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Sample records for lesions incidentally identified

  1. [Managing focal incidental renal lesions].

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    Nicolau, C; Paño, B; Sebastià, C

    2016-01-01

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

  2. Incidental Breast Lesions Identified by 18F-FDG PET/CT: Which Clinical Variables Differentiate between Benign and Malignant Breast Lesions?

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    Shin, Kyung Min; Jung, Su Jin; Lim, Hyo Soon; Lee, Sang Woo; Cho, Seung Hyun; Jang, Yun-Jin; Lee, Hui Joong; Kim, Gab Chul; Jung, Jin Hyang; Park, Ji Young

    2015-01-01

    Purpose The aim of our study was to evaluate the risk of malignancy and to determine which clinical variables differentiate between benign and malignant focal breast lesions found incidentally on 18F-flourodeoxyglucose positron emission tomography and computed tomography (FDG PET/CT). Methods From March 2005 to October 2011, 21,224 women with no history of breast cancer underwent FDG PET/CT at three university-affiliated hospitals. We retrospectively identified 214 patients with incidental focal hypermetabolic breast lesions and grouped them into benign and malignant lesion groups. Of the 214 patients, 82 patients with 91 lesions were included in this study. All lesions were confirmed histologically or were assessed by follow-up imaging for greater than 2 years. The patient age, maximum standardized uptake value (SUVmax), lesion size on ultrasonography (US), and Breast Imaging-Reporting and Data System (BI-RADS) category on US in conjunction with mammography were compared between the groups. Multivariate logistic regression analysis was used to identify independent factors associated with malignancy. Results The risk of malignancy was 29.7% (27/91) in breast incidentalomas detected by FDG PET/CT. The univariate analysis showed that the patient age, SUVmax, tumor size, and BI-RADS category differed significantly between the malignant and benign groups. The multivariate analysis showed that the BI-RADS category was the only significant factor differentiating benign from malignant lesions (p=0.002). Conclusion BIRADS category based on US in conjunction with mammography was the only useful tool to differentiate between malignant and benign lesions in breast incidentalomas on FDG PET/CT. PMID:25834614

  3. Focal liver lesions found incidentally

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

    2016-01-01

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

  4. Incidental thyroid lesions detected by FDG-PET/CT: prevalence and risk of thyroid cancer

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    Kim Sung

    2009-08-01

    Full Text Available Abstract Background Incidentally found thyroid lesions are frequently detected in patients undergoing FDG-PET/CT. The aim of this study was to investigate the prevalence of incidentally found thyroid lesions in patients undergoing FDG-PET/CT and determine the risk for thyroid cancer. Methods FDG-PET/CT was performed on 3,379 patients for evaluation of suspected or known cancer or cancer screening without any history of thyroid cancer between November 2003 and December 2005. Medical records related to the FDG-PET/CT findings including maximum SUV(SUVmax and pattern of FDG uptake, US findings, FNA, histopathology received by operation were reviewed retrospectively. Results Two hundred eighty five patients (8.4% were identified to have FDG uptake on FDG-PET/CT. 99 patients with focal or diffuse FDG uptake underwent further evaluation. The cancer risk of incidentally found thyroid lesions on FDG-PET/CT was 23.2% (22/99 and the cancer risks associated with focal and diffuse FDG uptake were 30.9% and 6.4%. There was a significant difference in the SUVmax between the benign and malignant nodules (3.35 ± 1.69 vs. 6.64 ± 4.12; P max and the size of the cancer. Conclusion The results of this study suggest that incidentally found thyroid lesions by FDG-PET/CT, especially a focal FDG uptake and a high SUV, have a high risk of thyroid malignancy. Further diagnostic work-up is needed in these cases.

  5. Imaging features, follow-up, and management of incidentally detected renal lesions

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    Bradley, A.J., E-mail: Alison.Bradley@uhsm.nhs.uk [Department of Radiology, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT (United Kingdom); Lim, Y.Y.; Singh, F.M. [Department of Radiology, University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT (United Kingdom)

    2011-12-15

    Incidental renal masses are common findings on cross-sectional imaging. Most will be readily identified as simple cysts, but with an inexorable rise in abdominal imaging, [particularly computed tomography (CT)], coupled with a rise in the incidence of renal cancer, the likelihood of detecting a malignant mass is increasing. This review informs the radiologist which lesions can be safely ignored, which will require further imaging for accurate categorization, and which require referral for consideration of treatment. For the small proportion of lesions that are indeterminate, careful attention to imaging technique, and the use of unenhanced and contrast-enhanced CT or magnetic resonance imaging (MRI) in all but a few specific instances will accurately characterize such lesions. The figures have been chosen to illustrate specific imaging features of common renal lesions. Management options for malignant, or presumed malignant, renal masses include active surveillance, percutaneous ablation, laparoscopic or open, partial or total nephrectomy. Biopsy has a role in determining the nature of masses that remain indeterminate on cross-sectional imaging, prior to definitive treatment. Common pitfalls in assessing incidental renal lesions are emphasized; some of these are due to sub-optimal imaging techniques and others to errors in interpretation.

  6. Neurocognition in individuals with incidentally-identified meningioma.

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    Butts, Alissa M; Weigand, Stephen; Brown, Paul D; Petersen, Ronald C; Jack, Clifford R; Machulda, Mary M; Cerhan, Jane H

    2017-08-01

    Meningiomas are primary intracranial tumors that are often asymptomatic. To our knowledge, no study has attempted to describe neurocognitive function in patients with incidentally-discovered meningioma. We utilized the Mayo Clinic Study of Aging (MCSA), which is a population-based sample of Olmsted County, Minnesota residents that includes neuropsychological testing and brain MRI approximately every 15 months. Using a text search of radiologists' notes of 2402 MCSA individuals (mean age 77 years, scanned between 2004 and 2014) we identified 48 eligible subjects (2%) who had at least one meningioma. Most meningiomas were small (90% age, sex, and education. Cognitive domains assessed included memory, attention-executive function, language, and visuospatial. More women (67%) had a meningioma than men (33%). Groups did not differ on prevalence of Mild Cognitive Impairment (Meningioma = 19%, Controls = 13%). Across cognitive domains, we observed similar performance for the two groups (p's ≥ 0.21). Subtle differences emerged in memory and language domains (p = 0.05 and p = 0.11) when we divided the Meningioma group by tumor location, wherein the small group with an infratentorial tumor performed more poorly than controls globally as well as on select memory and language measures. Our findings suggest that small meningiomas are generally cognitively benign, but that may change as the tumor evolves, and might be impacted by other factors such as meningioma location.

  7. Evaluation of hyperdense renal lesions incidentally detected on single-phase post-contrast CT using dual-energy CT

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    Park, Jung Jae; Park, Byung Kwan

    2016-01-01

    Objective: To investigate the utility of dual-energy CT (DECT) for differentiating between solid and benign cystic lesions presenting as hyperdense renal lesions incidentally detected on single-phase post-contrast CT. Methods: 90 hyperdense renal lesions incidentally detected on single-phase post-contrast CT were evaluated with follow-up DECT. DECT protocols included true non-contrast (TNC), DE corticomedullary and DE late nephrographic phase imaging. The CT numbers of hyperdense renal lesions were calculated on linearly blended and iodine overlay (IO) images, and the results were compared. Results: In total, 47 benign cystic and 43 solid renal lesions were analyzed. For differentiating between solid and benign cystic lesions on the two phases, the specificity and accuracy of all lesions and lesions  0.05). For all types of lesions ≥1.5 cm, the CT numbers between linearly blended and IO images and between TNC and virtual non-contrast images were not statistically different (p > 0.05). Conclusion: DECT may be useful for differentiating between solid and benign cystic lesions presenting as hyperdense renal lesions incidentally detected on single-phase post-contrast CT, particularly with the size ≥1.5 cm. Advances in knowledge: DECT may be used to characterize hyperdense renal lesions ≥1.5 cm incidentally detected on single-phase post-contrast CT, without the use of TNC images. PMID:27043480

  8. An intratesticular arteriovenous malformation identified incidentally during ultrasound evaluation of scrotal trauma

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    Mohammad Saleh Jafarpishefard

    2016-01-01

    Full Text Available Intratesticular arteriovenous malformation (AVM is an extremely rare benign testicular lesion. Ultrasonography (US usually reveals a hypoechoic solid vascular mass within the testicular parenchyma. Herein, we report our experience with a young patient in whom an intratesticular AVM was found incidentally by US during the workup of scrotal trauma.

  9. Clival Lesion incidentally discovered on cone-beam computed tomography: A case report and review of the literature

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    Jadhav, Aniket B.; Tadinada, Aditya; Rengasamy, Kandasamy; Lurie, Alan G. [Dept. of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington (United States); Douglas, Fellows [Division of Diagnostic Sciences and Therapeutics, University of Connecticut School of Medicine, Farmington (United States)

    2014-06-15

    An osteolytic lesion with a small central area of mineralization and sclerotic borders was discovered incidentally in the clivus on the cone-beam computed tomography (CBCT) of a 27-year-old male patient. This benign appearance indicated a primary differential diagnosis of non-aggressive lesions such as fibro-osseous lesions and arrested pneumatization. Further, on magnetic resonance imaging (MRI), the lesion showed a homogenously low T1 signal intensity with mild internal enhancement after post-gadolinium and a heterogeneous T2 signal intensity. These signal characteristics might be attributed to the fibrous tissues, chondroid matrix, calcific material, or cystic component of the lesion; thus, chondroblastoma and chondromyxoid fibroma were added to the differential diagnosis. Although this report was limited by the lack of final diagnosis and the patient lost to follow-up, the incidental skull base finding would be important for interpreting the entire volume of CBCT by a qualified oral and maxillofacial radiologist.

  10. Incidental white matter lesions in children presentıng with headache.

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    Bayram, Erhan; Topcu, Yasemin; Karaoglu, Pakize; Yis, Uluc; Cakmakci Guleryuz, Handan; Kurul, Semra Hiz

    2013-06-01

    We aimed to describe the prevalence and significance of white matter lesions detected on magnetic resonance imaging (MRI) in children with headache. Children who were admitted with the complaint of headache and had neuroimaging between December 2007 and June 2012 were included in the study. The clinical and neuroimaging data of the patients were retrospectively evaluated. MRI results of the patients were documented in detail. The patients with non-specific white matter lesions were called for a control visit, and current status of headache and neurological findings were determined. A total of 941 patients were included in the study. Sixty-one percent of the patients received cranial neuroimaging. 8.2% had only cranial computed tomography (CT), 7.5% had cranial CT and cranial MRI, and 84.3% had only cranial MRI. 22.1% of the patients had abnormal cranial MRI findings. The rate of incidental non-specific white matter changes detected in our study group was 23/527 (4.4%). Among the 23 patients, 12 (52.2%) were male and 11 (47.8%) were female. Fourteen (60.9%) had migraine without aura, 8 (34.8%) had tension-type headache, and 1 (4.3%) had migraine with aura. Mean age of patients at the time of imaging was 12.1 ± 3.4 years (range 4.0-16.0 years). All patients with non-specific white matter changes on MRI showed normal psychomotor development, and there was no history of seizures or head trauma. The physical and neurological examinations of all patients were normal. The mean clinical follow-up period of the patients was 16.8 ± 17.3 months (range 6-80 months). No patients showed neurological deterioration during the follow up. The white matter lesions were supratentorial in all patients. The mean size of the lesions was 5.1 ± 4.5 mm (minimum, 2 mm; maximum, 24 mm). Repeated radiological evaluations were performed in 11 (47.8%) of the patients. No new white matter lesions were detected in control MRI during follow up. Non-specific incidental white matter changes may be

  11. Thyroid lesions incidentally detected by 18F-FDG PET-CT ― a two centre retrospective study

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    Jamsek Jan

    2015-06-01

    Full Text Available Background. Incidental 18F-FDG uptake in the thyroid on PET-CT examinations represents a diagnostic challenge. The maximal standardized uptake value (SUVmax is one possible parameter that can help in distinguishing between benign and malignant thyroid PET lesions.

  12. Frequency of benign hepatic lesions incidentally detected with contrast-enhanced thin-section portal venous phase spiral CT

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    Voelk, M.; Strotzer, M.; Lenhart, M.; Techert, J.; Seitz, J.; Feuerbach, S. [Univ. Hospital, Regensburg (Germany). Dept. of Diagnostic Radiology

    2001-03-01

    To evaluate the frequency of benign focal hepatic lesions incidentally detected at contrast-enhanced thin-section portal venous phase spiral CT. Material and methods: Between January 1998 and February 1999, contrast-enhanced hepatic spiral CT examinations were performed in 1,892 patients. Out of these, only 100 patients fulfilled the following inclusion criteria: No underlying malignant disease, no liver cirrhosis, no suspected or known focal liver lesions. Standardized spiral CT parameters were applied. All CT studies were reviewed retrospectively by one radiologist. Any focal lesion was recorded and classified. Lesion size and number were noted. Results: A total of 108 hepatic lesions were reported in 33 out of 100 patients (80 cysts; 18 hemangiomas; 3 focal fatty infiltrations; 2 focal non-tumorous perfusion defects; 1 calcification; and 4 non-classified lesions). The average lesion size was 9.4 mm (5 mm: n=40; 6-10 mm: n=30; 11-15 mm: n=28; >15 mm: n=10). Conclusion: Benign liver lesions are probably a frequent incidental finding at abdominal spiral CT.

  13. The discrimination of incidental focal hypermetabolic colorectal lesions identified by 18 F-flurodeoxyglucose positron emission tomography%18F-FDG PET/CT 偶发直结肠局灶性高代谢灶良恶性判断价值

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    王志忠; 王钦媛; 苏家贵; 欧阳晓辉; 刘晓飞; 何宝明

    2014-01-01

    Objective Because colonic focal is predilection site of malignant tumors and inflammatory disease ,the pur-pose of this study was to investigate the discrimination of PET/CT detection of incidental colonic focal hypermetabolism . Methods 34 unexpected colonic focal uptake of 18 F-FDG localized by PET/CT were retrospectively analyzed ,and then semi-quantitatively analyzed the extent of radioactive uptake in colonic foci .After PET/CT ,the etiology of the findings was confirmed histological by surgery or endoscopic .All the data were assessed for statistical significance using one-way ANOVA .Results Among the 34 patients who underwent colonoscopy ,positive malignant or premalignant lesions were noted in 22 patients (64 .7% ) with the lesions coinciding with the location described in the PET/CT report .Adenomatous polyps were detected in 8 patients ,whereas in 14 patients ,malignant lesions were confirmed (adenocarcinoma n = 9 ,o-varian cancer metastatic ,n=2 ,Malignant Mesothelioma metastatic n=2 ,borderline tumor metastatic n=1) .The mean standardized uptake valuemax (SUVmax) for premalignant lesions was 7 .55 ± 2 .1 and for malignant lesions was 7 .62 ± 4.87 .4 patients (11 .8% ) colonic uptake was diagnosed as inflammatory ,the mean SUVmax was 9 .35 ± 4 .9 .8 patients (23 .5% )had normal findings ,the mean SUVmax was 7 .4 ± 1 .75 .The difference in mean SUVmax between the premalig-nant adenomatous polyps and the malignant lesions was not statistically significant ( P =0 .968) .Conclusion Our study shows that a significant proportion of patients showing an incidental focal FDG uptake will harbor premalignant (adenoma-tous polyps) or malignant lesions ,and further evaluation with colonoscopy and biopsy is warranted in such cases .%目的:探讨PET/CT意外发现直结肠FDG局灶性高代谢灶的临床意义。方法回顾性分析34例PET/CT意外探测到直结肠局灶性高放射性摄取灶的病例,半定量分析局部病灶

  14. Incidental demyelinating inflammatory lesions in asymptomatic patients: a Brazilian cohort with radiologically isolated syndrome and a critical review of current literature

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    Antonio Carlos Martins Maia Jr.

    2012-01-01

    Full Text Available Despite the definition of specific diagnostic criteria to identify radiologically isolated syndrome (RIS suggestive of multiple sclerosis, its natural history remains incompletely understood. We retrospectively analyzed a Brazilian cohort of 12 patients to clarify their features and to emphasize the role of imaging predictors in clinical conversion. We demonstrated that, although some individuals did not exhibit progression over a lengthy follow-up period (16.7%, most patients will progress clinically or radiologically in the initial years of the follow-up (83.3%. Infratentorial and spinal cord involvement, as well as the total number of lesions, were more relevant predictors of progression than gadolinium enhancement. Further studies remain necessary to define the risk of conversion in males and to clarify the cognitive abilities of RIS patients. This study may provide an improved understanding of the natural course and evolution of incidental magnetic resonance imaging lesions, and further assists with the management of RIS in clinical practice.

  15. Evaluation of focal thyroid lesions incidentally detected in fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography images

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    O Yaylali

    2014-01-01

    Full Text Available Background and Purpose: Increased uptake in the thyroid gland (TG is often identified as an incidental finding on the whole body fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT in non-thyroid cancer patients. Currently, there is no consensus on the appropriate approach for the management of these cases. Thyroid ultrasound, scintigraphy and fine-needle aspiration biopsy (FNAB are suggested to exclude malignant thyroid lesions. Our aim is to determine the importance of increased F-18-FDG uptake in the TG on positron emission tomography/computed tomography (PET/CT scans in patients who are being screened for various forms of non-thyroid cancer. Materials and Methods: We evaluated 2000 cases undergoing whole body PET/CT scanning between April 2011 and October 2012. The age, sex, type of primary cancer, maximum standardized uptake value (SUV max , size of the thyroid nodules and cervical lymph nodes (CLNs on 18 F-FDG PET/CT images and if available, the biopsy results were evaluated. Results: In total, 57 patients (23 men, 34 women, mean age ± standard deviation (SD, 60.89 ± 14 years showed an increased fluorine-18-fluorodeoxyglucose ( 18 F-FDG uptake by the TG (average SUV max : 4.07 ± 3.7. The CLNs were detected in 19/57 patients (33%. Only 20 cases (35% received FNAB. The final histopathological diagnosis was papillary thyroid carcinoma in seven patients (mean SUV max ± SD: 6.0 ± 5.43 and benign thyroid disease in seven patients (mean SUV max ± SD: 2.36 ± 0.63. The FNAB results were undetermined for six patients. Conclusion: Focal high 18 F-FDG uptake in the TG may be associated with an increased risk of malignancy, but the clinical significance is unclear. More data are needed to elucidate the role of the SUV in the differentiation of benign and malign thyroid lesions. If a focal increase in 18 F-FDG uptake in the TG on PET/CT is present, a prompt histopathological evaluation should be

  16. Incidental findings in the use of DNA to identify human remains: an ethical assessment.

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    Parker, Lisa S; London, Alex John; Aronson, Jay D

    2013-02-01

    DNA analysis is increasingly used to identify the remains of victims of conflicts and disasters. This is especially true in cases where remains are badly damaged and fragmented, or where antemortem records are unavailable. Incidental findings (IFs)-that is, genetics-related information for which investigators were not looking-may result from these identification efforts employing DNA analysis. Because of the critical role played by family members of the missing in identification efforts, as well as the familial nature of DNA, identification initiatives employing DNA analysis are particularly prone to reveal IFs about familial relationships, such as misattributed paternity or false beliefs about sibling relationships. Despite forensic scientists' widespread awareness of the possibility of generating IFs, to date there has been relatively little explicit guidance about their management. This paper fills that gap. It offers substantive guidance about the ethical management of IFs in this context. To ensure that the analysis addresses actual needs and practices in the field, one author (JDA) conducted semi-structured interviews with key informants from six regionally diverse organizations involved in post-conflict or post-disaster identification efforts. The paper first describes how methods of DNA analysis give rise to IFs. Next, it explains the importance of developing an ethically justified general policy for managing IFs and discusses features of DNA identification efforts that are relevant to such a policy. Then it presents an argument in support of a general policy of nondisclosure-specifically, that considerations of fair access to the individual and social benefits of identification efforts, and the concern to minimize and fairly distribute the risks of participation, support a policy of nondisclosure. It concludes by considering some implications of this argument for the choice among scientific practices involved in using DNA analysis to identify human remains

  17. Incidental Findings in the Use of DNA to Identify Human Remains: An Ethical Assessment

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    Parker, Lisa S.; Aronson, Jay D.

    2012-01-01

    DNA analysis is increasingly used to identify the remains of victims of conflicts and disasters. This is especially true in cases where remains are badly damaged and fragmented, or where antemortem records are unavailable. Incidental findings (IFs)—that is, genetics-related information for which investigators were not looking—may result from these identification efforts employing DNA analysis. Because of the critical role played by family members of the missing in identification efforts, as well as the familial nature of DNA, identification initiatives employing DNA analysis are particularly prone to reveal IFs about familial relationships, such as misattributed paternity or false beliefs about sibling relationships. Despite forensic scientists’ widespread awareness of the possibility of generating IFs, to date there has been relatively little explicit guidance about their management. This paper fills that gap. It offers substantive guidance about the ethical management of IFs in this context. To ensure that the analysis addresses actual needs and practices in the field, one author (JDA) conducted semi-structured interviews with key informants from six regionally diverse organizations involved in post-conflict or post-disaster identification efforts. The paper first describes how methods of DNA analysis give rise to IFs. Next, it explains the importance of developing an ethically justified general policy for managing IFs and discusses features of DNA identification efforts that are relevant to such a policy. Then it presents an argument in support of a general policy of nondisclosure—specifically, that considerations of fair access to the individual and social benefits of identification efforts, and the concern to minimize and fairly distribute the risks of participation, support a policy of nondisclosure. It concludes by considering some implications of this argument for the choice among scientific practices involved in using DNA analysis to identify human

  18. POSTMORTEM STUDY OF HISTOPATHOLOGICAL LESIONS OF HEART IN CASES OF SUDDEN DEATH - AN INCIDENTAL FINDINGS

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    Chandrakala

    2016-01-01

    Full Text Available OBJECTIVE To study the histopathological lesions of Heart in cases of sudden death. METHOD During the period from 1st July 2014 to 30 November 2015, out of 144 medicolegal autopsies, 120 autopsies of heart were received. Five specimen of heart were autolyzed so 115 autopsy specimen of heart were included for study. Routine H and E staining is used for microscopic examination. RESULT Out of 115 cases, 74 cases shows atherosclerosis, 33 cases shows features of myocardial infarction, myocardial hypertrophy found in 60 cases, 11 cases shows myocarditis, vaso-occlusive crisis in sickle cell was present in 6 cases and pericarditis present in 1 case. In 29 cases, there was no identifiable cause of death even after complete gross and microscopic autopsy was performed. CONCLUSION It was concluded that myocardial infarction due to atherosclerotic ischaemic heart disease is probably the commonest diagnosis made in majority of sudden death cases subjected to medicolegal autopsies. Histological findings must be evaluated with great attention for preventing incorrect conclusion to identify causes of deaths in sudden death cases.

  19. Stimulus Similarity and Encoding Time Influence Incidental Recognition Memory in Adult Monkeys with Selective Hippocampal Lesions

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    Zeamer, Alyson; Meunier, Martine; Bachevalier, Jocelyne

    2011-01-01

    Recognition memory impairment after selective hippocampal lesions in monkeys is more profound when measured with visual paired-comparison (VPC) than with delayed nonmatching-to-sample (DNMS). To clarify this issue, we assessed the impact of stimuli similarity and encoding duration on the VPC performance in monkeys with hippocampal lesions and…

  20. Inflammatory myofibroblastic tumour arising incidentally as a polypoid lesion in the gallbladder

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    Carlos Filipe C. Abrantes

    2015-12-01

    Full Text Available ABSTRACT Inflammatory myofibroblastic tumour (IMT is a rare mesenchymal neoplasm that usually originates from abdominal soft tissues. A female patient aged 50 years presented with a 1.2 cm gallbladder polyp. The microscopic study showed spindle cell proliferation in an edematous background rich in lymphocytes and plasma cells. Immunohistochemistry showed positivity for vimentin, smooth muscle actin, and anaplastic lymphoma kinase (ALK, and negativity for other markers. Fluorescent in situ hybridization (FISH revealed ALK gene rearrangement. The diagnosis was IMT of the gallbladder, a unique case considering that it was identified at the early stage of development of these neoplasms.

  1. Real-time MRI navigated US: Role in diagnosis and guided biopsy of incidental breast lesions and axillary lymph nodes detected on breast MRI but not on second look US

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    Pons, Elena Pastor, E-mail: elenapastorpons@gmail.com; Azcón, Francisco Miras, E-mail: frmiaz00@gmail.com; Casas, María Culiañez, E-mail: mariacc1980@gmail.com; Meca, Salvador Martínez, E-mail: isalvaa@hotmail.com; Espona, José Luis García, E-mail: gespona@hotmail.com

    2014-06-15

    Objectives: To prospectively evaluate the accuracy of real-time ultrasound combined with supine-MRI using volume navigation technique (RtMR-US) in diagnosis and biopsy of incidental breast lesions (ILSM) and axillary lymph nodes (LNSM) suspicious of malignancy on contrast enhanced magnetic resonance imaging (CE-MRI). Materials and methods: Five hundred and seventy-seven women were examined using breast CE-MRI. Those with incidental breast lesions not identified after second-look ultrasound (US) were recruited for RtMR-US. Biopsy was performed in ILSM. Breast lesions were categorized with BI-RADS system and Fisher’ exact test. Axillary lymph nodes morphology was described. To assess efficacy of RtMR-US, diagnostic accuracy, sensitivity, specificity, detection rate and Kappa index of conventional-US and RtMR-US were calculated. Results: Forty-three lesions were detected on CE-MRI before navigation. Eighteen were carcinomas and 25 ILSM. Of these, 21 underwent a RtMR-US. Detection rate on RtMR-US (90.7%) was higher than on conventional-US (43%) (p < 0.001). Agreement between both techniques was low (k = 0.138). Twenty ILSM and 2 LNSM were biopsied. Sixty-five percent were benign (100% of BI-RADS3 and 56% of BI-RADS4-5). Diagnostic performance of RtMR-US identifying malignant nodules for overall lesions and for the subgroup of ILSM was respectively: sensitivity 96.3% and 100%, specificity 18.8% and 30.7%, positive predictive value 66.7% and 43.7%, negative predictive value 75% and 100%. In addition RtMR-US enabled biopsy of 2 metastatic lymph nodes. Conclusions: Real time-US with supine-MRI using a volume navigation technique increases the detection of ILSM. RtMR-US may be used to detect occult breast carcinomas and to assess cancer extension, preventing unnecessary MRI-guided biopsies and sentinel lymph node biopsies. Incidental lesions BI-RADS 3 non-detected on conventional-US are probably benign.

  2. Incidentally detected enhancing lesions found in breast MRI: analysis of apparent diffusion coefficient and T2 signal intensity significantly improves specificity

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    Arponen, Otso; Masarwah, Amro; Taina, Mikko [Kuopio University Hospital, Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); Kuopio University Hospital, University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); Sutela, Anna; Koenoenen, Mervi; Hakumaeki, Juhana; Sudah, Mazen [Kuopio University Hospital, Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); Sironen, Reijo [Kuopio University Hospital, Kuopio University Hospital, Department of Pathology, PO Box 1777, Kuopio (Finland); Kuopio University Hospital, University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Clinical Pathology and Forensic Medicine, PO Box 1777, Kuopio (Finland); University of Eastern Finland, Cancer Center of Eastern Finland, Kuopio (Finland); Vanninen, Ritva [Kuopio University Hospital, Kuopio University Hospital, Diagnostic Imaging Centre, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); Kuopio University Hospital, University of Eastern Finland, Institute of Clinical Medicine, School of Medicine, Department of Clinical Radiology, PO Box 1777, Kuopio (Finland); University of Eastern Finland, Cancer Center of Eastern Finland, Kuopio (Finland)

    2016-12-15

    To evaluate the value of adding T2- and diffusion-weighted imaging (DWI) to the BI-RADS registered classification in MRI-detected lesions. This retrospective study included 112 consecutive patients who underwent 3.0T structural breast MRI with T2- and DWI on the basis of EUSOMA recommendations. Morphological and kinetic features, T2 signal intensity (T2 SI) and apparent diffusion coefficient (ADC) findings were assessed. Thirty-three (29.5 %) patients (mean age 57.0 ± 12.7 years) had 36 primarily MRI-detected incidental lesions of which 16 (44.4 %) proved to be malignant. No single morphological or kinetic feature was associated with malignancy. Both low T2 SI (P = 0.009) and low ADC values (≤0.87 x 10{sup -3} mm{sup 2}s{sup -1}, P < 0.001) yielded high specificity (80.0 %/80.0 %). The BI-RADS classification supplemented with information from DWI and T2-WI improved the diagnostic performance of the BI-RADS classification as sensitivity remained 100 % and specificity improved from 30 % to 65.0 %. The numbers of false positive lesions declined from 39 % (N = 14) to 19 % (N = 7). MRI-detected incidental lesions may be challenging to characterize as they have few specific malignancy indicating features. The specificity of MRI can be improved by incorporating T2 SI and ADC values into the BI-RADS assessment. (orig.)

  3. Differentiation of Malignant and Benign Incidental Breast Lesions Detected by Chest Multidetector-Row Computed Tomography: Added Value of Quantitative Enhancement Analysis.

    Directory of Open Access Journals (Sweden)

    Yu-Pang Lin

    Full Text Available To retrospectively determine the association between breast lesion morphology and malignancy and to determine the optimal value of lesion enhancement (HU, Hounsfield units to improve the diagnostic accuracy of breast cancer in patients with incidental breast lesions (IBLs. A total of 97 patients with 102 IBLs detected from July 2009 to December 2012 were enrolled in this study. Two radiologists analyzed CT images for the presence of malignancy based on the morphology of the lesions alone and in combination with an enhancement value (HU analysis. There were 36 malignant and 66 benign IBLs. When the morphology and enhancement values were combined, the sensitivity, specificity, and accuracy were 92%, 97%, and 95%, respectively, for reader 1 and 89%, 94%, and 92%, respectively, for reader 2. The addition of HU values led to correct changes in the diagnosis; specifically, the accuracy of the diagnosis of reader 1 and reader 2 improved by 6.9% and 11.8%, respectively. The addition of the enhancement value (HU to the CT morphology improved the diagnostic accuracy in the differentiation of malignant from benign IBLs by using the region of interest (ROI to measure the HU within the most suspicious part of the lesion.

  4. Incidental mild hyperglycemia in children: two MODY 2 families identified in Brazilian subjects.

    Science.gov (United States)

    Caetano, Lílian A; Jorge, Alexander A L; Malaquias, Alexsandra C; Trarbach, Ericka B; Queiroz, Márcia S; Nery, Márcia; Teles, Milena G

    2012-11-01

    Maturity-onset diabetes of the young (MODY) is characterized by an autosomal dominant mode of inheritance, early onset of hyperglycemia, and defects of insulin secretion. MODY subtypes described present genetic, metabolic, and clinical differences. MODY 2 is characterized by mild asymptomatic fasting hyperglycemia, and rarely requires pharmacological treatment. Hence, precise diagnosis of MODY is important for determining management and prognosis. We report two heterozygous GCK mutations identified during the investigation of short stature. Case 1: a prepubertal 14-year-old boy was evaluated for constitutional delay of growth and puberty. During follow-up, he showed abnormal fasting glucose (113 mg/dL), increased level of HbA1c (6.6%), and negative β-cell antibodies. His father and two siblings also had slightly elevated blood glucose levels. The mother had normal glycemia. A GCK heterozygous missense mutation, p.Arg191Trp, was identified in the proband. Eighteen family members were screened for this mutation, and 11 had the mutation in heterozygous state. Case 2: a 4-year-old boy investigated for short stature revealed no other laboratorial alterations than elevated glycemia (118 mg/dL); β-cell antibodies were negative. His father, a paternal aunt, and the paternal grandmother also had slightly elevated glycemia, whereas his mother had normal glycemia. A GCK heterozygous missense mutation, p.Glu221Lys, was identified in the index patient and in four family members. All affected patients had mild elevated glycemia. Individuals with normal glycemia did not harbor mutations. GCK mutation screening should be considered in patients with chronic mild early-onset hyperglycemia, family history of impaired glycemia, and negative β-cell antibodies.

  5. Malignancy rate of biopsied suspicious bone lesions identified on FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Hugo J.A.; Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Klerk, John M.H. de [Meander Medical Center, Department of Nuclear Medicine, Amersfoort (Netherlands); Heggelman, Ben G.F. [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Dubois, Stefan V. [Meander Medical Center, Department of Pathology, Amersfoort (Netherlands)

    2016-07-15

    To determine the malignancy rate of bone lesions identified on FDG PET/CT in patients who have undergone CT-guided biopsy because of the suspicion of malignancy. This single-centre retrospective study spanned eight consecutive years and included all patients who underwent both FDG PET/CT and CT-guided bone biopsy because of the suspicion of malignancy. The positive predictive value (PPV) for malignancy was calculated, and different patient and imaging characteristics were compared between malignant and benign bone lesions. Of 102 included patients with bone lesions that all showed FDG uptake exceeding mediastinal uptake, bone biopsy showed a malignant lesion in 91 patients, yielding a PPV for malignancy of 89.2 % (95 % CI 81.7 - 93.9 %). In the 94 patients with bone lesions that showed FDG uptake exceeding liver uptake, bone biopsy showed a malignant lesion in 83 patients, yielding a PPV for malignancy of 88.3 % (95 % CI 80.1 - 93.5 %). Higher age, bone marrow replacement of the lesion seen on CT, expansion of the lesion seen on CT, and presence of multifocal lesions on FDG PET/CT were significantly more frequent in patients with malignant lesions than in those with benign bone lesions (P = 0.044, P = 0.009, P = 0.015, and P = 0.019, respectively). Furthermore, there was a trend towards a higher incidence of cortical destruction (P = 0.056) and surrounding soft tissue mass (P = 0.063) in patients with malignant bone lesions. The PPV for malignancy of suspicious bone lesions identified on FDG PET/CT is not sufficiently high to justify changes in patient management without histopathological confirmation. Nevertheless, ancillary patient and imaging characteristics may increase the likelihood of a malignant bone lesion. (orig.)

  6. 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.)

  7. Incidental fleurodeoxyglucose uptake in the prostate.

    Science.gov (United States)

    Wong, W L; Moule, R N; Nunan, T

    2010-11-01

    This commentary confirms the rarity of prostatic cancer associated with incidental prostatic fleurodeoxyglucose (FDG) uptake. The study adds to the literature by showing that even if a prostate lesion is FDG avid it is unlikely to be due to cancer. The commentary considers the management of incidental prostate FDG uptake on the basis of the available evidence.

  8. Does {sup 18}F-FDG PET/CT add diagnostic accuracy in incidentally identified non-secreting adrenal tumours?

    Energy Technology Data Exchange (ETDEWEB)

    Tessonnier, L.; Colavolpe, C.; Mundler, O.; Taieb, D. [Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, Marseille Cedex 5 (France); Sebag, F.; Palazzo, F.F.; Henry, J.F. [Centre Hospitalo-Universitaire de la Timone, Service de Chirurgie Generale et Endocrinienne, Marseille Cedex 5 (France); Micco, C. de [Centre Hospitalo-Universitaire de la Timone, Faculte de Medecine, Institut National de la Sante et de la Recherche Medicale (U555), Marseille Cedex 5 (France); Mancini, J. [Centre Hospitalo-Universitaire de la Timone, Service de Sante Publique et d' Information Medicale, Marseille Cedex 5 (France); Conte-Devolx, B. [Centre Hospitalo-Universitaire de la Timone, Service d' Endocrinologie, Diabete et des Maladies Metaboliques, Marseille Cedex 5 (France)

    2008-11-15

    The widespread use of high-resolution cross-sectional imaging such as computed tomography (CT) and magnetic resonance imaging (MRI) for the investigation of the abdomen is associated with an increasing detection of incidental adrenal masses. We evaluated the ability of {sup 18}F-fluorodeoxyglucose positron emission tomography to distinguish benign from malignant adrenal masses when CT or MRI results had been inconclusive. We included only patients with no evidence of hormonal hypersecretion and no personal history of cancer or in whom previously diagnosed cancer was in prolonged remission. PET/CT scans were acquired after 90 min (mean, range 60-140 min) after FDG injection. The visual interpretation, maximum standardised uptake values (SUVmax) and adrenal compared to liver uptake ratio were correlated with the final histological diagnosis or clinico-radiological follow-up when surgery had not been performed. Thirty-seven patients with 41 adrenal masses were prospectively evaluated. The final diagnosis was 12 malignant, 17 benign tumours, and 12 tumours classified as benign on follow-up. The visual interpretation was more accurate than SUVmax alone, tumour diameter or unenhanced density, with a sensitivity of 100% (12/12), a specificity of 86% (25/29) and a negative predictive value of 100% (25/25). The use of 1.8 as the threshold for tumour/liver SUVmax ratio, retrospectively established, demonstrated 100% sensitivity and specificity. FDG PET/CT accurately characterises adrenal tumours, with an excellent sensitivity and negative predictive values. Thus, a negative PET may predict a benign tumour that would potentially prevent the need for surgery of adrenal tumours with inconclusive conventional imaging. (orig.)

  9. Clinical Relevance of Incidental Prostatic Lesions on FDG-Positron Emission Tomography/Computerized Tomography-Should Patients Receive Further Evaluation?

    NARCIS (Netherlands)

    Reesink, Daan J; Fransen van de Putte, Elisabeth E; Vegt, Erik; De Jong, Jeroen; van Werkhoven, Erik; Mertens, Laura S; Bex, Axel; van der Poel, Henk G; van Rhijn, Bas W G; Horenblas, Simon; Meijer, Richard P

    2016-01-01

    PURPOSE: FDG ((18)F-fluoro-2-deoxy-D-glucose)-PET/CT (positron emission tomography)/(computerized tomography) is a widely used diagnostic tool for whole body imaging. Incidental prostatic uptake is often found on FDG-PET/CT. The objective of this study was to determine the clinical relevance of inci

  10. Computed tomography vs magnetic resonance imaging for identifying acute lesions in pediatric traumatic brain injury.

    Science.gov (United States)

    Buttram, Sandra D W; Garcia-Filion, Pamela; Miller, Jeffrey; Youssfi, Mostafa; Brown, S Danielle; Dalton, Heidi J; Adelson, P David

    2015-02-01

    Pediatric traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children. Computed tomography (CT) is the modality of choice to screen for brain injuries. MRI may provide more clinically relevant information. The purpose of this study was to compare lesion detection between CT and MRI after TBI. Retrospective cohort of children (0-21 years) with TBI between 2008 and 2010 at a Level 1 pediatric trauma center with a head CT scan on day of injury and a brain MRI scan within 2 weeks of injury. Agreement between CT and MRI was determined by κ statistic and stratified by injury mechanism. One hundred five children were studied. Of these, 78% had mild TBI. The MRI scan was obtained a median of 1 day (interquartile range, 1-2) after CT. Overall, CT and MRI demonstrated poor agreement (κ=-0.083; P=.18). MRI detected a greater number of intraparenchymal lesions (n=36; 34%) compared with CT (n=16; 15%) (P<.001). Among patients with abusive head trauma, MRI detected intraparenchymal lesions in 16 (43%), compared with only 4 (11%) lesions with CT (P=.03). Of 8 subjects with a normal CT scan, 6 out of 8 had abnormal lesions on MRI. Compared with CT, MRI identified significantly more intraparenchymal lesions in pediatric TBI, particularly in children with abusive head trauma. The prognostic value of identification of intraparenchymal lesions by MRI is unknown but warrants additional inquiry. Risks and benefits from early MRI (including sedation, time, and lack of radiation exposure) compared with CT should be weighed by clinicians. Copyright © 2015 by the American Academy of Pediatrics.

  11. Incidental findings at MRI-enterography in patients with suspected or known Crohn's disease

    DEFF Research Database (Denmark)

    Jensen, Michael Dam; Nathan, Torben; Kjeldsen, Jens

    2010-01-01

    AIM: To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging (MRI)-enterography in patients with suspected or known Crohn's disease (CD). METHODS: Incidental findings were defined as unexpected lesions outside the small intestine...

  12. Incidental cranial CT findings in head injury patients in a Nigerian tertiary hospital

    Directory of Open Access Journals (Sweden)

    Godwin I Ogbole

    2015-01-01

    Full Text Available Background: Incidental findings on computed tomography (CT scans are occasionally noted in patients presenting with head injury. Since it can be assumed that head injured patients are of normal health status before the accident, these findings may be a representation of their frequency in the general population. Our aim was to determine the prevalence of such incidental findings among head injured patients in Nigeria′s foremost center of clinical neurosciences. Materials and Methods: We conducted a retrospective review of CT scan images of 591 consecutive eligible patients over a 5-year period (2006-2010 to identify incidental findings. The images were evaluated by consensus agreement of two radiologists. Associations with gender and age were explored using appropriate statistical tests with an alpha level of 0.05. Results: The mean patient age was 34.6 ± 21.2 years, and male to female ratio was 3.2: 1. Incidental findings were noted in 503/591 (85.1 % of the scans. Intracranial calcification was the commonest finding occurring in 61.8% of patients. Over 90% of the findings were benign. Compared with older ones, patients under the age of 60 were less likely, (P < 0.001, to have incidental findings. Conclusion: Although the majority of incidental findings in this African cohort of head injury patients are benign some clinically significant lesions were detectable. It is therefore recommended that such findings be adequately described in the radiological reports for proper counseling and follow-up.

  13. 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.)

  14. 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.)

  15. Optical coherence tomography accurately identifies patients with penile (pre malignant lesions: A single center prospective study

    Directory of Open Access Journals (Sweden)

    Ronni Wessels

    2015-01-01

    Conclusion: In this preliminary study, qualitative and quantitative analysis of OCT-images of suspicious penile lesions shows differences between benign lesions and (pre malignant lesions. These results encourage further research in a larger study population.

  16. The management of incidental findings of reduction mammoplasty specimens.

    Science.gov (United States)

    Goodwin, Jessica T; Decroff, Chantelle; Dauway, Emilia; Sybenga, Amelia; Mahabir, Raman C

    2013-01-01

    Reduction mammoplasty is one of the most commonly performed procedures in plastic surgery. Occasionally, there are findings reported by pathologists that are unfamiliar to the treating surgeon. The aim of the present study was to determine the types of pathologies encountered in reduction mammoplasty specimens. From this list of diagnoses, a best practice guideline for management will be organized to better assist plastic surgeons in the management of patients with incidental findings on pathology reports. A total of 441 pathology reports from patients who underwent bilateral or unilateral reduction mammoplasty in the past three years were identified. A list of 21 different pathologies was generated from the pathology reports, along with supplemental data from recent texts and articles. Occult carcinomas were encountered in two cases (0.45%) and high-risk lesions were found in three cases (0.68%) at the authors' institution. An algorithm was then constructed to organize the pathologies according to risk of malignancy and assign them to a management guideline. There are many different lesions encountered incidentally in reduction mammoplasty specimens that may or may not confer some cancer risk. It is important for plastic surgeons to know which lesions need closer follow-up to provide the best care for their patients.

  17. Clinical significance of incidental focal bowel uptake on (18)F-FDG PET/CT as related to colorectal cancer

    DEFF Research Database (Denmark)

    Soltau, Sofus Rønne; Hess, Søren; Nguyen, Tram

    2016-01-01

    with this finding in the clinic. Due to the non-specific appearance of such lesions and a certain rate of false positive findings, patients may by subjected to unnecessary invasive procedures or, conversely, cancers may be overlooked if the risk of malignancy is downplayed. The purpose of this study was to examine...... based cut-off values could not reliably discriminate benign from premalignant or malignant disease. CONCLUSION: It is the opinion of the authors that (18)F-FDG PET/CT scan may identify incidentally sites of colorectal carcinoma but cannot discriminate them from polyps/adenomas. Nevertheless, incidental...

  18. Incidental head and neck {sup 18}F-FDG uptake on PET/CT without corresponding morphological lesion: early predictor of cancer development?

    Energy Technology Data Exchange (ETDEWEB)

    Heusner, Till A.; Hahn, Steffen; Koegel, Svenja; Forsting, Michael; Antoch, Gerald [University Hospital Essen, University of Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Hamami, Monia E.; Bockisch, Andreas; Stahl, Alexander R. [University Hospital Essen, University of Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany)

    2009-09-15

    To retrospectively determine whether increased/asymmetric FDG uptake on PET without a correlating morphological lesion on fully diagnostic CT indicates the development of a head and neck malignancy. In 590 patients (mean age 55.4 {+-} 13.3 years) without a head and neck malignancy/inflammation FDG uptake was measured at (a) Waldeyer's ring, (b) the oral floor, (c) the larynx, and (d) the thyroid gland, and rated as absent (group A), present (group B), symmetric (group B1) or asymmetric (group B2). Differences between groups A and B and between B1 and B2 were tested for significance with the U-test (p < 0.05). An average follow-up of about 2.5 years (mean 29.5 {+-} 13.9 months) served as the reference period to determine whether patients developed a head and neck malignancy. Of the 590 patients, 235 (40%) showed no evidence of enhanced FDG uptake in any investigated site, and 355 (60%) showed qualitatively elevated FDG uptake in at least one site. FDG uptake values (SUV{sub max}, mean{+-}SD) for Waldeyer's ring were 3.0 {+-} 0.89 in group A (n = 326), 4.5 {+-} 2.18 in group B (n = 264; p < 0.01), 5.4 {+-} 3.35 in group B1 (n = 177), and 4.1 {+-} 1.7 in group B2 (n = 87; p < 0.01). Values for the oral floor were 2.8 {+-} 0.74 in group A (n = 362), 4.7 {+-} 2.55 in group B (n = 228; p < 0.01), 4.4 {+-} 3.39 in group B1 (n = 130), and 5.1 {+-} 2.69 in group B2 (n = 98, p = 0.01). Values for the larynx were 2.8 {+-} 0.76 in group A (n = 353), 4.2 {+-} 2.05 in group B (n = 237; p < 0.01), 4.0 {+-} 2.02 in group B1 (n = 165), and 4.6 {+-} 2.8 in group B2 (n = 72; p = 0.027). Values for the thyroid were 2.4 {+-} 0.63 in group A (n = 404), 3.0 {+-} 1.01 in group B (n = 186; p < 0.01), 2.6 {+-} 0.39 in group B1 (n = 130), and 4.0 {+-} 1.24 in group B2 (n = 56; p < 0.01). One patient developed a palatine tonsil carcinoma (group B1, SUV{sub max} 3.2), and one patient developed an oral floor carcinoma (group B1, SUV{sub max} 3.7). Elevated/asymmetric head and neck FDG

  19. Lugol's iodine identifies dysplastic tissue in precancerous lesions: A clinical trial

    Science.gov (United States)

    Fatima, Shereen; Basu, Rajarshi; Hallur, Neelakamal H.

    2016-01-01

    Introduction: Intraepithelial dysplasia, or “invisible” precancerous lesions, provides a challenge for visualization to the surgical team. The prognostic relevance of dysplasia and carcinoma in situ at surgical margins is well documented. Materials and Methods: We evaluated the use of Lugol's iodine in visualizing the surgical margins of dysplastic tissue by an observational study of 100 patients having oral precancerous lesions between June 2013 and March 2016. Conclusion: Lugol's iodine is a simple, inexpensive, and apparently effective means of diagnosing and visualizing the surgical margins of the dysplastic tissue in oral precancerous lesions. PMID:28299253

  20. Incidental renal neoplasms

    DEFF Research Database (Denmark)

    Rabjerg, Maj; Mikkelsen, Minne Nedergaard; Walter, Steen;

    2014-01-01

    On the basis of associations between tumor size, pathological stage, histological subtype and tumor grade in incidentally detected renal cell carcinoma vs symptomatic renal cell carcinoma, we discussed the need for a screening program of renal cell carcinoma in Denmark. We analyzed a consecutive...... series of 204 patients with renal tumors in 2011 and 2012. The tumors were classified according to detection mode: symptomatic and incidental and compared to pathological parameters. Eighty-nine patients (44%) were symptomatic, 113 (55%) were incidental. Information was not available in two patients...

  1. Utility of lead aVR for identifying the culprit lesion in acute myocardial infarction

    DEFF Research Database (Denmark)

    Kühl, Jørgen Tobias; Berg, Ronan M G

    2009-01-01

    -segment elevation AMI (STEMI). Pooled data showed a sensitivity of 47%, a specificity of 96%, a positive predicative value (PPV) of 91% and a NPV of 69%. Five studies examined if ST-segment depression (STD) in lead aVR is valuable for discerning lesions in the circumflex artery from those in the right coronary...

  2. CHARACTERIZATION OF ANTERIOR SEGMENT OPHTHALMOLOGIC LESIONS IDENTIFIED IN FREE-RANGING DOLPHINS AND THOSE UNDER HUMAN CARE.

    Science.gov (United States)

    Colitz, Carmen M H; Walsh, Michael T; McCulloch, Stephen D

    2016-03-01

    Cetaceans in the wild and under human care develop a variety of ocular lesions. Although they have echolocation, cetacean species have good sight, making ocular health an important part of overall health care. The cornea is the primary site of abnormalities in both populations. Typical lesions of cetaceans under human care are characterized in this retrospective review of cases. One hundred eighty animals (n = 360 eyes) were chosen from the author's ophthalmologic examination reports from different geographic areas; they included Atlantic bottlenose dolphins (Tursiops truncatus), Pacific bottle nose dolphins (Tursiopstruncatus gilli), Indopacific bottlenose dolphins (Steno bredanensis), Indopacific humpback dolphins (Sousa chinensis), and roughtooth dolphins (Steno bredanensis). These animals were examined at least once, although most were examined numerous times over many years; lesions were categorized and are described. Seventy-seven eyes from 47 animals were normal. Medial keratopathy was the most common lesion and identified in 180 eyes from 97 animals, with 83 affected bilaterally. Horizontal keratopathy was identified in 69 eyes from 41 animals, with 28 affected bilaterally. Axial keratopathy and nonspecific axial opacities were identified in 67 eyes from 44 animals, with 21 affected bilaterally. Seventy-eight eyes from 50 animals, with 28 affected bilaterally, had more than one type of corneal lesion. Cataracts were identified in 32 eyes from 19 animals, with 13 affected bilaterally. Traumatic injuries were also common and involved eyelids and cornea. Sixteen eyes from 11 animals were blind; five dolphins were blind bilaterally due to phthisis bulbi secondary to corneal perforation or severe trauma. None of the diseases had a sex predisposition; however, medial keratopathy was significantly more common as a bilateral presentation than as a unilateral presentation. Cetaceans under human care with impaired sight can use echolocation; however, ocular health

  3. Incidental bony pathology when reporting trauma orthopantomograms

    Energy Technology Data Exchange (ETDEWEB)

    Macanovic, M., E-mail: mladenmaca@gmail.co [Derriford Hospital NHS Trust, Plymouth (United Kingdom); Gangidi, S.; Porter, G.; Brown, S.; Courtney, D. [Derriford Hospital NHS Trust, Plymouth (United Kingdom); Porter, J. [Community Dental Service, Plymouth Primary Care Trust, Plymouth, Devon (United Kingdom)

    2010-10-15

    Radiologists frequently report orthopantomograms (OPTs) and other views of the mandible, most often in patients who have suffered facial trauma. These examinations may reveal incidental pathology. It is important that radiologists are aware of the radiological appearances and the clinical significance of these lesions. In this review we will present examples of the more common odontogenic lesions including: radicular cyst, odontogenic keratocyst, dentigerous cyst, ameloblastoma, and also examples of non-odontogenic pathology: bisphosphonate-related osteonecrosis of the jaw (BRONJ) and chronic osteomyelitis. Although some of the lesions will require computed tomography (CT) or magnetic resonance imaging (MRI) for further lesion characterization and evaluation of the surrounding tissues, we are going to focus on the plain film appearances. We will also briefly discuss the pathogenesis, epidemiology, and treatment of these lesions.

  4. Impact of variations in fatty liver on sonographic detection of focal hepatic lesions originally identified by CT

    Directory of Open Access Journals (Sweden)

    Size Wu

    2016-01-01

    Full Text Available Purpose: The aim of this study was to investigate the influence of variations in fatty liver on the ultrasonographic detection of focal liver lesions. Methods: A total of 229 patients with varying degrees of fatty liver and focal liver lesions and 200 patients with focal liver lesions but no fatty liver were randomly selected for inclusion in groups I and II, respectively. Findings of focal liver lesions identified on computed tomography were taken as the reference, and findings on ultrasonography were compared with them. Results: The number of focal liver lesions in groups I and II were 501 and 413, respectively. The ultrasonographic detection rates of focal liver lesions in groups I and II were 86.8% (435/501 and 94.2% (389/413, respectively. Comparison of the detection of the focal lesions between patients with and without fatty liver or different grades of fatty liver were as follows: mild fatty liver (162/177 vs. liver without fat infiltration (389/413 (P=0.277; mild fatty liver (162/177 vs. moderate fatty liver (190/212 (P=0.604; mild fatty liver (162/177 vs. severe fatty liver (83/112 (P<0.001; moderate fatty liver (190/212 vs. liver without fat infiltration (389/413 (P=0.051; moderate fatty liver (190/212 vs. severe fatty liver (83/112 (P<0.001; severe fatty liver (83/112 vs. liver without fat infiltration (389/413 (P<0.001; and fatty liver (435/501 vs. liver without fat infiltration (389/413 (P<0.001. Conclusion: Mild and moderate fatty liver are not significantly associated with the visualization of the lesion, while severe fatty liver usually impairs the detection of focal lesions in the liver. If a patient with severe fatty liver is suspected to have a liver tumor, ultrasonography should only be chosen cautiously in case of a missed diagnosis.

  5. Crane. Incidental Classroom Instruction 20295

    Energy Technology Data Exchange (ETDEWEB)

    Reynolds, Richard Jennings [Los Alamos National Laboratory

    2016-04-01

    The purpose of this course is to introduce safe hoisting and rigging practices to personnel who are attempting to become LANL incidental crane operators and to review and refresh safe hoisting and rigging practices with existing incidental crane operators.

  6. INCIDENTAL LEIOMYOMA IN MESH HERNIOPLASTY

    Directory of Open Access Journals (Sweden)

    Asha

    2013-05-01

    Full Text Available ABSTRACT: Incidental finding of leiomyoma is rare finding and can mimic an inguinal hernia or both can occur at a time. Very small mass beside he rnia sac identified during exploration of the inguinal canal. Inguinal hernia in females is less common compared to males, but more common than the femoral hernia. Beside the sac there may b e other structures, which have been reported like lipoma of cord, lymph node. In our hospital we have come across this case, and would like to report. Confirmatory diagnosis is established by hi stopathology. Surgical excision is the curative treatment

  7. Incidentally Detected Blue Nevus of Endocervix: a Case Report

    Science.gov (United States)

    Bhat, Shaila Talengala; Shivamurthy, Archana; Kini Rao, Anuradha Calicut

    2015-01-01

    Blue nevi are uncommon, asymptomatic lesions of the uterine cervix. These lesions are not often detected clinically or on colposcopy. Careful histopathological examination is required. The nevus cells are said to originate from the immature melanoblasts of the neural crest. These lesions need to be differentiated from malignant melanoma and melanosis of the cervix. We present here a case report of incidentally detected cervical blue nevus in a 52 year old lady. PMID:26351493

  8. Incidental findings at MRI-enterography in patients with suspected or known Crohn s disease

    Institute of Scientific and Technical Information of China (English)

    Michael; Dam; Jensen; Torben; Nathan; Jens; Kjeldsen; Sφren; Rafael; Rafaelsen

    2010-01-01

    AIM:To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging(MRI)-enterography in patients with suspected or known Crohn's disease(CD). METHODS:Incidental findings were defined as unexpected lesions outside the small intestine,not previously known or suspected at the time of referral, and not related to inflammatory bowel disease.Through a systematic review of medical charts we analyzed the clinical impact of incidental findings,and compared the MRI find...

  9. Work up of incidental adrenal mass: state of the art.

    Science.gov (United States)

    Bada, Maida; Castellan, Pietro; Tamburro, Fabiola R; Berardinelli, Francesco; Neri, Fabio; Cindolo, Luca; Schips, Luigi

    2016-11-18

    Due to the increasing use of radiological investigations, the detection of incidental adrenal masses has become even more frequent. Therefore, it is crucial to identify the nature of the adrenal mass in order to decide the type of treatment that should be undertaken. Toward this goal, biochemical tests are useful in order to assess catecholamines levels for the presence of a pheochromocytoma or cortisol excess in case of Cushing's syndrome. Furthermore, the dexamethasone suppression test and late-night salivary cortisol may be useful in measuring plasma cortisol, respectively, in the blood and urine. Hyperaldosteronism could be suspected in the presence of arterial hypertension. With regard to imaging modalities, the contrast washout and Hounsfield units estimation might play a role as indicators on computed tomography. In terms of treatment, a surgical approach is most suitable for a hyperfunctioning adrenal mass irrespective of size, and for nonfunctioning masses >4 cm. For indeterminate smaller lesions, with washout >50%, <10 Hounsfield Unit, nonfunctioning, benign-appearing, undergoing a follow-up in regular intervals is more appropriate in order to estimate mass growth. This paper summarizes recent findings on the management of incidental adrenal masses, with a special focus on the use of imaging, surgical management and follow-up modalities in improving patient outcomes.

  10. Laser micro-dissection and qPCR for identifying specific HPV types responsible for malignancy in penile lesions.

    Science.gov (United States)

    Lebelo, Ramokone L; Thys, Sofie; Benoy, Ina; Depuydt, Christophe E; Bogers, John-Paul; Bida, Meshack N; Mphahlele, M Jeffrey

    2015-10-01

    The aim of the study was to identify specific human papillomavirus (HPV) type responsible for malignancy in penile tissue samples using laser micro-dissection and TaqMan quantitative real-time PCR (qPCR). The study was based on two pre-malignant and seven malignant penile tissue samples and laser micro-dissection was performed on all. Genotyping was performed on whole tissue sections and laser micro-dissection samples using qPCR. Two whole tissue section samples were HPV negative while seven were HPV positive. In four samples that were single HPV infections with whole tissue section PCR, identical HPV types were confirmed with laser micro-dissection PCR. Clearly confirming that the single HPV type detected is responsible for malignancy. In two samples that had multiple HPV infections with whole tissue section PCR, only one HPV type with the highest viral load was detected with laser micro-dissection PCR, suggesting that the HPV type with the highest viral load is most likely the cause of that particular lesion. HPV 11 and/or HPV 16 were the only types detected with laser micro-dissection PCR in these cases, compared to multiple HPV types (HPV 11, HPV 16, HPV 18, HPV 31, HPV 33, HPV 35, and HPV 39) initially detected with whole tissue section PCR. HPV 11 was associated with verrucous lesions while HPV 16 was associated with squamous cell carcinoma and PIN 3 lesions. This study confirms that laser micro-dissection and qPCR are essential tools in identifying the HPV types responsible for malignancy in penile lesions, particularly in samples with multiple infections. © 2015 Wiley Periodicals, Inc.

  11. Simultaneous SPECT imaging of multi-targets to assist in identifying hepatic lesions

    Science.gov (United States)

    Guo, Zhide; Gao, Mengna; Zhang, Deliang; Li, Yesen; Song, Manli; Zhuang, Rongqiang; Su, Xinhui; Chen, Guibing; Liu, Ting; Liu, Pingguo; Wu, Hua; Du, Jin; Zhang, Xianzhong

    2016-01-01

    Molecular imaging technique is an attractive tool to detect liver disease at early stage. This study aims to develop a simultaneous dual-isotope single photon emission computed tomography (SPECT)/CT imaging method to assist diagnosis of hepatic tumor and liver fibrosis. Animal models of liver fibrosis and orthotopic human hepatocellular carcinoma (HCC) were established. The tracers of 131I-NGA and 99mTc-3P-RGD2 were selected to target asialoglycoprotein receptor (ASGPR) on the hepatocytes and integrin αvβ3 receptor in tumor or fibrotic liver, respectively. SPECT imaging and biodistribution study were carried out to verify the feasibility and superiority. As expected, 99mTc-3P-RGD2 had the ability to evaluate liver fibrosis and detect tumor lesions. 131I-NGA showed that it was effective in assessing the anatomy and function of the liver. In synchronized dual-isotope SPECT/CT imaging, clear fusion images can be got within 30 minutes for diagnosing liver fibrosis and liver cancer. This new developed imaging approach enables the acquisition of different physiological information for diagnosing liver fibrosis, liver cancer and evaluating residual functional liver volume simultaneously. So synchronized dual-isotope SPECT/CT imaging with 99mTc-3P-RGD2 and 131I-NGA is an effective approach to detect liver disease, especially liver fibrosis and liver cancer. PMID:27377130

  12. Using transcranial magnetic stimulation of the undamaged brain to identify lesion sites that predict language outcome after stroke.

