151
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Sunman B, Kiper N. Fibrotic lung diseases in children. Pediatr Pulmonol 2024; 59:1165-1174. [PMID: 38353393 DOI: 10.1002/ppul.26905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/08/2024] [Accepted: 01/31/2024] [Indexed: 04/30/2024]
Abstract
In children, pulmonary fibrosis (PF) is an extremely unusual entity that can be observed in some types of interstitial lung disease (ILD). Defining whether ILD is accompanied by PF is important for targeted therapy. Algorithm for the diagnosis of PF in children is not clearly established. Besides, the clinical, radiological, and histological definitions commonly used to diagnose particularly the cases of idiopathic PF in adult patients, is not applicable to pediatric cases. However, a few studies conducted in children offer good exemplary diagnostic approach to fibrosing ILD. Thorax high resonance computed tomography and/or lung biopsy scanning can provide valuable information about PF. Another issue that has not been clearly established is when to start antifibrotic treatment in pediatric patients with PF. The objective of this current review is to provide a comprehensive overview of pediatric PF by drawing upon adult research, particularly focusing on the areas of uncertainty.
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Affiliation(s)
- Birce Sunman
- Department of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nural Kiper
- Department of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Blum JD, Cho DY, Villavisanis DF, Goncalves FG, Swanson JW, Storm PB, Taylor JA, Bartlett SP. The Natural History of Fibrous Dysplasia of the Orbit. Plast Reconstr Surg 2024; 153:962e-970e. [PMID: 37184453 DOI: 10.1097/prs.0000000000010680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Orbital fibrous dysplasia (FD) is a disease of disordered fibro-osseous proliferation secondary to altered osteogenesis, with potential sequelae including compressive neuropathy and irreversible vision loss. The purpose of this study was to evaluate the natural history and longitudinal outcomes of 37 patients with orbital FD who underwent stratified surgical management. METHODS All patients treated for FD from 2015 to 2021 were identified, yielding 185 patients, 39 with orbital involvement. Impressions from head computed tomographic scans were analyzed by a craniofacial radiologist to evaluate location and timing of tumor growth. Operative records were reviewed to determine surgical approach (partial excision/contouring, complete excision, or partial excision with optic nerve decompression). RESULTS The average patient age at diagnosis was 10.7 ± 4.5 years, and the average follow-up was 5.2 ± 4.7 years. Of the 37 patients with orbital involvement, 28 (75.7%) had optic canal involvement. Of those with optic canal involvement, 13 (46.4%) required partial excision with optic nerve decompression, whereas 15 (53.6%) did not. Of those without optic canal involvement, two patients (22.2%) underwent partial excision/contouring of the anterior orbit to correct dystopia and/or proptosis, and four patients (44.4%) underwent complete excision of the orbital component and reconstruction with bone graft or mesh. Younger age at diagnosis was associated with an increased number of surgical interventions ( P = 0.011), younger age at first optic canal decompression ( P = 0.003), and worse visual outcomes ( P = 0.009). CONCLUSION In the authors' cohort, patients diagnosed at a younger age required more operations, underwent decompression earlier, and had worse visual outcomes. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III.
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Affiliation(s)
- Jessica D Blum
- From the Division of Plastic, Reconstructive, and Oral Surgery
| | - Daniel Y Cho
- From the Division of Plastic, Reconstructive, and Oral Surgery
| | | | | | | | - Philip B Storm
- Department of Neurosurgery, Children's Hospital of Philadelphia
| | - Jesse A Taylor
- From the Division of Plastic, Reconstructive, and Oral Surgery
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Chen L, Mercan E, Massenburg BB, Hopper RA, Susarla SM, Lee A, Ellenbogen RG, Birgfeld CB. Comparison of Morphometric Outcomes following Open Posterior Expansion versus Endoscopic Strip Craniectomy for Sagittal Synostosis. Plast Reconstr Surg 2024; 153:1095-1106. [PMID: 37199432 DOI: 10.1097/prs.0000000000010679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
BACKGROUND Open middle and posterior cranial vault expansion (OPVE) or endoscopic (ES) strip craniectomy are two surgical techniques for normalization of head shape in isolated sagittal synostosis. This study aims to compare 2-year cranial morphometrics after these two approaches. METHODS The authors performed morphometric analysis on preoperative [time (T) 0], immediately postoperative (T1), and 2-year (T2) postoperative computed tomographic scans of patients who underwent OPVE or ES before 4 months of age. Perioperative data and morphometrics were compared between the two groups and age-matched controls. RESULTS Nineteen patients were included in the ES cohort, 19 age-matched patients were included in the OPVE cohort, and 57 were included as controls. Median surgery time and blood transfusion volume were less for the ES approach (118 minutes and 0 cc, respectively) compared with OPVE (204 minutes and 250 cc, respectively). Anthropometric measurements after OPVE were closer in normal controls at T1 compared with ES, but the skull shapes were comparable at T2. In the midsagittal plane, anterior vault was higher after OPVE at T2 compared with both ES and controls, but the posterior length was shorter and closer to controls than in the ES cohort. Cranial volumes were like controls for both cohorts at T2. There was no difference in complication rate. CONCLUSIONS Both OPVE and ES techniques result in normalization of cranial shape in patients with isolated sagittal synostosis after 2 years with minimal morphometric differences. Family decision-making between the two approaches should be based on age at presentation, avoidance of blood transfusion, scar pattern, and availability of helmet molding and not on expected outcome. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, III.
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Affiliation(s)
- Leah Chen
- From the University of Washington School of Medicine
| | - Ezgi Mercan
- Craniofacial Center, Seattle Children's Hospital
| | | | - Richard A Hopper
- Craniofacial Center, Seattle Children's Hospital
- Division of Plastic Surgery, Department of Surgery
| | - Srinivas M Susarla
- Craniofacial Center, Seattle Children's Hospital
- Division of Plastic Surgery, Department of Surgery
| | - Amy Lee
- Craniofacial Center, Seattle Children's Hospital
- Department of Neurological Surgery, University of Washington
| | - Richard G Ellenbogen
- Craniofacial Center, Seattle Children's Hospital
- Department of Neurological Surgery, University of Washington
| | - Craig B Birgfeld
- Craniofacial Center, Seattle Children's Hospital
- Division of Plastic Surgery, Department of Surgery
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Trumble BC, Schwartz M, Ozga AT, Schwartz GT, Stojanowski CM, Jenkins CL, Kraft TS, Garcia AR, Cummings DK, Hooper PL, Eid Rodriguez D, Buetow K, Beheim B, Irimia A, Thomas GS, Thompson RC, Gatz M, Stieglitz J, Finch CE, Gurven M, Kaplan H. Poor Oral Health Is Associated With Inflammation, Aortic Valve Calcification, and Brain Volume Among Forager-Farmers. J Gerontol A Biol Sci Med Sci 2024; 79:glae013. [PMID: 38291985 PMCID: PMC11044433 DOI: 10.1093/gerona/glae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Indexed: 02/01/2024] Open
Abstract
Poor oral health is associated with cardiovascular disease and dementia. Potential pathways include sepsis from oral bacteria, systemic inflammation, and nutritional deficiencies. However, in post-industrialized populations, links between oral health and chronic disease may be confounded because the lower socioeconomic exposome (poor diet, pollution, and low physical activity) often entails insufficient dental care. We assessed tooth loss, caries, and damaged teeth, in relation to cardiovascular and brain aging among the Tsimane, a subsistence population living a relatively traditional forager-horticulturalist lifestyle with poor dental health, but minimal cardiovascular disease and dementia. Dental health was assessed by a physician in 739 participants aged 40-92 years with cardiac and brain health measured by chest computed tomography (CT; n = 728) and brain CT (n = 605). A subset of 356 individuals aged 60+ were also assessed for dementia and mild cognitive impairment (n = 33 impaired). Tooth loss was highly prevalent, with 2.2 teeth lost per decade and a 2-fold greater loss in women. The number of teeth with exposed pulp was associated with higher inflammation, as measured by cytokine levels and white blood cell counts, and lower body mass index. Coronary artery calcium and thoracic aortic calcium were not associated with tooth loss or damaged teeth. However, aortic valve calcification and brain tissue loss were higher in those who had more teeth with exposed pulp. Overall, these results suggest that dental health is associated with indicators of chronic diseases in the absence of typical confounds, even in a population with low cardiovascular and dementia risk factors.
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Affiliation(s)
- Benjamin C Trumble
- School of Human Evolution and Social Change, Center for Evolution and Medicine, Institute of Human Origins, Arizona State University, Tempe, Arizona, USA
| | - Matthew Schwartz
- School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Andrew T Ozga
- Department of Biological Sciences, Halmos College of Arts and Sciences, Fort Lauderdale, Florida, USA
| | - Gary T Schwartz
- School of Human Evolution and Social Change, Center for Evolution and Medicine, Institute of Human Origins, Arizona State University, Tempe, Arizona, USA
| | - Christopher M Stojanowski
- School of Human Evolution and Social Change, Center for Evolution and Medicine, Institute of Human Origins, Arizona State University, Tempe, Arizona, USA
| | - Carrie L Jenkins
- School of Human Evolution and Social Change, Center for Evolution and Medicine, Institute of Human Origins, Arizona State University, Tempe, Arizona, USA
| | - Thomas S Kraft
- Department of Anthropology, University of Utah, Salt Lake City, Utah, USA
| | - Angela R Garcia
- School of Human Evolution and Social Change, Center for Evolution and Medicine, Institute of Human Origins, Arizona State University, Tempe, Arizona, USA
| | - Daniel K Cummings
- Economic Science Institute, Chapman University, Orange, California, USA
| | - Paul L Hooper
- Economic Science Institute, Chapman University, Orange, California, USA
| | | | - Kenneth Buetow
- School of Human Evolution and Social Change, Center for Evolution and Medicine, Institute of Human Origins, Arizona State University, Tempe, Arizona, USA
| | - Bret Beheim
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Andrei Irimia
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Gregory S Thomas
- Heart & Vascular Institute, MemorialCare Health System, Fountain Valley, CA and University of California Irvine, Orange, California, USA
| | - Randall C Thompson
- Department of Cardiology, Saint Luke’s Mid America Heart Institute, Kansas City, Missouri, USA
| | - Margaret Gatz
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Jonathan Stieglitz
- Insititue for Advanced Study, Toulouse School of Economics, Toulouse, France
| | - Caleb E Finch
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Michael Gurven
- Integrative Anthropological Sciences, University of California Santa Barbara, Santa Barbara, California, USA
| | - Hillard Kaplan
- Economic Science Institute, Chapman University, Orange, California, USA
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Massè A, Giachino M, Audisio A, Donis A, Giai Via R, Secco DC, Limone B, Turchetto L, Aprato A. Ganz femoral head reduction associated with coverage and containment procedures improve radiological and functional outcomes in Perthes' disease. Bone Joint J 2024; 106-B:40-46. [PMID: 38688483 DOI: 10.1302/0301-620x.106b5.bjj-2023-0853.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Aims Ganz's studies made it possible to address joint deformities on both the femoral and acetabular side brought about by Perthes' disease. Femoral head reduction osteotomy (FHRO) was developed to improve joint congruency, along with periacetabular osteotomy (PAO), which may enhance coverage and containment. The purpose of this study is to show the clinical and morphological outcomes of the technique and the use of an implemented planning approach. Methods From September 2015 to December 2021, 13 FHROs were performed on 11 patients for Perthes' disease in two centres. Of these, 11 hips had an associated PAO. A specific CT- and MRI-based protocol for virtual simulation of the corrections was developed. Outcomes were assessed with radiological parameters (sphericity index, extrusion index, integrity of the Shenton's line, lateral centre-edge angle (LCEA), Tönnis angle), and clinical parameters (range of motion, visual analogue scale (VAS) for pain, Merle d'Aubigné-Postel score, modified Harris Hip Score (mHHS), and EuroQol five-dimension five-level health questionnaire (EQ-5D-5L)). Early and late complications were reported. Results The mean follow-up was 39.7 months (standard deviation (SD) 26.4). The mean age at surgery was 11.4 years (SD 1.6). No major complications were recorded. One patient required a total hip arthroplasty. Mean femoral head sphericity increased from 46.8% (SD 9.34%) to 70.2% (SD 15.44; p < 0.001); mean LCEA from 19.2° (SD 9.03°) to 44° (SD 10.27°; p < 0.001); mean extrusion index from 37.8 (SD 8.70) to 7.5 (SD 9.28; p < 0.001); and mean Tönnis angle from 16.5° (SD 12.35°) to 4.8° (SD 4.05°; p = 0.100). The mean VAS improved from 3.55 (SD 3.05) to 1.22 (1.72; p = 0.06); mean Merle d'Aubigné-Postel score from 14.55 (SD 1.74) to 16 (SD 1.6; p = 0.01); and mean mHHS from 60.6 (SD 18.06) to 81 (SD 6.63; p = 0.021). The EQ-5D-5L also showed significant improvements. Conclusion FHRO associated with periacetabular procedures is a safe technique that showed improved functional, clinical, and morphological outcomes in Perthes' disease. The newly introduced simulation and planning algorithm may help to further refine the technique.
