tratamiento a los pacientes.Many of the lesions of the mucosa in the oral cavity are related to anatomical and functional disorders of the organs of the digestive system. Some of them are part of the clinical picture of the entity and others appear as complications of them. Generally, they have an immunological, nutritional, or deficiency origin. These lesions are difficult to be treated and that's why it is important to know the clinical characteristics making easy an adequate interpretation, and to follow a suitable therapeutic conduct at the same time. An updated review of the semiological features of the oral lesions corresponding to the clinical picture of diverse digestive diseases is presented, so that the general physicians, clinicians, stomatologists and gastroenterologists be able to diagnose and give a better guidance and treatment to the patients.

  16. Can Physical Examination Create a Stener Lesion?

    Science.gov (United States)

    Lankachandra, Manesha; Eggers, John P; Bogener, James W; Hutchison, Richard L

    2017-09-01

    The purpose of this study is to determine whether a Stener lesion can be created while testing stability of the ulnar collateral ligament (UCL) of the thumb. Testing was performed in a manner that reproduced clinical examination. Six fresh frozen hand and forearm specimens underwent sequential sectioning of the accessory UCL, the proper UCL, and the ulnar sagittal band. Measurements of radial deviation of the metacarpophalangeal (MCP) joint were taken with the thumb in neutral rotation, pronation and supination, both with 0 degrees and with 30 degrees of flexion of the MCP joint. Visual examination was performed to assess the presence of a Stener lesion. No Stener lesion was created in any position as long as the fascial origin of the ulnar sagittal band at the adductor pollicis longus remained intact. After creating a defect in the ulnar sagittal band, a Stener lesion was created in two specimens, but only when the thumb was flexed and supinated. Pronation provided more stability, and supination provided less stability, with one or both components cut, especially when testing at 30° of flexion. Compared to both components cut without flexion or rotation, there was a statistically significant difference in angulation with the 30 degrees of MCP joint flexion in both neutral rotation in supination. Performing a physical examination to assess the amount of instability of an ulnar collateral ligament injury did not create a Stener lesion if the exam was performed in a controlled, gentle manner with the thumb held without rotation. If the thumb is held in neutral rotation during the exam, an iatrogenic Stener lesion should not be created.

  17. Detection of Helicobacter pylori in Oral Lesions

    Directory of Open Access Journals (Sweden)

    Soussan Irani

    2013-12-01

    Full Text Available Background and aims. Helicobacter pylori is a microaerophilic gram-negative spiral organism. It is recognized as the etiologic factor for peptic ulcers, gastric adenocarcinoma and gastric lymphoma. Recently, it has been isolated from dental plaque and the dorsum of the tongue. This study was designed to assess the association between H. pylori and oral lesions such as ulcerative/inflammatory lesions, squamous cell carcinoma (SCC and primary lymphoma. Materials and methods. A total of 228 biopsies diagnosed as oral ulcerative/inflammatory lesions, oral squamous cell carcinoma (OSCC and oral primary lymphoma were selected from the archives of the Pathology Department. Thirty-two samples that were diagnosed as being without any pathological changes were selected as the control group. All the paraffin blocks were cut for hematoxylin and eosin staining to confirm the diagnoses and then the samples were prepared for immunohistochemistry staining. Data were collected and analyzed. Results. Chi-squared test showed significant differences between the frequency of H. pylori positivity in normal tissue and the lesions were examined (P=0.000. In addition, there was a statistically significant difference between the lesions examined (P=0.042. Chi-squared test showed significant differences between H. pylori positivity and different tissue types except inside the muscle layer as follows: in epithelium and in lamina propria (P=0.000, inside the blood vessels (P=0.003, inside the salivary gland duct (P=0.036, and muscle layer (P=0.122. Conclusion. There might be a relation between the presence of H. pylori and oral lesions. Therefore, early detection and eradication of H. pylori in high-risk patients are suggested.

  18. CAMERON LESIONS: LITERATURE REVIEW AND CASE PRESENTATION

    Directory of Open Access Journals (Sweden)

    V. V. Vasilenko

    2016-01-01

    Full Text Available Cameron syndrome is the ulcerative or erosive lesions of mucosal layer at the sac of hiatal hernia which can cause chronic occult or overt bleeding and iron-deficiency anemia. Hiatal hernia is a relatively frequent finding, which is in most cases asymptomatic or manifested by dyspeptic symptoms of varying severity. Despite of being a very important association of hiatal hernia Cameron syndrome is not widely represented in medical literature. That`s the reason of a lack of awareness among physicians, surgeons and endoscopists about that pathology. Cameron lesions are significant pathology because they can become a source of chronic occult as well as an acute life-threatening bleeding. Those lesions of upper gastrointestinal tract are often misinterpreted or overlooked during standard diagnostic procedures. It can lead to the misdiagnosis and false ways of treatment. The review focuses on the pathogenesis, main diagnostic problems and treatment options of that pathology. The diagnostics of the Cameron syndrome is difficult because sometimes the lesions can`t be seen on upper gastrointestinal tract endoscopy. The review describes the criteria by which the physician may suspect Cameron syndrome when endoscopy results are not certain. Clinical case represents an important problem which is often faced by the doctors — the severe iron-deficiency anemia refractory to the medication and blood transfusions in the patients with Cameron lesions. It`s very important for doctor to be aware of that complication to include Cameron syndrome into the diagnostic search for the sources of persistent blood loss. Cameron lesions can be asymptomatic as well as be manifested in the form of severe chronic anemia. And that`s the reason why there are an important issue about the proper treatment which have to be provided in each case. The review describes the effectiveness of different treatment options and makes the conclusion about the principles on which doctor can

  19. SLAP lesion of the shoulder. MRI evaluation

    International Nuclear Information System (INIS)

    Barile, A.; Sabatini, M.; Maffey, M.V.; Di Cesare, E.; Masciocchi, C.

    2000-01-01

    Purpose of this work is to assess MR potentials in the evaluation of superior glenoid labrum disease and possible associated conditions of the rotator cuff and of the anterior mechanism of the shoulder. 51 patients ( age range 18 to 53 years) with a diagnosis of anteroposterior lesion of the superior glenoid labrum were retrospectively evaluated. MR examinations were performed with a 0.2 T permanent magnet and a dedicated coil, using T1- and T2-weighted SE sequences on mostly coronal-oblique planes. Slice thickness was 4 mm. In 8 cases, the examination was completed with intra-articular injection of contrast agent. Twenty-eight patients were submitted to surgery (arthrotomy in 7 cases; arthroscopy in 21 cases). MRI demonstrated 5 cases of superior labrum irregularities at the level of its glenoid insertional portion (type I lesion); 6 cases of detachment of the superior portion of the labrum (type II); 9 cases of bucket handle tear of the superior labrum with involvement of the insertional portion of the long head of the biceps tendon (type III); 8 cases of superior labrum tear extending within the long head of the biceps tendon (type IV). Subsequent surgery always confirmed the presence of associated lesions, while the superior labrum lesion was not confirmed in 3 patients. In 4 cases, surgical findings provided a different classification of the lesion type than MRI. MRI can be a valuable diagnostic technique in type III and IV lesions of the superior glenoid labrum. It often provides important information about the possible presence of associated diseases, especially of the rotator cuff, which are helpful for treatment planning [it

  20. Ureteritis cystica: A rare benign lesion

    Directory of Open Access Journals (Sweden)

    F. Ibrahim

    2014-09-01

    Full Text Available Ureteritis cystica is an uncommon benign pathology of the ureter. The etiology is unclear but the diagnosis has become much easier to make with the routine use of ureteroscopy for diagnosis of ureteric lesions. We present a case of a 63 year old Sudanese woman with a history of repeated attacks of right loin pain in whom magnetic resonance urography (MRU showed multiple filling defects in the right ureter. These were initially thought to be malignant urothelial lesions. Ureteroscopy revealed cystic smooth walled masses which discharged tiny turbid fluid on biopsy. An intraoperative diagnosis of ureteritis cystica was confirmed. The patient was managed conservatively.

  1. Post-traumatic contrast enhancing brain lesion

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Jung; Kim, Hyun Sook; Jeong, Min Sun; Kim, Deok Ryeong; Cho, Young Kwon; Choi, Yun Sun [Eulji Hospital, Eulji University College of Medicine, Seoul (Korea, Republic of)

    2014-10-15

    Only a few studies have been reported on the MR contrast enhancement and the apparent diffusion coefficient (ADC) findings of the post-traumatic lesion of the brain. We report a case of the venous ischemia in the left frontal lobe observed in the MRI obtained one day after the incidence of trauma. Considering the presented slight increase in the ADC, the vasogenic edema was thought to be the major mechanism of the venous ischemia and excitotoxic injury. In spite of a slight increase in the ADC, the hyperintensity in the diffusion weighted imaging and contrast-enhanced areas eventually changed into hemorrhagic lesions.

  2. Computed tomography of the retrofascial space lesions

    International Nuclear Information System (INIS)

    Miyake, Hiroko; Kohno, Atsushi; Tsuchiya, Fumiko

    1982-01-01

    CT offers a unique method to evaluate anatomy of the retrofascial space. Retrofascial space which mainly consist of psoas and quadratus lumborum muscles locates behind the transversalis fascia. CT findings of 10 lesions, five with abscess and five with hematoma were reviewed. CT provided clinically useful information regarding the presence, size, extent and composition of the lesions and also their effects on adjacent structures. Abscesses revealed a well-defined low density with enhanced rim in the enlarged muscle. Hematoma showed an illdefined low density area within the enlarged muscle. Abscesses can not be differentiated from hematomas and other retrofascial tumors by CT alone. (author)

  3. Visual performance of pigeons following hippocampal lesions.

    Science.gov (United States)

    Bingman, V P; Hodos, W

    1992-11-15

    The effect of hippocampal lesions on performance in two psychophysical measures of spatial vision (acuity and size-difference threshold) was examined in 7 pigeons. No difference between the preoperative and postoperative thresholds of the experimental birds was found. The visual performance of pigeons in the psychophysical tasks failed to reveal a role of the hippocampal formation in vision. The results argue strongly that the behavioral deficits found in pigeons with hippocampal lesions when tested in a variety of memory-related spatial tasks is not based on a defect in spatial vision but impaired spatial cognition.

  4. White Matter Lesion Progression in LADIS

    DEFF Research Database (Denmark)

    Schmidt, Reinhold; Berghold, Andrea; Jokinen, Hanna

    2012-01-01

    BACKGROUND AND PURPOSE: White matter lesion (WML) progression has been advocated as a surrogate marker in intervention trials on cerebral small vessel disease. We assessed the rate of visually rated WML progression, studied correlations between lesion progression and cognition, and estimated sample...... sizes for clinical trials with pure WML progression vs combined WML progression-cognitive outcomes. METHODS: Those 394 participants of the Leukoaraiosis and Disability Study (LADIS) study with magnetic resonance imaging scanning at baseline and 3-year follow-up were analyzed. WML progression rating...

  5. Ameloblastoma: an aggressive lesion of the mandible.

    Science.gov (United States)

    Suma, M S; Sundaresh, K J; Shruthy, R; Mallikarjuna, Rachappa

    2013-10-09

    Ameloblastoma is a benign locally invasive epithelial odontogenic tumour comprising 1% of all tumours and cysts arising in the jaws. It is commonly found in the third and fourth decade in the molar ramus region of the mandible. Among all types of ameloblastoma, multicystic ameloblastoma is believed to be locally aggressive lesion that has the tendency for recurrence. In this report we present a large multicystic ameloblastoma in the left body-ramus region of the mandible in a 55-year-old woman. This large lesion was diagnosed with the help of CT and was successfully managed by hemimandibulectomy with simultaneous reconstruction using iliac crest bone.

  6. Diagnosis of liver lesions in nuclear medicine

    International Nuclear Information System (INIS)

    Krause, T.; Juengling, F.

    2003-01-01

    With the introduction of new imaging protocols for ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI), the importance of conventional nuclear medicine diagnostic procedures has changed fundamentally. With the introduction of positron emission tomography (PET) into routine diagnostics, the assessment of tissue-specific function adds on to the modern, morphological imaging procedures and in principle allows for differentiating benign from malignant lesions. The actual clinical value of nuclear medicine procedures for the diagnostic workup of focal liver lesions is discussed. (orig.) [de

  7. CT diagnosis of cystic ovarian lesions

    International Nuclear Information System (INIS)

    Iio, Kazuto; Shinmura, Ryoji; Arima, Naomi; Yamada, Eiichiro; Ohkubo, Koichi; Nagata, Yukihiro

    1985-01-01

    CT was undertaken and CT numbers were measured in 47 patients with cystic ovarian lesions. CT features particularly for chocolate cyst revealed the uniform thickness of the whole cystic wall, findings suggesting adhesion to the surrounding organs, circular or oval shape, and higher CT numbers within the cyst than those in the other cystic ovarian lesions. However, because these features are not always observed in cases of chocolate cyst, one should not rely solely on CT findings in the diagnosis of chocolate cyst. (Namekawa, K.)

  8. Multispectral recordings and analysis of psoriasis lesions

    DEFF Research Database (Denmark)

    Clemmensen, Line Katrine Harder; Ersbøll, Bjarne Kjær

    2006-01-01

    An objective method to evaluate the severeness of psoriasis lesions is proposed. In order to obtain objectivity multi-spectral imaging is used. The multi-spectral images give rise to a large p, small n problem which is solved by use of elastic net model selection. The method is promising for furt......An objective method to evaluate the severeness of psoriasis lesions is proposed. In order to obtain objectivity multi-spectral imaging is used. The multi-spectral images give rise to a large p, small n problem which is solved by use of elastic net model selection. The method is promising...

  9. Infiltrating/sealing proximal caries lesions

    DEFF Research Database (Denmark)

    Martignon, S; Ekstrand, K R; Gomez, J

    2012-01-01

    This randomized split-mouth controlled clinical trial aimed at assessing the therapeutic effects of infiltration vs. sealing for controlling caries progression on proximal surfaces. Out of 90 adult students/patients assessed at university clinics and agreeing to participate, 39, each with 3...... differences in lesion progression between infiltration and placebo (P = 0.0012) and between sealing and placebo (P = 0.0269). The study showed that infiltration and sealing are significantly better than placebo treatment for controlling caries progression on proximal lesions. No significant difference...

  10. HLA-DR antigen detection in giant cell lesions.

    Science.gov (United States)

    Regezi, J A; Zarbo, R J; Lloyd, R V

    1986-09-01

    Sixty-six giant cell lesions ranging from inflammatory to neoplastic were evaluated for HLA-DR antigens using formalin/paraffin tissue and a monoclonal antibody labelled by the avidin-biotin peroxidase. HLA-DR antigens were expressed in nearly all lesions, predominantly on round, macrophage-like cells. Granulomatous inflammatory lesions were generally more immunoreactive than non-inflammatory lesions. Multinucleate giant cells were relatively unreactive in non-inflammatory lesions as compared to inflammatory lesions. Determination of HLA-DR expression does not appear to be helpful in discriminating between the various giant cell lesions.

  11. [Monteggia lesions in the growing skeleton: principles of therapy].

    Science.gov (United States)

    Pesl, T; Havránek, P

    2010-02-01

    In this retrospective study we analyse the methods of Monteggia lesion (ML) treatment in children used in our department. Based on the results we propose several general principals for the therapy of this complex injury to the forearm in agrowing skeleton. The group included patients with the diagnosis of acute ML treated at our department in the 2003-2007 period. No patients in whom therapy was started later than two weeks after injury were included. We assessed injuries according to the Bado classification system modified by Olney for young age, and also by the system based on ML stability assessment previously published by us.We evaluated the type of ulnar fracture and lesions affecting the radio-humero-ulnar joint, and the therapeutic method used. The treatment outcome was evaluated by the criteria proposed by Letts et al. for the elbow joint in children (minimal follow-up of one year). RESULTS In the five-year period, we treated 36 children with acute ML. The most frequent were patients with Bado type I equivalent lesion (61 %) and those with unstable ML (53 %).We treated 39 % of the patients conservatively and 61% by osteo-synthesis. The ;osteosynthesis of one bone was performed in 30 % (radius, 11 % ulna, 19 %) and of both bones in 31 % of the cases. The outcome assessed by the Letts score was excellent in 80 %, good in 17 % of the patients and poor in only one patient (3 %). There is general consensus in the literature that childhood ML, if early and correctly diagnosed and correctly treated, has a good prognosis in most of the cases, in contrast to adult ML. However, the views on therapy vary from closed reduction under general anaesthesia to routine surgical exploration of the radio-humero-ulnar joint with open reduction of dislocation of the radial head and temporary radio-humeral arthrodesis. However, a unified therapeutic approach to an immature skeleton has not been proposed yet. In the treatment of a growing skeleton, the reduction and stabilisation

  12. Breast lesion detection and characterization with 3D features.

    Science.gov (United States)

    Sreekumari, Arathi; Shriram, K S; Vaidya, Vivek

    2016-08-01

    Automated Breast Ultrasound (ABUS) is highly effective as breast cancer screening adjunct technology. Automation can greatly enhance the efficiency of the clinician sifting through the quantum of data in ABUS volumes to spot lesions. We have implemented a fully automatic generic algorithm pipeline for detection and characterization of lesions on such 3D volumes. We compare a wide range of features for region description on their effectiveness at the dual goals of lesion detection and characterization. On multiple feature images, we compute region descriptors at lesion candidate locations obviating the need for explicit lesion segmentation. We use Random Forests classifier to evaluate candidate region descriptors for lesion detection. Further, we categorize true lesions as Malignant or other masses (e.g. Cysts). Over a database of 145 volumes, with 36 biopsy verified lesions, we achieved Area Under the Curve (AUC) values of 92.6% for lesion detection and 89% for lesion characterization.

  13. Human papillomavirus in oral lesions Virus papiloma humano en lesiones orales

    Directory of Open Access Journals (Sweden)

    Joaquín V. Gónzalez

    2007-08-01

    Full Text Available Growing evidence suggests a role for human papillomavirus (HPV in oral cancer; however its involvement is still controversial. This study evaluates the frequency of HPV DNA in a variety of oral lesions in patients from Argentina. A total of 77 oral tissue samples from 66 patients were selected (cases; the clinical-histopathological diagnoses corresponded to: 11 HPV- associated benign lesions, 8 non-HPV associated benign lesions, 33 premalignant lesions and 25 cancers. Sixty exfoliated cell samples from normal oral mucosa were used as controls. HPV detection and typing were performed by polymerase chain reaction (PCR using primers MY09, 11, combined with RFLP or alternatively PCR using primers GP5+, 6+ combined with dot blot hybridization. HPV was detected in 91.0% of HPV- associated benign lesions, 14.3% of non-HPV associated benign lesions, 51.5% of preneoplasias and 60.0% of cancers. No control sample tested HPV positive. In benign HPV- associated lesions, 30.0% of HPV positive samples harbored high-risk types, while in preneoplastic lesions the value rose to 59.9%. In cancer lesions, HPV detection in verrucous carcinoma was 88.9% and in squamous cell carcinoma 43.8%, with high-risk type rates of 75.5% and 85.6%, respectively. The high HPV frequency detected in preneoplastic and neoplastic lesions supports an HPV etiological role in at least a subset of oral cancers.Crecientes evidencias sugieren que el virus Papiloma humano (HPV tiene un rol en el cáncer oral; sin embargo su participación es todavía controvertida. Este estudio evalúa la frecuencia de ADN de HPV en una variedad de lesiones orales de pacientes de Argentina. Se seleccionaron 77 muestras de tejido oral de 66 pacientes (casos; el diagnóstico histo-patológico correspondió a: 11 lesiones benignas asociadas a HPV, 8 lesiones benignas no asociadas a HPV, 33 lesiones premalignas y 25 cánceres. Como controles se usaron 60 muestras de células exfoliadas de mucosa oral normal. La

  14. Surgical treatment of gallbladder polypoid lesions

    Directory of Open Access Journals (Sweden)

    Pejić Miljko A.