    Science.gov (United States)

    Lorca-Puls, Diego L; Gajardo-Vidal, Andrea; Seghier, Mohamed L; Leff, Alexander P; Sethi, Varun; Prejawa, Susan; Hope, Thomas M H; Devlin, Joseph T; Price, Cathy J

    2017-06-01

    Transcranial magnetic stimulation focused on either the left anterior supramarginal gyrus or opercular part of the left inferior frontal gyrus has been reported to transiently impair the ability to perform phonological more than semantic tasks. Here we tested whether phonological processing abilities were also impaired following lesions to these regions in right-handed, English speaking adults, who were investigated at least 1 year after a left-hemisphere stroke. When our regions of interest were limited to 0.5 cm3 of grey matter centred around sites that had been identified with transcranial magnetic stimulation-based functional localization, phonological impairments were observed in 74% (40/54) of patients with damage to the regions and 21% (21/100) of patients sparing these regions. This classification accuracy was better than that observed when using regions of interest centred on activation sites in previous functional magnetic resonance imaging studies of phonological processing, or transcranial magnetic stimulation sites that did not use functional localization. New regions of interest were generated by redefining the borders of each of the transcranial magnetic stimulation sites to include areas that were consistently damaged in the patients with phonological impairments. This increased the incidence of phonological impairments in the presence of damage to 85% (46/54) and also reduced the incidence of phonological impairments in the absence of damage to 15% (15/100). The difference in phonological processing abilities between those with and without damage to these 'transcranial magnetic stimulation-guided' regions remained highly significant even after controlling for the effect of lesion size. The classification accuracy of the transcranial magnetic stimulation-guided regions was validated in a second sample of 108 patients and found to be better than that for (i) functional magnetic resonance imaging-guided regions; (ii) a region identified from an

  13. Spontaneous Regression of an Incidental Spinal Meningioma

    Directory of Open Access Journals (Sweden)

    Ali Yilmaz

    2015-12-01

    Full Text Available AIM: The regression of meningioma has been reported in literature before. In spite of the fact that the regression may be involved by hemorrhage, calcification or some drugs withdrawal, it is rarely observed spontaneously. CASE REPORT: We report a 17 year old man with a cervical meningioma which was incidentally detected. In his cervical MRI an extradural, cranio-caudal contrast enchanced lesion at C2-C3 levels of the cervical spinal cord was detected. Despite the slight compression towards the spinal cord, he had no symptoms and refused any kind of surgical approach. The meningioma was followed by control MRI and it spontaneously regressed within six months. There were no signs of hemorrhage or calcification. CONCLUSION: Although it is a rare condition, the clinicians should consider that meningiomas especially incidentally diagnosed may be regressed spontaneously.

  14. Spontaneous Regression of an Incidental Spinal Meningioma.

    Science.gov (United States)

    Yilmaz, Ali; Kizilay, Zahir; Sair, Ahmet; Avcil, Mucahit; Ozkul, Ayca

    2016-03-15

    The regression of meningioma has been reported in literature before. In spite of the fact that the regression may be involved by hemorrhage, calcification or some drugs withdrawal, it is rarely observed spontaneously. We report a 17 year old man with a cervical meningioma which was incidentally detected. In his cervical MRI an extradural, cranio-caudal contrast enchanced lesion at C2-C3 levels of the cervical spinal cord was detected. Despite the slight compression towards the spinal cord, he had no symptoms and refused any kind of surgical approach. The meningioma was followed by control MRI and it spontaneously regressed within six months. There were no signs of hemorrhage or calcification. Although it is a rare condition, the clinicians should consider that meningiomas especially incidentally diagnosed may be regressed spontaneously.

  15. Incidentally discovered giant mucocele of the appendix.

    Science.gov (United States)

    Harris, Syed Hasan; Khan, Roobina; Ansari, Maulana Mohammad; Maheshwari, Veena

    2014-11-01

    Mucocele of the appendix is a rare but well-recognized entity that can mimic several common clinical conditions or present as an incidental radiological or surgical finding at laparotomy. Mucoceles are characterized by distension of the lumen due to accumulation of mucoid substance. They can result from mucosal hyperplasia, mucinous cystadenoma, or mucinous cystadenocarcinoma. If untreated, they may rupture producing the potentially fatal entity Pseudomyxoma peritonei, which is difficult to treat both surgically or medically. Appendectomy is used for simple mucocele or for cystadenoma. Preoperative diagnosis of a mucocele is helpful at the time of surgical intervention with careful mobilization, particularly of large lesions reducing the possibility of rupture and complications. The authors report a case of a 65-year-old man presenting with peritonitis due to a pre-pyloric gastric perforation also having an incidental giant mucocele of the appendix.

  16. Coronary plaque quantification and fractional flow reserve by coronary computed tomography angiography identify ischaemia-causing lesions

    DEFF Research Database (Denmark)

    Gaur, Sara; Øvrehus, Kristian Altern; Dey, Damini

    2016-01-01

    tomography angiography (CTA)-derived fractional flow reserve (FFRCT), and lesion-specific ischaemia identified by FFR in a substudy of the NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps). METHODS AND RESULTS: Coronary CTA stenosis, plaque volumes, FFRCT, and FFR were assessed...... the receiver-operating characteristics curve (AUC) analysis. Ischaemia was defined by FFR or FFRCT ≤0.80. Plaque volumes were inversely related to FFR irrespective of stenosis severity. Relative risk (95% confidence interval) for prediction of ischaemia for stenosis >50%, NCP ≥185 mm(3), LD-NCP ≥30 mm(3), CP...

  17. Machine learning algorithm for automatic detection of CT-identifiable hyperdense lesions associated with traumatic brain injury

    Science.gov (United States)

    Keshavamurthy, Krishna N.; Leary, Owen P.; Merck, Lisa H.; Kimia, Benjamin; Collins, Scott; Wright, David W.; Allen, Jason W.; Brock, Jeffrey F.; Merck, Derek

    2017-03-01

    Traumatic brain injury (TBI) is a major cause of death and disability in the United States. Time to treatment is often related to patient outcome. Access to cerebral imaging data in a timely manner is a vital component of patient care. Current methods of detecting and quantifying intracranial pathology can be time-consuming and require careful review of 2D/3D patient images by a radiologist. Additional time is needed for image protocoling, acquisition, and processing. These steps often occur in series, adding more time to the process and potentially delaying time-dependent management decisions for patients with traumatic brain injury. Our team adapted machine learning and computer vision methods to develop a technique that rapidly and automatically detects CT-identifiable lesions. Specifically, we use scale invariant feature transform (SIFT)1 and deep convolutional neural networks (CNN)2 to identify important image features that can distinguish TBI lesions from background data. Our learning algorithm is a linear support vector machine (SVM)3. Further, we also employ tools from topological data analysis (TDA) for gleaning insights into the correlation patterns between healthy and pathological data. The technique was validated using 409 CT scans of the brain, acquired via the Progesterone for the Treatment of Traumatic Brain Injury phase III clinical trial (ProTECT_III) which studied patients with moderate to severe TBI4. CT data were annotated by a central radiologist and included patients with positive and negative scans. Additionally, the largest lesion on each positive scan was manually segmented. We reserved 80% of the data for training the SVM and used the remaining 20% for testing. Preliminary results are promising with 92.55% prediction accuracy (sensitivity = 91.15%, specificity = 93.45%), indicating the potential usefulness of this technique in clinical scenarios.

  18. Incidental Findings on CT Scans in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Ryan J. Thompson

    2011-01-01

    Full Text Available Objectives. Incidental findings on computed tomography (CT scans are common. We sought to examine rates of findings and disclosure among discharged patients who received a CT scan in the ED. Methods. Retrospective chart review (Aug-Oct 2009 of 600 patients age 18 and older discharged home from an urban Level 1 trauma center. CT reports were used to identify incidental findings and discharge paperwork was used to determine whether the patient was informed of these findings. Results. There were 682 CT scans among 600 patients: 199 Abdomen & Pelvis, 405 Head, and 78 Thorax. A total of 348 incidental findings were documented in 228/682 (33.4% of the scans, of which 34 (9.8% were reported to patients in discharge paperwork. Patients with 1 incidental finding were less likely to receive disclosure than patients with 2 or more (=.010. Patients age <60 were less likely to have incidental findings (<.001. There was no significant disclosure or incidental finding difference by gender. Conclusions. While previous research suggests that CT incidental findings are often benign, reporting to patients is recommended but this is rarely happening.

  19. Analysis of incidental focal hypermetabolic uptake in the breast as detected by 18F-FDG PET/CT: clinical significance and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Chae, Eun Young; Cha, Joo Hee; Kim, Hak Hee; Shin, Hee Jung; Kim, Hyun Ji; Oh, Ha Yeun [Dept. of Radiology, Research Inst. of Radiology, Asan Medical Center, Coll. of Medicine, Univ. of Ulsan, Seoul (Korea, Republic of)], e-mail: jhcha@amc.seoul.kr; Koh, Young Hwan [Center for Liver Cancer, National Cancer Center, Seoul (Korea, Republic of); Moon, Dae Hyuk [Dept. of Nuclear Medicine, Asan Medical Center, Coll. of Medicine, University of Ulsan, Seoul (Korea, Republic of)

    2012-06-15

    Background: With the widespread use of PET/CT, incidental hypermetabolic foci unrelated to the known malignancy have been described with increasing frequency. Purpose: To determine the frequency and clinical significance of incidental focal hypermetabolic uptake in the breast as detected by 18F-FDG PET/CT, and to explore factors differentiating benign and malignant breast uptake. Material and Methods: From January 2005 to June 2010, a total of 51971 whole-body FDG PET/CT examinations were performed in our clinic. After excluding 7254 sets of PET/CT data from patients known to have breast cancer, we retrospectively identified patients showing incidental focal hypermetabolic activity in the breast. Of 44717 PET/CT examinations conducted on 32988 patients, we identified 131 patients with no previous known or suspected benign and malignant breast disease. The etiology, mean SUVmax, and diameter of breast lesions were assessed. We also compared the presentation of the lesions on CT, mammography, and ultrasonography. Results: Of the 131 patients, 60 were histologically diagnosed with breast lesions, including 32 with malignant and 28 with benign lesions. An additional 11 patients were followed-up for more than 2 years and were clinically considered to have benign lesions. The remaining 60 patients who had neither histologic confirmation nor followed-up for more than 2 years were excluded. Therefore, 71 patients were finally included. The mean SUVmax of 39 benign lesions and 32 malignant lesions were 2.02{+-}1.52 and 3.71{+-}3.83, respectively (P 0.0001). At a cut-off value of 2.3, the rate of malignancy and specificity of the mean SUVmax for differentiating benign and malignant breast lesions were 61.3%, 76.3, respectively. The CT data from PET/CT revealed that the mean diameters of benign and malignant lesions were 1.19{+-}0.97 cm and 2.26{+-}1.96 cm, respectively (P = 0.0009). Conclusion: Incidental focal 18F-FDG uptake in the breast as detected by PET/CT was

  20. A screen for suppressors of gross chromosomal rearrangements identifies a conserved role for PLP in preventing DNA lesions.

    Directory of Open Access Journals (Sweden)

    Pamela Kanellis

    2007-08-01

    Full Text Available Genome instability is a hallmark of cancer cells. One class of genome aberrations prevalent in tumor cells is termed gross chromosomal rearrangements (GCRs. GCRs comprise chromosome translocations, amplifications, inversions, deletion of whole chromosome arms, and interstitial deletions. Here, we report the results of a genome-wide screen in Saccharomyces cerevisiae aimed at identifying novel suppressors of GCR formation. The most potent novel GCR suppressor identified is BUD16, the gene coding for yeast pyridoxal kinase (Pdxk, a key enzyme in the metabolism of pyridoxal 5' phosphate (PLP, the biologically active form of vitamin B6. We show that Pdxk potently suppresses GCR events by curtailing the appearance of DNA lesions during the cell cycle. We also show that pharmacological inhibition of Pdxk in human cells leads to the production of DSBs and activation of the DNA damage checkpoint. Finally, our evidence suggests that PLP deficiency threatens genome integrity, most likely via its role in dTMP biosynthesis, as Pdxk-deficient cells accumulate uracil in their nuclear DNA and are sensitive to inhibition of ribonucleotide reductase. Since Pdxk links diet to genome stability, our work supports the hypothesis that dietary micronutrients reduce cancer risk by curtailing the accumulation of DNA damage and suggests that micronutrient depletion could be part of a defense mechanism against hyperproliferation.

  1. Posterior parahepatic cyst as an incidental finding-review of 40 cases

    Energy Technology Data Exchange (ETDEWEB)

    Harvin, H.J., E-mail: hharvin@esmil.co [Scottsdale Medical Imaging, Scottsdale, Arizona (United States); Adduci, A.J. [Scottsdale Medical Imaging, Scottsdale, Arizona (United States)

    2010-01-15

    Aim: To describe the characteristic imaging features of the incidental, isolated posterior parahepatic cyst. Methods: Out of 150 patients previously identified on computed tomography (CT) to have an incidental, isolated posterior parahepatic cyst, 40 patients had lesions that were large enough to be assessed for enhancement on CT and/or magnetic resonance imaging (MRI) and had at least 1 year of imaging follow-up. All available CT, MRI, and 2- [{sup 18}F]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) examinations for these 40 patients were reviewed, and the lesions were assessed for size, attenuation, and location relative to the spine and right kidney. Results: For the 40 patients reviewed, all parahepatic lesions were shown to be cysts by absence of identifiable enhancement on CT or MRI. Cysts ranged in size from 3 mm to 2.5 cm. Hounsfield unit (HU) measurements ranged from 12 HU to 83 HU. In the transverse plane, all cysts were located lateral to the lateral margin of the right kidney. In the craniocaudal dimension, all cysts were at or above the level of the right kidney, and all were located between the T11-12 and L1-2 vertebral levels. All cysts were stable on follow-up imaging with a mean duration of follow-up of 41 months. Conclusion: Isolated, indolent posterior parahepatic cysts have a characteristic appearance and location and demonstrate benign behaviour with stability on follow-up imaging. These cysts should be considered in the differential diagnosis for isolated parahepatic lesions, and the imaging features described here aid in the distinction of these cysts from other entities such as metastatic disease.

  2. Incidental solid renal mass in a cadaveric donor kidney

    Directory of Open Access Journals (Sweden)

    R M Meyyappan

    2012-01-01

    Full Text Available The number of patients living with end-stage renal disease (ESRD is increasing in our country and demand for renal grafts is ever increasing. Cadaver renal transplantation is being established as a viable supplement to live transplantation. We present a case where a mass lesion was encountered in the donor kidney from a cadaver. Enucleation of the lesion was done and we proceeded with the grafting. Histopathological examination showed a ′Renomedullary interstitial cell tumour′, a rare benign lesion. Post transplant, the renal function recovered well and the patient is asymptomatic. Such incidental renal masses present an ethical dilemma to the operating surgeon.

  3. Incidental Cardiac Findings on Thoracic Imaging.

    LENUS (Irish Health Repository)

    Kok, Hong Kuan

    2013-02-07

    The cardiac structures are well seen on nongated thoracic computed tomography studies in the investigation and follow-up of cardiopulmonary disease. A wide variety of findings can be incidentally picked up on careful evaluation of the pericardium, cardiac chambers, valves, and great vessels. Some of these findings may represent benign variants, whereas others may have more profound clinical importance. Furthermore, the expansion of interventional and surgical practice has led to the development and placement of new cardiac stents, implantable pacemaker devices, and prosthetic valves with which the practicing radiologist should be familiar. We present a collection of common incidental cardiac findings that can be readily identified on thoracic computed tomography studies and briefly discuss their clinical relevance.

  4. Incidental prostate cancer in radical cystoprostatectomy specimens

    Institute of Scientific and Technical Information of China (English)

    Xiao-Dong Jin; Zhao-Dian Chen; Bo Wang; Song-Liang Cai; Xiao-Lin Yao; Bai-Ye Jin

    2008-01-01

    Aim: To investigate the rates of prostate cancer (Pca) in radical cystoprostatectomy (RCP) specimens for bladder cancer in mainland China. To determine the follow-up outcome of patients with two concurrent cancers and identify whether prostate-specific antigen (PSA) is a useful tool for the detection of Pca prior to surgery. Methods: From January 2002 to January 2007, 264 male patients with bladder cancer underwent RCP at our center. All patients underwent digital rectal examination (DRE) and B ultrasound. Serum PSA levels were tested in 168 patients. None of the patients had any evidence of Pca before RCP. Entire prostates were embedded and sectioned at 5 mm intervals. Results: Incidental Pca was observed in 37 of 264 (14.0%) RCP specimens. Of these, 12 (32.4%) were clinically significant according to an accepted definition. The PSA levels were not significantly different between patients with Pca and those without Pca, nor between patients with significant Pca and those with insignificant Pca. Thirty-four patients with incidental Pca were followed up. During a mean follow-up period of 26 months, two patients with PSA > 4 ng/mL underwent castration. None of the patients died of Pca. Conclusion: The incidence of Pca in RCP specimens in mainland China is lower than that in most developed countries. PSA cannot identify asymptomatic Pca prior to RCP. In line with published reports, incidental Pca does not impact the prognosis of bladder cancer patients undergoing RCP.

  5. Clinical and Radiologic Follow-up Study for Biopsy Diagnosis of Radial Scar/Radial Sclerosing Lesion without Other Atypia.

    Science.gov (United States)

    Kalife, Elizabeth Tágide; Lourenco, Ana P; Baird, Grayson L; Wang, Yihong

    2016-11-01

    To determine the incidence of malignancy for radial scars (RS)/radial sclerosing lesions (RSL) without associated atypia or malignancy identified at needle biopsy. Retrospective review of the pathology data base from January 2004 to July 2013 yielded 100 needle biopsies diagnosed as RS/RSL without associated atypia/malignancy. The RS/RSL was considered "incidental" if the target was calcifications and "targeted" if imaging revealed a mass, architectural distortion, or suspicious magnetic resonance imaging enhancement. The electronic medical record was used to identify surgical pathology, follow-up imaging, and clinical course; all pathology slides and imaging were reviewed by a board-certified pathologist and radiologist, respectively. Patient age, laterality, RS/RSL size, microcalcifications, and associated benign lesions were recorded. Among 100 cases, 54 were "incidental" and 46 were "targeted." In the incidental group, 14 underwent excision, 30 had imaging follow-up, and 10 were lost to follow-up. In the targeted group, 27 underwent excision, 11 had imaging follow-up, and 8 were lost to follow-up. Atypia was identified in four excisions: three from the incidental group and one from the targeted group. Among these, three had negative imaging follow-up (mean 45 months; range 15-60 months); the fourth patient (one of the incidental group) underwent excision alone. One of the 27 "targeted" patients who underwent excision developed ductal carcinoma in situ of the contralateral breast at 96 months. There have been no ipsilateral malignancies. We found no evidence of associated malignancy at excision for either incidental or targeted biopsies of RS/RSL without atypia. Our study suggests that close imaging follow-up is adequate for patients with RS/RSL without associated atypia/malignancy on needle biopsy. © 2016 Wiley Periodicals, Inc.

  6. A novel stem cell associated marker identified by monoclonal antibody HESC5:3 differentiates between neoplastic lesions in follicular thyroid neoplasms.

    Science.gov (United States)

    Heikkilä, Annukka; Fermér, Christian; Hagström, Jaana; Louhimo, Johanna; Mäenpää, Hanna; Siironen, Päivi; Heiskanen, Ilkka; Nilsson, Olle; Arola, Johanna; Haglund, Caj

    2015-07-01

    Follicular thyroid lesions are the bane of cytopathology. Differentiation between adenoma and carcinoma is impossible, and often these neoplasms are indistinguishable even from uninodular goitre. In other cancers as well, a theory of stem cells as the origin of cancer has been discussed in thyroid carcinogenesis. We aimed to examine a novel stem cell associated marker identified by monoclonal antibody HESC5:3 in follicular lesions in an attempt to find a marker for differential diagnosis in thyroid cytopathology. HESC5:3 was raised against and is specific for undifferentiated human embryonic stem cells. The epitope of this novel antibody is to be defined. Immunohistochemical expression of HESC5:3 was examined in clinical material comprised of follicular neoplasms (83 adenomas, 43 carcinomas) and non-neoplastic lesions (41 goitrous, 22 hyperplastic, 23 normal tissue specimens). Staining differed significantly between neoplastic and non-neoplastic lesions. Nuclear staining was increased in non-neoplastic cells, whereas in neoplastic cells expression was mainly cytoplasmic. There was no difference between benign and malignant lesions, suggesting a role in early tumourigenesis. In conclusion, the HESC5:3 epitope may be of benefit as a neoplasia marker in distinguishing between uninodular goitre and neoplasia. Characterization of the epitope would increase the interest in this promising new stem cell associated marker.

  7. An Incidental Renal Oncocytoma: 18F-Choline PET/MRI

    Directory of Open Access Journals (Sweden)

    Andrew Mallia

    2016-04-01

    Full Text Available PET/MRI is a new hybrid imaging modality and has the potential to become a powerful imaging tool. It is currently one of the most active areas of research in diagnostic imaging. The characterisation of an incidental renal lesion can be difficult. In particular, the differentiation of an oncocytoma from other solid renal lesions such as renal cell carcinoma (RCC represents a diagnostic challenge. We describe the detection of an incidental renal oncocytoma in a 79-year gentleman who underwent a re-staging 18F-Choline PET/MRI following a rise in PSA values (4.07, nadir 1.3.

  8. Simple bone cyst presenting as an incidental finding in pretreatment orthodontic radiograph: A case report

    Directory of Open Access Journals (Sweden)

    Salini G Sudha

    2017-01-01

    Full Text Available Pretreatment radiographs, especially panoramic and lateral cephalometric are routinely used as an aid in orthodontic diagnosis and treatment planning. Sometimes abnormalities may be detected as incidental findings in such radiographs that require medical or odontological management. Simple bone cyst is an uncommon lesion mostly occurring in young individuals; it is often asymptomatic and accidently discovered during routine radiological examination. Mostly the pathology presents as a unilocular radiolucency in the mandible between canine and third molar. A definite diagnosis is invariably achieved during surgery as it presents as an empty cavity without lining. We present a case of a simple bone cyst of the body of mandible identified during routine pretreatment orthodontic radiograph.

  9. Accuracy of magnetic resonance in identifying traumatic intraarticular knee lesions; Acuracia da ressonancia magnetica para identificar lesoes traumaticas intra-articulares do joelho

    Energy Technology Data Exchange (ETDEWEB)

    Vaz, Carlos Eduardo Sanches; Camargo, Olavo Pires de; Santana, Paulo Jose de; Valezi, Antonio Carlos [Universidade Estadual de Londrina, PR (Brazil). Hospital Regional do Parana. Dept. de Ortopedia e Traumatologia]. Email: carvaz@uol.com.br

    2005-12-15

    Purpose: To evaluate the diagnostic accuracy of magnetic resonance imaging of the knee in identifying traumatic intraarticular knee lesions. Method: 300 patients with a clinical diagnosis of traumatic intraarticular knee lesions underwent prearthoscopic magnetic resonance imaging. The sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for a positive test, likelihood ratio for a negative test, and accuracy of magnetic resonance imaging were calculated relative to the findings during arthroscopy in the studied structures of the knee (medial meniscus, lateral meniscus, anterior cruciate ligament, posterior cruciate ligament, and articular cartilage). Results: Magnetic resonance imaging produced the following results regarding detection of lesions: medial meniscus: sensitivity 97.5%, specificity 92.9%, positive predictive value 93.9%, positive negative value 97%, likelihood positive ratio 13.7, likelihood negative ratio 0.02, and accuracy 95.3%; lateral meniscus: sensitivity 91.9%, specificity 93.6%, positive predictive value 92.7%, positive negative value 92.9%, likelihood positive ratio 14.3, likelihood negative ratio 0.08, and accuracy 93.6%; anterior cruciate ligament: sensitivity 99.0%, specificity 95.9%, positive predictive value 91.9%, positive negative value 99.5%, likelihood positive ratio 21.5, likelihood negative ratio 0.01, and accuracy 96.6%; posterior cruciate ligament: sensitivity 100%, specificity 99%, positive predictive value 80.0%, positive negative value 100%, likelihood positive ratio 100, likelihood negative ratio 0.01, and accuracy 99.6%; articular cartilage: sensitivity 76.1%, specificity 94.9%, positive predictive value 94.7%, positive negative value 76.9%, likelihood positive ratio 14.9, likelihood negative ratio 0.25, and accuracy 84.6%. Conclusion: Magnetic resonance imaging is a satisfactory diagnostic tool for evaluating meniscal and ligamentous lesions of the knee, but it is unable to clearly

  10. Incidental Learning of Geospatial Concepts across Grade Levels: Map Overlay

    Science.gov (United States)

    Battersby, Sarah E.; Golledge, Reginald G.; Marsh, Meredith J.

    2006-01-01

    In this paper, the authors evaluate map overlay, a concept central to geospatial thinking, to determine how it is naively and technically understood, as well as to identify when it is leaner innately. The evaluation is supported by results from studies at three grade levels to show the progression of incidentally learned geospatial knowledge as…

  11. Incidental Learning of Geospatial Concepts across Grade Levels: Map Overlay

    Science.gov (United States)

    Battersby, Sarah E.; Golledge, Reginald G.; Marsh, Meredith J.

    2006-01-01

    In this paper, the authors evaluate map overlay, a concept central to geospatial thinking, to determine how it is naively and technically understood, as well as to identify when it is leaner innately. The evaluation is supported by results from studies at three grade levels to show the progression of incidentally learned geospatial knowledge as…

  12. Positron emission tomography of incidentally detected small pulmonary nodules

    DEFF Research Database (Denmark)

    Fischer, B M; Mortensen, J; Dirksen, A;

    2004-01-01

    The aim of this study was to assess the value of fluorodeoxyglucose positron emission tomography (FDG PET) imaging of small pulmonary nodules incidentally detected by spiral computed tomography (CT) in a high-risk population. Ten patients (five females, five males, aged 54-72 years) were recruited...... (approx. 3.3% of the entire study population). The prevalence of malignancy in this group was 50%. The accuracy of PET was high, in spite of the fact that seven patients had nodules smaller than 15 mm and two patients had bronchoalveolar cell carcinoma. This small prospective study indicates...... that subsequent assessment with FDG PET of small pulmonary nodules incidentally detected by CT has the potential to minimize the numbers of invasive procedures performed in individuals with a benign pulmonary lesion. FDG PET also increases the possibility of an early diagnosis as compared to the strategy...

  13. 78 FR 44539 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to a...

    Science.gov (United States)

    2013-07-24

    ... activities. Response: The density values cited by the Commission are found in the Navy Marine Species Density... correctly identify the target; Advanced education in biological science, wildlife management, mammalogy, or... National Oceanic and Atmospheric Administration RIN 0648-XC622 Takes of Marine Mammals Incidental to...

  14. Anatomy of a serial killer: differential diagnosis of tuberculosis based on rib lesions of adult individuals from the Coimbra Identified Skeletal Collection, Portugal.

    Science.gov (United States)

    Santos, Ana Luísa; Roberts, Charlotte Ann

    2006-05-01

    The role of new bone formation on visceral surfaces of ribs in the diagnosis of tuberculosis (TB) in past human populations has been explored by many researchers, using both skeletal remains with known causes of death and archaeological samples. This study focuses, firstly, on adult skeletons from the Coimbra Identified Skeletal Collection in Portugal and investigates the skeletal manifestations of individuals known to have died from TB; secondly, this study focuses on the role of rib lesions in the diagnostic criteria for TB. One hundred and fifty-seven males and 106 females aged between 22-87 years were examined; causes of death were assigned as pulmonary TB, extrapulmonary TB, and pulmonary non-TB; a control group, extrapulmonary non-TB, was selected from the remaining individuals. Of individuals with rib lesions, 85.7% (69/81) had pulmonary or extrapulmonary TB as an assigned cause of death, while 17.8% (16/90) of individuals with rib lesions had a non-TB cause of death. Rib lesions were significantly more common in individuals who had died from TB, although the lesions cannot be considered pathognomonic for TB. In individuals dying from pulmonary TB, ribs in the central part of the rib cage were most affected, at their vertebral ends. The lower part of the rib cage may be a marker for peritoneal TB, and "coral-like" new bone formation on ribs may be an indicator of neoplastic disease. Further work on rib involvement in TB in clinical contexts, and the study of further documented skeletal collections, are recommended.

  15. Prevalence and clinical significance of extravascular incidental findings in patients undergoing CT cervico-cerebral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Crockett, Matthew Thomas, E-mail: crockettmt@gmail.com; Murphy, Blathnaid, E-mail: blathnaidmurphy@hotmail.com; Smith, Jennifer, E-mail: jennifer.js.smith@gmail.com; Kavanagh, Eoin Carl, E-mail: kavanaghec@gmail.com

    2015-08-15

    Highlights: • CT cervico-cerebral angiography (CTCCA) is a commonly performed study for assessment of vascular pathologies of head and neck. • This study assessed the prevalence, clinical significance and management of extravascular incidental findings detected on CTCCA. • This study demonstrated the presence of clinically significant incidental findings in 14% of patients undergoing CTCCA with 8% of these findings deemed to be highly significant. 19% of patients with highly clinically significant findings did not receive appropriate follow up. • A standardised method of reporting incidental findings, such as that used in this paper is suggested to aid radiologists and referring physicians in recording and communicating these findings. - Abstract: Introduction: CT cervico-cerebral angiography (CTCCA) is now the first line diagnostic imaging modality for the majority of vascular pathologies of the head and neck with diagnostic value comparable to or better than traditional angiographic techniques. The aim of this study was to assess the prevalence, clinical significance and management of extravascular incidental findings detected on CTCCA. Materials and methods: A retrospective review of the CTCCA reports of 302 consecutive patients from 2009 to 2013 was undertaken. Extravascular incidental findings were classified, according to an adaptation of the CT colonography data and reporting system (CRADS), as EV1–EV4. EV1 = no incidental findings, EV2 = clinically insignificant incidental finding, EV3 = incidental finding of intermediate clinical significance, EV4 = highly clinically significant finding. Follow up of the electronic medical records of patients with EV3 or EV4 findings was undertaken to determine subsequent management. Results: Potentially clinically significant findings were demonstrated in 14.2% of patients with 8.6% of patients having a highly clinically significant finding. 4 incidental findings were confirmed to be malignant lesions and 5

  16. Incidentally detected lung nodules: clinical predictors of adherence to fleischner society surveillance guidelines.

    LENUS (Irish Health Repository)

    Ridge, Carole A

    2014-02-28

    The objective of this study was to determine adherence to incidentally detected lung nodule computed tomographic (CT) surveillance recommendations and identify demographic and clinical factors that increase the likelihood of CT surveillance.

  17. Cholestrol granuloma of the breast incidentally detected on dynamic abdominal CT: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Sun Hye; Lee, Eun Hye; Hong, Hyun Sook; Kwak, Jeong Ja [Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

    2016-01-15

    A breast cholesterol granuloma is an uncommon nodular breast lesion. We incidentally detected a persistently enhancing breast mass on the dynamic abdominal computed tomography (CT) of a 78-year-old woman. The mass decreased in diameter over 50 days following a core needle biopsy. This report is the first to describe the dynamic-enhanced CT features of a breast cholesterol granuloma.

  18. Benign thyroid and neck lesions mimicking malignancy with false positive findings on positron emission tomography-computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Ye Ri; Kim, Shin Young; Lee, Sang Mi [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Lee, Deuk Young [Dept. of Surgery, Younsei Angelot Women' s Clinic, Cheonan (Korea, Republic of)

    2017-02-15

    The increasing use of positron emission tomography-computed tomography (PET/CT) has led to the frequent detection of incidental thyroid and neck lesions with increased 18F-deoxyglucose (FDG) uptake. Although lesions with increased FDG uptake are commonly assumed to be malignant, benign lesions may also exhibit increased uptake. The purpose of this pictorial essay is to demonstrate that benign thyroid and neck lesions can produce false-positive findings on PET/CT, and to identify various difficulties in interpretation. It is crucial to be aware that differentiating between benign and malignant lesions is difficult in a considerable proportion of cases, when relying only on PET/CT findings. Correlation of PET/CT findings with additional imaging modalities is essential to avoid misdiagnosis.

  19. The ability to identify the intraparotid facial nerve for locating parotid gland lesions in comparison to other indirect landmark methods: evaluation by 3.0 T MR imaging with surface coils

    Energy Technology Data Exchange (ETDEWEB)

    Ishibashi, Mana; Fujii, Shinya; Nishihara, Keisuke; Matsusue, Eiji; Kodani, Kazuhiko; Kaminou, Toshio; Ogawa, Toshihide [Tottori University, Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori (Japan); Kawamoto, Katsuyuki [Tottori University, Division of Otolaryngology, Head and Neck Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori (Japan)

    2010-11-15

    It is important to know whether a parotid gland lesion is in the superficial or deep lobe for preoperative planning. We aimed to investigate the ability of 3.0 T magnetic resonance (MR) imaging with surface coils to identify the intraparotid facial nerve and locate parotid gland lesions, in comparison to other indirect landmark methods. We retrospectively evaluated 50 consecutive patients with primary parotid gland lesions. The position of the facial nerve was determined by tracing the nerve in the stylomastoid foramen and then following it on sequential MR sections through the parotid gland. The retromandibular vein and the facial nerve line (FN line) were also identified. For each radiologist and each method, we determined the diagnostic ability for deep lobe lesions and superficial lobe lesions, as well as accuracy. These abilities were compared among the three methods using the Chi-square test with Yates' correction. Mean diagnostic ability for deep lobe lesions, the diagnostic ability for superficial lobe lesions, and accuracy were 92%, 86%, 87%, respectively, for the direct identification method; 67%, 89%, 86%, respectively, for the retromandibular vein method; and 25%, 99%, 90%, respectively, for the FN line method. The direct identification method had significantly higher diagnostic ability for deep lesions than the FN line method (P < 0.01), but significantly lower diagnostic ability for superficial lobe lesions than the FN line method (P < 0.01). Direct identification of the intraparotid facial nerve enables parotid gland lesions to be correctly located, particularly those in the deep lobes. (orig.)

  20. Incidental imaging findings of congenital rib abnormalities - a case series and review of developmental concepts.

    Science.gov (United States)

    Aignătoaei, Anda Maria; Moldoveanu, Cristina Elena; Căruntu, Irina Draga; Giușcă, Simona Eliza; Partene Vicoleanu, Simona; Nedelcu, Alin Horațiu

    2017-09-04

    Congenital rib abnormalities are found in approximately 2% of the general population. Usually, they occur in isolation, when they are rarely symptomatic, but they can also associate with other malformations. We reviewed imaging examinations performed over a period of two years (2014-2015), enabling us to identify isolated rib abnormalities in six adult patients. The case series consisted in three cases with bilateral cervical ribs and one case each with bifid rib, costal fusion and rib pseudarthrosis. In all patients, the costal anomalies were discovered incidentally. All rib malformations were detected at thoracic radiography, except for the rib pseudarthrosis, which was identified at CT scan. Differential diagnosis was made between cervical ribs and abnormalities of the C7 transverse process and of the first rib, while the other costal malformations were distinguished from tumoral, traumatic or inflammatory lesions of the chest wall, lung and pleura. Considering the existing knowledge on rib development, we suggest a classification of the most common types of rib malformations in three categories: (I) results of homeotic transformation, referring to numerical aberrations; (II) segmentation errors, including costal fusion and bridging; (III) anomalies of resegmentation, resulting in bifid ribs. It is important that radiologists are familiarized with the imaging features of rib abnormalities, since these anomalies can be misinterpreted as lesions with different implications. We aim that the developmental classification proposed in this paper can contribute to a better understanding of this pathology.

  1. El recurso incidental de inconstitucionalidad

    Directory of Open Access Journals (Sweden)

    Willman Ruperto Durán Ribera

    2005-01-01

    Full Text Available El artículo analiza el desarrollo histórico de la jurisdicción constitucional en Bolivia hasta la configuración del sistema vigente de control concentrado de constitucionalidad de 1994. El modelo de control concentrado de constitucionalidad que nace en la reforma del 94. El análisis centra su atención en el recurso indirecto o incidental de inconstitucionalidad, considerando su configuración dentro del ordenamiento jurídico, sin perjuicio de realizar algunas consideraciones de derecho comparado.

  2. Incidental context information increases recollection

    Science.gov (United States)

    Norman, Liam J.; Eacott, Madeline J.; Easton, Alexander

    2017-01-01

    The current study describes a receiver-operating characteristic (ROC) task for human participants based on the spontaneous recognition memory paradigms typically used with rodents. Recollection was significantly higher when an object was in the same location and background as at encoding, a combination used to assess episodic-like memory in animals, but not when only one of these task-irrelevant cues was present. The results show that incidentally encoded cue information can determine the degree of recollection, and opens up the possibility of assessing recollection across species in a single experimental paradigm, allowing better understanding of the cognitive and biological mechanisms at play. PMID:28202718

  3. A Case of Bell's Palsy with an Incidental Finding of a Cerebellopontine Angle Lipoma.

    Science.gov (United States)

    Lagman, Carlito; Choy, Winward; Lee, Seung J; Chung, Lawrance K; Bui, Timothy T; Yang, Isaac; Goldman, Howard W

    2016-08-24

    This case report illustrates the potential fallacy of attributing a patient's symptoms to an incidental finding. Serial imaging of small, asymptomatic cerebellopontine angle (CPA) lipomas is favored. It is imperative to accurately diagnose CPA lipoma on imaging and differentiate it from more common CPA lesions. We herein present a patient with symptoms consistent with Bell's palsy and an incidental finding of a CPA lipoma. Additionally, we performed a review of the literature for case reports of patients presenting with facial symptoms and diagnosed with a CPA lipoma.

  4. Risk Factors and Management of Incidental Durotomy in Lumbar Interbody Fusion Surgery.

    Science.gov (United States)

    Enders, Frederik; Ackemann, Amelie; Müller, Simon; Kiening, Karl; Orakcioglu, Berk

    2017-08-28

    This is a retrospective study analysis. In this retrospective study we evaluated risk factors for incidental durotomy and its impact on the postoperative course. Lumbar interbody fusion (LIF) is increasingly applied for the treatment of degenerative instability. A known complication is incidental durotomy. A cohort of 541 patients who underwent primary LIF surgery between 2005 and 2015 was analyzed. Previous lumbar surgery, age, surgeon's experience, intraoperative use of a microscope, and the number of operated levels were assessed and the risk for incidental durotomy was estimated using the Log-likelihood test and Wald test, respectively. The association of incidental durotomy and outcome parameters was analyzed using the quantile regression model. In 77 (14.2%) patients intraoperative cerebrospinal fluid (CSF) fistula was observed. Previous lumbar surgery (P<0.001), number of operated levels (P=0.03), and surgeon's experience (P=0.01) were significantly associated with incidental durotomy. Incidental durotomy was significantly associated with a prolonged bed rest (P<0.001), hospital stay (P=0.041), and an increased use of postoperative antibiotics (P<0.001). Eleven of 77 patients with incidental durotomy (14.3%) developed postoperative CSF fistula of whom 10 (91%) needed revision surgery for dural repair. We could identify important risk factors for incidental durotomy in LIF surgery. In patients who had undergone previous lumbar surgery and those with multilevel disease particular precaution is required. Furthermore, we were able to verify the morbidity associated with CSF fistula as shown by increased immobilization and follow-up surgeries for postoperative CSF fistula which emphasizes the importance to develop strategies to minimize the risk for incidental durotomy.

  5. Incidentals

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    The Master-of-Nets Garden has characteristic night scenery. From March 15 to November 20, it is open to visitors in the evenings. Apart from viewing the garden by night, visitors can also enjoy performances full of local color, such as pingtan (story telling and ballad singing in Suzhou dialect), music played on the guzheng (zither-like musical instruments), and Kunqu Opera.

  6. Incidental Parathyroidectomy during Total Thyroidectomy: Risk Factors and Consequences

    Directory of Open Access Journals (Sweden)

    Dimitrios K. Manatakis

    2016-01-01

    Full Text Available Objective. To evaluate the incidence of accidental parathyroidectomy in our series of total thyroidectomies, to investigate its clinical and biochemical consequences, and to identify potential risk factors. Methods. Patients who underwent total thyroidectomy between January 2006 and December 2015 were retrospectively analyzed. Pathology reports were reviewed to identify those cases who had an incidental parathyroidectomy and these were compared to patients with no parathyroidectomy, in terms of clinical (age, sex, and symptoms of hypocalcemia, pathological (thyroid specimen weight, Hashimoto thyroiditis, and malignancy, and biochemical (serum calcium and phosphate levels factors. Results. 281 patients underwent total thyroidectomy during the study period. Incidental parathyroidectomy was noticed in 24.9% of cases, with 44.3% of parathyroid glands found in an intrathyroidal location. Evidence of postoperative biochemical hypocalcemia was noticed in 28.6% of patients with parathyroidectomy, compared with 13.3% in the no-parathyroidectomy group (p=0.003. Symptomatic hypocalcemia was observed in 5.7% and 3.8%, respectively (p=0.49. Age, sex, thyroid specimen weight, Hashimoto thyroiditis, and malignancy did not differ significantly between the two groups. Conclusions. Our study found an association of incidental parathyroidectomy with transient postoperative biochemical hypocalcemia, but not with clinically symptomatic disease. Age, sex, thyroid gland weight, Hashimoto thyroiditis, and malignancy were not identified as risk factors.

  7. 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...

  8. Renal Myxoma, an Incidental Finding

    Directory of Open Access Journals (Sweden)

    Parth Thakker

    2017-07-01

    Full Text Available Myxomas are mesenchymal tumors commonly found in the heart and skin. Renal myxomas are rare, having only been documented 14 times. Our case is a 55-year-old woman who presented to our clinic after a right renal mass was incidentally found on CT. Evaluation with MRI showed a mass that appeared to arise from the supero-medial cortex of the right kidney. As the imaging was concerning for renal cell carcinoma, the patient underwent a partial nephrectomy. Microscopic examination showed a well-circumscribed mass with polygonal to spindle-shaped cells in a granular eosinophilic cytoplasm. Immunohistochemical staining for CD-10, Desmin, HMB-45, and Pankeratin were negative.

  9. Pleuropulmonary blastoma type I following resection of incidentally found congenital lobar emphysema.

    LENUS (Irish Health Repository)

    Walsh, S

    2009-07-01

    Pleuropulmonary blastoma (PPB) is an aggressive tumour accounting for less than 1% of all primary malignant lung tumours in the paediatric population. It can be associated with cystic pulmonary lesions, which may be evident at the time of diagnosis or predate the appearance of the tumour. There are contradictory reports about the value of prophylactic resection of pulmonary cysts in protecting patients from developing PPB. We report an individual case where asymptomatic congenital lobar emphysema was incidentally picked up on CXR. Following a period of surveillance the lesion was resected due to increasing size. The histology of the lesion revealed PPB Type I.

  10. PET/CT联合高分辨超声对甲状腺偶发病灶良恶性鉴别诊断的价值%Diagnostic value of PET/CT combined with ultrasound for differentiating malignant from benign thyroid lesions incidentally found by 18F-FDG PET/CT

    Institute of Scientific and Technical Information of China (English)

    刘德军; 冯彦林; 黄伟俊; 余丰文; 袁建伟; 温广华; 杨明; 贺小红; 黄克敏

    2012-01-01

    Objective To investigate the value of 18F-FDG PET/CT combined with ultrasound (US) imaging for differentiating malignant from benign thyroid lesions.Methods Seventy-three thyroid lesions incidentally found by 18F-FDG PET/CT imaging were enrolled.Final diagnosis was confirmed by histopathology or cytology.Interpretations of PET/CT and US included a subjective classification on a 3-point scale (0:probably benign,1:uncertain,2:probably malignant),along with the longest diameter measure and SUVmax of the thyroid lesions.The accuracies of PET/CT,US and PET/CT + US for differentiating malignant from benign thyroid lesions were compared by ROC curve analysis,with a Z test to compare the AUC.The Kappa test,t-test and x2 test were also used.Results Of the 73 thyroid lesions,there were 43 (59%)malignant and 30 (41%) benign lesions.The SUVmmax of malignant lesions was significantly higher than that of benign lesions (7.0±8.1 vs 4.1±3.8; t=2.062,P=0.043),and the longest diameter of malignant lesions was smaller than that of benign lesions ( 2.0 ± 1.1 vs 2.7 ± 1.4 ; t=2.628,P=0.011 ).To differentiate malignant from benign thvroid lesions,the AUC of SUVmax was 0.580 (95% CI:0.448-0.713).After analyzing the features of PET and CT images,the AUC of PET/CT was significantly improved to 0.763(95% CI:0.647-0.878; Z=2.033,P=0.042).The AUC of US (0.905,95% CI:0.826-0.983)and PET/CT + US (0.909,95 % CI:0.840-0.979 ) were significantly higher than that of PET/CT ( Z =1.992 and 2.112,both P<0.05 ) or SUV max ( Z=4.120 and 4.276,both P<0.001 ).The optimal sensitivity,specificity,accuracy,positive predictive value,negative predictive value were 42%(18/43),83(25/30),59%(43/73),78%(18/23),50%(25/50) for SUVmax,79%(34/43),80%(24/30),79%(58/73),85%(34/40),73%(24/33) for PET/CT,84%(36/43),90%(27/30),86%(63/73),92%(36/39),79%(27/34) for US,and 98%(42/43),67%(20/30),85%(62/73),81%(42/52),95%(20/21) for PET/CT + US,respectively.Agreement was

  11. Incidental non-inguinals hernias in totally extra-peritoneal hernia repair.

    Science.gov (United States)

    Old, O J; Kulkarni, S R; Hardy, T J; Slim, F J; Emerson, L G; Bulbulia, R A; Whyman, M R; Poskitt, K R

    2015-03-01

    Totally extra-peritoneal (TEP) inguinal hernia repair allows identification and repair of incidental non-inguinal groin hernias. We assessed the prevalence of incidental hernias during TEP inguinal hernia repair and identified the risk factors for incidental hernias. Consecutive patients undergoing TEP repair from May 2005 to November 2012 were the study cohort. Inspection for ipsilateral femoral, obturator and rarer varieties of hernia was undertaken during TEP repair. Patient characteristics and operative findings were recorded on a prospectively collected database. A total of 1,532 TEP repairs were undertaken in 1,196 patients. Ninety-three patients were excluded due to incomplete data, leaving 1,103 patients and 1,404 hernias for analyses (1,380 male; 802 unilateral and 301 bilateral repairs; median age, 59 years). Among the 37 incidental hernias identified (2.6% of cases), the most common type of incidental hernia was femoral (n=32, 2.3%) followed by obturator (n=2, 0.1%). Increasing age was associated with an increased risk of incidental hernia, with a significant linear trend (p60 years of age was 4.0% vs 1.4% for those aged hernias were found in 29.2% of females vs 2.2% of males, (phernia in those with a recurrent inguinal hernia was 3.0% vs 2.6% for primary repair (p=0.79). Incidental hernias during TEP inguinal hernia repair were found in 2.6% of cases and, though infrequent, could cause complications if left untreated. The risk of incidental hernia increased with age and was significantly higher in patients aged >60 years and in females.

  12. Significance of fragmented QRS complexes for identifying culprit lesions in patients with non-ST-elevation myocardial infarction: a single-center, retrospective analysis of 183 cases

    Directory of Open Access Journals (Sweden)

    Guo Rong

    2012-06-01

    Full Text Available Abstract Background Fragmented QRS (fQRS complexes are novel electrocardiographic signals, which reflect myocardial conduction delays in patients with coronary artery disease (CAD. The importance of fQRS complexes in identifying culprit vessels was evaluated in this retrospective study. Methods A 12-lead surface electrocardiogram was obtained in 183 patients who had non-ST-elevation myocardial infarction (NSTEMI and subsequently underwent coronary angiography (CAG. On the basis of the frequency of fQRS complexes, indices such as sensitivity, specificity, positive and negative predictive values, and likelihood ratio were evaluated to determine the ability of fQRS complexes to identify the culprit vessels. Results Among the patients studied, elderly patients (age ≥ 65 years and those with diabetes had a significantly higher frequency of fQRS complexes (p = 0.005, p = 0.003, respectively. The fQRS complexes recorded in the 4 precordial leads had the highest specificity (81.8% for indentifying the culprit vessel (left anterior descending artery. However, the specificity of fQRS complexes to identify lesions in the left circumflex and right coronary arteries was lower for the inferior and lateral leads than for the limb leads (65.5% versus 71.7%; however, the limb leads had higher sensitivity (92.3% versus 89.4%. And the total sensitivity and specificity of fQRS (77.1% and 71.5% were higher than those values for ischemic T-waves. Conclusions The frequency of fQRS complexes was higher in elderly and diabetic patients with NSTEMI. The frequency of fQRS complexes recorded in each of the ECG leads can be used to identify culprit vessels in patients with NSTEMI.

  13. Benign breast lesions detected by positron emission tomography-computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Benveniste, Ana P., E-mail: apbenveniste@mdanderson.org [Department of Diagnostic Radiology,The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Yang, Wei, E-mail: wyang@mdanderson.org [Department of Diagnostic Radiology,The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Benveniste, Marcelo F., E-mail: mfbenveniste@mdanderson.org [Department of Diagnostic Radiology,The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Mawlawi, Osama R., E-mail: omawlawi@mdanderson.org [Department of imaging physics, The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Marom, Edith M., E-mail: emarom@mdanderson.org [Department of Diagnostic Radiology,The University of Texas MD Anderson Cancer Center, Houston, TX (United States)

    2014-06-15

    {sup 18}F-fluorodeoxyglucose positron emission computed tomography (FDG PET-CT) is widely used in the initial staging and response evaluation of patients with malignancy. This review describes a spectrum of benign breast findings incidentally detected by FDG PET-CT at staging that may be misinterpreted as malignancy. We describe the pattern of distribution and intensity of FDG uptake in a spectrum of benign breast diseases with their corresponding typical morphological imaging characteristics to help the nuclear medicine physician and/or general radiologist identify benign lesions, avoiding unnecessary breast imaging work-up and biopsies.

  14. Incidental gall bladder cancers:Are they truly incidental?

    Institute of Scientific and Technical Information of China (English)

    Ashwin; Rammohan; Sathya; D; Cherukuri; Jeswanth; Sathyanesan; Ravichandran; Palaniappan; Manoharan; Govindan

    2014-01-01

    AIM: To seek and analyze features suggestive of gallbladder cancer(GBC) on preoperative imaging and intraoperative findings in patients diagnosed as having incidental GBC(IGBC). METHODS: The study was conducted on 79 patients of IGBC managed in our department over a 10-year period(2003-2012). Review of preoperative imaging and operative notes was done to ascertain any suspicion of malignancy-in-retrospect.RESULTS: Of the 79 patients, Ultrasound abdomen showed diffuse thickening, not suspicious of malignancy in 5 patients, and diffuse suspicious thickening was seen in 4 patients. Focal thickening suspicious of malignancy was present in 24 patients. Preoperative computed tomography/magnetic resonance imaging was done in 9 patients for suspicion of malignancy. In 5 patients, dif-ficult Cholecystectomy was encountered due to dense/inflammatory adhesions. Intraoperative findings showed focal thickening of the gallbladder and a gallbladder mass in 9 and 17 patients respectively. On overall analysis, 37 patients had preoperative imaging or intraoperative findings suggestive of malignancy, which was either a missed GBC or an unsuspected/unexpected GBC. In 42(53.2%) patients, there was no evidence suggestive of malignancy and was an unanticipated diagnosis.CONCLUSION: Our study highlights a potential and not-so-rare pitfall of Laparoscopic Cholecystectomy. A greater awareness of this clinical entity along with a high index of suspicion and a low threshold for conversion to open procedure, especially in endemic areas may avert avoidable patient morbidity and mortality.

  15. Incidental adenocarcinoma in patients undergoing surgery for stricturing Crohn's disease

    Science.gov (United States)

    Kristo, Ivan; Riss, Stefan; Argeny, Stanislaus; Maschke, Svenja; Chitsabesan, Praminthra; Stift, Anton

    2017-01-01

    AIM To evaluate frequency and clinical course of incidental adenocarcinoma in patients with stricturing Crohn's disease (CD). METHODS In this study, consecutive patients, who were operated on for stricturing CD between 1997-2012, were included at an academic tertiary referral center. Demographic data and clinical course were obtained by an institutional database and individual chart review. Besides baseline characteristics, intraoperative findings and CD related history were also recorded. Colorectal cancer was classified and staged according to the Union for International Cancer Control (UICC). RESULTS During the study period 484 patients underwent resections due to stricturing CD. Incidental adenocarcinoma was histologically confirmed in 6 (1.2%) patients (4 males, 2 females). Patients diagnosed with colorectal cancer had a median age of 43 (27-66) years and a median history of CD of 16 (7-36) years. Malignant lesions were found in the rectum (n = 4, 66.7%), descending colon (n = 1, 16.7%) and ileocolon (n = 1, 16.7%). According to the UICC classification two patients were stages as I (33.3%), whereas the other patients were classified as stage IIA (16.7%), stage IIIB (16.7%), stage IIIC (16.7%) and stage IV (16.7%), respectively. After a median follow-up of 2 (0.03-8) years only 1 patient is still alive. CONCLUSION The frequency of incidental colorectal cancer in patients, who undergo surgery for stenotic CD, is low but associated with poor prognosis. However, surgeons need to be aware about the possibility of malignancy in stricturing CD, especially if localized in the rectum. PMID:28210083

  16. Fetal MRI: incidental findings in the mother

    Energy Technology Data Exchange (ETDEWEB)

    Abdullah, Selwan B. [University of Maryland Medical Center, Diagnostic Radiology and Nuclear Medicine, Baltimore, MD (United States); University of Minnesota, Medical School, Minneapolis, MN (United States); Dietz, Kelly R.; Holm, Tara L. [University of Minnesota, Department of Radiology, Minneapolis, MN (United States)

    2016-11-15

    Fetal magnetic resonance imaging (MRI) is a routinely used tool in prenatal diagnosis; however, there is a lack of studies evaluating incidental findings observed in the mother. This study describes and quantifies incidental findings observed in the mother during fetal MRI. We reviewed all fetal MRI studies at the University of Minnesota Medical Center from February 2008 to September 2014. Two pediatric radiologists retrospectively conducted a consensus evaluation. The maternal findings were categorized into neurologic, gynecologic, urinary, gastrointestinal and musculoskeletal. Hydronephrosis consistent with the stage of pregnancy was recorded but was not included as an abnormal finding. Abnormal findings were classified into three groups, depending on their clinical significance: level I (low), level II (medium) and level III (high). We evaluated 332 pregnant patients with a mean age of 29.3 years and a mean gestational age of 29 weeks. Of these, 55.4% had at least 1 incidental finding, for a total of 262 incidental maternal findings. Of the 262 abnormalities, 113 (43.1%) were neurologic, 69 were gynecologic (26.3%), 36 (13.7%) urinary, 24 (9.2%) gastrointestinal and 20 (7.6%) musculoskeletal. Of the 262 incidental findings, 237 (90.5%) were level I, 24 (9.2%) were level II and 1 (0.4%) was level III. Our results suggest that although the vast majority of incidental maternal findings are benign, more significant findings are still encountered and should be expected. (orig.)

  17. Coal-bed methane in Alberta : ownership and incidental production

    Energy Technology Data Exchange (ETDEWEB)

    Rogers, A.

    2006-04-05

    Some of the challenges facing the emerging coal-bed methane (CBM) industry in Alberta include concerns regarding water protection, compression noise, well spacing and fracturing issues. One of the most fundamental questions regarding CBM is who in fact owns the resource and what rules oversee its production. The characteristics, development potential and origins of split title ownership of CBM in North America were examined in this paper. The history of freehold and Crown-owned land and the law regarding ownership and incidental production of petroleum, natural gas and bitumen in split-title situations were reviewed. The legal status of CBM in other jurisdictions was also examined. The issues of ownership and incidental production in Alberta were also discussed. The basic common law ownership principles regarding mineral ownership were applied to the characteristics of CBM in situ to conclude its possible owner in Alberta. The extension of established incidental mineral production principles to CBM were examined in the context of its characteristics. The official governmental position on CBM issues and the prospect of future legislative intervention were identified and the implications for industry and resource companies were also presented. The paper presented several recommendations including that Alberta should legislate to eliminate any right of recovery for historical or current venting of CBM during coal mining in order to remove a cloud of uncertainty over the industry. refs.

  18. Incidental Learning of Melodic Structure of North Indian Music.

    Science.gov (United States)

    Rohrmeier, Martin; Widdess, Richard

    2017-07-01

    Musical knowledge is largely implicit. It is acquired without awareness of its complex rules, through interaction with a large number of samples during musical enculturation. Whereas several studies explored implicit learning of mostly abstract and less ecologically valid features of Western music, very little work has been done with respect to ecologically valid stimuli as well as non-Western music. The present study investigated implicit learning of modal melodic features in North Indian classical music in a realistic and ecologically valid way. It employed a cross-grammar design, using melodic materials from two modes (rāgas) that use the same scale. Findings indicated that Western participants unfamiliar with Indian music incidentally learned to identify distinctive features of each mode. Confidence ratings suggest that participants' performance was consistently correlated with confidence, indicating that they became aware of whether they were right in their responses; that is, they possessed explicit judgment knowledge. Altogether our findings show incidental learning in a realistic ecologically valid context during only a very short exposure, they provide evidence that incidental learning constitutes a powerful mechanism that plays a fundamental role in musical acquisition. Copyright © 2016 Cognitive Science Society, Inc.

  19. A novel approach to identify non-palpable breast lesions combining fluorescent liposomes and magnetic resonance-guided high intensity focused ultrasound-triggered release

    NARCIS (Netherlands)

    Oerlemans, Chris; Nijsen, Frank; van Amersfoort, Miranda; van Bloois, Louis; Heijman, Edwin; Luijten, Peter; Mali, Willem; Storm, Gert

    2011-01-01

    The combination of fluorescein-containing liposomes (FCL) and magnetic resonance-guided high intensity focused ultrasound (MR-HIFU)-triggered release is a promising approach for lesion demarcation and more efficient removal of non-palpable breast lesions. Exposure of FCL to ablation temperatures (60

  20. Incidental finding of esophageal pneumatosis.

    Science.gov (United States)

    Chelimilla, Haritha; Makker, Jasbir S; Dev, Anil

    2013-02-16

    Pneumatosis of the gastrointestinal tract is a rare condition characterized by the presence of air filled cavities in the gastrointestinal tract wall. Its occurrence has been described throughout the gastrointestinal tract from the esophagus to the rectum, however it is most commonly reported in the small intestine. Despite multiple case reports in literature, its pathogenesis still remains unclear. Pneumatosis may be idiopathic or associated with a variety of disorders namely peptic ulcer disease, jejunoileal bypass, intestinal obstruction and non-gastrointestinal disorders like asthma, chronic obstructive pulmonary disease, systemic lupus erythematosus, infectious enteritis, etc. We here present a rare case of pneumatosis of the esophagus diagnosed incidentally at an esophagogastroduodenoscopy (EGD). A 78-year-old asymptomatic woman underwent EGD and colonoscopy at our hospital for evaluation of anemia. Few months prior to EGD, she had undergone excision of laryngocele at our hospital. EGD revealed extensive submucosal blebs distributed throughout the esophagus, otherwise unremarkable stomach and duodenum. Colonoscopy showed a tubular adenomatous polyp. Since our patient was asymptomatic she did not require any surgical intervention. Management of pneumatosis depends on the underlying cause.

  1. Management of incidental pituitary tumors

    Directory of Open Access Journals (Sweden)

    Nicholas F. Marko

    2011-11-01

    Full Text Available Pituitary incidentalomas are common lesions for which neurosurgical referrals may become progressively more frequent, given the increasing application of neuroimaging. The initial evaluation of a patient with radiographic evidence of an incidentaloma should focus on addressing two questions: (1 is the lesion causing neurological symptoms, and (2 is the lesion hormonally active? The answers to these two questions provide a framework for subsequent clinical management. The initial patient assessment should include a detailed history and physical examination, including the bedside assessment of visual fields. High-quality MRI imaging is essential, and formal visual field testing should be obtained in patients where the lesion abuts or compresses the optic apparatus. The initial biochemical workup is intended to assess potential pituitary hypo- or hyperfunction and should include measurement of serum levels of prolactin, insulin-like growth factor type-1, free thyroxine, testosterone, and an assessment of axis hypothalamic–pituitary–adrenal axis function. Additional testing may include serum thyroid-stimulating hormone, follicle-stimulating hormone, and luteinizing hormone levels. Neurologically-asymptomatic patients without endocrine dysfunction can be managed with observation at regular intervals, including MRI imaging at 6 months and 1 year and then annually for a period of 3 years. Follow-up biochemical assessment is not necessary in the absence of clinical symptoms or radiographic enlargement of the lesion. After 3 years the follow-up interval may be prolonged, although closer follow-up may be indicated for patients with lesions C1 cm. Most patients who either present with or who subsequently develop neurologic or endocrinologic symptoms should be considered for surgery as the first-line therapy.

  2. Small Renal Masses: Incidental Diagnosis, Clinical Symptoms, and Prognostic Factors

    Directory of Open Access Journals (Sweden)

    F. M. Sánchez-Martín

    2008-01-01

    Full Text Available Introduction. The small renal masses (SRMs have increased over the past two decades due to more liberal use of imaging techniques. SRMs have allowed discussions regarding their prognostic, diagnosis, and therapeutic approach. Materials and methods. Clinical presentation, incidental diagnosis, and prognosis factors of SRMs are discussed in this review. Results. SRMs are defined as lesions less than 4 cm in diameter. SRM could be benign, and most malignant SMRs are low stage and low grade. Clinical symptoms like hematuria are very rare, being diagnosed by chance (incidental in most cases. Size, stage, and grade are still the most consistent prognosis factors in (RCC. An enhanced contrast SRM that grows during active surveillance is clearly malignant, and its aggressive potential increases in those greater than 3 cm. Clear cell carcinoma is the most frequent cellular type of malign SRM. Conclusions. Only some SRMs are benign. The great majority of malign SRMs have good prognosis (low stage and grade, no metastasis with open or laparoscopic surgical treatment (nephron sparing techniques. Active surveillance is an accepted attitude in selected cases.

  3. 78 FR 51147 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Science.gov (United States)

    2013-08-20

    ... marine mammal habitat are associated with elevated sound levels produced by airguns and vessels and their... National Oceanic and Atmospheric Administration RIN 0648-XC563 Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to Marine Seismic Survey in the Chukchi Sea, Alaska...

  4. A systematic health assessment of indian ocean bottlenose (Tursiops aduncus and indo-pacific humpback (Sousa plumbea dolphins incidentally caught in shark nets off the KwaZulu-Natal Coast, South Africa.