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Affiliation(s)
- Alessandro Massè
- Ortopedia e Traumatologia 1U, Centro Traumatologico Ortopedico, Città della Salute e della Scienza, Torino, Italy
- Dipartimento di Scienze Chirurgiche, Università degli Studi di Torino, Torino, Italy
| | - Matteo Giachino
- Ortopedia e Traumatologia 1U, Centro Traumatologico Ortopedico, Città della Salute e della Scienza, Torino, Italy
| | - Andrea Audisio
- Ortopedia e Traumatologia Pediatrica, Ospedale Infantile Regina Margherita, Torino, Italy
| | - Andrea Donis
- Dipartimento di Scienze Chirurgiche, Università degli Studi di Torino, Torino, Italy
| | - Riccardo Giai Via
- Dipartimento di Scienze Chirurgiche, Università degli Studi di Torino, Torino, Italy
| | - Davide C Secco
- Dipartimento di Scienze Chirurgiche, Università degli Studi di Torino, Torino, Italy
| | - Beatrice Limone
- Dipartimento di Scienze Chirurgiche, Università degli Studi di Torino, Torino, Italy
| | - Luigino Turchetto
- UOC Ortopedia e Traumatologia, Ospedale di Portogruaro, Portogruaro, Italy
| | - Alessandro Aprato
- Ortopedia e Traumatologia 1U, Centro Traumatologico Ortopedico, Città della Salute e della Scienza, Torino, Italy
- Dipartimento di Scienze Chirurgiche, Università degli Studi di Torino, Torino, Italy
- Ortopedia e Traumatologia Pediatrica, Ospedale Infantile Regina Margherita, Torino, Italy
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156
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Lee EW, Shim DJ, Kim D, Baek SH. Retrograde Distal Thoracic Duct Leak Embolization via Access Through Lymphocele After Thyroidectomy and Neck Dissection. Korean J Radiol 2024; 25:501-503. [PMID: 38685739 PMCID: PMC11058421 DOI: 10.3348/kjr.2024.0247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 03/17/2024] [Accepted: 03/18/2024] [Indexed: 05/02/2024] Open
Affiliation(s)
- Edward Wolfgang Lee
- Division of Interventional Radiology and Liver Transplant Surgery, Department of Radiology and Surgery, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Dong Jae Shim
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Doyoung Kim
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung Hwan Baek
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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157
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Kaira K, Imai H, Mouri A, Yamaguchi OU, Kagamu H. Progression to Lymph Node Metastasis After Spontaneous Regression of Pulmonary Adenocarcinoma Following Biopsy. In Vivo 2024; 38:1498-1502. [PMID: 38688648 PMCID: PMC11059875 DOI: 10.21873/invivo.13597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND/AIM Spontaneous regression (SR) of cancer, which indicates the natural disappearance of malignant tumors, is rare. Little is known about the mechanisms underlying SR; however, immunological reactions, infections, injuries, and medications have been presumed. Among previously reported cases of SR, lung cancer cases have been extremely limited. CASE REPORT Here, we present a case of lymph node metastasis exacerbation after SR of a primary adenocarcinoma following a biopsy. After complete disappearance of the primary site tumor, metastatic lymph nodes in the mediastinum gradually increased in size as a single lesion. Local treatment with resection and radiotherapy was effective for this metastasis, without recurrence for >3 years. CONCLUSION This is an interesting case of SR of pulmonary adenocarcinoma with inconsistent features in the primary and metastatic lesions. When physicians encounter exacerbation of metastatic sites with SR of the primary site in lung cancer, local intervention may be considered as a curative treatment.
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Affiliation(s)
- Kyoichi Kaira
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Hisao Imai
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Atsuto Mouri
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - O U Yamaguchi
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Hiroshi Kagamu
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
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158
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Liu Y, Cai L, Zhou Y. A blood blister-like aneurysm occurring on an intracranial dissecting aneurysm: A case report. Asian J Surg 2024; 47:2449-2450. [PMID: 38302355 DOI: 10.1016/j.asjsur.2024.01.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/19/2024] [Indexed: 02/03/2024] Open
Affiliation(s)
- Yongsheng Liu
- Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lize Cai
- Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Youxin Zhou
- Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
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159
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Wang R, You G, Yin S, Jiang S, Wang H, Shi H, Zhang L. Three-dimensional Mapping Analysis of Talus Fractures and Demonstration of Different Surgical Approaches for Talus Fractures. Orthop Surg 2024; 16:1196-1206. [PMID: 38485459 PMCID: PMC11062851 DOI: 10.1111/os.14033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 02/20/2024] [Accepted: 02/25/2024] [Indexed: 05/03/2024] Open
Abstract
OBJECTIVE The talus is an important component in the ankle, and its treatment after injury is crucial. However, complications and adverse events due to incomplete traditional classifications may still occur, and these classifications fail to analyze the patterns and distribution of fractures from a three-dimensional perspective. Therefore, in this study, we aimed to analyze the location and distribution of fracture lines in different types of talus fractures using three-dimensional (3D) and heat mapping techniques. Additionally, we aimed to determine the surface area of the talus that can be utilized for different approaches of internal fixation, aiding in the planning of surgical procedures. METHODS We retrospectively analyzed data from CT scans from 126 patients diagnosed with talus fractures at our two hospitals. We extracted the CT data of a healthy adult and created a standard talus model. We performed 3D reconstruction using patients' CT images and superimposed the fracture model onto the standard model for drawing fracture lines. Subsequently, we converted the fracture lines into a heat map for visualization. Additionally, we measured 20 specimens to determine the boundary for various ligaments attached to the talus. We determined the surface area of the talus available for different surgical approaches by integrating the boundary data with previously reported data on area of exposure. RESULTS Without considering the displacement distance of the fracture, fracture types were classified as follows, by combining Hawkins and Sneppen classifications: talar neck, 41.3%; posterior talar tubercle, 22.2%; body for the talus and comminuted, 17.5%; lateral talar tubercle, 11.9%; and talar head, 7.1%. We established fracture line and heat maps using this classification. Additionally, we demonstrated the available area for anteromedial, anterolateral, posteromedial, posterolateral, and medial malleolus osteotomy and Chaput osteotomy approaches. CONCLUSION Fracture line and heat map analyses can aid surgeons in planning a single or combined surgical approach for the reduction and internal fixation of talus fractures. Demonstrating the different surgical approaches can help surgeons choose the most effective technique for individual cases.
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Affiliation(s)
- Ruihan Wang
- School of Physical Education, Southwest Medical UniversityLuzhouChina
- Department of RehabilitationYibin Integrated Traditional Chinese and Western Medicine HospitalYibinChina
| | - Guixuan You
- School of Physical Education, Southwest Medical UniversityLuzhouChina
| | - Shiqin Yin
- School of Physical Education, Southwest Medical UniversityLuzhouChina
| | - Songtao Jiang
- School of Clinical Medicine, Southwest Medical UniversityLuzhouChina
| | - Hai Wang
- Department of Medical ImagingYibin Integrated Traditional Chinese and Western Medicine HospitalYibinChina
| | - Houyin Shi
- Department of OrthopaedicsThe Affiliated Traditional Chinese Medicine Hospital, Southwest Medical UniversityLuzhouChina
- Center for Orthopaedic Diseases ResearchThe Affiliated Traditional Chinese Medicine Hospital, Southwest Medical UniversityLuzhouChina
- Luzhou Key Laboratory of Orthopedic DisordersLuzhouChina
| | - Lei Zhang
- Department of OrthopaedicsThe Affiliated Traditional Chinese Medicine Hospital, Southwest Medical UniversityLuzhouChina
- Center for Orthopaedic Diseases ResearchThe Affiliated Traditional Chinese Medicine Hospital, Southwest Medical UniversityLuzhouChina
- Luzhou Key Laboratory of Orthopedic DisordersLuzhouChina
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160
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Wang XJ, Qiu X. Renal collecting-duct carcinoma in a 73-year-old man. Asian J Surg 2024; 47:2279-2280. [PMID: 38331604 DOI: 10.1016/j.asjsur.2024.01.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/26/2024] [Indexed: 02/10/2024] Open
Affiliation(s)
- Xiao Juan Wang
- Department of Imaging, Shandong Linglong Yingcheng Hospital, Zhaoyuan, Yantai, China
| | - Xuan Qiu
- Department of Faculty Surgery, St. Petersburg State University, Saint Petersburg, Russia, 199106; Department of Surgery, Shandong Linglong Yingcheng Hospital, Zhaoyuan, Yantai, China.
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161
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Zhou Z, Hua Q, Wen C, Qian W, Su J, Yang M, Lei M. Effect of Patellar Morphology on the Risk of Osteochondral Fracture after Patellar Dislocation: A Cross-sectional Study. Orthop Surg 2024; 16:1089-1100. [PMID: 38561949 PMCID: PMC11062850 DOI: 10.1111/os.14036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 02/07/2024] [Accepted: 02/25/2024] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE The risk of osteochondral fracture (OCF) after patellar dislocation has been shown to be related to patellofemoral anatomy, but its relationship to patellar morphology remains unknown. The aim of this study was to investigate the associations between patellar morphology and the risk of OCF after patellar dislocation. METHODS A total of 140 patients with patellar dislocation between January 2018 and June 2023 were enrolled in this study and divided into two groups. Sixty-five patellar dislocation patients with OCF were included in the OCF group, while 75 patellar dislocation patients without OCF were included in the non-OCF group. Computed tomography was used to compare measurements of patellar morphology including Wiberg classification, patellar width and thickness, Wiberg angle, Wiberg index, facet ratio, lateral patellar facet angle, and patellar tilt angle. A logistic regression model was performed to evaluate the correlations between patellar morphology and the risk of OCF after patellar dislocation. Receiver operating characteristic curves were used to calculate the area under the curve (AUC) and determine the diagnostic values of patellar morphology for OCF after patellar dislocation. Subgroup analyses for gender and age were conducted to compare the differences in patellar morphology of PD patients. RESULTS Wiberg angle was significantly lower in the OCF group (p = 0.017), while Wiberg index (p = 0.002) and facet ratio (p = 0.023) were significantly higher in the OCF group. According to the results of logistic regression analysis, Wiberg angle (odds ratio [OR] = 0.96, p = 0.022) and Wiberg index (OR = 1.105, p = 0.032) were the final relevant factors for the occurrence of OCF after patellar dislocation. The AUC was 0.622 (95% confidence interval [CI]: 0.529-0.714) for Wiberg angle, 0.65 (95% CI: 0.558-0.742) for Wiberg index, and 0.702 (95% CI: 0.615-0.788) for the combination of Wiberg angle plus Wiberg index. CONCLUSION Wiberg angle and Wiberg index were independent risk factors for the occurrence of osteochondral fracture after patellar dislocation. Moreover, Wiberg angle, Wiberg index, and the combination of Wiberg angle plus Wiberg index had good predictive diagnostic value for the occurrence of OCF after patellar dislocation.