    2003-01-01

    Full Text Available INTRODUCTION Polypoid lesions of the gallbladder can be divided into benign and malignant categories. Malignant polypoid lesions include carcinomas of the gallbladder, which is the fifth most common malignancy of the gastrointestinal tract and the most common malignancy of the biliary tract. Benign polypoid lesions of the gallbladder are divided into true tumors and pseudotumors. Pseudotumors account for most of polypoid lesions of the gallbladder, and include polyps, hyperplasia, and other miscellaneous lesions. Adenomas are the most common benign neoplasms of the gallbladder. Cholesterol polyps are the most common pseudotumors of the gallbladder. The polyps can be single or multiple, usually less than 10 mm in size. They have no predilection for any particular gallbladder site, and usually are attached to the gallbladder wall by a delicate, narrow pedicle. No malignant potential has been identified for this type of pseudotumor. Adenomas are the most common benign neoplasms of the gallbladder. They have no predilection site in the gallbladder, and may also be associated with gallstones or cholecystitis. The premalignant nature of adenomas remains controversial. Ultrasonography (US has been demonstrated to be significantly better in detecting polypoid lesions of the gallbladder as compared with computed tomography and cholecystography. A mass fixed to the gallbladder wall of normal thickness, without shadowing, is seen in case of gallbladder polyp. Since gallbladder cancers usually present as polypoid lesions, differentiation between benign polypoid lesion and malignant lesion can be very difficult, even with high-resolution imaging techniques. PATIENTS AND METHODS Retrospectively we have analyzed 38 patients with ultrasonographicaly detected gallbladder polyps during the period from January 1995 to December 2000, who were treated at surgical department of Health Centre in Uzice and at Surgical clinic of Clinical Centre in Nis. We have analyzed

  15. Oral White Lesions Associated with Chewing Khat

    Directory of Open Access Journals (Sweden)

    Gorsky Meir

    2004-09-01

    Full Text Available Abstract Introduction Khat is a cultivated plant whose leaves when chewed elevate mood. Unlike the chewing of betel nut, no association between the white oral mucosal lesions in khat users and oral malignancies has been reported. Chewing of khat has been documented in many countries and has increased with worldwide migration. The impact of chewing khat upon the oral mucosa is essentially unknown. Purpose The purpose of this study was to assess the occurrence of oral white changes in chronic khat chewers. Oral mucosal changes in a group of 47 Yemenite Israeli men over 30 years of age, who had chewed khat more than 3 years, were compared to those of 55 Yemenite men who did not chew. Results White lesions were significantly more prevalent in the khat chewers (83% compared to the non chewing individuals (16% (P Discussion This study demonstrated a relationship between khat chewing and oral white lesions, which we attribute to chronic local mechanical and chemical irritation of the mucosa. Our findings also suggest that mucosal changes associated with khat are benign, however, this initial study requires further studies including follow-up of khat users to confirm the current findings, including the likely benign changes associated with chronic use and histologic findings of clinical lesions.

  16. Roentgenologic diagnostics of capsular ligament lesions

    Energy Technology Data Exchange (ETDEWEB)

    Wirth, C.J.; Jaeger, M.

    1981-10-01

    The X-ray diagnostic is of obvious importance and relevance in the detection of acute or old capsular ligament lesions of the limb joint. On the one hand it serves as the plain radiograph (roentgenogram without contrast medium) for the assessment of osseous secondary lesions, for the documentation of luxationary positions of the joint partners, and in old capsular ligament lesions for the detection of an already existing arthrosis. On the other hand the X-ray images are of main importance, which are made from the hand-held limb in order to permit a comparison of the two sides, and which beyond the clinical detection of a joint instability indicate the extent and the direction of this instability and which also document it, and which allow in adolescents to recognize a separation of the epiphysis as an alternative to the capsular ligament rupture. Only in particular cases arthrography can provide some additional information, so for example in the case of an isolated syndesmosis rupture, ruptures of the rosette of the rotator muscle or of a damaged triangular disk in the hand. Angiography is only required in cases of traumatic luxations of the knee in order to exclude an intimal lesion of the popliteal artery.

  17. Misdiagnosis of intraspinal lesions in childhood

    African Journals Online (AJOL)

    1991-04-06

    Apr 6, 1991 ... tiv~ in symptomatology but are seldom diagnosed early in their course. Case presentations and comment. Case I - lesion ofhigh cervical cord- craniocervical junction. Four weeks before referral this previously well ll-year-old girl tripped and fell; this resulted in immediate severe pain in the neck and occiput.

  18. Managing Carious Lesions: Consensus Recommendations on Terminology

    NARCIS (Netherlands)

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

    2016-01-01

    Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current

  19. Pseudoepitheliomatous Hyperplasia in Oral Lesions: A Review.

    Science.gov (United States)

    Nayak, Vaidhehi Narayan; Uma, K; Girish, H C; Murgod, Sanjay; Shyamala, K; Naik, Ranajit B

    2015-09-01

    Pseudoepitheliomatous hyperplasia (PEH) is a histopathological reaction pattern to various stimuli, which includes trauma, infection, inflammation, neoplasia. It is seen as tongue like epithelial proliferation invading the connective tissue and should not be mistaken for squamous cell carcinoma (SCC). This review enlists oral lesions which exhibit PEH with a note on how to differentiate SCC from PEH.

  20. Untreated Hemangiomas : Growth Pattern and Residual Lesions

    NARCIS (Netherlands)

    Bauland, Constantijn G.; Luning, Thomas H.; Smit, Jeroen M.; Zeebregts, Clark J.; Spauwen, Paul H. M.

    Background: Hemangiomas of infancy can give rise to alarm because of their rapid growth and occasional dramatic appearance. The objective of this study was to investigate the growth pattern of hemangiomas and risk factors for residual lesions. Methods: A follow-up study was performed of patients

  1. Precancerous Lesions of the Oral Mucosa

    Directory of Open Access Journals (Sweden)

    Oya Gürbüz

    2012-12-01

    Full Text Available In this review of oral precancerous lesions, leukoplakia, erythroleukoplakia/erythroplakia and the least common variant proliferative verrucous leukoplakia will be focused with their clinical characteristics and their potential to develop oral squamous cell carcinoma and related factors will be discussed.

  2. Dural enhancement with primary calvarial lesions.

    Science.gov (United States)

    Arana, E; Martí-Bonmatí, L; Ricart, V; Pérez-Ebrí, M

    2004-11-01

    The purpose of this study was to relate the pathological and imaging features of dural enhancement and meningeal sign ("dural tail") on contrast-enhanced T1-weighted magnetic resonance (MR) images from patients with primary calvarial lesions as well to assess the accuracy of MR imaging in predicting dural invasion. Thirty-two calvarial tumors studied with contrast-enhanced MR imaging and histopathological examination of the dural specimens were reviewed. Sixteen patients presented dural enhancement, eight with tumor invasion. Tumoral invasion of the dura was observed in one case without enhancement. Malignant lesions showed enhanced dura more commonly than benign lesions (P=0.02). Nodular and discontinuous dural enhancement was statistically associated with dural invasion (P=0.05). Dural tail did not show a specific pathological association. Meningeal enhancement is a nonspecific reaction to calvarial lesions unless nodular and discontinuous. False-negative and -positive cases of dural invasion imply some limitation of contrast-enhanced MR imaging in predicting dural invasion by calvarial neoplasms.

  3. Scoliosis secondary to an unusual rib lesion.

    LENUS (Irish Health Repository)

    Burke, N G

    2012-04-01

    Tumours of the chest wall are uncommon and are usually malignant. A bone haemangioma is a rare benign vascular neoplasm, which more commonly occurs in middle-aged patients. We present the case of a scoliosis caused by a rib haemangioma in an adolescent male. Other causes of scoliosis secondary to rib lesions are discussed.

  4. Ureteritis cystica: A rare benign lesion

    African Journals Online (AJOL)

    F. Ibrahim

    www.sciencedirect.com. Case report. Ureteritis cystica: A rare benign lesion. F. Ibrahim. Department of Surgery, Alzaytona Specialized Hospital, Khartoum, Sudan. Received 16 January 2014; received in revised form 28 March 2014; accepted 28 March 2014. KEYWORDS. Ureter;. Ureteritis Cystica;. Ureteroscopy;. Sudan.

  5. Congenital granular cell lesion in newborn mandible

    African Journals Online (AJOL)

    2011-07-06

    ) or 'congenital epulis' is a rare lesion found in newborns also known as. Neumann's tumor; the word “Epulis” is derived from a Greek word and means “on the gum” or gum boil.[1] Since its first description by Neumann in 1871, ...

  6. [Meniscal repair in patients with chronic lesions].

    Science.gov (United States)

    Ponce de León, José Clemente Ibarra; Sierra Suárez, Luis; Almazán Díaz, Arturo; Cruz López, Francisco; Pérez Jiménez, Francisco Xavier; Encalada Díaz, Iván; León Hernández, Saúl Renán; Angulo Gutiérrez, Maritza

    2008-01-01

    To analyze the subjective and objective outcome of arthroscopic meniscal repair in patients with chronic meniscal lesions. A group of patients that underwent arthroscopic meniscal repair of chronic tears with a minimum follow-up of six months was retrospectively evaluated. Physical examination oriented at finding persistent meniscal lesions was performed. IKDC, Lysholm and Tegner scores were applied, and a control magnetic resonance imaging (MRI) was performed. Twenty seven menisci in 25 patients were repaired. There were 21 male and 4 female patients with a mean age of 29.6 +/- 8.2 years (20-45). Mean time from lesion to surgery was 25.24 +/- 26 months (6-120). 27. There was significant improvement in all parameters evaluated in 21 patients. Four patients were found to have signs and symptoms of persistent meniscal tears. Abnormal increased signal intensity in the repaired menisci was observed by MRI in all patients, not correlating with clinical findings. Short-term success rate of 85% was obtained with arthroscopic repair of chronic meniscal lesions in this study, which supports the fact that a long period of time before surgery does not necessarily lead to failure. It is valid to perform a meniscal repair in patients with chronic tears as long as the proper surgical technique and an adequate rehabilitation protocol are used.

  7. International Consensus for ultrasound lesions in gout

    DEFF Research Database (Denmark)

    Gutierrez, Marwin; Schmidt, Wolfgang A; Thiele, Ralf G

    2015-01-01

    OBJECTIVE: To produce consensus-based definitions of the US elementary lesions in gout and to test their reliability in a web-based exercise. METHODS: The process consisted of two steps. In the first step a written Delphi questionnaire was developed from a systematic literature review and expert ...

  8. Assessing Elementary Lesions in Gout by Ultrasound

    DEFF Research Database (Denmark)

    Terslev, Lene; Gutierrez, Marwin; Christensen, Robin

    2015-01-01

    OBJECTIVE: To test the reliability of the consensus-based ultrasound (US) definitions of elementary gout lesions in patients. METHODS: Eight patients with microscopically proven gout were evaluated by 16 sonographers for signs of double contour (DC), aggregates, erosions, and tophi in the first m...

  9. Differential diagnosis of small solid pancreatic lesions

    DEFF Research Database (Denmark)

    Dietrich, Christoph Frank; Sahai, Anand Vasante; D'Onofrio, Mirko

    2016-01-01

    BACKGROUND AND AIMS: Pancreatic ductal adenocarcinoma (PDAC) is typically diagnosed at a late stage. Little is known about the incidental finding of early-stage PDAC. The aim of the current study was to determine the etiology of small solid pancreatic lesions (≤15 mm) to optimize clinical managem...

  10. Monocanalicular lesions: to reconstruct or not

    NARCIS (Netherlands)

    Smit, T. J.; Mourits, M. P.

    1999-01-01

    OBJECTIVE: To evaluate the success rate of a simple surgical method for the treatment of a monocanalicular lacrimal lesion. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Thirteen consecutive patients with monocanalicular trauma who were seen from August 1995 to March 1998. In six

  11. CLINICOPATHOLOGICAL STUDY OF PAPULOSQUAMOUS SKIN LESIONS

    Directory of Open Access Journals (Sweden)

    Chowdari Balaji

    2018-02-01

    Full Text Available BACKGROUND Papulosquamous lesions form the largest group of skin diseases. Since, they are all characterized by scaling papules or plaques, clinical confusion may result in their diagnosis, hence definitive histopathological analysis is important for their differentiation. MATERIALS AND METHODS The study includes skin biopsies from 108 clinically diagnosed /suspected non-infectious, erythematous, papulosquamous skin diseases which were received in the Department of Pathology, Andhra Medical College, Visakhapatnam for a period of two years from January 2016 to December 2017. The specimens obtained were subjected to formalin fixation and was subjected to routine processing and sections were stained with haematoxylin and eosin (H&E. The lesions were classified as Lichen Planus, Psoriasis, along with rare conditions like Pityriasis Rosea, Parapsoriasis, Pityriasis Rubra Pilaris, Prurigo Nodularis and Lichen Simplex chronicus and clinicopathological correlation was done. RESULTS A total of 108 cases were studied. Lichen planus (51 cases- 47.22% was the most common lesions followed by Psoriasis (34 cases - 31.48% and with majority of cases in the age group of 21 to 30 years (25 cases– 23.15%. Females were more commonly affected with a male to female ratio of 0.89:1. Out of 108 cases, clinicopathological correlation was seen in 68 cases (62.96%. CONCLUSION The importance of specific histopathological diagnosis lies in distinguishing these lesions into different entities as the treatment and prognosis varies widely and is disease-specific.

  12. Amalgam Contact Hypersensitivity Lesion: An Unusual Presentation ...

    African Journals Online (AJOL)

    They also state that the lesion considerably regressed after replacement of the amalgam restoration with posterior composites. Interestingly, these authors clearly confirmed that hypersensitivity to amalgam might be attributed to mercury in amalgam, but they did not rule out the significant role of exposure to common sources.

  13. Utilization Behavior and Frontal Lobe Lesions

    OpenAIRE

    J Gordon Millichap

    1990-01-01

    Utilization behavior was investigated in an adult with an acute behavioral disturbance, memory deficits, and a localized inferior medial bifrontal lesion at the Psychology Department, National Hospital, Queen Square, London; the MRC Applied Psychology Unit, Cambridge; and Department of Neurology, Atkinson Morley's Hospital, Wimbledon; and St. Andrews Hospital, Northampton, UK.

  14. Expression of Malic Enzymes in Sebaceous Lesions.

    Science.gov (United States)

    Su, Ting-Fu; Gao, Hong-Wei

    2016-08-01

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

  15. MRI of fetal acquired brain lesions

    International Nuclear Information System (INIS)

    Prayer, Daniela; Brugger, Peter C.; Kasprian, Gregor; Witzani, Linde; Helmer, Hanns; Dietrich, Wolfgang; Eppel, Wolfgang; Langer, Martin

    2006-01-01

    Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images

  16. Multi-Sectional Views Textural Based SVM for MS Lesion Segmentation in Multi-Channels MRIs

    Science.gov (United States)

    Abdullah, Bassem A; Younis, Akmal A; John, Nigel M

    2012-01-01

    In this paper, a new technique is proposed for automatic segmentation of multiple sclerosis (MS) lesions from brain magnetic resonance imaging (MRI) data. The technique uses a trained support vector machine (SVM) to discriminate between the blocks in regions of MS lesions and the blocks in non-MS lesion regions mainly based on the textural features with aid of the other features. The classification is done on each of the axial, sagittal and coronal sectional brain view independently and the resultant segmentations are aggregated to provide more accurate output segmentation. The main contribution of the proposed technique described in this paper is the use of textural features to detect MS lesions in a fully automated approach that does not rely on manually delineating the MS lesions. In addition, the technique introduces the concept of the multi-sectional view segmentation to produce verified segmentation. The proposed textural-based SVM technique was evaluated using three simulated datasets and more than fifty real MRI datasets. The results were compared with state of the art methods. The obtained results indicate that the proposed method would be viable for use in clinical practice for the detection of MS lesions in MRI. PMID:22741026

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

    Science.gov (United States)

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

    2014-10-01

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

  18. Simultaneous surgical resections of two distant metastatic malignant melanoma lesions--case report.

    Science.gov (United States)

    Tanei, Takafumi; Nakahara, Norimoto; Takebayashi, Shigenori; Hirano, Masaki; Wakabayashi, Toshihiko

    2012-02-01

    A 41-year-old woman presented with disturbance of consciousness, right hemiparesis, and symptoms of Gerstmann syndrome. She had a history of malignant melanoma resections of an ear mole and her right neck lymph nodes and parotid gland, with subsequent chemotherapy and radiotherapy. Computed tomography showed two large lesions in the right frontal and left parietal lobes surrounded by severe brain edema. Magnetic resonance images revealed that the two lesions were strongly enhanced with cystic change, and a small round lesion was located in the left head of the caudate nucleus. (18F) fluoro-2-deoxyglucose positron emission tomography showed high accumulation in both lesions, and no sign of metastatic lesions except within the brain. The two lesions were large, causing increased intracranial pressure. Simultaneous surgical resections were performed using two approaches. The patient's neurological symptoms were greatly improved after surgery, and her Karnofsky Performance Status improved from 20% to 90%. She was discharged to her home almost completely free of neurological deficits. Although, simultaneous one-stage tumor resections for multiple metastatic brain tumors do not extend the survival period, they improve the quality of the patient's limited remaining life, and may be a treatment choice for young patients with well-controlled systemic disease.