    Directory of Open Access Journals (Sweden)

    Emily P Lane

    Full Text Available Coastal dolphins are regarded as indicators of changes in coastal marine ecosystem health that could impact humans utilizing the marine environment for food or recreation. Necropsy and histology examinations were performed on 35 Indian Ocean bottlenose dolphins (Tursiops aduncus and five Indo-Pacific humpback dolphins (Sousa plumbea incidentally caught in shark nets off the KwaZulu-Natal coast, South Africa, between 2010 and 2012. Parasitic lesions included pneumonia (85%, abdominal and thoracic serositis (75%, gastroenteritis (70%, hepatitis (62%, and endometritis (42%. Parasitic species identified were Halocercus sp. (lung, Crassicauda sp. (skeletal muscle and Xenobalanus globicipitis (skin. Additional findings included bronchiolar epithelial mineralisation (83%, splenic filamentous tags (45%, non-suppurative meningoencephalitis (39%, and myocardial fibrosis (26%. No immunohistochemically positive reaction was present in lesions suggestive of dolphin morbillivirus, Toxoplasma gondii and Brucella spp. The first confirmed cases of lobomycosis and sarcocystosis in South African dolphins were documented. Most lesions were mild, and all animals were considered to be in good nutritional condition, based on blubber thickness and muscle mass. Apparent temporal changes in parasitic disease prevalence may indicate a change in the host/parasite interface. This study provided valuable baseline information on conditions affecting coastal dolphin populations in South Africa and, to our knowledge, constitutes the first reported systematic health assessment in incidentally caught dolphins in the Southern Hemisphere. Further research on temporal disease trends as well as disease pathophysiology and anthropogenic factors affecting these populations is needed.

  5. Asymptomatic pancreatic lesions: New insights and clinical implications

    Institute of Scientific and Technical Information of China (English)

    Martin Loos; Christoph W Michalski; J(o)rg Kleeff

    2012-01-01

    Despite great efforts in experimental and clinical research,the prognosis of pancreatic cancer (PC) has not changed significantly for decades.Detection of pre-invasive lesions or early-stage PC with small resectable cancers in asymptomatic individuals remains one of the most promising approaches to substantially improve the overall outcome of PC.Therefore,screening programs have been proposed to identify curable lesions especially in individuals with a familial or genetic predisposition for PC.In this regard,Canto et al recently contributed an important article comparing computed tomography,magnetic resonance imaging,and endoscopic ultrasound for the screening of 216 asymptomatic high-risk individuals (HRI).Pancreatic lesions were detected in 92 of 216 asymptomatic HRI (42.6%).The high diagnostic yield in this study raises several questions that need to be answered of which two will be discussed in detail in this commentary:First:which imaging test should be performed? Second and most importantly:what are we doing with incidentally detected pancreatic lesions? Which ones can be observed and which ones need to be resected?

  6. Radiofrequency ablation for incidentally identified primary intrahepatic cholangiocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Witold Zgodzinski; N.Joseph Espat

    2005-01-01

    Cholangiocarcinoma is the second most common primary hepato-biliary malignancy. The majority of patients with primary hepatic tumors are not suitable candidates for resection, due to advanced stage of the disease at presentation, anatomic limitations and medical comorbidities. At present, radiofrequency ablation (RFA) may offer an alternative, feasible and safe therapy for selected patients with hepatic tumors, who are not otherwise candidates for hepatic resection. Herein, we present the case of successful RFA in a patient with a solitary, primary intrahepatic cholangiocarcinoma. The patient remained free of disease 24 mo after the procedure, and is still followed up. This is the first report of RFA application inthe treatment of primary intrahepatic cholangiocarcinoma.

  7. Incidental pulmonary embolism in cancer patients: clinical characteristics and outcome – a comprehensive cancer center experience

    Directory of Open Access Journals (Sweden)

    Abdel-Razeq H

    2011-03-01

    Full Text Available Hikmat N Abdel-Razeq1, Asem H Mansour2, Yousef M Ismael11Department of Internal Medicine, 2Department of Radiology, King Hussein Cancer Center, Amman, JordanBackground and objectives: Cancer patients undergo routine imaging studies much more than others. The widespread use of the recently introduced multi-detector CT scanners has resulted in an increasing number of incidentally diagnosed pulmonary embolism (PE in asymptomatic cancer patients. The significance and clinical outcome of such incidental PE is described.Methods: Both radiology department and hospital databases were searched for all cancer patients with a diagnosis of incidental PE. CT scans were performed using a 64-slice scanner with a 5.0 mm slice thickness.Results: During the study period, 34 patients with incidental PE were identified. The mean age (±SD was 57.7 (±12.4 years. All patients had active cancer, gastric, lung, colorectal, and lymphomas being the most frequent. Most patients had advanced-stage disease at the time of PE diagnosis; 26 (77% patients had stage IV, whereas only 3 patients had stages I or II disease. Twenty-seven (79% patients had their PE while undergoing active treatment with chemotherapy (68% or radiotherapy (12%; none, however, were on hormonal therapy. Most (74% patients had their PE diagnosed without history of recent hospital admission. Except for 5 (15%, all other patients were anticoagulated. With follow-up, 2 patients developed recurrent PE, 2 others had clinical and echocardiographic evidence of pulmonary hypertension, and 9 (26% died suddenly within 30 days of the diagnosis of incidental PE; 2 of these where among the 5 patients who were not anticoagulated.Conclusion: Incidental PE in cancer patients is increasingly encountered. Similar to symptomatic PE, many were diagnosed in patients with advanced stage disease and while undergoing active anti-cancer therapy. A significant percentage of patients had recurrent emboli, pulmonary hypertension

  8. Angiographic characteristics of intermediate stenosis of the left anterior descending artery for determination of lesion significance as identified by fractional flow reserve

    DEFF Research Database (Denmark)

    Biasco, Luigi; Pedersen, Frants; Lønborg, Jacob

    2015-01-01

    Previous studies have shown a poor correlation between angiographic assessment of stenosis grade (%) and its functional assessment by fractional flow reserve (FFR). This study aimed to investigate whether a more comprehensive evaluation of the coronary angiogram may contribute to a better...... identification of flow-limiting stenoses. Coronary angiograms of 1,350 patients (1,883 lesions) were retrospectively analyzed for stenosis grade (eyeballing, %) and matched with FFR values. Angiography-derived optimal cut-off values and intervals delineating the [90% sensitivity-90% specificity] range were 50...... wrap" of LAD, and (5) collaterals to an occluded LCX/RCA. Based on these results, a risk score (P20-DAC2) for prediction of flow limitation in intermediate LAD lesions was derived. In conclusion, a comprehensive evaluation of the coronary angiogram-in which besides stenosis grade also other lesion...

  9. Genetic associations of short- and long-term aggressiveness identified by skin lesion with growth, feed efficiency, and carcass characteristics in growing pigs.

    Science.gov (United States)

    Desire, S; Turner, S P; D'Eath, R B; Doeschl-Wilson, A B; Lewis, C R G; Roehe, R

    2015-07-01

    The objective of this study was to investigate the genetic relationships between skin lesion traits in group housed growing pigs as a measure of short- (in a newly mixed group) and long- (in a socially stable group) term aggression and commonly used commercial performance measures: growth, feed intake, feed efficiency, and carcass traits. Data on 2,413 growing pigs (138 groups) were available. Pigs were mixed into new social groups of 18 animals, and skin lesions were counted 24 h (SL24h) and 5 wk (SL5wk) postmixing. The animal model was used to estimate genetic parameters for skin lesion traits, test daily gain, lifetime daily gain, daily feed intake, feed efficiency (calculated as test daily gain divided by daily feed intake), loin depth, back fat, and HCW. Skin lesions had a heritable component, ranging from 0.08 for anterior SL24h to 0.22 for central SL5wk and would, therefore, be suitable as a method of phenotyping aggression for selection purposes. Significant positive genetic correlations were found between SL24h and SL5wk (0.46 to 0.81). Positive genetic correlations were also found between SL24h (central and posterior body regions) or SL5wk (all body regions) and the production traits lifetime daily gain, test daily gain, and HCW (0.29 to 0.54). Central SL24h, anterior SL5wk, and posterior SL5wk were found to correlate positively with feed efficiency (0.39 to 0.50), suggesting that pigs with more lesions convert feed more efficiently. Where significant, the magnitude of phenotypic correlations was low but positive (0.07 to 0.10). These results suggest that, genetically, animals that receive many lesions show improved performance compared to those with few lesions, except for anterior SL24h, which had previously been shown to be genetically positively correlated with the initiation of nonreciprocal attacks. It may, therefore, be possible, via selection against anterior skin lesions at mixing, to reduce this form of 1-sided aggression without adversely

  10. Etiology and significance of incidentally detected focal colonic uptake on FDG PET/CT

    Directory of Open Access Journals (Sweden)

    Nilendu C Purandare

    2012-01-01

    Full Text Available Background: Incidental colonic uptake of 18F-flurodeoxyglucose (FDG is not an infrequent finding encountered during whole body positron emission tomography (PET imaging. Almost all studies on this topic are in Western populations, which have a markedly different epidemiological profile for colorectal premalignant and malignant conditions as compared to that of the Indian subcontinent. Aim: The purpose of this study was to assess the etiology of incidentally detected focal FDG uptake in the colon by comparing it with colonoscopy and histopathology. Materials and Methods : Electronic medical records of patients who underwent FDG PET/computed tomography (CT at our institution for a 2΍-year period from January 2009 to July 2011 were reviewed. There were 32 out of 9000 (0.35% patients whose PET/CT reports mentioned incidental focal colonic FDG uptake, of which 24 patients subsequently underwent colonoscopy. Lesions which appeared neoplastic on colonoscopy were confirmed with histopathology obtained after biopsy or surgery. Colonoscopy and pathology findings were considered as gold standard. Results: Among the 24 patients who underwent a colonoscopy, 3 patients had normal findings (12.5%. A positive colonoscopy was noted in 21 patients (87.5% with the lesion coinciding with the location described in the PET/CT report. Adenomatous polyps were detected in 12 patients (37.5%, whereas in 8 patients (25% malignant lesions were confirmed [adenocarcinoma n = 5, non-Hodgkin′s lymphoma (NHL n = 2, malignant melanoma n = 1]. In one patient, colonic uptake was diagnosed as inflammatory. The mean standardized uptake value max (SUV max for the 12 premalignant lesions was 16.9 ± 9.6 (range 7.5-37.4 and the mean SUV max for the 8 malignant lesions was 12.9 ± 5.5 (range 6.7-21.6. The difference in SUV max between the premalignant adenomatous polyps and the malignant lesions was not statistically significant ( P = 0.316. Conclusions: Our study shows that a

  11. 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

  12. Silicone Granuloma in the Buttocks Incidentally Detected by 18F-FDG PET/CT 30 Years After Free Liquid Silicone Injections.

    Science.gov (United States)

    Ohnona, Jessica; Durand, Pauline; Amegnizin, Jean-Louis; Kerrou, Khaldoun

    2016-06-01

    A 59-year-old transexual (male to female) patient presented with a squamous cell carcinoma of the larynx. She underwent an F-FDG PET/CT for initial staging. The examination showed high F-FDG uptake of the primary lesion and a homolateral lymphadenopathy. Incidental heterogeneous uptake of round hyperdense lesions in the gluteal muscles and subcutaneous fat was visualized. The medical history revealed secondly that the patient had had free liquid silicone injections 30 years before the examination. Although the injection of free silicone is not practised since the 1980s, this incidental finding should prompt to check the patient's medical history over several decades.

  13. Incidental Sequence Learning across the Lifespan

    Science.gov (United States)

    Weiermann, Brigitte; Meier, Beat

    2012-01-01

    The purpose of the present study was to investigate incidental sequence learning across the lifespan. We tested 50 children (aged 7-16), 50 young adults (aged 20-30), and 50 older adults (aged >65) with a sequence learning paradigm that involved both a task and a response sequence. After several blocks of practice, all age groups slowed down…

  14. Incidental Foreign Language Acquisition from Media Exposure

    Science.gov (United States)

    Kuppens, An H.

    2010-01-01

    A number of experimental studies have demonstrated the incidental acquisition of a foreign language by children and adolescents when watching foreign language television. While such experiments can only establish short-term effects, this article investigates the extent to which children's foreign language skills benefit from their long-term…

  15. The Arithmetic of Emotion: Integration of Incidental and Integral Affect in Judgments and Decisions

    Directory of Open Access Journals (Sweden)

    Daniel eVastfjall

    2016-03-01

    Full Text Available Research has demonstrated that two types of affect have an influence on judgment and decision making: incidental affect (affect unrelated to a judgment or decision such as a mood and integral affect (affect that is part of the perceiver’s internal representation of the option or target under consideration. So far, these two lines of research have seldom crossed so that knowledge concerning their combined effects is largely missing. To fill this gap, the present review highlights differences and similarities between integral and incidental affect. Further, common and unique mechanisms that enable these two types of affect to influence judgment and choices are identified. Finally, some basic principles for affect integration when the two sources co-occur are outlined. These principles are discussed in relation to existing work that has focused on incidental or integral affect but not both.

  16. Incidental pancreatic cysts: natural history and diagnostic accuracy of a limited serial pancreatic cyst MRI protocol

    Energy Technology Data Exchange (ETDEWEB)

    Nougaret, Stephanie; Escal, Laure; Guiu, Boris [Saint Eloi University Hospital, Department of Abdominal Imaging, Montpellier Cedex 5 (France); Reinhold, Caroline; Chong, Jaron [McGill University, Department of Abdominal Imaging, MUHC, Montreal (Canada); Mercier, Gregoire; Molinari, Nicolas [CHU Montpellier, Department of Biostatistics, Montpellier (France); Fabre, Jean Michel [CHU Montpellier, Department of Surgery, Saint Eloi University Hospital, Montpellier (France)

    2014-05-15

    To examine the natural history of incidentally detected pancreatic cysts and whether a simplified MRI protocol without gadolinium is adequate for lesion follow-up. Over a 10-year period, 301-patients with asymptomatic pancreatic cysts underwent follow-up (45 months ± 30). The magnetic resonance imaging (MRI) protocol included axial, coronal T2-weighted images, MR cholangiopancreatographic and fat suppressed T1-weighted sequences before and after gadolinium. Three radiologists independently reviewed the initial MRI, the follow-up studies using first only unenhanced images, then secondly gadolinium-enhanced-sequences. Lesion changes during follow-up were recorded and the added value of gadolinium-enhanced sequences was determined by classifying the lesions into risk categories. Three hundred and one patients (1,174 cysts) constituted the study population. Only 35/301 patients (12 %) showed significant lesion change on follow-up. Using multivariate analysis the only independent factor of lesion growth (OR = 2.4; 95 % CI, 1.7-3.3; P < 0.001) and mural nodule development (OR = 1.9; 95 % CI, 1.1-3.4, P = 0.03) during follow-up was initial lesion size. No patient with a lesion initial size less than 2 cm developed cancer during follow-up. Intra-observer agreement with and without gadolinium enhancement ranged from 0.86 to 0.97. After consensus review of discordant cases, gadolinium-enhanced sequences demonstrated no added value. Most incidental pancreatic cystic lesions did not demonstrate change during follow-up. The addition of gadolinium-enhanced-sequences had no added-value for risk assignment on serial follow-up. (orig.)

  17. Incidental orbital calcifications on computed tomography scans; Calcificacoes orbitarias incidentais na tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Fugita, Dalton Yukio A.; Cruz, Daniela Nogueira; Cappucci, Alessandro; Arakava, Marcia Mayumi; Guimaraes, Maria Carolina; Wolosker, Angela Maria B.; Yamashita, Helio Kiitiro [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Dept. de Diagnostico por Imagem; Manso, Paulo Goes [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Dept. de Oftalmologia

    2001-02-01

    We retrospectively studied the computed tomography scans of the orbit in 75 patients in order to identify the presence of incidental calcifications (scleral and trochlear apparatus calcifications.). These imaging findings should integrate the vast list of differential diagnosis of orbital calcifications, as they may help radiologists to distinguish these calcifications from orbital foreign bodies. (author)

  18. High yellow color intensity by angioscopy with quantitative colorimetry to identify high-risk features in culprit lesions of patients with acute coronary syndromes.

    Science.gov (United States)

    Ishibashi, Fumiyuki; Mizuno, Kyoichi; Kawamura, Akio; Singh, Premranjan P; Nesto, Richard W; Waxman, Sergio

    2007-10-15

    High yellow color intensity (HYCI) regions of atherosclerotic plaque, determined by angioscopy with quantitative colorimetry, are associated with lipid cores underneath thin fibrous caps in ex vivo tissue samples. To determine whether HYCI regions of coronary plaque are associated with disruption or thrombus in living patients, quantitative colorimetry was applied to angioscopy, and the color of culprit lesions was measured in patients with acute coronary syndromes. In 46 patients with acute coronary syndromes (acute myocardial infarction, n = 14; unstable angina pectoris [UAP] with culprit thrombus, n = 16; and UAP without culprit thrombus, n = 16), the recorded angioscopic images of culprit lesions were analyzed using a quantitative colorimetric method based on the L*a*b* color space applied to angioscopy (positive b* = yellow color intensity). HYCI was defined as b* value >23. Plaque disruption was significantly more prevalent in 19 of 24 HYCI regions (79%) than in 9 of 22 non-HYCI regions (41%) (p = 0.007). Culprit HYCI regions were prevalent in patients with myocardial infarction (11 of 14 [79%]), followed by those with UAP with thrombus (9 of 16 [56%]) and UAP without thrombus (4 of 16 [25%]) (p = 0.01 for trend), and were significantly more prevalent in 66% of patients with myocardial infarction and UAP with thrombus compared with 25% of those with UAP without thrombus (p = 0.007). In conclusion, HYCI regions of coronary plaque may be indicative of high-risk lesions vulnerable to thrombosis. Coronary angioscopy with quantitative colorimetry could be used to study the association between high-risk coronary lesions and future cardiovascular events.

  19. Incidental Vocabulary Learning in Second Language Acquisition: A Literature Review

    Directory of Open Access Journals (Sweden)

    Falcon Dario Restrepo Ramos

    2015-01-01

    Full Text Available This literature review aims to analyze previous studies that address the incidental learning of vocabulary in second language acquisition. The articles included in this literature review look into the understanding of vocabulary learning through incidental means, the relationship of reading and incidental vocabulary learning, and the strategies and tasks that promote the incidental learning of vocabulary. The findings show that L2 learners develop much of their vocabulary by incidental means through exposure to words in informative contexts. Moreover, this exposure is promoted by reading, and enhanced through multimodal glosses. Further research may focus on listening for higher lexical retention rates, the circumstances that allow incidental learning of multi-word phrases and collocations, and the use of technology-based methods for incidental vocabulary acquisition.

  20. Incidental breast masses detected by computed tomography: are any imaging features predictive of malignancy?

    Energy Technology Data Exchange (ETDEWEB)

    Porter, G. [Primrose Breast Care Unit, Derriford Hospital, Plymouth (United Kingdom)], E-mail: Gareth.Porter@phnt.swest.nhs.uk; Steel, J.; Paisley, K.; Watkins, R. [Primrose Breast Care Unit, Derriford Hospital, Plymouth (United Kingdom); Holgate, C. [Department of Histopathology, Derriford Hospital, Plymouth (United Kingdom)

    2009-05-15

    Aim: To review the outcome of further assessment of breast abnormalities detected incidentally by multidetector computed tomography (MDCT) and to determine whether any MDCT imaging features were predictive of malignancy. Material and methods: The outcome of 34 patients referred to the Primrose Breast Care Unit with breast abnormalities detected incidentally using MDCT was prospectively recorded. Women with a known diagnosis of breast cancer were excluded. CT imaging features and histological diagnoses were recorded and the correlation assessed using Fisher's exact test. Results: Of the 34 referred patients a malignant diagnosis was noted in 11 (32%). There were 10 breast malignancies (seven invasive ductal carcinomas, one invasive lobular carcinoma, two metastatic lesions) and one axillary lymphoma. CT features suggestive of breast malignancy were spiculation [6/10 (60%) versus 0/24 (0%) p = 0.0002] and associated axillary lymphadenopathy [3/10 (33%) versus 0/20 (0%) p = 0.030]. Conversely, a well-defined mass was suggestive of benign disease [10/24 (42%) versus 0/10 (0%); p = 0.015]. Associated calcification, ill-definition, heterogeneity, size, and multiplicity of lesions were not useful discriminating CT features. There was a non-significant trend for lesions in involuted breasts to be more frequently malignant than in dense breasts [6/14 (43%) versus 4/20 (20%) p = 0.11]. Conclusion: In the present series there was a significant rate (32%) of malignancy in patients referred to the breast clinic with CT-detected incidental breast lesions. The CT features of spiculation or axillary lymphadenopathy are strongly suggestive of malignancy.

  1. Benign focal liver lesions-from diagnosis to treatment

    NARCIS (Netherlands)

    T. Terkivatan (Türkan)

    2006-01-01

    textabstractFocal liver lesions in a noncirrhotic liver often present as incidental finding during routine abdominal imaging as part of a general check-up, or during work-up in case of a known malignancy. Only in some cases, liver tumors may be symptomatic. The most important diagnostic challenge

  2. Incidental prostate ¹⁸F-FDG uptake without calcification indicates the possibility of prostate cancer.

    Science.gov (United States)

    Seino, Hiroko; Ono, Shuichi; Miura, Hiroyuki; Morohashi, Satoko; Wu, Yunyan; Tsushima, Fumiyasu; Takai, Yoshihiro; Kijima, Hiroshi

    2014-04-01

    Incidental 18F-fluorodeoxyglucose (18F-FDG) uptake in the prostate is often experienced in clinical practice; however, it is difficult to determine whether incidental uptake is indicative of a malignancy or benign state based on the maximum standardized uptake value (SUVmax). In the present study, we investigated the clinical significance of incidental prostate uptake by 18F-FDG positron emission tomography (PET)/CT, and examined the differences between malignant and benign uptake from a clinicopathological viewpoint. We reviewed 3,236 male subjects who underwent 18F-FDG PET/CT scans at Hirosaki University Hospital (Japan) from 2008 to 2012 in order to identify cases of incidental prostate FDG uptake. The final diagnosis was made by serum prostate-specific antigen (PSA) levels, biopsy, imaging studies and clinical follow-up with PET findings. Incidental FDG uptake of the prostate was observed in 53 cases (2%). Four cases were excluded due to insufficient clinical data, and 49 cases were included in the present study. Of the 49 cases, 8 (16%) had prostate cancer, while 41 (84%) were benign. All 8 malignant cases had high uptake areas, e.g. in the prostate peripheral zone, where there was no coexistence of calcification or FDG uptake. Of the 41 benign cases, 19 had high uptake in the inner zone, 17 in the peripheral zone, and 5 in both the inner and peripheral zones. Of the 41 cases, 18 (44%) showed FDG uptake coexisting with prostatic calcification. Incidental prostate 18F-FDG uptake infrequently signifies prostate cancer; however, FDG uptake not coexisting with calcification indicates the possibility of prostate cancer and should be included in the differential diagnosis for performing other clinical examinations.

  3. Benign mucocele-like lesions of the breast: revisited.

    Science.gov (United States)

    Jaffer, Shabnam; Bleiweiss, Ira J; Nagi, Chandandeep S

    2011-05-01

    Mucocele-like lesions of the breast are ruptured ducts that discharge their contents into the stroma. They constitute a spectrum from benign to atypical to malignant. The current management of these lesions diagnosed on core biopsy is excision. The goal of our study was to evaluate the necessity of this practice for benign mucocele-like lesions. Retrospective review of the pathology database from 1 January 2000 to 1 June 2008 identified 61 cases, with follow-up information available in 50 cases. Clinical, radiological, and pathological information was correlated. Core biopsies were reviewed to confirm the diagnosis and verify previous biopsy site. In all, 45 patients underwent surgery, whereas 5 patients were followed for >1 year and remained stable. Patient's ages ranged from 44 to 76 years. Most benign mucoceles were diagnosed stereotactically while targeting calcifications (93.3%); rarely, the lesion was a sonographically detected mass. Most excisions had no residual mucocele (37/45=82%). In seven cases (15.6%), atypical duct hyperplasia was present, three with residual mucocele. In one case, the residual mucocele showed a continuum from florid to atypical duct hyperplasia at the core biopsy site. The other six cases showed atypical duct hyperplasia adjacent to but not directly at the core biopsy site. The sizes of the benign mucoceles ranged from incipient to 0.6 cm, all containing calcifications except one, which was incidental. Radiological-pathological correlation was concordant in all cases except one with suspicious calcification, which was ductal carcinoma in situ on excision. In this series, the largest of its kind, the upstage rate of benign mucoceles diagnosed on core biopsy was 17.8%. With the exception of the ductal carcinoma in situ case, no radiological or morphological features were predictive of atypia. Thus, because of associated atypical duct hyperplasia, sampling reasons, and intralesional heterogeneity, we continue to recommend excision of

  4. Endodontic bacteria from primary and persistent endodontic lesions in Chinese patients as identified by cloning and 16S ribosomal DNA gene sequencing.

    Science.gov (United States)

    Li, Xin; Zhu, Xiao-fei; Zhang, Cheng-fei; Cathro, Peter; Seneviratne, C J; Shen, Song

    2013-02-01

    Few literatures pertain to the 16S ribosomal DNA (16S rDNA) analysis of bacteria contributing to primary and persistent endodontic lesions, with no information available for the Chinese population. As such, we investigated endodontic bacteria associated with primary and persistent endodontic lesions in adult Chinese patients living in Beijing, China using 16S rDNA gene sequencing techniques. Endodontic microbial samples were obtained from fourteen adult Chinese patients and subjected to DNA extraction. Pllymerase chain reaction (PCR) products were cloned and 100 clones from each generated library were randomly selected. Purified plasmid DNA with 16S rDNA gene inserts was sequenced, and the sequences were searched against GenBank databases using the BLASTN algorithm. Only significant identification with the highest-scored BLAST result and 99% minimum similarity was considered for phylotyping. More than 150 taxa were obtained. Primary endodontic infection was mainly associated with Burkholderia cepacia, Actinomyces, Aranicola spp. and Streptococcus sanguinis, whilst Burkholderia cepacia was predominant in the persistent endodontic infections. There is a difference in the species profile associated with endodontic infections of Chinese patients living in Beijing in comparison to other geographical or ethnic reports.

  5. Endodontic bacteria from primary and persistent endodontic lesions in Chinese patients as identified by cloning and 16S ribosomal DNA gene sequencing

    Institute of Scientific and Technical Information of China (English)

    LI Xin; ZHU Xiao-fei; ZHANG Cheng-fei; Peter Cathro; CJ Seneviratne; SHEN Song

    2013-01-01

    Background Few literatures pertain to the 16S ribosomal DNA (16S rDNA) analysis of bacteria contributing to primary and persistent endodontic lesions,with no information available for the Chinese population.As such,we investigated endodontic bacteria associated with primary and persistent endodontic lesions in adult Chinese patients living in Beijing,China using 16S rDNA gene sequencing techniques.Methods Endodontic microbial samples were obtained from fourteen adult Chinese patients and subjected to DNA extraction.Pllymerase chain reaction (PCR) products were cloned and 100 clones from each generated library were randomly selected.Purified plasmid DNA with 16S rDNA gene inserts was sequenced,and the sequences were searched against GenBank databases using the BLASTN algorithm.Only significant identification with the highest-scored BLAST result and 99% minimum similarity was considered for phylotyping.Results More than 150 taxa were obtained.Primary endodontic infection was mainly associated with Burkholderia cepacia,Actinomyces,Aranicola spp.and Streptococcus sanguinis,whilst Burkholderia cepacia was predominant in the persistent endodontic infections.Conclusion There is a difference in the species profile associated with endodontic infections of Chinese patients living in Beiiing in comoarison to other geographical or ethnic reports.

  6. Incidental Finding and Management of Mesenteric Fibromatosis.

    Science.gov (United States)

    Nicolas, Gregory; Kfoury, Tony; Shimlati, Rasha; Tohme, Maroon; Wakim, Raja

    2016-06-09

    Mesenteric fibromatosis, also known as mesenteric desmoids, is part of the clinical-pathologic spectrum of deep fibromatosis, which encompasses a group of benign fibro-proliferative processes that are locally aggressive and have the capacity to infiltrate or recur without metastasis. Case of a 45-year-old man, with a history of hypertension and lung fibrosis, presenting for a left abdominal mass, which was found incidentally during his lung fibrosis imaging. He complained of constipation due to pressure upon his bowel leading to difficulty in defecation. Although there are many overlapping criteria between gastrointestinal stromal tumors and mesenteric fibromatosis, making it difficult to discriminate between the two, there are differences that are unique to mesenteric fibromatosis that should be noticed during the diagnosis. In this case, mesenteric fibromatosis was unusual as it is not associated with Gardner's syndrome, desmoid tumors, nor familial adenomatous polyposis, but was an incidental finding.

  7. Incidental anaplastic thyroid carcinoma: A case report

    Directory of Open Access Journals (Sweden)

    Pembegül GÜNEŞ

    2008-01-01

    Full Text Available Anaplastic thyroid carcinoma is one of the most aggressive of all human malignant diseases. It has an unfavorable prognosis and responsible for most of the mortality and morbidity rates due to thyroid carcinomas. We present a case of incidental anaplastic thyroid carcinoma and discuss the epidemiology, biology, risk factors, prognostic factors of the disease and the approach to treatment, in the light of the current medical literature. The prognosis is much better in cases with incidental carcinoma compared to the classical type and surgical excision of the tumor has a favorable effect on the results. Our case was followed-up for 1.5 years with no evidence of recurrence or metastasis.

  8. An incidental case of triple gallbladder

    Institute of Scientific and Technical Information of China (English)

    Banu Alicioglu

    2007-01-01

    Triplication of the gallbladder is a very rare congenital anomaly of the biliary tract; there are only elevenreported cases to date. Gallbladder multiplications are not likely to be discovered unless associated with cholelithiasis, sludge, cholecystitis and carcinoma. Here we report an incidentally diagnosed triplicate gallbladder in a patient with sigmoid diverticulitis; two of the triplicate gallbladder were demonstrated with ultrasound and computed tomography, and an additional galballder was found at surgery.

  9. Incidental Anterior Cruciate Ligament Calcification: Case Report.

    Science.gov (United States)

    Hayashi, Hisami; Fischer, Hans

    2016-03-01

    The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding.

  10. Incidental findings on cone beam computed tomography: Relate and relay

    Directory of Open Access Journals (Sweden)

    Suhas P Pande

    2015-01-01

    Full Text Available Objective: To evaluate the presence of incidental findings on cone beam computed tomography (CBCT images and to recognize their clinical importance. Materials and Methods: A total of 700 CBCT scans between January 2013 to August 2014 at Government Dental College and Hospital were evaluated retrospectively. Results: 459 incidental findings (65.57% were observed in 700 patients. Most common individual incidental finding was mucosal thickening (119 followed by pineal/habenula calcification (99 and choroid plexus (77. Conclusion: The oral and maxillofacial radiologist should carefully interpret all scans and should not ignore the incidental findings and hence avoid untoward snowballing effects.

  11. A case of mesothelial/monocytic incidental cardiac excrescence and literature review

    Directory of Open Access Journals (Sweden)

    Hu Zhong-Liang

    2010-06-01

    Full Text Available Abstract Mesothelial/monocytic incidental cardiac excrescence (MICE is a rare entity which is an amalgam of mesothelial cells, histiocytes, and fibrin, often found occasionally during cardiac valve replacement. We report a case in a 25-year-old Chinese female with serous mitral stenosis and patent foramen ovale. Routine and immunohistochemical stains and ultrastructure examination revealed the vegetation was predominantly composed of histocytes with scattered mesothelial cells. In fact nodular histiocytic/mesothelial hyperplasia (NHMH is a similar lesion to MICE. MICE and NHMH could be unified, and NHMH may be a better choice.

  12. Incidental optochiasmatic cavernoma: Case report of an unusual finding on 3 Tesla MRI.

    Science.gov (United States)

    Trentadue, Mirko; Pozzi Mucelli, Roberto; Piovan, Enrico; Pizzini, Francesca Benedetta

    2016-08-01

    Cavernoma is a vascular hamartoma, which represents 10-20% of all central nervous system vascular malformations. The majority (80%) of them are supratentorial, while involvement of the cranial nerves and the optic pathways is extremely rare. The main clinical presentation of optochiasmatic cavernomas consists of chiasmatic apoplexy, which is a neurosurgical emergency. Here, we report a case in which the finding was incidentally detected in a 49-year-old man. We describe the imaging characteristics of the lesion in such a rare location, highlighting the role of magnetic resonance imaging (MRI) (specifically 3 Tesla) in the management of asymptomatic patients.

  13. Incidental colonic focal FDG uptake on PET/CT: can the maximum standardized uptake value (SUV{sub max}) guide us in the timing of colonoscopy?

    Energy Technology Data Exchange (ETDEWEB)

    Hoeij, F.B. van; Stadhouders, P.H.G.M.; Weusten, B.L.A.M. [St Antonius Ziekenhuis, Department of Gastroenterology, Nieuwegein (Netherlands); Keijsers, R.G.M. [St Antonius Ziekenhuis, Department of Nuclear Medicine, Nieuwegein (Netherlands); Loffeld, B.C.A.J. [Zuwe Hofpoort Ziekenhuis, Department of Internal Medicine, Woerden (Netherlands); Dun, G. [Ziekenhuis Rivierenland, Department of Internal Medicine, Tiel (Netherlands)

    2015-01-15

    In patients undergoing {sup 18}F-FDG PET/CT, incidental colonic focal lesions can be indicative of inflammatory, premalignant or malignant lesions. The maximum standardized uptake value (SUV{sub max}) of these lesions, representing the FDG uptake intensity, might be helpful in differentiating malignant from benign lesions, and thereby be helpful in determining the urgency of colonoscopy. The aim of our study was to assess the incidence and underlying pathology of incidental PET-positive colonic lesions in a large cohort of patients, and to determine the usefulness of the SUV{sub max} in differentiating benign from malignant pathology. The electronic records of all patients who underwent FDG PET/CT from January 2010 to March 2013 in our hospital were retrospectively reviewed. The main indications for PET/CT were: characterization of an indeterminate mass on radiological imaging, suspicion or staging of malignancy, and suspicion of inflammation. In patients with incidental focal FDG uptake in the large bowel, data regarding subsequent colonoscopy were retrieved, if performed within 120 days. The final diagnosis was defined using colonoscopy findings, combined with additional histopathological assessment of the lesion, if applicable. Of 7,318 patients analysed, 359 (5 %) had 404 foci of unexpected colonic FDG uptake. In 242 of these 404 lesions (60 %), colonoscopy follow-up data were available. Final diagnoses were: adenocarcinoma in 25 (10 %), adenoma in 90 (37 %), and benign in 127 (53 %). The median [IQR] SUV{sub max} was significantly higher in adenocarcinoma (16.6 [12 - 20.8]) than in benign lesions (8.2 [5.9 - 10.1]; p < 0.0001), non-advanced adenoma (8.3 [6.1 - 10.5]; p < 0.0001) and advanced adenoma (9.7 [7.2 - 12.6]; p < 0.001). The receiver operating characteristic curve of SUV{sub max} for malignant versus nonmalignant lesions had an area under the curve of 0.868 (SD ± 0.038), the optimal cut-off value being 11.4 (sensitivity 80 %, specificity 82

  14. Incidental internal carotid artery calcifications on temporal bone CT in children

    Energy Technology Data Exchange (ETDEWEB)

    Koch, Bernadette; Jones, Blaise [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Blackham, Aaron [University of Cincinnati College of Medicine, Cincinnati, OH (United States)

    2007-02-15

    Incidental internal carotid artery (ICA) calcifications are occasionally noted on CT images of the brain and temporal bone. In adults, incidental calcifications have been correlated with increased incidence of hypercholesterolemia, cardiac disease, diabetes and carotid stenosis. To determine the incidence of incidental calcifications of the carotid siphon on temporal bone CT in children. We retrospectively reviewed 24 months of consecutive temporal bone CT examinations in children aged 18 years and younger. CT examinations on 663 patients were reviewed and the presence or absence of ICA calcifications was ranked as absent, questionable or definitive. In patients in whom definitive calcifications were identified, hospital charts were reviewed for evidence of diabetes mellitus, hypercholesterolemia, hypertriglyceridemia, hyperlipidemia and chronic renal disease as potential causes of early atherosclerosis. Of the 663 patients, 25% had definitive calcifications within the wall of the ICA: 6% of children younger than 2 years and 28% of children 12-19 years of age. Incidentally noted ICA calcifications are a common finding on temporal bone CT in children, most likely a physiologic response to turbulent flow at natural bends in the artery rather than secondary to underlying disease predisposing to early atherosclerotic calcification. (orig.)

  15. Stranding and incidental catch of sea turtles in the coastal Tumbes, Peru

    Directory of Open Access Journals (Sweden)

    Carlos A. Rosales

    2011-05-01

    Full Text Available Strandings and incidental catches of four sea turtles species (Chelonia mydas, Lepidochelys olivacea, Dermochelys coriacea and Eretmochelys imbricata were registered in Tumbes Region since August 2007 to August 2009. These registers (52.6% of strandings and 47.4% of incidental catches occurred during all year; most frequently in Punta Picos (50.5%, Canoas (20.0% and Baja de Punta Mero (14.7%. The most registered species were C. mydas (64.2% and L. olivacea (30.5%; their sizes did not present significant differences between areas and climatic seasons. The higher percentage of C. mydas, L. olivacea and D. coriacea were considered sub-adults, including the only specimen of E. imbricata. The incidental catches were made with gillnets of different mesh sizes, but 8 inches mesh was most frequently. A high proportions of specimens were died with signs of drowning (22.2% this was due to the prolonged time of soak time of gillnet (approximately 12 hours. No significant differences in CPUE were found between climatic seasons and no seasonal pattern was evident. Lesions in 14% of stranded specimens were caused possibly by human attacks or by collisions with fishing boats. 77.8% of incidental catch specimens were sacrificed for the commercialization of his meat, and sometimes of his shell, this shows the lack of awareness of conservation. These observations indicate that the coast of Tumbes is an important foraging area and development of sub-adult specimens of sea turtles; so it is recomend to develop monitoring, awareness and critical areas protection programs to foment the conservation of these organisms in the Eastern Pacific.

  16. Prevalence of incidental thyroid nodules in ultrasound studies of dogs with hypercalcemia (2008-2013).

    Science.gov (United States)

    Pollard, Rachel E; Bohannon, Laurie K; Feldman, Edward C

    2015-01-01

    Ultrasound is commonly used to evaluate the cervical region in dogs with hypercalcemia due to suspected hyperparathyroidism. Incidental thyroid nodules may be detected during these studies, however little information has been published to guide clinical decision-making when this occurs. The purpose of this cross-sectional study was to determine the prevalence of incidental thyroid nodules in hypercalcemic dogs undergoing cervical ultrasound at our hospital during the period of 2008-2013. Dogs with a palpable neck mass were excluded. Cervical ultrasound images for each dog were retrieved and reviewed by a board certified veterinary radiologist who was unaware of patient outcome. Presence, number, and dimensions of thyroid nodules were recorded. Results of thyroid nodule aspirate, biopsy or necropsy were recorded from medical records when available. Ninety-one dogs met inclusion criteria. Of these, 14/91 (15%) dogs had at least one thyroid nodule. Mean (± standard deviation) thyroid gland nodule length, width, and height were 1.51 ± 0.74, 0.96 ± 0.73, and 0.75 ± 0.36 cm, respectively. A histologic diagnosis was available for the incidental thyroid lesions in eight dogs, including one dog with two nodules. Confirmed diagnoses for these nodules were thyroid cyst (3/9, 33%), thyroid adenoma (3/9, 33%), thyroid adenocarcinoma (2/9, 22%) and nodular hyperplasia (1/9, 11%). Findings indicated that incidental thyroid nodules may be present in hypercalcemic dogs with no palpable neck mass and no clinical signs of thyroid disease. Some of these nodules may be malignant and therefore a recommendation for cytology or biopsy may be justified.

  17. 78 FR 18965 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Science.gov (United States)

    2013-03-28

    ... (NOAA), Commerce. ACTION: Notice; proposed incidental harassment authorization; extension of comment... Harassment Authorization (IHA) to ConocoPhillips Company (COP) to take small numbers of marine mammals, by... and other Federal review processes related to this action, NMFS has decided to extend the...

  18. 77 FR 50990 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Science.gov (United States)

    2012-08-23

    ... the islands above the mean high tide mark is designated as the Farallon National Wildlife Refuge... housing availability, seabird breeding cycles, and at the discretion of Refuge management. Each visit will... intertidal habitat may cause incidental Level B (behavioral) harassment of pinnipeds through some unavoidable...

  19. 78 FR 33357 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

    Science.gov (United States)

    2013-06-04

    ... manatee (Trichechus manatus) is managed by the U.S. Fish and Wildlife Service and is not considered... values, so overall confidence in these values is unknown. Table 3--Marine Mammal Density Estimates... National Oceanic and Atmospheric Administration RIN 0648-XC561 Takes of Marine Mammals Incidental to...

  20. Private Arbitration of Incidental Public Law Issues

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2009-01-01

     The article discusses the incidental public law issues which can arise in an arbitration case, e.g. concerning power, heating, natural gas and other public facility legislation, national or Community legal restrictive trade practices law, and rules on state administration approval of the terms...... by arbitration, and where the award is nullifiable only if its findings are in violation of public policy, the ordre public. The article relies on UNCITRAL's Model Arbitration Law, the new Danish arbitration act (DAA), national European case law, and literature and case law of the European Court....

  1. Laparoscopic resection for incidentally detected Meckel diverticulum

    Institute of Scientific and Technical Information of China (English)

    Davide Bona; Luigi Stefano Schipani; Marco Nencioni; Barbara Rubino; Luigi Bonavina

    2008-01-01

    The management of Meckel diverticulum found un-expectedly during an abdominal operation remains controversial.Most published reports have included only patients undergoing diverticulectomy or bowel resection through laparotomy.We report a case of a carcinoid tumor in a Meckel's diverticulum which was incidentally detected and removed during laparoscopic inguinal hernia repair.Although there is no compelling evidence in the literature to recommend prophylactic diverticulectomy,laparoscopic stapled resection represents a viable and safe approach in healthy individuals undergoing elective surgery for other purposes.

  2. BENIGN INTRACRANIAL HYPOTENSION WITH INCIDENTAL PARASAGITTAL MENINGIOMA

    Directory of Open Access Journals (Sweden)

    Sukumar

    2015-12-01

    Full Text Available Benign intracranial hypotension, otherwise called as idiopathic intracranial hypotension is caused by CSF leaks due to disruption in spinal meninges. It is most commonly caused by disruption and leak at cervical and thoracic spine. Imaging is sometimes the most important key to the diagnosis of idiopathic intracranial hypotension, which helps in appropriate treatment of the patient. Here, we are presenting a case of benign intracranial hypotension associated with incidental parasagittal meningioma. The presence of benign intracranial hypotension was confirmed by taking MR myelogram.

  3. Lesiones laborales

    OpenAIRE

    2015-01-01

    Las lesiones laborales se producen por un esfuerzo repetitivo, cuando un exceso de presión se ejerce sobre una parte del cuerpo provocando lesiones óseas, articulares, musculares y daños en los tejidos. Los accidentes laborales también pueden producir una lesión en el organismo y esto sumado a diversos factores es un problema para la reinserción laboral de los trabajadores de la energía eléctrica. Objetivo: Establecer cuáles son las lesiones más frecuentes que afectan a los ...

  4. Tarlov cysts: a controversial lesion of the sacral spine.

    Science.gov (United States)

    Lucantoni, Corrado; Than, Khoi D; Wang, Anthony C; Valdivia-Valdivia, Juan M; Maher, Cormac O; La Marca, Frank; Park, Paul

    2011-12-01

    The primary aim of our study was to provide a comprehensive review of the clinical, imaging, and histopathological features of Tarlov cysts (TCs) and to report operative and nonoperative management strategies in patients with sacral TCs. A literature review was performed to identify articles that reported surgical and nonsurgical management of TCs over the last 10 years. Tarlov cysts are often incidental lesions found in the spine and do not require surgical intervention in the great majority of cases. When TCs are symptomatic, the typical clinical presentation includes back pain, coccyx pain, low radicular pain, bowel/bladder dysfunction, leg weakness, and sexual dysfunction. Tarlov cysts may be revealed by MR and CT imaging of the lumbosacral spine and must be meticulously differentiated from other overlapping spinal pathological entities. They are typically benign, asymptomatic lesions that can simply be monitored. To date, no consensus exists about the best surgical strategy to use when indicated. The authors report and discuss various surgical strategies including posterior decompression, cyst wall resection, CT-guided needle aspiration with intralesional fibrin injection, and shunting. In operative patients, the rates of short-term and long-term improvement in clinical symptoms are not clear. Although neurological deficit frequently improves after surgical treatment of TC, pain is less likely to do so.

  5. Dynamic Assessment of Incidental Vocabularies: A Case of Iranian ESP Learners

    Directory of Open Access Journals (Sweden)

    Sepideh Hanifi

    2016-04-01

    Full Text Available Dynamic assessment (DA, stemmed from both Vygotsky’s (1978 learning theory and Feuerstein’s (1979 theory of mediated learning experiences, is an alternative to static assessment. It focuses on both instruction and assessment aiming at promoting learning through mediation.  DA has been widely researched in different linguistic areas, but there is paucity of research on its practice in ESP contexts. Accordingly, this study investigated the effectiveness of DA on incidental vocabularies emerging in technical reading textbooks, written for electronic engineering students. The study employed a quasi-experimental research design. Due to sample selection problems, an intact group of 25 BA electronic students were selected from the University of Zanjan. A pre-test was administered to check whether they had previous knowledge of the target words, incidentally acquired during the reading activity. As for the instrument stage, DA procedures were utilized in order to individualize participants’ assessment. Following DA implementation, a post-test similar in content to pre-test, was administered to the same participants. The significance of DA for the enhancement of incidental vocabularies was to make participants aware of the strategies of identifying, evaluating and monitoring vocabularies (Nassaji, 2003 through mediation process.  The results indicated that participants' incidental vocabulary learning promoted dramatically using DA, which employed structured hints for the mediation process.  The results of this study can inform both teachers and learners to provide a step by step procedure to promote both teaching and assessment of ESP learners' vocabulary.Keywords: Dynamic Assessment, Incidental Vocabulary Learning, ESP Learners, ZPD, mediation 

  6. Incidental and intentional flavor memory in young and older subjects

    NARCIS (Netherlands)

    Moller, P.; Mojet, J.; Koster, E.P.

    2007-01-01

    Incidental and intentional learning and memory for 2 novel flavors were compared in young and elderly subjects. Incidental and intentional learning groups rated 2 new soups on acceptability for different occasions and were tested for memory the next day. On the first day, only the intentional group

  7. Incidental and intentional flavor memory in young and older subjects

    NARCIS (Netherlands)

    Moller, P.; Mojet, J.; Koster, E.P.

    2007-01-01

    Incidental and intentional learning and memory for 2 novel flavors were compared in young and elderly subjects. Incidental and intentional learning groups rated 2 new soups on acceptability for different occasions and were tested for memory the next day. On the first day, only the intentional group

  8. Rare case of dual lesion: nonossifying fibroma and osteochondroma.

    Science.gov (United States)

    Grimshaw, Charles S; Zawin, Joan; Brink, David S; Greenberg, David D

    2014-05-01

    In this paper, we offer radiographic and pathologic evidence of a unique coexisting dual lesion. A 14-year-old boy presented for evaluation of a painful right knee after sustaining a twisting injury. The patient was found to have a torn anterior cruciate ligament, in addition to incidental finding of distal femoral dual lesion composed of tissue consistent with a nonossifying fibroma and an osteochondroma. To our knowledge, this is the first report in the medical literature of a dual lesion containing both an osteochondroma and nonossifying fibroma.

  9. Molecular Characterization of eutF Mutants of Salmonella typhimurium LT2 Identifies eutF Lesions as Partial-Loss-of-Function tonB Alleles

    Science.gov (United States)

    Thomas, Michael G.; O’Toole, George A.; Escalante-Semerena, Jorge C.

    1999-01-01

    The eutF locus of Salmonella typhimurium LT2 was identified as a locus necessary for the utilization of ethanolamine as a sole carbon source. Initial models suggested that EutF was involved in either ethanolamine transport or was a transcriptional regulator of an ethanolamine transporter. Phenotypic characterization of eutF mutants suggested EutF was somehow involved in 1,2-propanediol, propionate, and succinate utilization. Here we provide evidence that two alleles defining the eutF locus, Δ903 and eutF1115, are partial-loss-of-function tonB alleles. Both mutations were complemented by plasmids containing a wild-type allele of the Escherichia coli tonB gene. Immunoblot analysis using TonB monoclonal antibodies detected a TonB fusion protein in strains carrying eutF alleles. Molecular analysis of the Δ903 allele identified a deletion that resulted in the fusion of the 3′ end of tonB with the 3′ end of trpA. In-frame translation of the tonB-trpA fusion resulted in the final 9 amino acids of TonB being replaced by a 45-amino-acid addition. We isolated a derivative of a strain carrying allele Δ903 that regained the ability to grow on ethanolamine as a carbon and energy source. The molecular characterization of the mutation that corrected the Eut− phenotype caused by allele Δ903 showed that the new mutation was a deletion of two nucleotides at the tonB-trpA fusion site. This deletion resulted in a frameshift that replaced the 45-amino-acid addition with a 5-amino-acid addition. This change resulted in a TonB protein with sufficient activity to restore growth on ethanolamine and eut operon expression to nearly wild-type levels. It was concluded that the observed EutF phenotypes were due to the partial loss of TonB function, which is proposed to result in reduced cobalamin and ferric siderophore transport in an aerobic environment; thus, the eutF locus does not exist. PMID:9882647

  10. An exploratory study of the use of the Wechsler Digit-Symbol Incidental Learning procedure with the WAIS-IV.

    Science.gov (United States)

    Ashendorf, Lee

    2012-01-01

    The Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) does not include the optional Incidental Learning procedure for the Digit-Symbol subtest (now simply called Coding) that had been available in the WAIS-Third Edition (WAIS-III). However, the procedure itself has been shown to have some utility in assessment of incidental memory processes. The current study of a mixed clinical outpatient sample (n = 75) sought to identify salient characteristics of the Incidental Learning tasks as applied to WAIS-IV Coding. Findings showed that the Pairing procedure, when applied to the WAIS-IV, has different characteristics than it did with the WAIS-III; it is more difficult overall, and different items tend to be more prominently recalled than others. The Free Recall procedure for the WAIS-IV is comparable to the WAIS-III version in overall difficulty. Implications and implementation of the current findings are discussed.

  11. Use of Anisotropy, 3D Segmented Atlas, and Computational Analysis to Identify Gray Matter Subcortical Lesions Common to Concussive Injury from Different Sites on the Cortex.

    Directory of Open Access Journals (Sweden)

    Praveen Kulkarni

    Full Text Available Traumatic brain injury (TBI can occur anywhere along the cortical mantel. While the cortical contusions may be random and disparate in their locations, the clinical outcomes are often similar and difficult to explain. Thus a question that arises is, do concussions at different sites on the cortex affect similar subcortical brain regions? To address this question we used a fluid percussion model to concuss the right caudal or rostral cortices in rats. Five days later, diffusion tensor MRI data were acquired for indices of anisotropy (IA for use in a novel method of analysis to detect changes in gray matter microarchitecture. IA values from over 20,000 voxels were registered into a 3D segmented, annotated rat atlas covering 150 brain areas. Comparisons between left and right hemispheres revealed a small population of subcortical sites with altered IA values. Rostral and caudal concussions were of striking similarity in the impacted subcortical locations, particularly the central nucleus of the amygdala, laterodorsal thalamus, and hippocampal complex. Subsequent immunohistochemical analysis of these sites showed significant neuroinflammation. This study presents three significant findings that advance our understanding and evaluation of TBI: 1 the introduction of a new method to identify highly localized disturbances in discrete gray matter, subcortical brain nuclei without postmortem histology, 2 the use of this method to demonstrate that separate injuries to the rostral and caudal cortex produce the same subcortical, disturbances, and 3 the central nucleus of the amygdala, critical in the regulation of emotion, is vulnerable to concussion.

  12. MR imaging for evaluation of lesions of the cranial vault: a pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Amaral, Lazaro; Chiurciu, Miriam; Almeida, Joao Ricardo; Ferreira, Nelson Fortes; Mendonca, Renato; Lima, Sergio Santos [Hospital da Beneficiencia Portuguesa, Sao Paulo, SP (Brazil). MEDIMAGEM]. E-mail: lazden@terra.com.br

    2003-09-01

    A variety of diseases affect the calvaria. They may be identified clinically as palpable masses or incidentally in radiologic examinations. There are many diagnostic possibilities, including congenital, neoplastic, inflammatory and traumatic lesions. The purpose of this study is to illustrate the main calvarial lesions through MR imaging, their signal intensity and extension to neighboring sites. A retrospective analysis of 81 cases, from November 1996 to July 2001, was conducted. The examinations were performed on a 1.5 T equipment and each one of the cases was pathologically proven. The results were: dermoid cysts [4 cases (5%)], epidermoid cysts [2 cases (2.5%)], cephalocele [14 cases (17.5%)], sinus pericranii [3 cases (3.7%)], leptomeningeal cysts [4 cases (5%)], Langerhans cell histiocytosis [10 cases (12.5%)], lipoma [4 cases (5%)], fibrous dysplasia [13 cases (16.2%)], osteoma [8 cases (10%)], hemangioma [1 case (1.2%)], meningioma [3 cases (3.7%)], chondrosarcoma [5 cases (6.2%)], hemangiosarcoma [1 case (1.2%)], multiple myeloma [3 cases (3.7%)], sarcomatous transformation of Paget disease [1 case (1.3%)], and metastasis [5 cases (6.2%)]. MRI identifies bone marrow abnormalities and invasion of adjacent tissues at an early stage. Therefore, it is an essential method when it comes to properly evaluating calvarial lesions. (author)

  13. 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.

  14. Usefulness of layer-specific strain for identifying complex CAD and predicting the severity of coronary lesions in patients with non-ST-segment elevation acute coronary syndrome: Compared with Syntax score.

    Science.gov (United States)

    Zhang, Li; Wu, Wei-Chun; Ma, Hong; Wang, Hao

    2016-11-15

    Layer-specific strain allows the assessment of the function of every layer of myocardium. To evaluate the changes of non-ST-segment elevation acute coronary syndrome(NSTE-ACS) patients with and without complex coronary artery disease(CAD) by layer-specific strain and determine if myocardial strain can identify complex CAD and assess the severity of coronary lesions as defined by Syntax score (SS). A total of 139 patients undergoing coronary angiography due to suspected NSTE-ACS were prospectively enrolled. Echocardiography was performed 1h before angiography. Global longitudinal strain (GLS), territorial longitudinal strain (TLS), global circumferential strain (GCS) and territorial circumferential strain (TCS) of the three layers of LV wall were assessed by two-dimensional (2D) speckle tracking echocardiography (STE) with layer-specific myocardial deformation quantitative analysis based on the perfusion territories of the three major coronary arteries in an 18-segment model of LV. SS was used for predicting the severity of coronary lesions in patients with complex CAD. 78 had complex CAD, 32 had 1- or 2-vessel disease and 29 had no significant coronary stenosis confirmed by coronary angiography. According to SS value, 78 complex CAD subjects were subdivided into three groups, 24 in group SS1 (SS≤22), 26 in group SS2 (SS 23-32) and 28 in group SS3 (SS≥33). Compared to the other two groups without complex CAD, patients with NSTE-ACS due to complex CAD had worse function in all 3 myocardial layers assessed by GLS, TLS, GCS and TCS. Endocardial GLS and TLS (all, PCAD than in those without (all, PCAD and predict the severity of coronary lesions in patients with NSTE-ACS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Autosomal-dominant osteopetrosis: An incidental finding

    Directory of Open Access Journals (Sweden)

    Rajathi Maria

    2010-01-01

    Full Text Available Osteopetrosis is a descriptive term that refers to a group of rare, heritable disorders of the skeleton. Osteopetrotic conditions vary greatly in their presentation and severity, from just as an incidental finding on radiographs to causing life-threatening complications such as bone marrow suppression. It is caused by failure of osteoclast development and function. Osteopetrosis can be inherited as autosomal-recessive, autosomal-dominant or as X-linked traits, with the most severe forms being the autosomal-recessive ones. The severity of the disease is mild to moderate in the autosomal-dominant forms, with normal life expectancy. Diagnosis is largely based on clinical and radiographic evaluation. The present paper reports a case of autosomal-dominant osteopetrosis complicated by osteomyelitis with a short review of the condition.

  16. Relevance of an incidental chest finding

    Science.gov (United States)

    Cortés-Télles, Arturo; Mendoza, Daniel

    2012-01-01

    Solitary pulmonary nodule represents 0.2% of incidental findings in routine chest X-ray images. One of the main diagnoses includes lung cancer in which small-cell subtype has a poor survival rate. Recently, a new classification has been proposed including the very limited disease stage (VLD stage) or T1-T2N0M0 with better survival rate, specifically in those patients who are treated with surgery. However, current recommendations postulate that surgery remains controversial as a first-line treatment in this stage. We present the case of a 46-year-old female referred to our hospital with a preoperative diagnosis of a solitary pulmonary nodule. On initial approach, a biopsy revealed a small cell lung cancer. She received multimodal therapy with surgery, chemotherapy, and prophylactic cranial irradiation and is currently alive without recurrence on a 2-year follow-up. PMID:22345914

  17. Mesothelial/monocytic incidental cardiac excrescences (cardiac MICE) associated with acute aortic dissection: a study of two cases

    Science.gov (United States)

    Strecker, Thomas; Bertz, Simone; Wachter, David Lukas; Weyand, Michael; Agaimy, Abbas

    2015-01-01

    Acute aortic dissection is a life-threatening condition mainly caused by hypertension, atherosclerotic disease and other degenerative diseases of the connective tissue of the aortic wall. Mesothelial/monocytic incidental cardiac excrescences (cardiac MICE) is a rare benign reactive tumor-like lesion composed of admixture of histiocytes, mesothelial cells, and inflammatory cells set within a fibrinous meshwork without a vascular network or supporting stroma. Cardiac MICE occurring in association with aortic dissection is exceptionally rare (only one such case reported to date). We herein report on the surgical repair of two Stanford type A aortic dissections caused by idiopathic giant cell aortitis in a 66-year-old-woman and by atherosclerotic disease in a 58-year-old-man, respectively. In both cases, the dissections could be visualized via computed tomography. Histopathology showed cardiac incidental MICE within the external aortic wall near the pericardial surface which was confirmed by immunohistochemistry. PMID:26097568

  18. Incidental Reflector Comparison of Containerized Dry Fire Extinguishing Agents

    Energy Technology Data Exchange (ETDEWEB)

    Chapman, Bryan Scott [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Wysong, Andrew Russell [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-12-14

    This document addresses the incidental reflector reactivity worth of containerized fire extinguishing agents authorized for use in PF-4 at Los Alamos National Laboratory (LANL). The intent of the document is to analyze dry fire extinguishing agent that remains in a container and is not actively being used in a fire emergency. The incidental reflector reactivity worth is determined by comparison to various thicknesses of close fitting water reflection which is commonly used to bound incidental reflectors in criticality safety evaluations. The conclusion is that even in unlimited quantities, when containerized the authorized dry fire extinguishing agents are bound by 0.4 inches of close fitting water.

  19. Differential diagnosis of focal lesions of the kidney in CT and MRT; Differentialdiagnose fokaler Nierenlaesionen in CT und MRT

    Energy Technology Data Exchange (ETDEWEB)

    Heckmann, M.; Heinrich, M.; Bautz, W.; Uder, M. [Universitaetsklinikum Erlangen (Germany). Radiologisches Inst.; Humke, U. [Katharinenhospital Stuttgart (Germany). Urologische Klinik

    2008-07-01

    The great majority of renal masses are found incidentally as a result of the use of ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI). If ultrasonography is not diagnostic CT or MRI should be initiated to differentiate lesions of the kidney that need surgical intervention from those that do not and from those that need follow-up examinations. Cystic renal masses are characterized by using the Bosniak classification, including category IIF. In solid lesions of the kidney first non-surgical lesions as well as lymphoma, renal infarction and nephritis should be excluded. Identifying fatty components in renal lesions is very important because in angiomyolipoma they are almost always present. CT and MRI are excellent for tumor detection. Careful evaluation of imaging finding combined with the patient's history should assist the radiologist in making the proper diagnosis or recommending the appropriate treatment in most cases. This article provides a review about renal masses, the imaging methods for their evaluation and their characteristic features at CT and MR imaging. Different lesions are demonstrated like xantogranulomatous pyelonephritis, acute pyelonephritis, renal infarction, lymphoma, angiomyolipoma, renal oncocytoma, cystic lesion and polycystic disease the kidney, echinococcosis, renal cystadenoma, metastases, renal cell carcinoma (RCC), and multiple bilateral RCC in patients with Hippel-Lindau-Syndrome. This article should help to differentiate complex cystic lesions of the kidney by using the Bosniak-classification, especially Bosniak Category IIF. Solid masses should be characterized and the major question to be answered is whether the mass represents a surgical or nonsurgical lesion or if follow-up studies are necessary. (orig.)