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Affiliation(s)
- Zirui Zhou
- College of Sports Medicine and HealthChengdu Sport UniversityChengduChina
| | - Qiang Hua
- Department of Sports Injury, Affiliated Sports Hospital of Chengdu Sport UniversityChengdu Sport UniversityChengduChina
| | - Chenghong Wen
- Department of Sports Injury, Affiliated Sports Hospital of Chengdu Sport UniversityChengdu Sport UniversityChengduChina
| | - Wenduo Qian
- Department of Sports Injury, Affiliated Sports Hospital of Chengdu Sport UniversityChengdu Sport UniversityChengduChina
| | - Jide Su
- Department of Sports Injury, Affiliated Sports Hospital of Chengdu Sport UniversityChengdu Sport UniversityChengduChina
| | - Min Yang
- Department of Sports Injury, Affiliated Sports Hospital of Chengdu Sport UniversityChengdu Sport UniversityChengduChina
| | - Mingming Lei
- Department of Sports Injury, Affiliated Sports Hospital of Chengdu Sport UniversityChengdu Sport UniversityChengduChina
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Kuo YR, Lee YC, Wang CT, Liu WC, Ou CH, Lin KC, Cheng TH, Jan HC, Hu CY. Prognostic value of preoperative radiographic perinephric fat features in renal cell carcinoma patients undergoing surgery. Asian J Surg 2024; 47:2188-2194. [PMID: 38383186 DOI: 10.1016/j.asjsur.2024.02.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/23/2024] [Accepted: 02/02/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND We aimed to assess the prognostic importance of perinephric fat features in images of patients with non-metastatic renal cell carcinoma (RCC) undergoing surgery. METHODS We enrolled RCC patients who underwent surgical treatment between 2011 and 2019. Two characteristics, including perinephric fat thickness and perinephric fat stranding, were evaluated using preoperative computed tomography or magnetic resonance images. The association between perinephric fat characteristics and disease progression was examined by Kaplan-Meier survival analysis and Cox regression model. RESULTS In a multivariate Cox proportional hazards model adjusting for tumor stage, intratumoral necrosis, and neutrophil-to-lymphocyte ratio, we found that patients in the thin perinephric fat group (<1 cm) had a poorer progression-free survival (PFS) compared to the thick perinephric fat group (≥1 cm) (HR 2.8; 95% CI 1.175-6.674, p = 0.02). Additionally, the fat stranding group had a poorer PFS than the non-stranding group (HR 3.852; 95% CI 1.082-13.704, p = 0.037). The non-stranding with thick perinephric fat group exhibits the highest cumulative PFS while the stranding with thin perinephric fat group has the lowest cumulative PFS. In receiver operating characteristic curve analysis, combing these two perinephric fat characteristics with tumor stage can achieve a better discriminatory power than tumor stage alone. CONCLUSIONS Our study indicates that the evaluation of image-based perinephric fat features is a simple, straightforward, reproducible tool for predicting RCC prognosis and may assist in preoperative risk stratification.
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Affiliation(s)
- Yuh-Ren Kuo
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC
| | - Ya-Che Lee
- Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, 600, Taiwan, ROC
| | - Chung-Teng Wang
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC
| | - Wan-Chen Liu
- Department of Medical Imaging, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC
| | - Chien-Hui Ou
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC; Department of Urology, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC
| | - Kun-Che Lin
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC
| | - Tsung-Han Cheng
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC
| | - Hau-Chern Jan
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC.
| | - Che-Yuan Hu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC.
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García García A, Mora Pinilla J, Raboso Moreno B, Río Ramírez MT, Abad Fernández A. Cheerio Sign: Pulmonary Langerhans Cell Histiocytosis. Arch Bronconeumol 2024; 60:308-309. [PMID: 38508925 DOI: 10.1016/j.arbres.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/22/2024]
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Gupta KK, Davda D, Mughal Z, Lotfallah A, Anari S. Correlation of maximal nasal septal deviation with deviation at the maxillary insertion. Surg Radiol Anat 2024; 46:567-573. [PMID: 38489066 DOI: 10.1007/s00276-024-03334-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 02/23/2024] [Indexed: 03/17/2024]
Abstract
PURPOSE It is unclear if septal deviation at the insertion points to the nasal cavity is associated with the overall septal deviation. This study aimed to assess septal deviation at the cribriform plate (CP) and maxillary crest (MC) using CT scans and to see if there was any correlation with overall septal deviation. METHODS All consecutive CT sinus scans between January 2020 and December 2021 were retrospectively reviewed. Patients were excluded if they had a history of head, nasal or facial trauma, or any previous nasal surgical procedure. Angles between the septum and MC and the septum and CP as well as maximal angle of septal deviation (MSD) were measured. RESULTS A total of 70 scans were included in the final analysis. The mean MSD was 8.14°. The mean septal deviation was 0.89° at the CP and 2.02° at the MC. The correlation coefficient between the deviation at the CP and MSD was 0.025 and between the deviation at the MC and MSD was 0.321. CONCLUSION Our data reveal a positive correlation between septal deviation at the floor of the nose and overall septal deviation; this was not observed at the septal deviation at the roof. This could be explained due to the inherent tilt in the cribriform plate or by earlier ossification and fixation of the septum during its development at its insertion to the roof, thereby allowing further growth and potential for deviation of the lower part of the septum and its insertion to the floor.
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Affiliation(s)
- Keshav Kumar Gupta
- Department of Otorhinolaryngology Heartlands Hospital, University Hospitals Birmingham NHS Trust, Bordesley Green East, Birmingham, B9 5SS, England.
| | - Dean Davda
- Department of Radiology Heartlands Hospital, University Hospitals Birmingham NHS Trust, Birmingham, England
| | - Zahir Mughal
- Department of Otorhinolaryngology Queen Elizabeth Hospital, University Hospitals Birmingham NHS Trust, Birmingham, B15 2TH, England
| | - Andrew Lotfallah
- Department of Otorhinolaryngology Queen Elizabeth Hospital, University Hospitals Birmingham NHS Trust, Birmingham, B15 2TH, England
| | - Shahram Anari
- Department of Otorhinolaryngology Heartlands Hospital, University Hospitals Birmingham NHS Trust, Bordesley Green East, Birmingham, B9 5SS, England
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Xie D, Huang J, Fan S, Guo C, Sun W, Peng Z, Zhang L, Yue C, Qiu Z, Sang H, Liang D, Hu J, Yang J, Huang J, Li L, Liu J, Yang D, Liu X, Kong W, Liu S, Yang Q, Zi W, Li F. Endovascular Therapy and Outcomes Among Patients With Very Large Ischemic Core Stroke. JAMA Netw Open 2024; 7:e249298. [PMID: 38696171 PMCID: PMC11066696 DOI: 10.1001/jamanetworkopen.2024.9298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/04/2024] [Indexed: 05/05/2024] Open
Abstract
Importance The association of endovascular therapy (EVT) with outcomes is unclear for patients with very low Alberta Stroke Program Early Computed Tomography Score (ASPECTS) within 24 hours of stroke onset. Objective To explore the association of EVT with functional and safety outcomes among patients with ASPECTS of 0 to 2 scored with noncontrast computed tomography. Design, Setting, and Participants This cohort study used data from an ongoing, prospective, observational, nationwide registry including all patients treated at 38 stroke centers in China with an occlusion in the internal carotid artery or M1 or M2 segment of the middle cerebral artery within 24 hours of witnessed symptom onset. Patients with ASPECTS of 0 to 2 between November 1, 2021, and February 8, 2023, were included in analysis. Data were analyzed October to November 2023. Exposures EVT vs standard medical treatment (SMT). Main Outcomes and Measures The primary outcome was favorable functional outcome, defined as modified Rankin Scale score (mRS) of 0 to 3, at 90 days. Safety outcomes included symptomatic intracerebral hemorrhage (sICH) within 48 hours and mortality at 90 days. Results A total of 245 patients (median [IQR] age, 71 [63-78] years; 118 [48%] women) with ASPECTS of 0 to 2 were included, of whom 111 patients (45.1%) received SMT and 135 patients (54.9%) received EVT. The EVT group had significantly greater odds of favorable functional outcome at 90 days than the SMT group (30 patients [22.2%] vs 11 patients [9.9%]; P = .01; adjusted odds ratio [aOR], 3.07 [95% CI, 1.29-7.31]; P = .01). Patients in the EVT group, compared with the SMT group, had significantly greater odds of any ICH (56 patients [41.5%] vs 16 patients [11.4%]; P < .001; aOR, 4.27 [95% CI, 2.19-8.35]; P < .001) and sICH (24 patients [17.8%] vs 1 patient [0.9%]; P < .001; aOR, 23.07 [95% CI, 2.99-177.79]; P = .003) within 48 hours. There were no differences between groups for 90-day mortality (80 patients [59.3%] vs 59 patients [53.2%]; P = .34; aOR, 1.38 [95% CI, 0.77-2.47]; P = .28). The results remained robust in the propensity score-matched analysis. Conclusions and Relevance In this cohort study of patients with very low ASPECTS based on NCCT within 24 hours of stroke onset, those treated with EVT had higher odds of a favorable functional outcome compared with those who received SMT. Randomized clinical trials are needed to assess these findings.
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Affiliation(s)
- Dongjing Xie
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jiacheng Huang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shitao Fan
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Changwei Guo
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Wenzhe Sun
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhouzhou Peng
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Lingyu Zhang
- Department of Neurology, Weifang Medical University, Weifang, China
| | - Chengsong Yue
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhongming Qiu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Hongfei Sang
- Department of Neurology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Dingwen Liang
- Department of Neurology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jinrong Hu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jie Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jiandi Huang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Linyu Li
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Juan Liu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Dahong Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xiang Liu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Weilin Kong
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shuai Liu
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Qingwu Yang
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Wenjie Zi
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Fengli Li
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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Liu JX, Song HC, Li XH. Enterogenic embryonic residual cyst: a rare abdominal mass. J Gastrointest Surg 2024; 28:779-781. [PMID: 38704212 DOI: 10.1016/j.gassur.2024.01.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 01/27/2024] [Indexed: 05/06/2024]
Affiliation(s)
- Jia-Xin Liu
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China; Department of Urology, Beijing Fuxing Hospital, Capital Medical University, Beijing, China
| | - Hong-Chen Song
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xuan-Hao Li
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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167
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Guler S, Hull NC, Arteta M, Allen-Rhoades W, Shahi M, Ishitani MB, Demirel N. An unusual case of metastatic trophoblastic neoplasm presenting with diffuse cystic lung disease and pulmonary artery pseudoaneurysms in a teenager. Pediatr Pulmonol 2024; 59:1482-1486. [PMID: 38390771 DOI: 10.1002/ppul.26936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 01/07/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024]
Abstract
Diffuse cystic lung diseases (DCLDs) are a diverse group of lung disorders characterized by the presence of multiple air filled cysts within the lung tissue. These cysts are thin walled and surrounded by normal lung tissue. In adults, DCLD can be associated with various conditions such as lymphangioleiomyomatosis (LAM), Langerhans cell histiocytosis, cancers, and more. In children, DCLD is often linked to lung developmental abnormalities, with bronchopulmonary dysplasia being a common cause. Patients with pulmonary cysts are typically asymptomatic, but some may experience mild symptoms or pneumothorax. While DCLD in children is rarely due to malignancy, metastatic lung disease can be a cause. It is important for clinicians to be aware of the possibility of metastatic lung disease when encountering DCLD.