  19. Juxtacortical Lesions and Cortical Thinning in Multiple Sclerosis.

    Science.gov (United States)

    Pareto, D; Sastre-Garriga, J; Auger, C; Vives-Gilabert, Y; Delgado, J; Tintoré, M; Montalban, X; Rovira, A

    2015-12-01

    The role of juxtacortical lesions in brain volume loss in multiple sclerosis has not been fully clarified. The aim of this study was to explore the role of juxtacortical lesions on cortical atrophy and to investigate whether the presence of juxtacortical lesions is related to local cortical thinning in the early stages of MS. A total of 131 patients with clinically isolated syndrome or with relapsing-remitting MS were scanned on a 3T system. Patients with clinically isolated syndrome were classified into 3 groups based on the presence and topography of brain lesions: no lesions (n = 24), only non-juxtacortical lesions (n = 33), and juxtacortical lesions and non-juxtacortical lesions (n = 34). Patients with relapsing-remitting MS were classified into 2 groups: only non-juxtacortical lesions (n = 10) and with non-juxtacortical lesions and juxtacortical lesions (n = 30). A juxtacortical lesion probability map was generated, and cortical thickness was measured by using FreeSurfer. Juxtacortical lesion volume in relapsing-remitting MS was double that of patients with clinically isolated syndrome. The insula showed the highest density of juxtacortical lesions, followed by the temporal, parietal, frontal, and occipital lobes. Patients with relapsing-remitting MS with juxtacortical lesions showed significantly thinner cortices overall and in the parietal and temporal lobes compared with those with clinically isolated syndrome with normal brain MR imaging. The volume of subcortical structures (thalamus, pallidum, putamen, and accumbens) was significantly decreased in relapsing-remitting MS with juxtacortical lesions compared with clinically isolated syndrome with normal brain MR imaging. The spatial distribution of juxtacortical lesions was not found to overlap with areas of cortical thinning. Cortical thinning and subcortical gray matter volume loss in patients with a clinically isolated syndrome or relapsing-remitting MS was related to the presence of juxtacortical

  20. Computed tomographic findings of traumatic intracranial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Seong Wook; Kim, Il Young; Lee, Byung Ho; Kim, Ki Jeoung; Yoon, Il Gyu [Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    1985-10-15

    Traumatic intracranial lesion has been one of the most frequent and serious problem in neurosurgical pathology. Computed tomography made it possible to get prompt diagnosis and surgical intervention of intracranial lesions by its safety, fastness and accuracy. Computed tomographic scan was carried out on 1309 cases at Soonchunhyang Chunan Hospital for 15 months from October 1983 to December 1984. We have reviewed the computed tomographic scans of 264 patients which showed traumatic intracranial lesion. The result were as follows: 1. Head trauma was the most frequent diagnosed disease using computed tomographic scans (57.8%) and among 264 cases the most frequent mode of injury was traffic accident (73.9%). 2. Skull fracture was accompanied in frequency of 69.7% and it was detected in CT in 38.6%: depression fracture was more easily detected in 81%. 3. Conutercoup lesion (9.5%) was usually accompanied with temporal and occipital fracture, and it appeared in lower incidence among pediatric group. 4. Intracranial lesions of all 264 cases were generalized cerebral swelling (24.6%), subdural hematoma (22.3%), epidural hematoma (20.8%), intracerebral hematoma (6.1%), and subarachnoid hemorrhage (3.0%). 5. The shape of hematoma was usually biconvex (92.7%) in acute epidural hematoma and cresentic (100%) in acute subdural hematoma, but the most chronic the case became, they showed planoconvex and bicconvex shapes. 6. Extra-axial hematoma was getting decreased in density as time gone by. 7. Hematoma density was not in direct proportion to serum hemoglobin level as single factor.

  1. CAROTID ATHEROSCLEROTIC LESION IN YOUNG PATIENTS

    Directory of Open Access Journals (Sweden)

    N. V. Pizova

    2014-01-01

    Full Text Available Objective: to determine the incidence of atherosclerotic lesions in the carotid and vertebral arteries of young patients from Doppler ultrasound data and to compare the quantitatively assessed traditional risk factors of coronary heart disease (CHD with severe extracranial artery atherosclerotic lesion.Subjects and methods. Doppler ultrasound was carried out evaluating structural changes in the aortic arch branches in 1563 railway transport workers less than 45 years of age. A separate sample consisted of 68 young people with carotid atherosclerotic changes, in whom traditional risk factors for CHD were studied, so were in a control group of individuals without atherosclerotic changes (n = 38.Results. Among the examinees, carotid atherosclerotic lesion was detected in 112 (7.1 % cases, the increase in the rate of atherosclerotic plaques in patients aged 35–45 years being 9.08 %; that in the rate of local intima-media thickness in those aged 31–40 years being 5.1 %. Smoking (particularly that along with hypercholesterolemia and a family history of cardiovascular diseases, obesity (along with low activity, and emotional overstrain were defined as important risk factors in the young patients. Moreover, factor analysis has shown that smoking,hypertension, and early cardiovascular pathology in the next of kin makes the greatest contribution to the development of carotid atherosclerotic lesion.Conclusion. Among the patients less than 45 years of age, carotid and vertebral artery atherosclerotic changes were found in 112 (7.1 % cases, which were more pronounced in male patients. Smoking, particularly along with hypercholesterolemia and genetic predisposition to cardiovascular diseases, was a risk factor that had the highest impact on the degree of atherosclerotic lesion in the aortic arch branches of the young patients.

  2. MIMoSA: An Automated Method for Intermodal Segmentation Analysis of Multiple Sclerosis Brain Lesions.

    Science.gov (United States)

    Valcarcel, Alessandra M; Linn, Kristin A; Vandekar, Simon N; Satterthwaite, Theodore D; Muschelli, John; Calabresi, Peter A; Pham, Dzung L; Martin, Melissa Lynne; Shinohara, Russell T

    2018-03-08

    Magnetic resonance imaging (MRI) is crucial for in vivo detection and characterization of white matter lesions (WMLs) in multiple sclerosis. While WMLs have been studied for over two decades using MRI, automated segmentation remains challenging. Although the majority of statistical techniques for the automated segmentation of WMLs are based on single imaging modalities, recent advances have used multimodal techniques for identifying WMLs. Complementary modalities emphasize different tissue properties, which help identify interrelated features of lesions. Method for Inter-Modal Segmentation Analysis (MIMoSA), a fully automatic lesion segmentation algorithm that utilizes novel covariance features from intermodal coupling regression in addition to mean structure to model the probability lesion is contained in each voxel, is proposed. MIMoSA was validated by comparison with both expert manual and other automated segmentation methods in two datasets. The first included 98 subjects imaged at Johns Hopkins Hospital in which bootstrap cross-validation was used to compare the performance of MIMoSA against OASIS and LesionTOADS, two popular automatic segmentation approaches. For a secondary validation, a publicly available data from a segmentation challenge were used for performance benchmarking. In the Johns Hopkins study, MIMoSA yielded average Sørensen-Dice coefficient (DSC) of .57 and partial AUC of .68 calculated with false positive rates up to 1%. This was superior to performance using OASIS and LesionTOADS. The proposed method also performed competitively in the segmentation challenge dataset. MIMoSA resulted in statistically significant improvements in lesion segmentation performance compared with LesionTOADS and OASIS, and performed competitively in an additional validation study. Copyright © 2018 by the American Society of Neuroimaging.

  3. Specific bone region localization of osteolytic versus osteoblastic lesions in a patient-derived xenograft model of bone metastatic prostate cancer

    Directory of Open Access Journals (Sweden)

    Takeshi Hirata

    2016-10-01

    Conclusion: PCSD1 cells reproducibly induced bone loss leading to osteolytic lesions at the ends of the femur, and, in contrast, induced aberrant bone formation leading to osteoblastic lesions along the femur shaft. Therefore, the interaction of PCSD1 cells with different bone region-specific microenvironments specified the type of bone lesion. Our approach can be used to determine if different bone regions support more therapy resistant tumor growth, thus, requiring novel treatments.

  4. Lesion mapping in acute stroke aphasia and its implications for recovery.

    Science.gov (United States)

    Forkel, Stephanie J; Catani, Marco

    2018-03-29

    Patients with stroke lesions offer a unique window into understanding human brain function. Studying stroke lesions poses several challenges due to the complexity of the lesion anatomy and the mechanisms causing local and remote disruptions on brain networks. In this prospective longitudinal study, we compare standard and advanced approaches to white matter lesion mapping applied to acute stroke patients with aphasia. Eighteen patients with acute left hemisphere stroke were recruited and scanned within two weeks from symptom onset. Aphasia assessment was performed at baseline and six-month follow-up. Structural and diffusion MRI contrasts indicated an area of maximum overlap in the anterior external/extreme capsule with diffusion images showing a larger overlap extending into posterior perisylvian regions. Predictors of recovery included damage to ipsilesional tracts (as shown by both structural and diffusion images) and contralesional tracts (as shown by diffusion images only). These findings indicate converging results from structural and diffusion lesions mapping analysis but clear differences between the two approaches in their ability to identify predictors of recovery. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Automatic ultrasound image enhancement for 2D semi-automatic breast-lesion segmentation

    Science.gov (United States)

    Lu, Kongkuo; Hall, Christopher S.

    2014-03-01

    Breast cancer is the fastest growing cancer, accounting for 29%, of new cases in 2012, and second leading cause of cancer death among women in the United States and worldwide. Ultrasound (US) has been used as an indispensable tool for breast cancer detection/diagnosis and treatment. In computer-aided assistance, lesion segmentation is a preliminary but vital step, but the task is quite challenging in US images, due to imaging artifacts that complicate detection and measurement of the suspect lesions. The lesions usually present with poor boundary features and vary significantly in size, shape, and intensity distribution between cases. Automatic methods are highly application dependent while manual tracing methods are extremely time consuming and have a great deal of intra- and inter- observer variability. Semi-automatic approaches are designed to counterbalance the advantage and drawbacks of the automatic and manual methods. However, considerable user interaction might be necessary to ensure reasonable segmentation for a wide range of lesions. This work proposes an automatic enhancement approach to improve the boundary searching ability of the live wire method to reduce necessary user interaction while keeping the segmentation performance. Based on the results of segmentation of 50 2D breast lesions in US images, less user interaction is required to achieve desired accuracy, i.e. live-wire segmentation.

  6. Lesion dimensions during temperature-controlled radiofrequency catheter ablation of left ventricular porcine myocardium

    DEFF Research Database (Denmark)

    Høgh Petersen, H; Chen, X; Pietersen, Adrian

    1999-01-01

    BACKGROUND: It is important to increase lesion size to improve the success rate for radiofrequency ablation of ischemic ventricular tachycardia. This study of radiofrequency ablation, with adjustment of power to approach a preset target temperature, ie, temperature-controlled ablation, explores...

  7. The dilemma of selecting suitable proximal carious lesions in primary molars for restoration using ART technique

    NARCIS (Netherlands)

    Kemoli, A.M.; van Amerongen, W.E.

    2011-01-01

    OBJECTIVE: To determine the examiner's accuracy in selecting proximal carious lesions in primary molars for restoration using the atraumatic restorative treatment (ART) approach. BASIC RESEARCH DESIGN: Intervention study. CLINICAL SETTING AND PARTICIPANTS: A total of 804 six to eight year-olds from

  8. Rehabilitation of children with lesions of the proximal humeral metaepiphysis using transosseous distraction osteosynthesis technique

    Directory of Open Access Journals (Sweden)

    Юрий Евгеньевич Гаркавенко

    2015-09-01

    Full Text Available We present an analysis of the treatment of 39 children with a shortening of the humerus after sustained osteomyelitis. Variants of lesions of the proximal humerus metaepiphysis are highlighted, and the differentiated approach to therapeutic measures depending on the identified changes resulted in a positive outcome.

  9. Yellowish lesions of the oral cavity. Suggestion for a classification.

    Science.gov (United States)

    Gómez, Iria; Varela, Pablo; Romero, Amparo; García, María José; Suárez, María Mercedes; Seoane, Juan

    2007-08-01

    The colour of a lesion is due to its nature and to its histological substratum. In order to ease diagnosis, oral cavity lesions have been classified according to their colour in: white, red, white and red, bluish and/or purple, brown, grey and/or black lesions. To the best of our knowledge, there is no such a classification for yellow lesions. So, a suggestion for a classification of yellowish lesions according to their semiology is made with the following headings: diffuse macular lesions, papular, hypertrophic, or pustular lesions, together with cysts and nodes. This interpretation of the lesions by its colour is the first step to diagnosis. It should be taken into account that, as happens with any other classification, the yellowish group of lesions includes items with different prognosis as well as possible markers of systemic disorders.

  10. Penile lesion from gunshot wound: a 43-case experience

    Directory of Open Access Journals (Sweden)

    Cavalcanti Andre G.

    2006-01-01

    Full Text Available OBJECTIVE: To demonstrate the main aspects of diagnosis, treatment and follow-up of 43 patients with gunshot wounds to the penis. MATERIALS AND METHODS: The location of the lesion, the presence of associated lesions, the performance of complementary exams, surgical treatment, postoperative complications and long term follow-up of 43 patients with penile lesions from gunshot wounds were retrospectively analyzed. RESULTS: Of 43 cases assessed, 41 were submitted to surgical exploration (95.3% and 2 were submitted to conservative treatment (4.7%. We found penile lesions involving the corpus cavernosum in 37 cases; the remaining 4 patients presented no lesions involving the corpus cavernosum, urethra or testicles but did in the superficial structures. Ten cases presented an association with testicular lesions and 14 cases association with anterior urethral lesions. CONCLUSION: Penile lesions from gunshot wounds should be treated with immediate surgical intervention. In exceptional situations featuring superficial lesions only conservative treatment may be applied.

  11. Clinical correlations of brain lesion distribution in multiple sclerosis

    DEFF Research Database (Denmark)

    Vellinga, M M; Geurts, J J G; Rostrup, E

    2009-01-01

    PURPOSE: To explore relations between spatial distribution of multiple sclerosis (MS) lesions, and disability. In MS, the presence of asymptomatic brain lesions challenges the prediction of disability based on conventional brain MRI. Hypothesizing that symptomatology may partly be determined...... not influence correlations with disability when included in its analyses. CONCLUSION: Periventricular lesions were related to disability. LL influenced relations between disability and lesion probability throughout the brain, suggesting interplay between lesional burden and its location in determining...... by lesion location, this retrospective study explored relations between lesion location and disability using voxelwise analyses in standard space. MATERIALS AND METHODS: Using nonparametric permutation-based statistics, voxelwise lesion probability on T2 lesion masks was related to expanded disability...

  12. 4D numerical observer for lesion detection in respiratory-gated PET

    Energy Technology Data Exchange (ETDEWEB)

    Lorsakul, Auranuch [Center for Advanced Medical Imaging Sciences, Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114 and Department of Biomedical Engineering, Columbia University, New York, New York 10027 (United States); Li, Quanzheng; Ouyang, Jinsong; El Fakhri, Georges, E-mail: elfakhri@pet.mgh.harvard.edu [Center for Advanced Medical Imaging Sciences, Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114 and Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115 (United States); Trott, Cathryn M. [International Centre for Radio Astronomy Research, Curtin University, Bentley, WA 6102, Australia and ARC Centre of Excellence for All-Sky Astrophysics (CAASTRO), Redfem, NSW 2016 (Australia); Hoog, Christopher; Petibon, Yoann [Center for Advanced Medical Imaging Sciences, Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States); Laine, Andrew F. [Department of Biomedical Engineering, Columbia University, New York, New York 10027 (United States)

    2014-10-15

    Purpose: Respiratory-gated positron emission tomography (PET)/computed tomography protocols reduce lesion smearing and improve lesion detection through a synchronized acquisition of emission data. However, an objective assessment of image quality of the improvement gained from respiratory-gated PET is mainly limited to a three-dimensional (3D) approach. This work proposes a 4D numerical observer that incorporates both spatial and temporal informations for detection tasks in pulmonary oncology. Methods: The authors propose a 4D numerical observer constructed with a 3D channelized Hotelling observer for the spatial domain followed by a Hotelling observer for the temporal domain. Realistic {sup 18}F-fluorodeoxyglucose activity distributions were simulated using a 4D extended cardiac torso anthropomorphic phantom including 12 spherical lesions at different anatomical locations (lower, upper, anterior, and posterior) within the lungs. Simulated data based on Monte Carlo simulation were obtained using GEANT4 application for tomographic emission (GATE). Fifty noise realizations of six respiratory-gated PET frames were simulated by GATE using a model of the Siemens Biograph mMR scanner geometry. PET sinograms of the thorax background and pulmonary lesions that were simulated separately were merged to generate different conditions of the lesions to the background (e.g., lesion contrast and motion). A conventional ordered subset expectation maximization (OSEM) reconstruction (5 iterations and 6 subsets) was used to obtain: (1) gated, (2) nongated, and (3) motion-corrected image volumes (a total of 3200 subimage volumes: 2400 gated, 400 nongated, and 400 motion-corrected). Lesion-detection signal-to-noise ratios (SNRs) were measured in different lesion-to-background contrast levels (3.5, 8.0, 9.0, and 20.0), lesion diameters (10.0, 13.0, and 16.0 mm), and respiratory motion displacements (17.6–31.3 mm). The proposed 4D numerical observer applied on multiple-gated images was

  13. [Efficacy of pulsed-dye laser on residual red lesions of cutaneous leishmaniasis].

    Science.gov (United States)

    Slaoui, W; Chiheb, S; Benchikhi, H

    2015-01-01

    Cutaneous leishmaniasis caused by Leishmania tropica can leave troublesome and unsightly lesions. Treatment of these scars remains difficult. Pulsed-dye laser (PDL) is one therapeutic approach that may improve the clinical appearance of erythematosus lesions. The purpose of this retrospective study was to evaluate the effectiveness of PDL on the residual red lesions of erythematous facial leishmaniasis in three patients. Case no. 1: a 14-year-old girl presented an ulcerative and erythematous nodular lesion on her left cheek. One month after treatment, an erythematous lesion measuring 3 cm persisted on the patient's cheek, without atrophy or hyperpigmentation. PDL 595nm was used at the following settings: duration: 3ms; spot size: 7mm; energy: 8 j/cm(2). Case no. 2: a 43-year-old woman presented an erythematous papular lesion on her right cheek. Following treatment, a 4-cm hypertrophic, red telangiectasic lesion remained. PDL 595nm was used with the following settings: pulse duration: 3 ms; spot-size: 10mm; energy: 8 j/cm(2). Case no. 3: a 60-year-old woman presented an erythematous papular lesion on her cheek. After treatment, an infiltrated erythematous macule with surface telangiectasia measuring 3.5cm remained. PDL 595nm was also given using the following settings: pulse duration: 3 ms; spot size: 10mm; energy: 8 j/cm(2). All three patients underwent three sessions of PDL. The erythematous and telangiectasic lesions showed improvement after the initial session and had completely disappeared after the third session. Post-laser purpura subsided within around 10 days. Therapeutic response was assessed clinically by comparing photographs taken before and after treatment and follow-up lasted 12 months. Cutaneous leishmaniasis caused by L. tropica is endemo-epidemic in Morocco. A number of treatments are available for red residual lesions but thanks to its effect on erythematous and vascular lesions, PDL has been shown to provide the most reproducibly

  14. Epidermal hydrogen peroxide is not increased in lesional and non-lesional skin of vitiligo.

    Science.gov (United States)

    Zailaie, Mohammad Z

    2017-01-01

    It is widely believed that the loss of the epidermal melanocytes in vitiligo is basically due to excessive oxidative stress. Previous research work described abnormal elevation of the absolute concentration of the epidermal hydrogen peroxide (H 2 O 2 ) in lesional and non-lesional skin of vitiligo. Based on this finding, our primary research objective was to use this feature as a screening marker in individuals at a great risk of developing vitiligo. Ninety-six patients of non-segmental vitiligo (NSV) of varying durations, skin phototypes, and treatment modalities (psoralen UVA-, narrow band UVB-treated) were recruited for this study. Raman spectroscopic measurements, using an external probehead, of the lesional and non-lesional skin were obtained, and the resulting spectra were analyzed using the Opus software package of the MultiRam spectrometer and the intensity of the peak at 875 cm -1 that represents the absolute concentration of H 2 O 2 was calculated. Contrary to previous reports, in patients of skin phototype IV, the absolute concentrations of H 2 O 2 in non-lesional and lesional NSV of all groups were non-significantly decreased compared to normal control. In patients of NSV of skin phototype V, the decrease in the absolute concentrations of H 2 O 2 was not significant in the untreated group, and a slight non-significant increase in the NBUVB-treated group was noted. However, in the PUVA-treated group, the non-lesional skin demonstrated significant increase in the absolute concentration of H 2 O 2 , whereas the lesional skin showed only a slight non-significant increase compared to normal control. In NSV patients of skin phototype VI who were previously treated with PUVA, the non-lesional skin showed a slight non-significant increase in the absolute concentration of H 2 O 2 ; however, the lesional skin showed a marked significant decrease compared to normal control and the non-lesional skin. Thereof, one can conclude that the epidermal H 2 O 2 is not

  15. [Color Doppler sonography of focal abdominal lesions].