  20. GISTs múltiplos em neurofibromatose tipo 1: diagnóstico incidental em paciente com abdome agudo Multiple GISTs in neurofibromatosis type 1: incidental diagnosis in a patient with acute abdomen

    Directory of Open Access Journals (Sweden)

    Tomaz de Jesus Maria Grezzana-Filho

    2009-03-01

    Full Text Available INTRODUÇÃO: Tem sido descrito na literatura incidência aumentada de tumores estromais gastrointestinais (GISTs em portadores de neurofibromatose tipo 1. Estes tumores tipicamente ocorrem no intestino delgado e, frequentemente, são múltiplos. RELATO DO CASO: Diagnóstico incidental de GIST em um paciente portador de neurofibromatose tipo 1 com abdome agudo. No trans-operatório foi identificada apendicite retrocecal perfurada e massa neoplásica no jejuno proximal. A referida lesão ocupava aproximadamente 70% da circunferência do órgão e não apresentava invasão de estruturas adjacentes. Além disso, observaram-se dezenas de pequenos nódulos disseminados por toda a extensão do jejuno e íleo. O anatomopatológico revelou neoplasia compatível com GIST, com grau moderado de atipias, baixo índice mitótico (BACKGROUND: The literature described an increased incidence of gastrointestinal stromal tumors (GISTs in patients with neurofibromatosis type 1. These tumors typically occur in the small intestine, and frequently are multiple. Often the behavior of the tumor in this association is more favorable than in sporadic cases. CASE REPORT: Incidental diagnosis of GIST was done in a patient with neurofibromatosis type 1 during treatment for acute abdomen. Trans-operatively was identified a retrocecal perforated appendicitis and a neoplastic mass in the proximal jejunum. The lesion occupied approximately 70% of the circumference of the organ and had no invasion of adjacent structures. Moreover, there were dozens of small nodules scattered throughout the length of the jejunum and ileum. The pathology revealed malignancy consistent with GIST, with moderate degree of atypia, low mitotic index (<5 / 50 and absence of necrosis. In immunohistochemical analysis, the neoplastic cells were positive for CD-34 and CD-117 (c-KIT, and negative for desmin. After surgery, the use of Imatinib chemotherapy was indicated. After a follow-up period of 12 months

  1. Incidental Suspicious Regional Lymph Nodes on Breast Sonography: Is Sampling Necessary?

    Science.gov (United States)

    Raj, Sean D; Amer, Ahmed M; Garg, Naveen; Krishnamurthy, Savitri; Hess, Kenneth R; Park, Young Mi; Moseley, Tanya; Whitman, Gary J

    Suspicious regional lymph nodes may be incidentally identified on breast ultrasound examinations in patients who present for sonographic evaluation without a known or a suspected breast malignancy, and there is a paucity of data on whether biopsy should be performed. This study aims to characterize incidental sonographically detected suspicious regional lymph nodes and determine whether tissue sampling or follow-up imaging is required. A total of 40,773 consecutive breast ultrasounds were reviewed. Overall, 7 women with nonpalpable, incidental, suspicious axillary or supraclavicular lymph nodes in an otherwise unremarkable breast and without history of malignancy or systemic disease were identified. In all, 5 women with 6 nodes underwent ultrasound-guided fine needle aspiration and 2 women with 3 nodes were recommended follow-up ultrasound. Follow-up imaging, cytology, and all-cause clinical data were reviewed to evaluate outcomes. All 6 biopsied lymph nodes (mean = 1.5cm) were benign on cytology. Follow-up imaging was available for 3 nodes (mean = 2.6 years), with all-cause follow-up for all nodes of 2.2 years. In the follow-up group, 3 lymph nodes (mean = 1.6cm) were monitored (mean = 4.3 years) with all-cause follow-up of 4.7 years. No new cancers, growth, or suspicious features were found in these nodes during follow-up for either group of women. In conclusion, women without history of prior malignancy or systemic disease with incidentally detected, nonpalpable, suspicious regional lymph nodes with an otherwise normal breast ultrasound examination underwent fine needle aspiration or were recommended short-term follow-up ultrasound. No indeterminate features or malignancies were observed at the time of tissue sampling or developed over several years of follow-up. Avoiding sampling of these nodes would reduce patient morbidity and health care costs. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Incidental mortality of seabirds in selected commercial fisheries in Alaska

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Fishery-seabird observers monitored the incidental mortality of seabirds between 1989 and 1993 in three groundfish longline, trawl, and pot fisheries in the Bering...

  3. Serous cystadenocarcinoma as incidental finding during a repeat cesarean section.

    Science.gov (United States)

    Ahram, J; Lakoff, K; Miller, R

    1985-09-01

    Primary ovarian carcinoma and pregnancy are rarely found to coexist. We report here a case of cystadenocarcinoma discovered as an incidental finding during an elective cesarean section in a 26-year-old woman.

  4. Uterine didelphys coexisting with term pregnancy, an incidental ...

    African Journals Online (AJOL)

    Uterine didelphys coexisting with term pregnancy, an incidental finding during an ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... carry their pregnancies to term with live deliveries without any complication, some ...

  5. Critical social theory approach to disclosure of genomic incidental findings.

    Science.gov (United States)

    Bevan, Jeffrey L; Senn-Reeves, Julia N; Inventor, Ben R; Greiner, Shawna M; Mayer, Karen M; Rivard, Mary T; Hamilton, Rebekah J

    2012-11-01

    Technology has expanded genomic research and the complexity of extracted gene-related information. Health-related genomic incidental findings pose new dilemmas for nurse researchers regarding the ethical application of disclosure to participants. Consequently, informed consent specific to incidental findings is recommended. Critical Social Theory is used as a guide in recognition of the changing meaning of informed consent and to serve as a framework to inform nursing of the ethical application of disclosure consent in genomic nursing research practices.

  6. Parasellar lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ruscalleda, J. [Hospital Sant Pau, Radiology Department, Neuroradiology, Barcelona (Spain)

    2005-03-01

    The sellar and parasellar region is an anatomically complex area that represents a crucial crossroad of important adjacent structures, e.g. orbits, cavernous sinus and its content, polygon of Willis, hypothalamus through the pituitary stalk and dural reflections forming the diaphragm sellae and the walls of the cavernous sinuses. Although the cavernous sinus represents the most relevant parasellar structure, from the practical and clinical point of view all the structures that surround the sella turcica can be included in the parasellar region. CT and, mainly, MRI are the imaging modalities to study and characterise the normal anatomy and the majority of processes in this region. We present a practical short review of the most relevant CT and MRI characteristics, such as location, nature of contrast enhancement and presence of cystic components, together with clinical findings, which permit differentiation of the most frequent and less common lesions found in the parasellar region. Learning objectives: A short review of the anatomy and clinical symptoms related to the parasellar region. Radiological characterisation, mainly by MRI, of the many lesions that alter the structure and function of sellar and parasellar anatomy. Description of the MRI features that permit differentiation among less common lesions. (orig.)

  7. Incidental mood state before dissonance induction affects attitude change.

    Science.gov (United States)

    Martinie, Marie-Amélie; Almecija, Yves; Ros, Christine; Gil, Sandrine

    2017-01-01

    The way that incidental affect impacts attitude change brought about by controlled processes has so far been examined when the incidental affective state is generated after dissonance state induction. We therefore investigated attitude change when the incidental mood occurs prior to dissonance state induction. We expected a negative mood to induce systematic processing, and a positive mood to induce heuristic processing. Given that both systematic processing and attitude change are cognitively costly, we expected participants who experienced the dissonance state in a negative mood to have insufficient resources to allocate to attitude change. In our experiment, after mood induction (negative, neutral or positive), participants were divided into low-dissonance and high-dissonance groups. They then wrote a counterattitudinal essay. Analysis of their attitudes towards the essay topic indicated that attitude change did not occur in the negative incidental mood condition. Moreover, written productivity-one indicator of cognitive resource allocation-varied according to the type of incidental mood, and only predicted attitude change in the high-dissonance group. Our results suggest that incidental mood before dissonance induction influences the style of information processing and, by so doing, affects the extent of attitude change.

  8. Incidental Vocabulary Learning: A Semantic Field Approach

    Directory of Open Access Journals (Sweden)

    Parvaneh Khosravizadeh

    2011-10-01

    Full Text Available

    This study is an attempt to explore the difference between acquiring new words with different semantic fields to which they belong. In other words, the purpose of this study is to scrutinize the contribution of semantic field theory in learning new vocabulary items in an EFL setting. Thirty-eight students of three different levels of education took part in this research. They were exposed to some new words from four different semantic fields, and then they were tested on their acquisition of the words meaning. This exposure was through reading texts and the aim of reading was just comprehension, therefore the words were acquired incidentally. The outcome showed significant differences between groups with different levels of education regarding retention of words from different semantic fields.

  9. Incidental mastoid opacification in children on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Sumit; Kuruva, Manohar [University of Arkansas for Medical Sciences, Pediatric Radiology, Little Rock, AR (United States); Rettiganti, Mallikarjuna Rao [University of Arkansas for Medical Sciences and Arkansas Children' s Hospital Research Institute, Biostatistics Program, Department of Pediatrics, Little Rock, AR (United States); Qin, Curtis [Georgetown University Hospital, Radiology, Washington, DC (United States); Hegde, Shilpa V. [University of Pittsburgh Medical Centre, Section of Neuroradiology, Pittsburgh, PA (United States)

    2016-05-15

    The opacification the mastoid cavity is frequently reported by radiologists on cross-sectional imaging done for non-otological indications. It is well known that presence of fluid the mastoid does not amount to mastoiditis. This study seeks to provide an evidence-based confirmation of this known finding. The purpose of our study was to determine the prevalence of mastoid opacification in children undergoing outpatient brain MRI examination. Our study included 515 outpatient children who had brain MRI for indications other than mastoiditis or otitis media from January 2014 to March 2014. Children with history of skull base trauma or radiation were excluded. The age range was 15 days to 18 years. The overall prevalence of mastoid opacification was determined using one sample proportion and exact 95% Clopper-Pearson confidence intervals. The prevalence of mastoid opacification was analyzed based on gender, age and presenting symptoms using chi-square test of association. One hundred ten children (21.4%) had mastoid opacification. Younger patients tended to have higher opacification rates with the prevalence in children younger than 1 year of age and between 1 and 2 years of age as high as 41.7% (20/48) and 47.5% (38/80), respectively. The diagnosis of mastoiditis in children should not be based upon a radiologist's report of finding fluid or mucosal thickening in the mastoid air cells as incidental opacification the mastoid is seen frequently. (orig.)

  10. 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)

  11. 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.

  12. Incidental cardiac findings on computed tomography imaging of the thorax

    Directory of Open Access Journals (Sweden)

    El-Gendi Hossam

    2010-12-01

    Full Text Available Abstract Background Investigation of pulmonary pathology with computed tomography also allows visualisation of the heart and major vessels. We sought to explore whether clinically relevant cardiac pathology could be identified on computed tomography pulmonary angiograms (CTPA requested for the exclusion of pulmonary embolism (PE. 100 consecutive CT contrast-enhanced pulmonary angiograms carried out for exclusion of PE at a single centre were assessed retrospectively by two cardiologists. Findings Evidence of PE was reported in 5% of scans. Incidental cardiac findings included: aortic wall calcification (54%, coronary calcification (46%, cardiomegaly (41%, atrial dilatation (18%, mitral annulus calcification (15%, right ventricular dilatation (11%, aortic dilatation (8% and right ventricular thrombus (1%. Apart from 3 (3% reports describing cardiomegaly, no other cardiac findings were described in radiologists' reports. Other reported pulmonary abnormalities included: lung nodules (14%, lobar collapse/consolidation (8%, pleural effusion (2%, lobar collapse/consolidation (8%, emphysema (6% and pleural calcification (4%. Conclusions CTPAs requested for the exclusion of PE have a high yield of cardiac abnormalities. Although these abnormalities may not have implications for acute clinical management, they may, nevertheless, be important in long-term care.

  13. Fragmentary and incidental behaviour of columns, slabs and crystals.

    Science.gov (United States)

    Whiteley, Walter

    2014-02-13

    Between the study of small finite frameworks and infinite incidentally periodic frameworks, we find the real materials which are large, but finite, fragments that fit into the infinite periodic frameworks. To understand these materials, we seek insights from both (i) their analysis as large frameworks with associated geometric and combinatorial properties (including the geometric repetitions) and (ii) embedding them into appropriate infinite periodic structures with motions that may break the periodic structure. A review of real materials identifies a number of examples with a local appearance of 'unit cells' which repeat under isometries but perhaps in unusual forms. These examples also refocus attention on several new classes of infinite 'periodic' frameworks: (i) columns--three-dimensional structures generated with one repeating isometry and (ii) slabs--three-dimensional structures with two independent repeating translations. With this larger vision of structures to be studied, we find some patterns and partial results that suggest new conjectures as well as many additional open questions. These invite a search for new examples and additional theorems.

  14. Comparison of cone-beam computed tomography and periapical radiographs in identifying periapical bone lesions%锥形束CT与根尖X线片识别根尖周骨病损形貌差异的研究

    Institute of Scientific and Technical Information of China (English)

    张杰; 岳林; 张万林

    2013-01-01

    Objective To compare the difference in identifing periapical bone lesions between cone-beam computed tomography (CBCT) and periapical radiographs (PR).Methods Ten healthy maxillary incisors and 38 maxillary incisors which were diagnosed as apical periodontitis in clinic were included.All the teeth were taken with PR,and periapical index (PAI) was determined.All the teeth were taken with CBCT,and the longest diameter of incisorgingival,mesiodistal and labiapalatal dimension of bone lesion were measured and compared in axial,sagittal and coronal view separately.Results When PAI was 1,the image of PR and CBCT showed normal state of periapical region.When PAI was 2,the image of CBCT showed bone lesion in periapical region.When PAI were 3,4,5,the range of longest diameter of incisorgingival dimension were 2.75-7.00,4.51-10.63,6.75-13.38 mm,mesiodistal dimension were 1.88-4.13,3.98-7.25,5.38-10.63 mm,labiapalatal dimension were 1.50-5.70,2.63-6.25,4.50-9.91 mm.Within every grade the range of the longest diameter of bone lesion in all three dimensions varied.Among the three grades,the range of the longest diameter in same dimension was overlapped.Conclusions CBCT could show the bone lesion that PR couldn't.Use of PR in identifying bone lesion may underestimate the size of the lesion.%目的 比较锥形束CT与根尖X线片识别根尖周骨病损形貌的差异,为临床准确判断根尖周炎严重程度及治疗效果提供参考.方法 收集临床上颌切牙诊断为慢性根尖周炎的患牙38颗和健康对照牙10颗,用根尖周指数(periapical index,PAI)对根尖X线片进行分级评定,同时进行锥形束CT扫描,在轴位、矢状位和冠状位图像上定点测量并分别比较根尖周骨质缺损切龈向、近远中向和唇腭向的最大径.结果 PAI为1时,锥形束CT显示根尖周骨质无破坏;PAI为2时,锥形束CT显示根尖周骨质明显缺损;PAI为3、4、5时,骨破坏切龈向最大径分别为2.75 ~7.00、4.51 ~ 10.63、6

  15. PET/CT detection of incidental colorectal foci of F.D.G. uptake: Correlation with colonoscopy results;Decouverte fortuite de fixations colorectales focales du FDG en TEP/TDM: correlation aux donnees de la coloscopie

    Energy Technology Data Exchange (ETDEWEB)

    Nouira, M.; Evangelista, E.; Meignan, M.; Itti, E. [Universite Paris-12, Service de medecine nucleaire, hopital Henri-Mondor, AP-HP, 94 - Creteil (France); Sobhani, I. [Universite Paris-12, Service de gastroenterologie, hopital Henri-Mondor, AP-HP, 94 - Creteil (France); Hagege, H. [centre hospitalier intercommunal, Service de gastroenterologie, 94 - Creteil (France); Meignan, M.; Itti, E. [EAC CNRS 7054, 94 - Creteil (France)

    2010-04-15

    Purpose: F.D.G.-PET is an established tool for the diagnosis of recurrent or metastatic colorectal carcinoma. Several case series suggest that F.D.G.-PET often detects incidental adenomatous polyps or colorectal adenocarcinomas. The aim of this study was to correlate unexpected colorectal foci of F.D.G. uptake to pathology findings after systematic colonoscopy. Patients and methods: We reviewed the records of 3541 patients who underwent F.D.G. PET/CT in our institution over a 30-month period for the assessment of a known or suspected malignancy. In 85 of them, incidental, nodular shaped and well-circumscribed foci of abnormal uptake were identified in the area of the colon or rectum. Patients with segmental or diffuse abnormal colorectal uptake were excluded, as well as patients with known benign or malignant colorectal disease. Colonoscopy and complete pathology report was available in 29 patients. Maximal standardized uptake value (SUV{sub max}) was measured in all lesions. Results: Unexpected colorectal foci of F.D.G. uptake were associated with colonoscopic abnormalities in 23 patients (true positive rate: 79 %). Adenocarcinomas were found in six patients (SUV{sub max} = 7.3 +- 2.6), tubular adenomas in four patients (SUV{sub max} = 7.3 +- 4.9) and tubulovillous adenomas in 12 patients (SUV{sub max} = 4.2 +- 1.1). Hyperplasic polyps with no sign of dysplasia were found in the last patient (SUV{sub max} 3.3). Concomitant CT abnormalities were found on PET/CT fusion in eight patients and consisted of wall thickening (n = 5) or nodular mass (n = 3). Conversely, PET was falsely positive in six patients (21 %), with no concomitant CT abnormalities and no abnormal findings at endoscopy (SUV{sub max} 6.2 +- 2.8, no significant difference with true positive lesions). Conclusion: Our findings emphasize the need to perform a colonoscopy in front of incidental nodular colorectal foci of F.D.G. uptake because malignant or pre-malignant neoplasms, which are not clinically

  16. Actionable, pathogenic incidental findings in 1,000 participants' exomes.

    Science.gov (United States)

    Dorschner, Michael O; Amendola, Laura M; Turner, Emily H; Robertson, Peggy D; Shirts, Brian H; Gallego, Carlos J; Bennett, Robin L; Jones, Kelly L; Tokita, Mari J; Bennett, James T; Kim, Jerry H; Rosenthal, Elisabeth A; Kim, Daniel S; Tabor, Holly K; Bamshad, Michael J; Motulsky, Arno G; Scott, C Ronald; Pritchard, Colin C; Walsh, Tom; Burke, Wylie; Raskind, Wendy H; Byers, Peter; Hisama, Fuki M; Nickerson, Deborah A; Jarvik, Gail P

    2013-10-01

    The incorporation of genomics into medicine is stimulating interest on the return of incidental findings (IFs) from exome and genome sequencing. However, no large-scale study has yet estimated the number of expected actionable findings per individual; therefore, we classified actionable pathogenic single-nucleotide variants in 500 European- and 500 African-descent participants randomly selected from the National Heart, Lung, and Blood Institute Exome Sequencing Project. The 1,000 individuals were screened for variants in 114 genes selected by an expert panel for their association with medically actionable genetic conditions possibly undiagnosed in adults. Among the 1,000 participants, 585 instances of 239 unique variants were identified as disease causing in the Human Gene Mutation Database (HGMD). The primary literature supporting the variants' pathogenicity was reviewed. Of the identified IFs, only 16 unique autosomal-dominant variants in 17 individuals were assessed to be pathogenic or likely pathogenic, and one participant had two pathogenic variants for an autosomal-recessive disease. Furthermore, one pathogenic and four likely pathogenic variants not listed as disease causing in HGMD were identified. These data can provide an estimate of the frequency (∼3.4% for European descent and ∼1.2% for African descent) of the high-penetrance actionable pathogenic or likely pathogenic variants in adults. The 23 participants with pathogenic or likely pathogenic variants were disproportionately of European (17) versus African (6) descent. The process of classifying these variants underscores the need for a more comprehensive and diverse centralized resource to provide curated information on pathogenicity for clinical use to minimize health disparities in genomic medicine.

  17. Actionable, Pathogenic Incidental Findings in 1,000 Participants’ Exomes

    Science.gov (United States)

    Dorschner, Michael O.; Amendola, Laura M.; Turner, Emily H.; Robertson, Peggy D.; Shirts, Brian H.; Gallego, Carlos J.; Bennett, Robin L.; Jones, Kelly L.; Tokita, Mari J.; Bennett, James T.; Kim, Jerry H.; Rosenthal, Elisabeth A.; Kim, Daniel S.; Tabor, Holly K.; Bamshad, Michael J.; Motulsky, Arno G.; Scott, C. Ronald; Pritchard, Colin C.; Walsh, Tom; Burke, Wylie; Raskind, Wendy H.; Byers, Peter; Hisama, Fuki M.; Nickerson, Deborah A.; Jarvik, Gail P.

    2013-01-01

    The incorporation of genomics into medicine is stimulating interest on the return of incidental findings (IFs) from exome and genome sequencing. However, no large-scale study has yet estimated the number of expected actionable findings per individual; therefore, we classified actionable pathogenic single-nucleotide variants in 500 European- and 500 African-descent participants randomly selected from the National Heart, Lung, and Blood Institute Exome Sequencing Project. The 1,000 individuals were screened for variants in 114 genes selected by an expert panel for their association with medically actionable genetic conditions possibly undiagnosed in adults. Among the 1,000 participants, 585 instances of 239 unique variants were identified as disease causing in the Human Gene Mutation Database (HGMD). The primary literature supporting the variants’ pathogenicity was reviewed. Of the identified IFs, only 16 unique autosomal-dominant variants in 17 individuals were assessed to be pathogenic or likely pathogenic, and one participant had two pathogenic variants for an autosomal-recessive disease. Furthermore, one pathogenic and four likely pathogenic variants not listed as disease causing in HGMD were identified. These data can provide an estimate of the frequency (∼3.4% for European descent and ∼1.2% for African descent) of the high-penetrance actionable pathogenic or likely pathogenic variants in adults. The 23 participants with pathogenic or likely pathogenic variants were disproportionately of European (17) versus African (6) descent. The process of classifying these variants underscores the need for a more comprehensive and diverse centralized resource to provide curated information on pathogenicity for clinical use to minimize health disparities in genomic medicine. PMID:24055113

  18. Incidentally Detected Kaposi Sarcoma of Adrenal Gland with Anaplastic Features in an HIV Negative Patient

    Directory of Open Access Journals (Sweden)

    Zeliha Esin Celik

    2016-01-01

    Full Text Available Kaposi sarcoma (KS, a vascular tumor caused by infection with human herpesvirus 8 (HHV8, is a systemic disease that can present with cutaneous lesions with or without visceral involvement. Very few cases of KS, most of which were associated with AIDS, have been reported in the adrenal gland. Anaplastic transformation of KS is a rare clinical presentation known as an aggressive disease with local recurrence and metastatic potential. We report here a 47-year-old HIV negative male presented with extra-adrenal symptoms and had an incidentally detected anaplastic adrenal KS exhibited aggressive clinical course. To the best of our knowledge, this is the first case of anaplastic primary adrenal KS without mucocutaneous involvement but subsequently developed other side adrenal metastases in an HIV negative patient.

  19. Incidentally Detected Kaposi Sarcoma of Adrenal Gland with Anaplastic Features in an HIV Negative Patient

    Science.gov (United States)

    Celik, Murat; Sen, Erdem; Cebeci, Hakan; Ata, Ozlem; Yavas, Cagdas

    2016-01-01

    Kaposi sarcoma (KS), a vascular tumor caused by infection with human herpesvirus 8 (HHV8), is a systemic disease that can present with cutaneous lesions with or without visceral involvement. Very few cases of KS, most of which were associated with AIDS, have been reported in the adrenal gland. Anaplastic transformation of KS is a rare clinical presentation known as an aggressive disease with local recurrence and metastatic potential. We report here a 47-year-old HIV negative male presented with extra-adrenal symptoms and had an incidentally detected anaplastic adrenal KS exhibited aggressive clinical course. To the best of our knowledge, this is the first case of anaplastic primary adrenal KS without mucocutaneous involvement but subsequently developed other side adrenal metastases in an HIV negative patient.

  20. Incidentally Detected Inoperable Malignant Pheochromocytoma with Hepatic Metastasis Treated by Transcatheter Arterial Chemoembolization

    Directory of Open Access Journals (Sweden)

    Joong Keun Kim

    2014-12-01

    Full Text Available Malignant pheochromocytoma (PCC is a rare condition. Although the liver is the second most frequent site of metastasis in malignant PCC, no definite treatments have been established. Herein, we report a case of liver metastasis of PCC that was successfully treated by transcatheter arterial chemoembolization (TACE. A 69-year-old man was admitted to the Department of Gastroenterology for evaluation of an incidental hepatic mass in August 2013. He had undergone right adrenalectomy in May 2005 and PCC had been confirmed on the basis of histopathological findings. Liver biopsy was performed, and metastatic PCC was diagnosed. The lesion appeared inoperable because of invasion of the portal vein and metastases in the lymph nodes along the hepatoduodenal ligament. Thus, TACE was performed instead. After TACE, symptoms including dizziness and cold sweating improved, and the patient's serum catecholamine levels decreased. On the basis of this case, we believe that TACE may be a useful treatment for liver metastasis in malignant PCC.

  1. [Incidentally detected bronchial artery aneurysm with combined operation for mitral regurgitation;report of a case].

    Science.gov (United States)

    Sato, Hisashi; Oteki, Hitoshi; Naito, Kozo; Yunoki, Junji

    2015-02-01

    A 77-year-old woman was admitted to the hospital for heart failure with orthopnea. Echocardiography revealed massive mitral regurgitation. During preoperative cardiac catheterization, an aneurysm was indentified incidentally just below the tracheal carina. Three dimensional computed tomography showed three bronchial artery aneurysms behind the pulmonary artery and the left atrium. The proximal aneurysm was the largest and was 22 mm in diameter. It was resected by retracting the ascending aorta to the left, the superior vana cava to the right and right pulmonary artery cranially under cardiopulmonary bypass, and mitral valve plasty was performed. We believed that resection of the proximal aneurysm would cause thrombotic occlusion of the other 2 aneurysms. Bronchial artery aneurysm is a rare entity that is observed in fewer than 1% of those who undergo selective bronchial arteriography. In addition, because bronchial artery aneurysm is a potentially life-threatening lesion, it should be treated promptly when diagnosed.

  2. A Structured Approach to Incidental Take Decision Making

    Science.gov (United States)

    McGowan, Conor P.

    2013-01-01

    Decision making related to incidental take of endangered species under U.S. law lends itself well to a structured decision making approach. Incidental take is the permitted killing, harming, or harassing of a protected species under the law as long as that harm is incidental to an otherwise lawful activity and does not "reduce appreciably the probability of survival and recovery in the wild." There has been inconsistency in the process used for determining incidental take allowances across species and across time for the same species, and structured decision making has been proposed to improve decision making. I use an example decision analysis to demonstrate the process and its applicability to incidental take decisions, even under significant demographic uncertainty and multiple, competing objectives. I define the example problem, present an objectives statement and a value function, use a simulation model to assess the consequences of a set of management actions, and evaluate the tradeoffs among the different actions. The approach results in transparent and repeatable decisions.

  3. Incidentes transfusionais imediatos: revisão integrativa da literatura Incidentes transfusionales inmediatos: revisión integrativa de la literatura Immediate transfusion incidents: an integrative literature review

    Directory of Open Access Journals (Sweden)

    Adriana Lemos de Sousa Neto

    2012-01-01

    Full Text Available Este estudo de revisão integrativa da literatura teve como objetivo analisar as pesquisas que abordam a ocorrência de incidentes transfusionais imediatos e ações de hemovigilância implantadas. Os dados foram obtidos por meio de busca nas bases de dados - LILACS, MEDLINE e PUBMED - abrangendo o período de 1980 a 2009, nos idiomas português, inglês e espanhol. Foram identificados 1.382 artigos, dos quais 29 atenderam aos critérios de inclusão estabelecidos. Destes artigos, 20 (69,0% eram estudos retrospectivos transversais, 8 (27,5% prospectivos e um (3,5% caso-controle. Em relação à abordagem, os estudos foram classificados em dois focos temáticos: tipos de incidentes transfusionais imediatos e ações de hemovigilância implantadas associadas aos tipos de incidentes transfusionais imediatos. A análise dos trabalhos destacou a maior ocorrência de reação febril não hemolítica e alérgica, avanço em ações de hemovigilância e maior preocupação com a qualidade da assistência hemoterápica.Este estudio de revisión integrativa de la literatura tuvo como objetivo analizar las investigaciones que abordan la ocurrencia de incidentes transfusionales inmediatos y acciones de hemovigilancia implantadas. Los datos fueron obtenidos por medio de la búsqueda en las bases de datos - LILACS, MEDLINE y PUBMED - abarcando el período de 1980 a 2009, en los idiomas portugués, inglés y español. Fueron identificados 1,382 artículos, de los cuales 29 atendieron a los criterios de inclusión establecidos. De estos artículos, 20 (69,0% eran estudios retrospectivos transversales, 8 (27,5% prospectivos y un (3,5% caso-control. En relación al abordaje, los estudios fueron clasificados en dos focos temáticos: tipos de incidentes transfusionales inmediatos y acciones de hemovigilancia implantadas asociadas a los tipos de incidentes transfusionales inmediatos. El análisis de los trabajos destacó una ocurrencia mayor de reacción febril no

  4. Terminologia de incidentes com medicamentos no contexto hospitalar Terminology for drug incidents in the hospital context

    Directory of Open Access Journals (Sweden)

    Maria de Almeida Rocha Rissato

    2008-09-01

    Full Text Available Incidentes com medicamentos geram problemas aos pacientes e custos adicionais ao sistema de saúde. A variedade de termos utilizada para comunicá-los propicia divergências nos resultados de pesquisas e confundem notificadores. Objetivou-se revisar os termos utilizados para descrever estes incidentes confrontando-os com as conceituações/definições oficiais disponíveis. Pesquisaram-se as bases PubMed, MEDLINE, IPA e LILACS para selecionar estudos publicados entre janeiro de 1990 e dezembro de 2005. Selecionaram-se 33 publicações. Verificou-se que a terminologia supranacional recomendada para descrever incidentes com medicamentos é insuficiente, mas que há consenso de uso das expressões em função do gênero do incidente. O termo Reação Adversa a Medicamento é mais utilizado quando não se verifica intencionalidade. A expressão Evento Adverso a Medicamento foi mais usada quando se descreviam incidentes durante a hospitalização; e Problema Relacionado a Medicamento foi mais utilizada em estudos que avaliaram atenção/cuidados farmacêuticos (uso/falta do medicamento. Ainda assim, a linha divisória entre essas três categorias não é clara e simples. Futuros estudos das relações entre as categorias e investigações multidisciplinares sobre erro humano podem subsidiar a proposição de novas conceituações.In-hospital drug incidents cause problems for patients and additional costs for the health system. The variety of terms used to report them leads to disparities in research results and confuses the professionals that report them. This study aimed to review the terms used to describe drug incidents by collating them with the official concepts and definitions. PubMed, MEDLINE, IPA, and LILACS were searched to select studies published from January 1990 to December 2005. Thirty-three publications were selected. The supranational terminology recommended for describing drug incidents proved insufficient, but there was consensus

  5. Lymphoepithelial cysts and cystic lymphangiomas: Underrecognized benign cystic lesions of the pancreas

    Institute of Scientific and Technical Information of China (English)

    Ioannis; T; Konstantinidis; Avinash; Kambadakone; Onofrio; A; Catalano; Dushyant; V; Sahani; Vikram; Deshpe; David; G; Forcione; Jennifer; A; Wargo; Carlos; Fernandez-del; Castillo; Keith; D; Lillemoe; Andrew; L; Warshaw; Cristina; R; Ferrone

    2014-01-01

    AIM: To identify their diagnostic and prognostic clinical characteristics in a large series.METHODS: Retrospective review of clinicopathologic and imaging characteristics of patients diagnosed with lymphoepithelial cysts and cystic lymphangiomas of the pancreas at Massachusetts General Hospital.RESULTS: Twelve patients were identified between 1/1/1997 and 8/1/2007. Their median age was 55.5 years(range 19-78 years), and 6 were females. The le-sion was incidentally discovered in half of the patients.Contrast enhanced computed tomography demonstrat-ed that the cysts had thin walls, without calcifications, pancreatic duct dilation or pancreatic parenchyma inva-sion. Endoscopic ultrasound with fine needle aspiration(EUS/FNA) confirmed the diagnosis of a lymphoepithe-lial cyst in 3 patients, one of whom was spared an op-eration and continues to do well after 6 years. Eleven patients had a resection: 3 pancreaticoduodenecto-mies, 7 distal pancreatectomies, and 1 enucleation. The median size of the cysts was 3 cm(range 2-20 cm). At a median follow-up of 57 mo no recurrences or other pancreas-related conditions occurred.CONCLUSION: Lymphoepithelial cysts and cystic lymphangiomas of the pancreas can be diagnosed with a combination of contrast-enhanced computed tomog-raphy scans and EUS/FNA. If the lesion is asymptom-atic, an operation might be avoided.

  6. Collagenous spherulosis: An interesting cytological finding in breast lesion

    Directory of Open Access Journals (Sweden)

    Shailja Puri

    2015-01-01

    Full Text Available Collagenous spherulosis (CS is a rare and interesting entity associated with benign breast lesions. CS is an incidental finding picked up only on 0.2% of cytology specimen. Typically cytologically of CS of breast consists of central spherical hyaline spherule surrounded by myoepithelial cells. The central hyaline spherule has been found to be basement membrane material histochemically and immunohistochemically. The importance of recognizing CS of breast lies in the fact that similar hyaline globules can occur in adenoid cystic carcinoma of the breast (ACCB. The two lesions need to be differentiated on cytology failing which inappropriate treatment can be given for either of the two lesions. We present here a case of CS associated with benign breast lesion and a case of ACCB to describe their cytological features and key points to differentiate them cytologically.

  7. Clinical course of incidental syringomyelia without predisposing pathologies.

    Science.gov (United States)

    Kim, Jiha; Kim, Chi Heon; Jahng, Tae-Ahn; Chung, Chun Kee

    2012-05-01

    Although the widespread use of MRI has facilitated the diagnosis of subclinical syringomyelia, little information has been established regarding its natural course. To elucidate the clinical course and treatment strategy of incidental syringomyelia without predisposing pathologies, we retrospectively reviewed the clinical course of 12 adult patients with incidental syringomyelia. No patients had any predisposing pathology, including Chiari malformation or spinal cord tumor. Using the medical records and MRI, we analyzed the neurological and radiological features of each patient. After a mean of 39.9 months follow-up, no patient developed neurological deterioration. Although one patient had radiological progression without neurological deterioration, 11 patients (91.7%) had no change on MRI. Additionally, all patients experienced a favorable clinical course without surgery. These results indicate that, for patients with incidental syringomyelia without predisposing pathology, close observation rather than surgery can be recommended.

  8. Adult attachment and incidental memory for emotional words

    Directory of Open Access Journals (Sweden)

    Nanxin Li

    2011-06-01

    Full Text Available A dual task of attachment priming and memory recognition was proposed to explore the effect of adult attachment styles on the incidental memory for emotional words. Subjects completed an attachment priming task which intends to activate internal working model of attachment by describing attachment-related scenes, and then an incidental memory recognition test of words which differ in emotional meaning and relevance of attachment styles. Signal detection theory was used to compare the discriminability index and decision criterion of emotional words in subjects of different attachment style. Results showed that subjects with secure attachment styles performed better than insecure-attached subjects in the memory recognition test, in terms of higher hit rate, lower false alarm rate, and higher discriminability index. We extended the influence of attachment styles on cognition to lower level of incidental memory, not just on higher cognitive level with emotional arousal as suggested by previous research.

  9. Patients' views on incidental findings from clinical exome sequencing

    Directory of Open Access Journals (Sweden)

    Kristin E. Clift

    2015-03-01

    Full Text Available This article characterizes the opinions of patients and family members of patients undergoing clinical genomic-based testing regarding the return of incidental findings from these tests. Over sixteen months, we conducted 55 in-depth interviews with individuals to explore their preferences regarding which types of results they would like returned to them. Responses indicate a diversity of attitudes toward the return of incidental findings and a diversity of justifications for those attitudes. The majority of participants also described an imperative to include the patient in deciding which results to return rather than having universal, predetermined rules governing results disclosure. The results demonstrate the importance of a patient centered-approach to returning incidental findings.

  10. Incidentally detected splanchnic vein thrombosis: A sub-study from an international registry

    NARCIS (Netherlands)

    Riva, N.; Ageno, W.; Schulman, S.; Bang, S.-M.; Sartori, M.T.; Grandone, E.; Beyer, J.; Barillari, G.; Di Minno, D.; Duce, R.; Malato, A.; Santoro, R.; Poli, D.; Verhamme, P.; Martinelli, I.; Kamphuisen, P.; Alatri, A.; Becattini, C.; Bucherini, E.; Piana, A.; De Stefano, V.; Dentali, F.

    2012-01-01

    Background Splanchnic vein thrombosis (SVT) is often diagnosed incidentally. Whether demographic characteristics, underlying risk factors and therapeutic management of patients with incidentally detected SVT (IDSVT) differ from symptomatic patients is unknown. Materials and Methods Consecutive patie

  11. The Study of the Effects of Reading Factors on Incidental Vocabulary Acquisition

    Institute of Scientific and Technical Information of China (English)

    李海燕

    2007-01-01

    To figure out the most robust factors influencing incidental vocabulary acquisition (IVA) performance, in this paper three reader variables are identified based on literature review, i.e., reading proficiency, sight vocabulary and content schema; and an investigation is conducted to search for their different impacts.After the analysis of the collected data by SPSS 10.0, the results suggested that individual difference in IVA is largely caused by the difference in reading ability and previous vocabulary knowledge.Therefore, to foster learners' IVA ability, EFL teachers need to help students develop independent reading strategies for IVA, provide material suitable to students' level and enrich their background knowledge.

  12. Incidental diagnosis of HLRCC following investigation for Asperger Syndrome: actionable and actioned.

    Science.gov (United States)

    Duong, Bich-Thu; Savarirayan, Ravi; Winship, Ingrid

    2016-01-01

    Incidental findings are inevitable as clinical research and practice transitions from a single gene approach to a genomic approach. A novel deletion of the Fumarate Hydratase (FH) gene was identified in a 22 year old male who underwent a molecular karyotype as part of an autism spectrum disorder research project. This unexpected result implies a predisposition to Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC), a rare, autosomal dominant condition and has unforeseen implications for him and his family. We review the typical features and management of HLRCC and discuss the challenges that face health professionals, as genetic testing advances and becomes more accessible.

  13. Incidental findings in musculoskeletal radiology; Zufallsbefunde in der muskuloskeletalen Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Wuennemann, F.; Rehnitz, C.; Weber, M.A. [Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany)

    2017-04-15

    Increasing numbers of conventional X-rays, computed tomography and magnetic resonance imaging in the inpatient, outpatient and scientific routine leads to an increasing number of incidental findings. The correct interpretation of these incidental findings with respect to the relevance and the evaluation concerning further work-up is an important task of radiologists. Description of common incidental findings in musculoskeletal imaging and their clinical classification. A PubMed literature search was performed using the following terms: incidental findings, population-based imaging, musculoskeletal imaging, non-ossifying fibroma, enchondroma, osteodystrophia deformans, chondrosarcoma, fibrous dysplasia, simple bone cyst, unicameral bone cyst, solitary bone cyst, aneurysmal bone cyst, vertebral hemangioma, bone island, osteopoikilosis, Tarlov cyst and diffuse idiopathic skeletal hyperostosis (DISH). Incidental findings are observed in up to 40% of imaging procedures. In up to 6% these incidental findings involve the skeletal system. Common incidental findings are discussed and their clinical relevance is explained. (orig.) [German] Mit steigender Menge an konventionellen Roentgen- sowie CT- und MRT-Bildern im stationaeren, ambulanten und wissenschaftlichen Alltag steigt unweigerlich auch die Zahl der Zufallsbefunde. Die korrekte Einordnung bzgl. deren Relevanz, ob eine weitere Abklaerung notwendig ist oder nicht, stellt eine wichtige Aufgabe des Radiologen dar. Vorstellung haeufiger Zufallsbefunde des muskuloskeletalen Systems und deren klinische Einordnung. Pubmed-Literaturrecherche zu den Stichworten ''incidental findings'', ''population-based imaging'', ''musculoskeletal imaging'', ''non-ossifying fibroma'', ''enchondroma'', ''osteodysthrophia deformans'', ''chondrosarcoma'', ''fibrous dysplasia'', &apos

  14. Detection and monitoring of early caries lesions

    DEFF Research Database (Denmark)

    Pretty, I A; Ekstrand, K R

    2016-01-01

    AIM: To review the current evidence base of detecting and monitoring early carious lesions in children and adolescents and a rationale proposed to ensure that such lesions are identified and appropriately managed. METHODS: The systematic literature search identified initially a review by Gomez...... of existing visible and radiographical systems to monitor lesions over time. Using low-cost intra-oral cameras facilitates the recording of lesion appearance in the patient record and may be of significant benefit in monitoring early lesions over time following their detection. This benefit extends...

  15. A Review of Effect of Different Tasks on Incidental Vocabulary Acquisition

    Science.gov (United States)

    Liu, Chen L.

    2015-01-01

    Studies of incidental vocabulary acquisition in second language learning have got more and more attention both at home and abroad. By first introducing the definition and theoretical foundations of incidental vocabulary acquisition, this paper reviews empirical studies of effect of different tasks on incidental vocabulary acquisition and points…

  16. 30 CFR 937.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the... WITHIN EACH STATE OREGON § 937.702 Exemption for coal extraction incidental to the extraction of other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of Other...

  17. 30 CFR 922.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the... WITHIN EACH STATE MICHIGAN § 922.702 Exemption for coal extraction incidental to the extraction of other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of Other...

  18. 30 CFR 942.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the... WITHIN EACH STATE TENNESSEE § 942.702 Exemption for coal extraction incidental to the extraction of other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of Other...

  19. 30 CFR 947.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the... WITHIN EACH STATE WASHINGTON § 947.702 Exemption for coal extraction incidental to the extraction of other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of...

  20. 30 CFR 910.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the... WITHIN EACH STATE GEORGIA § 910.702 Exemption for coal extraction incidental to the extraction of other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of Other...

  1. 30 CFR 921.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the... WITHIN EACH STATE MASSACHUSETTS § 921.702 Exemption for coal extraction incidental to the extraction of other minerals. Part 702 of the chapter, Exemption for Coal Extraction Incidental to the Extraction of...

  2. 30 CFR 939.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the... WITHIN EACH STATE RHODE ISLAND § 939.702 Exemption for coal extraction incidental to the extraction of other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of...

  3. 30 CFR 905.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the... WITHIN EACH STATE CALIFORNIA § 905.702 Exemption for coal extraction incidental to the extraction of other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of...

  4. 30 CFR 903.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the... WITHIN EACH STATE ARIZONA § 903.702 Exemption for coal extraction incidental to the extraction of other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of Other...

  5. 30 CFR 912.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the... WITHIN EACH STATE IDAHO § 912.702 Exemption for coal extraction incidental to the extraction of other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of Other...

  6. 30 CFR 941.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the... WITHIN EACH STATE SOUTH DAKOTA § 941.702 Exemption for coal extraction incidental to the extraction of other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of...

  7. 30 CFR 933.702 - Exemption for coal extraction incidental to the extraction of other minerals.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Exemption for coal extraction incidental to the... WITHIN EACH STATE NORTH CAROLINA § 933.702 Exemption for coal extraction incidental to the extraction of other minerals. Part 702 of this chapter, Exemption for Coal Extraction Incidental to the Extraction of...

  8. Incidental renal artery stenosis is an independent predictor of mortality in patients with peripheral vascular disease

    NARCIS (Netherlands)

    Mui, KW; Sleeswijk, M; van den Hout, H; van Baal, J; Navis, G; Woittiez, AJ

    In patients with peripheral vascular disease (PVD), mortality is high and renal artery stenosis (RAS) is a frequent incidental finding. RAS carries a high risk for mortality, but whether incidentally discovered RAS is a risk factor for mortality is unknown. The prognostic impact of incidental RAS

  9. Patient-centered clinical impact of incidentally detected abnormalities on chest CT scans

    Directory of Open Access Journals (Sweden)

    Sherine G. Moftah

    2014-09-01

    Conclusion: The clinically significant different incidental abnormalities on chest CT scans represented 10.4% of all incidental findings, 3.3% were due to malignancies. The clinical impact of incidental abnormalities on chest CT may be of utmost importance on patient care.

  10. Cystadenocarcinoma of the appendix: an incidental imaging finding in a patient with adenocarcinomas of the ascending and the sigmoid colon

    Directory of Open Access Journals (Sweden)

    Prassopoulos Panos

    2003-10-01

    Full Text Available Abstract Background Primary adenocarcinomas of the appendix are uncommon. Mucoceles that result from mucinous adenocarcinomas of the appendix may be incidentally detected on imaging. Case presentation A case of a mucocele of the appendix, due to cystadenocarcinoma, is presented as an incidental imaging finding in a female, 86-year-old patient. The patient was admitted due to rectal hemorrhage and underwent colonoscopy, x-ray, US and CT. Adenocarcinoma of the ascending colon, adenomatous polyp of the sigmoid colon and a cystic lesion in the right iliac fossa were diagnosed. The cystic lesion was characterized as mucocele. The patient underwent right hemicolectomy, excision of the mucocele and sigmoidectomy. She recovered well and in two-year follow-up is free from cancer. Conclusions Preoperative diagnosis of an underlying malignancy in a mucocele is important for patient management, but it is difficult on imaging studies. Small lymph nodes or soft tissue stranding in the surrounding fat on computed tomography examination may suggest the possibility of malignancy.

  11. Is Incidental Vocabulary Acquisition Feasible to EFL Learning?

    Science.gov (United States)

    Luo, Jian-ping

    2013-01-01

    For learning English as a foreign language, the efficiency of the approach of incidental vocabulary acquisition depends on the word frequency and text coverage. However, the statistics of English corpus reveals that English is a language that has a large vocabulary size but a low word frequency as well as text coverage, which is obviously not in…

  12. Parkinsonism "Plus" Syndrome With Incidental Corpus Callosal Agenesis

    Directory of Open Access Journals (Sweden)

    Shanbhogue K R

    1999-01-01

    Full Text Available A case of Parkinsonism ′Plus′ syndrome with cranial CT scan and MRI showing corpus callosal agenesis is reported. There were no clinical signs of callosal separation. The causes for the discrepancies between the lack of clinical signs of callosal separation and imaging appearances are discussed. The callosal agenesis is in all probability incidental.

  13. Parkinsonism "Plus" Syndrome With Incidental Corpus Callosal Agenesis

    OpenAIRE

    Shanbhogue K R; Bennett D; Shankar V; Murugesan S; Stephen A S K; Karnan B; Srikanth S

    1999-01-01

    A case of Parkinsonism ′Plus′ syndrome with cranial CT scan and MRI showing corpus callosal agenesis is reported. There were no clinical signs of callosal separation. The causes for the discrepancies between the lack of clinical signs of callosal separation and imaging appearances are discussed. The callosal agenesis is in all probability incidental.

  14. Beyond Raw Frequency: Incidental Vocabulary Acquisition in Extensive Reading

    Science.gov (United States)

    Kweon, Soo-Ok; Kim, Hae-Ri

    2008-01-01

    Second language vocabulary can be learned incidentally while the learner is engaged in extensive reading or reading for meaning, inferring the meaning of unknown words (Huckin & Coady, 1999; Hulstijn, 1992; Krashen, 1993; Pigada & Schmitt, 2006). 12 Korean learners of English read authentic literary texts and were tested on their knowledge of…

  15. Incidental Vocabulary Acquisition in French as a Foreign Language.

    Science.gov (United States)

    Dupuy, Beatrice; Krashen, Stephen D.

    1993-01-01

    Third semester college students of French viewed part of a film, read part, and then were given a surprise vocabulary test with colloquial words from the text. Their performance, compared to a control group, suggests that incidental vocabulary acquisition is possible in a foreign language situation. The test is appended. (Contains eight…

  16. 21 CFR 178.3570 - Lubricants with incidental food contact.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) FOOD FOR HUMAN CONSUMPTION (CONTINUED) INDIRECT FOOD ADDITIVES: ADJUVANTS, PRODUCTION AIDS, AND SANITIZERS Certain Adjuvants and Production Aids § 178.3570 Lubricants with incidental food contact.... Polybutene, hydrogenated; complying with the identity prescribed under § 178.3740 Do. Polyethylene Do...

  17. Implicit and Explicit Cognitive Processes in Incidental Vocabulary Acquisition

    Science.gov (United States)

    Ender, Andrea

    2016-01-01

    Studies on vocabulary acquisition in second language learning have revealed that a large amount of vocabulary is learned without an overt intention, in other words, incidentally. This article investigates the relevance of different lexical processing strategies for vocabulary acquisition when reading a text for comprehension among 24 advanced…

  18. Preparación Hospitalaria en incidentes NBQ

    Directory of Open Access Journals (Sweden)

    A. Cique Moya

    2015-03-01

    Full Text Available Los incidentes de Goainia, Matsumoto, Tokio, así como la crisis del carbunco muestran que los hospitales intervienen de forma directa en la respuesta a incidentes NBQ, debiendo estar integrados en el sistema de respuesta a desastres junto con los servicios de asistencia prehospitalaria para poder dar una respuesta efectiva a este tipo de accidentes. Los retos organizativos y de gestión a los que tiene que hacer frente la estructura hospitalaria ante un incidente no sólo afectan a los servicios de urgencias, sino que trascienden a ésta, debiendo estar contemplados en el Plan de Emergencia del Centro Hospitalario. La respuesta pasa por el establecimiento de un plan de mejora continua en la instalación mediante la valoración del índice de seguridad de la instalación y la preparación, individual y colectiva, del centro sanitario para activar el plan de emergencias de forma inmediata una vez establecida la alarma, para así evitar los problemas de transferencia de contaminación a las instalaciones y al personal minimizando las consecuencias de un incidente NBQ.

  19. Renal arterial aneurysm--an incidental finding at autopsy.

    Directory of Open Access Journals (Sweden)

    Vaideeswar P

    1998-01-01

    Full Text Available Herein we describe a rare case of saccular renal artery aneurysm seen as an incidental autopsy finding in an elderly, hypertensive female. The aneurysm was seen as a small exophytic mass with calcified wall and lumen occluded by recanalized thrombus.

  20. 76 FR 18232 - Marine Mammals; Incidental Take During Specified Activities

    Science.gov (United States)

    2011-04-01

    ... harassment incidental to airport construction on Akun Island and hovercraft operation between Akun Island and..., Airport Construction and Hovercraft Operation (Project). The request was published in the Federal Register... hovercraft operations were conducted during this period of time. On January25, 2010, we received a joint...

  1. Mycobacterium Xenopi Found Incidentally on MRI of the Cervical Spine

    Science.gov (United States)

    2010-01-01

    no malignant cells. The patient had a VATS (Video Assisted Thoracic Surgery) wedge excision of the lung mass. The lung mass turned out to be AFB...and relief of symptoms with treatment characteristic of the disease. This case report highlights the importance of incidental findings included

  2. Incidental sadness biases social economic decisions in the ultimatum game

    NARCIS (Netherlands)

    Harlé, K.M.; Sanfey, A.G.

    2007-01-01

    Recent dual-process models of decision making have suggested that emotion plays an important role in decision making: however, the impact of incidental moods (i.e., emotions unrelated to the immediate situation) on decisions remains poorly explored. This question was investigated by inducing 2 basic

  3. Incidental Finding of Isolated Colonic Neurofibroma

    Directory of Open Access Journals (Sweden)

    Haritha Chelimilla

    2013-09-01

    Full Text Available Neurofibromatosis is a genetic disorder manifested by characteristic cutaneous lesions called neurofibromas. There are two distinct neurocutaneous syndromes named neurofibromatosis type 1 (also called von Recklinghausen disease or NF1 and neurofibromatosis type 2 (NF2. NF1 is by far the most common presentation and is caused by an autosomal dominant mutation in the NF1 gene mapped to chromosome 17q11.2. The literature shows that gastrointestinal involvement is noted in systemic neurofibromatosis in up to 25% of patients, but isolated intestinal neurofibromatosis is a very rare manifestation. We herein present the case of a 70-year-old woman who was diagnosed with an isolated colonic neurofibroma without any systemic signs of neurofibromatosis; only a few case reports of this condition have been published to date.

  4. Incidental findings in chest X-rays; Zufallsbefunde im Roentgenthorax

    Energy Technology Data Exchange (ETDEWEB)

    Wielpuetz, M.O.; Kauczor, H.U. [Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaet Heidelberg, Translational Lung Research Center (TLRC), Deutsches Zentrum fuer Lungenforschung (DZL), Heidelberg (Germany); Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie mit Nuklearmedizin, Thoraxklinik, Heidelberg (Germany); Weckbach, S. [Universitaetsklinikum Heidelberg, Klinik fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany); Universitaet Heidelberg, Translational Lung Research Center (TLRC), Deutsches Zentrum fuer Lungenforschung (DZL), Heidelberg (Germany)

    2017-04-15

    Conventional projection radiography (chest x-ray) is one of the most frequently requested procedures in radiology. Even though chest x-ray imaging is frequently performed in asymptomatic patients for preoperative assessment, clinically relevant incidental findings are relatively scarce. This is due to the relatively low sensitivity of chest x-rays where few clinically relevant incidental findings are to be expected, as any detectable pathologies will as a rule already be clinically symptomatic. Recommendations from relevant societies for the management of incidental findings, apart from the clarification of incidental nodules, do not exist. This review article therefore describes the most frequent and typical incidental findings of lung parenchyma (apart from pulmonary nodules), mediastinal structures including the hilum of the lungs, pleura, chest wall and major vessels. Also described are those findings which can be diagnosed with sufficient certainty from chest x-rays so that further clarification is not necessary and those which must be further clarified by multislice imaging procedures or other techniques. (orig.) [German] Eine der haeufigsten Untersuchungen in der Radiologie ist die konventionelle Projektionsradiographie des Thorax (Roentgenthorax). Auch wenn projektionsradiographische Aufnahmen im Rahmen einer praeoperativen Abklaerung haeufig als orientierende Untersuchung angefertigt werden, sind - bedingt durch die relativ geringe Sensitivitaet des Roentgenthorax - wenig klinisch relevante Zufallsbefunde zu erwarten, da nachweisbare Pathologien in der Regel bereits auch klinisch apparent sind. Empfehlungen entsprechender Fachgesellschaften zu Zufallsbefunden im Roentgenthorax jenseits der Abklaerung von Rundherden liegen nicht vor. Die vorliegende Arbeit beleuchtet daher haeufige und typische Zufallsbefunde des Lungenparenchyms (ausser den Lungenrundherden), der mediastinalen Strukturen einschliesslich der Hili, der Pleura, der Thoraxwand sowie der

  5. Incidental durotomy in lumbar spine surgery - incidence, risk factors and management

    Directory of Open Access Journals (Sweden)

    Adam D.

    2015-03-01

    Full Text Available Incidental durotomy is a common complication of lumbar spine operations for degenerative disorders. Its incidence varies depending on several risk factors and regarding the intra and postoperative management, there is no consensus. Our objective was to report our experience with incidental durotomy in patients who were operated on for lumbar disc herniation, lumbar spinal stenosis and revision surgeries. Between 2009 and 2012, 1259 patients were operated on for degenerative lumbar disorders. For primary operations, the surgical approach was mino-open, interlamar, uni- or bilateral, as for recurrences, the removal of the compressive element was intended: the epidural scar and the disc fragment. 863 patients (67,7% were operated on for lumbar disc herniation, 344 patients (27,3% were operated on for lumbar spinal stenosis and 52 patients (5% were operated for recurrences. The operations were performed by neurosurgeons with the same professional degree but with different operative volume. Unintentional durotomy occurred in 20 (2,3% of the patients with herniated disc, in 14 (4,07% of the patients with lumbar spinal stenosis and in 12 (23% of the patients who were operated on for recurrences. The most frequent risk factors were: obesity, revised surgery and the physician’s low operative volume. Intraoperative dural fissures were repaired through suture (8 cases, by applying muscle, fat graft or by applying curaspon, tachosil. There existed 4 CSF fistulas which were repaired at reoperation. Incidental dural fissures during operations for degenerative lumbar disorders must be recognized and immediately repaired to prevent complications such as CSF fistula, osteodiscitis and increased medical costs. Preventing, identifying and treating unintentional durotomies can be best achieved by respecting a neat surgical technique and a standardized treatment protocol.

  6. Incidental Prostate Cancer in Transurethral Resection of the Prostate Specimens in the Modern Era

    Directory of Open Access Journals (Sweden)

    Brandon Otto

    2014-01-01

    Full Text Available Objectives. To identify rates of incidentally detected prostate cancer in patients undergoing surgical management of benign prostatic hyperplasia (BPH. Materials and Methods. A retrospective review was performed on all transurethral resections of the prostate (TURP regardless of technique from 2006 to 2011 at a single tertiary care institution. 793 men (ages 45–90 were identified by pathology specimen. Those with a known diagnosis of prostate cancer prior to TURP were excluded (n=22 from the analysis. Results. 760 patients had benign pathology; eleven (1.4% patients were found to have prostate cancer. Grade of disease ranged from Gleason 3+3=6 to Gleason 3+4=7. Nine patients had cT1a disease and two had cT1b disease. Seven patients were managed by active surveillance with no further events, one patient underwent radiation, and three patients underwent radical prostatectomy. Conclusions. Our series demonstrates that 1.4% of patients were found to have prostate cancer, of these 0.5% required treatment. Given the low incidental prostate cancer detection rate, the value of pathologic review of TURP specimens may be limited depending on the patient population.

  7. Should incidental asymptomatic angiographic stenoses and occlusions be treated in patients with peripheral arterial disease?

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2009-09-01

    The clinical importance of angiographically detected asymptomatic lower-limb stenoses and occlusions is unknown. This study aims to (i) assess the clinical outcome of asymptomatic lesions in the lower limb, (ii) identify predictors of clinical deterioration, and (iii) determine which asymptomatic lower-limb lesions should be treated at presentation.

  8. Incidentally Detected Primary Giant Renal Cystic Enchinococcosis in a Young Patient: An Underestimated Entity?

    Directory of Open Access Journals (Sweden)

    Emre Urer

    2015-01-01

    Full Text Available Echinococcosis is a parasitic infestation caused by Echinococcus granulosus and is an endemic disease in many parts of world. The symptoms and signs depend on the location and size of the cyst. Renal cystic echinococcosis or hydatid cyst (HC disease of the kidney is extremely rare and constitutes only 2-4% of all cases of hydatid disease (HD. We present a 39-year-old male patient who was referred to our outpatient clinic with cystic right kidney mass that was incidentally diagnosed during hepatobiliary ultrasound for chronic hepatitis B evaluation. Routine blood tests were normal without eosinophilia. Indirect haemagglutination test was negative. Abdominal kidneys, ureters, and bladder X-ray showed an 83×95 mm sized curvilinear calcification in the right upper abdominal quadrant. Abdominal computed tomography scan and magnetic resonance imaging demonstrated a 10x9x10 cm sized cystic mass arising from the middle pole of the right kidney, destructing the whole upper pole and extending into the liver. Daughter vesicles were present in the cystic lesion suggesting renal HD. Right retroperitoneal exploration with flank approach and right radical nephrectomy was performed without any complications. Pathology confirmed HC lesion. Following surgery, albendazole 400 mg per os twice daily for 4 weeks was suggested.

  9. An unusual case of incidental rupture of liver hemangioma during labor

    Institute of Scientific and Technical Information of China (English)

    Tayfun Güng(o)r; Hakan Aytan; (O)mer Lütfi Tapisiz; Sema Zergero(g)lu

    2004-01-01

    @@ Cavernous hemangiomas are the most common benign tumors of the liver and are found in about 2% of autopsy patients. 1,2 The vast majority of these tumors are small and asymptomatic; however, there have been a few reported cases in which these lesions led to spontaneous fatal hemorrhage. 1,2 Although liver hemangiomas occur in both sexes, most studies point to a female predominance; one study reported a ratio of female predominance of 4. 5: 1.3 It has been suggested that estrogen may be associated with the growth of liver hemangiomas, but the incidence of these lesions in pregnancy and the effect on them of the increased estrogen levels during pregnancy are unknown. 2 Symptomatic liver hemangiomas have been treated by steroids, radiation therapy, surgical resection and recently embolization, but surgeons may sometimes be confronted with intraabdominal hemorrhage originating from rupture of asymptomatic liver hemangiomas. This case describes an incidental intraabdominal hemorrhage originating from a liver hemangioma in a 36 weeks twin pregnancy being delivered emergently by Cesarean section due to fetal distress.

  10. 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.

  11. A retrospective study of post-operative gall bladder pathology with special reference to incidental carcinoma of the gall bladder

    Directory of Open Access Journals (Sweden)

    Jagannath Dev Sharma

    2014-06-01

    Methods: This retrospective study was carried out at a multi-specialty hospital in eastern India from the pathology records for the period from August 2005 to July 2008. The records were analyzed for gender, age group distribution, and pathological types with different histology. Results: Out of 863 records, chronic cholecystitis 51.2% was the most common histology and malignancy was seen in 2.7% (23/863 both pre-operative and post-operative diagnosis. In the neoplastic group incidental carcinoma was diagnosed in 1.9% (17/23 of cases Conclusion: Histopathological examination of gallbladder specimen helps to identify non-neoplastic conditions with its complications and also, for the detection of incidental carcinoma. Thorough sampling of all gallbladder specimens is a must to detect focal neoplastic changes. [Int J Res Med Sci 2014; 2(3.000: 1050-1053

  12. LIPOMA CEREBRAL EN CUERPO CALLOSO: HALLAZGO INCIDENTAL EN PACIENTE CON EVENTO CEREBROVASCULAR

    Directory of Open Access Journals (Sweden)

    Gloria Cárcamo-Portillo

    2016-07-01

    Full Text Available Los lipomas intracraneales son lesiones infrecuentes y benignas que representan el 0,03 al 0,08% de todas las masas intracraneales. Estos se encuentran relacionados a un defecto de la línea media debido a un mal cierre del tubo neural; lo que conlleva a una mala diferenciación y una persistencia anormal de la meninge primitiva con posterior diferenciación al tejido adiposo. La mitad de los casos permanecen asintomáticos y son diagnosticados como un hallazgo incidental en los estudios imagenológicos. Sin embargo, otros casos se asocian a sintomatología neurológica como retraso psicomotor, cefalea, epilepsia y parálisis cerebral. Se presenta el caso de una paciente de 46 años de edad, con antecedentes de hipertensión arterial y diabetes mellitus tipo 2; que cursa con sintomatología de Evento Cerebrovascular Isquémico por lo que le realizan –una Tomografía Computarizada (TC y una Resonancia Magnética (RM. En el reporte se describen múltiples infartos a nivel del hemisferio cerebral izquierdo mientras que al nivel de la línea media se observó una imagen compatible con lipoma cerebral que afectaba el rostro, la rodilla y la porción anterior del cuerpo calloso. La identificación de este hallazgo fue incidental. Palabras claves: Lipoma Cerebral; Cuerpo Calloso; Resonancia Magnética; Accidente Cerebrovascular. (Fuente: DeCS BIREME.