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Affiliation(s)
- Sevim Guler
- Istanbul University-Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Nathan C Hull
- Division of Pediatric Radiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Manuel Arteta
- Division of Pediatric Pulmonology, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Wendy Allen-Rhoades
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Maryam Shahi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael B Ishitani
- Division of Pediatric Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Nadir Demirel
- Division of Pediatric Pulmonology, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Lee MS, Lee GW, Lee KB. Bone grafting for periprosthetic bone cysts following total ankle arthroplasty. Bone Joint J 2024; 106-B:475-481. [PMID: 38688515 DOI: 10.1302/0301-620x.106b5.bjj-2023-1091.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Aims The purpose of this study was to assess the success rate and functional outcomes of bone grafting for periprosthetic bone cysts following total ankle arthroplasty (TAA). Additionally, we evaluated the rate of graft incorporation and identified associated predisposing factors using CT scan. Methods We reviewed a total of 37 ankles (34 patients) that had undergone bone grafting for periprosthetic bone cysts. A CT scan was performed one year after bone grafting to check the status of graft incorporation. For accurate analysis of cyst volumes and their postoperative changes, 3D-reconstructed CT scan processed with 3D software was used. For functional outcomes, variables such as the Ankle Osteoarthritis Scale score and the visual analogue scale for pain were measured. Results Out of 37 ankles, graft incorporation was successful in 30 cases. Among the remaining seven cases, four (10.8%) exhibited cyst re-progression, so secondary bone grafting was needed. After secondary bone grafting, no further progression has been noted, resulting in an overall 91.9% success rate (34 of 37) at a mean follow-up period of 47.5 months (24 to 120). The remaining three cases (8.1%) showed implant loosening, so tibiotalocalcaneal arthrodesis was performed. Functional outcomes were also improved after bone grafting in all variables at the latest follow-up (p < 0.05). The mean incorporation rate of the grafts according to the location of the cysts was 84.8% (55.2% to 96.1%) at the medial malleolus, 65.1% (27.6% to 97.1%) at the tibia, and 81.2% (42.8% to 98.7%) at the talus. Smoking was identified as a significant predisposing factor adversely affecting graft incorporation (p = 0.001). Conclusion Bone grafting for periprosthetic bone cysts following primary TAA is a reliable procedure with a satisfactory success rate and functional outcomes. Regular follow-up, including CT scan, is important for the detection of cyst re-progression to prevent implant loosening after bone grafting.
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Affiliation(s)
- Min-Su Lee
- Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Gun-Woo Lee
- Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Keun-Bae Lee
- Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, Gwangju, South Korea
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Moreno-Navarro L, Farrerons-Llopart M, López-Hernández N, Moliner-Castellano S, Ballesteros-Aparicio MJ, Gallego-León J, Concepción-Aramendía L. Clinicoradiological application of the use of spectral cranial computed tomography in the management of acute ischemic stroke after mechanical thrombectomy. Rev Neurol 2024; 78:247-252. [PMID: 38682762 DOI: 10.33588/rn.7809.2023340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
INTRODUCTION Acute ischemic stroke is one of the leading global causes of morbidity and mortality. Mechanical thrombectomy has improved the functional prognosis of this condition; however, hemorrhagic transformation is a common complication. Spectral computed tomography (CT) imaging, as a neuroimaging control test, distinguishes contrast extravasation from hemorrhagic transformation due to the differential behavior of materials at dual energy levels. This distinction is valuable in its clinical therapeutic management. MATERIAL AND METHODS A single-center, observational, retrospective study was conducted in which the presence of various clinical, radiological, and therapeutic variables in patients with acute ischemic stroke treated with mechanical thrombectomy at our hospital between July 2022 and March 2023 was investigated using access to a dissociated database and medical records. RESULTS Out of 155 included patients, spectral cranial CT was performed in 63, and conventional cranial CT in 75. In the spectral CT group, 21 hyperdense images were detected, compared to 28 in the conventional CT group. In 42.8% of cases where hyperdensity was detected in the conventional CT group, it was not possible to distinguish between contrast extravasation and hemorrhagic transformation, in contrast to the 4.8% in the spectral CT group (p < 0.001). CONCLUSIONS Spectral CT provides high diagnostic confidence to the radiologist in identifying the type of detected hyperdensity, thereby offering significant therapeutic confidence to the neurologist in early resuming anticoagulation therapy.
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Affiliation(s)
- L Moreno-Navarro
- Hospital General Universitario Dr. Balmis, Alicante, España
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
| | - M Farrerons-Llopart
- Hospital General Universitario Dr. Balmis, Alicante, España
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
| | - N López-Hernández
- Hospital General Universitario Dr. Balmis, Alicante, España
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
| | | | | | - J Gallego-León
- Hospital General Universitario Dr. Balmis, Alicante, España
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Humphries SM, Thieke D, Baraghoshi D, Strand MJ, Swigris JJ, Chae KJ, Hwang HJ, Oh AS, Flaherty KR, Adegunsoye A, Jablonski R, Lee CT, Husain AN, Chung JH, Strek ME, Lynch DA. Deep Learning Classification of Usual Interstitial Pneumonia Predicts Outcomes. Am J Respir Crit Care Med 2024; 209:1121-1131. [PMID: 38207093 DOI: 10.1164/rccm.202307-1191oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024] Open
Abstract
Rationale: Computed tomography (CT) enables noninvasive diagnosis of usual interstitial pneumonia (UIP), but enhanced image analyses are needed to overcome the limitations of visual assessment. Objectives: Apply multiple instance learning (MIL) to develop an explainable deep learning algorithm for prediction of UIP from CT and validate its performance in independent cohorts. Methods: We trained an MIL algorithm using a pooled dataset (n = 2,143) and tested it in three independent populations: data from a prior publication (n = 127), a single-institution clinical cohort (n = 239), and a national registry of patients with pulmonary fibrosis (n = 979). We tested UIP classification performance using receiver operating characteristic analysis, with histologic UIP as ground truth. Cox proportional hazards and linear mixed-effects models were used to examine associations between MIL predictions and survival or longitudinal FVC. Measurements and Main Results: In two cohorts with biopsy data, MIL improved accuracy for histologic UIP (area under the curve, 0.77 [n = 127] and 0.79 [n = 239]) compared with visual assessment (area under the curve, 0.65 and 0.71). In cohorts with survival data, MIL-UIP classifications were significant for mortality (n = 239, mortality to April 2021: unadjusted hazard ratio, 3.1; 95% confidence interval [CI], 1.96-4.91; P < 0.001; and n = 979, mortality to July 2022: unadjusted hazard ratio, 3.64; 95% CI, 2.66-4.97; P < 0.001). Individuals classified as UIP positive by the algorithm had a significantly greater annual decline in FVC than those classified as UIP negative (-88 ml/yr vs. -45 ml/yr; n = 979; P < 0.01), adjusting for extent of lung fibrosis. Conclusions: Computerized assessment using MIL identifies clinically significant features of UIP on CT. Such a method could improve confidence in radiologic assessment of patients with interstitial lung disease, potentially enabling earlier and more precise diagnosis.
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Affiliation(s)
| | | | | | | | - Jeffrey J Swigris
- Division of Pulmonary and Critical Care Medicine, National Jewish Health, Denver, Colorado
| | - Kum Ju Chae
- Department of Radiology, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea
| | - Hye Jeon Hwang
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Andrea S Oh
- Department of Radiology, University of California Los Angeles, Los Angeles, California
| | - Kevin R Flaherty
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan
| | | | - Renea Jablonski
- Section of Pulmonary and Critical Care, Department of Medicine
| | - Cathryn T Lee
- Section of Pulmonary and Critical Care, Department of Medicine
| | - Aliya N Husain
- Department of Pathology, The University of Chicago, Chicago, Illinois
| | | | - Mary E Strek
- Section of Pulmonary and Critical Care, Department of Medicine
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Hardcastle N, Vasquez Osorio E, Jackson A, Mayo C, Aarberg AE, Ayadi M, Belosi F, Ceylan C, Davey A, Dupuis P, Handley JC, Hemminger T, Hoffmann L, Kelly C, Michailidou C, Muscat S, Murrell DH, Pérez-Alija J, Palmer C, Placidi L, Popovic M, Rønde HS, Selby A, Skopidou T, Solomou N, Stroom J, Thompson C, West NS, Zaila A, Appelt AL. Multi-centre evaluation of variation in cumulative dose assessment in reirradiation scenarios. Radiother Oncol 2024; 194:110184. [PMID: 38453055 DOI: 10.1016/j.radonc.2024.110184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/18/2024] [Accepted: 02/20/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND AND PURPOSE Safe reirradiation relies on assessment of cumulative doses to organs at risk (OARs) across multiple treatments. Different clinical pathways can result in inconsistent estimates. Here, we quantified the consistency of cumulative dose to OARs across multi-centre clinical pathways. MATERIAL AND METHODS We provided DICOM planning CT, structures and doses for two reirradiation cases: head & neck (HN) and lung. Participants followed their standard pathway to assess the cumulative physical and EQD2 doses (with provided α/β values), and submitted DVH metrics and a description of their pathways. Participants could also submit physical dose distributions from Course 1 mapped onto the CT of Course 2 using their best available tools. To assess isolated impact of image registrations, a single observer accumulated each submitted spatially mapped physical dose for every participating centre. RESULTS Cumulative dose assessment was performed by 24 participants. Pathways included rigid (n = 15), or deformable (n = 5) image registration-based 3D dose summation, visual inspection of isodose line contours (n = 1), or summation of dose metrics extracted from each course (n = 3). Largest variations were observed in near-maximum cumulative doses (25.4 - 41.8 Gy for HN, 2.4 - 33.8 Gy for lung OARs), with lower variations in volume/dose metrics to large organs. A standardised process involving spatial mapping of the first course dose to the second course CT followed by summation improved consistency for most near-maximum dose metrics in both cases. CONCLUSION Large variations highlight the uncertainty in reporting cumulative doses in reirradiation scenarios, with implications for outcome analysis and understanding of published doses. Using a standardised workflow potentially including spatially mapped doses improves consistency in determination of accumulated dose in reirradiation scenarios.
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Affiliation(s)
- Nicholas Hardcastle
- Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia; Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia.
| | | | - Andrew Jackson
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Charles Mayo
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA
| | | | - Myriam Ayadi
- Department of Radiation Oncology, Physics Unit, Centre Léon Bérard, Lyon, France
| | - Francesca Belosi
- Department of Radiation Oncology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Cemile Ceylan
- Department of Radiation Oncology, Istanbul Oncology Hospital, Istanbul, Turkey; Department of Medical Physics, University of Yeditepe, Istanbul, Turkey
| | - Angela Davey
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
| | - Pauline Dupuis
- Department of Radiation Oncology, Physics Unit, Centre Léon Bérard, Lyon, France
| | | | | | - Lone Hoffmann
- Department of Medical Physics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark
| | - Colin Kelly
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | | | - Sarah Muscat
- Department of Medical Physics, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - Donna H Murrell
- Department of Oncology, Western University, London, Ontario, Canada; London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
| | - Jaime Pérez-Alija
- Servei de Radiofísica i Radioprotecció, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Catherine Palmer
- Department of Radiotherapy Physics, Norfolk and Norwich University Hospitals, NHS Foundation Trust, UK
| | - Lorenzo Placidi
- Department of Radiology, Radiation Oncology and Hematology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Marija Popovic
- Department of Medical Physics, McGill University Health Centre, Montreal, Quebec, Canada
| | - Heidi S Rønde
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Adam Selby
- South West Wales Cancer Centre, Swansea, Wales, UK
| | | | - Natasa Solomou
- Department of Radiotherapy Physics, Norfolk and Norwich University Hospitals, NHS Foundation Trust, UK
| | - Joep Stroom
- Department of Radiation Oncology, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | | | | | - Ali Zaila
- Biomedical Physics Department, King Faisal Specialist Hospital and Research Center (KFSHRC), Riyadh, Saudi Arabia
| | - Ane L Appelt
- Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
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Kiraly AP, Cunningham CA, Najafi R, Nabulsi Z, Yang J, Lau C, Ledsam JR, Ye W, Ardila D, McKinney SM, Pilgrim R, Liu Y, Saito H, Shimamura Y, Etemadi M, Melnick D, Jansen S, Corrado GS, Peng L, Tse D, Shetty S, Prabhakara S, Nadich DP, Beladia N, Eswaran K. Assistive AI in Lung Cancer Screening: A Retrospective Multinational Study in the United States and Japan. Radiol Artif Intell 2024; 6:e230079. [PMID: 38477661 DOI: 10.1148/ryai.230079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Purpose To evaluate the impact of an artificial intelligence (AI) assistant for lung cancer screening on multinational clinical workflows. Materials and Methods An AI assistant for lung cancer screening was evaluated on two retrospective randomized multireader multicase studies where 627 (141 cancer-positive cases) low-dose chest CT cases were each read twice (with and without AI assistance) by experienced thoracic radiologists (six U.S.-based or six Japan-based radiologists), resulting in a total of 7524 interpretations. Positive cases were defined as those within 2 years before a pathology-confirmed lung cancer diagnosis. Negative cases were defined as those without any subsequent cancer diagnosis for at least 2 years and were enriched for a spectrum of diverse nodules. The studies measured the readers' level of suspicion (on a 0-100 scale), country-specific screening system scoring categories, and management recommendations. Evaluation metrics included the area under the receiver operating characteristic curve (AUC) for level of suspicion and sensitivity and specificity of recall recommendations. Results With AI assistance, the radiologists' AUC increased by 0.023 (0.70 to 0.72; P = .02) for the U.S. study and by 0.023 (0.93 to 0.96; P = .18) for the Japan study. Scoring system specificity for actionable findings increased 5.5% (57% to 63%; P < .001) for the U.S. study and 6.7% (23% to 30%; P < .001) for the Japan study. There was no evidence of a difference in corresponding sensitivity between unassisted and AI-assisted reads for the U.S. (67.3% to 67.5%; P = .88) and Japan (98% to 100%; P > .99) studies. Corresponding stand-alone AI AUC system performance was 0.75 (95% CI: 0.70, 0.81) and 0.88 (95% CI: 0.78, 0.97) for the U.S.- and Japan-based datasets, respectively. Conclusion The concurrent AI interface improved lung cancer screening specificity in both U.S.- and Japan-based reader studies, meriting further study in additional international screening environments. Keywords: Assistive Artificial Intelligence, Lung Cancer Screening, CT Supplemental material is available for this article. Published under a CC BY 4.0 license.