    Science.gov (United States)

    Licanin, Zoran; Lincender, Lidija; Djurović, V; Salihefendić, Nizama; Smajlović, Fahrudin

    2004-01-01

    Color Doppler sonography (CDS--spectral, color and power), harmonic imaging techniques (THI, PHI), possibility of 3D analysis of picture, usage of contrast agents, have raised the values of ultrasound as a diagnostic method to a very high level. THI--non-linear gray scale modality, is based on the processing of higher reflected frequencies, that has improved a picture resolution, which is presented with less artifacts and limiting effects of obesity and gases. Ultrasound contrast agents improve analysis of micro and macro circulation of the examined area, and with the assessment of velocity of supply in ROI (wash in), distribution and time of signal weakening (wash out), are significantly increasing diagnostic value of ultrasound. Besides the anatomical and topographic presentation of examined region (color, power), Color Doppler sonography gives us haemodynamic-functional information on vascularisation of that region, as well as on pathologic vascularisation if present. Avascular aspect of a focal pathologic lesion corresponds to a cyst or haematoma, while coloration and positive spectral curve discover that anechogenic lesions actually represents aneurysms, pseudoaneurysms or AVF. In local inflammatory lesion, abscess in an acute phase, CDS shows first increased, and then decreased central perfusion, while in a chronic phase, a pericapsular vascularisation is present. Contribution of CDS in differentiation of hepatic tumors (hemangioma, HCC and metastasis) is very significant. Central color dots along the peripheral blood vessels and the blush phenomenon are characteristics of capillary hemangioma, peritumoral vascular ring "basket" of HCC, and "detour" sign of metastasis. The central artery, RI from 0.45 to 0.60 and radial spreading characterize FNH. Hepatic adenoma is characterized by an intratumoral vein, and rarely by a vascular hallo. Further on, blood velocity in tumor defined by Color Doppler, distinguishes malignant from benign lesion, where 40 cm/s is a

  16. Endoscopic biopsy of foramen of Monro and third ventricle lesions guided by frameless neuronavigation: usefulness and limitations.

    Science.gov (United States)

    Prat, Ricardo; Galeano, Inmaculada

    2009-09-01

    To describe our institution experience regarding the usefulness and limitations of frameless neuronavigation in the endoscopic biopsy of foramen of Monro and third ventricle lesions. We report our experience with 22 patients harbouring intraventricular lesions located in the region of the foramen of Monro or the third ventricle who underwent endoscopic biopsy guided by the neuronavigation system. Nine lesions were located on the posterior aspect of the third ventricle or at the pineal region, and thirteen lesions were located at the foramen of Monro or anterior third ventricle region. The endoscopes were introduced via an operating sheath, which had previously been inserted with a trocar under neuronavigational control. After approaching the foramen of Monro from the planned angle, surgery was continued under direct visualisation until the lesion was reached, if it was located on the third ventricle. In cases where the lesion was located at the foramen of Monro, an excellent view of the lesion was obtained and neuronavigation was used to determine the location of critical areas. Histological examination of biopsy specimens obtained endoscopically was diagnostic in all cases. Open surgery following endoscopic biopsy was only needed in 1 patient out of 22. In our experience, image-guided neuroendoscopy can improve the accuracy of the endoscopic approach, minimising brain trauma. It can be particularly helpful when performing a brain biopsy in the absence of clear intraventricular landmarks or in the event of adverse visual conditions such as intraventricular bleeding.

  17. A generative probabilistic model and discriminative extensions for brain lesion segmentation – with application to tumor and stroke

    Science.gov (United States)

    Menze, Bjoern H.; Van Leemput, Koen; Lashkari, Danial; Riklin-Raviv, Tammy; Geremia, Ezequiel; Alberts, Esther; Gruber, Philipp; Wegener, Susanne; Weber, Marc-André; Székely, Gabor; Ayache, Nicholas; Golland, Polina

    2016-01-01

    We introduce a generative probabilistic model for segmentation of brain lesions in multi-dimensional images that generalizes the EM segmenter, a common approach for modelling brain images using Gaussian mixtures and a probabilistic tissue atlas that employs expectation-maximization (EM) to estimate the label map for a new image. Our model augments the probabilistic atlas of the healthy tissues with a latent atlas of the lesion. We derive an estimation algorithm with closed-form EM update equations. The method extracts a latent atlas prior distribution and the lesion posterior distributions jointly from the image data. It delineates lesion areas individually in each channel, allowing for differences in lesion appearance across modalities, an important feature of many brain tumor imaging sequences. We also propose discriminative model extensions to map the output of the generative model to arbitrary labels with semantic and biological meaning, such as “tumor core” or “fluid-filled structure”, but without a one-to-one correspondence to the hypo-or hyper-intense lesion areas identified by the generative model. We test the approach in two image sets: the publicly available BRATS set of glioma patient scans, and multimodal brain images of patients with acute and subacute ischemic stroke. We find the generative model that has been designed for tumor lesions to generalize well to stroke images, and the generative-discriminative model to be one of the top ranking methods in the BRATS evaluation. PMID:26599702

  18. Retrograde recanalization of complex SFA lesions indications and techniques.

    Science.gov (United States)

    Fanelli, F; Cannavale, A

    2014-08-01

    Femoro-popliteal segment is often characterized by diffuse and severe steno-obstructive atheroclerotic disease. Most recent guidelines recommended endovascular techniques as a valid and safe treatment in highly symptomatic patients (Rutherford class 4 to 6) with complex femoropopliteal lesions (TASC C and D). Continuous technical development is increasing the efficacy of the endovascular technique with the introduction of new dedicated devices. In most complex situation also retrograde recanalization can be applied. The main indication to this technique is when conventional antegrade recanalisation fails or cannot be apply. The most common retrograde access is through the popliteal artery. However many operators do not like this approach due to the technical issue correlated to the patient position. Recently several reports have been published keeping the patient supine improving patient comfort and operator activity. This tehnique was also affected by several complications at the level of the popliteal puncture site, but those were resolved with the improvement of technique and operator skills. Hence several Authors described different variants of such technique (subintimal techniques, patient in supine position, puncture of the distal superficial femoral artery, tibial/pedal artery access) all obtaining an high rate of success with a low complication rate. In conclusion retrograde recanalization can be considered a safe and effective technique for complex femoral lesions. It is also less expensive than recanalisation devices, less time consuming and can increase the outcome due to the higher percentage of intraluminal recanalization.

  19. Surrogate marker profiles for genetic lesions in acute leukemias.

    Science.gov (United States)

    Paietta, Elisabeth

    2010-09-01

    The basic hypothesis of surrogate marker profiles is that individual genetic lesions result in characteristic distortions of the cellular phenotype with some predictable consistency that can be exploited by sophisticated immunophenotyping. While cytogenetic and molecular aberrancies currently are accepted prognostic predictors in acute leukemias, single antigen expression and even antigenic profiles rarely impact on prognosis. However, increasingly, phenotypes are delineated which can serve as surrogates for underlying genetic aberrations of clinical importance. This development is of particular significance as antileukemic therapy becomes available that targets any component of the disturbed molecular pathways associated with these genetic lesions. This chapter will focus on established surrogate marker profiles, such as those for PML/RARα, AML1/ETO, FLT3-gene mutated acute lymphocytic leukemia (ALL), and BCR/ABL(POS) ALL. As the list of therapeutic targets grows, the role of surrogate antigen profiles will grow, as they can predict for the efficacy of targeted approaches in lieu of expensive, time-consuming and not always accessible genetic analyses. Copyright © 2010 Elsevier Ltd. All rights reserved.

  20. Focal lesions in external auditory canal: computed tomography images

    International Nuclear Information System (INIS)

    Asensio, J.; Lopez Rios, J.

    1999-01-01

    To analyze and review the most common focal lesions of the external auditory canal (EAC), describing the computed tomography (CT) findings. The CT images of EAC were reviewed in a series of 167 patients. Abnormal findings were recorded in 13 cases. The CT images were correlated with otoscopic and/or intraoperative findings. There were four cases of osteoma (one located outside the EAC); all of which were treated surgically, as was the one case of exostosis. Six patients presented debris in EAC, coinciding with clinical evidence of external otitis. There were two cholesteatomas derived from EAC, one of them secondary to survery to treat osteoma. On patient was diagnosed as having a basal cell carcinoma of the ear, extending to EAC, but refused to undergo surgery. Five patients presented small triangular laminae of dense bone arising from the upper wall of the EAC which were defined as abnormal variants of the fusion of the temporal squamous epithelium to the promontory. CT is the technique of choice for assessing bone erosion in EAC, enabling the determination of the extension and grade of the lesion, as well as the definitive diagnosis of exostoses and osteomas. It also provides excellent information on the projection of the EAC walls, knowledge that is decisive in the selection of the endaural or retroauricular surgical approach. (Author) 23 refs

  1. Mapping human brain lesions and their functional consequences.

    Science.gov (United States)

    Karnath, Hans-Otto; Sperber, Christoph; Rorden, Christopher

    2018-01-15

    Neuroscience has a long history of inferring brain function by examining the relationship between brain injury and subsequent behavioral impairments. The primary advantage of this method over correlative methods is that it can tell us if a certain brain region is necessary for a given cognitive function. In addition, lesion-based analyses provide unique insights into clinical deficits. In the last decade, statistical voxel-based lesion behavior mapping (VLBM) emerged as a powerful method for understanding the architecture of the human brain. This review illustrates how VLBM improves our knowledge of functional brain architecture, as well as how it is inherently limited by its mass-univariate approach. A wide array of recently developed methods appear to supplement traditional VLBM. This paper provides an overview of these new methods, including the use of specialized imaging modalities, the combination of structural imaging with normative connectome data, as well as multivariate analyses of structural imaging data. We see these new methods as complementing rather than replacing traditional VLBM, providing synergistic tools to answer related questions. Finally, we discuss the potential for these methods to become established in cognitive neuroscience and in clinical applications. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Visual attention capacity after right hemisphere lesions

    DEFF Research Database (Denmark)

    Habekost, Thomas; Rostrup, Egill

    2007-01-01

    for both VSTM capacity and ipsilesional processing speed. The study also showed that lesions in a large region of the right hemisphere, including the putamen, insula, and inferior frontal cortex, do not lead to general deficits in the capacity of visual attention. Udgivelsesdato: 2007-Apr-8......Recently there has been a growing interest in visual short-term memory (VSTM) including the neural basis of the function. Processing speed, another main aspect of visual attention capacity, has received less investigation. For both cognitive functions human lesion studies are sparse. We used...... a whole report experiment for estimation of these two parameters in 22 patients with right side stroke. Psychophysical performance was analyzed using Bundesen's [Bundesen, C. (1990). A theory of visual attention. Psychological Review, 97, 523-547] Theory of Visual Attention (TVA) and compared...

  3. HYPERVASCULAR LIVER LESIONS IN RADIOLOGICALLY NORMAL LIVER.

    Science.gov (United States)

    Amico, Enio Campos; Alves, José Roberto; Souza, Dyego Leandro Bezerra de; Salviano, Fellipe Alexandre Macena; João, Samir Assi; Liguori, Adriano de Araújo Lima

    2017-01-01

    The hypervascular liver lesions represent a diagnostic challenge. To identify risk factors for cancer in patients with non-hemangiomatous hypervascular hepatic lesions in radiologically normal liver. This prospective study included patients with hypervascular liver lesions in radiologically normal liver. The diagnosis was made by biopsy or was presumed on the basis of radiologic stability in follow-up period of one year. Cirrhosis or patients with typical imaging characteristics of haemangioma were excluded. Eighty-eight patients were included. The average age was 42.4. The lesions were unique and were between 2-5 cm in size in most cases. Liver biopsy was performed in approximately 1/3 of cases. The lesions were benign or most likely benign in 81.8%, while cancer was diagnosed in 12.5% of cases. Univariate analysis showed that age >45 years (p3 nodules (p=0.003) and elevated alkaline phosphatase (p=0.013) were significant risk factors for cancer. It is safe to observe hypervascular liver lesions in normal liver in patients up to 45 years, normal alanine aminotransaminase, up to three nodules and no personal history of cancer. Lesion biopsies are safe in patients with atypical lesions and define the treatment to be established for most of these patients. As lesões hepáticas hipervasculares representam um desafio diagnóstico. Identificar fatores de risco para câncer em pacientes portadores de lesão hepática hipervascular não-hemangiomatosa em fígado radiologicamente normal. Estudo prospectivo que incluiu pacientes com lesões hepáticas hipervasculares em que o diagnóstico final foi obtido por exame anatomopatológico ou, presumido a partir de seguimento mínimo de um ano. Diagnóstico prévio de cirrose ou radiológico de hemangioma foram considerados critérios de exclusão. Oitenta e oito pacientes foram incluídos. A relação mulher/homem foi de 5,3/1. A idade média foi de 42,4 anos. Na maior parte das vezes as lesões hepáticas foram únicas e com

  4. Proteome profiling of human cutaneous leishmaniasis lesion.

    Science.gov (United States)

    da Silva Santos, Claire; Attarha, Sanaz; Saini, Ravi Kanth; Boaventura, Viviane; Costa, Jackson; Khouri, Ricardo; Barral-Netto, Manoel; Brodskyn, Cláudia Ida; Souchelnytskyi, Serhiy

    2015-02-01

    In this study, we used proteomics and biological network analysis to evaluate the potential biological processes and components present in the identified proteins of biopsies from cutaneous leishmaniasis (CL) patients infected by Leishmania braziliensis in comparison with normal skin. We identified 59 proteins differently expressed in samples from infected and normal skin. Biological network analysis employing identified proteins showed the presence of networks that may be involved in the cell death mediated by cytotoxic T lymphocytes. After immunohistochemical analyses, the expression of caspase-9, caspase-3, and granzyme B was validated in the tissue and positively correlated with the lesion size in CL patients. In conclusion, this work identified differentially expressed proteins in the inflammatory site of CL, revealed enhanced expression of caspase-9, and highlighted mechanisms associated with the progression of tissue damage observed in lesions.

  5. [Onychomatricoma, a rare lesion of the nail].

    Science.gov (United States)

    Pommepuy, Isabelle; Roblet, Denis; Blaise, Sophie; Delage-Corre, Manuela; Bonnetblanc, Jean-Marie; Fayol, Jacqueline; Labrousse, François

    2004-09-01

    Onychomatricoma is a rare fibroepithelial lesion of the nail matrix with peculiar clinical and histological features. Clinically, it is characterized by a longitudinal band of yellow thickening of the nail plate with transverse overcurvature and splinter hemorrhages. Nail avulsion exposes a villous tumor of the matrix with filamentous digitations extending into multiple holes of the nail plate. Histologically, a thick keratogenous zone forms a thickened nail plate. The lesion in its proximal portion is characterized by deep epithelial invaginations and by a stroma organized in two layers. The distal zone corresponds to multiple fibroepithelial projections extending into the nail plate. The diagnosis can be difficult in the presence of misleading clinical features or when the specimen is incomplete or examined with an improper orientation. Surgical resection is the recommended treatment.

  6. Visual attention capacity after right hemisphere lesions

    DEFF Research Database (Denmark)

    Habekost, Thomas; Rostrup, Egill

    2007-01-01

    Recently there has been a growing interest in visual short-term memory (VSTM) including the neural basis of the function. Processing speed, another main aspect of visual attention capacity, has received less investigation. For both cognitive functions human lesion studies are sparse. We used...... a whole report experiment for estimation of these two parameters in 22 patients with right side stroke. Psychophysical performance was analyzed using Bundesen's [Bundesen, C. (1990). A theory of visual attention. Psychological Review, 97, 523-547] Theory of Visual Attention (TVA) and compared...... for both VSTM capacity and ipsilesional processing speed. The study also showed that lesions in a large region of the right hemisphere, including the putamen, insula, and inferior frontal cortex, do not lead to general deficits in the capacity of visual attention. Udgivelsesdato: 2007-Apr-8...

  7. Oral lesions associated with hydroxyurea treatment

    Directory of Open Access Journals (Sweden)

    Regina Mendonça

    2011-01-01

    Full Text Available Hydroxyurea (HU is an antimetabolic agent commonly used in myeloproliferative disorders and hematological diseases as well as in severe psoriasis. Despite of usually be well tolerated, sometimes it can induce immunosuppression and mucocutaneous adverse effects associated with discomfort or pain. Nevertheless, oral mucosal adverse reactions are extremely uncommon and present as ulcers, tongue depapilation and dyschromia. Complete remission of adverse effects is usually observed after withdrawal of the medication. The aim of this paper is to report two patients with oral lesions related to HU treatment. T0 he patients were adequately managed by changing hydroxyurea with imatinib mesilate. Oral lesions are rare complications of long-term hydroxyurea treatment and may be an indication of stopping therapy and substitution with imatinib mesilate.

  8. Neurosonography of cranial lesions in infants

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Seok; Lee, Sung Sik; Lee, Soon Il [Sowha Children' s Hospital, Seoul (Korea, Republic of); Lee, Seung Ro [Hanyang University College of Medicine, Seoul (Korea, Republic of); Chi, Je Geun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1986-04-15

    Since early 1980's, high resolution ultrasound has been world-widely used for detection of cranial lesions in infants but not widely used in Korea. Authors prospectively analysed ultrasonographic findings of 107 cases which were confirmed by CT, autopsy or follow-up studies as supplement. The distribution of 107 cases was intracranial hematoma 40 cases, hydrocephalus 36 cases, hypoxic-ischemic encephalopathy 10 cases, porencephalic cyst 5 cases, cephalhematoma 5 case, agenesis of corpus callosum 4 cases, medulloblastoma 2 cases and each one case of A-V malformation, intraventricular cyst, Dandy Walker cyst, lipoma and hydranencephaly. We could conclude that neurosonography of infants was very useful and effective method in detection of cranial lesions such as intracranial hematoma, especially germinal matrix hemorrhage or intraventricular hemorrhage in preterm infant, hydrocephalus, hypoxic-ischemic encephalopathy and congenital anomalies.