  13. Nanoparticle formation in a chemical storage room as a new incidental nanoaerosol source at a nanomaterial workplace.

    Science.gov (United States)

    Kim, K H; Kim, J B; Ji, J H; Lee, S B; Bae, G N

    2015-11-15

    Chemical storage rooms located near engineered nanomaterials (ENMs) workplaces can be a significant source of unintentional nanoaerosol generation. A new incidental nanoparticle source was identified and characterized in a chemical storage room located at an ENMs workplace. Stationary and mobile measurements using on-line instruments and chemical analysis of volatile organic compounds (VOCs) were carried out to identify the source. The number of nanoaerosols emitted from the chemical storage room was found to be several orders of magnitude higher than that existing in the ENMs workplace. VOC analysis showed that the accumulated precursors and oxygenated VOCs in the chemical storage room could be attributed to incidental particle formation via gas-to-particle conversion. We stress the importance of identification of the incidental nanoaerosols to allow characterization of the nanoaerosols at ENMs workplaces, and to estimate additional nanoaerosols exposure, which was previously unknown. Hazardous chemical substances in the workplace have been regulated in many countries; however, most of the regulations are focused on gas-phase or liquid-phase substances. The present study emphasizes the importance of secondary pollutants in particulate form that can be generated from the gas or liquid phase of hazardous chemical substances.

  14. Unusual cause of generalized osteolytic vertebral lesions: a case report

    Directory of Open Access Journals (Sweden)

    Nanda Sudip

    2007-06-01

    Full Text Available Abstract Background Vertebral sarcoidosis is an extremely rare form of osseous sarcoidosis. Although osseous sarcoidosis is almost always an incidental finding of sarcoidosis elsewhere in the body, vertebrae may be the primary disease site. Involvement of vertebrae is usually localized and sclerotic or lytic. Case presentation We describe a case of extensive asymptomatic vertebral involvement by sarcoid with osteolytic lesions. Making the diagnosis requires biopsy and ruling out other commoner causes of osteolytic vertebral lesions. Conclusion We report this case in the hope of expanding the knowledge of osseous sarcoidosis. Our patient was unique in that all involvement was axial with sparing of the peripheral skeleton, near absence of any other organ involvement, diffuse involvement of the whole spine and osteolytic bone lesions.

  15. Significance of incidental nasopharyngeal uptake on {sup 1}''8F-FDG PET/CT: Patterns of benign/physiologic uptake and differentiation from malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Na Rae; Yoo, Le Ryung; Yoon, Hyuk Jin; Lee, Yeong Joo; Oh, Jin Kyoung [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2015-03-15

    The purpose of this study was to assess the significance of incidental nasopharyngeal uptake on 18F-FDG PET/CT and to identify image patterns useful in the differentiation between benign or physiologic activity and nasopharyngeal carcinoma. We retrospectively reviewed medical records of patients with nasopharyngeal uptakes on 18F-FDG PET/CT scans taken between January 2010 and July 2011. Patients with head and neck cancer, other metastatic head and neck lesions, or lymphoma were excluded. Total 177 patients were enrolled (Group A). PET images were reviewed for patterns of nasopharyngeal FDG uptake, presence/absence of cervical lymph node uptake and pattern of cervical node uptake. Diagnostic confirmation was made by pathology or clinical and radiological follow-up for 1 year or longer. Furthermore, initial PET/CT images of 48 patients with nasopharyngeal carcinoma (Group B) were reviewed for comparison with PET/CT images of Group A patients. All nasopharyngeal uptakes in Group A were confirmed to be benign. Group B showed significantly more intense FDG uptake (SUV{sub max} of Group A 3.9 ± 1.4 vs. Group B 10.4 ± 4.6, p<0.001). and asymmetric nasopharyngeal uptake (asymmetric uptake of Group A 67.8% vs. Group B 89.6%). When SUV{sub max} of 6.0 was used as cut off for detection of malignant nasopharyngeal uptake, the area under the ROC curve was 0.93 (95% confidence interval, 0.88-0.98), with a sensitivity of 88.1% and a specificity of 91.7%. Metastatic nodes in Group B showed higher SUV{sub max} (Group A 2.3 ± 0.6 vs. Group B 7.1 ± 4.0, p<0.001) and larger size (short axis of Group A 5.3 ± 2.0 mm vs. Group B 13.1 ± 4.7 mm, p<0.001) than benign nodes of Group A. The majority of Group B cases demonstrated retropharyngeal lymph node uptake (70.8%), compared to only 2 cases in Group A. In patients without a history of underlying malignancy involving head and neck, incidental nasopharyngeal uptake on PET/CT does not indicate malignancy. However, if the

  16. Cortical Lesions as Determinants of White Matter Lesion Formation and Cognitive Abnormalities in MS

    Science.gov (United States)

    2015-05-01

    matter lesion, gray matter lesion, diffusion tensor imaging, double inversion recovery imaging, connectivity 3. ACCOMPLISHMENTS:  What were the major...two independent raters (Raters 1 and 2) reviewed all subjects and identified cortical and white matter lesions. Diffusion tensor data was used to

  17. Imaging findings of various calvarial bone lesions witha focus on osteolytic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Young Hee; Moon, Won Jin; An, Hyeong Su; Cho, Joon [Konkuk University Medical Center, Konkuk University School of Medicine, Seoul (Korea, Republic of); Rho, Myung Ho [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2016-01-15

    In this review, we present computed tomography (CT) and magnetic resonance imaging (MRI) findings of various calvarial lesions on the basis of their imaging patterns and list the differential diagnoses of the lesions. We retrospectively reviewed 256 cases of calvarial lesion (122 malignant neoplasms, 115 benign neoplasms, and 19 non-neoplastic lesions) seen in our institutions, and classified them into six categories based on the following imaging features: generalized skull thickening, focal skull thickening, generalized skull thinning, focal skull thinning, single lytic lesion, and multiple lytic lesions. Although bony lesions of the calvarium are easily identified on CT, bone marrow lesions are better visualized on MRI including diffusion-weighted imaging or fat-suppressed T2-weighted imaging. Careful interpretation of calvarial lesions based on pattern recognition can effectively narrow a range of possible diagnoses.

  18. Cystic lesion around the hip joint

    Science.gov (United States)

    Yukata, Kiminori; Nakai, Sho; Goto, Tomohiro; Ikeda, Yuichi; Shimaoka, Yasunori; Yamanaka, Issei; Sairyo, Koichi; Hamawaki, Jun-ichi

    2015-01-01

    This article presents a narrative review of cystic lesions around the hip and primarily consists of 5 sections: Radiological examination, prevalence, pathogenesis, symptoms, and treatment. Cystic lesions around the hip are usually asymptomatic but may be observed incidentally on imaging examinations, such as computed tomography and magnetic resonance imaging. Some cysts may enlarge because of various pathological factors, such as trauma, osteoarthritis, rheumatoid arthritis, or total hip arthroplasty (THA), and may become symptomatic because of compression of surrounding structures, including the femoral, obturator, or sciatic nerves, external iliac or common femoral artery, femoral or external iliac vein, sigmoid colon, cecum, small bowel, ureters, and bladder. Treatment for symptomatic cystic lesions around the hip joint includes rest, nonsteroidal anti-inflammatory drug administration, needle aspiration, and surgical excision. Furthermore, when these cysts are associated with osteoarthritis, rheumatoid arthritis, and THA, primary or revision THA surgery will be necessary concurrent with cyst excision. Knowledge of the characteristic clinical appearance of cystic masses around the hip will be useful for determining specific diagnoses and treatments. PMID:26495246

  19. Clinicopathological characteristics of incidental prostate cancer discovered from radical cystoprostatectomy specimen: a multicenter French study.

    Science.gov (United States)

    Pignot, Géraldine; Salomon, Laurent; Neuzillet, Yann; Masson-Lecomte, Alexandra; Lebacle, Cédric; Patard, Jean-Jacques; Lunardi, Pierre; Rischmann, Pascal; Pasticier, Gilles; Bernhard, Jean-Christophe; Cohen, Jérémy; Timsit, Marc-Olivier; Verkarre, Virginie; Peyronnet, Benoit; Verhoest, Gregory; Le Goux, Constance; Zerbib, Marc; Brecheteau, François; Bigot, Pierre; Larre, Stéphane; Murez, Thibault; Thuret, Rodolphe; Lacarriere, Emeric; Champy, Cécile; Roupret, Morgan; Comperat, Eva; Berger, Julien; Descazeaud, Aurélien; Toledano, Harry; Bastide, Cyrille; Lavilledieu, Sébastien; Avances, Christophe; Delage, Francky; Valeri, Antoine; Molimard, Benoit; Houlgatte, Alain; Gres, Pascal; Donnaint, Alain; Kleinclauss, François; Legal, Sophie; Doerfler, Arnaud; Koutlidis, Nicolas; Cormier, Luc; Hetet, Jean-François; Colls, Philippe; Arvin-Berod, Alexis; Rambeaud, Jean-Jacques; Quintens, Hervé; Soulie, Michel; Pfister, Christian

    2014-02-01

    The present study assessed the incidence and histopathological features of incidentally diagnosed prostate cancer (PCa) in specimens from radical cystoprostatectomy (RCP) for bladder cancer. The patient outcomes also were evaluated. We retrospectively reviewed the histopathological features and survival data of 4,299 male patients who underwent a RCP for bladder cancer at 25 French centers between January 1996 and June 2012. No patients had preoperative clinical or biological suspicion of PCa. Among the 4,299 RCP specimens, PCa was diagnosed in 931 patients (21.7%). Most tumors (90.1%) were organ-confined (pT2), whereas 9.9% of them were diagnosed at a locally advanced stage (≥pT3). Gleason score was 7 in 40 cases (4.3%). After a median follow-up of 25.5 months (interquartile range 14.2-47.4), 35.4% of patients had bladder cancer recurrence and 23.8% died of bladder cancer. Only 16 patients (1.9%) experienced PCa biochemical recurrence during follow-up, and no preoperative predictive factor was identified. No patients died from PCa. The rate of incidentally diagnosed PCa in RCP specimens was 21.7%. The majority of these PCas were organ-confined. PCa recurrence occurred in only 1.9% of cases during follow-up.

  20. Weight and see: loading working memory improves incidental identification of irrelevant faces.

    Science.gov (United States)

    Carmel, David; Fairnie, Jake; Lavie, Nilli

    2012-01-01

    Are task-irrelevant stimuli processed to a level enabling individual identification? This question is central both for perceptual processing models and for applied settings (e.g., eye-witness testimony). Lavie's load theory proposes that working memory actively maintains attentional prioritization of relevant over irrelevant information. Loading working memory thus impairs attentional prioritization, leading to increased processing of task-irrelevant stimuli. Previous research has shown that increased working memory load leads to greater interference effects from response-competing distractors. Here we test the novel prediction that increased processing of irrelevant stimuli under high working memory load should lead to a greater likelihood of incidental identification of entirely irrelevant stimuli. To test this, we asked participants to perform a word-categorization task while ignoring task-irrelevant images. The categorization task was performed during the retention interval of a working memory task with either low or high load (defined by memory set size). Following the final experimental trial, a surprise question assessed incidental identification of the irrelevant image. Loading working memory was found to improve identification of task-irrelevant faces, but not of building stimuli (shown in a separate experiment to be less distracting). These findings suggest that working memory plays a critical role in determining whether distracting stimuli will be subsequently identified.

  1. 21 CFR 884.2990 - Breast lesion documentation system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Breast lesion documentation system. 884.2990... Devices § 884.2990 Breast lesion documentation system. (a) Identification. A breast lesion documentation... lesions identified during a clinical breast examination. (b) Classification. Class II (special controls...

  2. Incidental and intentional encoding in young and elderly adults.

    Science.gov (United States)

    Téllez-Alanís, Bernarda; Cansino, Selene

    2004-08-06

    Event-related potentials (ERPs) were recorded in young and elderly adults during the performance of an incidental encoding task (subjects were unexpectedly given a recognition test) followed by an intentional task (subjects expected the recognition test). Both tasks consisted of an encoding stage in which subjects classified words (natural/artificial) and a recognition stage in which they indicated whether the words were old (presented during the encoding stage) or new. In both groups and tasks, the ERPs, during encoding, differed as a function of subsequent recognition: the old words correctly recognized generated greater amplitude potentials than the incorrect ones. The memory processes expressed by these ERPs are preserved in elderly adults, independently of whether the information is incidentally or intentionally encoded.

  3. Unexpected but Incidental Positive Outcomes Predict Real-World Gambling.

    Science.gov (United States)

    Otto, A Ross; Fleming, Stephen M; Glimcher, Paul W

    2016-03-01

    Positive mood can affect a person's tendency to gamble, possibly because positive mood fosters unrealistic optimism. At the same time, unexpected positive outcomes, often called prediction errors, influence mood. However, a linkage between positive prediction errors-the difference between expected and obtained outcomes-and consequent risk taking has yet to be demonstrated. Using a large data set of New York City lottery gambling and a model inspired by computational accounts of reward learning, we found that people gamble more when incidental outcomes in the environment (e.g., local sporting events and sunshine) are better than expected. When local sports teams performed better than expected, or a sunny day followed a streak of cloudy days, residents gambled more. The observed relationship between prediction errors and gambling was ubiquitous across the city's socioeconomically diverse neighborhoods and was specific to sports and weather events occurring locally in New York City. Our results suggest that unexpected but incidental positive outcomes influence risk taking.

  4. Pseudocystic pheochromocytoma: An incidental finding and a rare entity

    Directory of Open Access Journals (Sweden)

    Petramala L,

    2014-07-01

    Full Text Available Cystic adrenal neoplasms are uncommon and may be incidentally discovered during radiologic procedure not directly performed for the evaluation of adrenal disease. Cystic pheochromocytomas are uncommon neoplasms that originate from the adrenal medulla, clinically differing from the more frequent solid pheochromocytomas. Here, we report a case of 72 year-old woman affected by asymptomatic pseudocystic pheochromocytoma (70x50mm, incidentally discovered, with a false negative 123I-monoiodobenzylguanidine (123I-MIBG scintigraphy. Histopathological examination led to diagnosis of pseudocystic pheochromocytoma with typical architecture. The screening for germline mutation of succinate dehydrogenase complex subunits (SDHB, SDHC, Von Hipple-Lindau syndrome (VHL and multiple endocrine neoplasia type 2 (RET genes were negative, finding only some polymorphisms for RET and SDHB. We emphasize the relevance of an accurate pre-operative diagnosis, especially in rare diseases, and the requirement of experience and multidisciplinary management in these rare pathologies.

  5. Spontaneous regression together with increased calcification of incidental meningioma

    Directory of Open Access Journals (Sweden)

    Kengo Hirota

    2014-01-01

    Full Text Available Background: Regression of meningioma has been reported after hemorrhage or hormonal withdrawal. However, meningioma regression is rarely observed spontaneously. Case Description: A right falx meningioma was incidentally diagnosed and was followed at every one-year by magnetic resonance imaging (MRI for over 7 years. The tumor, with a maximum diameter of 4 cm, showed a slightly high density and was enhanced on computed tomography (CT, and a high intensity with a low-intensity core on T2 MRI, with significant edema. The meningioma gradually shrank together with a decrease of edema and increase of calcification. The initial volume, 25.5 cm 3 , regressed linearly to less than half, 9.9 cm 3 . Conclusion: Here, we report a case of an incidentally diagnosed meningioma that regressed spontaneously. The pattern of the regression was similar to that following gamma knife radiosurgery.

  6. Managing the incidentally detected gallbladder cancer: algorithms and controversies.

    Science.gov (United States)

    Cavallaro, Andrea; Piccolo, Gaetano; Di Vita, Maria; Zanghì, Antonio; Cardì, Francesco; Di Mattia, Paolo; Barbera, Giuseppina; Borzì, Laura; Panebianco, Vincenzo; Di Carlo, Isidoro; Cavallaro, Marco; Cappellani, Alessandro

    2014-01-01

    Gallbladder cancer (GBC) is the fifth most common neoplasm of the gastrointestinal tract and the most common cancer of the biliary tract. GBC is suspected preoperatively in only 30-40% of patients. The other 60-70% are discovered incidentally (IGBC) by the pathologist on a gallbladder specimen following cholecystectomy for benign diseases such as polyps, gallstones, and cholecystitis. Between 1995 and 2011, 30 cases of GBC, who underwent resection with curative intent in our institutions, were retrospectively reviewed. They were analyzed for demographic data, and type of operation, surgical morbidity and mortality, histopathological classification, and survival. Incidental GBC was compared with suspected or preoperatively diagnosed GBC. Overall survival, disease-free survival (DFS) and the difference in DFS between patients previously treated with laparoscopic cholecystectomy and those who had oncological resection as first intervention were analyzed. The authors also present a systematic review to evaluate the role of extended surgery in the treatment of the incidental GBC. GBC was diagnosed in 30 patients, 16 women and 14 men. The M/F ratio was 1:1.14 and the mean age was 69.4 years (range 45-83 years). A preoperative diagnosis was possible only in 14 cases; fourteen of the incidental cases were diagnosed postoperatively after the pathological examination; two were suspected intraoperatively at the opening of the surgical specimen and then confirmed by frozen sections. The ratio between incidental and nonincidental cases was 1, 14/1, with twelve cases discovered after laparoscopic cholecystectomy. Eighty-one per cent of the incidental cases were discovered at an early stage (≤II). The preoperative diagnosis of the 30 patients with GBC was: GBC with liver invasion diagnosed by preoperative CT (nine cases); gallbladder abscess perforated into hepatic parenchyma and involving the transversal mesocolon and hepatic hilum (one case); porcelain gallbladder (three

  7. Incidental findings, genetic screening and the challenge of personalisation

    Directory of Open Access Journals (Sweden)

    Carlo Petrini

    2014-12-01

    Full Text Available Genetic tests frequently produce more information than is initially expected. Several documents have addressed this issue and offer suggestions regarding how this information should be managed and, in particular, concerning the expedience of revealing (or not revealing it to the persons concerned. While the approaches to the management of these incidental findings (IFs vary, it is usually recommended that the information be disclosed if there is confirmed clinical utility and the possibility of treatment or prevention. However, this leaves unsolved some fundamental issues such as the different ways of interpreting "clinical utility", countless sources of uncertainty and varying ways of defining the notion of "incidental". Guidelines and other reference documents can offer indications to those responsible for managing IFs but should not be allowed to relieve researchers and healthcare professionals of their responsibilities.

  8. 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

  9. Incidental pituitary uptake on whole-body {sup 18}F-FDG PET/CT: a multicentre study

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Shin Young; Lee, Sang-Woo; Kang, Sungmin; Seo, Ji-Hyoung; Ahn, Byeong-Cheol; Lee, Jaetae [Kyungpook National University Hospital, Department of Nuclear Medicine, Daegu (Korea, Republic of); Lee, Hui Joong [Kyungpook National University Hospital, Radiology, Daegu (Korea, Republic of); Chun, Kyung Ah; Cho, Ihn Ho [Yeungnam University Medical Center, Department of Nuclear Medicine, Daegu (Korea, Republic of); Won, Kyung Sook; Zeon, Seok Kil [Keimyung University Dongsan Medical Center, Department of Nuclear Medicine, Daegu (Korea, Republic of)

    2010-12-15

    The purpose of this study was to determine the incidence of incidental pituitary uptake on whole-body {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and to investigate its clinical significance. The files of 40,967 patients who underwent whole-body FDG PET/CT were retrospectively reviewed. Quantification of pituitary metabolic activity was obtained by using the maximum standardized uptake value (SUV{sub max}). Hormone assays and pituitary MRIs were performed to assess pituitary lesions. Focally increased pituitary FDG uptake on PET/CT was found in 30 of 40,967 patients, accounting for an incidence of 0.073%. The mean SUV{sub max} of 30 patients was 8.9 {+-} 6.6 (range: 3.2-32.6). Histological diagnosis was obtained in three patients and included two growth hormone-secreting adenomas and one non-functioning adenoma. Hormone assays were performed on serum samples from 11 patients, 2 of whom were shown to have hypersecretion of pituitary hormone. MRI was performed on 19 patients. Abnormal MRI findings suggesting a pituitary mass were found in 18 of 19 cases (94.7%). The mean SUV{sub max} calculated without correction for partial volume effect for macroadenomas was significantly higher than the SUV{sub max} for microadenomas (11.5 {+-} 8.4 vs 4.8 {+-} 1.3; p < 0.05). There were no cases diagnosed with metastasis to the pituitary gland during clinical follow-up. Incidental pituitary FDG uptake was a very rare finding. Cases with incidental pituitary FDG uptake were diagnosed primarily with clinically non-functioning adenomas, and there were also a few functioning adenomas. Further evaluations, including hormone assays and pituitary MRI, are warranted when pituitary uptake is found on FDG PET/CT. (orig.)

  10. PROMOTING INCIDENTAL VOCABULARY LEARNING THROUGH VERBAL DRAMATIZATION OF WORDS

    Directory of Open Access Journals (Sweden)

    Looi-Chin Ch’ng

    2014-12-01

    Full Text Available Despite the fact that explicit teaching of vocabulary is often practised in English as a Second Language (ESL classrooms, it has been proven to be rather ineffective, largely because words are not taught in context. This has prompted the increasing use of incidental vocabulary learning approach, which emphasises on repeated readings as a source for vocabulary learning. By adopting this approach, this study aims to investigate students’ ability in learning vocabulary incidentally via verbal dramatization of written texts. In this case, readers’ theatre (RT is used as a way to allow learners to engage in active reading so as to promote vocabulary learning. A total of 160 diploma students participated in this case study and they were divided equally into two groups, namely classroom reading (CR and RT groups. A proficiency test was first conducted to determine their vocabulary levels. Based on the test results, a story was selected as the reading material in the two groups. The CR group read the story through a normal reading lesson in class while the RT group was required to verbally dramatize the text through readers’ theatre activity. Then, a post-test based on vocabulary levels was carried out and the results were compared. The findings revealed that incidental learning was more apparent in the RT group and their ability to learn words from the higher levels was noticeable through higher accuracy scores. Although not conclusive, this study has demonstrated the potential of using readers’ theatre as a form of incidental vocabulary learning activity in ESL settings.

  11. Asymptomatic mucormycosis of middle ear: An incidental finding during tympanoplasty

    Directory of Open Access Journals (Sweden)

    K Biniyam

    2014-01-01

    Full Text Available Mucormycosis is a fungal infection, commonly affecting the paranasal sinuses. An aggressive invasive form of infection is common in people with uncontrolled diabetes and in immunocompromised people. Mucormycosis affecting temporal bone is a rare entity, most of the reported cases are of invasive disease in diabetic people. We report a case of mucormycosis of middle ear cavity which was found incidentally in a healthy nondiabetic woman while performing revision tympanoplasty for chronic suppurative otitis media.

  12. Lesions of the Seminal Vesicles and their MRI Characteristics.

    Science.gov (United States)

    Reddy, Mahati N; Verma, Sadhna

    2014-01-01

    Over the past few decades, MRI of the prostate has made great strides in improving cancer detection and is being embraced by more clinicians each day. This article aims to review the imaging characteristics of common and uncommon, but consequential lesions involving the seminal vesicles (SV), as seen predominantly on MRI. Many of these findings are seen incidentally during imaging of the prostate. Anatomy and embryology of the SV will be described which will help illustrate the associations of abnormalities seen. Congenital, infectious, neoplastic, and tumor mimics will be explored in detail, with discussion on clinical presentation and treatment strategies.

  13. Lesions of the Seminal Vesicles and their MRI Characteristics

    Directory of Open Access Journals (Sweden)

    Mahati N Reddy

    2014-01-01

    Full Text Available Over the past few decades, MRI of the prostate has made great strides in improving cancer detection and is being embraced by more clinicians each day. This article aims to review the imaging characteristics of common and uncommon, but consequential lesions involving the seminal vesicles (SV, as seen predominantly on MRI. Many of these findings are seen incidentally during imaging of the prostate. Anatomy and embryology of the SV will be described which will help illustrate the associations of abnormalities seen. Congenital, infectious, neoplastic, and tumor mimics will be explored in detail, with discussion on clinical presentation and treatment strategies.

  14. Digit Symbol-Incidental Learning in the WAIS-III: construct validity and clinical significance.

    Science.gov (United States)

    Joy, Stephen; Kaplan, Edith; Fein, Deborah

    2003-05-01

    We analyzed WAIS-III/WMS-III standardization data for evidence of the construct validity and clinical utility of the Digit Symbol-Incidental Learning procedures (Pairing and Free Recall). Scores on both tests correlated moderately with WMS-III memory index scores (mean r=.38 for Pairing and .36 for Free Recall). Cutoff scores can be used to identify younger and older adults likely to suffer from memory impairment. In the standardization sample (which excludes neurological patients), these have moderate positive predictive power (averaging .56 if either test yields a positive finding), moderate negative predictive power (.76), and high specificity (.88), but low sensitivity (.35). In a clinical sample, the same cutoff scores were much more sensitive, correctly identifying 88% of a group of patients with Alzheimer's Disease. Examinees who obtain these low scores should receive follow-up memory testing. Very high scores are associated with a reduced risk of memory impairment.

  15. The hidden cost of coaching: intentional training of shot adequacy discrimination in basketball hampers utilization of informative incidental cues.

    Science.gov (United States)

    Suárez Cadenas, Ernesto; Cárdenas, David; Sánchez Delgado, Guillermo; Perales, José C

    2015-02-01

    The goal was to identify the advantages and disadvantages of using intentional guidance to teach to discriminate between good and bad circumstances to shoot in basketball. A simulated shot-adequacy learning task was developed, in which participants were asked to decide, in each trial, whether the player in possession of the ball should shoot or not. After each decision, they received feedback on their response (determined by five cues: Opposition, Rebound, Balance, Alternative, and Distance). 65 naïve participants (M age = 18.6 yr., SD = 1.3) were divided into two groups. The Incidental group received no guiding instructions. The Intentional group was instructed to utilize four of the five cues. The Distance cue was kept incidental for both groups. Participants effectively incorporated the cues into their decisions. Guidance had a markedly different effect across cues. The Intentional group utilized Distance less efficiently than the Incidental group, i.e., intentional instructions on the other four cues nearly blocked the utilization of Distance.

  16. Managing incidental findings in population based biobank research

    Directory of Open Access Journals (Sweden)

    Berge Solberg

    2012-04-01

    Full Text Available With the introduction of whole genome sequencing in medical research, the debate on how to handle incidental findings is becoming omnipresent. Much of the literature on the topic so far, seems to defend the researcher’s duty to inform, the participant’s right to know combined with a thorough informed consent in order to protect and secure high ethical standards in research. In this paper, we argue that this ethical response to incidental findings and whole genome sequencing is appropriate in a clinical context, in what we call therapeutic research. However, we further argue, that it is rather inappropriate in basic research, like the research going on in public health oriented population based biobanks. Our argument is based on two premises: First, in population based biobank research the duties and rights involved are radically different from a clinical based setting. Second, to introduce the ethical framework from the clinical setting into population based basic research, is not only wrong, but it may lead to unethical consequences. A Norwegian population based biobank and the research-ethical debate in Norway on the regulation of whole genome sequencing is used as an illustrative case to demonstrate the pitfalls when approaching the debate on incidental findings in population based biobank research.

  17. Clinicopathologic features of incidental prostatic adenocarcinoma in radical cystoprostatectomy specimens

    Directory of Open Access Journals (Sweden)

    Vuruskan Hakan

    2011-07-01

    Full Text Available Abstract Background The aim of this study is to review all features of incidentally discovered prostate adenocarcinoma in patients undergoing radical cystoprostatectomy for bladder cancer. Methods The medical charts of 300 male patients who underwent radical cystoprostatectomy for bladder cancer between 1997 and 2005 were retrospectively reviewed. The mean age of the patients was 62 (range 51-75 years. Results Prostate adenocarcinoma was present in 60 (20% of 300 specimens. All were acinar adenocarcinoma. Of these, 40 (66.7% were located in peripheral zone, 20 (33.3% had pT2a tumor, 12 (20% had pT2b tumor, 22(36.7% had pT2c and, 6 (10% had pT3a tumor. Gleason score was 6 or less in 48 (80% patients. Surgical margins were negative in 54 (90% patients, and tumor volume was less than 0.5 cc in 23 (38.3% patients. Of the 60 incidentally detected cases of prostate adenocarcinoma 40 (66.7% were considered clinically significant. Conclusion Incidentally detected prostate adenocarcinoma is frequently observed in radical cystoprostatectomy specimens. The majority are clinically significant.

  18. Incidental pheochromocytoma in a patient with nasopharyngeal carcinoma.

    Science.gov (United States)

    Baldane, S; Ipekci, S H; Celik, E; Gedik, G K; Ozaslan, E; Guler, I; Kebapcilar, L

    2015-10-01

    Because the adrenal glands are common locations for metastases, pheochromocytoma is frequently misdiagnosed as adrenal metastasis in patients with a history of cancer. An incidental adrenal mass was detected during an abdominal computed tomography (CT) scan performed to stage the nasopharyngeal carcinoma in a 35-year-old male patient. The features of an adrenal mass on the CT, magnetic resonance imaging (MRI), and fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) were thought to show adrenal metastasis. However, the patient did not complain about flushing, palpitation, headache or excessive sweating. His blood pressure was 132/74 mmHg, and his pulse rate was 82 bpm. A pheochromocytoma was found during a biochemical diagnosis that evaluated the catecholamine in urine collected over a 24-hour period. The urine had elevated urinary adrenaline, metanephrine, and vanillylmandelic. An I123 MIBG scan showed avid tracer uptake in the right adrenal mass with no evidence of abnormal uptake elsewhere. A right adrenalectomy operation was performed and a diagnosis of pheochromocytoma was confirmed histopathologically. Incidental adrenal masses detected in the presence history of cancer should always be subjected to hormonal evaluation. Although patients may be asymptomatic, the probability of incidental pheochromocytoma should not be ignored.

  19. Ocular lesions in free-living raptors.

    Science.gov (United States)

    Murphy, C J; Kern, T J; McKeever, K; McKeever, L; MacCoy, D

    1982-12-01

    In a retrospective study, records of 931 raptors admitted to the Avian Clinic at the New York State College of Veterinary Medicine and to the Owl Rehabilitation Research Foundation were evaluated to determine the prevalence, cause, and distribution of ocular lesions. Some form of ocular lesion was identified in 135 (14.5%) birds. Of these, 90% were the result of physical injury. Collisions accounted for 33% of ocular lesions; gunshot wounds accounted for 11%. Unilateral lesions were more common than bilateral lesions, with the anterior segment being most frequently involved. Hyphema was the most common clinical finding. In a prospective study involving raptors admitted to the Avian Clinic from 1980-1982, it was found that 17 of 61 birds (28%) had some form of ocular lesion. The higher prevalence in this study was attributed to a lower proportion of juvenile cases and to increased detection of subtle lesions, especially those involving the posterior segment.

  20. 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.

  1. Heterotopic Pancreas of the Jejunum Incidentally Detected by Preoperative Abdominal CT: Report of Two Cases and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Manabu Watanabe

    2012-09-01

    Full Text Available Heterotopic pancreas (HP is typically an asymptomatic malformation that can present anywhere along the gastrointestinal tract. It is often detected incidentally on surgery for other diseases or autopsy. We encountered 2 patients with jejunal HP incidentally detected by computed tomography (CT performed for close evaluation of other diseases. In a 57-year-old woman diagnosed with reactive lymphoid hyperplasia on the dorsal portion of the pancreas head, CT detected a 15 mm oval-shaped submucosal lesion at the jejunum. In an 87-year-old woman diagnosed with type 2 adenocarcinoma occupying the sigmoid colon, CT detected a round-shaped submucosal tumor 15 mm in diameter in the jejunum. Both cases were histologically diagnosed as type 1 HP according to the classification by Heinrich. Contrast-enhanced CT revealed that the CT analyses of HP and pancreatic parenchyma were nearly identical in the arterial phase, but in the equilibrium phase, contrast enhancement persisted longer in HP than in the pancreatic parenchyma. There has been no report of asymptomatic jejunal HP preoperatively diagnosed by CT. These cases are presented with a review of the literature, particularly focusing on CT findings.

  2. Incidental gallbladder cancer during laparoscopic cholecystectomy: Managing an unexpected finding

    Institute of Scientific and Technical Information of China (English)

    Andrea Cavallaro; Gaetano Piccolo; Vincenzo Panebianco; Emanuele Lo Menzo; Massimiliano Berretta; Antonio Zanghì; Maria Di Vita; Alessandro Cappellani

    2012-01-01

    AIM:To evaluate the impact of incidental gallbladder cancer on surgical experience.METHODS:Between 1998 and 2008 all cases of cholecystectomy at two divisions of general surgery,one university based and one at a public hospital,were retrospectively reviewed.Gallbladder pathology was diagnosed by history,physical examination,and laboratory and imaging studies [ultrasonography and computed tomography (CT)].Patients with gallbladder cancer (GBC) were further analyzed for demographic data,and type of operation,surgical morbidity and mortality,histopathological classification,and survival.Incidental GBC was compared with suspected or preoperatively diagnosed GBC.The primary endpoint was diseasefree survival (DFS).The secondary endpoint was the difference in DFS between patients previously treated with laparoscopic cholecystectomy and those who had oncological resection as first intervention.RESULTS:Nineteen patients (11 women and eight men) were found to have GBC.The male to female ratio was 1∶1.4 and the mean age was 68 years (range:45-82 years).Preoperative diagnosis was made in 10 cases,and eight were diagnosed postoperatively.One was suspected intraoperatively and confirmed by frozen sections.The ratio between incidental and nonincidental cases was 9/19.The tumor node metastasis stage was:pTis (1),pT1a (2),pT1b (4),pT2 (6),pT3 (4),pT4 (2); five cases with stage Ⅰa (T1 a-b); two with stage Ⅰb (T2 N0); one with stage Ⅱa (T3 N0); six with stage Ⅱb (T1-T3 N1); two with stage Ⅲ (T4 Nx Nx); and one with stage Ⅳ (Tx Nx Mx).Eighty-eight percent of the incidental cases were discovered at an early stage (≤ Ⅱ).Preoperative diagnosis of the 19 patients with GBC was:GBC with liver invasion diagnosed by preoperative CT (nine cases),gallbladder abscess perforated into hepatic parenchyma and involving the transversal mesocolon and hepatic hilum (one case),porcelain gallbladder (one case),gallbladder adenoma (one case),and chronic cholelithiasis (eight cases

  3. Incidental gallbladder cancer during laparoscopic cholecystectomy: Managing an unexpected finding

    Science.gov (United States)

    Cavallaro, Andrea; Piccolo, Gaetano; Panebianco, Vincenzo; Menzo, Emanuele Lo; Berretta, Massimiliano; Zanghì, Antonio; Vita, Maria Di; Cappellani, Alessandro

    2012-01-01

    AIM: To evaluate the impact of incidental gallbladder cancer on surgical experience. METHODS: Between 1998 and 2008 all cases of cholecystectomy at two divisions of general surgery, one university based and one at a public hospital, were retrospectively reviewed. Gallbladder pathology was diagnosed by history, physical examination, and laboratory and imaging studies [ultrasonography and computed tomography (CT)]. Patients with gallbladder cancer (GBC) were further analyzed for demographic data, and type of operation, surgical morbidity and mortality, histopathological classification, and survival. Incidental GBC was compared with suspected or preoperatively diagnosed GBC. The primary endpoint was disease-free survival (DFS). The secondary endpoint was the difference in DFS between patients previously treated with laparoscopic cholecystectomy and those who had oncological resection as first intervention. RESULTS: Nineteen patients (11 women and eight men) were found to have GBC. The male to female ratio was 1:1.4 and the mean age was 68 years (range: 45-82 years). Preoperative diagnosis was made in 10 cases, and eight were diagnosed postoperatively. One was suspected intraoperatively and confirmed by frozen sections. The ratio between incidental and nonincidental cases was 9/19. The tumor node metastasis stage was: pTis (1), pT1a (2), pT1b (4), pT2 (6), pT3 (4), pT4 (2); five cases with stage Ia (T1 a-b); two with stage Ib (T2 N0); one with stage IIa (T3 N0); six with stage IIb (T1-T3 N1); two with stage III (T4 Nx Nx); and one with stage IV (Tx Nx Mx). Eighty-eight percent of the incidental cases were discovered at an early stage (≤ II). Preoperative diagnosis of the 19 patients with GBC was: GBC with liver invasion diagnosed by preoperative CT (nine cases), gallbladder abscess perforated into hepatic parenchyma and involving the transversal mesocolon and hepatic hilum (one case), porcelain gallbladder (one case), gallbladder adenoma (one case), and

  4. The incidental binding of color and shape is insensitive to the perceptual load

    OpenAIRE

    Hugo Cezar Palhares Ferreira; César Galera

    2016-01-01

    Abstract The binding of information in visual short-term memory may occur incidentally when irrelevant information for the task at hand is stored together with relevant information. We investigated the process of the incidental conjunction of color and shape (Exp1) and its potential association with the selection of relevant information to the memory task (Exp2). The results in Exp1 show that color and shape are incidentally and asymmetrically conjugated: color interferes with the recognition...

  5. The incidental binding of color and shape is insensitive to the perceptual load

    OpenAIRE

    Hugo Cezar Palhares Ferreira; César Galera

    2016-01-01

    Abstract The binding of information in visual short-term memory may occur incidentally when irrelevant information for the task at hand is stored together with relevant information. We investigated the process of the incidental conjunction of color and shape (Exp1) and its potential association with the selection of relevant information to the memory task (Exp2). The results in Exp1 show that color and shape are incidentally and asymmetrically conjugated: color interferes with the recognition...

  6. Analysis And Assessment Of The Security Method Against Incidental Contamination In The Collective Water Supply System

    Directory of Open Access Journals (Sweden)

    Szpak Dawid

    2015-09-01

    Full Text Available The paper presents the main types of surface water incidental contaminations and the security method against incidental contamination in water sources. Analysis and assessment the collective water supply system (CWSS protection against incidental contamination was conducted. Failure Mode and Effects Analysis (FMEA was used. The FMEA method allow to use the product or process analysis, identification of weak points, and implementation the corrections and new solutions for eliminating the source of undesirable events. The developed methodology was shown in application case. It was found that the risk of water contamination in water-pipe network of the analyzed CWSS caused by water source incidental contamination is at controlled level.

  7. Estimativas das componentes da radiacao solar incidente em superficies inclinadas baseadas na radiacao global horizontal

    National Research Council Canada - National Science Library

    Souza, Adilson P; Escobedo, Joao F; Dal Pai, Alexandre; Gomes, Eduardo N

    2011-01-01

    Foram avaliadas equacoes estatisticas de estimativas com agrupamentos de dados anuais e mensais e suas respectivas validacoes, para as componentes global, direta e difusa da radiacao solar incidente...

  8. Unique psoriatic lesion versus multiple lesions

    Directory of Open Access Journals (Sweden)

    Anca Chiriac

    2014-10-01

    Full Text Available Aim: To evaluate the number of lesions of psoriasis and to find risk factors for multiple lesions. Material and Methods: 1,236 patients (male 54.13%, female 45.87% with psoriasis were seen over a period of 8 years in an Outpatient Clinic. Patients filled out questionnaires containing age at onset, number of lesions and location at the beginning of the disease, gender, type and localization of psoriasis at the time of clinical examination, psoriasis family history, previous treatment, comorbidities, and social status. Results: The number of psoriasis lesions correlates with: onset age of psoriasis (F=8.902, p=0.0029; age at the moment of clinical examination (F=8.902, p=0.0029; residence in rural area (χ2=8.589, p=0.00338, 95%CI; alcohol intake (χ2=16.47, p=0.00005, 95%CI; smoking (χ2=8.408, p=0.00373, 95%CI; occupation: workers/pupils/students (χ2=14.11, p=0.0069, 95%CI. Conclusions: There is a correlation between number of psoriatic lesions and some factors. Multiple lesions were observed in older patients, smokers and drinkers, coming from rural area and social active (workers and pupils/students. No correlation was statistically proved between number of lesions and gender, comorbidities and family history of psoriasis.

  9. Benign incidental findings of osteopoikilosis on Tc-99m MDP bone SPECT/CT: A case report and literature review.

    Science.gov (United States)

    Tsai, Szu-Ying; Wang, Shan-Ying; Shiau, Yu-Chien; Wu, Yen-Wen

    2016-06-01

    Osteopoikilosis is a benign but rare condition characterized by bone islands throughout the osseous tissue, which could be easily confused with bone metastasis. We present a case of a 37-year-old man presented to orthopedic outpatient clinic with right hip pain for 2 weeks. There were multiple, small punctate lesions scattered throughout the skeleton on radiograph. Subsequent Tc-99m methylene diphosphonate (MDP) bone scan with pelvic single-photon emission computed tomography (SPECT)/computed tomography (CT) showed multiple enostoses without abnormal focal MDP uptake. Therefore, clinical diagnosis was compatible with osteopoikilosis while bone metastasis was unlikely. The symptoms then improved by conservative treatments. Osteopoikilosis is usually an incidental finding on radiograph or CT, and a normal MDP confirmed the diagnosis by excluding bone metastasis. It is important for clinicians to recognize the specific image features to prevent further unnecessary interventions. In addition, bone SPECT/CT could also make the diagnosis in one step.

  10. Incidental finding of an extensive oropharyngeal mass in magnetic resonance imaging of a patient with temporomandibular disorder: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Omolehinwa, Temitope T.; Mupparapu, Mel; Akintoye, SundayO. [Dept. of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia (United States)

    2016-12-15

    In this report, we describe the incidental finding of an oropharyngeal mass in a patient who presented with a chief complaint of temporomandibular pain. The patient was initially evaluated by an otorhinolaryngologist for complaints of headaches, earache, and sinus congestion. Due to worsening headaches and trismus, he was further referred for the management of temporomandibular disorder. The clinical evaluation was uneventful except for limited mouth opening (trismus). An advanced radiological evaluation using magnetic resonance imaging revealed a mass in the nasopharyngeal/oropharyngeal region. The mass occupied the masticatory space and extended superioinferiorly from the skull base to the mandible. A diagnostic biopsy of the lesion revealed a long-standing human papilloma virus (HPV-16)-positive squamous cell carcinoma of the oropharynx. This case illustrates the need for the timely radiological evaluation of seemingly innocuous orofacial pain.

  11. Long-term effects of neonatal hippocampal lesions on novelty preference in monkeys.

    Science.gov (United States)

    Zeamer, Alyson; Bachevalier, Jocelyne

    2013-09-01

    In a recent longitudinal study to assess the development of incidental recognition memory processes in monkeys, we showed that the effects of neonatal hippocampal lesions did alter incidental recognition memory only when the animals reached the juvenile period (Zeamer et al., ). The current follow-up study tested whether this incidental memory loss was long-lasting, i.e., present in adulthood, or only transitory, due to functional compensation with further brain maturation. The same animals with neonatal hippocampal lesions and their sham-operated controls were re-tested in the visual paired-comparison task when they reached adulthood (48 months). The results demonstrated that, at least for easily discriminable color pictures of objects, the involvement of the hippocampus was only transitory, given that when re-tested as adults, animals with neonatal hippocampal lesions performed as well as sham-operated controls at all delays. Yet, significant recognition memory impairment was re-instated when the discriminability of the stimuli was made more difficult (black/white pictures of similar objects). The data demonstrate profound functional remodeling within the hippocampus and its interactions with different medial temporal lobe structures from the juvenile period to adulthood, which is substantiated by a parallel morphological maturation of hippocampal intrinsic circuits (Lavenex et al., ; Jabès et al., ).

  12. MR imaging of the pelvis: a guide to incidental musculoskeletal findings for abdominal radiologists.

    Science.gov (United States)

    Gaetke-Udager, Kara; Girish, Gandikota; Kaza, Ravi K; Jacobson, Jon; Fessell, David; Morag, Yoav; Jamadar, David

    2014-08-01

    Occasionally patients who undergo magnetic resonance imaging for presumed pelvic disease demonstrate unexpected musculoskeletal imaging findings in the imaged field. Such incidental findings can be challenging to the abdominal radiologist, who may not be familiar with their appearance or know the appropriate diagnostic considerations. Findings can include both normal and abnormal bone marrow, osseous abnormalities such as Paget's disease, avascular necrosis, osteomyelitis, stress and insufficiency fractures, and athletic pubalgia, benign neoplasms such as enchondroma and bone island, malignant processes such as metastasis and chondrosarcoma, soft tissue processes such as abscess, nerve-related tumors, and chordoma, joint- and bursal-related processes such as sacroiliitis, iliopsoas bursitis, greater trochanteric pain syndrome, and labral tears, and iatrogenic processes such as bone graft or bone biopsy. Though not all-encompassing, this essay will help abdominal radiologists to identify and describe this variety of pelvic musculoskeletal conditions, understand key radiologic findings, and synthesize a differential diagnosis when appropriate.

  13. Incidental prostate cancer prevalence at radical cystoprostatectomy--importance of the histopathological work-up.

    Science.gov (United States)

    Wetterauer, C; Weibel, M; Gsponer, J R; Vlajnic, T; Zellweger, T; Bütikofer, S; Müller, G; Püschel, H; Bachmann, A; Gasser, T C; Bubendorf, L; Rentsch, C A

    2014-12-01

    The reported incidental prostate cancer prevalence rates at radical cystoprostatectomy cover a range from 4 to 60 %. We investigated the influence of the histopathological work-up on prostate cancer prevalence rates. We identified 114 patients who had undergone cystoprostatectomy for bladder cancer between 2000 and 2012. Complete histopathological assessment was defined as follows: (i) complete embedding of the prostate gland, (ii) sectioning of 15 or more prostate sections, and (iii) processing as whole mount slides. Prostate cancer prevalence rates derived from complete and incomplete histopathological assessments were compared. The overall prostate cancer prevalence rate was 59.6 %. A mean of 14.4 macroscopic tissue sections (thickness 3-5 mm) were sectioned. Sectioning ≥15 sections resulted in a prostate cancer detection rate of 75 %, compared to 42.6 % when sectioning prevalence rates at cystoprostatectomy (CP). The high proportion of significant prostate cancer found in our series calls for a careful surgical approach to the prostate during CP.

  14. Infiltrating/sealing proximal caries lesions

    DEFF Research Database (Denmark)

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

    2012-01-01

    proximal lesions identified radiographically around the enamel-dentin junction to the outer third of the dentin, were included. Lesions were randomly allocated for treatment to test-A (Infiltration: ICON-pre-product; DMG), test-B (Sealing: Prime-Bond-NT; Dentsply), or control-C (Placebo). Primary outcome...

  15. Comparison of explicit and incidental learning strategies in memory-impaired patients.

    Science.gov (United States)

    Smith, Christine N; Urgolites, Zhisen J; Hopkins, Ramona O; Squire, Larry R

    2014-01-07

    Declarative memory for rapidly learned, novel associations is thought to depend on structures in the medial temporal lobe (MTL), whereas associations learned more gradually can sometimes be supported by nondeclarative memory and by structures outside the MTL. A recent study suggested that even rapidly learned associations can be supported by structures outside the MTL when an incidental encoding procedure termed "fast mapping" (FM) is used. We tested six memory-impaired patients with bilateral damage to hippocampus and one patient with large bilateral lesions of the MTL. Participants saw photographs and names of animals, plants, and foods that were previously unfamiliar (e.g., mangosteen). Instead of asking participants to study name-object pairings for a later memory test (as with traditional memory instructions), participants answered questions that allowed them to infer which object corresponded to a particular name. In a second condition, participants learned name-object associations of unfamiliar items by using standard, explicit encoding instructions (e.g., remember the mangosteen). In FM and explicit encoding conditions, patients were impaired (and performed no better than a group that was given the same tests but had not previously studied the material). The same results were obtained in a second experiment that used the same procedures with modifications to allow for more robust learning and more reliable measures of performance. Thus, our results with the FM procedure and memory-impaired patients yielded the same deficits in learning and memory that have been obtained by using other more traditional paradigms.

  16. Incidental diagnosis of a retroperitoneal schwannoma in a patient with chronic leukemia undergoing prostatic biopsy.

    Science.gov (United States)

    Autieri, Domenico; Pastore, Antonio Luigi; Silvestri, Luigi; Leto, Antonino; Ripoli, Andrea; Palleschi, Giovanni; Porta, Natale; Petrozza, Vincenzo; Carbone, Antonio

    2012-12-30

    We present a case of retroperitoneal schwannoma incidentally diagnosed in a patient undergoing surgical drainage of a pelvic abscess as a complication of a prostatic biopsy. A 50-year-old male, suffering from lymphatic leukemia, came to our observation due to lichen ruber planus and ejaculatory pain. The patient underwent a trans-perineal ultrasound-guided biopsy of the right seminal vesicle and of a hypoechoic area documented by ultrasonography. 48 hours after the procedure, the patient had developed: cold sores, shortness of breath with dyspnea, and high fever (40°C). The patient was hospitalized, underwent an emergency CT which documented a right presacral and pararectal liquid mass (abscess). The patient underwent emergency laparotomy and drainage of the abscess. The lesion histological examination revealed a retroperitoneal schwannoma with inflammatory phenomena and hyperplasic lymphadenitis. The retroperitoneal schwannoma is a silent disease whose only clinical manifestation coincides with the compression of adjacent anatomical structures. In many cases, the symptoms, even if present, as in this case (ejaculatory pain with compression of the seminal vesicle), are non-specific, thus delaying diagnosis and the therapeutic approach.

  17. Paleoindian unifacial stone tool 'spurs': intended accessories or incidental accidents?

    Directory of Open Access Journals (Sweden)

    Metin I Eren

    Full Text Available Paleoindian unifacial stone tools frequently exhibit distinct, sharp projections, known as "spurs". During the last two decades, a theoretically and empirically informed interpretation-based on individual artifact analysis, use-wear, tool-production techniques, and studies of resharpening-suggested that spurs were sometimes created intentionally via retouch, and other times created incidentally via resharpening or knapping accidents. However, more recently Weedman strongly criticized the inference that Paleoindian spurs were ever intentionally produced or served a functional purpose, and asserted that ethnographic research "demonstrates that the presence of so called 'graver' spurs does not have a functional significance." While ethnographic data cannot serve as a direct test of the archaeological record, we used Weedman's ethnographic observations to create two quantitative predictions of the Paleoindian archaeological record in order to directly examine the hypothesis that Paleoindian spurs were predominantly accidents occurring incidentally via resharpening and reshaping. The first prediction is that the frequency of spurs should increase as tool reduction proceeds. The second prediction is that the frequency of spurs should increase as tool breakage increases. An examination of 563 unbroken tools and 629 tool fragments from the Clovis archaeological record of the North American Lower Great Lakes region showed that neither prediction was consistent with the notion that spurs were predominately accidents. Instead, our results support the prevailing viewpoint that spurs were sometimes created intentionally via retouch, and other times, created incidentally via resharpening or knapping accidents. Behaviorally, this result is consistent with the notion that unifacial stone tools were multifunctional implements that enhanced the mobile lifestyle of Pleistocene hunter-gatherers.

  18. Paleoindian unifacial stone tool 'spurs': intended accessories or incidental accidents?

    Science.gov (United States)

    Eren, Metin I; Jennings, Thomas A; Smallwood, Ashley M

    2013-01-01

    Paleoindian unifacial stone tools frequently exhibit distinct, sharp projections, known as "spurs". During the last two decades, a theoretically and empirically informed interpretation-based on individual artifact analysis, use-wear, tool-production techniques, and studies of resharpening-suggested that spurs were sometimes created intentionally via retouch, and other times created incidentally via resharpening or knapping accidents. However, more recently Weedman strongly criticized the inference that Paleoindian spurs were ever intentionally produced or served a functional purpose, and asserted that ethnographic research "demonstrates that the presence of so called 'graver' spurs does not have a functional significance." While ethnographic data cannot serve as a direct test of the archaeological record, we used Weedman's ethnographic observations to create two quantitative predictions of the Paleoindian archaeological record in order to directly examine the hypothesis that Paleoindian spurs were predominantly accidents occurring incidentally via resharpening and reshaping. The first prediction is that the frequency of spurs should increase as tool reduction proceeds. The second prediction is that the frequency of spurs should increase as tool breakage increases. An examination of 563 unbroken tools and 629 tool fragments from the Clovis archaeological record of the North American Lower Great Lakes region showed that neither prediction was consistent with the notion that spurs were predominately accidents. Instead, our results support the prevailing viewpoint that spurs were sometimes created intentionally via retouch, and other times, created incidentally via resharpening or knapping accidents. Behaviorally, this result is consistent with the notion that unifacial stone tools were multifunctional implements that enhanced the mobile lifestyle of Pleistocene hunter-gatherers.

  19. Incidentally detected clear cell renal cell carcinoma with rhabdoid differentiation

    Directory of Open Access Journals (Sweden)

    Venkatesh Krishnamoorthy

    2016-01-01

    Full Text Available Renal cell carcinoma with rhabdoid differentiation (RCC-R has an aggressive biologic behavior and poor prognosis. A recent consensus statement of the International Society of Urological Pathology (ISUP proposed a nucleolar grading system (ISUP grade for RCC to replace Fuhrman system and recommended reporting the presence of rhabdoid differentiation and considering tumors with rhabdoid differentiation to be ISUP Grade 4. We report a case of incidentally detected clear cell RCC-R in a 52-year-old man. This is one of the earliest cases of RCC-R (pT1b detected and first such case from Indian subcontinent.

  20. Incidental Findings in Neuroimaging: Ethical and Medicolegal Considerations.

    Science.gov (United States)

    Leung, Lawrence

    2013-01-01

    With the rapid advances in neurosciences in the last three decades, there has been an exponential increase in the use of neuroimaging both in basic sciences and clinical research involving human subjects. During routine neuroimaging, incidental findings that are not part of the protocol or scope of research agenda can occur and they often pose a challenge as to how they should be handled to abide by the medicolegal principles of research ethics. This paper reviews the issue from various ethical (do no harm, general duty to rescue, and mutual benefits and owing) and medicolegal perspectives (legal liability, fiduciary duties, Law of Tort, and Law of Contract) with a suggested protocol of approach.

  1. Incidental finding of a giant asymptomatic right atrial tumor

    Science.gov (United States)

    Strecker, Thomas; Agaimy, Abbas; Zelzer, Peter; Weyand, Michael; Wachter, David Lukas

    2014-01-01

    Primary cardiac tumors are very rare, atrial myxoma being the most common benign tumor of the heart. They may present with a great variety of incidental asymptomatic masses to severe life-threatening cardiovascular complications necessitating emergency surgery. Here we report the diagnostic evaluation and successful surgical resection of such a giant cardiac tumor which was found on a routine medical check-up in a 62-year-old patient. Histology confirmed diagnosis of unusually huge myxoma. This article demonstrates it’s necessary to include cardiac tumors in the differential diagnosis of subtle and non-specific cardiothoracic symptoms. PMID:25120848

  2. Incidental Cerebral Microbleeds and Cerebral Blood Flow in Elderly Individuals.

    Science.gov (United States)

    Gregg, Nicholas M; Kim, Albert E; Gurol, M Edip; Lopez, Oscar L; Aizenstein, Howard J; Price, Julie C; Mathis, Chester A; James, Jeffrey A; Snitz, Beth E; Cohen, Ann D; Kamboh, M Ilyas; Minhas, Davneet; Weissfeld, Lisa A; Tamburo, Erica L; Klunk, William E

    2015-09-01

    Cerebral microbleeds (CMBs) are collections of blood breakdown products that are a common incidental finding in magnetic resonance imaging of elderly individuals. Cerebral microbleeds are associated with cognitive deficits, but the mechanism is unclear. Studies show that individuals with CMBs related to symptomatic cerebral amyloid angiopathy have abnormal vascular reactivity and cerebral blood flow (CBF), but, to our knowledge, abnormalities in cerebral blood flow have not been reported for healthy individuals with incidental CMBs. To evaluate the association of incidental CMBs with resting-state CBF, cerebral metabolism, cerebrovascular disease, β-amyloid (Aβ), and cognition. A cross-sectional study of 55 cognitively normal individuals with a mean (SD) age of 86.8 (2.7) years was conducted from May 1, 2010, to May 1, 2013, in an academic medical center in Pittsburgh; data analysis was performed between June 10, 2013, and April 9, 2015. 3-Tesla magnetic resonance imaging was performed with susceptibility-weighted imaging or gradient-recalled echo to assess CMBs, arterial spin labeling for CBF, and T1- and T2-weighted imaging for atrophy, white matter hyperintensities, and infarcts. Positron emission tomography was conducted with fluorodeoxyglucose to measure cerebral metabolism and Pittsburgh compound B for fibrillar Aβ. Neuropsychological evaluation, including the Clinical Dementia Rating scale, was performed. Magnetic resonance images were rated for the presence and location of CMBs. Lobar CMBs were subclassified as cortical or subcortical. Measurements of CBF, metabolism, and Aβ were compared with the presence and number of CMBs with voxelwise and region-of-interest analyses. The presence of cortical CMBs was associated with significantly reduced CBF in multiple regions on voxelwise and region-of-interest analyses (percentage difference in global CBF, -25.3%; P = .0003), with the largest reductions in the parietal cortex (-37.6%; P CMBs showed a

  3. Incidentally detected clear cell renal cell carcinoma with rhabdoid differentiation.

    Science.gov (United States)

    Krishnamoorthy, Venkatesh; Gowda, Kiran Krishne; Rao, Raman Narayana

    2016-01-01

    Renal cell carcinoma with rhabdoid differentiation (RCC-R) has an aggressive biologic behavior and poor prognosis. A recent consensus statement of the International Society of Urological Pathology (ISUP) proposed a nucleolar grading system (ISUP grade) for RCC to replace Fuhrman system and recommended reporting the presence of rhabdoid differentiation and considering tumors with rhabdoid differentiation to be ISUP Grade 4. We report a case of incidentally detected clear cell RCC-R in a 52-year-old man. This is one of the earliest cases of RCC-R (pT1b) detected and first such case from Indian subcontinent.

  4. Plataformas de compartición de incidentes de ciberseguridad

    OpenAIRE

    Jiménez Gallardo, Jenifer

    2016-01-01

    Identification, description and analysis of the characteristics and quality of information available on cybersecurity incidents sharing platforms. Identificación, descripción y análisis de las características y calidad de la información disponible en plataformas de compartición de incidentes de ciberseguridad. Identificació, descripció i anàlisi de les característiques i qualitat de la informació disponible en plataformes de compartició d'incidents de ciberseguretat.

  5. Carotid lesions in outpatients with nonalcoholic fatty liver disease

    Institute of Scientific and Technical Information of China (English)

    Stefano Ramilli; Stefano Pretolani; Antonio Muscari; Barbara Pacelli; Vincenzo Arienti

    2009-01-01

    AIM: To ascertain whether carotid lesions are more prevalent in outpatients with incidental findings of nonalcoholic fatty liver disease (NAFLD) at abdominal ultrasound (US). METHODS: One hundred and fifty-four consecutive outpatients (age range 24-90 years, both sexes) referred by general practitioners for abdominal US, and drinking less than 20 g alcohol/day, underwent carotid US for an assessment of carotid intima-media thickness (c-IMT) and carotid plaque prevalence. Hepatic steatosis, visceral fat thickness and subcutaneous fat thickness were also assessed at ultrasonography. RESULTS: Higher c-IMT values were found in the presence of NAFLD (90 patients), even after adjustment for indices of general and abdominal obesity and for the principal cardiovascular risk factors (0.84 ± 0.10 mm vs 0.71 ± 0.10 mm, P < 0.001). The prevalence of carotid plaques was 57.8% in the patients with NAFLD vs 37.5% in the patients without this condition ( P = 0.02). The adjusted relative risk of having carotid plaques for paients with NAFLD was 1.85 (95% CI: 1.33-2.57, P < 0.001). CONCLUSION: An incidental finding of hepatic steatosis may suggest the presence of silent carotid atherosclerotic lesions.