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Affiliation(s)
- Atilla P Kiraly
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Corbin A Cunningham
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Ryan Najafi
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Zaid Nabulsi
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Jie Yang
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Charles Lau
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Joseph R Ledsam
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Wenxing Ye
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Diego Ardila
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Scott M McKinney
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Rory Pilgrim
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Yun Liu
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Hiroaki Saito
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Yasuteru Shimamura
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Mozziyar Etemadi
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - David Melnick
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Sunny Jansen
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Greg S Corrado
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Lily Peng
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Daniel Tse
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Shravya Shetty
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Shruthi Prabhakara
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - David P Nadich
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Neeral Beladia
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
| | - Krish Eswaran
- From Google Health Research, 1600 Amphitheatre Pkwy, Mountain View, CA 94043 (A.P.K., C.A.C., R.N., Z.N., C.L., J.R.L., D.A., S.M.M., R.P., Y.L., S.J., G.S.C., L.P., D.T., S.S., S.P., K.E.); Waymo, Mountain View, Calif (J.Y., N.B.), David Geffen School of Medicine at UCLA, Los Angeles, Calif (C.L.); Google, Mountain View, Calif (W.Y.); Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Japan (H.S.); MNES Inc, Hiroshima, Japan (Y.S.); Department of Telemedicine, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.E., D.M.); and Center for Biological Imaging, New York University-Langone Medical Center, New York, NY (D.P.N.)
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Gopal P, Banerjee D, Karad A, Dandi K, Dahale AS. Gastrointestinal: Congenital portosystemic shunt (Abernathy type 2) with cirrhosis of liver. J Gastroenterol Hepatol 2024; 39:781-782. [PMID: 38148590 DOI: 10.1111/jgh.16456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/11/2023] [Indexed: 12/28/2023]
Affiliation(s)
- P Gopal
- Department of Medical Gastroenterology, Dr. D Y Patil Medical College, Hospital and Research Centre, Pune, India
| | - D Banerjee
- Department of Medical Gastroenterology, Dr. D Y Patil Medical College, Hospital and Research Centre, Pune, India
| | - A Karad
- Department of Medical Gastroenterology, Dr. D Y Patil Medical College, Hospital and Research Centre, Pune, India
| | - K Dandi
- Department of Medical Gastroenterology, Dr. D Y Patil Medical College, Hospital and Research Centre, Pune, India
| | - A S Dahale
- Department of Medical Gastroenterology, Dr. D Y Patil Medical College, Hospital and Research Centre, Pune, India
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174
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Bousigues S, Gajny L, Skalli W, Ohl X, Tétreault P, Hagemeister N. Evaluation of a method to quantify posture and scapula position using biplanar radiography. Med Eng Phys 2024; 127:104167. [PMID: 38692766 DOI: 10.1016/j.medengphy.2024.104167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/26/2024] [Accepted: 04/10/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Recent studies have stated the relevance of having new parameters to quantify the position and orientation of the scapula with patients standing upright. Although biplanar radiography can provide 3D reconstructions of the scapula and the spine, it is not yet possible to acquire these images with patients in the same position. METHODS Two pairs of images were acquired, one for the 3D reconstruction of the spine and ribcage and one for the 3D reconstruction of the scapula. Following 3D reconstructions, scapular alignment was performed in two stages, a coarse alignment based on manual annotations of landmarks on the clavicle and pelvis, and an adjusted alignment. Clinical parameters were computed: protraction, internal rotation, tilt and upward rotation. Reproducibility was assessed on an in vivo dataset of upright biplanar radiographs. Accuracy was assessed using supine cadaveric CT-scans and digitally reconstructed radiographs. FINDINGS The mean error was less than 2° for all clinical parameters, and the 95 % confidence interval for reproducibility ranged from 2.5° to 5.3°. INTERPRETATION The confidence intervals were lower than the variability measured between participants for the clinical parameters assessed, which indicates that this method has the potential to detect different patterns in pathological populations.
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Affiliation(s)
- S Bousigues
- Arts et Métiers, Institut de Biomécanique Humaine Georges Charpak, Paris, France.
| | - L Gajny
- Arts et Métiers, Institut de Biomécanique Humaine Georges Charpak, Paris, France
| | - W Skalli
- Arts et Métiers, Institut de Biomécanique Humaine Georges Charpak, Paris, France
| | - X Ohl
- Hôpital Maison Blanche, CHU de Reims, France
| | - P Tétreault
- Centre Hospitalier de l'Université de Montréal, Canada
| | - N Hagemeister
- Ecole de Technologie Supérieure, Laboratoire de recherche en Imagerie et Orthopédie, Montréal, Canada
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Abstract
Schwannoma in primary neurogenic tumors of the trachea is an extremely rare disease. A 21-year-old male patient with stridor was followed up with a diagnosis of asthma for two years. While no lesion was observed in the chest X-ray, tracheal schwannoma was diagnosed in the case who underwent tracheotomy due to the lesion obstructing the trachea almost completely on chest CT. The clinical findings of the patient improved ultimately in the postoperative period. We aimed to discuss the approach and follow-up of the disease with our case, although it is rare that schwannoma might be in the differential diagnosis of masses with upper airway obstruction.
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Affiliation(s)
- Emine Afsin
- Chest Diseases, Bolu Abant Izzet Baysal Universitesi Tip Fakultesi, Bolu, Turkey
| | - Osman Yaksi
- Toracic Surgery, Bolu Abant Izzet Baysal Universitesi Tip Fakultesi, Bolu, Turkey
| | - Alican Önal
- Pathology, Bolu Abant Izzet Baysal Universitesi Tip Fakultesi, Bolu, Turkey
| | - Emre Bacaksiz
- Chest Diseases, Bolu Abant Izzet Baysal Universitesi Tip Fakultesi, Bolu, Turkey
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176
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Li P, Zhang L, Liang J, Tuo HF. A sarcomatoid carcinoma in the pancreas tail: A case report with literature review. Asian J Surg 2024; 47:2349-2351. [PMID: 38331612 DOI: 10.1016/j.asjsur.2024.01.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 01/26/2024] [Indexed: 02/10/2024] Open
Affiliation(s)
- Pengcheng Li
- Department of Hepatobiliary Surgery, Hebei General Hospital, Shijiazhuang, 050051, China
| | - Liangliang Zhang
- Department of Hepatobiliary Surgery, Hebei General Hospital, Shijiazhuang, 050051, China
| | - Jiale Liang
- Department of Hepatobiliary Surgery, Hebei General Hospital, Shijiazhuang, 050051, China
| | - Hong Fang Tuo
- Department of Hepatobiliary Surgery, Hebei General Hospital, Shijiazhuang, 050051, China.
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de Frémont GM, Monaya A, Chassagnon G, Bouam S, Canniff E, Cohen P, Casadevall M, Mouthon L, Le Guern V, Revel MP. Lung fibrosis is uncommon in primary Sjögren's disease: A retrospective analysis of computed tomography features in 77 patients. Diagn Interv Imaging 2024; 105:183-190. [PMID: 38262872 DOI: 10.1016/j.diii.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/29/2023] [Accepted: 01/05/2024] [Indexed: 01/25/2024]
Abstract
PURPOSE The purpose of this study was to describe lung abnormalities observed on computed tomography (CT) in patients meeting the 2016 American College of Rheumatology/European League Against Rheumatism (EULAR) classification criteria for primary Sjögren's disease (pSD). MATERIALS AND METHODS All patients with pSD seen between January 2009 and December 2020 in the day care centre of our National Reference Center for rare systemic autoimmune diseases, who had at least one chest CT examination available for review and for whom the cumulative EULAR Sjögren's Syndrome Disease Activity Index (cumESSDAI) could be calculated were retrospectively evaluated. CT examinations were reviewed, together with clinical symptoms and pulmonary functional results. RESULTS Seventy-seven patients (73 women, four men) with a median age of 51 years at pSD diagnosis (age range: 17-79 years), a median follow-up time of 6 years and a median cumESSDAI of 7 were included. Sixty-six patients (86%) had anti-SSA antibodies. Thirty-three patients (33/77; 43%) had respiratory symptoms, without significant alteration in pulmonary function tests. Forty patients (40/77; 52%) had abnormal lung CT findings of whom almost half of them had no respiratory symptoms. Abnormalities on chest CT were more frequently observed in patients with anti-SSA positivity and a history of lymphoma. Air cysts (28/77; 36%) and mosaic perfusion (35/77; 35%) were the predominant abnormalities, whereas lung fibrosis was observed in five patients (5/77; 6%). CONCLUSION More than half of patients with pSD have abnormal CT findings, mainly air cysts and mosaic perfusion, indicative of small airways disease, whereas lung fibrosis is rare, observed in less than 10% of such patients.
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Affiliation(s)
- Grégoire Martin de Frémont
- Université Paris Cité, Faculté de Médecine, 75006 paris, France; Department of Internal Medicine, Centre de Référence des Maladies Auto-immunes et Systémiques Rares d'Ile de France, Hôpital Cochin, AP-HP, 75014 Paris, France
| | | | - Guillaume Chassagnon
- Université Paris Cité, Faculté de Médecine, 75006 paris, France; Department of Radiology, Hôpital Cochin, AP-HP, 75014 Paris, France
| | - Samir Bouam
- Department of Medical Informatics, Hôpital Cochin, AP-HP, 75014 Paris, France
| | - Emma Canniff
- Department of Radiology, Hôpital Cochin, AP-HP, 75014 Paris, France
| | - Pascal Cohen
- Department of Internal Medicine, Centre de Référence des Maladies Auto-immunes et Systémiques Rares d'Ile de France, Hôpital Cochin, AP-HP, 75014 Paris, France
| | - Marion Casadevall
- Department of Internal Medicine, Centre de Référence des Maladies Auto-immunes et Systémiques Rares d'Ile de France, Hôpital Cochin, AP-HP, 75014 Paris, France
| | - Luc Mouthon
- Université Paris Cité, Faculté de Médecine, 75006 paris, France; Department of Internal Medicine, Centre de Référence des Maladies Auto-immunes et Systémiques Rares d'Ile de France, Hôpital Cochin, AP-HP, 75014 Paris, France
| | - Véronique Le Guern
- Department of Internal Medicine, Centre de Référence des Maladies Auto-immunes et Systémiques Rares d'Ile de France, Hôpital Cochin, AP-HP, 75014 Paris, France
| | - Marie-Pierre Revel
- Université Paris Cité, Faculté de Médecine, 75006 paris, France; Department of Radiology, Hôpital Cochin, AP-HP, 75014 Paris, France.