  9. Computer tomographic localization and lesion size in aphasia

    International Nuclear Information System (INIS)

    Hojo, Kei

    1985-01-01

    Using a microcomputer, the locus and extent of the lesions demonstrated on CT were superimposed on standardized matrices in 127 cases with various types of aphasia, to investigate the relationship between location of the lesions and types of aphasia. Main results were as follows. 1. Broca aphasics: The lesions involved rather large areas in the deep structures of the lower part of the precentral gyrus, the insula and the lenticular nucleus. Therefore, the finding was regarded as being of little localizing value. 2. Wernicke aphasics: At least 70 % of the patients had superior temporal lesions involving Wernicke's area and the subcortical lesions of the superior and middle temporal gyri. The site of the lesion corresponded roughly with that in the previous clinico-pathological reports but was indicated in a little deeper area. 3. Amnestic aphasics: The size of the lesion was smaller than any other type but the lesions were distributed throughout the left hemisphere. Amnestic asphasia was thought to be the least localizable. 4. Conduction aphasics: Most patients had lesions in the posterior speech area involving part of Wernicke's area. In particular, in more than 80 % of the conduction aphasics the lesions were revealed in the supramarginal gyrus and it's adjacent deep structures. 5. Global aphasics: In general, the size of the lesion was very large and 70 % of the global aphasics had extensive lesions involving both Broca's and Wernicke's areas. However, there were some patients showing small and confined lesions. (author)

  10. Immunoreactivity of granular cell lesions of skin, mucosa, and jaw.

    Science.gov (United States)

    Regezi, J A; Zarbo, R J; Courtney, R M; Crissman, J D

    1989-10-01

    Granular cell lesions from many different sites share similar light and electron microscopic features. Immunologically, however, these lesions do not appear to be a homogenous group. This study determines the extent of immunologic heterogeneity of granular cell lesions from a wide variety of sites in skin, mucosa, and jaw. Thirty-one granular cell lesions (26 granular cell tumors [GCT] and five other granular cell lesions) from 18 different sites were evaluated immunohistochemically for keratins, vimentin, desmin, muscle actin, ACT, HLA-DR, and S-100 protein. Paraffin-embedded sections were utilized with an avidin-biotin complex immunoperoxidase technique. Except for ameloblastomas, all lesions were negative for keratin and positive for vimentin. All lesions were negative for desmin and actin. Positive ACT reactivity was found in one of seven GCT of tongue, a colonic lesion, a nose lesion, and a granular cell ameloblastic fibroma. All lesions were positive for HLA-DR except a few in which fixation appeared inadequate. S-100 immunoreactivity was found in all lesions except the congenital epulis, a GCT of the skin of the nose, a colonic lesion, and the odontogenic tumors. The antigenic profile of GCT of skin and mucosa is consistent with Schwann cell origin. However, some GCT and other granular cell lesions appear to be derived from macrophages, epithelial cells, or other cells. The expression of HLA-DR by granular cells is believed to be unrelated to cellular origin but rather to some common immunologic function.

  11. Vestibular Perception following Acute Unilateral Vestibular Lesions

    Science.gov (United States)

    Cousins, Sian; Kaski, Diego; Cutfield, Nicholas; Seemungal, Barry; Golding, John F.; Gresty, Michael; Glasauer, Stefan; Bronstein, Adolfo M.

    2013-01-01

    Little is known about the vestibulo-perceptual (VP) system, particularly after a unilateral vestibular lesion. We investigated vestibulo-ocular (VO) and VP function in 25 patients with vestibular neuritis (VN) acutely (2 days after onset) and after compensation (recovery phase, 10 weeks). Since the effect of VN on reflex and perceptual function may differ at threshold and supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5°/s2 and velocity steps of 90°/s (acceleration 180°/s2). We hypothesised that the vestibular lesion or the compensatory processes could dissociate VO and VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute and recovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory this indicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesion-induced bias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any ‘perceptual noise’ added by the vertigo does not disrupt the cognitive decision-making processes inherent to the perceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing and suggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, a significant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VP responses were reduced – asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VP responses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-threshold responses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. We provide evidence of

  12. COLLISIONS IN THE CLASSIFICATION OF SLAP LESIONS

    Directory of Open Access Journals (Sweden)

    V. G. Yevsyeyenko

    2012-01-01

    Full Text Available There is no agreement among experts on the classification of injury of o the long head tendon of biceps brachii in the area of its attachment to the shoulder blade. Some authors take the Snyder’s classification as basis; others describe it as a separate injury. The authors presented the review of existing classifications of the labrum shoulder injury (so-called SLAP lesions and traumas of the tendon of the long head biceps.

  13. Vestibular perception following acute unilateral vestibular lesions.

    Directory of Open Access Journals (Sweden)

    Sian Cousins

    Full Text Available Little is known about the vestibulo-perceptual (VP system, particularly after a unilateral vestibular lesion. We investigated vestibulo-ocular (VO and VP function in 25 patients with vestibular neuritis (VN acutely (2 days after onset and after compensation (recovery phase, 10 weeks. Since the effect of VN on reflex and perceptual function may differ at threshold and supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5°/s(2 and velocity steps of 90°/s (acceleration 180°/s(2. We hypothesised that the vestibular lesion or the compensatory processes could dissociate VO and VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute and recovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory this indicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesion-induced bias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any 'perceptual noise' added by the vertigo does not disrupt the cognitive decision-making processes inherent to the perceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing and suggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, a significant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VP responses were reduced - asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VP responses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-threshold responses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. We provide evidence of

  14. Remineralization of artificial enamel lesions by theobromine.

    Science.gov (United States)

    Amaechi, B T; Porteous, N; Ramalingam, K; Mensinkai, P K; Ccahuana Vasquez, R A; Sadeghpour, A; Nakamoto, T

    2013-01-01

    This study investigated the remineralization potential of theobromine in comparison to a standard NaF dentifrice. Three tooth blocks were produced from each of 30 teeth. Caries-like lesion was created on each block using acidified gel. A smaller block was cut from each block for baseline scanning electron microscopy imaging and electron-dispersive spectroscopy (EDS) analysis for surface Ca level. A tooth slice was cut from each lesion-bearing block for transverse microradiography (TMR) quantification of baseline mineral loss (Δz) and lesion depth (LD). Then baseline surface microhardness (SMH) of each lesion was measured. The three blocks from each tooth were assigned to three remineralizing agents: (1) artificial saliva; (2) artificial saliva with theobromine (0.0011 mol/l), and (3) NaF toothpaste slurry (0.0789 mol/l F). Remineralization was conducted using a pH cycling model with storage in artificial saliva. After a 28-day cycle, samples were analyzed using EDS, TMR, and SMH. Intragroup comparison of pre- and posttest data was performed using t tests (p theobromine (38 ± 32%) and toothpaste (29 ± 16%). With TMR (Δz/lD), theobromine and toothpaste exhibited significantly (p theobromine and toothpaste was not significantly different. With EDS, calcium deposition was significant in all groups, but not significantly different among the groups (theobromine 13 ± 8%, toothpaste 10 ± 5%, and artificial saliva 6 ± 8%). The present study demonstrated that theobromine in an apatite-forming medium can enhance the remineralization potential of the medium. Copyright © 2013 S. Karger AG, Basel.

  15. Encephalitis with Prolonged but Reversible Splenial Lesion

    Directory of Open Access Journals (Sweden)

    Alena Meleková

    2015-12-01

    Full Text Available Introduction: The splenium of the corpus callosum has a specific structure of blood supply with a tendency towards blood-brain barrier breakdown, intramyelinic edema, and damage due to hypoxia or toxins. Signs and symptoms of reversible syndrome of the splenium of the corpus callosum typically include disorientation, confusion, impaired consciousness, and epileptic seizures. Case report: A previously healthy 32-year-old man suffered from weakness, headache, and fever. Subsequently, he developed apathy, ataxia, and inability to walk, and therefore was admitted to the hospital. Cerebrospinal fluid showed protein elevation (0.9 g/l and pleocytosis (232/1 ul. A brain MRI showed hyperintense lesions in the middle of the corpus callosum. The patient was treated with antibiotics, and subsequently, in combination with steroids. Two months later, the hyperintense lesions in the splenium and the basal ganglia had disappeared. Almost seven months since his hospitalization in the Department of Neurology, the patient has returned to his previous employment. He now does not exhibit any mental changes, an optic edema and urological problems have improved. In addition, he is now actively engaged in sports. Conclusion: We have described a case of a 32-year-old man with confusion, ataxia, and inability to stand and walk. The man developed a febrile meningeal syndrome and a hyperintense lesion of the splenium, which lasted for two months. Neurological changes, optic nerve edema, and urinary retention have resolved over the course of seven months. We think that the prolonged but transient lesion of the splenium may have been caused by encephalitis of viral origin.

  16. Malignancy Risk Models for Oral Lesions

    OpenAIRE

    Zarate, Ana M.; Brezzo, Mar?a M.; Secchi, Dante G.; Barra, Jos? L.; Brunotto, Mabel

    2013-01-01

    Abstract Objectives: The aim of this work was to assess risk habits, clinical and cellular phenotypes and TP53 DNA changes in oral mucosa samples from patients with Oral Potentially Malignant Disorders (OPMD), in order to create models that enable genotypic and phenotypic patterns to be obtained that determine the risk of lesions becoming malignant. Study Design: Clinical phenotypes, family history of cancer and risk habits were collected in clinical histories. TP53 gene mutation and mor...

  17. Hyperdense lesions in CT of cerebral toxoplasmosis

    International Nuclear Information System (INIS)

    Quinones Tapia, D.; Ramos Amador, A.; Monereo Alonso, A.

    1994-01-01

    We report a case of cerebral toxoplasmosis in a patient with stage IV C 1 AIDS who presented hyperdense CT images 13 days after beginning antitoxoplasma treatment. These lesions could be caused by calcifications or blood. The attenuation values lead us to believe that they are calcium. Intracranial calcification in adult cerebral toxoplasmosis is an uncommon finding. Its presence in AIDS patients should not suggest any etiology other than toxoplasmosis. (Author) 16 refs

  18. Restrictive cardiomyopathy and pseudoxanthoma elasticum skin lesions.

    Science.gov (United States)

    Musumeci, Maria B; Semprini, Lorenzo; Casenghi, Matteo; Montesanti, Dalma; Mastromarino, Vittoria; Socciarelli, Fabio; Volpe, Massimo; Autore, Camillo

    2016-12-01

    : We report a rare case of a patient with AL amyloidosis and pseudoxanthoma elasticum skin lesions. An association between these two diseases has been previously described as amyloid elastosis in only six cases, but cardiac findings were not fully elucidated. The peculiarity of our case is that a severe cardiac involvement influenced the prognosis negatively. Furthermore, the electron microscopic examination did not show all the peculiar histopathological findings of amyloid elastosis, precluding a final diagnosis of this disease.

  19. Lesiones periapicales agudas en pacientes adultos

    Directory of Open Access Journals (Sweden)

    María Elena Fernández Collazo

    2012-06-01

    Full Text Available Se realizó un estudio analítico de corte transversal en el área de salud del Policlínico "27 de Noviembre" del municipio Marianao, La Habana, en el periodo correspondiente de enero a diciembre de 2009. Se incluyeron todos los pacientes que acudieron al servicio de urgencia y que presentaron lesiones periapicales agudas. Se recogió información de las variables edad, sexo, grupo dentario, causa de la enfermedad, características clínicas e higiene bucal. Esta última se clasificó en las categorías eficiente y deficiente según el índice simplificado de higiene bucal. Se utilizó el X² para estimar la relación entre las variables, y la comparación de proporciones para contrastar la hipótesis de que existieran diferencias entre las lesiones periapicales para las categorías de las variables grupo dentario, causa de la enfermedad y características clínicas. Se encontró un predominio del absceso periapical agudo en un 84,7 % del grupo de edad de 35 a 59 años y del sexo masculino, aunque no se encontraron diferencias significativas para estas variables, ni en los grupos dentarios con respecto a la enfermedad. La higiene bucal resultó estar relacionada con las lesiones periapicales. Se encontraron diferencias significativas en las lesiones periapicales respecto a todas las causas estudiadas, con excepción de las enfermedades periodontales. Respecto a las características clínicas hubo significación en cuanto al aumento de volumen del fondo del surco vestibular y la movilidad dentaria.

  20. CURATIVE CONDUCT IN UTERIN CERVIX LESIONS

    Directory of Open Access Journals (Sweden)

    Eduard Crauciuc

    2012-03-01

    Full Text Available When talking about the feminine population, for which cervical cancer is an important problem of publichealth, it is very important to have an activity of detecting and treating preinvasive cervical lesions in the family planningoffices, in collaboration with specialized doctors from specialized services. The study intends to find out the possibilitiesand limitations in diagnosing and treating preinvasive cervical lesions. The study was made on a heterogenic lot ofpatients (n=16732, of which 1115 patients were diagnosed and monitoring in order to detect preinvasive cervical lesionswithin the family planning services, contraception or contragestion in different clinics of Obstetrics-Gynaecology in Iaşiand Buzău, between 2005 and 2011. In Iaşi, the smears were harvested, prepared and interpreted in a specialized service (thesame lab, experienced doctors and a unique data storage device, which lead to a superior percentage of detection ofpreinvasive cervical lesions, when compared to the lot in Buzău: MCB 47.9% vs 35.2%; LSIL 11.5% vs 0,5%; HSIL2.1% vs 1.2%

  1. Ultrasonography of anterior abdominal wall lesion

    Energy Technology Data Exchange (ETDEWEB)

    Lee, K.N.; Lee, S. K.; Park, H. Y.; Kim, Y. S.; Park, B. H. [Maryrnoll Hospital, Busan (Korea, Republic of)

    1983-12-15

    The anterior abdominal wall has received little attention in the ultrasonic evaluation. However recently the improved resolution of ultrasound scanning devices has made possible routine examination of the anterior abdominal wall. The authors evaluated ultrasonographic findings of anterior abdominal wall lesions in 27 cases for 1 year(from July '82 to Aug. '83), which were finally diagnosed pathologically and clinically. The results were as follows: 1. Well defined peritoneal line and layers of the anterior abdominal wall made it possible to localize the lesions accurately from adjacent structures. 2. Abscess and hematoma were lower in echogenecity than adjacent tissues, such as muscle layer or subcutaneous fat space and were well delineated from normal structures. 3. In hernia, easy differentiation was made due to oval shape, poor or decreased echo pattern and protrustion from skin layer. Conclusively, in the doubtful cases of palpable mass in the abdominal wall, postoperative complications of sequele, such as accurately but also the guide of treatment. Ultrasonography of anterior abdominal wall is useful to demonstrate the exact location, extent of the lesions and to decrease the frequency of useless laparatomy

  2. Lesions associated with drowning in bycaught penguins.

    Science.gov (United States)

    Vanstreels, Ralph Eric; Hurtado, Renata; Ewbank, Ana Carolina; Bertozzi, Carolina Pacheco; Catão-Dias, José Luiz

    2016-10-27

    Fisheries bycatch, the incidental mortality that occurs as a result of entanglement in fishing gear, is an important conservation threat to penguins and other seabirds. Identification of entanglement and drowning in beach-cast carcasses of seabirds remains a challenge, as it is still unclear what lesions are to be expected in a bycaught seabird. We necropsied 2 Magellanic penguins Spheniscus magellanicus that were entangled and drowned in gillnets. Marked distension of the lungs with foamy red fluid and marked oedema of the dorsal visceral pleura were prominent lesions consistent with those described in cases of 'wet drowning' in humans. On the other hand, the air sacs contained very small quantities of liquid, suggesting that absence of water in the air sacs might not be a reliable sign to exclude drowning. Other relevant findings included cutaneous lacerations and bruising in one bird and cervical and pectoral rhabdomyolysis in both birds. While cutaneous or subcutaneous hematomas may be an indication of bycatch, especially if linear or cross-linear patterns consistent with fishing nets are present, these lesions might not always be discernible and their absence does not suffice to exclude the possibility of entanglement in fishing nets. Additionally, our findings suggest that the histological examination of skeletal muscles, particularly of the neck, may provide additional clues to corroborate the diagnosis of drowning in penguins.

  3. Porcine deltacoronavirus: histological lesions and genetic characterization.

    Science.gov (United States)

    Wang, Leyi; Hayes, Jeff; Sarver, Craig; Byrum, Beverly; Zhang, Yan

    2016-01-01

    First identified in 2012 in a surveillance study in Hong Kong, porcine deltacoronavirus (PDCoV) is a proposed member of the genus Deltacoronavirus of the family Coronaviridae. In February of 2014, PDCoV was detected in pigs with clinical diarrheal symptoms for the first time in the USA. Since then, it has been detected in more than 20 states in the USA and in other countries, including Canada, South Korea, and mainland China. So far, histological lesions in the intestines of pigs naturally infected with PDCoV under field conditions have not been reported. In this report, we describe the characteristic histological lesions in the small intestine that were associated with PDCoV infection, as evidenced by detection of viral nucleic acid by RT-PCR. In addition, we performed genomic analysis to determine the genetic relationship of all PDCoV strains from the four countries. We found that PDCoV mainly caused histological lesions in the small intestines of naturally infected piglets. Sequence analysis demonstrated that the PDCoV strains of different countries are closely related and shared high nucleotide sequence similarity; however, deletion patterns in the spike and 3' untranslated regions are different among the strains from mainland China, Hong Kong, the USA, and South Korea. Our study highlights the fact that continual surveillance is needed to trace the evolution of this virus.

  4. Transarterial embolization in head and neck lesions

    International Nuclear Information System (INIS)

    Chang, Kee Hyun; Han, Man Chung

    1985-01-01

    The transarterial embolization procedures have been performed in a total of 38 patients with head and neck lesions, including 5 carotid-cavernous fistulas, 1 internal carotid aneurysm, 10 meningiomas, 16 nasopharyngeal angiofibromas, 1 post-traumatic epistaxis and 5 other vascular tumors, over the 18 months-period. Six cases of C-C fistula and ICA aneurysm were treated with the detachable balloon catheter technique. The meningiomas, angiofibromas and all other lesions were embolized with superselection of the branches of the external carotid artery such as the internal maxillary, the middle meningeal, the ascending pharyngeal the facial or other branches, using Berenstein superselective catheters or conventional angiographic catheters. The PVA (polyvinyl alcohol foam) and/or Gelfoam particles were used as embolic materials in these cases. Most of the lesions were successfully embolized with minor transient complications such as pain, headache, vomiting, fever and etc. But in 4 cases occurred the serious complications; one cerebral hemorrhage, two cerebral infarctions, and one acute laryngeal edema. The selection of the embolic materials and the catheters, and the complications are briefly discussed

  5. Transarterial embolization in head and neck lesions

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Kee Hyun; Han, Man Chung [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    1985-06-15

    The transarterial embolization procedures have been performed in a total of 38 patients with head and neck lesions, including 5 carotid-cavernous fistulas, 1 internal carotid aneurysm, 10 meningiomas, 16 nasopharyngeal angiofibromas, 1 post-traumatic epistaxis and 5 other vascular tumors, over the 18 months-period. Six cases of C-C fistula and ICA aneurysm were treated with the detachable balloon catheter technique. The meningiomas, angiofibromas and all other lesions were embolized with superselection of the branches of the external carotid artery such as the internal maxillary, the middle meningeal, the ascending pharyngeal the facial or other branches, using Berenstein superselective catheters or conventional angiographic catheters. The PVA (polyvinyl alcohol foam) and/or Gelfoam particles were used as embolic materials in these cases. Most of the lesions were successfully embolized with minor transient complications such as pain, headache, vomiting, fever and etc. But in 4 cases occurred the serious complications; one cerebral hemorrhage, two cerebral infarctions, and one acute laryngeal edema. The selection of the embolic materials and the catheters, and the complications are briefly discussed.