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

    Science.gov (United States)

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

    2010-05-01

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

  7. Incidental diagnosis of tumor thrombosis on FDG PET/CT imaging.

    Science.gov (United States)

    Erhamamci, S; Reyhan, M; Nursal, G N; Torun, N; Yapar, A F

    2015-01-01

    Clinical data are presented on patients with tumor thrombosis (TT) incidentally detected on FDG PET/CT imaging, as well as determining its prevalence and metabolic characteristics. Out of 12,500 consecutive PET/CT examinations of patients with malignancy, the PET/CT images of 15 patients with TT as an incidental finding were retrospectively investigated. A visual and semiquantitative analyses was performed on the PET/CT scans. An evaluation was made of the pattern of FDG uptake in the involved vessel as linear or focal via visual analyses. For the semiquantitative analyses, the metabolic activity was measured using SUVmax by drawing the region of interest at the site of the thrombosis and tumor (if any). The prevalence of occult TT was 0.12%. A total of 15 patients had various malignancies including renal (1 patient), liver (4), pancreas (2), stomach (1), colon (1), non-Hodgkin lymphoma (1), leiomyosarcoma (1), endometrial (1), ovarian (1), malign melanoma (1) and parotid (1). Nineteen vessels with TT were identified in 15 patients; three patients had more than one vessel. Various vessels were affected; the most common was the inferior vena cava (n=7) followed by the portal (n=5), renal (n=3), splenic (n=1), jugular (n=1), common iliac (n=1) and ovarian vein (n=1). The FDG uptake pattern was linear in 12 and focal in 3 patients. The mean SUVmax values in the TT and primary tumors were 8.40±4.56 and 13.77±6.80, respectively. Occult TT from various malignancies and locations was found incidentally in 0.12% of patients. Interesting cases with malign melanoma and parotid carcinoma and with TT in ovarian vein were first described by FDG PET/CT. Based on the linear FDG uptake pattern and high SUVmax value, PET/CT may accurately detect occult TT, help with the assessment of treatment response, contribute to correct tumor staging, and provide additional information on the survival rates of oncology patients. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All

  8. The clinical significance and management of incidental focal FDG uptake in the thyroid gland on positron emission tomography/computed tomography (PET/CT) in patients with non-thyroidal malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Christine (Univ. of New South Wales (Australia)); Lin, Michael (Univ. of New South Wales (Australia); Liverpool Hospital, Dept. of Nuclear Medicine and PET, Liverpool (Australia)), email: Michael.lin@swsahs.nsw.gov.au; Chicco, Andrew; Benson, Rhonda (Liverpool Hospital, Dept. of Nuclear Medicine and PET, Liverpool (Australia))

    2011-10-15

    Background Incidental focal fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG) uptake in the thyroid is not uncommon. A significant proportion is due to intercurrent thyroid cancer on further evaluation. Purpose To investigate and discuss the clinical significance and management of incidental focal FDG uptake in the thyroid gland on positron emission tomography/computed tomography (PET/CT) in patients with non-thyroidal malignancy. Material and Methods We investigated 188/7896 (2.4%) patients who had incidental focal thyroid uptake on FDG PET/CT in an oncology population over a 45-month period. Diagnosis was confirmed in 63 patients of whom 59 patients had histopathological verification. Results Thirty-two percent of confirmed cases were malignant comprising intercurrent thyroid cancer in three-quarters of these patients. Maximum standardized uptake values of the thyroid lesions and SUV ratios compared with background thyroid and mediastinal uptake were not predictive of a benign or malignant etiology. In patients with incidental thyroid cancers, more than half had non-papillary and intermediate to high-risk pathology. Conclusion Focal FDG uptake in the thyroid gland on PET/CT showed a malignancy risk of 32%. The intensity of uptake does not predict histology and underpins the importance of further investigations to exclude intercurrent thyroid cancer in suitable patients

  9. 77 FR 43259 - Takes of Marine Mammals Incidental to Specified Activities; Pile Driving for Honolulu Seawater...

    Science.gov (United States)

    2012-07-24

    ... Specified Activities; Pile Driving for Honolulu Seawater Air Conditioning Project AGENCY: National Marine... Harassment Authorization (IHA) to take marine mammals, by harassment, incidental to pile driving offshore... for the take, by Level B harassment, of small numbers of 17 marine mammal species incidental to...

  10. Incidental Focus on Form in Teacher-Learner and Learner-Learner Interactions

    Science.gov (United States)

    Zhao, Susan Yuqin; Bitchener, John

    2007-01-01

    Current attention in L2 acquisition research focuses on the integration of message-focused and form-focused instruction. One way to accomplish this is through the incidental focus on form during meaning-focused activities. Some studies have investigated incidental focus on form in different contexts and shown that it exists in L2 classes and…

  11. Relative Preference and Localized Food Affect Predator Space Use and Consumption of Incidental Prey.

    Science.gov (United States)

    Schartel, Tyler E; Schauber, Eric M

    2016-01-01

    Abundant, localized foods can concentrate predators and their foraging efforts, thus altering both the spatial distribution of predation risk and predator preferences for prey that are encountered incidentally. However, few investigations have quantified the spatial scale over which localized foods affect predator foraging behavior and consumption of incidental prey. In spring 2010, we experimentally tested how point-source foods altered how generalist predators (white-footed mice, Peromyscus leucopus) utilized space and depredated two incidental prey items: almonds (Prunus dulcis; highly profitable) and maple seeds (Acer saccharum; less profitable). We estimated mouse population densities with trapping webs, quantified mouse consumption rates of these incidental prey items, and measured local mouse activity with track plates. We predicted that 1) mouse activity would be elevated near full feeders, but depressed at intermediate distances from the feeder, 2) consumption of both incidental prey would be high near feeders providing less-preferred food and, 3) consumption of incidental prey would be contingent on predator preference for prey relative to feeders providing more-preferred food. Mouse densities increased significantly from pre- to post-experiment. Mean mouse activity was unexpectedly greatest in control treatments, particularly preferred food (sunflower seeds) created localized refuges for incidental prey at intermediate distances (15 to 25m) from the feeder. Feeders with less-preferred food (corn) generated localized high risk for highly preferred almonds food on risk experienced by incidental prey, which can be positive or negative depending on both spatial proximity and relative preference.

  12. 75 FR 18160 - Small Takes of Marine Mammals Incidental to Specified Activities; Antioch Bridge Seismic Retrofit...

    Science.gov (United States)

    2010-04-09

    ... Federal Register notice (December 21, 2009, 74 FR 67856) and are summarized here. Marine mammals produce... National Oceanic and Atmospheric Administration RIN 0648-XS24 Small Takes of Marine Mammals Incidental to... of an incidental take authorization. SUMMARY: In accordance with the Marine Mammal Protection Act...

  13. Involvement in Traditional Cultural Practices and American Indian Children's Incidental Recall of a Folktale

    Science.gov (United States)

    Tsethlikai, Monica; Rogoff, Barbara

    2013-01-01

    This study examined incidental recall of a folktale told to 91 Tohono O'odham American Indian children (average age 9 years) who either were directly addressed or had the opportunity to overhear the telling of the folktale. Learning from surrounding incidental events contrasts with learning through direct instruction common in Western schooling,…

  14. Maintaining binding in working memory : Comparing the effects of intentional goals and incidental affordances

    NARCIS (Netherlands)

    Morey, Candice C.

    2011-01-01

    Much research on memory for binding depends on incidental measures. However, if encoding associations benefits from conscious attention, then incidental measures of binding memory might not yield a sufficient understanding of how binding is accomplished. Memory for letters and spatial locations was

  15. An "Adventure" of MBA Students in Europe: How Volcanic Ash Produced an Incidental Learning Experience

    Science.gov (United States)

    Vazquez, Ana Claudia Souza; Ruas, Roberto Lima; Cervo, Clarissa S.; Hutz, Claudio Simon

    2013-01-01

    Because the volcanic ash that affected air travel in Western Europe in 2010 was considered as one of the most meaningful learning experiences by a group of MBA students, this article aims to outline the main aspects of an incidental learning situation, rarely described on management education literature. Incidental learning is an unsystematic…

  16. 40 CFR 1033.650 - Incidental use exemption for Canadian and Mexican locomotives.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Incidental use exemption for Canadian and Mexican locomotives. 1033.650 Section 1033.650 Protection of Environment ENVIRONMENTAL PROTECTION... Provisions § 1033.650 Incidental use exemption for Canadian and Mexican locomotives. You may ask us to...

  17. 30 CFR 750.21 - Coal extraction incidental to the extraction of other minerals.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal extraction incidental to the extraction of other minerals. 750.21 Section 750.21 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND... RECLAMATION OPERATIONS ON INDIAN LANDS § 750.21 Coal extraction incidental to the extraction of other minerals...

  18. Oculomotor and Manual Indexes of Incidental and Intentional Spatial Sequence Learning during Middle Childhood and Adolescence

    Science.gov (United States)

    Karatekin, Canan; Marcus, David J.; White, Tonya

    2007-01-01

    The goal of this study was to examine incidental and intentional spatial sequence learning during middle childhood and adolescence. We tested four age groups (8-10 years, 11-13 years, 14-17 years, and young adults [18+ years]) on a serial reaction time task and used manual and oculomotor measures to examine incidental sequence learning.…

  19. Incidental L2 Vocabulary Acquisition "from" and "while" Reading: An Eye-Tracking Study

    Science.gov (United States)

    Pellicer-Sánchez, Ana

    2016-01-01

    Previous studies have shown that reading is an important source of incidental second language (L2) vocabulary acquisition. However, we still do not have a clear picture of what happens when readers encounter unknown words. Combining offline (vocabulary tests) and online (eye-tracking) measures, the incidental acquisition of vocabulary knowledge…

  20. 46 CFR 276.1 - Partial repayment-incidental domestic trading.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Partial repayment-incidental domestic trading. 276.1 Section 276.1 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS AFFECTING...—incidental domestic trading. In every instance where a vessel, with respect to which a...

  1. Spontaneous lesions in aged captive raccoons (Procyon lotor).

    Science.gov (United States)

    Hamir, Amir N

    2011-05-01

    In nature, free-ranging raccoons typically do not live longer than 2 y; most raccoons in the wild die young due to accidents and diseases. Therefore, few data are available regarding lesions associated with advancing age in raccoons. This communication documents the lesions present in raccoons (7 male; 3 female) that were older than 7 y and had been used as breeders at a commercial facility in central Iowa. The most frequent microscopic lesions in these raccoons included accumulation of iron pigment in livers and spleens (10 of 10 animals evaluated), neuroaxonal degeneration in caudal medulla (10 of 10), vascular mineralization (psammoma body) in choroid plexus (9 of 10), myocardial inclusions (7 of 8), and cystic endometrial hyperplasia (2 of 3). Other conditions were seen with less prevalence. Except for the detection of gastritis with bacteria in the gastric mucosa of 1 raccoon, the presence of inflammatory cells in 3 choroid plexuses, and the presence of Lafora bodies in the brain of 1 animal, all conditions observed had previously been reported in raccoons. Surprisingly, islet-cell amyloidosis, previously observed as common incidental finding in older captive raccoons, was not seen in any of the raccoons we examined. Because free-ranging raccoons are distributed over wide geographic areas, their local environment may have considerable influence on the range of spontaneous lesions that would occur in raccoons obtained from a specific location. Therefore, the lesions found in these raccoons from central Iowa may differ from those of other raccoon populations.

  2. Incidental Vocabulary Learning in Second Language Acquisition: A Literature Review (Aprendizaje incidental de vocabulario en la adquisición de una segunda lengua: una revisión de literatura)

    Science.gov (United States)

    Restrepo Ramos, Falcon Dario

    2015-01-01

    This literature review aims to analyze previous studies that address the incidental learning of vocabulary in second language acquisition. The articles included in this literature review look into the understanding of vocabulary learning through incidental means, the relationship of reading and incidental vocabulary learning, and the strategies…

  3. Cardiac Sarcoidosis Diagnosed by Incidental Lymph Node Biopsy.

    Science.gov (United States)

    Matsuda, Jun; Fujiu, Katsuhito; Roh, Solji; Tajima, Miyu; Maki, Hisataka; Kojima, Toshiya; Ushiku, Tetsuo; Nawata, Kan; Takeda, Norihiko; Watanabe, Masafumi; Akazawa, Hiroshi; Komuro, Issei

    2017-02-07

    Cardiac involvement in systemic sarcoidosis sometimes provokes life-threatening ventricular tachyarrhythmia. Steroid administration is one of the fundamental anti-arrhythmia therapies. For an indication of steroid therapy, a definitive diagnosis of sarcoidosis is required.(1)) However, cases that are clearly suspected of cardiac sarcoidosis based on their clinical courses sometimes do not meet the current diagnostic criteria and result in the loss of an appropriate opportunity to perform steroid therapy.Here we report a case that was diagnosed as sarcoidosis by incidental biopsy of an inguinal lymph node during cardiac resuscitation for cardiac tamponade.(2)) While the inguinal lymph node was not swollen on computed tomography, a specimen obtained from an incidental biopsy during the exposure of a femoral vessel for the establishment of extracorporeal cardio-pulmonary resuscitation showed a non-caseating granuloma.This findings suggest a non-swelling lymph node biopsy might be an alternative strategy for the diagnosis for sarcoidosis if other standard strategies do not result in a diagnosis of sarcoidosis.

  4. Computed Tomography Features of Incidentally Detected Diffuse Thyroid Disease

    Directory of Open Access Journals (Sweden)

    Myung Ho Rho

    2014-01-01

    Full Text Available Objective. This study aimed to evaluate the CT features of incidentally detected DTD in the patients who underwent thyroidectomy and to assess the diagnostic accuracy of CT diagnosis. Methods. We enrolled 209 consecutive patients who received preoperative neck CT and subsequent thyroid surgery. Neck CT in each case was retrospectively investigated by a single radiologist. We evaluated the diagnostic accuracy of individual CT features and the cut-off CT criteria for detecting DTD by comparing the CT features with histopathological results. Results. Histopathological examination of the 209 cases revealed normal thyroid (n=157, Hashimoto thyroiditis (n=17, non-Hashimoto lymphocytic thyroiditis (n=34, and diffuse hyperplasia (n=1. The CT features suggestive of DTD included low attenuation, inhomogeneous attenuation, increased glandular size, lobulated margin, and inhomogeneous enhancement. ROC curve analysis revealed that CT diagnosis of DTD based on the CT classification of “3 or more” abnormal CT features was superior. When the “3 or more” CT classification was selected, the sensitivity, specificity, positive and negative predictive values, and accuracy of CT diagnosis for DTD were 55.8%, 95.5%, 80.6%, 86.7%, and 85.6%, respectively. Conclusion. Neck CT may be helpful for the detection of incidental DTD.

  5. The incidental binding of color and shape is insensitive to the perceptual load

    Directory of Open Access Journals (Sweden)

    Hugo Cezar Palhares Ferreira

    2016-01-01

    Full Text Available Abstract The binding of information in visual short-term memory may occur incidentally when irrelevant information for the task at hand is stored together with relevant information. We investigated the process of the incidental conjunction of color and shape (Exp1 and its potential association with the selection of relevant information to the memory task (Exp2. The results in Exp1 show that color and shape are incidentally and asymmetrically conjugated: color interferes with the recognition of shape; however, shape does not interfere with the recognition of color. In Exp2, we investigated whether an increase in perceptual load would eliminate the processing of irrelevant information. The results of this experiment show that even with a high perceptual load, the incidental conjunction is not affected, and color remains to interfere with shape recognition, suggesting that the incidental conjunction is an automatic process.

  6. Incidental ovarian {sup 18}F-FDG accumulation on PET: correlation with the menstrual cycle

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seok-Ki; Kang, Keon Wook; Roh, Ju Won; Sim, Jung Suk; Lee, Eun Sook; Park, Sang-Yoon [Research Institute and Hospital, National Cancer Center, Gyeonggi (Korea)

    2005-07-01

    The aim of this study was to determine the nature of incidental ovarian {sup 18}F-fluoro-2-deoxyglucose (FDG) accumulation on positron emission tomography (PET) and the correlation with the menstrual cycle and menopause. We identified 19 incidental FDG accumulations in the ovary (FAOs). FDG PET images were compared with other anatomical imaging methods [magnetic resonance imaging (MRI), computed tomography (CT) or ultrasonography (US)]. Pathological findings, FDG PET scan during the next menstrual cycle and follow-up images (PET, CT and MRI) were reviewed. To establish the relation of FAOs to the menstrual cycle, we reviewed whole-body FDG PET acquired from 207 consecutive women and the pre-examination questionnaires, including data regarding the menstrual cycle. All spherical or discoid FAOs were attributed to normally developing ovarian follicles and corpora lutea on the basis of concurrent MRI, US or the follow-up PET scan. Three of the FAOs were proved pathologically to be either normal ovaries or a haemorrhagic corpus luteum. Fifteen FAOs spontaneously disappeared on the short-term follow-up PET scans. Of 207 women, 61 had active menstrual cycles. FAOs were found in 12 out of 61 premenopausal women (20%), appearing between the 10th and 25th days of the menstrual cycle. No FAOs were found in the women who did not have a menstrual cycle. Physiological ovarian FDG accumulation could be found around the time of ovulation and during the early luteal phase of the menstrual cycle in premenopausal woman. Since FAO is dependent on the menstrual cycle, it can be avoided by scheduling PET just after menstruation. (orig.)

  7. Differential diagnosis of incidentally detected adrenal masses revealed on routine abdominal CT

    Energy Technology Data Exchange (ETDEWEB)

    Ctvrtlik, Filip [Department of Radiology, University Hospital Olomouc, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: ctvrtlikf@seznam.cz; Herman, Miroslav [Department of Radiology, University Hospital Olomouc, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: miroslav.herman@fnol.cz; Student, Vladimir [Department of Urology, University Hospital Olomouc, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: studentv@seznam.cz; Ticha, Vlastislava [Department of Pathology, University Hospital Olomouc, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: tichym@tunw.upol.cz; Minarik, Jiri [Department of Internal medicine, University Hospital Olomouc, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: abretina@email.cz

    2009-02-15

    Purpose: The aim of this study was to compare CT findings of adrenal incidentalomas with a definitive histological diagnosis in order to establish CT features characteristic for individual types of lesions. Patients and methods: The retrospective study comprised of patients with adrenal lesions detected on abdominal CT. The patients with these incidental findings subsequently underwent adrenalectomy. The adrenalectomy was followed by a histological assessment of the expansion process. The study consisted of 62 adrenal expansions found in 55 patients (in seven patients bilateral lesions were found). According to the definitive histological diagnosis after adrenalectomy, the lesions were divided into the following six groups: primary adrenocortical carcinoma (n = 4), metastasis (n = 7), adrenocortical adenoma (n = 37), pheochromocytoma (n = 9), myelolipoma (n = 2), and others (n = 3). CT observations were categorized as follows: size, shape, margins, density, side of the expansion, homogeneous or heterogeneous density before and after contrast application, presence of central hypodensity, presence of central calcifications and fat deposits. Statistical analysis was carried out using the {chi}{sup 2}-test, Kruskal-Wallis test and Mann-Whitney test. To estimate the differences between the subgroups, the t-test was used. For the evaluation of the mutual relations of maximum size, mean size, and volume, regression analysis (coefficient of determination R{sup 2}) was used. Results: The correlation and regression analysis suggest that there will be no statistically significant error if the maximum size measurements are used instead of the mean size or volume measurements of the lesion. Sensitivity, specificity, accuracy, positive predictive value, negative predictive value for distinguishing adenomas and non-adenomas using a cut-off diameter of 41.5 mm were 81.1%, 70.0%, 77.2%, 83.3%, 66.7%, respectively; using the non-contrast density threshold of 23 HU, they were 89

  8. Divertículo de Meckel: conduta no achado incidental Meckel's diverticulum: behavior on accidental found

    Directory of Open Access Journals (Sweden)

    Luiz Alberto Mendonça de Freitas

    1999-02-01

    Full Text Available O Divertículo de Meckel é uma malfonnação rara. Quando presente, na maioria das vezes não é motivo de sintomatologia. Nos casos complicados, os sintomas são inespecíficos, o que torna o diagnóstico pré-operatório muito difícil. A raridade desta condição, assim como as dificuldades diagnósticas e as controvérsias no tratamento, principalmente quando seu achado é incidental, motivaram a análise de uma série de 18 Divertículos de Meckel (DM operados na Unidade de Cirurgia Geral (UCG do Hospital Regional de Sobradinho (HRS, Brasília-DF, no período de 1985 a 1995. O estudo demonstrou que os portadores destas anomalias foram operados sem diagnóstico pré-operatório mesmo nos pacientes sintomáticos. Em nove oportunidades, os achados foram incidentais durante laparotomias por outros motivos. Diversas condutas operatórias foram verificadas nesta revisão, variando desde a simples diverticulectomia até a enterectomia segmentar com reconstrução por anastomose primária término-terminal. Estas controvérsias levaram o staff da UCG do HRS a eleger a última técnica citada como a mais adequada para a uniformização do tratamento não só dos casos sintomáticos como também para os achados incidentais.Meckel's diverticulum is rare malformation, and in most of the suspectis has no symptoms. In complicated cases, the symptoms are not specific, what makes difficult the preoperative diagnosis. The rarity of this condition as well difficulties in diagnosis and controversies in treatment let us review and analyse records of 18 patients with Meckel 's diverticulum operated at Hospital Regional of Sobradinho in a ten year period (1985-1995. The review showed that all 18 patients underwent surgical procedure without preoperative diagnosis of Meckel's diverticulum. In nine patients the MD were found in the course of operation for some other lesion and remaining had others preoperative diagnosis due of complications of a existing MD

  9. 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.

  10. Detection of low-contrast lesions in computed body tomography: an experimental study of simulated lesions.

    Science.gov (United States)

    Meaney, T F; Raudkivi, U; McIntyre, W J; Gallagher, J H; Haaga, J R; Havrilla, T R; Reich, N E

    1980-01-01

    Observer accuracy in the identification of low-contrast objects in computed tomography (CT) was studied. Thresholds were established for detection of lesions of various sizes and attenuation differences in CT images produced at different radiation doses. Noise reduction was important in identifying certain types of lesions. Detection was not accurate when the standard deviation of the mean of an organ exceeded the difference in the means of the lesion and the surround region.

  11. Ghost cell lesions

    Directory of Open Access Journals (Sweden)

    E Rajesh

    2015-01-01

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

  12. 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...... the activity of primary coronal and root lesions reliably and accurately at one examination by using the combined information obtained from a range of indicators--such as visual appearance, location of the lesion, tactile sensation during probing and gingival health....

  13. The importance of a full clinical examination: assessment of index lesions referred to a skin cancer clinic without a total body skin examination would miss one in three melanomas.

    Science.gov (United States)

    Aldridge, R Benjamin; Naysmith, Lisa; Ooi, Ee Ting; Murray, Caroline S; Rees, Jonathan L

    2013-11-01

    Traditional clinical teaching emphasises the importance of a full clinical examination. In the clinical assessment of lesions that may be skin cancer, full examination allows detection of incidental lesions, as well as helping in the characterisation of the index lesion. Despite this, a total body skin examination is not always performed. Based on two prospective studies of over 1,800 sequential patients in two UK centres we show that over one third of melanomas detected in secondary care are found as incidental lesions, in patients referred for assessment of other potential skin cancers. The majority of these melanomas occurred in patients whose index lesion turned out to be benign. Alternative models of care--for instance some models of teledermatology in which a total body skin examination is not performed by a competent practitioner--cannot be considered equivalent to a traditional consultation and, if adopted uncritically, without system change, will likely lead to melanomas being missed.

  14. Combined Undifferentiated and Neuroendocrine Carcinomas of the Gallbladder Appearing as Two Separate Lesions: A Case Report with Radiological-Pathological Correlation.

    Science.gov (United States)

    Lee, So Won; Baek, Seung Yon; Sung, Sun Hee

    2015-05-01

    We report herein a rare case of incidentally detected combined undifferentiated and neuroendocrine carcinomas of the gallbladder. An incidental gallbladder malignancy was revealed on abdominal ultrasound and multi-detector computed tomography in a 54-year-old man. A short distance from the main polypoid hypoechoic mass at the fundus of the gallbladder, focal wall thickening was noted with prominently increased power Doppler flow. Extended cholecystectomy was performed, and histology confirmed the main polypoid mass as undifferentiated carcinoma and the separate nodule as neuroendocrine carcinoma. To our knowledge, this is the first report presenting two separate lesions of combined gallbladder carcinomas by radiological features.

  15. Dissociable neural mechanisms for goal-directed versus incidental memory reactivation.

    Science.gov (United States)

    Kuhl, Brice A; Johnson, Marcia K; Chun, Marvin M

    2013-10-09

    Remembering a past event involves reactivation of distributed patterns of neural activity that represent the features of that event-a process that depends on associative mechanisms supported by medial temporal lobe structures. Although efficient use of memory requires prioritizing those features of a memory that are relevant to current behavioral goals (target features) over features that may be goal-irrelevant (incidental features), there remains ambiguity concerning how this is achieved. We tested the hypothesis that although medial temporal lobe structures may support reactivation of both target and incidental event features, frontoparietal cortex preferentially reactivates those features that match current goals. Here, human participants were cued to remember either the category (face/scene) to which a picture belonged (category trials) or the location (left/right) in which a picture appeared (location trials). Multivoxel pattern analysis of fMRI data were used to measure reactivation of category information as a function of its behavioral relevance (target vs incidental reactivation). In ventral/medial temporal lobe (VMTL) structures, incidental reactivation was as robust as target reactivation. In contrast, frontoparietal cortex exhibited stronger target than incidental reactivation; that is, goal-modulated reactivation. Reactivation was also associated with later memory. Frontoparietal biases toward target reactivation predicted subsequent memory for target features, whereas incidental reactivation in VMTL predicted subsequent memory for nontested features. These findings reveal a striking dissociation between goal-modulated reactivation in frontoparietal cortex and incidental reactivation in VMTL.

  16. Oncocytic lesions of the ophthalmic region

    DEFF Research Database (Denmark)

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

    2011-01-01

    Purpose: This study aimed to make a nationwide clinicopathological study of oncocytic lesions in the ophthalmic region and to characterize their cytokeratin (CK) expression. Methods: All histologically diagnosed oncocytic lesions in the ophthalmic region registered in Denmark over a 25-year period...... were collected and re-evaluated using a monoclonal antimitochondrial antibody (MU213-UC). Clinical data were registered. Immunohistochemical characterization was performed with a panel of anti-CK antibodies. Results: A total of 34 oncocytic lesions were identified and reviewed. The incidence...... 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...

  17. Memory for incidentally perceived social cues: Effects on person judgment.

    Science.gov (United States)

    Pawling, Ralph; Kirkham, Alexander J; Tipper, Steven P; Over, Harriet

    2017-02-01

    Dynamic face cues can be very salient, as when observing sudden shifts of gaze to a new location, or a change of expression from happy to angry. These highly salient social cues influence judgments of another person during the course of an interaction. However, other dynamic cues, such as pupil dilation, are much more subtle, affecting judgments of another person even without awareness. We asked whether such subtle, incidentally perceived, dynamic cues could be encoded in to memory and retrieved at a later time. The current study demonstrates that in some circumstances changes in pupil size in another person are indeed encoded into memory and influence judgments of that individual at a later time. Furthermore, these judgments interact with the perceived trustworthiness of the individual and the nature of the social context. The effect is somewhat variable, however, possibly reflecting individual differences and the inherent ambiguity of pupil dilation/constriction. © 2016 The British Psychological Society.

  18. Incidental Findings in Neuroimaging: Ethical and Medicolegal Considerations

    Directory of Open Access Journals (Sweden)

    Lawrence Leung

    2013-01-01

    Full Text Available With the rapid advances in neurosciences in the last three decades, there has been an exponential increase in the use of neuroimaging both in basic sciences and clinical research involving human subjects. During routine neuroimaging, incidental findings that are not part of the protocol or scope of research agenda can occur and they often pose a challenge as to how they should be handled to abide by the medicolegal principles of research ethics. This paper reviews the issue from various ethical (do no harm, general duty to rescue, and mutual benefits and owing and medicolegal perspectives (legal liability, fiduciary duties, Law of Tort, and Law of Contract with a suggested protocol of approach.

  19. Incidental experiences of affective coherence and incoherence influence persuasion.

    Science.gov (United States)

    Huntsinger, Jeffrey R

    2013-06-01

    When affective experiences are inconsistent with activated evaluative concepts, people experience what is called affective incoherence; when affective experiences are consistent with activated evaluative concepts, people experience affective coherence. The present research asked whether incidental feelings of affective coherence and incoherence would regulate persuasion. Experiences of affective coherence and incoherence were predicted and found to influence the processing of persuasive messages when evoked prior to receipt of such messages (Experiments 1 and 3), and to influence the confidence with which thoughts generated by persuasive messages were held when evoked after presentation of such messages (Experiments 2 and 3). These results extend research on affective coherence and incoherence by showing that they exert a broader impact on cognitive activity than originally assumed.

  20. Incidental foreign language vocabulary acquisition from social network games

    Directory of Open Access Journals (Sweden)

    Yakup Çetin

    2012-08-01

    Full Text Available It is widely known that young people use social networks not only for sharing and communication purposes but also as means of entertainment and pleasure by playing various online games. Furthermore, there is a common belief among pedagogues that spending valuable amount of time on social networks to play online games can lead to negative academic, personal and social outcomes. However, the findings of this study based on survey conducted with 248 high school students reveal that social network games can also have pedagogical benefits. The results of this research have shown that students can incidentally learn an important number of foreign language words from popular online games on social networks.

  1. Incidental spontaneous coronary dissection: An interventionist′s dilemma

    Directory of Open Access Journals (Sweden)

    Akshyaya Pradhan

    2015-01-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is an uncommon entity, frequently presenting as ST-elevation myocardial infarction (MI or sudden cardiac death. It is usually reported in association with pregnancy and has a high mortality. We present here a case of asymptomatic dissection of the right coronary artery, incidentally detected, in a young normotensive male when coronary angiography was done following acute anterior wall MI. This patient had none of the risk factors to which SCAD is generally ascribed. While management of the infarct-related artery was clear-cut, whether or not to intervene for this nonocclusive dissection was a difficult decision. A conservative approach was finally adopted for the spontaneous dissection and the patient is faring well till date.

  2. INCIDENTAL PROTECTION: AN EXAMINATION OF THE MORRILL TARIFF

    Directory of Open Access Journals (Sweden)

    Jane Flaherty

    2001-01-01

    Full Text Available Historians refer to the Morrill Tariff as the first statement of the nascent Republican party’s protectionist agenda, yet an analysis of the measure reveals that this enduring icon of historiography needs modification. Implemented as a direct response to the fiscal crisis created by the Buchanan administration, the Morrill Tariff represents a bipartisan effort to augment federal revenue for a depleted Treasury. Both President James Buchanan and many of his Democratic colleagues in Congress urged revising the Tariff of 1857 to arrest the growth of the federal deficit. However, the bitter rhetoric that accompanied the secession crisis has obscured the true nature of this short-lived, but important, revenue measure. An examination of the Morrill Tariff and the circumstances surrounding its passage demonstrate that it re-established the rates from the free trade Tariff of 1846 while providing incidental protection for select industries, a practice accepted, even advocated, by the Democratic party for over a decade.

  3. Divertículo de Meckel: conduta no achado incidental

    OpenAIRE

    Freitas,Luiz Alberto Mendonça de; Jorge,Alexandre; Aloísio,Dimas Alberto Campos; Silva,André Gleivson Barbosa da

    1999-01-01

    O Divertículo de Meckel é uma malfonnação rara. Quando presente, na maioria das vezes não é motivo de sintomatologia. Nos casos complicados, os sintomas são inespecíficos, o que torna o diagnóstico pré-operatório muito difícil. A raridade desta condição, assim como as dificuldades diagnósticas e as controvérsias no tratamento, principalmente quando seu achado é incidental, motivaram a análise de uma série de 18 Divertículos de Meckel (DM) operados na Unidade de Cirurgia Geral (UCG) do Hospita...

  4. Incidental Finding of Intercostal Artery Aneurysm During Coarctation Surgery.

    Science.gov (United States)

    Sabzi, Feridoun; Ghasemi, Fahime

    2017-06-01

    Intercostal artery aneurysms (ICAA) are very rare vascular complication of coarctation. The most cases are asymptomatic and could be found incidentally during thoracotomy for others vascular pathology or may present with fatal problems such as rupture that is leading to bleeding and hypovolemic shock. Intercostal artery aneurysm most commonly accompanies with neurofibromatosis, aortic coarctation, or in chest trauma. We report a 10-year-old girl who complained of lower extremities pain and hypertension for a few months. His final diagnosis was coarctation of the aorta. She was scheduled for thoracotomy and coarctation repair by resection and end to end anastomosis. During thoracotomy at lateral side of coarctation, an ICAA distal to coarctation site was seen that by a collateral artery connects to its upper intercostals artery. The patient was treated by ligation and resection of the affected intercostal artery and subsequent coarctation repair. The postoperative course was uneventful and, she was discharged on 7th postoperative day.

  5. The fiduciary relationship model for managing clinical genomic "incidental" findings.

    Science.gov (United States)

    Lázaro-Muñoz, Gabriel

    2014-01-01

    This paper examines how the application of legal fiduciary principles (e.g., physicians' duty of loyalty and care, duty to inform, and duty act within the scope of authority), can serve as a framework to promote management of clinical genomic "incidental" or secondary target findings that is patient-centered and consistent with recognized patient autonomy rights. The application of fiduciary principles to the clinical genomic testing context gives rise to at least four physician fiduciary duties in conflict with recent recommendations by the American College of Medical Genetics and Genomics (ACMG). These recommendations have generated much debate among lawyers, clinicians, and bioethicists hence I believe this publication will be of value and interest to your readership. © 2014 American Society of Law, Medicine & Ethics, Inc.

  6. Positive Predictive Values in Diagnosis of Incidental Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Caner Ediz

    2016-03-01

    Full Text Available Objective: Although the incidence of incidental prostate cancer (IPCa decreases in recent years; for patients who performed by transurethral resection of the prostate (TURP due to bladder outlet obstruction with or without prostatism symptoms (BPH, it is still can be seen. This article purposes to answer two questions a for urologist, which clinical parameters including obesity and smoking have positive predictive value. b for pathologists; which materials are wholly sampled for reducing the cancer ? Methods: We evaluated 1315 cases who were per­formed by TURP due to bladder outlet obstruction with or without prostatism symptoms the years 2006-2015. The ages of the patients, smoking, body mass index (BMI, digital rectal examination (DRE findings, preoperative prostate specific antigen (PSA levels, uroflow values, to­tal prostate volume determined by suprapubic ultrasound and Gleason score were recorded. We analyzed the re­lationship between these parameters and IPCa. These situation compared with benign prostate tissue materials. Results: Totally 31 cases (2.35% were found in the IPCa. While the cases of 24 were pT1a, 7 cases were pT1b. Age, body mass index, PSA, peak current speed and mean flow rate parameters respectively 8.887, 5.668, 9.660, 4.814 and 3.716 times as an incidental effect in detecting prostate cancer has been concluded. Conclusion: Older patient age, over the 25 kg/m2 of BMI, over the 4 ng/dl of PSA levels, the peak flow rate less than 10 ml/sec and the mean flow rate less than 5 ml/sec might be independent risk factors for detecting IPCa. More ex­ternal validation is needed for confirming our results.

  7. Incidental pineal cysts in children who undergo 3-T MRI

    Energy Technology Data Exchange (ETDEWEB)

    Whitehead, Matthew T. [University of Tennessee Health Science Center, Department of Radiology, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); Le Bonheur Children' s Hospital, Department of Radiology, Memphis, TN (United States); Oh, Christopher C. [University of Tennessee Health Science Center, Department of Radiology, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); Choudhri, Asim F. [University of Tennessee Health Science Center, Department of Radiology, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); University of Tennessee Health Science Center, Department of Neurosurgery, Memphis, TN (United States)

    2013-12-15

    Pineal cysts, both simple and complex, are commonly encountered in children. More cysts are being detected with MR technology; however, nearly all pineal cysts are benign and require no follow-up. To discover the prevalence of pineal cysts in children at our institution who have undergone high-resolution 3-T MRI. We retrospectively reviewed 100 consecutive 3-T brain MRIs in children ages 1 month to 17 years (mean 6.8 {+-} 5.1 years). We evaluated 3-D volumetric T1-W imaging, axial T2-W imaging, axial T2-W FLAIR (fluid attenuated inversion recovery) and coronal STIR (short tau inversion recovery) sequences. Pineal parenchymal and cyst volumes were measured in three planes. Cysts were analyzed for the presence and degree of complexity. Pineal cysts were present in 57% of children, with a mean maximum linear dimension of 4.2 mm (range 1.5-16 mm). Of these cysts, 24.6% showed thin septations or fluid levels reflecting complexity. None of the cysts demonstrated complete T2/FLAIR signal suppression. No cyst wall thickening or nodularity was present. There was no significant difference between the ages of children with and without cysts. Cysts were more commonly encountered in girls than boys (67% vs. 52%; P = 0.043). There was a slight trend toward increasing pineal gland volume with age. Pineal cysts are often present in children and can be incidentally detected by 3-T MRI. Characteristic-appearing pineal cysts in children are benign, incidental findings, for which follow-up is not required if there are no referable symptoms or excessive size. (orig.)

  8. The incidental relationship between serum ferritin levels and hypertension.

    Science.gov (United States)

    Ryoo, Jae-Hong; Kim, Sun Yong; Oh, Chang-Mo; Park, Sung Keun; Kim, Eugene; Park, Se-Jin; In Yu, Jae; Kim, Min-Gi; Choi, Yong-Sung; Ko, Taeg Su

    2015-03-15

    Although several studies have shown an association between ferritin level and hypertension, only a few studies have investigated the longitudinal relationship between them. Thus, we evaluated the incidental risk for hypertension according to baseline ferritin level. A total of 7104 healthy Korean men matched by a propensity score, who had participated in a medical health check-up program in 2005, were followed up from 2005 to 2010. They were divided into four groups according to baseline serum ferritin level (first quartile-fourth quartile). The incidence of hypertension was compared among the four groups, and the Cox-proportional hazard model was used to assess whether the development of hypertension was associated with higher baseline serum ferritin level. A total of 1252 (17.6%) cases had newly developed hypertension during the 26,339.5 person-years of follow-up between 2006 and 2010. The adjusted hazard ratios (HRs) (95% confidence intervals, CIs) for incident hypertension were 1.00 (reference), 1.09 (0.91-1.30), 1.21 (1.01-1.45) and 1.28 (1.07-1.52), respectively (P for trend=0.003) through the quartiles of serum ferritin levels, respectively, after adjusting for multiple confounders. For the log-transformed serum ferritin levels as a continuous variable, adjusted HRs and 95% CIs for HTN were 1.15 (1.02-1.29). Elevated serum ferritin level was independently associated with the incidental risk for hypertension in Korean men. This finding suggests the value of elevated ferritin level as an early predictor of hypertension. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Incidental Finding of Dual Ectopic Thyroid on Computed Tomography Angiography.

    Science.gov (United States)

    Pierro, Antonio; Cilla, Savino; Modugno, Pietro; Sallustio, Giuseppina

    2017-01-01

    The presence of simultaneous two ectopic foci of thyroid tissue (dual ectopic thyroid) is rare, and few cases have been reported in the literature. The ectopic thyroid tissue is an extremely uncommon embryological aberration due to the alterations occurring during the embryological development with incomplete migration of thyroid precursors. Commonly ectopic thyroid tissue is a midline structures, but the lateral location is possible but very rare. Ectopic thyroid is common in women and can vary in size from a microscopic focus to a few centimeters. The normal process of migration of the thyroid can be interrupted at various levels determining a lingual ectopy, a sublingual ectopic, prelaryngeal ectopy, or mediastinic ectopy. Intrathoracic and subdiaphragmatic organs are other sites where the ectopic thyroid tissue may be present. In most of the cases, ectopic tissue is a lingual thyroid and this condition can be totally asymptomatic, discovered incidentally, or occurs with symptoms such as dysphonia, dysphagia, dyspnea, and hemoptysis. Sublingual or suprahyoid ectopia is rare and even rarer are the cases of two foci of ectopic thyroid tissue simultaneously present. On imaging, the ectopic tissue shows the same characteristics of orthotopic thyroid tissue and similarly can undergo goiterous and cancerous transformation. We report a case of incidental dual ectopic thyroid in lingual and suprahyoid level in a 72-year-old female patient, asymptomatic and with normal thyroid function, who underwent computed tomography (CT) angiography before vascular surgery for the treatment of carotid stenosis. The presence of a lingual thyroid can lead to a difficult and dangerous intubation, with possible fatal consequences. For this reason, the discovery of these abnormalities has totally changed the patient management who has been subjected to endovascular treatment, instead to the classical surgery.

  10. Management of intracranial incidental findings on brain MRI; Management intrakranieller Zufallsbefunde in der MRT-Bildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Langner, S.; Buelow, R.; Kirsch, M. [University Medicine Greifswald (Germany). Inst. for Diagnostic Radiology and Neuroradiology; Fleck, S. [University Medicine Greifswald (Germany). Dept. of Neurosurgery; Angermaier, A. [University Medicine Greifswald (Germany). Dept. of Neurology

    2016-12-15

    The wider use of MRI for imaging of the head in both research and clinical practice has led to an increasing number of intracranial incidental findings. Most of these findings have no immediate medical consequences. Nevertheless, knowledge of common intracranial incidental findings and their clinical relevance is necessary to adequately discuss the findings with the patient. Based on the author's experiences from a large population-based study, the most common incidental MR findings in the brain will be presented, discussing their clinical relevance and giving recommendations for management according to the current literature and guidelines.

  11. Is the morphology and activity of the occlusal carious lesion related to the lesion progression stage?

    Science.gov (United States)

    Neves, Aline Almeida; Vargas, Daniel Otero Amaral; Santos, Thais Maria Pires; Lopes, Ricardo Tadeu; Sousa, Frederico Barbosa

    2016-12-01

    To investigate the relationship between degree of dentin demineralization with both lesion activity and morphology of the occlusal carious cavity. Occlusal sites (n=138) were identified by visual examination (Nyvad's scores 0-6) in 67 extracted teeth which were scanned in a high energy micro-CT. After 3D reconstruction, each stack was resliced in the mesio-distal direction and tooth mineral density (MD) was measured along a path from enamel to the deepest part of dentin in the slice showing the most severe carious involvement. Each site was classified in "open" or "closed" (if cavitated) depending on the morphology of the surrounding enamel walls as measured using micro-CT and as active or inactive in enamel or dentin by a clinical scoring system. Lesions showing dentin cavitation presented higher demineralization degree compared to non-cavitated, or enamel cavitated lesions. Inactive lesions presented lower demineralization degree compared to active lesions, although with a low effect size. According to the morphological aspect of the carious cavity, open enamel lesions showed lower dentin demineralization degree than closed lesion environments. Active lesions showed higher dentin demineralization degree than inactive ones, while lesions showing closed cavitation resulted in higher dentin demineralization degree only for enamel lesions. Including those parameters in treatment decisions may help to improve prognosis and increase effectiveness of the caries diagnostic systems in the clinical setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Incidental extracolonic findings on bright lumen MR colonography in a population at increased risk for colorectal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yusuf, Erlangga, E-mail: angga.yusuf@gmail.com [Department of Radiology, Academic Medical Center, Amsterdam, Postbus 22660, 1100 DD Amsterdam (Netherlands); Florie, Jasper; Nio, Chung Yung; Jensch, Sebastian; Nievelstein, Rutger A.J.; Baak, Lubbertus; Stoker, Jaap [Department of Radiology, Academic Medical Center, Amsterdam, Postbus 22660, 1100 DD Amsterdam (Netherlands)

    2011-04-15

    Purpose: Incidental extracolonic findings affect patient treatment and cost. Therefore, to consider magnetic resonance colonography (MRC) as a tool for colorectal cancer and polyps screening, more knowledge is needed on extracolonic findings. In this study, we sought to determine the prevalence and the spectrum of extracolonic findings in patients with an increased risk colorectal cancer that underwent bright lumen MRC. Materials and methods: MRC examinations were performed in 210 patients. A gadolinium solution was administered rectally for distension of the colon. Extracolonic findings were scored by two radiologists and classified by using C-RADS Reporting System. All findings (with advice regarding work-up) were reported to the patient's physician and followed up for 4.5 years on average. Results: Extracolonic findings were found in 125 (59.5%) patients. Ten (4.8%) had 'potentially important' findings (C-RADS category E4). Twenty-five patients (11.9%) had 'likely unimportant' findings (E3), 90 (42.8%) had 'clinically unimportant' findings (E2) and 85 (40.5%) had a normal exam (E1). In 14 (6.7%) patients additional work-up was performed for their incidentally discovered lesions. In three of them surgery was performed. After work-up, only in two (1.0%) patients a malignancy was found. Conclusion: The number of new relevant extracolonic findings is small and the required additional work-up is limited. This should be considered for implementation of 'bright lumen' MRC as a screening tool.

  13. Incidental extracerebral findings on brain nonenhanced magnetic resonance imaging: frequency, nondetection rate, and clinical importance

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Ming-Liang; Wei, Xiao-Er [School of Medicine, Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, Shanghai (China); Lu, Li-Yan [Nanjing Medical University, Department of Radiology, Nanjing First Hospital, Nanjing (China); Li, Wen-Bin [School of Medicine, Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, Shanghai (China); Kashgar Prefecture Second People' s Hospital, Imaging Center, Kashgar (China)

    2017-03-15

    This study aims to elucidate the frequency, nondetection rate, and clinical importance of incidental extracerebral findings (IECFs) on brain nonenhanced magnetic resonance imaging (MRI). A total of 8284 brain MRIs performed between January 1, 2015 and December 31, 2015 were evaluated for the presence of IECFs and the distribution of IECFs was analyzed. IECFs were categorized as E1 (clinically unimportant, e.g., sinus mucosal thickening); E2 (likely unimportant, e.g., pharyngeal mucosal symmetrical thickening); and E3 (potentially important, e.g., pharyngeal mucosal asymmetrical thickening). The nondetection rate was determined by comparing the results of the structured approach with the initial MRI reports. The medical records were examined for patients with E3 IECFs to assess clinical importance and outcome of these lesions. A total of 5992 IECFs were found in 4469 of the 8284 patients (54.0%). E1 findings constituted 82.2% (4924/5992) of all IECFs; E2 constituted 16.6% (995/5992) and E3 constituted 1.2% (73/5992). Overall IECFs and E1 findings were significantly more common in male patients (P < 0.05). Statistically significant difference was also seen between the different age groups (P < 0.001). The nondetection rate was 56.9% (3409/5992) for overall IECFs and 32.9% (24/73) for E3 IECFs. Of the 73 patients with E3 IECFs, 34 (46.6%) received final diagnosis and appropriate treatment during the study period. IECFs are prevalent in clinical patients on brain MR images with a nondetection rate of 32.9% for potentially important (E3) findings. The reporting of IECFs according to clinical importance is helpful for patients' management. (orig.)

  14. 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.

  15. A prospective study on contrast-enhanced magnetic resonance imaging of testicular lesions: distinctive features of Leydig cell tumours

    Energy Technology Data Exchange (ETDEWEB)

    Manganaro, Lucia; Vinci, Valeria; Saldari, Matteo; Bernardo, Silvia; Cantisani, Vito; Catalano, Carlo [Sapienza University of Rome, Department of Radiology, Rome (Italy); Pozza, Carlotta; Gianfrilli, Daniele; Pofi, Riccardo; Lenzi, Andrea; Isidori, Andrea M. [Sapienza University of Rome, Department of Experimental Medicine, Rome (Italy); Scialpi, Michele [Perugia University, S. Maria della Misericordia Hospital, Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia (Italy)

    2015-12-15

    Up to 20 % of incidentally found testicular lesions are benign Leydig cell tumours (LCTs). This study evaluates the role of contrast-enhanced magnetic resonance imaging (MRI) in the identification of LCTs in a large prospective cohort study. We enrolled 44 consecutive patients with at least one solid non-palpable testicular lesion who underwent scrotal MRI. Margins of the lesions, signal intensity and pattern of wash-in and wash-out were analysed by two radiologists. The frequency distribution of malignant and benign MRI features in the different groups was compared by using the chi-squared or Fisher's exact test. Sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy were calculated. The sensitivity of scrotal MRI to diagnose LCTs was 89.47 % with 95.65 % specificity; sensitivity for malignant lesions was 95.65 % with 80.95 % specificity. A markedly hypointense signal on T2-WI, rapid and marked wash-in followed by a prolonged washout were distinctive features significantly associated with LCTs. Malignant lesions were significantly associated with blurred margins, weak hypointense signal on T2-WI,and weak and progressive wash-in. The overall diagnostic accuracy was 93 %. LCTs have distinctive contrast-enhanced MRI features that allow the differential diagnosis of incidental testicular lesions. (orig.)

  16. 76 FR 67419 - Takes of Marine Mammals Incidental to Specified Activities; Piling and Structure Removal in...

    Science.gov (United States)

    2011-11-01

    ... create optimal spacing and heat requirements for the maternity roost. Equipment employed will include... crew leave the site (or until dark). The PSO will record incidental takes (i.e., numbers of seals...

  17. Incidental prostate cancer diagnosed at radical cystoprostatectomy for bladder cancer: disease-specific outcomes and survival

    Directory of Open Access Journals (Sweden)

    Joshua B. Kaelberer

    2016-09-01

    Conclusion: For men undergoing RCP for bladder cancer, the present study suggests that incidentally discovered prostate cancers, irrespective of pathologic stage, Gleason score, or clinical significance, do not impact 5-year disease control or survival outcomes.

  18. Incidentally detected right pulmonary artery agenesis with right coronary artery collateralization.

    Science.gov (United States)

    Mikaberidze, Nino; Goldberg, Ythan; Khosraviani, Khashayar; Taub, Cynthia

    2014-01-01

    Unilateral pulmonary artery agenesis (UPAA) with pulmonary hypoplasia is a rare congenital anomaly. We describe a 71-year old male who was incidentally diagnosed with the right UPAA and a hypoplastic right lung supplied by collateralized right coronary.

  19. Incidental acquisition of foreign language vocabulary through brief multi-modal exposure.

    Science.gov (United States)

    Bisson, Marie-Josée; van Heuven, Walter J B; Conklin, Kathy; Tunney, Richard J

    2013-01-01

    First language acquisition requires relatively little effort compared to foreign language acquisition and happens more naturally through informal learning. Informal exposure can also benefit foreign language learning, although evidence for this has been limited to speech perception and production. An important question is whether informal exposure to spoken foreign language also leads to vocabulary learning through the creation of form-meaning links. Here we tested the impact of exposure to foreign language words presented with pictures in an incidental learning phase on subsequent explicit foreign language learning. In the explicit learning phase, we asked adults to learn translation equivalents of foreign language words, some of which had appeared in the incidental learning phase. Results revealed rapid learning of the foreign language words in the incidental learning phase showing that informal exposure to multi-modal foreign language leads to foreign language vocabulary acquisition. The creation of form-meaning links during the incidental learning phase is discussed.

  20. Incidental acquisition of foreign language vocabulary through brief multi-modal exposure.

    Directory of Open Access Journals (Sweden)

    Marie-Josée Bisson

    Full Text Available First language acquisition requires relatively little effort compared to foreign language acquisition and happens more naturally through informal learning. Informal exposure can also benefit foreign language learning, although evidence for this has been limited to speech perception and production. An important question is whether informal exposure to spoken foreign language also leads to vocabulary learning through the creation of form-meaning links. Here we tested the impact of exposure to foreign language words presented with pictures in an incidental learning phase on subsequent explicit foreign language learning. In the explicit learning phase, we asked adults to learn translation equivalents of foreign language words, some of which had appeared in the incidental learning phase. Results revealed rapid learning of the foreign language words in the incidental learning phase showing that informal exposure to multi-modal foreign language leads to foreign language vocabulary acquisition. The creation of form-meaning links during the incidental learning phase is discussed.

  1. Incidental avian observations: Northern Alaska Peninsula with an emphasis on field season

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report compiles observations of birds recorded during surveys and incidental to surveys over a broad geographic area of the Northern Alaska Peninsula. These...

  2. Effect of Color and Monochrome Versions of a Film on Incidental and Task Relevant Learning.

    Science.gov (United States)

    Chute, Alan G.

    1980-01-01

    This study found that color in a film helped fourth- and fifth-grade students of all ability levels learn incidental information, but affected learning of task-relevant information differently depending on ability level. (Author/JEG)

  3. Comparative study of ultrasound and computed tomography for incidentally detecting diffuse thyroid disease.

    Science.gov (United States)

    Kim, Dong Wook; Jung, Soo Jin; Ha, Tae Kwun; Park, Ha Kyoung; Kang, Taewoo

    2014-08-01

    The aim of this study was to compare the diagnostic values of thyroid ultrasound (US) and neck computed tomography (CT) in incidentally detecting diffuse thyroid disease (DTD). A single radiologist made US and CT diagnoses of incidentally detected DTD in 130 consecutive patients before thyroidectomy for various malignancies. Histopathologic examinations confirmed normal thyroid (n = 80), Hashimoto thyroiditis (n = 20), non-Hashimoto lymphocytic thyroiditis (n = 28) and diffuse hyperplasia (n = 2). Receiver operating characteristic curves revealed that the best diagnostic indices of both imaging methods were achieved on the basis of two or more abnormal imaging findings. The sensitivity, specificity and accuracy of US and CT in incidentally detecting DTD by this classification were 72% and 72%, 87.5% and 91.3% and 81.5% and 83.8%, respectively. Thyroid US and neck CT have similar diagnostic values for differentiating incidental DTD from normal thyroid.

  4. 77 FR 64961 - Taking and Importing Marine Mammals; Taking Marine Mammals Incidental to Replacement of the...

    Science.gov (United States)

    2012-10-24

    ... location and construction schedule. Information Solicited Interested persons may submit information... incidental to construction associated with the replacement of the Elliott Bay Seawall in Seattle, Washington... Elliott Bay Seawall. Construction activities, namely vibratory and impact pile installation and...

  5. Common conjunctival lesions

    African Journals Online (AJOL)

    ocular appearance. is discussion does not attempt to classify lesions, but only highlights ... magnifying glass. Examine what you can see and evert the upper ... look at the cornea and feel for pre-auricular and submandibular lymph nodes.

  6. Oropharynx lesion biopsy

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003850.htm Oropharynx lesion biopsy To use the sharing features on this ... Department of Otolaryngology - Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. ...

  7. Managing Carious Lesions

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...... health, and maximizing restoration success. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralized tissues close to the pulp do not need to be removed. In deeper lesions in teeth with sensible (vital) pulps, preserving pulpal health...

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

    Science.gov (United States)

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

    2010-04-01

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

  9. Unusual benign breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Porter, G.J.R. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom)]. E-mail: gporter@ncht.trent.nhs.uk; Evans, A.J. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom); Lee, A.H.S. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom); Hamilton, L.J. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom); James, J.J. [Nottingham Breast Institute, City Hospital, Hucknall Rd, Nottingham NG5 1PB (United Kingdom)

    2006-07-15

    The purpose of this article is to show examples of the radiological (mammography and/or ultrasound) and pathological appearances of unusual benign breast lesions. The conditions covered are granular cell tumours, fibromatosis, nodular fasciitis, myofibroblastomas, haemangiomas, neurofibromas, and leiomyomas. The article includes the first published description of the ultrasound appearance of a myofibroblastoma. Knowledge of these appearances may help confirm or refute radiological-pathological concordance of percutaneous biopsy results during multidisciplinary assessment of these lesions and aid patient management.

  10. Andersson Lesion in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Manimegalai N, KrishnanKutty K, Panchapakesa Rajendran C, Rukmangatharajan S, Rajeswari S

    2004-04-01

    Full Text Available Andersson lesions are destructive foci that appear at the discovertebral junction in ankylosingspondylitis. We report three cases of ankylosing spondylitis with such lesions. These lesions simulatean infection and in our country, mimic spinal tuberculosis.

  11. p53 Expression Helps Identify High Risk Oral Tongue Pre- malignant Lesions and Correlates with Patterns of Invasive Tumour Front and Tumour Depth in Oral Tongue Squamous Cell Carcinoma Cases.

    Science.gov (United States)

    Viveka, Thangaraj Soundara; Shyamsundar, Vidyarani; Krishnamurthy, Arvind; Ramani, Pratibha; Ramshankar, Vijayalakshmi

    2016-01-01

    Oral tongue squamous cell carcinoma (OTSCC) is the most common oral cancer subtype with a maximum propensity for regional spread. Our objective was to study if p53 expression might have any correlation with aggressive patterns of invasion within oral tongue cancers as well as with the histologically identified degree of oral tongue dysplasia. p53 immunoexpression was studied using immunohistochemistry in early staged OTSCCs (n=155), oral tongue dysplasias, (n=29) and oral tongue normal specimens (n=10) and evaluated for correlations with histological and clinicopathological parameters. Our study (n=194) showed a pattern of p53 expression increasing with different grades of tongue dysplasia to different grades of invasive OTSCC (p=0.000). Among the OTSCC tumours, positive p53 expression was seen in 43.2% (67/155) and a higher p53 labelling index was significantly associated with increased Bryne's grade of the tumour invasive front (p=0.039) and increased tumour depth (p=0.018). Among the OTSCC patients with tobacco habits, (n=91), a higher p53 labelling index was significantly associated with increased risk of local recurrence (p=0.025) and with lymphovascular space involvement (p=0.014). Evaluation of p53 through varying degrees of dysplasia to oral tongue cancer indicates that p53 expression is linked to aggressive features of oral tongue cancers and tongue precancers entailing a closer monitoring in positive cases. Among the OTSCCs, p53 expression is associated with tumour aggressiveness correlating with increased grading of invasive tumour front and tumour depth.

  12. Factors influencing incidental representation of previously unknown conservation features in marine protected areas.

    Science.gov (United States)

    Bridge, Tom C L; Grech, Alana M; Pressey, Robert L

    2016-02-01

    Spatially explicit information on species distributions for conservation planning is invariably incomplete; therefore, the use of surrogates is required to represent broad-scale patterns of biodiversity. Despite significant interest in the effectiveness of surrogates for predicting spatial distributions of biodiversity, few researchers have explored questions involving the ability of surrogates to incidentally represent unknown features of conservation interest. We used the Great Barrier Reef marine reserve network to examine factors affecting incidental representation of conservation features that were unknown at the time the reserve network was established. We used spatially explicit information on the distribution of 39 seabed habitats and biological assemblages and the conservation planning software Marxan to examine how incidental representation was affected by the spatial characteristics of the features; the conservation objectives (the minimum proportion of each feature included in no-take areas); the spatial configuration of no-take areas; and the opportunity cost of conservation. Cost was closely and inversely correlated to incidental representation. However, incidental representation was achieved, even in a region with only coarse-scale environmental data, by adopting a precautionary approach that explicitly considered the potential for unknown features. Our results indicate that incidental representation is enhanced by partitioning selection units along biophysical gradients to account for unknown within-feature variability and ensuring that no-take areas are well distributed throughout the region; by setting high conservation objectives that (in this case >33%) maximize the chances of capturing unknown features incidentally; and by carefully considering the designation of cost to planning units when using decision-support tools for reserve design. The lessons learned from incidental representation in the Great Barrier Reef have implications for

  13. Sumatera Incidental Music Di Taman Budaya Sumatera Utara: Deskripsi Pengelolaan, Pertunjukan, dan Struktur Musik.

    OpenAIRE

    Hutagalung, Jefri

    2011-01-01

    Group musik Sumatera Incidental Music adalah salah satu grup musik yang menyajikan musik etnik dalam setiap pertunjukannya. Grup ini di ketuai oleh Hendri Perangin Angin dan bersekretariat di Taman Budaya Sumatera Utara. Pada awalnya Sumatera Incidental Music dibentuk oleh Hendri Perangin Angin dan Winarto Kartupat. Hendri Perangin Angin dan Winarto Kartupat mempunyai visi dan pemikiran yang sama untuk membentuk sebuah grup musik pada tahun 2000. Sehingga pada tanggal 8 apri...

  14. Sumatera Incidental Music Di Taman Budaya Sumatera Utara: Deskripsi Pengelolaan, Pertunjukan, dan Struktur Musik.

    OpenAIRE

    Hutagalung, Jefri

    2011-01-01

    Group musik Sumatera Incidental Music adalah salah satu grup musik yang menyajikan musik etnik dalam setiap pertunjukannya. Grup ini di ketuai oleh Hendri Perangin Angin dan bersekretariat di Taman Budaya Sumatera Utara. Pada awalnya Sumatera Incidental Music dibentuk oleh Hendri Perangin Angin dan Winarto Kartupat. Hendri Perangin Angin dan Winarto Kartupat mempunyai visi dan pemikiran yang sama untuk membentuk sebuah grup musik pada tahun 2000. Sehingga pada tanggal 8 apri...

  15. Three-dimensional conformal radiation for esophageal squamous cell carcinoma with involved-field irradiation may deliver considerable doses of incidental nodal irradiation

    Directory of Open Access Journals (Sweden)

    Ji Kai

    2012-11-01

    Full Text Available Abstract Background To quantify the incidental irradiation dose to esophageal lymph node stations when irradiating T1-4N0M0 thoracic esophageal squamous cell carcinoma (ESCC patients with a dose of 60 Gy/30f. Methods Thirty-nine patients with medically inoperable T1–4N0M0 thoracic ESCC were treated with three-dimensional conformal radiation (3DCRT with involved-field radiation (IFI. The conformal clinical target volume (CTV was re-created using a 3-cm margin in the proximal and distal direction beyond the barium esophagogram, endoscopic examination and CT scan defined the gross tumor volume (GTV and a 0.5-cm margin in the lateral and anteroposterior directions of the CT scan-defined GTV. The PTV encompassed 1-cm proximal and distal margins and 0.5-cm radial margin based on the CTV. Nodal regions were delineated using the Japanese Society for Esophageal Diseases (JSED guidelines and an EORTC-ROG expert opinion. The equivalent uniform dose (EUD and other dosimetric parameters were calculated for each nodal station. Nodal regions with a metastasis rate greater than 5% were considered a high-risk lymph node subgroup. Results Under a 60 Gy dosage, the median Dmean and EUD was greater than 40 Gy in most high-risk nodal regions except for regions of 104, 106tb-R in upper-thoracic ESCC and 101, 104-R, 105, 106rec-L, 2, 3&7 in middle-thoracic ESCC and 107, 3&7 in lower-thoracic ESCC. In the regions with an EUD less than 40Gy, most incidental irradiation doses were significantly associated with esophageal tumor length and location. Conclusions Lymph node stations near ESCC receive considerable incidental irradiation doses with involved-field irradiation that may contribute to the elimination of subclinical lesions.

  16. Anti-1-Amino-3-18F-Fluorocyclobutane-1-Carboxylic Acid: Physiologic Uptake Patterns, Incidental Findings, and Variants That May Simulate Disease

    Science.gov (United States)

    Schuster, David M.; Nanni, Cristina; Fanti, Stefano; Oka, Shuntaro; Okudaira, Hiroyuki; Inoue, Yusuke; Sörensen, Jens; Owenius, Rikard; Choyke, Peter; Turkbey, Baris; Bogsrud, Trond V.; Bach-Gansmo, Tore; Halkar, Raghuveer K.; Nye, Jonathon A.; Odewole, Oluwaseun A.; Savir-Baruch, Bital; Goodman, Mark M.