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178
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Smith T, Howick V JF, Sweetser S. 75-Year-Old Woman With Abdominal Distention. Mayo Clin Proc 2024; 99:832-835. [PMID: 38520449 DOI: 10.1016/j.mayocp.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 03/25/2024]
Affiliation(s)
- Thomas Smith
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN
| | - James F Howick V
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN
| | - Seth Sweetser
- Advisor to residents and Consultant in Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
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179
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Fall Hypopharynxtumor. Laryngorhinootologie 2024; 103:383. [PMID: 38697085 DOI: 10.1055/a-2287-8335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
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180
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Sakhrekar R, Shkumat N, Ertl-Wagner B, Lewis S, Lebel D, McVey MJ, Camp M. Pedicle screw accuracy placed with assistance of machine vision technology in patients with neuromuscular scoliosis. Spine Deform 2024; 12:739-746. [PMID: 38413472 DOI: 10.1007/s43390-024-00830-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 01/13/2024] [Indexed: 02/29/2024]
Abstract
INTRODUCTION Pedicle screws are the primary method of vertebral fixation in scoliosis surgery, but there are lingering concerns over potential malposition. The rates of pedicle screw malposition in pediatric spine surgery vary from 10% to 21%. Malpositioned screws can lead to potentially catastrophic neurological, vascular, and visceral complications. Pedicle screw positioning in patients with neuromuscular scoliosis is challenging due to a combination of large curves, complex pelvic anatomy, and osteopenia. This study aimed to determine the rate of pedicle screw malposition, associated complications, and subsequent revision from screws placed with the assistance of machine vision navigation technology in patients with neuromuscular scoliosis undergoing posterior instrumentation and fusion. METHOD A retrospective analysis of the records of patients with neuromuscular scoliosis who underwent thoracolumbar pedicle screw insertion with the assistance of machine-vision image guidance navigation was performed. Screws were inserted by either a staff surgeon, orthopaedic fellow, or orthopaedic resident. Post-operative ultra-low dose CT scans were used to assess pedicle screw accuracy. The Gertzbein classification was used to grade any pedicle breaches (grade 0, no breach; grade 1, <2 mm; grade 2, 2-4 mm; grade 3, >4 mm). A screw was deemed accurate if no breach was identified (grade 0). RESULTS 25 patients were included in the analysis, with a mean age of 13.6 years (range 11 to 18 years; 13/25 (52.0%) were female. The average pre-operative supine Cobb angle was 90.0 degrees (48-120 degrees). A total of 687 screws from 25 patients were analyzed (402 thoracic, 241 lumbosacral, 44 S2 alar-iliac (S2AI) screws). Surgical trainees (fellows and orthopaedic residents) inserted 46.6% (320/687) of screws with 98.8% (4/320) accuracy. The overall accuracy of pedicle screw insertion was 98.0% (Grade 0, no breach). All 13 breaches that occurred in the thoracic and lumbar screws were Grade 1. Of the 44 S2AI screws placed, one screw had a Grade 3 breach (2.3%) noted on intra-operative radiographs following rod placement and correction. This screw was subsequently revised. None of the breaches resulted in neuromonitoring changes, vessel, or visceral injuries. CONCLUSION Machine vision navigation technology combined with careful free-hand pedicle screw insertion techniques demonstrated high levels of pedicle screw insertion accuracy, even in patients with challenging anatomy.
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Affiliation(s)
- Rajendra Sakhrekar
- Division of Orthopaedic Surgery, University of Toronto, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
| | - Nicholas Shkumat
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Birgit Ertl-Wagner
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Stephen Lewis
- Division of Orthopaedic Surgery, University of Toronto, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - David Lebel
- Division of Orthopaedic Surgery, University of Toronto, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - M J McVey
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada
- Department of Physics, Toronto Metropolitan University, Toronto, ON, Canada
| | - Mark Camp
- Division of Orthopaedic Surgery, University of Toronto, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
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181
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Luo E, Zhou M, Chen W, Ding M. Retroperitoneal teratoma in adults:a case report. Asian J Surg 2024; 47:2529-2530. [PMID: 38458867 DOI: 10.1016/j.asjsur.2024.02.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/02/2024] [Indexed: 03/10/2024] Open
Affiliation(s)
- Enxiu Luo
- Department of Urology Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
| | - Mengdi Zhou
- Department of Urology Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wujie Chen
- Department of Urology Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Mingxia Ding
- Department of Urology Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
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182
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Harth S, Roller FC, Zeppernick F, Meinhold-Heerlein I, Krombach GA. Cystic echinococcosis, a rare differential diagnosis of cystic pelvic masses. ROFO-FORTSCHR RONTG 2024; 196:491-493. [PMID: 38052227 DOI: 10.1055/a-2211-2444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Affiliation(s)
- Sebastian Harth
- Department of Diagnostic and Interventional Radiology, University Hospital Giessen, Justus Liebig University, Giessen, Germany
| | - Fritz Christian Roller
- Department of Diagnostic and Interventional Radiology, University Hospital Giessen, Justus Liebig University, Giessen, Germany
| | - Felix Zeppernick
- Department of Gynecology and Obstetrics, University Hospital Giessen, Justus Liebig University, Giessen, Germany
| | - Ivo Meinhold-Heerlein
- Department of Gynecology and Obstetrics, University Hospital Giessen, Justus Liebig University, Giessen, Germany
| | - Gabriele Anja Krombach
- Department of Diagnostic and Interventional Radiology, University Hospital Giessen, Justus Liebig University, Giessen, Germany
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183
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Jiang Y, Lin Y, Yang C, He P, Liu Z, Wang H, Zhong R, Huang L, Li Z, Xu F, Lin X, Liu J, Xu X, Li S, Cui F, Wang W, Liang W, Zhao L, Hu J, Li B, Chen D, Tang W, Chen C, Fu J, Leng X, Pang D, He J, Liang H. Spatiotemporal distribution of mediastinal neoplasms: A comprehensive multi-center study. Lung Cancer 2024; 191:107558. [PMID: 38569278 DOI: 10.1016/j.lungcan.2024.107558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/07/2024] [Accepted: 03/29/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Mediastinal neoplasms are typical but uncommon thoracic diseases with increasing incidence and unfavorable prognoses. A comprehensive understanding of their spatiotemporal distribution is essential for accurate diagnosis and timely treatment. However, previous studies are limited in scale and data coverage. Therefore, this study aims to elucidate the distribution of mediastinal lesions, offering valuable insights into this disease. MATERIALS AND METHODS This multi-center, hospital-based observational study included 20 nationwide institutions. A retrospective search of electronic medical records from January 1st, 2009, to December 31st, 2020, was conducted, collecting sociodemographic data, computed tomography images, and pathologic diagnoses. Analysis focused on age, sex, time, location, and geographical region. Comparative assessments were made with global data from a multi-center database. RESULTS Among 7,765 cases, thymomas (30.7%), benign mediastinal cysts (23.4%), and neurogenic tumors (10.0%) were predominant. Distribution varied across mediastinal compartments, with thymomas (39.6%), benign cysts (28.1%), and neurogenic tumors (51.9%) most prevalent in the prevascular, visceral, and paravertebral mediastinum, respectively. Age-specific variations were notable, with germ cell tumors prominent in patients under 18 and aged 18-29, while thymomas were more common in patients over 30. The composition of mediastinal lesions across different regions of China remained relatively consistent, but it differs from that of the global population. CONCLUSION This study revealed significant heterogeneity in the spatiotemporal distribution of mediastinal neoplasms. These findings provide useful demographic data when considering the differential diagnosis of mediastinal lesions, and would be beneficial for tailoring disease prevention and control strategies.
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Affiliation(s)
- Yu Jiang
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Yuechun Lin
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Chao Yang
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Ping He
- Department of Pathology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Zhichao Liu
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Haixuan Wang
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Ran Zhong
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Linchong Huang
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Zhigang Li
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Fuhao Xu
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Xu Lin
- Department of Thoracic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Jun Liu
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Xin Xu
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Shuben Li
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Fei Cui
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Wei Wang
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Wenhua Liang
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Lei Zhao
- Department of Physiology, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou 511495, China
| | - Jian Hu
- Department of Thoracic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Bin Li
- Department of Thoracic Surgery, Lanzhou University Second Hospital, Lanzhou University Second Clinical Medical College, Lanzhou 730030, China
| | - Donglai Chen
- Department of Thoracic Surgery, Zhongshan Hospital Fudan University, Shanghai 200032, China
| | - Wenfang Tang
- Department of Cardiothoracic Surgery, Zhongshan City People's Hospital, Zhongshan 528403, China
| | - Chun Chen
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350000, China
| | - Junke Fu
- Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Xuefeng Leng
- Division of Thoracic Surgery, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China
| | - Dazhi Pang
- Department of Thoracic Surgery, the University of Hong Kong-Shenzhen Hospital, Shenzhen 518004, China
| | - Jianxing He
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China.
| | - Hengrui Liang
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China.
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184
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Timmer FEF, Geboers B, Ruarus AH, Vroomen LGPH, Schouten EAC, van der Lei S, Vos DJW, Dijkstra M, Schulz HH, Bakker J, van den Bemd BAT, van den Tol PM, Puijk RS, Lissenberg-Witte BI, de Gruijl TD, de Vries JJJ, Lagerwaard FJ, Scheffer HJ, Bruynzeel AME, Meijerink MR. MRI-guided stereotactic ablative body radiotherapy versus CT-guided percutaneous irreversible electroporation for locally advanced pancreatic cancer (CROSSFIRE): a single-centre, open-label, randomised phase 2 trial. Lancet Gastroenterol Hepatol 2024; 9:448-459. [PMID: 38513683 DOI: 10.1016/s2468-1253(24)00017-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Pancreatic ductal adenocarcinoma is an aggressive disease with a dismal prognosis. Stage III locally advanced pancreatic cancer is considered unresectable and current palliative chemotherapy regimens only modestly improve survival. Guidelines suggest chemoradiation or stereotactic ablative body radiotherapy (SABR) could be beneficial in certain circumstances. Other local treatments such as irreversible electroporation could enhance patient outcomes by extending survival while preserving quality of life. We aimed to compare the efficacy and safety of MRI-guided SABR versus CT-guided percutaneous irreversible electroporation following standard FOLFIRINOX chemotherapy. METHODS CROSSFIRE was an open-label, randomised phase 2 superiority trial conducted at the Amsterdam University Medical Centre (Amsterdam, Netherlands). Eligible patients were aged 18 years or older with confirmed histological and radiological stage III locally advanced pancreatic cancer. The maximum tumour diameter was 5 cm and patients had to be pretreated with three to eight cycles of FOLFIRINOX. Patients were randomly assigned (1:1) to MRI-guided SABR (five fractions of 8 Gy delivered on non-consecutive days) or CT-guided percutaneous irreversible electroporation using a computer-generated variable block randomisation model. The primary endpoint was overall survival from randomisation, assessed in the intention-to-treat population. Safety was assessed in the per-protocol population. A prespecified interim futility analysis was done after inclusion of half the original sample size, with a conditional probability of less than 0·2 resulting in halting of the study. The trial was registered at ClinicalTrials.gov, NCT02791503. FINDINGS Between May 1, 2016, and March 31, 2022, 68 patients were enrolled and randomly assigned to SABR (n=34) or irreversible electroporation (n=34), of whom 64 were treated according to protocol. Of the 68 participants, 36 (53%) were male and 32 (47%) were female, with a median age of 65 years (IQR 57-70). Median overall survival from randomisation was 16·1 months (95% CI 12·1-19·4) in the SABR group versus 12·5 months (10·9-17·0) in the irreversible electroporation group (hazard ratio [HR] 1·39 [95% CI 0·84-2·30]; p=0·21). The conditional probability to demonstrate superiority of either technique was 0·13; patient accrual was therefore stopped early for futility. 20 (63%) of 32 patients in the SABR group versus 19 (59%) of 32 patients in the irreversible electroporation group had adverse events (p=0·8) and five (16%) patients in the SABR group versus eight (25%) in the irreversible electroporation group had grade 3-5 adverse events (p=0·35). The most common grade 3-4 adverse events were cholangitis (two [6%] in the SABR group vs one [3%] in the irreversible electroporation group), abdominal pain (one [3%] vs two [6%]), and pancreatitis (none vs two [6%]). One (3%) patient in the SABR group and one (3%) in the irreversible electroporation group died from a treatment-related adverse event. INTERPRETATION CROSSFIRE did not identify a difference in overall survival or incidence of adverse events between MRI-guided SABR and CT-guided percutaneous irreversible electroporation after FOLFIRINOX. Future studies should further assess the added value of local ablative treatment over chemotherapy alone. FUNDING Adessium Foundation, AngioDynamics.