  6. The Role of Endoscopic Ultrasound in the Diagnostic Assessment of Subepithelial Lesions of the Upper Gastrointestinal Tract

    Directory of Open Access Journals (Sweden)

    Francisca Dias de Castro

    2016-11-01

    Conclusion: EUS is the method of choice in the study of subepithelial lesions of the upper gastrointestinal tract, in most cases defining a diagnosis. The need for a definitive diagnosis or therapeutic approaches can be based on ultrasound risk features, presented, in the majority, at presentation. This study shows that EUS is capable of safely and accurately define those subepithelial lesions that can be managed only with surveillance ultrasound while waiting for better results with fine needle aspiration.

  7. A Rare Case of Aggressive Digital Adenocarcinoma of the Lower Extremity, Masquerading as an Ulcerative Lesion that Clinically Favored Benignancy

    Directory of Open Access Journals (Sweden)

    Ryan Vazales

    2014-08-01

    Full Text Available A rare case report of Aggressive Digital Adenocarcinoma (ADPCa is presented complete with a literature review encompassing lesions that pose potential diagnostic challenges. Similarities between basal cell carcinoma (BCC, marjolin’s ulceration/squamous cell carcinoma (MSCC and ADPCa are discussed. This article discusses potential treatment options for ADPCa and the need for early biopsy when faced with any challenging lesion. An algorithmic approach to ADPCa treatment based on the most current research is recommended.

  8. [A man with a skin lesion on his abdomen].

    Science.gov (United States)

    Thijssen, Annemieke Y; Mostard, Guy J M

    2012-01-01

    A 56-year-old man presented with a skin lesion 2 days after surgery for a perianal abscess. The lesion was red, swollen and very painful, with central necrosis and arose shortly after starting coumarine therapy.

  9. Placental fetal vascular thrombosis lesions and maternal thrombophilia

    NARCIS (Netherlands)

    Beeksma, F. A.; Erwich, J. J. H. M.; Khong, T. Y.

    Aims: Following intrauterine fetal death (IUFD), the placental fetal vessels undergo regressive changes. These changes are virtually indistinguishable from lesions that are the result of fetal vascular thrombosis (FVT). This study investigated the relation between these lesions and maternal

  10. REVIEW ARTICLE Adrenal lesions encountered in current medical ...

    African Journals Online (AJOL)

    6]. C. Positron-emission tomography. Positron-emission tomography (PET) plays an increasingly pivotal role in functional imaging, governed by the metabolic activity of the adrenal lesion. Like most other non- benign lesions, malignant adrenal ...

  11. Histopathological Patterns of Endometrial Lesions in Patients with ...

    African Journals Online (AJOL)

    Histopathological Patterns of Endometrial Lesions in Patients with Abnormal Uterine Bleeding in a Cosmopolitan Population. ... among reproductive women. Nevertheless, endometrial hyperplasia was most frequent in perimenopausal age group. Keywords: Cancer, endometrium, histopathology, lesions, private practice ...

  12. Cerebral Venous Thrombosis with Nonhemorrhagic Lesions: Clinical Correlates and Prognosis

    NARCIS (Netherlands)

    Ferro, José M.; Canhão, Patrícia; Bousser, Marie-Germaine; Stam, Jan; Barinagarrementeria, Fernando; Stolz, Erwin

    2010-01-01

    Background and Purpose: Brain imaging of patients with acute cerebral venous thrombosis often shows parenchymal hemorrhagic and nonhemorrhagic lesions. The clinical relevance of nonhemorrhagic lesions is poorly known. Method: In the International Study on Cerebral Vein and Dural Sinus Thrombosis

  13. Diverse Imaging characteristics of a mandibular intraosseous vascular lesion

    Energy Technology Data Exchange (ETDEWEB)

    Handa, Hina; Naidu, Giridhar S.; Dara, Balaji Gandhi Babu; Deshpande, Ashwini; Raghavendra, Raju [Peoples Dental Academy, Bhopal (Iran, Islamic Republic of)

    2014-03-15

    Intraosseous vascular lesions of the maxillofacial region are rare, and the differential diagnosis of intraosseous vascular malformations from other jaw lesions can be challenging. In the present case, magnetic resonance imaging and three-dimensional computed tomographic angiography (CTA) was used for diagnosis, and the lesion was treated with surgical excision. Diverse characteristics such as the 'honeycomb' and 'sunburst' radiographic appearances and the absence of major peripheral feeder vessels in the CTA were noted. Intraosseous vascular malformations have a varied radiographic appearance, and the nomenclature of these lesions is equally diverse, with several overlapping terms. Pathologists do not generally differentiate among intraosseous vascular lesions on the basis of histopathology, although these lesions may present with contrasting immunohistochemical and clinical behaviors requiring varied treatment strategies. This case report highlights the need for multiple imaging modalities to differentiate among vascular lesions, as well as to better understand the behaviors of these unique lesions.

  14. Processive DNA demethylation via DNA deaminase-induced lesion resolution.

    Directory of Open Access Journals (Sweden)

    Don-Marc Franchini

    Full Text Available Base modifications of cytosine are an important aspect of chromatin biology, as they can directly regulate gene expression, while DNA repair ensures that those modifications retain genome integrity. Here we characterize how cytosine DNA deaminase AID can initiate DNA demethylation. In vitro, AID initiated targeted DNA demethylation of methyl CpGs when in combination with DNA repair competent extracts. Mechanistically, this is achieved by inducing base alterations at or near methyl-cytosine, with the lesion being resolved either via single base substitution or a more efficient processive polymerase dependent repair. The biochemical findings are recapitulated in an in vivo transgenic targeting assay, and provide the genetic support of the molecular insight into DNA demethylation. This targeting approach supports the hypothesis that mCpG DNA demethylation can proceed via various pathways and mCpGs do not have to be targeted to be demethylated.

  15. Automated Dermoscopy Image Analysis of Pigmented Skin Lesions

    Directory of Open Access Journals (Sweden)

    Alfonso Baldi

    2010-03-01

    Full Text Available Dermoscopy (dermatoscopy, epiluminescence microscopy is a non-invasive diagnostic technique for the in vivo observation of pigmented skin lesions (PSLs, allowing a better visualization of surface and subsurface structures (from the epidermis to the papillary dermis. This diagnostic tool permits the recognition of morphologic structures not visible by the naked eye, thus opening a new dimension in the analysis of the clinical morphologic features of PSLs. In order to reduce the learning-curve of non-expert clinicians and to mitigate problems inherent in the reliability and reproducibility of the diagnostic criteria used in pattern analysis, several indicative methods based on diagnostic algorithms have been introduced in the last few years. Recently, numerous systems designed to provide computer-aided analysis of digital images obtained by dermoscopy have been reported in the literature. The goal of this article is to review these systems, focusing on the most recent approaches based on content-based image retrieval systems (CBIR.

  16. Morel-Lavallee lesion in the knee: a case report

    International Nuclear Information System (INIS)

    Pitrez, Eduardo Hennemann; Pellanda, Roberto Campos; Silva, Mariana Eltz; Holz, Gustavo Garcia; Hertz, Felipe Teixeira; Hoefel Filho, Joao Rubiao

    2010-01-01

    Morel-Lavallee lesion is a degloving injury of the interface between the subcutaneous fat and the underlying fascia. This lesion is characterized by the development of a fluid collection that, although originally described in the thigh, it has also been described in other anatomical sites. The authors report the case of a patient with Morel-Lavallee lesion in the knee after trauma and describe the main characteristics of the lesion. (author)

  17. Morel-Lavallee lesion in the knee: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Pitrez, Eduardo Hennemann, E-mail: epitrez@terra.com.b [Clinica Radiologica Osorio Lopes, Porto Alegre, RS (Brazil); Pellanda, Roberto Campos; Silva, Mariana Eltz; Holz, Gustavo Garcia; Hertz, Felipe Teixeira [Pontificia Univ. Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS (Brazil). Hospital Sao Lucas; Hoefel Filho, Joao Rubiao [Pontificia Univ. Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS (Brazil). Center of Imaging Diagnosis

    2010-09-15

    Morel-Lavallee lesion is a degloving injury of the interface between the subcutaneous fat and the underlying fascia. This lesion is characterized by the development of a fluid collection that, although originally described in the thigh, it has also been described in other anatomical sites. The authors report the case of a patient with Morel-Lavallee lesion in the knee after trauma and describe the main characteristics of the lesion. (author)

  18. Flow Cytometric Ploidy Determination of Oral Premalignant and Malignant Lesions

    Science.gov (United States)

    1990-01-01

    identifiable lesions, some were associated with oral white lesions, either concomitant or precedent. These white lesions were referred to as leukoplakia , a...widely variable results. These authors undertook a clinical-pathologic correlation of oral leukoplakia encountered in the biopsy services of two...with oral leukoplakia for an average period of 7.2 years. All lesions were more than one centimeter in size and had been present and observed for a

  19. Detection of early carious lesions using contrast enhancement with coherent light scattering (speckle imaging)

    Science.gov (United States)

    Deana, A. M.; Jesus, S. H. C.; Koshoji, N. H.; Bussadori, S. K.; Oliveira, M. T.

    2013-07-01

    Currently, dental caries still represent one of the chronic diseases with the highest prevalence and present in most countries. The interaction between light and teeth (absorption, scattering and fluorescence) is intrinsically connected to the constitution of the dental tissue. Decay induced mineral loss introduces a shift in the optical properties of the affected tissue; therefore, study of these properties may produce novel techniques aimed at the early diagnosis of carious lesions. Based on the optical properties of the enamel, we demonstrate the application of first-order spatial statistics in laser speckle imaging, allowing the detection of carious lesions in their early stages. A highlight of this noninvasive, non-destructive, real time and cost effective approach is that it allows a dentist to detect a lesion even in the absence of biofilm or moisture.

  20. Hybrid technologies in surgical treatment of patients with concomitant atherosclerotic lesions of carotid and coronary arteries

    Directory of Open Access Journals (Sweden)

    А. М. Чернявский

    2015-10-01

    Full Text Available Cardiovascular diseases, which have their origins in atherosclerosis, are the "leaders" in morbidity and mortality among the population in many countries. Given the increase of elderly people in the population, it is important to choose the best strategy for surgical treatment of patients with combined atherosclerotic lesions of several arteries (coronary arteries, carotid arteries, peripheral arteries of the lower extremities, atherosclerosis visceral branches of the abdominal aorta. Currently, there is yet no common approach to the timing and sequence of revascularization surgery in this group of patients. The rapid development of endovascular techniques enables us to carry out the so-called hybrid procedures in patients with atherosclerotic lesions of several arteries. In this article we analyze different strategies that are used to manage patients with both coronary and carotid arteries atherosclerotic lesions.

  1. Detection of early carious lesions using contrast enhancement with coherent light scattering (speckle imaging)

    International Nuclear Information System (INIS)

    Deana, A M; Jesus, S H C; Koshoji, N H; Bussadori, S K; Oliveira, M T

    2013-01-01

    Currently, dental caries still represent one of the chronic diseases with the highest prevalence and present in most countries. The interaction between light and teeth (absorption, scattering and fluorescence) is intrinsically connected to the constitution of the dental tissue. Decay induced mineral loss introduces a shift in the optical properties of the affected tissue; therefore, study of these properties may produce novel techniques aimed at the early diagnosis of carious lesions. Based on the optical properties of the enamel, we demonstrate the application of first-order spatial statistics in laser speckle imaging, allowing the detection of carious lesions in their early stages. A highlight of this noninvasive, non-destructive, real time and cost effective approach is that it allows a dentist to detect a lesion even in the absence of biofilm or moisture. (paper)

  2. Dataset for the quantitative proteomics analysis of the primary hepatocellular carcinoma with single and multiple lesions

    Directory of Open Access Journals (Sweden)

    Xiaohua Xing

    2015-12-01

    Full Text Available Hepatocellular Carcinoma (HCC is one of the most common malignant tumor, which is causing the second leading cancer-related death worldwide. The tumor tissues and the adjacent noncancerous tissues obtained from HCC patients with single and multiple lesions were quantified using iTRAQ. A total of 5513 proteins (FDR of 1% were identified which correspond to roughly 27% of the total liver proteome. And 107 and 330 proteins were dysregulated in HCC tissue with multiple lesions (MC group and HCC tissue with a single lesion (SC group, compared with their noncancerous tissue (MN and SN group respectively. Bioinformatics analysis (GO, KEGG and IPA allowed these data to be organized into distinct categories. The data accompanying the manuscript on this approach (Xing et al., J. Proteomics (2015, http://dx.doi.org/10.1016/j.jprot.2015.08.007 [1] have been deposited to the iProX with identifier IPX00037601.

  3. A New Method for Segmentation of Multiple Sclerosis (MS Lesions on Brain MR Images

    Directory of Open Access Journals (Sweden)

    Simin Jafari

    2015-07-01

    Full Text Available Automatic segmentation of multiple sclerosis (MS lesions in brain MRI has been widely investigated in recent years with the goal of helping MS diagnosis and patient follow-up. In this study we applied gaussian mixture model (GMM to segment MS lesions in MR images. Usually, GMM is optimized using expectation-maximization (EM algorithm. One of the drawbacks of this optimization method is that, it does not convergence to optimal maximum or minimum. Starting from different initial points and saving best result, is a strategy which is used to reach the near optimal. This approach is time consuming and we used another way to initiate the EM algorithm. Also, FAST- Trimmed Likelihood Estimator (FAST-TLE algorithm was applied to determine which voxels should be rejected. The automatically segmentation outputs were scored by two specialists and the results show that our method has capability to segment the MS lesions with Dice similarity coefficient (DSC score of 0.82.

  4. Lesion in Scalp and Skull as the First Manifestation of Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    V. R. Ferraz

    2016-01-01

    Full Text Available Hepatocellular carcinoma (HCC is the most common primary tumor of the liver and the fifth most common cancer in the world. The lungs, bone, and lymph nodes are frequent sites of metastasis of HCC. The purpose of the present study is show that metastases, although rare, must be among the differential diagnosis of skin lesions and that a diagnostic research based on these findings can be conducted. The authors report a rare case of metastatic hepatocellular injury to the scalp and skull treated by a radical surgical approach. Excision of the lesion in the scalp was performed “en bloc.” The tumor was supplied by the frontal branch of the superficial temporal artery. There are few case reports of metastatic HCC to scalp and skull; treatment of these lesions should be individualized in order to control symptoms, improve quality of life, and promote an increase in survival.

  5. Representation learning for mammography mass lesion classification with convolutional neural networks.

    Science.gov (United States)

    Arevalo, John; González, Fabio A; Ramos-Pollán, Raúl; Oliveira, Jose L; Guevara Lopez, Miguel Angel

    2016-04-01

    The automatic classification of breast imaging lesions is currently an unsolved problem. This paper describes an innovative representation learning framework for breast cancer diagnosis in mammography that integrates deep learning techniques to automatically learn discriminative features avoiding the design of specific hand-crafted image-based feature detectors. A new biopsy proven benchmarking dataset was built from 344 breast cancer patients' cases containing a total of 736 film mammography (mediolateral oblique and craniocaudal) views, representative of manually segmented lesions associated with masses: 426 benign lesions and 310 malignant lesions. The developed method comprises two main stages: (i) preprocessing to enhance image details and (ii) supervised training for learning both the features and the breast imaging lesions classifier. In contrast to previous works, we adopt a hybrid approach where convolutional neural networks are used to learn the representation in a supervised way instead of designing particular descriptors to explain the content of mammography images. Experimental results using the developed benchmarking breast cancer dataset demonstrated that our method exhibits significant improved performance when compared to state-of-the-art image descriptors, such as histogram of oriented gradients (HOG) and histogram of the gradient divergence (HGD), increasing the performance from 0.787 to 0.822 in terms of the area under the ROC curve (AUC). Interestingly, this model also outperforms a set of hand-crafted features that take advantage of additional information from segmentation by the radiologist. Finally, the combination of both representations, learned and hand-crafted, resulted in the best descriptor for mass lesion classification, obtaining 0.826 in the AUC score. A novel deep learning based framework to automatically address classification of breast mass lesions in mammography was developed. Copyright © 2015 Elsevier Ireland Ltd. All rights

  6. External and internal resin infiltration of natural proximal subsurface caries lesions: A valuable enhancement of the internal tunnel restoration.

    Science.gov (United States)

    Kielbassa, Andrej M; Ulrich, Ina; Werth, Vanessa D; Schüller, Christoph; Frank, Wilhelm; Schmidl, Rita

    2017-01-01

    The aim of this ex-vivo study was to evaluate both the external and the internal penetration ability of a resin infiltrant into natural proximal and macroscopically intact white spot lesions, and to merge this approach with the internal tunnel preparation concept. 20 premolars and 20 molars with proximal subsurface lesions (ICDAS, code 2) and respective radiographic lesion depths extending into the middle third of dentin (D2 lesions) were selected and divided into two groups. Treatment needs were confirmed using digital imaging fiber-optic transillumination and laser fluorescence. Deproteinization (NaOCl; 2%) followed, and lesions of Group 1 (control; n = 20) were etched (HCl; 15%) and externally infiltrated (Icon). Accordingly, the specimens of Group 2 (n = 20) were treated with the resin infiltrant from external; then, internal Class I tunnels were prepared, lesions were internally infiltrated (Icon), and the occlusal cavities were restored (G-ænial Flo X) after etching (H3PO4 gel; 40%). Teeth were cut perpendicular to the proximal lesion surfaces, and percentage infiltrations were analyzed using confocal laser microscopy and a dedicated image manipulation program (GIMP). Regarding the external infiltration, no differences between both groups were detected (P = .114; Mann-Whitney). Additional internal application of the resin infiltrant significantly increased the percentage amount of enamel lesion infiltration (P < .0001; Wilcoxon). External and internal infiltration seem to complement the internal tunnel approach, thus remediating the drawbacks of the latter by occluding and stabilizing the porous areas of the proximal caries lesion, and preserving both the marginal ridge and the proximal contact area.

  7. Benign breast lesions in an African population: A 25-year ...

    African Journals Online (AJOL)

    The single most common lesion was fibroadenoma accounting for 43.1% of cases, followed by fibrocystic change (23.8%) with mean ages of 22.3 years and 30.2 years, respectively. Both lesions had a peak occurrence in the third decade. Other major lesions encountered were sclerosing adenosis (7.3%), atypical ductal ...

  8. Multidetector computed tomography of jaw lesions in children and adolescents

    International Nuclear Information System (INIS)

    Gadodia, A.; Seith, A.; Sharma, R.; Choudhury, A.R.; Bhutia, O.; Gupta, A.

    2010-01-01

    Full text: Jaw lesions in paediatric and adolescent population are uncommon and can arise in odontogenic or non-odontogenic tissues. With the advent of multidetector computed tomography (MDCT), algorithm for imaging jaw lesions has changed dramatically. This pictorial essay describes the imaging appearance of commonly encountered jaw lesions in children and adolescents with emphasis on MDCT findings

  9. 21 CFR 882.4725 - Radiofrequency lesion probe.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiofrequency lesion probe. 882.4725 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4725 Radiofrequency lesion probe. (a) Identification. A radiofrequency lesion probe is a device connected to a radiofrequency (RF...