    2016-01-01

    Anti-1-amino-3-18F-fluorocyclobutane-1-carboxylic acid (18F-FACBC) is a synthetic amino acid analog PET radiotracer undergoing clinical trials for the evaluation of prostate and other cancers. We aimed to describe common physiologic uptake patterns, incidental findings, and variants in patients who had undergone 18F-FACBC PET. Methods Sixteen clinical trials involving 611 18F-FACBC studies from 6 centers, which included dosimetry studies on 12 healthy volunteers, were reviewed. Qualitative observations of common physiologic patterns, incidental uptake, and variants that could simulate disease were recorded and compared with similar observations in studies of the healthy volunteers. Quantitative analysis of select data and review of prior published reports and observations were also made. Results The liver and pancreas demonstrated the most intense uptake. Moderate salivary and pituitary uptake and variable mild to moderate bowel activity were commonly visualized. Moderate bone marrow and mild muscle activity were present on early images, with marrow activity decreasing and muscle activity increasing with time. Brain and lungs demonstrated activity less than blood pool. Though 18F-FACBC exhibited little renal excretion or bladder uptake during the clinically useful early imaging time window, mild to moderate activity might accumulate in the bladder and interfere with evaluation of adjacent prostate bed and seminal vesicles in 5%–10% of patients. Uptake might also occur from benign processes such as infection, inflammation, prostatic hyperplasia, and metabolically active benign bone lesions such as osteoid osteoma. Conclusion Common physiologic uptake patterns were similar to those noted in healthy volunteers. The activity in organs followed the presence of amino acid transport and metabolism described with other amino acid–based PET radiotracers. As with other PET radiotracers such as 18F-FDG, focal nonphysiologic uptake may represent incidental malignancy

  17. The role of verbal and pictorial information in multimodal incidental acquisition of foreign language vocabulary.

    Science.gov (United States)

    Bisson, Marie-Josée; van Heuven, Walter J B; Conklin, Kathy; Tunney, Richard J

    2015-01-01

    This study used eye tracking to investigate the allocation of attention to multimodal stimuli during an incidental learning situation, as well as its impact on subsequent explicit learning. Participants were exposed to foreign language (FL) auditory words on their own, in conjunction with written native language (NL) translations, or with both written NL translations and pictures. Incidental acquisition of FL words was assessed the following day through an explicit learning task where participants learned to recognize translation equivalents, as well as one week later through recall and translation recognition tests. Results showed higher accuracy scores in the explicit learning task for FL words presented with meaning during incidental learning, whether written meaning or both written meaning and picture, than for FL words presented auditorily only. However, participants recalled significantly more FL words after a week delay if they had been presented with a picture during incidental learning. In addition, the time spent looking at the pictures during incidental learning significantly predicted recognition and recall scores one week later. Overall, results demonstrated the impact of exposure to multimodal stimuli on subsequent explicit learning, as well as the important role that pictorial information can play in incidental vocabulary acquisition.

  18. Incidental sinus abnormalities in 256 patients referred for brain MRI

    Directory of Open Access Journals (Sweden)

    Ghanaati H

    2007-06-01

    Full Text Available Background: Imaging abnormalities in the paranasal sinuses are regularly noted as incidental findings on MRI, however, little is known about their prevalence in the Iranian population. The purpose of this study was to classify these findings in the paranasal sinuses as seen on MRI and to investigate the prevalence, according to site and type of paranasal abnormality. Methods: In this cross-sectional study, the T2-weighted axial MRI of 256 patients with diseases unrelated to their paranasal sinuses were reviewed between May 2002 and June 2003. The findings were categorized according to the anatomic location and the imaging characteristics of the abnormality. The abnormalities recorded included total sinus opacification, mucoperiosteal thickening >5mm, air fluid levels and retention cysts or polyps. Unilateral or bilateral involvement and septal deviation were also noted. A sinus was considered normal if it was fully aerated and no soft-tissue density was apparent within the cavity. Results: Among our cases, 111 (43.5% were male and 145 (56.5% were female. Of these patients, abnormalities in one or more of the sinus groups were found in 110 subjects (42.9%, 55.5% of which were male and 44.5% were female (P=0.001. Maxillary sinus abnormalities were observed in 66.4% of the patients, while ethmoid sinus abnormalities were found in 63.6%. Of the ethmoid abnormalities, 21% were found in the anterior section, 9% in the middle ethmoid, and 8% in the posterior ethmoid. The most common abnormality found was mucosal thickening. Among our cases, 23.4% had septal deviation, which was significantly higher among those with sinusitis (29% versus 19.1%; P<0.01. Of those patients with sinus involvement, 16% were involved in the sphenoid sinus and 5% in the frontal sinus. The results obtained from the patients with sinus abnormality revealed that 85% suffered from cough, nasal obstruction, runny nose, facial pain and post nasal discharge and 24% had been diagnosed

  19. Topographic congruence of calcified parenchymal neurocysticercosis and other structural brain lesions with epileptiform activity

    Science.gov (United States)

    Saito, Erin K; Nagpal, Meera; Leon, Amanda; Mehta, Bijal; McMurtray, Aaron Matthew

    2016-01-01

    Introduction: Calcified parenchymal neurocysticercosis (NCC) lesions are commonly detected in many individuals with refractory epilepsy. However, the relationship between these lesions and epilepsy is not fully determined. We sought to determine if calcified parenchymal NCC demonstrated topographic congruence with epileptiform activity in refractory epilepsy patients. Additional patients with other structural brain lesions were included for comparison. Subjects and Methods: Retrospective cross-sectional analysis of all patients treated at a community-based neurology clinic for refractory epilepsy during a 3-month period and with structural brain lesions detected by neuroimaging studies. Results: A total of 105 patients were included in the study, including 63 with calcified parenchymal NCC lesions and 42 with other structural brain lesions. No significant relationship was detected between hemispheric localization of calcified parenchymal NCC lesions and epileptiform activity. For those with other structural brain lesions, the hemispheric localization was significantly related to the side of epileptiform activity (Chi-square = 11.13, P = 0.025). In addition, logistic regression models showed that those with right-sided non-NCC lesions were more likely to have right-sided epileptiform activity (odds ratio = 4.36, 95% confidence interval [CI] =1.16–16.31, P = 0.029), and those with left-sided non-NCC lesions were more likely to have left-sided epileptiform activity (odds ratio = 7.60, 95% CI = 1.89–30.49, P = 0.004). Conclusion: The lack of correlation between the side of calcified parenchymal NCC lesions and the side of the epileptiform activity suggests that these lesions may be incidental findings in many patients. PMID:26998434

  20. Incidence of vestibular schwannoma and incidental findings on the magnetic resonance imaging and computed tomography scans of patients from a direct referral audiology clinic.

    Science.gov (United States)

    Wong, B Y W; Capper, R

    2012-07-01

    To identify the incidence of vestibular schwannoma amongst patients referred from a direct referral audiology clinic, and also the number of incidental findings, as seen on magnetic resonance imaging or computed tomography scans. Prospective data collection for patients referred from a direct referral audiology clinic due to audiological evidence of asymmetrical hearing loss. The audiograms, magnetic resonance imaging and computed tomography scans of patients with diagnosed vestibular schwannoma were subsequently reviewed. A total of 4100 patients were seen during the study period, with 396 scans performed. Six (1.5 per cent) patients had vestibular schwannoma, while 12 (3 per cent) had significant incidental findings. Patients referred from the direct referral audiology clinic had a low incidence of vestibular schwannoma detection. Their detection rate for significant incidental findings was similar to previous reports. If the current protocol had not been in place, over 300 patients would have been needlessly added to the ENT clinic list. Thus, general practitioner referral to direct referral audiology clinics provides a cost-effective way of managing asymmetrical sensorineural hearing loss in older patients. The number of such clinics could be expanded.

  1. Comparison of Cone-Beam CT Incidental Findings between Moderate/Severe Obstructive Sleep Apnea patients and Mild/Normal patients

    Science.gov (United States)

    Enciso, Reyes; Shigeta, Yuko; Nguyen, Manuel; Clark, Glenn T.

    2012-01-01

    Objective To compare the incidental radiographic findings in the maxillofacial structures and the pharyngeal airway between moderate/severe Obstructive Sleep Apnea (OSA) subjects and mild OSA/normal subjects using Cone-Beam Computed Tomography (CBCT) scans. Study Design 53 moderate/severe OSA subjects (with a Respiratory Disturbance Index [RDI]≥15 events/hr) and 33 mild OSA/normal subjects, (RDI<15) based on ambulatory somnographic assessment were recruited. Supine CBCT’s were taken and sent for radiological report. The incidental findings were compared between the two groups. Results Moderate/severe subjects had larger prevalence of conchae bullosa, hypertrophic turbinates, hypertrophic tonsils, elongated or posteriorly placed soft palate, narrower airway, enlarged tongue, and focal calcifications, though no significant differences were found. Conclusions CBCT is useful in identifying maxillofacial and airway anomalies that could interfere with normal breathing. However, no significant difference was found in prevalence of incidental findings between moderate/severe OSA and mild/normal subjects. Further studies are necessary to generalize our results. PMID:22862979

  2. Incidental finding of malignant renal cystic tumour diagnosed sonographically

    Directory of Open Access Journals (Sweden)

    Stojanović Milan

    2008-01-01

    Full Text Available Introduction Malignant cystic renal tumor is a rare variant of renal malignancy. Cystic neoplasm results from haemorrhage, necrosis and colliquation of a solid tumour or tumour occurring within the wall of a cyst. That pathoanatomic substratum reflects characteristic sonographic features indicating its malignant nature. It is important to distinguish a simple cyst (not requiring surgery from intracystic malignant lesion because it requires surgery. Case Outline The authors present a 59-year-old woman with a sonographic finding of a simple cyst in the upper pole of the right kidney revealed during gynaecological ultrasonography. Immediately afterwards, the radiologist performed renal sonography and its finding was a cystic lesion suggestive of malignancy. Further evaluation by CT scan showed that the lesion was clearly malignant. After surgery, the histological finding verified cystic renal cancer. Conclusion Ultrasonography may reveal a complex cyst and solid mass but requires an experienced sonographer. Contrast CT scan would be performed to examine the "suspicious" lesion because it clearly shows if a cystic lesion is benign or malignant. .

  3. Tubal epithelial lesions in salpingo-oophorectomy specimens of BRCA-mutation carriers and controls.

    NARCIS (Netherlands)

    Mingels, M.J.J.M.; Roelofsen, T.; Laak, J.A.W.M. van der; Hullu, J.A. de; Ham, M.A.P.C. van; Massuger, L.F.A.G.; Bulten, J.; Bol, M.

    2012-01-01

    OBJECTIVE: A precursor lesion for ovarian carcinoma, tubal intraepithelial carcinoma (TIC), has been identified in BRCA-mutation carriers undergoing prophylactic bilateral salpingo-oophorectomy (pBSO). Other lesions were also identified in fallopian tubes, but different terminology, interpretation,

  4. Space Occupying Lesions in the Liver

    Directory of Open Access Journals (Sweden)

    Nasser Ebrahimi Daryani

    2009-01-01

    Full Text Available "nRadiology (imaging plays a pivotal role for the diagnosis, staging, treatment planning, and follow-up of focal liver lesions. The differential diagnosis in patients presenting with a focal liver lesion is broad. "nThe size of the liver mass is an important consideration in guiding the evaluation. Lesions smaller than approximately 1.0 cm are commonly benign incidental findings on imaging studies, and in most cases represent small cysts, hemangiomas, or biliary hamartomas. Furthermore, they are frequently difficult to definitively characterize by imaging methods, due to their small size, and difficult to biopsy percutaneously. Often clinical follow-up is the only recourse for these lesions. "nTo formulate a practical approach to these patients, several factors must be incorporated into a clinical decision-making algorithm (figure below, including: the particular clinical setting (e.g., known co-morbidities, underlying cirrhosis or a known primary neoplasm, the presence of clinical signs and symptoms, the results of laboratory tests, and the critical information provided by imaging studies. "nDue to a combination of high spatial resolution and inherent soft-tissue contrast, lack of ionizing radiation, low cost, and wide availability, ultrasonography (US is frequently the first-line imaging modality for the study of the liver. "nMulti-detector row CT (MDCT has become the most commonly used modality in the preoperative diagnosis, staging, treatment planning, and follow-up of patients with known or suspected hepatic tumors. "nTo maximize the detection and characterization of liver tumors, the CT protocol must be designed according to the diagnostic task. To increase the attenuation difference (i.e., conspicuity between the hepatic parenchyma and liver tumors,3 several injection factors need to be optimized, including the volume and iodine concentration of contrast media, the injection rate (4-5mL/s, and the scanning delay from the start of contrast

  5. Diagnostic and radiological management of cystic pancreatic lesions: Important features for radiologists

    Energy Technology Data Exchange (ETDEWEB)

    Buerke, B., E-mail: buerkeb@uni-muenster.de [Department of Clinical Radiology, University of Muenster, Muenster (Germany); Domagk, D. [Department of Medicine B, University of Muenster, Muenster (Germany); Heindel, W.; Wessling, J. [Department of Clinical Radiology, University of Muenster, Muenster (Germany)

    2012-08-15

    Cystic pancreatic neoplasms are often an incidental finding, the frequency of which is increasing. The understanding of such lesions has increased in recent years, but the numerous types of lesions involved can hinder differential diagnosis. They include, in particular, intraductal papillary mucinous neoplasms (IPMN), serous cystic neoplasms (SCN), and mucinous cystic neoplasms (MCN). Knowledge of their histological and radiological structure, as well as distribution in terms of localization, age, and sex, helps to differentiate such tumours from common pancreatic pseudocysts. Several types of cystic pancreatic neoplasms can undergo malignant transformation and, therefore, require differentiated radiological management. This review aims to develop a broader understanding of the pathological and radiological characteristics of cystic pancreatic neoplasms, and provide a guideline for everyday practice based on current concepts in the radiological management of the given lesions.

  6. Delphinid behavioral responses to incidental mid-frequency active sonar.

    Science.gov (United States)

    Henderson, E Elizabeth; Smith, Michael H; Gassmann, Martin; Wiggins, Sean M; Douglas, Annie B; Hildebrand, John A

    2014-10-01

    Opportunistic observations of behavioral responses by delphinids to incidental mid-frequency active (MFA) sonar were recorded in the Southern California Bight from 2004 through 2008 using visual focal follows, static hydrophones, and autonomous recorders. Sound pressure levels were calculated between 2 and 8 kHz. Surface behavioral responses were observed in 26 groups from at least three species of 46 groups out of five species encountered during MFA sonar incidents. Responses included changes in behavioral state or direction of travel, changes in vocalization rates and call intensity, or a lack of vocalizations while MFA sonar occurred. However, 46% of focal groups not exposed to sonar also changed their behavior, and 43% of focal groups exposed to sonar did not change their behavior. Mean peak sound pressure levels when a behavioral response occurred were around 122 dB re: 1 μPa. Acoustic localizations of dolphin groups exhibiting a response gave insight into nighttime movement patterns and provided evidence that impacts of sonar may be mediated by behavioral state. The lack of response in some cases may indicate a tolerance of or habituation to MFA sonar by local populations; however, the responses that occur at lower received levels may point to some sensitization as well.

  7. Examining the durability of incidentally learned trust from gaze cues.

    Science.gov (United States)

    Strachan, James W A; Tipper, Steven P

    2017-10-01

    In everyday interactions we find our attention follows the eye gaze of faces around us. As this cueing is so powerful and difficult to inhibit, gaze can therefore be used to facilitate or disrupt visual processing of the environment, and when we experience this we infer information about the trustworthiness of the cueing face. However, to date no studies have investigated how long these impressions last. To explore this we used a gaze-cueing paradigm where faces consistently demonstrated either valid or invalid cueing behaviours. Previous experiments show that valid faces are subsequently rated as more trustworthy than invalid faces. We replicate this effect (Experiment 1) and then include a brief interference task in Experiment 2 between gaze cueing and trustworthiness rating, which weakens but does not completely eliminate the effect. In Experiment 3, we explore whether greater familiarity with the faces improves the durability of trust learning and find that the effect is more resilient with familiar faces. Finally, in Experiment 4, we push this further and show that evidence of trust learning can be seen up to an hour after cueing has ended. Taken together, our results suggest that incidentally learned trust can be durable, especially for faces that deceive.

  8. Dengue-associated hypokalemic paralysis: causal or incidental?

    Science.gov (United States)

    Malhotra, Hardeep Singh; Garg, Ravindra Kumar

    2014-05-15

    Dengue-associated hypokalemic paralysis is considered an important but under-emphasized neuromuscular complication of dengue virus infection. Review of the published literature reveals that 35 instances of hypokalemic paralysis associated with dengue have been recorded from the Indian subcontinent and all but two, were males. The median age of presentation is 29 years and moderate to severe grade pure motor quadriparesis is precipitated during the phase of defervescence of moderate to high-grade fever. Recovery starts within 12h of potassium supplementation and is usually complete in a couple of days. Redistribution or increased loss of potassium from the body is speculated as the pathophysiological mechanism involved in the causation of hypokalemia. It is not possible to derive the exact etiopathological correlation from the published literature either due to a lack of comprehensive reporting or inadequate work-up of the patients. Curious is the fact that only 35 patients had manifest-paralysis when more than two-thirds affected with the dengue virus exhibit hypokalemia; whether this indicates a genetically mediated channel disorder or an incidental association remains to be seen. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. 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

  10. Post-mortal lesions in freshwater environment.

    Science.gov (United States)

    Vanin, Stefano; Zancaner, Silvano

    2011-10-10

    Postmortem animal feeding activity may cause considerable damage to bodies resulting in the modification of wounds, loss of identifying features and injury. Certain postmortem lesions may appear inflicted or non-inflicted antemortem injuries. At present, apart from cases in sea water, no data are available about post mortal lesions performed by aquatic organisms. This note that represents the first report concerning colonisation of a dead body by crustaceans a few hours after death, describes injuries caused by the amphipod Niphargus elegans on the face, and in particular on the eye region, of a young man dead by drowning. The lesions recorded in this case are comparable with the lesions caused by ants. The high plasticity in the food choice can allow Amphipoda to colonise drowning bodies in every moment after dead, however the benthonic behaviour of these animals suggests a more important role in the colonisation during post-mortem submersion periods.

  11. 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.

  12. Oral mucosa lesions in Mazahua Indian adolescents.

    Science.gov (United States)

    Banderas, J A; Toshikasu, O; González, M

    1999-01-01

    The epidemiologic data on oral lesions in native Indians remain unknown in many countries around the world. This paper reports the prevalence and distribution of oral congenital anomalies and pathologic lesions found in a survey of 107 schoolchildren (ages 12 to 17), from two isolated communities in the ethnographic Mazahua area in the State of Mexico. The main entities identified were: pigmented lesions (47.6%), lingual anomalies (17.4%) and developmental tooth alterations (6.9%). The remaining 24.4% of the lesions were gingival inflammatory hyperplasia, partial ankilosis of the tongue, lichen planus, focal epithelial hyperplasia and the double lip. The most frequent localization was lips and tongue. These findings suggest the high prevalence of oral anomalies in this Indian population. Therefore, we suggest that health programs should emphasize the prevention, diagnosis and treatment of these pathologies in Indians groups.

  13. Differential diagnosis and radiological management of cystic pancreatic lesions; Differenzialdiagnose und radiologisches Management von zystischen Tumoren des Pankreas

    Energy Technology Data Exchange (ETDEWEB)

    Buerke, B.; Heindel, W.; Wessling, J. [Universitaetsklinikum Muenster (Germany). Inst. fuer Klinische Radiologie

    2010-10-15

    Cystic pancreatic lesions are often discovered incidentally as an asymptomatic finding, at a rate which is increasing considerably. In recent years the understanding of such tumors has become clearly differentiated. The spectrum of relevant lesions includes in particular the intraductal papillary mucinous neoplasm (IPMN), serous cystic neoplasm (SCN) and mucinous cystic neoplasm (MCN). With certain knowledge of their histological and radiomorphological structure as well as their distribution in terms of location, age and sex, such tumors are easy to differentiate and demarcate from common pancreatic pseudocysts. This also implies the fundamental understanding of complementary endoscopic procedures such as endosonography, which enables aspiration of the content of the cyst. A number of cystic pancreatic lesions have the potential to undergo malignant transformation along the adenoma-carcinoma sequence and therefore necessitate a differentiated approach to their radiological management. This review aims to develop a broad understanding of the pathological and radiomorphological characteristics of cystic pancreatic lesions and provides advice regarding procedures, particularly with respect to incidentally detected lesions. (orig.)

  14. Signal recognition particle immunoglobulin g detected incidentally associates with autoimmune myopathy

    Science.gov (United States)

    Apiwattanakul, Metha; Milone, Margherita; Pittock, Sean J.; Kryzer, Thomas J.; Fryer, James P.; O'toole, Orna; Mckeon, Andrew

    2016-01-01

    ABSTRACT Introduction: Paraneoplastic autoantibody screening of 150,000 patient sera by tissue‐based immunofluorescence incidentally revealed 170 with unsuspected signal recognition particle (SRP) immunoglobulin G (IgG), which is a recognized biomarker of autoimmune myopathy. Of the 77 patients with available information, 54 had myopathy. We describe the clinical/laboratory associations. Methods: Distinctive cytoplasm‐binding IgG (mouse tissue substrate) prompted western blot, enzyme‐linked immunoassay, and immunoprecipitation analyses. Available histories were reviewed. Results: The immunostaining pattern resembled rough endoplasmic reticulum, and mimicked Purkinje‐cell cytoplasmic antibody type 1 IgG/anti‐Yo. Immunoblotting revealed ribonucleoprotein reactivity. Recombinant antigens confirmed the following: SRP54 IgG specificity alone (17); SRP72 IgG specificity alone (3); both (32); or neither (2). Coexisting neural autoantibodies were identified in 28% (low titer). Electromyography revealed myopathy with fibrillation potentials; 78% of biopsies had active necrotizing myopathy with minimal inflammation, and 17% had inflammatory myopathy. Immunotherapy responsiveness was typically slow and incomplete, and relapses were frequent on withdrawal. Histologically confirmed cancers (17%) were primarily breast and hematologic, with some others. Conclusions: Autoimmune necrotizing SRP myopathy, both idiopathic and paraneoplastic, is underdiagnosed in neurological practice. Serological screening aids early diagnosis. Cancer surveillance and appropriate immunosuppressant therapy may improve outcome. Muscle Nerve 53: 925–932, 2016 PMID:26561982

  15. Risk factors for incidental durotomy during lumbar surgery: a retrospective study by multivariate analysis.

    Science.gov (United States)

    Chen, Zhixiang; Shao, Peng; Sun, Qizhao; Zhao, Dong

    2015-03-01

    The purpose of the present study was to use a prospectively collected data to evaluate the rate of incidental durotomy (ID) during lumbar surgery and determine the associated risk factors by using univariate and multivariate analysis. We retrospectively reviewed 2184 patients who underwent lumbar surgery from January 1, 2009 to December 31, 2011 at a single hospital. Patients with ID (n=97) were compared with the patients without ID (n=2019). The influences of several potential risk factors that might affect the occurrence of ID were assessed using univariate and multivariate analyses. The overall incidence of ID was 4.62%. Univariate analysis demonstrated that older age, diabetes, lumbar central stenosis, posterior approach, revision surgery, prior lumber surgery and minimal invasive surgery are risk factors for ID during lumbar surgery. However, multivariate analysis identified older age, prior lumber surgery, revision surgery, and minimally invasive surgery as independent risk factors. Older age, prior lumber surgery, revision surgery, and minimal invasive surgery were independent risk factors for ID during lumbar surgery. These findings may guide clinicians making future surgical decisions regarding ID and aid in the patient counseling process to alleviate risks and complications. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Right Hemispheric Leukoencephalopathy as an Incidental Finding Following a Lightning Strike.

    Science.gov (United States)

    Kruja, Jera; Kuqo, Altin; Grabova, Serla; Rroji, Arben; Vyshka, Gentian

    2016-12-15

    Lightning injuries may produce a variety of medical conditions, and specific neurological complications have been identified, with the character of immediate aftershock effects or even long-term consequences. The authors describe the incidental finding following a routine unenhanced brain MRI performed to a young female patient, suffering from a headache. Diffuse white matter changes with the character of a leukoencephalopathy were seen, which strictly interested only the right cerebral hemisphere. The parents referred that she suffered from an indoor lightning strike at age of seven months, although she survived with almost no external burns or signs, and recovered uneventfully at that time. A discussion over the effects of electrocution and lightning strike on the human body in general, and over the nervous system, is made. Particular attention must be shown when making the differential diagnosis of leukoencephalopathies with a strictly one-hemisphere extension since several other conditions might resemble each other under the radiological aspect, here including brain viral infections, genetic disorders, and so on. The particularity of the long-term aftershock effects of the lightning strike on the central nervous system raise again the necessity of collecting data and duly reporting every electrical accident, lightning events included.

  17. Detection of incidental vertebral fractures in breast imaging: the potential role of MR localisers

    Energy Technology Data Exchange (ETDEWEB)

    Bazzocchi, Alberto [Orthopaedic Institute, Diagnostic and Interventional Radiology, Bologna (Italy); Bologna Univ. (Italy). Imaging Div.; Spinnato, Paolo; Garzillo, Giorgio; Ciccarese, Federica [Bologna Univ. (Italy). Imaging Div.; Albisinni, Ugo; Mignani, Stefano; Battista, Giuseppe [Orthopaedic Institute, Diagnostic and Interventional Radiology, Bologna (Italy); Rossi, Cristina [Parma Univ. (Italy). Imaging Div.

    2012-12-15

    Incidental diagnosis of vertebral fractures (VFs) may represent a key point in the assessment of bone health status. Our purpose was to retrospectively evaluate localisation sequences (MR-loc) of breast MRI as a potential tool to detect osteoporotic VFs. MR-loc sagittal images of 856 breast MRIs were reviewed by three expert musculoskeletal radiologists with a semiquantitative approach to detecting VFs. Anamnesis and data of patients were investigated. Official breast MRI and previous imaging reports were checked to understand if VFs or other relevant bone findings were known in patients' clinical history. A total of 780/856 female patients (91.1 %) undergoing MRI for oncological reasons and 76/856 (8.9 %) with non-oncological aims were recruited into the study (54.7 {+-} 12.2 years old, 21-89 years); 57/856 MR-loc images (6.7 %) were considered inadequate for diagnostic purposes and were excluded from the analysis. MR-loc detected VFs in 71/799 patients (8.9 %). VFs were neither reported nor previously known in the clinical history of 63/71 patients (88.7 %; P < 0.001). No mention of VFs was found in any breast MR reports. In four patients MR-loc identified vertebral metastases. A systematic evaluation of MR-loc may offer additional clinical information to prevent unrecognised VFs. MR-loc may screen for VFs in other imaging settings. (orig.)

  18. Managing Carious Lesions

    DEFF Research Database (Denmark)

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

    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...... managementshould be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereascarious lesion managementcontrols the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions' clinical...... manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm...

  19. Differentiation of thyroid lesion detected by FDG PET/CT using SUV ratio

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bom Sahn; Kang, Won Jun; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    We investigated the usefulness of SUV ratio to discriminate focal thyroid lesion incidentally detected on 18F-FDG PET/CT (FDG PET) in patients with malignant disease. A total of 2167 subjects with malignant tumor underwent PET/CT for staging. Forty-five of 2167 subjects (2.1%) showed hypermetabolic thyroid lesions on FDG PET. Of 45, 21 lesions were confirmed by pathology (n = 16) or follow up exam (n=5). Seventeen patients had focal FDG uptakes, while 4 patients had diffuse thyroid uptakes. Standardized uptake value (SUV) was measured by drawing region of interest (ROI) on bilateral thyroid lobes and liver. From 21 patients, 12 thyroid lesions were confirmed as malignant lesions and 9 lesions as benign lesions. All of bilateral thyroid FDG uptakes were determined as benign disease such as thyroiditis. From seventeen focal thyroid incidentaloma, FDG PET had 100 % (12/12) of sensitivity and 60 % (3/5) of specificity, retrospectively. Malignant nodules had a significantly higher lesion to liver ratio than those of benign nodules (2.10.9 vs. 1.20.6, p=0.029). With ROC curve, the best cut-off value of lesion to liver was 1.0 with sensitivity of 100% and specificity of 60 % (area under the curve=0.783). The SUV ratio of lesion to contralateral lobe do not have statistical significance to determine malignancy (3.72.1 vs. 2.61.7, p=0.079). This study showed that focal thyroidal FDG uptake detected by FDG PET could be differentiated with best performance by SUV ratio of lesion to liver.

  20. The Effect of Incidental Focus on Form on EFL Learners’ Grammatical Accuracy

    Directory of Open Access Journals (Sweden)

    Somaieh Abdollahzadeh

    2015-10-01

    Full Text Available Focus on form instruction is a kind of instruction that draws students, attention to linguistic elements as they arise incidentally in meaning based instruction.  There are different types of focus on form instruction. The present study was designed to investigate the effect of incidental focus on form on grammatical accuracy among Iranian L2 learners. Eighty learners from Sahand language Institute in Miandoab after taking grammatical judgment test which was administered to homogenize them, were placed in two control and experimental groups. Learners in experimental group received feedback through recasting during retelling the reading passage according to principles of Jigsaw task. But learners in control group did not receive any feedback. After treatment, which lasted for eight sessions, post-test was given to both control and experimental groups to observe the difference resulted from the treatment. To be sure about the significance of the difference between post-test means of both groups, a t-test was used. The results at the end supported the hypotheses of the study and positive effect of incidental focus on form on grammatical accuracy of L2 learners. After that, for the purpose of analyzing the effect of incidental focus on form on accuracy of pronouns, tenses, articles and propositions separately, other tests (pronoun, article, tense, proposition tests was given to the learners in both control and experimental groups. The data collected was computed through t-test which revealed that the effect of incidental focus on form on grammatical accuracy of articles is greater than pronouns and tenses but incidental focus on form didn’t have any effect on accuracy of propositions. Pedagogical implications have been discussed. Keywords:  Focus on form, Incidental focus on form, recast, task, Accuracy

  1. Lesiones deportivas Sports injuries

    OpenAIRE

    2007-01-01

    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 participa...

  2. Oncogenic and incidental HPV types associated with histologically ...

    African Journals Online (AJOL)

    and the diagnosis of cervical intraepithelial neoplasia (CIN) requires ... decline in CD4 cell count and rising HIV viral load are both risk factors for ... We investigated low-risk (lrHPV) and high-risk (hrHPV) HPV types in a cohort of women with cervical intraepithelial neoplasia ... high-grade squamous intraepithelial lesions.

  3. Asymptomatic pontine and extra-pontine lesions in a patient with end-stage renal disease

    Directory of Open Access Journals (Sweden)

    Raj Kanwar Yadav

    2016-01-01

    Full Text Available Osmotic demyelination syndrome leading to central pontine/extra-pontine myelinolysis (CPM/EPM occurs mainly in patients with history of alcohol abuse, malnourishment, following liver transplantation and less commonly, in association with other systemic diseases. Asymptomatic CPM/EPM is rare. Patients with end-stage renal disease (ESRD who develop CPM/EPM are usually symptomatic with florid neurologic manifestations. Herein, we present a patient with ESRD on maintenance hemodialysis who was incidentally detected to have pontine and extra-pontine lesions suggestive of myelinolysis without any neurologic signs or symptoms.

  4. Traumatic plexus lesion.

    NARCIS (Netherlands)

    Dongen, R.T.M. van; Cohen, S.P.; Kleef, M. van; Mekhail, N.; Huygen, F.

    2011-01-01

    Pain, motor, and sensory deficits characterize patients with a traumatic lesion of the brachial plexus. Frequently, more severe injuries co-exist that require immediate surgical attention. Early rehabilitation and physical therapy are the cornerstones of treatment. Pharmacological management can be

  5. Immunopathology of skin lesions

    Directory of Open Access Journals (Sweden)

    Khan Nazoora

    2001-09-01

    Full Text Available A study was conducted on 130 patients suffering from skin lesions which included psoriasis, lichen planus, DLE, pemphigus, vitiligo and alopecia areata. Forty age-and-sex-matched healthy individuals served as control. Serum IgG, IgM, and circulating immune complexes (CIC were estimated. Significant increase in serum IgG (1937.2 ± 1030.43 mg% and IgM (232.12 ± 136.98 mg% was observed in all the skin lesions when compared with controls except in lichen planus where they were significantly lowered, values being 580.61± 77.35 mg% and 66.88 ± 6.59mg% respectively. CIC levels were significantly raised (P<0.00 1 in various skin lesions (40.49±23.29 when compared with controls (17.68± 3.21, but no significance was observed in lichen planus( 17.72 ± 4.28. Serum IgG, IgM and CIC were statistically significantly altered depending on the extent of the lesion and lowered significantly to almost normal values following treatment, thereby confirming the role of immunity in the pathogenesis of these skin disorders.

  6. Genital lesions following bestiality

    Directory of Open Access Journals (Sweden)

    Mittal A

    2000-01-01

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

  7. 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...

  8. Endocarditis-associated Brain Lesions in Slaughter Pigs

    DEFF Research Database (Denmark)

    Karstrup, C.C.; Jensen, H.E.; Aalbæk, B.

    2011-01-01

    Left-sided valvular endocarditis (LSVE) is a common finding in slaughter pigs. The lesion is often associated with renal thromboembolism, but information on embolization to other organs is sparse. This study focuses on the presence and type of endocarditis-associated brain lesions (EABLs......-situ hybridization examinations. These examinations identified 11 cases of Streptococcus suis, six cases of Erysipelothrix rhusiopathiae, one Streptococcus spp. and two cases that remained aetiologically undetermined. One of the S. suis cases had a dual infection with S. suis in the aortic valve lesions...... and Streptococcus dysgalactiae subsp. equisimilis in the atrioventricular valve lesions. Renal infarcts were present in eight cases. Focal encephalitis was found in 12 cases, with the number of lesions ranging from one to 11. Most pigs had less than four microscopical lesions. Acute lesions were characterized...

  9. Evaluating lesion segmentation on breast sonography as related to lesion type.

    Science.gov (United States)

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

    2013-09-01

    Breast sonography currently provides a complementary diagnosis when other modalities are not conclusive. However, lesion segmentation on sonography is still a challenging problem due to the presence of artifacts. To solve these problems, Markov random fields and maximum a posteriori-based methods are used to estimate a distortion field while identifying regions of similar intensity inhomogeneity. In this study, different initialization approaches were exhaustively evaluated using a database of 212 B-mode breast sonograms and considering the lesion types. Finally, conclusions about the relationship between the segmentation results and lesions types are described.

  10. Morel-Lavallee lesion

    Institute of Scientific and Technical Information of China (English)

    Li Hui; Zhang Fangjie; Lei Guanghua

    2014-01-01

    Objective To review current knowledge of the Morel-Lavallee lesion (MLL) to help clinicians become familiar with this entity.Familiarization may decrease missed diagnoses and misdiagnoses.It could also help steer the clinician to the proper treatment choice.Data sources A search was performed via PubMed and EMBASE from 1966 to July 2013 using the following keywords:Morel-Lavallee lesion,closed degloving injury,concealed degloving injury,Morel-Lavallee effusion,Morel-Lavallee hematoma,posttraumatic pseudocyst,posttraumatic soft tissue cyst.Study selection Chinese and English language literatures relevant to the subject were collected.Their references were also reviewed.Results Morel-Lavallee lesion is a relatively rare condition involving a closed degloving injury.It is characterized by a filled cystic cavity created by separation of the subcutaneous tissue from the underlying fascia.Apart from the classic location over the region of the greater trochanter,MLLs have been described in other parts of the body.The natural history of MLL has not yet been established.The lesion may decrease in volume,remain stable,enlarge progressively or show a recurrent pattern.Diagnosis of MLL was often missed or delayed.Ultrasonography,computed tomography,and magnetic resonance imaging have great value in the diagnosis of MLL.Treatment of MLL has included compression,local aspiration,open debridement,and sclerodesis.No standard treatment has been established.Conclusions A diagnosis of MLL should be suspected when a soft,fluctuant area of skin or chronic recurrent fluid collection is found in a region exposed to a previous shear injury.Clinicians and radiologists should be aware of both the acute and chronic appearances to make the correct diagnosis.Treatment decisions should base on association with fractures,the condition of the lesion,symptom and desire of the patient.

  11. Prevalence of incidental maxillary sinus pathologies in dental patients on cone-beam computed tomographic images

    Directory of Open Access Journals (Sweden)

    Mamta Raghav

    2014-01-01

    Full Text Available Objectives: The aim of the present study was to infer and to record the prevalence of incidental maxillary sinus pathologies in patients presenting with dental problems using the cone-beam computed tomography (CBCT scans performed for maxillofacial diagnostic purposes. Materials and Methods: This retrospective study has evaluated 201 patients (402 maxillary sinuses consecutive CBCT for various incidental maxillary sinus pathologies by two observers. Pathologic findings were categorized as mucosal thickening (MT, opacification (OPA, polypoidal-mucosal thickening (PT, others (antrolith and discontinuity of the sinus fl oor and no pathologic findings. Correlations for pathologic findings and the factors of age and gender were calculated. Results: The prevalence for total incidental findings is 59.7%. The present study showed MT (35.1% as most prevalent finding followed by OPA in (16.6%, PT in 7.2% and others in 0.7%. There was no statistically significant difference between gender and between the age groups. There was no statistically significant difference between different indications groups for CBCT scans. Conclusions: The incidental maxillary sinus abnormalities are highly prevalent in the asymptomatic dental patients; hence oral radiologists should be aware of these incidental findings and comprehensively evaluate the entire captured CBCT volume, which can help in early diagnosis, treatment and follow-up of the patient.

  12. The Role of Repeated Exposure to Multimodal Input in Incidental Acquisition of Foreign Language Vocabulary.

    Science.gov (United States)

    Bisson, Marie-Josée; van Heuven, Walter J B; Conklin, Kathy; Tunney, Richard J

    2014-12-01

    Prior research has reported incidental vocabulary acquisition with complete beginners in a foreign language (FL), within 8 exposures to auditory and written FL word forms presented with a picture depicting their meaning. However, important questions remain about whether acquisition occurs with fewer exposures to FL words in a multimodal situation and whether there is a repeated exposure effect. Here we report a study where the number of exposures to FL words in an incidental learning phase varied between 2, 4, 6, and 8 exposures. Following the incidental learning phase, participants completed an explicit learning task where they learned to recognize written translation equivalents of auditory FL word forms, half of which had occurred in the incidental learning phase. The results showed that participants performed better on the words they had previously been exposed to, and that this incidental learning effect occurred from as little as 2 exposures to the multimodal stimuli. In addition, repeated exposure to the stimuli was found to have a larger impact on learning during the first few exposures and decrease thereafter, suggesting that the effects of repeated exposure on vocabulary acquisition are not necessarily constant.

  13. Clinical magnetic resonance imaging. Frequent incidental cerebral findings; Klinische Magnetresonanztomographie. Haeufige zerebrale Zufallsbefunde

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, A.; Ditter, P.; Schild, H.H.; Hattingen, E. [Universitaetsklinikum Bonn, Funktionseinheit Neuroradiologie der Klinik fuer Radiologie, Bonn (Germany); Weidauer, S. [St.-Katharinen-Krankenhaus, Neurologische Klinik, Frankfurt/M (Germany)

    2017-04-15

    The increasing use of magnetic resonance imaging (MRI) in clinical diagnostics means that patients and physicians are confronted more often with incidental findings. In the literature there are fluctuating data on the incidence of such findings and guidelines concerning the further procedure exist in only very few cases, such as incidental aneurysms and pituitary adenomas. The diagnostic and therapeutic implications which can be derived from incidental findings depend on multiple factors, such as anatomical location, patient age, comorbidity and patient wishes. For this reason it often makes sense to refer patients with incidental findings to an interdisciplinary neurological center at an early stage. In this review frequent incidental cerebral findings, epidemiological data, imaging criteria and, where possible, recommendations for the further procedure are shown. (orig.) [German] Durch den gehaeuften Einsatz der MRT in der zerebralen Diagnostik werden Arzt und Patienten in zunehmendem Masse mit Zufallsbefunden, auch Nebenbefunde genannt, konfrontiert. In der Literatur existieren sehr schwankende Angaben zur Haeufigkeit solcher Zufallsbefunde. Nur fuer einzelne dieser Befunde, wie z. B. das inzidentelle Aneurysma oder das Hypophysenadenom, existieren Leitlinien fuer das weitere Prozedere. Die aus einem Zufallsbefund abzuleitenden diagnostischen und therapeutischen Konsequenzen sind von vielen Faktoren, wie z. B. der anatomischen Lage, dem Patientenalter, den Komorbiditaeten und dem Patientenwunsch abhaengig. Daher ist es oft sinnvoll, den Patienten mit einem Zufallsbefund fruehzeitig in einem interdisziplinaeren Neurozentrum vorzustellen. In der vorliegenden Arbeit werden haeufige zerebrale Zufallsbefunde mit epidemiologischen Daten, bildgebenden Kriterien und - wenn moeglich - Empfehlungen bzgl. des weiteren Vorgehens gezeigt. (orig.)

  14. Clinically relevant incidental cardiovascular findings in CT examinations; Klinisch relevante kardiovaskulaere Zufallsbefunde bei CT-Untersuchungen

    Energy Technology Data Exchange (ETDEWEB)

    Voigt, P.; Fahnert, J.; Kahn, T.; Surov, A. [Universitaetsklinikum Leipzig, Klinik fuer Diagnostische und Interventionelle Radiologie, Leipzig (Germany); Schramm, D.; Bach, A.G. [Universitaetsklinikum Halle (Saale), Klinik fuer Radiologie, Halle (Germany)

    2017-04-15

    Incidental cardiovascular findings are a frequent phenomenon in computed tomography (CT) examinations. As the result of a dedicated PubMed search this article gives a systemic overview of the current literature on the most important incidental cardiovascular findings, their prevalence and clinical relevance. The majority of incidental cardiovascular findings are of only low clinical relevance; however, highly relevant incidental findings, such as aortic aneurysms, thromboses and thromboembolic events can also occasionally be found, especially in oncology patients. The scans from every CT examination should also be investigated for incidental findings as they can be of decisive importance for the further clinical management of patients, depending on their clinical relevance. (orig.) [German] Inzidentelle kardiovaskulaere Befunde sind ein haeufiges Phaenomen bei CT-Untersuchungen. Mit dieser Arbeit soll nach gezielter PubMed-Recherche ein systematischer Literaturueberblick ueber die wichtigsten kardiovaskulaeren Zufallsbefunde sowie deren Haeufigkeit und klinische Relevanz gegeben werden. Die Mehrzahl der inzidentellen kardiovaskulaeren Befunde sind klinisch nur von untergeordneter Bedeutung, allerdings werden immer wieder auch hochgradig relevante Zufallsbefunde wie beispielsweise Aortenaneurysmata oder - gerade bei onkologischen Patienten - Thrombosen und thrombembolische Ereignisse detektiert. Jede CT-Untersuchung sollte gezielt nach inzidentellen Befunden durchsucht werden, da diese je nach klinischer Relevanz von entscheidender Bedeutung fuer das weitere klinische Management des Patienten sein koennen. (orig.)

  15. Incidental durotomy during spinal surgery: a multivariate analysis for risk factors.

    Science.gov (United States)

    Du, Jerry Y; Aichmair, Alexander; Kueper, Janina; Lam, Cyrena; Nguyen, Joseph T; Cammisa, Frank P; Lebl, Darren R

    2014-10-15

    Multivariate analysis. The purpose of this study was to investigate risk factors for incidental durotomy (ID) in modern spine surgery techniques. ID, a relatively common complication of spine surgery, has been associated with postoperative complications such as durocutaneous fistulas, pseudomeningoceles, and arachnoiditis. Revision surgery may be necessary if the dural tear is not recognized and repaired during the initial procedure. ID was prospectively documented in patients who underwent spine surgery at a single institution during a 2-year period (n=4822). Patients with ID (n=182) from lumbar or thoracolumbar cases were matched 1:1 to a control cohort without ID. Demographic, diagnostic, and surgical procedure data were retrospectively collected and analyzed. Multivariate analysis identified revision spine surgery (adjusted odds ratio [aOR]: 4.78, 95% confidence interval [CI]: 2.84-8.06, P<0.01), laminectomy (aOR: 3.82, 95% CI: 2.02-7.22, P<0.01), and older age (aOR: 1.03, 95% CI: 1.01-1.04, P<0.01) as independent risk factors for ID. Fusion (aOR: 0.59, 95% CI: 0.35-0.99, P=0.04), foraminectomy, (aOR: 0.42, 95% CI: 0.25-0.69, P<0.01), and lateral approach (aOR: 0.29, 95% CI: 0.14-0.61, P<0.01) were independent protective factors. Prior spine surgery, laminectomy, and older age were significant independent risk factors for ID. The recently developed lateral approach to interbody fusion was identified as a significant protective factor for ID, along with fusion and foraminectomy. These findings may help guide future surgical decisions regarding ID and aid in the patient informed-consent process. 3.

  16. Keratomycosis after incidental spillage of vegetative material into the eye: Report of two cases

    Directory of Open Access Journals (Sweden)

    Ali Tabatabaee

    2013-01-01

    Full Text Available Fungal corneal ulcers mostly occur after incidental corneal trauma by plant leaves in farm lands or the use of topical corticosteroids or antibiotics. The infection is more prevalent among farmers and harvesters and in some parts of the world is considered as an occupational disease; however, there have been a few reports on the occurrence of such ulcers in healthy individuals after incidental spillage of vegetative material into the eye. The importance of these ulcers is their long-term and refractory course, which makes the visual prognosis unfavorable in most patients, even after appropriate antifungal therapy or ocular interventions. Herein, we present two rare cases of fungal ulcers caused by incidental spillage of vegetative material into the eye while eating nuts and corn. We also discuss the diagnostic and therapeutic approaches, as well as visual outcome reviewing the relevant literature.

  17. 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.

  18. Whole-body MRI in neurofibromatosis: incidental findings and prevalence of scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Jaremko, Jacob L.; MacMahon, Peter J.; Torriani, Martin; Bredella, Miriam A. [Massachusetts General Hospital and Harvard Medical School, Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Merker, Vanessa L.; Plotkin, Scott R. [Massachusetts General Hospital, Department of Neurology and Cancer Center, Boston, MA (United States); Mautner, Victor F. [University Medical Center Hamburg-Eppendorf, Department of Neurology, Hamburg (Germany)

    2012-08-15

    To demonstrate incidental findings and scoliosis on whole-body MRI (WBMRI) in patients with neurofibromatosis type 1 and 2 (NF1 and NF2, respectively), and schwannomatosis. Institutional review board approval and written informed consent were obtained for this prospective HIPAA-compliant study. A total of 247 subjects (141 with NF1, 55 with NF2, 51 with schwannomatosis; 132 women (53.5%); mean age, 41 years, range, 18-97 years) underwent WBMRI using coronal STIR (TR/TE: 4190/111 ms, TI: 150 ms) and T1-weighted images (TR/TE: 454/10 ms), 10-mm slice thickness, imaging time {proportional_to}40 min. Images were reviewed for the presence of incidental findings, outside of nerve sheath tumors. The presence of scoliosis was recorded and curve morphology was assessed and quantified. Incidental findings other than scoliosis were recorded in 104/247 (42%) patients, most often affecting the musculoskeletal system (65/247 patients, 26%). We found 16/247 (6.5%) significant incidental findings likely to affect clinical management, including avascular necrosis of bone in eight patients (five with NF2), eight insufficiency fractures, and four non-neurogenic neoplasms (Hodgkin's lymphoma, liposarcoma, dermoid cyst, large uterine myoma requiring excision). Scoliosis was seen in 50/247 patients (20%), including 8/55 with NF2 (15%) and 11/51 with schwannomatosis (22%). Incidental findings in the neurofibromatoses frequently involve the skeleton. Given the relatively high incidence of unsuspected osteonecrosis and stress fractures, close attention to the skeleton on WBMRI is advised. In addition, knowledge of common incidental findings can help clinicians prepare patients who undergo WBMRI for potential unexpected findings. (orig.)

  19. Whole-body MRI in neurofibromatosis: incidental findings and prevalence of scoliosis.

    Science.gov (United States)

    Jaremko, Jacob L; MacMahon, Peter J; Torriani, Martin; Merker, Vanessa L; Mautner, Victor F; Plotkin, Scott R; Bredella, Miriam A

    2012-08-01

    To demonstrate incidental findings and scoliosis on whole-body MRI (WBMRI) in patients with neurofibromatosis type 1 and 2 (NF1 & NF2, respectively), and schwannomatosis. Institutional review board approval and written informed consent were obtained for this prospective HIPAA-compliant study. A total of 247 subjects (141 with NF1, 55 with NF2, 51 with schwannomatosis; 132 women (53.5%); mean age, 41 years, range, 18-97 years) underwent WBMRI using coronal STIR (TR/TE: 4190/111 ms, TI: 150 ms) and T1-weighted images (TR/TE: 454/10 ms), 10-mm slice thickness, imaging time ~40 min. Images were reviewed for the presence of incidental findings, outside of nerve sheath tumors. The presence of scoliosis was recorded and curve morphology was assessed and quantified. Incidental findings other than scoliosis were recorded in 104/247 (42%) patients, most often affecting the musculoskeletal system (65/247 patients, 26%). We found 16/247 (6.5%) significant incidental findings likely to affect clinical management, including avascular necrosis of bone in eight patients (five with NF2), eight insufficiency fractures, and four non-neurogenic neoplasms (Hodgkin's lymphoma, liposarcoma, dermoid cyst, large uterine myoma requiring excision). Scoliosis was seen in 50/247 patients (20%), including 8/55 with NF2 (15%) and 11/51 with schwannomatosis (22%). Incidental findings in the neurofibromatoses frequently involve the skeleton. Given the relatively high incidence of unsuspected osteonecrosis and stress fractures, close attention to the skeleton on WBMRI is advised. In addition, knowledge of common incidental findings can help clinicians prepare patients who undergo WBMRI for potential unexpected findings.

  20. Meniscal Ramp Lesions

    OpenAIRE

    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, ...

  1. 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

  2. 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.

  3. A Reader Response to File and Adams's "The Reality, Robustness, and Possible Superiority of Incidental Vocabulary Acquisition"

    Science.gov (United States)

    Mason, Beniko; Krashen, Stephen

    2010-01-01

    File and Adams (2010) conclude that their data confirm the superiority of form-focused vocabulary instruction over incidental acquisition. The authors of this response argue that File and Adams's data actually confirm the reality, robustness, and possible superiority of incidental acquisition. Their subjects heard two passages read to them that…

  4. The Influence of Two Cognitive-Linguistic Variables on Incidental Word Learning in 5-Year-Olds

    Science.gov (United States)

    Abel, Alyson D.; Schuele, C. Melanie

    2014-01-01

    The relation between incidental word learning and two cognitive-linguistic variables--phonological memory and phonological awareness--is not fully understood. Thirty-five typically developing, 5-year-old, preschool children participated in a study examining the association between phonological memory, phonological awareness, and incidental word…

  5. Effects of a Brief Staff Training Procedure on Instructors' Use of Incidental Teaching and Students' Frequency of Initiation toward Instructors

    Science.gov (United States)

    Ryan, Carolyn S.; Hemmes, Nancy S.; Sturmey, Peter; Jacobs, Joseph D.; Grommet, Erich K.

    2008-01-01

    Incidental teaching is a technique that is used to increase the spontaneous use of language. This study evaluated effects of a brief staff training procedures on instructors' incidental teaching responses and on student initiations. In three experiments, instructors of children with autism participated in individual or group training sessions…

  6. 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

    2015-01-01

    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. PMID:25207817

  7. Seizure attack and Morgagni diaphragmatic hernia: incidental diagnosis or direct correlation?

    Science.gov (United States)

    Zisa, Monica; Pulvirenti, Elia; Toro, Adriana; Mannino, Maurizio; Reale, Giulio; Di Carlo, Isidoro

    2011-03-01

    Asymptomatic Morgagni hernia can be discovered in adults as an incidental finding or because of acute gastrointestinal symptoms. We report a case of a 76-year-old man with an incidental diagnosis of seizure attack. Obesity and the increased abdominal pressure caused by abdominal muscles contraction during seizure could have contributed to the clinical presentation. The omentum, small bowel, and transverse colon were found in the right side of the chest using an open transabdominal approach. The hernia sac was excised and the diaphragmatic defect closed by direct suturing. The postoperative period was uneventful and the shortness of breath attributed to obesity disappeared.

  8. Asymptomatic Incidental Ductal Carcinoma in situ in a Male Breast Presenting with Contralateral Gynecomastia

    Directory of Open Access Journals (Sweden)

    Laura M Isley

    2012-01-01

    Full Text Available Ductal carcinoma in situ (DCIS in males is rare and usually presents with symptoms on the affected side, such as, palpable mass or bloody nipple discharge. Even as DCIS has been reported in conjunction with gynecomastia in the same breast, we report an unusual case of a 62-year-old Caucasian male, with no family history of breast cancer, who presented with symptomatic side gynecomastia, and was incidentally found to have DCIS in a completely asymptomatic left breast. To the best of our knowledge, this case is the first report in literature of asymptomatic, incidentally discovered DCIS in a male patient.

  9. Histochemical identification of malignant and premalignant lesions

    Science.gov (United States)

    Liebow, Charles; Maloney, M. J.

    1991-06-01

    Malignant and transforming cells can be identified by biochemical parameters which can be used to localize lesions in situ for laser surgery. These cells express unique proteins, proteins in unusual quantities, or other biochemical alterations which can be utilized to image lesions of such cells. Several methods have been identified, both in vitro and in vivo, to identify such lesions. Several antibodies were examined for their properties of tissue identification, including CEA, F36/22, and AE1/AE3. F36/22, an antibody developed by M. T. Chu against human breast cancer cells, associated with two lines of oral cancer (KB and HCPC), and against two naturally occurring human oral squamous cell cancers. CEA, an antibody developed against human colon cancer, also reacted against both cell lines and both pathological samples. AE1/AE3, developed against normal fibrous components, also reacted against the samples, but in a much less regular manner. F36/22 associated with the histologically identifiably most dedifferentiated cells at the leading edge of the invading cancer. CEA, on the other hand, associated with more quiescent, older, established cancer cells. This demonstrates that antibodies developed against cancers of different organs can be used to identify a wide variety of cancers, and may have prognostic value. F36/22 coupled to fluorescein was used to identify oral cancer cells. Other properties of cancers and developing cancers can also be exploited to identify cancers, including their over-expression of tyrosine kinase and tyrosine kinase stimulating hormones such as Epidermal Growth Factor (EGF). A model of premalignant lesion produced in the hamster buccal cheek pouch with 6 week application of DMBA over-expresses constitutive tyrosine kinase which can be demonstrated biochemically. This initiated lesion can be promoted to frank cancer by growth factors released in response to laser surgery. Preliminary results suggest that these lesions can be identified by

  10. 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...

  11. [Effect of chlorpromazine and amphetamine on incidental memory and its relation to the introvert-extravert structure of personality].

    Science.gov (United States)

    Zaimov, K; Kokoshkarova, A

    1978-10-01

    A total of fifty-four test subjects divided into one control group and two experimental groups were used to study the effects of chlorpromazine and amphetamine upon the incidental memory, its accuracy, and possible dependence on the introversive or extroversive personality structure, respectively. It has been found that chlorpromazine tends to lessen the incidental memory in extent and increase the number of allomnesias or instances of inaccurate remembrance, whereas amphetamine has the effects of increasing the extent of the incidental memory and reducing the number of allomnesias. A comparison of the extent of the incidental memory with the structure of personality in respect of introversion or extroversion in the control group also showed significant differences, the incidental memory being of smaller extent in the case of introversion and greater extent in the case of extroversion.

  12. Finding the imposter: brain connectivity of lesions causing delusional misidentifications.

    Science.gov (United States)

    Darby, R Ryan; Laganiere, Simon; Pascual-Leone, Alvaro; Prasad, Sashank; Fox, Michael D

    2017-02-01

    SEE MCKAY AND FURL DOI101093/AWW323 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: Focal brain injury can sometimes lead to bizarre symptoms, such as the delusion that a family member has been replaced by an imposter (Capgras syndrome). How a single brain lesion could cause such a complex disorder is unclear, leading many to speculate that concurrent delirium, psychiatric disease, dementia, or a second lesion is required. Here we instead propose that Capgras and other delusional misidentification syndromes arise from single lesions at unique locations within the human brain connectome. This hypothesis is motivated by evidence that symptoms emerge from sites functionally connected to a lesion location, not just the lesion location itself. First, 17 cases of lesion-induced delusional misidentifications were identified and lesion locations were mapped to a common brain atlas. Second, lesion network mapping was used to identify brain regions functionally connected to the lesion locations. Third, regions involved in familiarity perception and belief evaluation, two processes thought to be abnormal in delusional misidentifications, were identified using meta-analyses of previous functional magnetic resonance imaging studies. We found that all 17 lesion locations were functionally connected to the left retrosplenial cortex, the region most activated in functional magnetic resonance imaging studies of familiarity. Similarly, 16 of 17 lesion locations were functionally connected to the right frontal cortex, the region most activated in functional magnetic resonance imaging studies of expectation violation, a component of belief evaluation. This connectivity pattern was highly specific for delusional misidentifications compared to four other lesion-induced neurological syndromes (P Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Anatomical analysis of incidental left atrial diverticula in patients with suspected coronary artery disease using 64-channel multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Shin, S.Y. [Department of Radiology, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Kwon, S.H., E-mail: Kwon98@khu.ac.kr [Department of Radiology, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Oh, J.H. [Department of Radiology, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    2011-10-15

    Aim: To describe and evaluate anatomical characterizations of incidental left atrial (LA) diverticula in patients with suspected coronary artery disease using 64-channel multidetector computed tomography (MDCT). Materials and methods: From October 2008 to June 2009, 2059 patients with suspected coronary artery disease underwent electrocardiogram-gated 64-channel MDCT. Five hundred and thirty-two LA diverticula were identified in 377 patients (18.3%, male to female ratio: 216:161, mean age 59 {+-} 10.89 years, range from 20 to 91 years). Two radiologists retrospectively analysed the number (single or multiple), size (diameter and length), shape (cystiform or tubiform), surface (smooth or irregular), and location (right or mid or left/upper or lower/lateral or posterior). If the length/diameter was <1.5, the diverticular shape was considered to be cystiform. Results: Among 532 LA diverticula, single (270/532, 51.1%), cystiform (411/532, 77.3%), and smooth (332/532, 62.4%) diverticula were found. The right upper region (255/532, 47.9%) was the most common location, followed by the left lateral area (172/532, 32.3%). The average diameter was 4.7 {+-} 2 mm (range from 1-19 mm), and the average length was 4.7 {+-} 2.1 mm (range 1-13 mm). The average ratio of length to diameter was 1.15 (range 0.25-1.45). The average number of diverticula was 2 {+-} 1.06 (range 1-5). Conclusion: Incidental LA diverticulum is not an uncommon finding in patients with suspected coronary artery disease. MDCT can provide anatomical details of LA diverticula. However, further studies are needed to determine their clinical significance.

  14. Role of endoscopic ultrasonography in evaluation of metastatic lesions to the pancreas: a tertiary cancer center experience.

    Science.gov (United States)

    Atiq, Muslim; Bhutani, Manoop S; Ross, William A; Raju, Gottumukkala S; Gong, Yun; Tamm, Eric P; Javle, Milind; Wang, Xuemei; Lee, Jeffrey H

    2013-04-01

    Metastatic lesions to the pancreas pose diagnostic challenges with regards to their differentiation from primary pancreatic cancer. Data on the yield of endoscopic ultrasonography (EUS)-guided fine-needle aspiration in detection of these lesions are limited. This is a retrospective review of 23 patients referred to a tertiary referral center for further evaluation of suspected pancreatic metastases. Main outcome measures were diagnostic yield of endoscopic ultrasonography-guided fine-needle aspiration in evaluation of metastatic lesions to the pancreas. Of 644 patients, 23 (3.6%) undergoing EUS of the pancreas were diagnosed to have metastatic disease to the pancreas based on clinical, radiological, and cytological results. Mean (SD) age was 64.3 (11.7) years. Of the 23 patients, 18 (78.3%) were asymptomatic. Mean (SD) size of lesion on EUS was 39.1 (19.9) mm. A diagnosis of malignant lesion was made in 21 of 23 cases, with a diagnostic accuracy of 91.3%. Metastatic lesions to the pancreas present as incidental, solitary mass lesions on staging or surveillance imaging. Endoscopic ultrasonography-guided fine-needle aspiration is an important tool in the characterization and further differentiation of metastatic lesions to the pancreas from primary pancreatic cancer.

  15. 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.

  16. Automated detection using natural language processing of radiologists recommendations for additional imaging of incidental findings.