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Affiliation(s)
- Florentine E F Timmer
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands.
| | - Bart Geboers
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Alette H Ruarus
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Laurien G P H Vroomen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Evelien A C Schouten
- Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | - Susan van der Lei
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Danielle J W Vos
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Madelon Dijkstra
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Hannah H Schulz
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Joyce Bakker
- Department of Medical Oncology, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Bente A T van den Bemd
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | | | - Robbert S Puijk
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands; Department of Radiology and Nuclear Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Tanja D de Gruijl
- Department of Medical Oncology, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Jan J J de Vries
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands; Department of Radiology and Nuclear Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Frank J Lagerwaard
- Department of Radiation Oncology, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Hester J Scheffer
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands; Department of Radiology and Nuclear Medicine, Northwest Clinics, Alkmaar, Netherlands
| | - Anna M E Bruynzeel
- Department of Radiation Oncology, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Martijn R Meijerink
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
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185
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Lou Q, Lin T, Qian Y, Lu F. Semi-supervised liver segmentation based on local regions self-supervision. Med Phys 2024; 51:3455-3463. [PMID: 38108537 DOI: 10.1002/mp.16886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/30/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Semi-supervised learning has gained popularity in medical image segmentation due to its ability to reduce reliance on image annotation. A typical approach in semi-supervised learning is to select reliable predictions as pseudo-labels and eliminate unreliable predictions. Contrastive learning helps prevent the insufficient utilization of unreliable predictions, but neglecting the anatomical structure of medical images can lead to suboptimal optimization results. PURPOSE We propose a novel approach for semi-supervised liver segmentation using contrastive learning, which leverages unlabeled data and enhances the suitability of contrastive learning for liver segmentation. METHOD AND MATERIALS Contrastive learning helps prevent the inappropriate utilization of unreliable predictions, but neglecting the anatomical structure of medical images can lead to suboptimal optimization results. Therefore, we propose a semi-supervised contrastive learning method with local regions self-supervision (LRS2). On one side, we employ Shannon entropy to distinguish between reliable and unreliable predictions and reduce the dissimilarity between their representations within regional artificial units. Within each unit of the liver image, we strongly encourage unreliable predictions to acquire valuable information pertaining to the correct category by leveraging the representations of reliable predictions in their vicinity. On the other side, we introduce a dynamic reliability threshold based on the Shannon entropy of each prediction, gradually evaluating the confidence threshold of reliable predictions as predictive accuracy improves. After selecting reliable predictions, we sequentially apply erosion and dilation to refine them for better selection of qualified positive and negative samples. We evaluate our proposed method on abdominal CT images, including 131 images (train data: 77, validation data: 26, and testing data: 28) from 2017 ISBI Liver Tumors Segmentation Challenge. RESULTS Our method obtains satisfactory performance in different proportion by exploiting the unreliable predictions. Compared with the result of VNet only under supervised settings (with 10, 30, 50, 70% and full labeled data), LRS2, respectively, brings an improvement of Dice coefficient by +6.11, +3.55, +4.43, and +2.25%, achieving Dice coefficients of 93.44, 93.31, 94.85, and 95.12%, respectively. CONCLUSION In this study, we carefully select appropriate positive and negative samples from reliable regions, ensuring that anchor pixels within unreliable regions are correctly assigned to their respective categories. With a consideration of the anatomical structure present in CT images, we partition the image representations into regional units, enabling anchor pixels to capture more precise sample information. Extensive experiments confirm the effectiveness of our method.
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Affiliation(s)
- Qiong Lou
- School of Science, Zhejiang University of Science and Technology, Hangzhou, China
| | - Tingyi Lin
- School of Science, Zhejiang University of Science and Technology, Hangzhou, China
| | - Yaguan Qian
- School of Science, Zhejiang University of Science and Technology, Hangzhou, China
| | - Fang Lu
- School of Science, Zhejiang University of Science and Technology, Hangzhou, China
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186
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Narushima M, Shiraishi M, Banda CH, Ishiura R. Microsurgical Treatment for Arteriovenous Malformations in the Hand. Hand Clin 2024; 40:229-236. [PMID: 38553094 DOI: 10.1016/j.hcl.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Vascular malformations in the extremities are a common site of occurrence; arteriovenous malformations (AVMs) are the least frequent of all vascular malformations, estimated at 5% to 20%. The first step in management is to perform a thorough clinical examination. Symptoms are assessed, and staging is performed using the Schobinger classification. Next, ultrasonography and contrast-enhanced computed tomography are used to confirm the diagnosis of AVM and to confirm the extent of the malformation. Surgery is the first-line treatment and reconstruction is performed. In cases where surgery is not feasible, embolization and sclerotherapy may be used to alleviate symptoms.
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Affiliation(s)
- Mitsunaga Narushima
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, 2-174, Edobashi, Tsu514-8507, Japan.
| | - Makoto Shiraishi
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chihena Hansini Banda
- Plastic and Reconstructive Surgery Unit, Department of Surgery, The University Teaching Hospital, Lusaka, Zambia
| | - Ryohei Ishiura
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan
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187
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Smees CJ, van Es EM, Tuijthof GJM, Colaris JW, de Graaff F, Vochteloo AJH. A comparison of 3-D CT and 2-D plain radiograph measurements of the wrist in extra-articular malunited fractures of the distal radius. J Hand Surg Eur Vol 2024; 49:546-553. [PMID: 37987680 PMCID: PMC11044515 DOI: 10.1177/17531934231213790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023]
Abstract
Two-dimensional (2-D) plain radiographs may be insufficient for the evaluation of distal radial malunion, as it is a three-dimensional (3-D) deformity. This study introduced a 3-D measuring method that outputs radial inclination, ulnar variance, palmar tilt and axial rotation. To this end, a standardized and clearly defined coordinate system was constructed that allowed 3-D measurements closely resembling the conventional 2-D method in 35 patients. Mean differences between 3-D and 2-D measurements in affected wrists were 1.8° for radial inclination, 0.8 mm for ulnar variance and 3.7° for palmar tilt. In addition, inter- and intra-observer reproducibility of all 3-D and 2-D measurements were good or excellent (intraclass correlation coefficient >0.75), with 3-D reproducibility always better than 2-D. Axial rotation was present in all patients with a mean of 7.9° (SD 6.9). Although the differences between 2-D and 3-D measurements were small, 3-D evaluation enables the assessment of axial rotation and brings us closer to a routine 3-D evaluation of malunion.Level of evidence: III.
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Affiliation(s)
- Camiel J. Smees
- Centre for Orthopaedic Surgery and Sports Medicine, OCON, Hengelo, The Netherlands
- Biomedical Device Design and Production Technology, University of Twente, Enschede, The Netherlands
| | - Eline M. van Es
- Department of Orthopaedics and Sports Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Gabriëlle J. M. Tuijthof
- Biomedical Device Design and Production Technology, University of Twente, Enschede, The Netherlands
| | - Joost W. Colaris
- Department of Orthopaedics and Sports Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Feike de Graaff
- Centre for Orthopaedic Surgery and Sports Medicine, OCON, Hengelo, The Netherlands
| | - Anne J. H. Vochteloo
- Centre for Orthopaedic Surgery and Sports Medicine, OCON, Hengelo, The Netherlands
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188
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Kemal S, Ramgopal S, Macy ML. Traumatic Injuries and Radiographic Study Utilization Among Children With Drowning Presenting to U.S. Pediatric Hospitals. Acad Pediatr 2024; 24:677-685. [PMID: 37743013 DOI: 10.1016/j.acap.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVE The role of traumatic injuries in fatal and nonfatal drownings is poorly described. We sought to characterize the incidence of traumatic injuries and diagnostic imaging performed among children who received pediatric hospital care for drowning. METHODS We conducted a retrospective study of children (≤18 years) with drowning encounters at 45 pediatric hospitals, October 2015 through December 2020. We described the presence of clinically important traumatic injuries to the following body regions: brain, spinal cord, thoracic and intra-abdominal organs, axial skeleton, pelvis, and long bones, and major vessels. We described patient characteristics and radiographic testing. We compared patients with and without traumatic injuries using the Fisher's exact and Wilcoxon signed rank tests. RESULTS We identified 10,397 children with a drowning encounter. Most (83.4%) were treated in the emergency department and 52.8% were admitted. There were 238 (2.3%) encounters with clinically important traumatic injuries. Intracranial injury was the most common (1.0%) with other traumatic injuries occurring in ≤0.5%. Less than 2% of children had a moderate or severe injury severity score and approximately half of these children had a clinically important traumatic injury. Among children with traumatic injuries, a higher proportion were 10 to 14 or 15 to 18 years old and from ZIP codes with lower median household income. Computerized tomography imaging was performed in the following proportions: brain (11.4%), cervical spine (3.7%), abdomen/pelvis (1.2%), chest (0.5%) and face/orbits (0.2%). CONCLUSIONS Clinically important traumatic injuries in children with drowning are rare. Further studies are needed to guide the optimal utilization of radiographic studies in this population.
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Affiliation(s)
- Samaa Kemal
- Division of Emergency Medicine (S Kemal, S Ramgopal, and ML Macy), Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill; Department of Pediatrics (S Kemal, S Ramgopal, and ML Macy), Northwestern University Feinberg School of Medicine, Chicago, Ill.
| | - Sriram Ramgopal
- Division of Emergency Medicine (S Kemal, S Ramgopal, and ML Macy), Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill; Department of Pediatrics (S Kemal, S Ramgopal, and ML Macy), Northwestern University Feinberg School of Medicine, Chicago, Ill; Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center (S Ramgopal and ML Macy), Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Michelle L Macy
- Division of Emergency Medicine (S Kemal, S Ramgopal, and ML Macy), Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill; Department of Pediatrics (S Kemal, S Ramgopal, and ML Macy), Northwestern University Feinberg School of Medicine, Chicago, Ill; Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center (S Ramgopal and ML Macy), Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
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189
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Yu Y, Wang M, Liu J. Triple synchronous epigastric tumors: A rare case. Dig Liver Dis 2024; 56:894-895. [PMID: 38341376 DOI: 10.1016/j.dld.2024.01.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/20/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024]
Affiliation(s)
- Yongquan Yu
- Department of Radiology, Weihai Central Hospital Affiliated to Qingdao University, Weihai, Shandong, China
| | - Minglei Wang
- Department of Ultrasound, Weihai Central Hospital Affiliated to Qingdao University, Weihai, Shandong, China
| | - Jie Liu
- Department of Radiology, Weihai Central Hospital Affiliated to Qingdao University, Weihai, Shandong, China.
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190
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Liang Y, Zhang J. Acinar cell carcinoma of splenic heterotopic pancreas origin. Dig Liver Dis 2024; 56:899-900. [PMID: 38342742 DOI: 10.1016/j.dld.2024.01.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/13/2024]
Affiliation(s)
- Yajun Liang
- IV Ward of Pulmonary and Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, Hubei 430030, PR China
| | - Jun Zhang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
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191
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Deng J, Sun Y, He R, Cai L, Chen Y. FDG Uptake Caused by Right Varicocele. Clin Nucl Med 2024; 49:449-450. [PMID: 38377339 DOI: 10.1097/rlu.0000000000005092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
ABSTRACT A 67-year-old man underwent 18 F-FDG PET/CT for lung cancer staging. Interestingly, the PET scan revealed strip-shaped FDG uptake in the right inguinal contoured area, which was later confirmed as a right varicocele through ultrasound imaging.