  10. Predictive features for histology of gastric subepithelial lesions

    OpenAIRE

    SCHULZ, Ricardo Teles; FABIO, Lizandra Castilho; FRANCO, Matheus Cavalcante; SIQUEIRA, Sheila A; SAKAI, Paulo; MALUF-FILHO, Fauze

    2017-01-01

    ABSTRACT BACKGROUND Gastric subepithelial lesion is a relatively common diagnosis after routine upper endoscopy. The diagnostic workup of an undetermined gastric subepithelial lesion should take into consideration clinical and endoscopic features. OBJECTIVE We aimed to investigate the association between patients' characteristics, endoscopic and echographic features with the histologic diagnosis of the gastric subepithelial lesions. METHODS This is a retrospective study with 55 patients, w...

  11. Retrospective Survey of Biopsied Oral Lesions in Pediatric Patients

    Directory of Open Access Journals (Sweden)

    Yin-Lin Wang

    2009-11-01

    Conclusion: The mucous extravasation phenomenon, odontoma, or dentigerous cyst was the most common inflammatory and reactive, neoplastic, or cystic lesion, respectively, in pediatric patients. The relatively high incidence of inflammatory and reactive lesions in pediatric patients implies the importance of stringent oral hygiene in children. Most oral neoplastic lesions in pediatric patients are benign, and malignant oral tumors rarely occur in pediatric patients.

  12. Peripheral Exophytic Oral Lesions: A Clinical Decision Tree

    Directory of Open Access Journals (Sweden)

    Hamed Mortazavi

    2017-01-01

    Full Text Available Diagnosis of peripheral oral exophytic lesions might be quite challenging. This review article aimed to introduce a decision tree for oral exophytic lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of keywords such as “oral soft tissue lesion,” “oral tumor like lesion,” “oral mucosal enlargement,” and “oral exophytic lesion.” Related English-language articles published since 1988 to 2016 in both medical and dental journals were appraised. Upon compilation of data, peripheral oral exophytic lesions were categorized into two major groups according to their surface texture: smooth (mesenchymal or nonsquamous epithelium-originated and rough (squamous epithelium-originated. Lesions with smooth surface were also categorized into three subgroups according to their general frequency: reactive hyperplastic lesions/inflammatory hyperplasia, salivary gland lesions (nonneoplastic and neoplastic, and mesenchymal lesions (benign and malignant neoplasms. In addition, lesions with rough surface were summarized in six more common lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method.

  13. management of clinically indefinite right iliac fossa lesions

    African Journals Online (AJOL)

    MANAGEMENT OF CLINICALLY INDEFINITE RIGHT ILIAC FOSSA LESIONS. A Abdel-Razek, A Afifi, A-A El Nekeidy. Abstract. Many diseases can cause lesions in right iliac fossa with indefinite clinical presentations. Improper diagnosis, missed lesions and unexpected morbidity may follow variable clinical puzzles.

  14. Histologic Analysis of Gynaecologic Lesions in Nigerians | Keshinro ...

    African Journals Online (AJOL)

    Uterine leiomyomas were the most common lesions and majority of them were seen in age groups 30-39 and 40-49 years. Simple endometrial hyperplasia without atypia accounted for most endometrial lesions (52,3%) and were seen more in age groups 30-39 and 40-49 years. Most ovarian lesions (45.9%) were non ...

  15. A residual cystic lesion in acute disseminated encephalomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Go, T. [Otsu Red Cross Hospital, Nagara (Japan). Dept. of Paediatrics; Imai, T. [Kyoto Univ. School of Medicine, Kyoto (Japan). Dept. of Paediatrics

    2000-09-01

    We report a case of acute disseminated encephalomyelitis (ADEM) with a residual cystic lesion on MRI. This seemed to be induced by Japanese encephalitis vaccination. Despite complete clinical improvement with high-dose steroid therapy, the cystic lesion has persisted for 3 years on MRI. There have been no previous reports of residual cystic lesions in ADEM. (orig.)

  16. High-definition optical coherence tomography imaging of melanocytic lesions

    DEFF Research Database (Denmark)

    Boone, Marc A L M; Norrenberg, Sarah; Jemec, Gregor B E

    2014-01-01

    and cytologic features of melanocytic lesions. All lesions were examined by one observer clinically and using dermoscopy. Cross-sectional HD-OCT images were compared with histopathology. En face HD-OCT images were compared with reflectance confocal microscopy (RCM). Twenty-six melanocytic lesions of 26 patients...

  17. Detection activity assessment and diagnosis of dental caries lesions

    DEFF Research Database (Denmark)

    Braga, Mariana M; Mendes, Fausto M; Ekstrand, Kim R

    2010-01-01

    This article reviews the current methods for detection and assessment of caries lesions focusing on applicability for daily clinical practice. The end point is to arrive at a diagnosis for each caries lesion. Visual inspection aided by a ball-ended probe is essential for caries lesions assessment...

  18. Magnetic resonance imaging guided biopsy of musculoskeletal lesions

    Directory of Open Access Journals (Sweden)

    Hung-Ta H. Wu

    2012-04-01

    Conclusion: Biopsy under MRI guidance is especially valuable for the localization of bone marrow lesions, viable tumors (after chemotherapy or radiation, and lesions that cannot be visualized using CT. It is both accurate and safe, is a good alternative biopsy method, and may be a good adjunctive technique for the localization of bone lesions for radiofrequency ablation or other interventional procedures.

  19. Sonographic Findings of Morel-Lavalle'e Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Yu Jin; Yang, Ik; Lee, Yul; Woo, Ji Young; Hong, Hye Suk; Jung, Ah Young; Jeh, Su Kyung [Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul (Korea, Republic of)

    2011-09-15

    We reviewed the sonographic features of Morel-Lavalle'e lesions by correlating the US image findings with a lesion's age. We obtained the sonography reports of 20 Morel-Lavalle'e lesions of the hip and extremities from 18 patients with a history of trauma. The US images were reviewed to characterize the echogenicity, shape, homogeneity, margins, location and size of the lesions. The results were correlated with the age of the lesions and the clinical histories. All the Morel-Lavalle'e lesions were hypoechoic or anechoic fluid collections located between the subcutaneous fat and the underlying fascia. Regarding the shape of the fluid collections, the lobular shaped lesions were all less than 21 days for the lesion's age, and the flat fluid collections were all greater than 1 month of age. Regarding the homogeneity, the heterogeneous fluid collections were all less than 25 days of age, and the homogeneous fluid collections were all greater than 1 month of age. A Morel-Lavalle'e lesion is seen as a posttraumatic fluid collection in the potential space between the subcutaneous fat and the underlying fascia on an ultrasound examination. Acute Morel-Lavalle'e lesions tended to be heterogeneous and lobular, and they became more homogeneous and flat in shape as the lesions evolved. Awareness of these imaging findings will help us to properly diagnose Morel- Lavalle'e lesions

  20. 21 CFR 882.4400 - Radiofrequency lesion generator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiofrequency lesion generator. 882.4400 Section 882.4400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... lesion generator. (a) Identification. A radiofrequency lesion generator is a device used to produce...

  1. 21 CFR 882.5500 - Lesion temperature monitor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Lesion temperature monitor. 882.5500 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5500 Lesion temperature monitor. (a) Identification. A lesion temperature monitor is a device used to monitor the tissue...

  2. Morphological spectrum of non‑neoplastic lesions of the uterine ...

    African Journals Online (AJOL)

    Background: The uterine cervix is a gateway to several non‑neoplastic and neoplastic gynecological lesions. Most of these non‑neoplastic lesions are commonly found in women of reproductive age. These lesions constitute a source of morbidity and mortality in women worldwide hence the need to analyze them to provide ...

  3. Outcome of breast lesions detected at screening ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Ja, E-mail: winnerkim89@gmail.com [Department of Radiology, Seoul Metropolitan Government Seoul National University, Boramae Medical Center, 41, Boramae-gil, Dongjak-gu, Seoul 156-707 (Korea, Republic of); Chang, Jung Min, E-mail: imchangjm@gmail.com [Department of Radiology, Seoul National University Hospital, 28, Yongon-dong, Chongno-gu, Seoul 100-744 (Korea, Republic of); Cho, Nariya, E-mail: river7774@gmail.com [Department of Radiology, Seoul National University Hospital, 28, Yongon-dong, Chongno-gu, Seoul 100-744 (Korea, Republic of); Chung, Se-Yeong, E-mail: jsyuni@hanmail.net [Healthcare System Gangnam Center, Seoul National University Hospital, 737, Gangnam Finance Center, Yeoksam-dong, Gangnam-gu, Seoul 135-984 (Korea, Republic of); Han, Wonshik, E-mail: hanw@snu.ac.kr [Department of Surgery, Seoul National University Hospital, 28, Yongon-dong, Chongno-gu, Seoul 100-744 (Korea, Republic of); Moon, Woo Kyung, E-mail: moonwk@snu.ac.kr [Department of Radiology, Seoul National University Hospital, 28, Yongon-dong, Chongno-gu, Seoul 100-744 (Korea, Republic of)

    2012-11-15

    Objective: To assess the final outcome of breast lesions detected during screening ultrasonography (US) and categorized by BI-RADS final assessment. Materials and methods: During a 1-year period, 3817 consecutive asymptomatic women with negative findings at both clinical breast examinations and mammography underwent bilateral whole breast US and BI-RADS categories were provided for US-detected breast lesions. The reference standard was a combination of histology and US follow-up ({>=}12 months), and the final outcomes of 1192 US-detected lesions were analyzed. Results: Of 904 category 2 lesions, 890 remained stable for 12-60 months. Biopsies of 14 lesions revealed no malignancies (NPV = 100%). Of 247 category 3 lesions, 232 remained stable for 12-60 months. Biopsies of 15 lesions revealed 2 malignancies, which were diagnosed within 6 months of the index examination and were node negative (NPV = 99.2%). Of 41 category 4 lesions, biopsies of 38 lesions revealed 5 malignancies (PPV = 12.2%), and 3 remained stable for 37-51 months. No US-detected lesion was classified as category 5. Conclusion: The rates of malignancy for US-detected BI-RADS categories 2, 3, and 4 lesions were 0%, 0.8%, and 12.2%, respectively. The final assessment of US BI-RADS categorization showed it to be an appropriate predictor of malignancy for screening US-detected breast lesions.

  4. Crusade Microcatheter-Facilitated Reverse Wire Technique for Revascularization of Bifurcation Lesions of Coronary Arteries.

    Science.gov (United States)

    Lee, Hsin-Fu; Chou, Shing-Hsien; Tung, Ying-Chang; Lin, Chia-Pin; Ko, Yu-Shien; Chang, Chi-Jen

    2018-01-01

    This study aims to analyze the lesion characteristics of bifurcations that required reverse wire technique and the efficacy and safety of this technique in approaching branches with a highly angulated take-off. We enrolled patients in whom reverse wire technique was used after failed conventional antegrade wiring with the support of a Crusade catheter. The study endpoints were the technical success defined as succeeding in sending the reversely bent wire to the targeted branches without complications and the procedural success defined as succeeding in revascularization of the bifurcation lesions without complications. Among 158 patients with bifurcation lesions undergoing percutaneous coronary intervention using a Crusade catheter to facilitate wiring, 23 (14.6%) requiring the reverse wire technique in an attempt to access branches of the bifurcation lesions with an acutely angulated take-off were enrolled for analysis. The obtainable angle of take-off was 162.9 ± 4.7 degrees. For the parent vessel, the ostium of the targeted branch, and nontargeted branch, the minimal luminal diameters were 0.3 ± 0.5 mm, 0.4 ± 0.2 mm, and 1.8 ± 0.5 mm, respectively; the diameter stenosis were 88.8 ± 18.5%, 83.0 ± 7.3%, and 32.0 ± 14.5%, respectively. Technical and procedural success was achieved in 22 cases (96% for both). We showed in the present study that the reverse wire technique is effective and safe for approaching highly angulated branches of bifurcation lesions and consequently for complete revascularization of difficult bifurcation lesions.

  5. Clinical and angiographic predictors of haemodynamically significant angiographic lesions: development and validation of a risk score to predict positive fractional flow reserve.

    Science.gov (United States)

    Sareen, Nishtha; Baber, Usman; Kezbor, Safwan; Sayseng, Sonny; Aquino, Melissa; Mehran, Roxana; Sweeny, Joseph; Barman, Nitin; Kini, Annapoorna; Sharma, Samin K

    2017-04-07

    Coronary revascularisation based upon physiological evaluation of lesions improves clinical outcomes. Angiographic or visual stenosis assessment alone is insufficient in predicting haemodynamic stenosis severity by fractional flow reserve (FFR) and therefore cannot be used to guide revascularisation, particularly in the lesion subset system formulated. Of 1,023 consecutive lesions (883 patients), 314 (31%) were haemodynamically significant. Characteristics associated with FFR ≤0.8 include male gender, higher SYNTAX score, lesions ≥20 mm, stenosis >50%, bifurcation, calcification, absence of tortuosity and smaller reference diameter. A user-friendly integer score was developed with the five variables demonstrating the strongest association. On prospective validation (in 279 distinct lesions), the increasing value of the score correlated well with increasing haemodynamic significance (C-statistic 0.85). We identified several clinical and angiographic characteristics and formulated a scoring system to guide the approach to intermediate lesions. This may translate into cost savings. Larger studies with prospective validation are required to confirm our results.

  6. Weighted locality-constrained linear coding for lesion classification in CT images.

    Science.gov (United States)

    Yuan, Yixuan; Hoogi, Assaf; Beaulieu, Christopher F; Meng, Max Q-H; Rubin, Daniel L

    2015-01-01

    Computed tomography is a popular imaging modality for detecting abnormalities associated with abdominal organs such as the liver, kidney and uterus. In this paper, we propose a novel weighted locality-constrained linear coding (LLC) method followed by a weighted max-pooling method to classify liver lesions into three classes: cysts, metastases, hemangiomas. We first divide the lesions into same-size patches. Then, we extract the raw features in all patches followed by Principal Components Analysis (PCA) and apply K means to obtain a single LLC dictionary. Since the interior lesion patches and the boundary patches contribute different information in the image, we assign different weights on these two types of patches to obtain the LLC codes. Moreover, a weighted max pooling approach is also proposed to further evaluate the importance of these two types of patches in feature pooling. Experiments on 109 images of liver lesions were carried out to validate the proposed method. The proposed method achieves a best lesion classification accuracy of 96.33%, which appears to be superior compared with traditional image coding methods: LLC method and Bag-of-words method (BoW) and traditional features: Local Binary Pattern (LBP) features, uniform LBP and complete LBP, demonstrating that the proposed method provides better classification.

  7. Theoretical evaluation of the detectability of random lesions in bayesian emission reconstruction

    International Nuclear Information System (INIS)

    Qi, Jinyi

    2003-01-01

    Detecting cancerous lesion is an important task in positron emission tomography (PET). Bayesian methods based on the maximum a posteriori principle (also called penalized maximum likelihood methods) have been developed to deal with the low signal to noise ratio in the emission data. Similar to the filter cut-off frequency in the filtered backprojection method, the prior parameters in Bayesian reconstruction control the resolution and noise trade-off and hence affect detectability of lesions in reconstructed images. Bayesian reconstructions are difficult to analyze because the resolution and noise properties are nonlinear and object-dependent. Most research has been based on Monte Carlo simulations, which are very time consuming. Building on the recent progress on the theoretical analysis of image properties of statistical reconstructions and the development of numerical observers, here we develop a theoretical approach for fast computation of lesion detectability in Bayesian reconstruction. The results can be used to choose the optimum hyperparameter for the maximum lesion detectability. New in this work is the use of theoretical expressions that explicitly model the statistical variation of the lesion and background without assuming that the object variation is (locally) stationary. The theoretical results are validated using Monte Carlo simulations. The comparisons show good agreement between the theoretical predications and the Monte Carlo results

  8. Cyclooxygenase-2 expression in central giant cell lesion of the jaws: an immunohistochemical study.

    Science.gov (United States)

    Nogueira, Renato Luiz Maia; Faria, Mário Henrique Girão; Osterne, Rafael Lima Verde; Cavalcante, Roberta Barroso; Ribeiro, Ronaldo Albuquerque; Rabenhorst, Silvia Helena Barem

    2012-02-01

    Central Giant Cell Lesion (CGCL) is an uncommon benign jaw lesion, with uncertain etiology, and a variable clinical behavior. Studies of molecular markers of CGCL, may help understanding better the nature and behavior of this lesion, and eventually may represent a definitive target to pharmacological approach in the treatment of CGCL. Chronic inflammation has been found to mediate a wide variety of diseases including neoplasms. Among the gene products involved in the induction of the inflammatory process, Cyclooxygenase 2 (COX-2) has been shown to have a close relationship with tumorigenesis, however COX-2 expression has never been evaluated in CGCL. The aim of the study was to investigate the expression of COX-2 in CGCL. Immunohistochemical assessment for COX-2 expression was performed in 18 patients previously diagnosed with CGCL. Multinucleated giant cells (MGC) and mononucleated stromal cells (MSC) were used in the slide analysis. Among the patients studied, 10 were male and 8 were female, with a median age of 15.4 years. Lesions in the mandible were observed in 11 cases and 7 were found in the maxilla. There were 9 aggressive and 9 non-aggressive CGCLs. COX-2 immunopositivity was present in only 3 cases stained in both MGC and MSC. All 3 cases presented with ulcerations in the mucosa lesion, suggesting that the COX-2 expression is due to the presence of inflammation. This study does not support the involvement of COX-2 in the etiophatogenesis of CGCL.

  9. Differentiation of benign and malignant lung lesions: Dual-Energy Computed Tomography findings

    International Nuclear Information System (INIS)

    González-Pérez, Víctor; Arana, Estanislao; Barrios, María; Bartrés, Albert; Cruz, Julia; Montero, Rafael; González, Manuel; Deltoro, Carlos; Martínez-Pérez, Encarnación; De Aguiar-Quevedo, Karol; Arrarás, Miguel

    2016-01-01

    Purpose: To determine whether parameters generated by Dual-Energy Computed Tomography (DECT) can distinguish malignant from benign lung lesions. Methods: A prospective review of 125 patients with 126 lung lesions (23 benign and 103 malignant) who underwent lung DECT during arterial phase. All lesions were confirmed by tissue sampling. A radiologist semi-automatically contoured lesions and placed regions of interest (ROIs) in paravertebral muscle (PVM) for normalization. Variables related to absorption in Hounsfield units (HU), effective atomic number (Z eff ), iodine concentration (ρ I ) and spectral CT curves were assessed. Receiver operating characteristic (ROC) curves were generated to calculate sensitivity and specificity as predictors of malignancy. Multivariate logistic regression analysis was performed. Results: Reproducibility of measures normalized with PVM was poor. Bivariate analysis showed minimum Z eff and normalized mean Z eff to be statistically significant (p = 0.001), with area under the curve (AUC) values: 0.66 (CI 95% 0.54–0.80) and 0.72 (CI 95%, 0.60–0.84), respectively. Logistic regression models showed no differences between raw and normalized measurements. In both models, minimum HU (OR: 0.9) and size (OR: 0.1) were predictive of benign lesions. Conclusions: A quantitative approach to DECT using raw measurements is simpler than logistic regression models. Normalization to PVM was not clinically reliable due to its poor reproducibility. Further studies are needed to confirm our findings.