    Science.gov (United States)

    Dutta, Sayon; Long, William J; Brown, David F M; Reisner, Andrew T

    2013-08-01

    As use of radiology studies increases, there is a concurrent increase in incidental findings (eg, lung nodules) for which the radiologist issues recommendations for additional imaging for follow-up. Busy emergency physicians may be challenged to carefully communicate recommendations for additional imaging not relevant to the patient's primary evaluation. The emergence of electronic health records and natural language processing algorithms may help address this quality gap. We seek to describe recommendations for additional imaging from our institution and develop and validate an automated natural language processing algorithm to reliably identify recommendations for additional imaging. We developed a natural language processing algorithm to detect recommendations for additional imaging, using 3 iterative cycles of training and validation. The third cycle used 3,235 radiology reports (1,600 for algorithm training and 1,635 for validation) of discharged emergency department (ED) patients from which we determined the incidence of discharge-relevant recommendations for additional imaging and the frequency of appropriate discharge documentation. The test characteristics of the 3 natural language processing algorithm iterations were compared, using blinded chart review as the criterion standard. Discharge-relevant recommendations for additional imaging were found in 4.5% (95% confidence interval [CI] 3.5% to 5.5%) of ED radiology reports, but 51% (95% CI 43% to 59%) of discharge instructions failed to note those findings. The final natural language processing algorithm had 89% (95% CI 82% to 94%) sensitivity and 98% (95% CI 97% to 98%) specificity for detecting recommendations for additional imaging. For discharge-relevant recommendations for additional imaging, sensitivity improved to 97% (95% CI 89% to 100%). Recommendations for additional imaging are common, and failure to document relevant recommendations for additional imaging in ED discharge instructions occurs

  17. Lesiones deportivas Sports injuries

    Directory of Open Access Journals (Sweden)

    Isabel Cristina Gallego Ching

    2007-04-01

    Full Text Available 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, los países, el nivel competitivo, las edades y la metodología empleada en los estudios. Se ha definido la lesión deportiva como la que ocurre cuando los atletas están expuestos a la práctica del deporte y se produce alteración o daño de un tejido, afectando el funcionamiento de la estructura. Los deportes de contacto generan mayor riesgo de presentar lesiones; se destacan al respecto los siguientes: fútbol, rugby, baloncesto, balonmano, artes marciales y jockey. Las lesiones ocurren con mayor probabilidad en las competencias que en el entrenamiento. 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

  18. Alcoholism and the Armanni-Ebstein lesion.

    Science.gov (United States)

    Parai, Jacqueline L; Kodikara, Sarathchandra; Milroy, Christopher M; Pollanen, Michael S

    2012-03-01

    The Armanni-Ebstein lesion is a histological change in the kidney consisting of sub-nuclear vacuolation of the proximal tubules. It has been most associated with diabetic ketoacidosis. The vacuoles have been reported to contain glycogen. More recent studies show them to contain fat. Recent papers have associated the Armanni-Ebstein lesion with non-diabetic ketoacidosis. We present 11 cases of alcoholic ketoacidosis where the Armanni-Ebstein lesion was identified. None had a history of diabetes mellitus and none showed any changes of diabetic nephropathy. All 11 cases had raised acetone levels (3-67 mg/100 mL (mean 17.9 mg/100 mL and median value of 16 mg/100 mL). In addition a case of isopropanol poisoning was found to have the Armanni-Ebstein lesion. Isopropanol is converted to acetone but is not associated with acidosis. These results indicate that the Armanni-Ebstein lesion is not specific to diabetes mellitus.

  19. Klatskin-Like Lesions

    Directory of Open Access Journals (Sweden)

    M. P. Senthil Kumar

    2012-01-01

    Full Text Available Hilar cholangiocarcinoma, also known as Klatskin tumour, is the commonest type of cholangiocarcinoma. It poses unique problems in the diagnosis and management because of its anatomical location. Curative surgery in the form of major hepatic resection entails significant morbidity. About 5–15% of specimens resected for presumed Klatskin tumour prove not to be cholangiocarcinomas. There are a number of inflammatory, infective, vascular, and other pathologies, which have overlapping clinical and radiological features with a Klatskin tumour, leading to misinterpretation. This paper aims to summarise the features of such Klatskin-like lesions that have been reported in surgical literature.

  20. Klatskin-like lesions.

    Science.gov (United States)

    Senthil Kumar, M P; Marudanayagam, R

    2012-01-01

    Hilar cholangiocarcinoma, also known as Klatskin tumour, is the commonest type of cholangiocarcinoma. It poses unique problems in the diagnosis and management because of its anatomical location. Curative surgery in the form of major hepatic resection entails significant morbidity. About 5-15% of specimens resected for presumed Klatskin tumour prove not to be cholangiocarcinomas. There are a number of inflammatory, infective, vascular, and other pathologies, which have overlapping clinical and radiological features with a Klatskin tumour, leading to misinterpretation. This paper aims to summarise the features of such Klatskin-like lesions that have been reported in surgical literature.

  1. Lesiones en el deporte

    OpenAIRE

    2000-01-01

    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, fundamentalmen...

  2. Atrichia with Papular Lesions

    OpenAIRE

    Bansal, Manish; Manchanda, Kajal; Lamba, Sachin; Pandey, SS

    2011-01-01

    Atrichia with papular lesions (APL) is a rare autosomal recessive form of irreversible alopecia with onset at few months of age with papular keratin cysts over the body. It is associated with mutation in the Zinc finger domain of the human hairless gene on chromosome region 8p12. An eleven-year-old male presented with extensive alopecia starting at six months of age refractory to the treatment along with keratotic papules on the face and trunk. Biopsy from a papule showed mid-dermal keratin c...

  3. Lesiones en corredores amateurs

    OpenAIRE

    Natale, Vanesa

    2011-01-01

    Se realizó un estudio tomando como muestra a 100 corredores amateurs de la ciudad de Mar del Plata, en la cual el objetivo general fue determinar cuáles son las patologías más frecuentes en corredores. Correr no es solo un deporte en si mismo sino que tiene elementos de otras actividades deportivas, es decir, que las lesiones de los corredores también son comunes en otros tipos de deportes. El número de deportistas aumenta diariamente y al mismo tiempo aumentan el número de per...

  4. Arrested pneumatization of the sphenoid sinus mimicking intraosseous lesions of the skull base

    Energy Technology Data Exchange (ETDEWEB)

    Jalali, Elnaz; Tadinada, Aditya [Dept. of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington (United States)

    2015-03-15

    Arrested pneumatization of the sphenoid sinus is a developmental variant that is not always well recognized and is often confused with other pathologies associated with the skull base. This report describes the case of a patient referred for cone-beam computed tomography (CBCT) imaging for dental implant therapy. CBCT demonstrated a well-defined incidental lesion in the left sphenoid sinus with soft tissue-like density and sclerotic borders with internal curvilinear opacifications. The differential diagnoses included intraosseous lipoma, arrested pneumatization of the sphenoid sinus, chondrosarcoma, chondroid chordoma, and ossifying fibroma. The radiographic diagnosis of arrested pneumatization was based on the location of the lesion, its well-defined nature, the presence of internal opacifications, and lack of expansion. Gray-scale CBCT imaging of the area demonstrated values similar to fatty tissue. This case highlighted the fact that benign developmental variants associated with the skull base share similar radiographic features with more serious pathological entities.

  5. Cystic Lesions of the Mediastinum.

    Science.gov (United States)

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

    2016-06-01

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

  6. Children with Intellectual Disabilities May Be Impaired in Encoding and Recollecting Incidental Information

    Science.gov (United States)

    Witt, Arnaud; Vinter, Annie

    2013-01-01

    Children with intellectual disabilities (ID) and controls were exposed to an incidental learning phase, where half of the participants received highly implicit instructions at test while the other half received explicit instructions. When learning was assessed for simple chunks of information, children with ID performed better with implicit…

  7. Direct Vocabulary Instruction in Preschool: A Comparison of Extended Instruction, Embedded Instruction, and Incidental Exposure

    Science.gov (United States)

    Loftus-Rattan, Susan M.; Mitchell, Alison M.; Coyne, Michael D.

    2016-01-01

    Based on its coincidence with a significant period in language development for children, preschool provides a favorable setting to foster vocabulary growth. The purpose of this study was to evaluate the effectiveness of two instructional conditions and an incidental exposure condition for teaching targeted vocabulary words to preschool students…

  8. Incidental Foreign-Language Acquisition by Children Watching Subtitled Television Programs

    Science.gov (United States)

    Ina, Lekkai

    2014-01-01

    Series of international studies have shown that subtitled television programs provide a rich context for foreign language acquisition. This study investigated whether incidental language acquisition occurs from watching a television program with/without subtitles. Children in the experimental conditions watch: (a) a 15 minute snapshot of a well…

  9. Incidental Learning of Trust: Examining the Role of Emotion and Visuomotor Fluency

    Science.gov (United States)

    Strachan, James W. A.; Kirkham, Alexander J.; Manssuer, Luis R.; Tipper, Steven P.

    2016-01-01

    Eye gaze is a powerful directional cue that automatically evokes joint attention states. Even when faces are ignored, there is incidental learning of the reliability of the gaze cueing of another person, such that people who look away from targets are judged less trustworthy. In a series of experiments, we demonstrated further properties of the…

  10. 78 FR 54553 - Taking of Threatened or Endangered Marine Mammals Incidental to Commercial Fishing Operations...

    Science.gov (United States)

    2013-09-04

    ... and Atmospheric Administration RIN 0648-XC645 Taking of Threatened or Endangered Marine Mammals... mammals listed as threatened or endangered under the Endangered Species Act (ESA) by the California (CA) thresher shark/ swordfish drift gillnet (DGN) fishery (>=14 inch mesh) and the incidental, but...

  11. The Effects of Spatial Configuration on Preschoolers' Attention Strategies, Selective Attention, and Incidental Learning

    Science.gov (United States)

    Blumberg, Fran C.; Torenberg, Meira

    2005-01-01

    This study investigated the effects of spatial arrangement on preschool children's selective attention and incidental learning. Three- and four-year old children were shown a multi-coloured box designated as a "special place" containing miniature chairs and models of animals. One category of objects were designated as relevant and one as…

  12. The Role of Orthotactic Probability in Incidental and Intentional Vocabulary Acquisition L1 and L2

    Science.gov (United States)

    Bordag, Denisa; Kirschenbaum, Amit; Rogahn, Maria; Tschirner, Erwin

    2017-01-01

    Four experiments were conducted to examine the role of orthotactic probability, i.e. the sequential letter probability, in the early stages of vocabulary acquisition by adult native speakers and advanced learners of German. The results show different effects for orthographic probability in incidental and intentional vocabulary acquisition: Whereas…

  13. Dupuytren Contracture in a Patient with Congenital Camptodactyly and Incidental Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    S Mahendran

    2008-11-01

    Full Text Available Dupuytren contracture is commonly seen in northern European populations but not in Asians. Even more rare is a presentation of flexion deformity of fingers involving two different pathologies with incidental carpal tunnel syndrome in the same patient. We report herein a case of Dupuytren contracture with congenital camptodactyly and unilateral carpal tunnel syndrome.

  14. Incidental prenatal diagnosis of sex chromosome aneuploidies: health, behavior, and fertility.

    NARCIS (Netherlands)

    Pieters, J.J.; Kooper, A.J.A.; Geurts van Kessel, A.H.M.; Braat, D.D.M.; Smits, A.P.T.

    2011-01-01

    Objective. To assess the diagnostic relevance of incidental prenatal findings of sex chromosome aneuploidies. Methods. We searched with medical subject headings (MeSHs) and keywords in Medline and the Cochrane Library and systematically screened publications on postnatally diagnosed sex chromosomal

  15. Prevalence of incidental findings in paranasal sinus in brain and orbital CT scans in pediatric patients

    Directory of Open Access Journals (Sweden)

    Adriano Ferreira da Silva

    2011-09-01

    Full Text Available In emergency services a significant amount of pediatric patients undergoa brain or orbit CT scans for suspicion other than sinusitis. Assuming thispremise, this study was held to show the incidental findings of the paranasalsinuses of children with nonspecific symptoms such as fever, headache andvomiting that underwent brain or orbits CT scans, without the initial suspicion of sinusitis. In a retrospective study, we evaluated 70 CT scans of the brainand orbits of children between 0 and 12 years. The incidental findings of theparanasal sinuses occurred in 32 cases (45.7%. Mucosal thickening was themost common incidental finding, being observed in 35% of patients, followed bycomplete opacification observed in 28% of cases and incomplete opacificationobserved in 28% of patients. Bilateral involvement occurred in 78% patients.The sinuses most frequently affected were the maxillary sinus followed byethmoid sinuses. The abnormalities were more severe in children under theage of three years. The prevalence of incidental tomographic abnormalities inpatients without an initial diagnosis of sinusitis is high. The predominance ofthese findings are mild abnormalities.

  16. Incidental Displays of Cultural Knowledge in the Nonnative-English-Speaking Teacher's Classroom.

    Science.gov (United States)

    Lazaraton, Anne

    2003-01-01

    Examines incidental cultural knowledge displays by two nonnative-English-speaking teachers (NNESTs) in their intensive English program classrooms. Focuses on the nature of the discourse produced in English-as-a-Second-Language (ESL) classes taught by NNESTs. Analysis of videotaped classroom data indicates that a wide and unpredictable range of…

  17. 75 FR 34476 - Draft Supplemental Environmental Impact Statement for Incidental Take and Wetland Fill Permits...

    Science.gov (United States)

    2010-06-17

    ... Wetland Fill Permits for Two Condominium Developments on the Fort Morgan Peninsula, Baldwin County, AL...) and place fill in wetlands on the Fort Morgan peninsula, Baldwin County, Alabama. The HCP analyzes the take of the Federally endangered Alabama beach mouse and fill in wetlands incidental to...

  18. 77 FR 23547 - Taking and Importing Marine Mammals; Taking Marine Mammals Incidental to Columbia River Crossing...

    Science.gov (United States)

    2012-04-19

    ... Columbia River originates on the west slope of the Rocky Mountains in Canada and flows approximately 1,200... Part 217 Taking and Importing Marine Mammals; Taking Marine Mammals Incidental to Columbia River... Administration 50 CFR Part 217 RIN 0648-BB16 Taking and Importing Marine Mammals; Taking Marine...

  19. Incidental findings on cone beam computed tomography scans in cleft lip and palate patients

    NARCIS (Netherlands)

    Kuijpers, Mette A. R.; Pazera, Andrzej; Admiraal, Ronald J.; Berge, Stefaan J.; Vissink, Arjan; Pazera, Pawel

    2014-01-01

    Cone beam computed tomography (CBCT) is frequently used in treatment planning for alveolar bone grafting (ABG) and orthognathic surgery in patients with cleft lip and palate (CLP). CBCT images may depict coincident findings. The aim of this study was to assess the prevalence of incidental findings o

  20. Incidental detection of a bleeding gastrointestinal stromal tumor on Tc-99m red blood cell scintigraphy.

    Science.gov (United States)

    Santhosh, Sampath; Bhattacharya, Anish; Gupta, Vikas; Singh, Rajinder; Radotra, Bishan Dass; Mittal, Bhagwant Rai

    2012-10-01

    The role of 99m-technetium labeled red blood cell (RBC) scintigraphy in acute gastro-intestinal bleed is well-established. The authors report a case of a bleeding gastrointestinal stromal tumor (GIST) incidentally discovered on Tc-99m RBC scintigraphy.

  1. 76 FR 61735 - Incidental Take Permit; Auwahi Wind Energy Generation Facility, Maui, HI; Draft Habitat...

    Science.gov (United States)

    2011-10-05

    ... Fish and Wildlife Service Incidental Take Permit; Auwahi Wind Energy Generation Facility, Maui, HI..., Interior. ACTION: Notice of availability; receipt of permit application. SUMMARY: Auwahi Wind Energy LLC... Hawaiian goose occurs in the vicinity of the proposed wind energy facility and may collide with...

  2. 77 FR 49412 - Takes of Marine Mammals Incidental to Specified Activities; Navy Research, Development, Test and...

    Science.gov (United States)

    2012-08-16

    ... Specified Activities; Navy Research, Development, Test and Evaluation Activities at the Naval Surface... (Navy) to take marine mammals, by harassment, incidental to conducting research, development, test and... hearing sensitivity as a simple function of development and aging has been observed in marine mammals, as...

  3. 78 FR 47282 - Takes of Marine Mammals Incidental to Specified Activities; Navy Research, Development, Test and...

    Science.gov (United States)

    2013-08-05

    ... Specified Activities; Navy Research, Development, Test and Evaluation Activities at the Naval Surface... marine mammals, by harassment, incidental to conducting research, development, test and evaluation (RDT&E..., but will research opportunities for leveraged work that could be added under an adaptive management...

  4. 75 FR 64996 - Takes of Marine Mammals Incidental to Specified Activities; Marine Geophysical Survey in the...

    Science.gov (United States)

    2010-10-21

    ... Environmental Research and Development Program (SERDP) team in close collaboration with the SWFSC SERDP team... marine mammals, incidental to conducting a marine geophysical survey in the ETP. SIO, with research... Costa Rica, Panama, Colombia, Ecuador, and Peru, in the high seas and within the Exclusive Economic...

  5. The Effects of Repetition and L1 Lexicalization on Incidental Vocabulary Acquisition by Iranian EFL Learners

    Science.gov (United States)

    Heidari-Shahreza, Mohammad Ali; Tavakoli, Mansoor

    2016-01-01

    Based on a prior study by Chen and Truscott, the present study investigated the possible effects of repetition (repeated exposure) and L1 lexicalization on the incidental acquisition and retention of 10 English target words by 90 Persian-speaking EFL learners at an Iranian university. Seven aspects of vocabulary knowledge were measured, including…

  6. Exploring Learner Factors in Second Language (L2) Incidental Vocabulary Acquisition through Reading

    Science.gov (United States)

    Zhao, Aiping; Guo, Ying; Biales, Carrie; Olszewski, Arnold

    2016-01-01

    This study examined the predictive role of several learner factors in second language (L2) incidental vocabulary acquisition through reading: L2 proficiency, motivation, anxiety, and mastery of strategies. Participants were 129 English learners in a comprehensive university in China. Participants read two English texts and were given an…

  7. Incidentally found situs inversus with dextrocardia: inferior myocardial infarction in an 86-year-old woman.

    Science.gov (United States)

    Hudzik, Bartosz; Polonski, Lech

    2012-10-01

    Situs inversus with dextrocardia is a rare condition. Yet, the incidence of atheroclerosis and myocardial infarction in patients with dextrocardia is similar to that in general population. The diagnosis of acute myocardial infarction is somewhat tricky and difficult if the dextrocardia is not recognized. We present the electrocardiogram, coronary angiograms, and chest radiogram of a patient with incidentally found situs inversus with dextrocardia.

  8. 50 CFR 229.7 - Monitoring of incidental mortalities and serious injuries.

    Science.gov (United States)

    2010-10-01

    ... serious injuries. 229.7 Section 229.7 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL... mortalities and serious injuries. (a) Purpose. The Assistant Administrator will establish a program to monitor incidental mortality and serious injury of marine mammals during the course of commercial fishing operations...

  9. 77 FR 45268 - Taking of Marine Mammals Incidental to Commercial Fishing Operations; Bottlenose Dolphin Take...

    Science.gov (United States)

    2012-07-31

    ... Incidental to Commercial Fishing Operations; Bottlenose Dolphin Take Reduction Plan AGENCY: National Marine... Dolphin Take Reduction Plan (BDTRP) and its implementing regulations by permanently continuing nighttime... November 1 through April 30. Members of the Bottlenose Dolphin Take Reduction Team (Team) recommended...

  10. The effectiveness of deductive, inductive, implicit and incidental grammatical instruction in second language classrooms

    NARCIS (Netherlands)

    Tammenga-Helmantel, Marjon; Arends, Enti; Canrinus, Esther

    2014-01-01

    This quasi-experimental study compares the effectiveness of deductive, inductive, implicit and incidental grammar instruction and investigates to what extent complexity influences these results. A total of 981 Dutch students in lower secondary education learning German, English or Spanish as a secon

  11. 78 FR 27421 - Endangered and Threatened Wildlife and Plants; Receipt of Application for Incidental Take Permit...

    Science.gov (United States)

    2013-05-10

    ... availability of an incidental take permit (ITP) application and a Habitat Conservation Plan (HCP). Vulcan Materials Company, Florida Rock Divisions (dba Florida Rock Industries, Inc. a subsidiary of Vulcan... announce the availability of an ITP application and HCP. Vulcan Materials Company, Florida Rock...

  12. 22 CFR 92.68 - Foreign Service fees and incidental costs in the taking of evidence.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Foreign Service fees and incidental costs in the taking of evidence. 92.68 Section 92.68 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES NOTARIAL AND RELATED SERVICES Depositions and Letters Rogatory § 92.68 Foreign Service fees...

  13. The Effects of Target Word Properties on the Incidental Acquisition of Vocabulary through Reading

    Science.gov (United States)

    Reynolds, Barry Lee

    2016-01-01

    The primary aim of this investigation was to determine what combination of target word variables (frequency, patternedness, length, cognateness, lexicalization) could best predict the difficulty of incidentally acquiring vocabulary through reading. A group of adult English First Language (EL1) (n = 20) and adult English as a Foreign Language (EFL)…

  14. 76 FR 10564 - Takes of Marine Mammals Incidental to Specified Activities; St. George Reef Light Station...

    Science.gov (United States)

    2011-02-25

    ... Reef Lighthouse Preservation Society (SGRLPS) to incidentally harass, by Level B harassment only, four... and the NMFS' Director of the Office of Protected Resources immediately. Aerial photographic surveys... monitoring program. Photographic documentation of marine mammals present at the end of each three-day...

  15. The effectiveness of deductive, inductive, implicit and incidental grammatical instruction in second language classrooms

    NARCIS (Netherlands)

    Tammenga-Helmantel, Marjon; Arends, Enti; Canrinus, Esther

    2014-01-01

    This quasi-experimental study compares the effectiveness of deductive, inductive, implicit and incidental grammar instruction and investigates to what extent complexity influences these results. A total of 981 Dutch students in lower secondary education learning German, English or Spanish as a secon

  16. 77 FR 14347 - Proposed Information Collection; Comment Request; Reporting of Sea Turtle Incidental Take in...

    Science.gov (United States)

    2012-03-09

    ... of Sea Turtle Incidental Take in Virginia Chesapeake Bay Pound Net Operations AGENCY: National... endangered and threatened sea turtles, found both live and dead, in their pound net operations. When a live or dead sea turtle is discovered during a pound net trip, the Virginia pound net fisherman...

  17. Renal lymphangiectasia: incidental finding at multislice computed tomography and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Vasconcelos, Rodrigo Abdalla de; Pereira, Emanuelle Santiago [Hospital de Base do Distrito Federal (HBDF), Brasilia, DF (Brazil); Bauab Junior, Tufik [Instituto de Radiodiagnostico Rio Preto - Ultra-X and Hospital de Base de Faculdade de Medicina de Sao Jose do Rio Preto (Famerp), Sao Jose do Rio Preto, SP (Brazil); Valente, Rodolfo Silva [Hospital Universitario de Brasilia (HUB), Brasilia, DF (Brazil)

    2012-05-15

    Renal lymphangiectasia is a rare condition characterized by parapyelic and perirenal fluid collections, which may progress from asymptomatic condition to chronic renal failure. The present report describes a case of incidental computed tomography finding of bilateral lymphangiectasia in an asymptomatic patient, as well as the main imaging findings with a comprehensive literature review. (author)

  18. 75 FR 8305 - Taking of Threatened or Endangered Marine Mammals Incidental to Commercial Fishing Operations...

    Science.gov (United States)

    2010-02-24

    ... was expanded to include determinations related to incidental taking from commercial fishing (50 CFR... indicated that the expanded fishery is not likely to lethally take more than one humpback whale per year... limits to the allowable human-caused mortality of cetaceans and pinnipeds. Mar. Mamm. Sci., 14(1): 1-37...

  19. Incidental findings on cone beam computed tomography scans in cleft lip and palate patients

    NARCIS (Netherlands)

    Kuijpers, Mette A. R.; Pazera, Andrzej; Admiraal, Ronald J.; Berge, Stefaan J.; Vissink, Arjan; Pazera, Pawel

    Cone beam computed tomography (CBCT) is frequently used in treatment planning for alveolar bone grafting (ABG) and orthognathic surgery in patients with cleft lip and palate (CLP). CBCT images may depict coincident findings. The aim of this study was to assess the prevalence of incidental findings

  20. Context, Task, and Reader Effects in Children's Incidental Word Learning from Text

    NARCIS (Netherlands)

    Leeuw, L.C. de; Segers, P.C.J.; Verhoeven, L.T.W.

    2014-01-01

    Incidental word learning is influenced by context, task, and reader characteristics. The present study aimed to determine the contribution and interactions of these factors for fifth-grade students. The focus was on contextual differences: words' meanings are inferred from local or global contexts.

  1. Effects of Online Academic Lectures on ESL Listening Comprehension, Incidental Vocabulary Acquisition, and Strategy Use

    Science.gov (United States)

    Smidt, Esther; Hegelheimer, Volker

    2004-01-01

    This paper investigates how authentic web-delivered video can inform ESL online instruction and enhance the incidental acquisition of vocabulary and listening comprehension. A total of 24 adult learners of English as a Second Language enrolled in a listening comprehension class at a major Midwestern university participated in the study. The…

  2. Communication between the right and circumflex coronary arteries discovered incidentally by multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Se Hwan; Kim, Eui Jong; Woo, Jong Shin; Kim, Soo Joong; Youn, Hyo Chul; Oh, Joo Hyeong [College of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    2016-09-15

    Intercoronary communication is a rare congenital coronary anomaly. We present a case of a 48-year-old man with an incidentally discovered communication between the right and circumflex coronary arteries, who was admitted with chest tightness and exertional dyspnea. The initial diagnosis was made using electrocardiogram-gated multidetector computed tomography.

  3. The Effects of Hypertext Gloss on Comprehension and Vocabulary Retention under Incidental and Intentional Learning Conditions

    Science.gov (United States)

    Zandieh, Zeinab; Jafarigohar, Manoochehr

    2012-01-01

    The present study investigated comprehension, immediate and delayed vocabulary retention under incidental and intentional learning conditions via computer mediated hypertext gloss. One hundred and eighty four (N = 184) intermediate students of English as a foreign language at an English school participated in the study. They were randomly assigned…

  4. Incidental finding of multiple well-differentiated papillary mesotheliomas in peritoneum

    DEFF Research Database (Denmark)

    Jakobsen, Mark; Engvad, Birte; Jensen, Thor

    2016-01-01

    We present a case of multiple well-differentiated papillary mesotheliomas (WDPM) in the peritoneum found incidentally in a 63-year-old man with urothelial carcinoma of the bladder. When multiple tumors are seen, malignant mesothelioma should be excluded by histopathological examination as this ma...

  5. Perspective and Contrast; Design Principles for Supporting Self-directed and Incidental Learning

    NARCIS (Netherlands)

    Glahn, Christian; Specht, Marcus; Koper, Rob

    2009-01-01

    Glahn, C., Specht, M., & Koper, R. (2009). Perspective and contrast; design principles for supporting self-directed and incidental learning. In K. Tochtermann & H. Maurer (Eds.), 9th International Conference on Knowledge Management and Knowledge Technologies (I-KNOW'09) and 5th International Confere

  6. 76 FR 30311 - Takes of Marine Mammals Incidental to Specified Activities; Seabird and Pinniped Research...

    Science.gov (United States)

    2011-05-25

    ... breed from late November to March. Females typically give birth to a single pup and attend the pup for... low numbers there currently (S. Allen, unpubl. data). Steller sea lions give birth in May through July.... The potential for incidental take related to the mark/recapture studies is very low as...

  7. Incidentes críticos nas trajetórias profissionais de gestores escolares

    Directory of Open Access Journals (Sweden)

    Jurema Silvia de Souza Alves

    2015-11-01

    Full Text Available School management is considered one of the greatest challenges in achieving quality standards of contemporary education. Knowing the path of its main protagonist, the manager, with time experienced and in different contexts from those where he/she acts, is essential to guide the continued career management as well as to re-advise the initial career of teachers, future managers. In order to contribute to this knowledge, we present the result of a biographical-narrative research that seeks to identify the critical incidents present in the professional life of school managers of a medium-sized municipality in the state of São Paulo region, Brazil. The answers to a questionnaire allowed the characterization of 25 managers, of 32 school units in the city, and the selection of nine for interview. The interviews, transcribed and organized into biograms, showed that these professionals, mostly women, unlike men surveyed, did not direct their careers to the management function. Most of the regular critical incidents on professional paths refer to the influence of supervisors that indicated their name or encouraged them to study for admission tests related to management; the birth of their children, which motivated them to progress on their career and/or promoting a break for future investment; their initial training, for many the Faculty of Education, considered by participants as insufficient for the exercise of management. It is considered that the career in management must be intensified as a continued career and revised/altered from its initial background, so that managing activities correspond to the objectives of a high quality education. A gestão escolar constitui um dos grandes desafios para a qualidade da educação na contemporaneidade. Conhecer a trajetória de seu protagonista, o gestor, vivenciada em tempo e contexto diversos daqueles em que ele atua, é fundamental para orientar a formação continuada, assim como para reorientar a forma

  8. [Bony Bankart lesions].

    Science.gov (United States)

    Spiegl, U J; Braun, S; Euler, S A; Warth, R J; Millett, P J

    2014-12-01

    Fractures of the anteroinferior glenoid rim, termed bony Bankart lesions, have been reported to occur in up to 22% of first time anterior shoulder dislocations. The primary goal of treatment is to create a stable glenohumeral joint and a good shoulder function. Options for therapeutic intervention are largely dependent on the chronicity of the lesion, the activity level of the patient and postreduction fracture characteristics, such as the size, location and number of fracture fragments. Non-operative treatment can be successful for small, acute fractures, which are anatomically reduced after shoulder reduction. However, in patients with a high risk profile for recurrent instability initial Bankart repair is recommended. Additionally, bony fixation is recommended for acute fractures that involve more than 15-20% of the inferior glenoid diameter. On the other hand chronic fractures are generally managed on a case-by-case basis depending on the amount of fragment resorption and bony erosion of the anterior glenoid with high recurrence rates under conservative therapy. When significant bone loss of the anterior glenoid is present, anatomical (e.g. iliac crest bone graft and osteoarticular allograft) or non-anatomical (e.g. Latarjet and Bristow) reconstruction of the anterior glenoid is often indicated.

  9. Incidental Learning: A Brief, Valid Measure of Memory Based on the WAIS-IV Vocabulary and Similarities Subtests.

    Science.gov (United States)

    Spencer, Robert J; Reckow, Jaclyn; Drag, Lauren L; Bieliauskas, Linas A

    2016-12-01

    We assessed the validity of a brief incidental learning measure based on the Similarities and Vocabulary subtests of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). Most neuropsychological assessments for memory require intentional learning, but incidental learning occurs without explicit instruction. Incidental memory tests such as the WAIS-III Symbol Digit Coding subtest have existed for many years, but few memory studies have used a semantically processed incidental learning model. We conducted a retrospective analysis of 37 veterans with traumatic brain injury, referred for outpatient neuropsychological testing at a Veterans Affairs hospital. As part of their evaluation, the participants completed the incidental learning tasks. We compared their incidental learning performance to their performance on traditional memory measures. Incidental learning scores correlated strongly with scores on the California Verbal Learning Test-Second Edition (CVLT-II) and Brief Visuospatial Memory Test-Revised (BVMT-R). After we conducted a partial correlation that controlled for the effects of age, incidental learning correlated significantly with the CVLT-II Immediate Free Recall, CVLT-II Short-Delay Recall, CVLT-II Long-Delay Recall, and CVLT-II Yes/No Recognition Hits, and with the BVMT-R Delayed Recall and BVMT-R Recognition Discrimination Index. Our incidental learning procedures derived from subtests of the WAIS-IV Edition are an efficient and valid way of measuring memory. These tasks add minimally to testing time and capitalize on the semantic encoding that is inherent in completing the Similarities and Vocabulary subtests.

  10. HISTOMORPHOLOGICAL SPECTRUM OF BREAST LESIONS

    Directory of Open Access Journals (Sweden)

    Kiran H. S

    2016-07-01

    Full Text Available BACKGROUND Cancer of the breast is the second most common cause of cancer in women. Benign or malignant lesions presenting as mass in the breast causes anxiety to the patients and the family members. AIMS AND OBJECTIVES OF THE STUDY 1. To classify different types of lesions of breast, both benign and malignant. 2. Histomorphological study of various types of benign and malignant breast lesions. 3. To study spectrum of lesions associated with benign and malignant breast diseases. SETTING AND DESIGN All the breast biopsies, lumpectomies, and mastectomy specimens presenting to Department of Pathology of our institution between June 2012 to June 2014. MATERIALS AND METHODS A sample size of 100 cases are included in this study. Clinical details are taken from records. The specimens of breast sent to the Department of Pathology are processed by routine histopathological techniques. Histopathological features are studied on haematoxylin and eosin-stained sections. STATISTICAL ANALYSIS Statistically, the test of proportion is used to obtain the frequency of all lesions. Chi-square test, which is used to find the association between the spectrum of lesions showed a p value of 0.0438 and hence the study was considered significant. RESULTS In our study, out of 100 cases, malignant breast lesions constituted the majority of the lesions comprising of 49 cases (49%, followed by benign lesions comprising 46 cases (46% and the inflammatory lesions comprising 5 cases (5%. Among benign lesions, fibrocystic disease was the predominant lesion comprising of 39 cases (41%, followed by fibroadenoma comprising 26 cases (28%, which is followed by 13 cases (14% of fibrocystic disease with columnar cell change and 8 cases (9% of sclerosing adenosis. Among malignant lesions, invasive ductal carcinoma (NST type was the most common lesion comprising 31 cases (61% followed by 11 cases (21% of invasive lobular carcinoma. Invasive papillary carcinoma and medullary carcinoma

  11. 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.

  12. Spectroscopic Detection of Caries Lesions

    OpenAIRE

    Mika Ruohonen; Katri Palo; Jarmo Alander

    2013-01-01

    Background. A caries lesion causes changes in the optical properties of the affected tissue. Currently a caries lesion can be detected only at a relatively late stage of development. Caries diagnosis also suffers from high interobserver variance. Methods. This is a pilot study to test the suitability of an optical diffuse reflectance spectroscopy for caries diagnosis. Reflectance visible/near-infrared spectroscopy (VIS/NIRS) was used to measure caries lesions and healthy enamel on extracted h...

  13. Significance of incidental focal uptake in prostate on 18-fluoro-2-deoxyglucose positron emission tomography CT images.

    Science.gov (United States)

    Han, E J; H O, J; Choi, W H; Yoo, I R; Chung, S K

    2010-11-01

    To evaluate the clinical significance of incidental focal prostate fluorodeoxyglucose (FDG) uptake, we reviewed 18-F-FDG positron emission tomography (PET)/CT scans from 2003 to 2007 and selected cases with focal FDG uptake in prostate. Cases of known prostate cancer were excluded. The maximum standardised uptake value (SUV(max)), site (central or peripheral) and pattern (discrete or ill-defined) of FDG uptake, calcification (present or absent) and prostate volume (prostate-specific antigen (PSA) levels, imaging studies, clinical follow-up and biopsy. Of a total of 5119 cases, 63 (1.2%) demonstrated focal FDG uptake in prostate. Eight cases were lost to follow-up. Among the 55 cases with follow-up, malignancy was confirmed by biopsy in 3 (5.4%). The three malignant cases had SUV(max) values of 3.3, 3.6 and 2.3, and all were noted in the peripheral portion of prostate; two of these cases had a discrete FDG uptake pattern, none had calcification corresponding to the FDG uptake area and one had a prostatic volume greater than 30 cc. The mean SUV(max) of 52 benign cases was 3.2 ± 1.7 and focal FDG uptake was noted in the peripheral portion in 34 (65%), 20 (38%) cases showed a discrete FDG uptake pattern, 35 (67%) were accompanied by calcification and 32 (62%) had a prostatic volume greater than 30 cc. The majority of cases demonstrating focal FDG uptake in prostate were benign and no PET/CT finding could reliably differentiate benign from malignant lesions; however, when discrete focal FDG uptake without coincidental calcification is seen, particularly in the peripheral zone of the prostate, further clinical evaluation is recommended.

  14. 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.

  15. 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.

  16. Microcarcinomas papilares de tiroides no incidentales Non-incidental papillary microcarcinomas of the thyroid

    Directory of Open Access Journals (Sweden)

    Marcelo Monteros Alvi

    2008-04-01

    Full Text Available El significado clínico de los microcarcinomas papilares de tiroides sigue siendo controvertido. La alta prevalencia en autopsias e incidental en tiroidectomías por patología benigna indican un comportamiento clínico indolente. Sin embargo, algunos desarrollan metástasis ganglionares y recurrencia local. Nuestro objetivo fue determinar características clínicas y patológicas de microcarcinonas papilares de tiroides no incidentales (MPT-NI. Se analizaron 18 pacientes con diagnóstico de microcarcinomas (tumor The clinical significance of papillary microcarcinoma of the thyroid gland keeps being controversial. Its high prevalence in autopsies and as incidental findings in thyroidectomy specimens for benign pathology indicate an indolent clinical behavior. Nevertheless some of the microcarcinomas develop lymph node metastasis and local recurrence. To determine the clinical and pathological characteristics of non-incidental papillary microcarcinomas of the thyroid (PTM -NI. 18 patients with diagnosis of non-incidental papillary microcarcinoma (tumor < 1cm with nodular expression in the thyroid gland or with lymph node metastasis have been studied. Initial diagnosis, prediction factors and evolution have been evaluated. Of 18 patients with PTM-NI, 12 demonstrated lymph node metastasis. 6 patients had positive fine needle aspiration (FNA of palpable thyroid nodules. Multifocality and extraglandular extension were associated with lymph node metastasis. Seven of the nine metastatic lymph nodes diagnosed by FNA were cystic. Histologically 83.3% of the nodules in the thyroid were non-encapsulated and showed papillary growth pattern. Multifocality and extrathyroid infiltration were associated with lymph node metastasis at presentation. 46% of the patients with thyroid nodules < 4 mm and lymph node involvement (N1 showed recurrence/persistence. The non-incidental intrathyroideal papillary microcarcinoma without capsular involvement, extraglandular

  17. Magnetic Resonance Imaging in the Assessment of Cystic Pancreatic Lesions: Differentiation of Benign and Malignant Lesion Status

    Energy Technology Data Exchange (ETDEWEB)

    Haenninen, E. Lopez; Pech, M.; Ricke, J.; Denecke, T.; Amthauer, H.; Lehmkuhl, L.; Boehmig, M.; Roettgen, R.; Pinkernelle, J.; Felix, R.; Langrehr, J. [Charite Medical Univ. Center, Campus Virchow Clinic, Berlin (Germany). Depts. of Radiology, Visceral and Transplant Surgery, Gastroenterology and Hepatology

    2006-03-15

    Purpose: To characterize cystic pancreatic lesions and tumors with magnetic resonance imaging (MRI), and to assess the value of morphological criteria in differentiating pseudocysts versus cystic tumors and benign versus malignant cystic tumors. Material and Methods: Twenty-three patients with cystic pancreatic tumors or lesions underwent plain and contrast-material-enhanced MRI, including magnetic resonance cholangiopancreatography (MRCP). The MR findings were characterized and analyzed by two readers, and the role of various imaging criteria and combinations thereof for final lesion assignment were assessed. Final diagnoses were obtained from the results of open surgery (n = 19) and/or biopsy (n = 4). Results: Final diagnoses included cystic tumors (n = 11) and pseudocysts (n = 12). The lesions were located in the head (56%) and body or tail (44%). Lesion diameters ranged from 7 to 50 mm. Various lesion contrast enhancement patterns were observed for both benign and malignant lesions. Serous cystadenomas were located in the head, they were lobulated, and had wall diameters >2 mm; with the combination of these characteristics all patients with serous cystadenoma could be identified, whereas in no other patient was this constellation observed. Conclusion: MRI facilitated the diagnosis of serous cystadenomas, although no definite morphologic criterion for the differentiation between pseudocysts and mucinous cystadenomas was identified. In consideration of the substantial therapeutic consequences, either diagnostics in unclear cystic pancreatic lesions should comprise cyst fluid analysis if necessary, or eligible patients should be referred for surgical resection.

  18. Oral lichenoid lesions - A review and update

    Directory of Open Access Journals (Sweden)

    Venkatesh Vishwanath Kamath

    2015-01-01

    Full Text Available Background: Oral lichenoid lesions or reactions (OLLs/OLRs are clinical and histological contemporaries of the classical oral lichen planus (OLP that have generated a lot of debate in literature. In contrast to the idiopathic nature of OLP, OLLs are often associated with a known identifiable inciting factor. A superficial examination of these lesions clinically and histologically often reveals many similarities with OLP, but recent data indicate that distinguishable features do exist and form the basis of most classifications. Aims and Objectives: This paper attempts to collate available data in English literature on OLLs, highlight distinguishing features clinically and histologically and reflect on the malignant transformation potential and treatment modalities of the condition. Materials and Methods: A comprehensive search of medical and dental databases including PubMed, Ovid, Cochrane, Pubget, Researchgate, and non-medical search engines were utilized for the review. The search words included "oral lichen planus", "oral lichenoid lesions", "oral drug reactions", "lichenoid dysplasia", and "adverse effects of dental materials". Review Results: OLLs seem to grossly underrated and most cases were clubbed as OLP. Definite clinical and histological features were uncovered to establish the identity of this lesion. Associations with dental restorative materials, drugs, and medications have been conclusively proven in the etiology of this condition. Specific markers are being utilized to diagnose the condition and monitor its progress. Conclusion: Substantial differentiating features were uncovered to delineate OLLs as a separate entity with definite etiology, pathogenesis, and a high malignant transformation rate compared with OLP.

  19. Identifying Activity

    CERN Document Server

    Lewis, Adrian S

    2009-01-01

    Identification of active constraints in constrained optimization is of interest from both practical and theoretical viewpoints, as it holds the promise of reducing an inequality-constrained problem to an equality-constrained problem, in a neighborhood of a solution. We study this issue in the more general setting of composite nonsmooth minimization, in which the objective is a composition of a smooth vector function c with a lower semicontinuous function h, typically nonsmooth but structured. In this setting, the graph of the generalized gradient of h can often be decomposed into a union (nondisjoint) of simpler subsets. "Identification" amounts to deciding which subsets of the graph are "active" in the criticality conditions at a given solution. We give conditions under which any convergent sequence of approximate critical points finitely identifies the activity. Prominent among these properties is a condition akin to the Mangasarian-Fromovitz constraint qualification, which ensures boundedness of the set of...

  20. 78 FR 33369 - Takes of Marine Mammals Incidental to Specified Activities; Low-Energy Marine Geophysical Survey...

    Science.gov (United States)

    2013-06-04

    ... expedition underscored the inadequacy of these data for complete characterization of the gas hydrate deposits... state that the USFWS in its Polar Bear and Walrus incidental take regulations clarified how it...

  1. Incidental findings are frequent in young healthy individuals undergoing magnetic resonance imaging in brain research imaging studies

    DEFF Research Database (Denmark)

    Hartwigsen, Gesa; Siebner, Hartwig R; Deuschl, Günther;

    2010-01-01

    There is an ongoing debate about how to handle incidental findings (IF) detected in healthy individuals who participate in research-driven magnetic resonance imaging (MRI) studies. There are currently no established guidelines regarding their management.......There is an ongoing debate about how to handle incidental findings (IF) detected in healthy individuals who participate in research-driven magnetic resonance imaging (MRI) studies. There are currently no established guidelines regarding their management....

  2. A retrospective study of post-operative gall bladder pathology with special reference to incidental carcinoma of the gall bladder

    OpenAIRE

    Jagannath Dev Sharma; Indrajit Kalita; Tonmoy Das; Papari Goswami; Manigreeva Krishnatreya

    2014-01-01

    Background: Surgical removal of gall bladder for its diseases is common. However, not much is known about the incidence of incidental carcinoma in such patients in our population. Objective of current study was to analyze the different pathological entities of post-operative gall bladder specimen with particular emphasis on incidental carcinoma. Methods: This retrospective study was carried out at a multi-specialty hospital in eastern India from the pathology records for the period from Au...

  3. A Cohort Study on Meniscal Lesions among Airport Baggage Handlers

    DEFF Research Database (Denmark)

    Mikkelsen, Sigurd; Brauer, Charlotte; Pedersen, Ellen Bøtker;

    2016-01-01

    Meniscal lesions are common and may contribute to the development of knee arthrosis. A few case-control and cross-sectional studies have identified knee-straining work as risk factors for meniscal lesions, but exposure-response relations and the role of specific exposures are uncertain......, and previous results may be sensitive to reporting and selection bias. We examined the relation between meniscal lesions and cumulative exposure to heavy lifting in a prospective register-based study with complete follow-up and independent information on exposure and outcome. We established a cohort...... hospital diagnosis or surgery of a meniscal lesion. Baggage handlers had a higher incidence of meniscal lesions than the referents. Within baggage handlers spline regression showed that the incidence rate ratio was 1.91 (95% confidence interval: 1.29-2.84) after five years as a baggage handler...

  4. Multi-scale classification based lesion segmentation for dermoscopic images.

    Science.gov (United States)

    Abedini, Mani; Codella, Noel; Chakravorty, Rajib; Garnavi, Rahil; Gutman, David; Helba, Brian; Smith, John R

    2016-08-01

    This paper presents a robust segmentation method based on multi-scale classification to identify the lesion boundary in dermoscopic images. Our proposed method leverages a collection of classifiers which are trained at various resolutions to categorize each pixel as "lesion" or "surrounding skin". In detection phase, trained classifiers are applied on new images. The classifier outputs are fused at pixel level to build probability maps which represent lesion saliency maps. In the next step, Otsu thresholding is applied to convert the saliency maps to binary masks, which determine the border of the lesions. We compared our proposed method with existing lesion segmentation methods proposed in the literature using two dermoscopy data sets (International Skin Imaging Collaboration and Pedro Hispano Hospital) which demonstrates the superiority of our method with Dice Coefficient of 0.91 and accuracy of 94%.

  5. Comparision of Incidental Reflection From Containerized Maintenance/Housekeeping Solutions and One Inch of Water

    Energy Technology Data Exchange (ETDEWEB)

    Chapman, Bryan Scott [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); MacQuigg, Michael Robert [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Wysong, Andrew Russell [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-12-15

    This document addresses the incidental reflector reactivity worth of containerized maintenance/housekeeping fluids for use in PF-4 at Los Alamos National Laboratory (LANL). The intent of the document is to analyze containerized maintenance/housekeeping fluids which will be analyzed as water that may be present under normal conditions of an operation. The reactivity worth is compared to the reactivity worth due to I-inch of close-fitting 4n water reflection and I-inch of close-fitting radial water reflection. Both have been used to bound incidental reflection by 2-liter bottles in criticality safety evaluations. The conclusion is that, when the maintenance/housekeeping fluids are containerized the reactivity increase from a configuration which is bounding of normal conditions (up to eight bottles modeled with 2-liters of solution at varying diameter) is bound by I-inch of close fitting 4n water relection.

  6. An incidental case of dihydropyrimidine dehydrogenase deficiency: One case, multiple challenges

    Directory of Open Access Journals (Sweden)

    Hamoud H Al Khallaf

    2013-01-01

    Full Text Available Dihydropyrimidine dehydrogenase (DPD deficiency is an autosomal recessive disorder that shows large phenotypical variability, ranging from no symptoms to intellectual disability, motor retardation, and convulsions. In addition, homozygous and heterozygous mutation carriers can develop severe 5-fluorouracil (5-FU toxicity. The lack of genotype-phenotype correlation and the possibility of other factors playing a role in the manifestation of the neurological abnormalities, make the management and education of asymptomatic DPD individuals more challenging. We describe a 3-month-old baby who was incidentally found by urine organic acid testing (done as part of positive newborn screen to have very high level of thymine and uracil, consistent with DPD deficiency. Since the prevalence of asymptomatic DPD deficiency in the general population is fairly significant (1 in 10,000, we emphasize in this case study the importance of developing a guideline in genetic counseling and patient education for this condition as well as other incidental laboratory findings.

  7. Pneumoperitoneum diagnosed as an incidental finding using focus assessed transthoracic echocardiography: a case report

    DEFF Research Database (Denmark)

    Laursen, Christian Borbjerg

    2010-01-01

    Introduction In this case report we describe how pneumoperitoneum was diagnosed in a patient admitted with acute chest pain, as an incidental finding using focus assessed transthoracic echocardiography (FATE). Case report A 79-year-old male smoker with arterial hypertension was admitted to a coro......Introduction In this case report we describe how pneumoperitoneum was diagnosed in a patient admitted with acute chest pain, as an incidental finding using focus assessed transthoracic echocardiography (FATE). Case report A 79-year-old male smoker with arterial hypertension was admitted...... to a coronary unit with a sudden onset of constant left sided thoracic pain. At position 1 (subcostal) of the FATE protocol, the heart and liver could not be visualised. Instead the peritoneum could be seen as a hyperechoic stripe, corresponding horizontal reverberation artefacts was visible under...... in extracardial diseases can directly ensure the patients a quicker diagnosis and treatment....

  8. Incidentally found and unexpected tumors discovered by MRI examination for temporomandibular joint arthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Yanagi, Yoshinobu; Asaumi, Jun-ichi E-mail: asaumi@md.okayama-u.ac.jp; Maki, Yuu; Murakami, Jun; Hisatomi, Miki; Matsuzaki, Hidenobu; Konouchi, Hironobu; Honda, Yosutoshi; Kishi, Kanji

    2003-07-01

    We examined the frequency of incidentally found or unexpected tumors discovered at the time of magnetic resonance imaging (MRI) examinations in the temporomandibular joint (TMJ) region for patients with suspicion of TMJ arthrosis. Five MR images (T1-weighted transverse scout image and proton density and T2-weighted oblique sagittal images at the open and closed mouth) were acquired. In 2776 MRI examinations of TMJ arthrosis, two tumors were discovered. They consisted of an adenoid cystic carcinoma in the deep portion of the parotid gland, and a malignant tumor extending from the infratemporal fossa to the parapharyngeal space. The rate of incidentally founded or unexpected tumors in TMJ examinations was low (0.072%), but the two tumors found were malignant tumors, and therefore, scout image should be carefully examined, not only used for positing the slice.

  9. Incidental Discovery of a Membranous Ventricular Septal Aneurysm in Two Dissimilar Patients

    Directory of Open Access Journals (Sweden)

    Abhishek Naidu

    2012-01-01

    Full Text Available A ventricular septal aneurysm (VSA is a rare cardiac anomaly, and an accurate statistic of its prevalence has not been reported in the literature. True incidence is likely underestimated as most patients are thought to be asymptomatic. As a result, most VSAs are discovered incidentally on echocardiography, during angiography, or at autopsy. Potential complications include rupture, bacterial endocarditis, right ventricular outflow tract obstruction, and thromboembolic disease. It has been proposed that VSAs occur in association with ventricular septal defects (VSDs and other congenital cardiac abnormalities. It is uncommon for a VSA to exist in the absence of a known prior ventricular septal defect. We present two cases, each highlighting an incidental intact aneurysm involving the membranous interventricular septum. We discuss the contrast in the two patients with regard to their age, accompanying cardiac anomalies and cardiovascular fitness. Clinical implications of the condition are reviewed.

  10. Pneumoperitoneum diagnosed as an incidental finding using focus assessed transthoracic echocardiography: a case report

    DEFF Research Database (Denmark)

    Laursen, Christian Borbjerg

    2010-01-01

    Introduction In this case report we describe how pneumoperitoneum was diagnosed in a patient admitted with acute chest pain, as an incidental finding using focus assessed transthoracic echocardiography (FATE). Case report A 79-year-old male smoker with arterial hypertension was admitted to a coro......Introduction In this case report we describe how pneumoperitoneum was diagnosed in a patient admitted with acute chest pain, as an incidental finding using focus assessed transthoracic echocardiography (FATE). Case report A 79-year-old male smoker with arterial hypertension was admitted...... the peritoneal line. Based on these findings, a conventional X-ray image of the abdomen was taken with the patient in the left lateral decubitus position, confirming the diagnosis of pneumoperitoneum. Conclusion This demonstrates how systematic use of FATE combined with knowledge of sonographic patterns...... in extracardial diseases can directly ensure the patients a quicker diagnosis and treatment....

  11. Incidental and intentional learning of verbal episodic material differentially modifies functional brain networks.

    Directory of Open Access Journals (Sweden)

    Marie-Therese Kuhnert

    Full Text Available Learning- and memory-related processes are thought to result from dynamic interactions in large-scale brain networks that include lateral and mesial structures of the temporal lobes. We investigate the impact of incidental and intentional learning of verbal episodic material on functional brain networks that we derive from scalp-EEG recorded continuously from 33 subjects during a neuropsychological test schedule. Analyzing the networks' global statistical properties we observe that intentional but not incidental learning leads to a significantly increased clustering coefficient, and the average shortest path length remains unaffected. Moreover, network modifications correlate with subsequent recall performance: the more pronounced the modifications of the clustering coefficient, the higher the recall performance. Our findings provide novel insights into the relationship between topological aspects of functional brain networks and higher cognitive functions.

  12. Incidental Diagnosis of Cerebral Cortical Venous Thrombosis in Postdural Puncture Headache on Brain Computed Tomography.

    Science.gov (United States)

    Humbertjean, Lisa; Ducrocq, Xavier; Lacour, Jean-Christophe; Mione, Gioia; Richard, Sébastien

    2015-01-01

    Diagnosis of cerebral cortical venous thrombosis in patients with postdural puncture headache (PDPH) is usually secondary to changes in headache pattern or cerebral infarctions. Nevertheless, incidental discovery of asymptomatic forms on brain imaging has never been reported before and its management thus remains ill-defined. We describe 2 cases of patients with asymptomatic cortical vein thrombosis in the context of PDPH. In both cases, brain computed tomography (CT) scans showed an isolated cortical vein thrombosis without cerebral damage. Neurological examination revealed the typical orthostatic feature of PDPH, independently of cortical vein thrombosis which was considered as a radiological incidental finding. Clinical and radiological signs resolved after bed rest, oral caffeine, and anticoagulation therapy. Asymptomatic cortical vein thrombosis may be found on radiological exploration, even basic like brain CT scan without contrast, of PDPH. Utility of anticoagulation therapy, which could increase the risk of cerebral hemorrhagic complications in this specific context, has to be assessed.

  13. Colon in the chest: an incidental dextrocardia: a case report study.

    Science.gov (United States)

    Abd Elrazek, Abd Elrazek; Shehab, Abdullah; Elnour, Asim A; Al Nuaimi, Saif K; Baghdady, Shazly

    2015-02-01

    Diaphragmatic injury is an uncommon traumatic injury (Dextrocardia was an incidental finding, diagnosed by electrocardiography, chest radiograph, and CT chest. Parts of the colon, small intestine, and stomach were within the thorax in the left side due to left diaphragmatic hernia of a nontraumatic cause. Acquired incidental dextrocardia was the main problem due to displacement of the heart to contralateral side by the GI (gastrointestinal) viscera (left diaphragmatic hernia).The patient was prepared for the laparoscopic surgical repair, using a polyethylene mesh 20 cm to close the defect, and the patient recovered with accepted general condition. However, 5 days postoperative, the patient passed away suddenly due to unexplained cardiac arrest.Intrathoracic herniation of abdominal viscera should be considered in patients presented with sudden chest pain concomitant with a history of increased intra-abdominal pressure.

  14. Incidentally discovered adrenal tumors: a lesson from observation of 1,444 patients.

    Science.gov (United States)

    Kasperlik-Załuska, A A; Otto, M; Cichocki, A; Rosłonowska, E; Słowińska-Srzednicka, J; Jeske, W; Papierska, L; Zgliczyński, W

    2008-05-01

    This study was aimed at summarizing our experience in the management of 1,444 patients with incidentally found adrenal tumors observed at a single endocrinological centre. Hormonal determinations were performed in all patients at the beginning of the observation period to detect subclinical adrenal hyperfunction. The imaging phenotype on CT and MRI was analyzed for defining the malignant potential of the tumors. Based on the results of these examinations we diagnosed among our cohort probably benign masses in 87%, malignant tumors in 10% (adrenal carcinoma - 9%), and metastases in 3%. Subclinical hyperfunction was diagnosed in 8%; the most frequent was the pre-Cushing's syndrome. A subgroup of 480 patients (33%) was submitted to surgery because of oncological or endocrinological indications. The patients not qualified for surgery were carefully controlled by imaging and hormonal examinations. Malignancy is the most serious risk in the group of patients with incidentally discovered adrenal tumors.

  15. CASE REPORT: Papillary Adenoma of Kidney- An Incidental Autopsy Finding: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Bhakti D. Deshmukh

    2012-01-01

    Full Text Available Background: Renal papillary adenoma is usually an incidental finding at autopsy with an incidence of 7% to 23%. The frequency of small papillary tumours of kidney increases with age to approximately 40% of the population over the age of 65. These tumours occur morefrequently in scarred kidneys, acquired renal cystic disease and in children with von Hippel-Lindau syndrome. Case history: In this report we describe renal papillary adenoma incidentally detected during autopsies of two elderly males. Gross examination of kidneyshowed two tiny subcapsular yellowish nodules in one case and single nodule with similar morphology in the other. Microscopic examination in both the cases showed a well circumscribed tumour composed of densely packed tubules and papillae lined by small cuboidal to columnar cells with rounded uniform nuclei. However there was no nuclear atypia, mitosis or necrosis.

  16. The influence of vertical motor responses on explicit and incidental processing of power words.

    Science.gov (United States)

    Jiang, Tianjiao; Sun, Lining; Zhu, Lei

    2015-07-01

    There is increasing evidence demonstrating that power judgment is affected by vertical information. Such interaction between vertical space and power (i.e., response facilitation under space-power congruent conditions) is generally elicited in paradigms that require participants to explicitly evaluate the power of the presented words. The current research explored the possibility that explicit evaluative processing is not a prerequisite for the emergence of this effect. Here we compared the influence of vertical information on a standard explicit power evaluation task with influence on a task that linked power with stimuli in a more incidental manner, requiring participants to report whether the words represented people or animals or the font of the words. The results revealed that although the effect is more modest, the interaction between responses and power is also evident in an incidental task. Furthermore, we also found that explicit semantic processing is a prerequisite to ensure such an effect.

  17. Direct teaching and incidental learning of vocabulary: a further cycle of research

    Directory of Open Access Journals (Sweden)

    Faisal Al-Homoud

    2015-02-01

    Full Text Available The current research compares two conditions of L2 vocabulary learning, i.e. explicit teaching and incidental learning. Forty-five female participants, majoring in English at Alimam Mohammad Ibn-Saud Islamic University, Saudi Arabia, took part in this research. They were divided into two groups: read plus (RP and read only (RO. Three levels of vocabulary knowledge (form recall, meaning recall, and meaning recognition were assessed. The results showed that both conditions cater for vocabulary learning, however the RP group had significantly outperformed their RO counterparts. Moreover, the results showed that vocabulary learning in this study followed the general tendency starting from a receptive level to a productive level. Finally, the results of the current study confirmed what Sonbul and Schmitt (2010 have arrived at. Key words: vocabulary knowledge, vocabulary learning, explicit (direct teaching, incidental learning, attrition, retention.

  18. Two Invasive Thymomas Incidentally Found during Coronary Artery Bypass Graft Surgery

    Directory of Open Access Journals (Sweden)

    Navid Omidifar

    2016-01-01

    Full Text Available Thymoma, the most common neoplasm of the anterior mediastinum, is a rare tumor of thymic epithelium that can be locally invasive. We reported 2 cases of invasive thymoma incidentally found during routine coronary artery bypass graft (CABG surgery at Faghihee Hospital of Shiraz University of Medical Sciences of Iran in a period of about 6 months. The 2 patients were male and above 60 years old. They had no clinical symptoms and radiological evidence of mediastinal mass before detection of the tumor during operation. For both patients mass was completely excised and sent to the laboratory. The ultimate pathological diagnosis of both masses was invasive thymoma (stage 2. There are few reports in which thymomas were found incidentally during cardiac surgery. In spite of rare coincidence, due to being asymptomatic and possibly invasive, special attention to thymus gland during cardiac surgery or other mediastinal surgery and preoperative imaging studies seem to be reasonable approach.

  19. "Hybrid" lesion of the maxilla

    Directory of Open Access Journals (Sweden)

    S Sankaranarayanan

    2011-01-01

    Full Text Available Juvenile ossifying fibroma is an uncommon benign but aggressive fibroosseous lesion that affects the craniofacial skeleton. Their distinct clinical and histopathological features warrant the lesion to be considered as a separate entity from other fibro-osseous group of lesions such as fibrous dysplasia and cemento ossifying fibroma. Concomitant development of secondary aneurysmal bone cyst may rarely occur, which makes the lesion more aggressive and difficult to treat. We report a case of a 6 year old girl who was diagnosed with aneurysmal bone cyst during her earlier presentation at a private hospital and was treated for the same. The lesion recurred within 6 months. The second incisional biopsy specimen revealed features of trabecular variant of juvenile ossifying fibroma along with areas of aneurysmal bone cyst.

  20. Magnetic Resonance Imaging of the Cervical, Thoracic, and Lumbar Spine in Children: Spinal Incidental Findings in Pediatric Patients

    Science.gov (United States)

    Ramadorai, Uma E.; Hire, Justin M.; DeVine, John G.

    2014-01-01

    Study Design Retrospective case series. Objective To determine the rate of spinal incidental findings on magnetic resonance imaging (MRI) of the cervical, thoracic, and lumbar spine in the pediatric population. Methods We reviewed MRI imaging of the neuraxial spine in patients less than 18 years of age and documented abnormal spinal findings. We then reviewed the charts of these patients to determine the reason for ordering the study. Those who presented with pain were considered symptomatic. Those who had no presenting complaint were considered asymptomatic. The data were analyzed to break down the rate of spinal incidental findings in the cervical, thoracic, and lumbar spine, respectively. Results Thirty-one of the 99 MRIs had positive findings, with the most common being disk protrusion (51.6%). Spinal incidental findings were most common in the lumbar spine (9.4%) versus the cervical spine (8%) or thoracic spine (4.7%). In this group, Schmorl nodes and disk protrusion were the two most common findings (37.5% each). Other spinal incidental findings included a vertebral hemangioma and a Tarlov cyst. In the thoracic spine, the only spinal incidental finding was a central disk protrusion without spinal cord or nerve root compression. Conclusion MRI is a useful modality in the pediatric patient with scoliosis or complaints of pain, but the provider should remain cognizant of the potential for spinal incidental findings. PMID:25396102