  10. Differentiation of benign and malignant lung lesions: Dual-Energy Computed Tomography findings.

    Science.gov (United States)

    González-Pérez, Víctor; Arana, Estanislao; Barrios, María; Bartrés, Albert; Cruz, Julia; Montero, Rafael; González, Manuel; Deltoro, Carlos; Martínez-Pérez, Encarnación; De Aguiar-Quevedo, Karol; Arrarás, Miguel

    2016-10-01

    To determine whether parameters generated by Dual-Energy Computed Tomography (DECT) can distinguish malignant from benign lung lesions. A prospective review of 125 patients with 126 lung lesions (23 benign and 103 malignant) who underwent lung DECT during arterial phase. All lesions were confirmed by tissue sampling. A radiologist semi-automatically contoured lesions and placed regions of interest (ROIs) in paravertebral muscle (PVM) for normalization. Variables related to absorption in Hounsfield units (HU), effective atomic number (Zeff), iodine concentration (ρI) and spectral CT curves were assessed. Receiver operating characteristic (ROC) curves were generated to calculate sensitivity and specificity as predictors of malignancy. Multivariate logistic regression analysis was performed. Reproducibility of measures normalized with PVM was poor. Bivariate analysis showed minimum Zeff and normalized mean Zeff to be statistically significant (p=0.001), with area under the curve (AUC) values: 0.66 (CI 95% 0.54-0.80) and 0.72 (CI 95%, 0.60-0.84), respectively. Logistic regression models showed no differences between raw and normalized measurements. In both models, minimum HU (OR: 0.9) and size (OR: 0.1) were predictive of benign lesions. A quantitative approach to DECT using raw measurements is simpler than logistic regression models. Normalization to PVM was not clinically reliable due to its poor reproducibility. Further studies are needed to confirm our findings. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Simulation of high-intensity focused ultrasound lesions in presence of boiling.

    Science.gov (United States)

    Grisey, Anthony; Yon, Sylvain; Letort, Véronique; Lafitte, Pauline

    2016-01-01

    The lesions induced by high-intensity focused ultrasound (HIFU) thermal ablations are particularly difficult to simulate due to the complexity of the involved phenomena. In particular, boiling has a strong influence on the lesion shape. Thus, it must be accounted for if it happens during the pulses to be modeled. However, no acoustic model enables the simulation of the resulting wave scattering. Therefore, we propose an equivalent model for the heat deposition pattern in the presence of boiling. Firstly, the acoustic field is simulated with k-Wave and the heat source term is calculated. Then, a thermal model is designed, including the equivalent model for boiling. It is rigorously calibrated and validated through the use of diversified ex vivo and in vivo data, including usually unexploited data types related to the bubble clouds. The proposed model enabled to efficiently simulate unitary pulses properties, including the sizes of the lesions, their morphology, the boiling onset time, and the influence of the boiling onset time on the lesions sizes. In this article, the whole procedure of model design, calibration, and validation is discussed. In addition to depicting the creative use of data, our modeling approach focuses on the understanding of the mechanisms influencing the shape of the lesion. Further work is required to study the influence of the remaining bubble clouds in the context of pulse groups.

  12. Nonsurgical Clinical Management of Periapical Lesions Using Calcium Hydroxide-Iodoform-Silicon-Oil Paste

    Directory of Open Access Journals (Sweden)

    Qusai Al Khasawnah

    2018-01-01

    Full Text Available Background. The study aim is to avoid tooth extraction by nonsurgical treatment of periapical lesion. It assesses healing progress in response to calcium hydroxide-iodoform-silicon oil paste (CHISP. Numeric Pain Rating Scale was used to validate the approach. Furthermore, CHISP was used to treat cystic lesions secondary to posttraumatic avulsion of permanent teeth. Materials and Methods. Over 200 patients with radicular cysts were treated with CHISP through the root canal. Radiographs were used to verify lesion size and position, ensure correct delivery to the site, and monitor the progress of bone healing in the lesion area. Ten males and 10 females were randomly selected for statistical assessment. Results. No severe pain, complications, or failure in cyst healing was reported. Complete healing was achieved in an average of 75 days. Furthermore, healing of radicular cyst secondary to posttraumatic tooth avulsion was successful. Conclusion. CHISP indicated an antiseptic effect, which enhanced and shortened healing time of periapical lesions. The less invasive procedure avoids tooth extraction and reduces bone resorption. Cyst management with CHISP can remedy failed root canal treatments. The results show a bone regenerative capacity of CHISP suggested in first rapid phase and a second slow phase.

  13. Multimodal ultrasonographic characterisation of parotid gland lesions-A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Knopf, Andreas, E-mail: a.knopf@lrz.tum.de [Technische Universitaet Muenchen, Hals-Nasen-Ohrenklinik und Poliklinik, Ismaningerstrasse 22, 81675 Muenchen (Germany); Mansour, Naglaa; Chaker, Adam; Bas, Murat [Technische Universitaet Muenchen, Hals-Nasen-Ohrenklinik und Poliklinik, Ismaningerstrasse 22, 81675 Muenchen (Germany); Stock, Konrad [Technische Universitaet Muenchen, Abteilung fuer Nephrologie der II. Medizinischen Klinik und Poliklinik, Ismaningerstrasse 22, 81675 Muenchen (Germany)

    2012-11-15

    Objectives: Lesions of the major salivary glands represent a heterogeneous group comprising infectious, autoimmune, and neoplastic disorders. The reliable pre-operative assessment of the lesional dignity might reduce patient's morbidity preventing re-surgery. To date, there exists no imaging technique which reliably distinguishes tumour entities. Methods: 35 parotid lesions were analysed in this study. B-mode ultrasound, colour duplex imaging and contrast enhanced ultrasound were applied for all patients. After fractionated boli of 4.8 ml SonoVue{sup Registered-Sign} perfusion kinetics, time to peak (TP) and mean transit time (MTT), were analysed for intraparotideal lesion and were normalised by circumjacent parotid tissue. Ultrasonographic data was structured in a multimodal diagnostic pathway. Results: B-mode ultrasound identifies six lymphoepithelial lesions due to Sjoegren's syndrome (p: 0.0001). CDS further differentiates hypovascularised pleomorphic adenoma from hypervascularised Warthin's tumours, monomorphic adenomas, and carcinomas (p < 0.0001). Application of CEUS detected Warthin's tumours being significantly hypervascularised compared to monomorphic adenomas (MTT, p < 0.05) and carcinomas (MTT, p < 0.02). Conclusions: A multimodal diagnostic pathway unifies different ultrasonographic techniques and identifies pleomorphic adenomas, Warthin's tumours and carcinomas with sensitivities of 100%. Further studies have to be performed to validate this diagnostic approach and to specify monomorphic adenomas.

  14. A Cellular Neural Network methodology for the automated segmentation of multiple sclerosis lesions.

    Science.gov (United States)

    Cerasa, Antonio; Bilotta, Eleonora; Augimeri, Antonio; Cherubini, Andrea; Pantano, Pietro; Zito, Giancarlo; Lanza, Pierluigi; Valentino, Paola; Gioia, Maria C; Quattrone, Aldo

    2012-01-15

    We present a new application based on genetic algorithms (GAs) that evolves a Cellular Neural Network (CNN) capable of automatically determining the lesion load in multiple sclerosis (MS) patients from magnetic resonance imaging (MRI). In particular, it seeks to identify brain areas affected by lesions, whose presence is revealed by areas of higher intensity if compared to healthy tissue. The performance of the CNN algorithm has been quantitatively evaluated by comparing the CNN output with the expert's manual delineation of MS lesions. The CNN algorithm was run on a data set of 11 MS patients; for each one a single dataset of MRI images (matrix resolution of 256×256 pixels) was acquired. Our automated approach gives satisfactory results showing that after the learning process the CNN is capable of detecting MS lesions with different shapes and intensities (mean DICE coefficient=0.64). The system could provide a useful support tool for the evaluation of lesions in MS patients, although it needs to be evolved and developed in the future. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Differentiation of benign and malignant lung lesions: Dual-Energy Computed Tomography findings

    Energy Technology Data Exchange (ETDEWEB)

    González-Pérez, Víctor [Dept Radiophysics, Foundation IVO, Valencia (Spain); Arana, Estanislao, E-mail: aranae@uv.es [Dept Radiology, Foundation IVO, Valencia (Spain); Barrios, María [Dept Radiology, Foundation IVO, Valencia (Spain); Bartrés, Albert [Dept Radiophysics, Foundation IVO, Valencia (Spain); Cruz, Julia [Dept Pathology, Foundation IVO, Valencia (Spain); Montero, Rafael [GE Healthcare Diagnostic Imaging, Iberia (Spain); González, Manuel; Deltoro, Carlos [Dept Radiology, Foundation IVO, Valencia (Spain); Martínez-Pérez, Encarnación [Dept Pneumology, Foundation IVO, Valencia (Spain); De Aguiar-Quevedo, Karol; Arrarás, Miguel [Dept Thoracic Surgery, Foundation IVO, Valencia (Spain)

    2016-10-15

    Purpose: To determine whether parameters generated by Dual-Energy Computed Tomography (DECT) can distinguish malignant from benign lung lesions. Methods: A prospective review of 125 patients with 126 lung lesions (23 benign and 103 malignant) who underwent lung DECT during arterial phase. All lesions were confirmed by tissue sampling. A radiologist semi-automatically contoured lesions and placed regions of interest (ROIs) in paravertebral muscle (PVM) for normalization. Variables related to absorption in Hounsfield units (HU), effective atomic number (Z{sub eff}), iodine concentration (ρ{sub I}) and spectral CT curves were assessed. Receiver operating characteristic (ROC) curves were generated to calculate sensitivity and specificity as predictors of malignancy. Multivariate logistic regression analysis was performed. Results: Reproducibility of measures normalized with PVM was poor. Bivariate analysis showed minimum Z{sub eff} and normalized mean Z{sub eff} to be statistically significant (p = 0.001), with area under the curve (AUC) values: 0.66 (CI 95% 0.54–0.80) and 0.72 (CI 95%, 0.60–0.84), respectively. Logistic regression models showed no differences between raw and normalized measurements. In both models, minimum HU (OR: 0.9) and size (OR: 0.1) were predictive of benign lesions. Conclusions: A quantitative approach to DECT using raw measurements is simpler than logistic regression models. Normalization to PVM was not clinically reliable due to its poor reproducibility. Further studies are needed to confirm our findings.

  16. ROLE OF SINGLE VOXEL PROTON MAGNETIC RESONANCE SPECTROSCOPY ON A 3 TESLA MR SCANNER IN CHARACTERISING BREAST LESIONS- A TERTIARY CARE CENTRE EXPERIENCE IN EASTERN INDIA

    Directory of Open Access Journals (Sweden)

    Archana Singh

    2016-12-01

    Full Text Available BACKGROUND To evaluate whether the detection of choline-containing compounds in single voxel MR spectroscopy of breast lesions can differentiate between benign and malignant breast lesions. MATERIALS AND METHODS This prospective observational study included 99 breast lesions in 77 patients (between 18 and 86 years age who underwent 3T breast MRI including proton MR spectroscopy before biopsy. Following dynamic contrast-enhanced study, single voxel, water and fat suppressed proton MR spectroscopy was performed. The position and size of the Volume of Interest (VOI was placed so as to include the enhancing part of the lesion and excluding as much as possible the nonenhancing gland parenchyma, adjoining fat or necrotic part of the lesion. Choline peak at 3.2 ppm was qualitatively evaluated. MRI BIRADS scoring was done for each lesion. Sensitivity and specificity of the (1 H-MRS were calculated. Final histopathological diagnosis was taken as the gold standard. RESULTS According to histopathology, 53 lesions were malignant and 46 were benign. The qualitative approach based on presence or absence of choline peak yielded 88.68% [95% CI 76.97% to 95.73%] sensitivity and 76.09% [95% CI 61.23 to 87.41%] specificity for differentiating malignant and benign lesions (p<0.0001. CONCLUSION In vivo proton, MR spectroscopy can be used as an adjunctive tool for characterising breast lesions. However, the detection of choline-containing compounds is not specific for malignancy. Benign breast lesions may also demonstrate choline peak.

  17. Early Results of Retrograde Transpopliteal Angioplasty of Iliofemoral Lesions

    International Nuclear Information System (INIS)

    Saha, Saumitra; Gibson, Matthew; Magee, Timothy R.; Galland, Robert B.; Torrie, E. Peter H.

    2001-01-01

    Purpose: To assess whether the retrograde transpopliteal approach is a safe, practical and effective alternative to femoral puncture for percutaneous transluminal angioplasty (PTA).Methods: Forty PTAs in 38 patients were evaluated. Intentional subintimal recanalization was performed in 13 limbs. Ultrasound evaluation of the popliteal fossa was carried out 30 min and 24 hr post procedurally in the first 10 patients to exclude local complications. All patients had a follow-up of at least 6 weeks.Results: The indication for PTA was critical ischemia in seven limbs and disabling claudication in the remainder.Stenoses (single or multiple) were present in 24 and occlusion in 15.The superficial femoral artery (SFA) was the commonest segment affected(36) followed by common femoral artery (CFA) in four and iliac artery in four. Technical success was achieved in 38 of 39 limbs where angioplasty was carried out. In one limb no lesion was found.Immediate complications were distal embolization in two and thrombosis in one. None of these required immediate surgery. There were no puncture site hematomas or popliteal arteriovenous fistulae.Symptomatic patency at 6 weeks was 85%. Further reconstructive surgery was required in three limbs and amputation in two.Conclusion: The transpopliteal approach has a high technical success rate and a low complication rate with a potential to develop into an outpatient procedure. It should be considered for flush SFA occulsions or iliac disease with tandem CFA/SFA disease where the contralateral femoral approach is often technically difficult

  18. The Immune Landscapes of Polypoid and Nonpolypoid Precancerous Colorectal Lesions.

    Directory of Open Access Journals (Sweden)

    Antonella Maglietta

    Full Text Available Little is known about the immunoediting process in precancerous lesions. We explored this aspect of benign colorectal adenomas with a descriptive analysis of the immune pathways and immune cells whose regulation is linked to the morphology and size of these lesions. Two series of polypoid and nonpolypoid colorectal adenomas were used in this study: 1 84 samples (42 lesions, each with matched samples of normal mucosa whose gene expression data were used to quantify the tumor morphology- and size-related dysregulation of immune pathways collected in the Molecular Signature Database, using Gene Set Enrichment Analysis; 2 40 other lesions examined with immunohistochemistry to quantify the presence of immune cells in the stromal compartment. In the analysis of transcriptomic data, 429 immune pathways displayed significant differential regulation in neoplasms of different morphology and size. Most pathways were significantly upregulated or downregulated in polypoid lesions versus nonpolypoid lesions (regardless of size. Differential pathway regulation associated with lesion size was observed only in polypoid neoplasms. These findings were mirrored by tissue immunostaining with CD4, CD8, FOXP3, MHC-I, CD68, and CD163 antibodies: stromal immune cell counts (mainly T lymphocytes and macrophages were significantly higher in polypoid lesions. Certain markers displayed significant size-related differences regardless of lesion morphology. Multivariate analysis of variance showed that the marker panel clearly discriminated between precancerous lesions of different morphologies and sizes. Statistical analysis of immunostained cell counts fully support the results of the transcriptomic data analysis: the density of infiltration of most immune cells in the stroma of polypoid precancerous lesions was significantly higher than that observed in nonpolypoid lesions. Large neoplasms also have more immune cells in their stroma than small lesions. Immunoediting in

  19. Basal ganglia lesions in children and adults

    International Nuclear Information System (INIS)

    Bekiesinska-Figatowska, Monika; Mierzewska, Hanna; Jurkiewicz, Elżbieta

    2013-01-01

    The term “basal ganglia” refers to caudate and lentiform nuclei, the latter composed of putamen and globus pallidus, substantia nigra and subthalamic nuclei and these deep gray matter structures belong to the extrapyramidal system. Many diseases may present as basal ganglia abnormalities. Magnetic resonance imaging (MRI) and computed tomography (CT) – to a lesser degree – allow for detection of basal ganglia injury. In many cases, MRI alone does not usually allow to establish diagnosis but together with the knowledge of age and circumstances of onset and clinical course of the disease is a powerful tool of differential diagnosis. The lesions may be unilateral: in Rassmussen encephalitis, diabetes with hemichorea/hemiballism and infarction or – more frequently – bilateral in many pathologic conditions. Restricted diffusion is attributable to infarction, acute hypoxic–ischemic injury, hypoglycemia, Leigh disease, encephalitis and CJD. Contrast enhancement may be seen in cases of infarction and encephalitis. T1-hyperintensity of the lesions is uncommon and may be observed unilaterally in case of hemichorea/hemiballism and bilaterally in acute asphyxia in term newborns, in hypoglycemia, NF1, Fahr disease and manganese intoxication. Decreased signal intensity on GRE/T2*-weighted images and/or SWI indicating iron, calcium or hemosiderin depositions is observed in panthotenate kinase-associated neurodegeneration, Parkinson variant of multiple system atrophy, Fahr disease (and other calcifications) as well as with the advancing age. There are a few papers in the literature reviewing basal ganglia lesions. The authors present a more detailed review with rich iconography from the own archive

  20. Basal ganglia lesions in children and adults

    Energy Technology Data Exchange (ETDEWEB)

    Bekiesinska-Figatowska, Monika, E-mail: m.figatowska@mp.pl [Department of Diagnostic Imaging, Institute of Mother and Child, ul. Kasprzaka 17a, 01-211 Warsaw (Poland); Mierzewska, Hanna, E-mail: h.mierzewska@gmail.com [Department of Neurology of Children and Adolescents, Institute of Mother and Child, ul. Kasprzaka 17a, 01-211 Warsaw (Poland); Jurkiewicz, Elżbieta, E-mail: e-jurkiewicz@o2.pl [Department of Diagnostic Imaging, Children' s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw (Poland)

    2013-05-15

    The term “basal ganglia” refers to caudate and lentiform nuclei, the latter composed of putamen and globus pallidus, substantia nigra and subthalamic nuclei and these deep gray matter structures belong to the extrapyramidal system. Many diseases may present as basal ganglia abnormalities. Magnetic resonance imaging (MRI) and computed tomography (CT) – to a lesser degree – allow for detection of basal ganglia injury. In many cases, MRI alone does not usually allow to establish diagnosis but together with the knowledge of age and circumstances of onset and clinical course of the disease is a powerful tool of differential diagnosis. The lesions may be unilateral: in Rassmussen encephalitis, diabetes with hemichorea/hemiballism and infarction or – more frequently – bilateral in many pathologic conditions. Restricted diffusion is attributable to infarction, acute hypoxic–ischemic injury, hypoglycemia, Leigh disease, encephalitis and CJD. Contrast enhancement may be seen in cases of infarction and encephalitis. T1-hyperintensity of the lesions is uncommon and may be observed unilaterally in case of hemichorea/hemiballism and bilaterally in acute asphyxia in term newborns, in hypoglycemia, NF1, Fahr disease and manganese intoxication. Decreased signal intensity on GRE/T2*-weighted images and/or SWI indicating iron, calcium or hemosiderin depositions is observed in panthotenate kinase-associated neurodegeneration, Parkinson variant of multiple system atrophy, Fahr disease (and other calcifications) as well as with the advancing age. There are a few papers in the literature reviewing basal ganglia lesions. The authors present a more detailed review with rich iconography from the own archive.