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Affiliation(s)
| | - Yuanyuan Sun
- Qingdao Hiser Hospital Affiliated of Qingdao University (Qingdao Traditional Chinese Medicine Hospital), Qingdao, Shandong
| | - Renjie He
- Southwest Medical University, Luzhou, Sichuan, People's Republic of China
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192
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Usher-Smith JA, Godoy A, Kitt J, Farquhar F, Waller J, Sharp SJ, Shinkins B, Cartledge J, Kimuli M, Burge SW, Burbidge S, Eckert C, Hancock N, Marshall C, Rogerson S, Rossi SH, Smith A, Simmonds I, Wallace T, Ward M, Callister MEJ, Stewart GD. Short-term psychosocial outcomes of adding a non-contrast abdominal computed tomography (CT) scan to the thoracic CT within lung cancer screening. BJU Int 2024; 133:539-547. [PMID: 38097529 DOI: 10.1111/bju.16260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
OBJECTIVES To evaluate psychological, social, and financial outcomes amongst individuals undergoing a non-contrast abdominal computed tomography (CT) scan to screen for kidney cancer and other abdominal malignancies alongside the thoracic CT within lung cancer screening. SUBJECTS AND METHODS The Yorkshire Kidney Screening Trial (YKST) is a feasibility study of adding a non-contrast abdominal CT scan to the thoracic CT within lung cancer screening. A total of 500 participants within the YKST, comprising all who had an abnormal CT scan and a random sample of one-third of those with a normal scan between 14/03/2022 and 24/08/2022 were sent a questionnaire at 3 and 6 months. Outcomes included the Psychological Consequences Questionnaire (PCQ), the short-form of the Spielberger State-Trait Anxiety Inventory, and the EuroQoL five Dimensions five Levels scale (EQ-5D-5L). Data were analysed using regression adjusting for participant age, sex, socioeconomic status, education, baseline quality of life (EQ-5D-5L), and ethnicity. RESULTS A total of 380 (76%) participants returned questionnaires at 3 months and 328 (66%) at 6 months. There was no difference in any outcomes between participants with a normal scan and those with abnormal scans requiring no further action. Individuals requiring initial further investigations or referral had higher scores on the negative PCQ than those with normal scans at 3 months (standardised mean difference 0.28 sd, 95% confidence interval 0.01-0.54; P = 0.044). The difference was greater in those with anxiety or depression at baseline. No differences were seen at 6 months. CONCLUSION Screening for kidney cancer and other abdominal malignancies using abdominal CT alongside the thoracic CT within lung cancer screening is unlikely to cause significant lasting psychosocial or financial harm to participants with incidental findings.
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Affiliation(s)
- Juliet A Usher-Smith
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Angela Godoy
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Jessica Kitt
- Department of Surgery, University of Cambridge, Cambridge, UK
| | | | - Jo Waller
- Faculty of Life Sciences and Medicine, Kings College London, London, UK
| | - Stephen J Sharp
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Bethany Shinkins
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | | | | | - Sarah W Burge
- Department of Oncology, University of Cambridge, Cambridge, UK
| | | | - Claire Eckert
- Leeds Institute of Health Science, University of Leeds, Leeds, UK
| | - Neil Hancock
- Leeds Institute of Health Science, University of Leeds, Leeds, UK
| | | | | | - Sabrina H Rossi
- Department of Surgery, University of Cambridge, Cambridge, UK
| | | | - Irene Simmonds
- Leeds Institute of Health Science, University of Leeds, Leeds, UK
| | - Tom Wallace
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Matthew Ward
- Leeds Institute of Health Science, University of Leeds, Leeds, UK
| | - Matthew E J Callister
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Health Science, University of Leeds, Leeds, UK
| | - Grant D Stewart
- Department of Surgery, University of Cambridge, Cambridge, UK
- CRUK Cambridge Centre, Cambridge, UK
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193
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Davis DP. A Clinical Decision Rule for Isolated Subdural Hematomas: Divine Inspiration, Slippery Slope, or Meaningless Machinations? Ann Emerg Med 2024; 83:432-434. [PMID: 38180399 DOI: 10.1016/j.annemergmed.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/12/2023] [Accepted: 11/29/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Daniel P Davis
- Emergency Medical Services, Logan Health, Kalispell, MT.
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194
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Zhang S, He C, Wan Z, Shi N, Wang B, Liu X, Hou D. Diagnosis of pulmonary tuberculosis with 3D neural network based on multi-scale attention mechanism. Med Biol Eng Comput 2024; 62:1589-1600. [PMID: 38319503 DOI: 10.1007/s11517-024-03022-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/03/2024] [Indexed: 02/07/2024]
Abstract
This paper presents a novel multi-scale attention residual network (MAResNet) for diagnosing patients with pulmonary tuberculosis (PTB) by computed tomography (CT) images. First, a three-dimensional (3D) network structure is applied in MAResNet based on the continuity and correlation of nodal features on different slices of CT images. Secondly, MAResNet incorporates the residual module and Convolutional Block Attention Module (CBAM) to reuse the shallow features of CT images and focus on key features to enhance the feature distinguishability of images. In addition, multi-scale inputs can increase the global receptive field of the network, extract the location information of PTB, and capture the local details of nodules. The expression ability of both high-level and low-level semantic information in the network can also be enhanced. The proposed MAResNet shows excellent results, with overall 94% accuracy in PTB classification. MAResNet based on 3D CT images can assist doctors make more accurate diagnosis of PTB and alleviate the burden of manual screening. In the experiment, a called Grad-CAM was employed to enhance the class activation mapping (CAM) technique for analyzing the model's output, which can identify lesions in important parts of the lungs and make transparent decisions.
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Affiliation(s)
- Shidong Zhang
- Key Laboratory of Digital Medical Engineering of Hebei Province, College of Electronic and Information Engineering, Hebei University, Baoding, 071002, China
| | - Cong He
- Key Laboratory of Digital Medical Engineering of Hebei Province, College of Electronic and Information Engineering, Hebei University, Baoding, 071002, China.
| | - Zhenzhen Wan
- Key Laboratory of Digital Medical Engineering of Hebei Province, College of Electronic and Information Engineering, Hebei University, Baoding, 071002, China
| | - Ning Shi
- Key Laboratory of Digital Medical Engineering of Hebei Province, College of Electronic and Information Engineering, Hebei University, Baoding, 071002, China
| | - Bing Wang
- Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China.
| | - Xiuling Liu
- Key Laboratory of Digital Medical Engineering of Hebei Province, College of Electronic and Information Engineering, Hebei University, Baoding, 071002, China
| | - Dailun Hou
- Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China.
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195
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Zhang YS, Kong DT, Zhang M, Liu XY. Monomorphic epitropic intestinal T-cell lymphoma presenting with intestinal perforation. Asian J Surg 2024; 47:2494-2495. [PMID: 38296683 DOI: 10.1016/j.asjsur.2024.01.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/19/2024] [Indexed: 02/02/2024] Open
Affiliation(s)
- Yong-Sheng Zhang
- Department of Gastroenterology, Sishui People's Hospital, Jining, Shandong Province, China
| | - De-Tong Kong
- Department of General Surgery, Sishui People's Hospital, Jining, Shandong Province, China
| | - Min Zhang
- Department of Painless Endoscopy, Sishui People's Hospital, Jining, Shandong Province, China
| | - Xiang-Yu Liu
- Department of Gastroenterology, Jining No. 1 People's Hospital, Jining, 272000, Shandong Province, China.
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196
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Hara Y, Ohkubo H, Fujita K, Niimi A. Pulmonary Artery Pseudoaneurysm after Transbronchial Lung Cryobiopsy. Intern Med 2024; 63:1325-1326. [PMID: 37722891 DOI: 10.2169/internalmedicine.2652-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Affiliation(s)
- Yumi Hara
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Hirotsugu Ohkubo
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Kohei Fujita
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Akio Niimi
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
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197
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Li H, Wu J, Mai X, Zeng W, Cai S, Huang X, Zhou C, Li J, Jiang Q, Lai C, Xie C. Novel Patterns in High-Resolution Computed Tomography in Whipple Pneumonia. Emerg Infect Dis 2024; 30:1042-1045. [PMID: 38666708 PMCID: PMC11060448 DOI: 10.3201/eid3005.231130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2024] Open
Abstract
With the use of metagenomic next-generation sequencing, patients diagnosed with Whipple pneumonia are being increasingly correctly diagnosed. We report a series of 3 cases in China that showed a novel pattern of movable infiltrates and upper lung micronodules. After treatment, the 3 patients recovered, and lung infiltrates resolved.
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198
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Poltronieri TS, Pérsico RS, Viana LV. Body adipose tissue depots and treatment outcomes for women with breast cancer: A systematic review. Clin Nutr 2024; 43:1033-1042. [PMID: 38547637 DOI: 10.1016/j.clnu.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 02/14/2024] [Accepted: 03/16/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND & AIMS Excessive adipose tissue is associated with poorer prognosis in women with breast cancer (BC). However, several body adiposity depots, such as visceral (VAT), subcutaneous (SAT), intermuscular (IMAT), and gluteofemoral adipose tissues (GFAT) may have heterogeneous metabolic roles and health effects in these patients. This systematic review aims to evaluate the impact of different body adipose tissue depots, assessed via computed tomography (CT), on treatment outcomes for women with BC. We hypothesize that distinct body adipose tissue depots may be associated differently with outcomes in patients with BC. METHODS A comprehensive bibliographical search was conducted using PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases (until January 2024). The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale. RESULTS The final sample comprised 23 retrospective studies (n = 12,462), with fourteen presenting good quality. A lack of standardization in CT body adipose tissue depots measurement and outcome presentation precluded quantitative analysis. Furthermore, most included studies had heterogeneous clinical characteristics. Survival and treatment response were the most prevalent outcomes. VAT (n = 19) and SAT (n = 17) were the most frequently evaluated depots and their increase was associated with worse outcomes, mainly in terms of survival. IMAT (n = 4) presented contradictory findings and a higher GFAT (n = 1) was associated with better outcomes. CONCLUSION This systematic review found an association between increased VAT and SAT with worse outcomes in patients with BC. However, due to the heterogeneity of the included studies, further research with homogeneous methodologies is necessary to better understand the impact of body adipose tissue depots on treatment outcomes. Such knowledge could lead to improved care for this patient population.
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Affiliation(s)
- Taiara Scopel Poltronieri
- Programa de Pós-Graduação em Ciências Médicas, Endocrinologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Raquel Stocker Pérsico
- Programa de Pós-Graduação em Ciências Médicas, Endocrinologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Luciana Verçoza Viana
- Programa de Pós-Graduação em Ciências Médicas, Endocrinologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
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Haneda M, Okamoto I, Shimizu A, Arai S, Yamakura T, Yunaiyama D, Tsukahara K. Parotid Gland Cancer With First Bite Syndrome Detected via CT-Guided Fine Needle Aspiration Cytology. In Vivo 2024; 38:1454-1458. [PMID: 38688641 PMCID: PMC11059903 DOI: 10.21873/invivo.13590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/23/2024] [Accepted: 02/05/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND/AIM First bite syndrome (FBS) is a symptom of severe pain at the beginning of a meal that lessens as the meal progresses. It is a common postoperative complication of parapharyngeal space tumors and is rarely reported as the first symptom of parotid carcinoma. The parapharyngeal space is considered a difficult area for approach; hence, preoperative histopathology is often challenging. However, there are hardly any reports on the approach of performing biopsies under computerized tomography (CT) guidance. CASE REPORT A 28-year-old woman presented to our hospital with the chief complaint of pain in the left parotid region since the past year. Contrast-enhanced magnetic resonance imaging of the parotid gland revealed a 10-mm high-signal area on T2-weighted images extending from the deep lobe of the left parotid gland to the parapharyngeal space, which could not be visualized on ultrasound. She was suspected to have a malignant tumor because of the presence of a parotid tumor with FBS. Therefore, she underwent CT-guided fine-needle aspiration cytology (FNAC) and was diagnosed with adenoid cystic carcinoma. The patient underwent left parotid tumor resection and left cervical dissection, and her pain during feeding improved postoperatively. CONCLUSION In a patient with parotid tumor extending into the parapharyngeal space with FBS as the initial symptom, CT-guided FNAC was successfully used to diagnose parotid carcinoma. Symptoms of pain, including FBS, should be considered in cases of malignancy. CT-guided FNAC is effective for lesions that cannot be visualized by ultrasound, such as those in the parapharyngeal space.
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Affiliation(s)
- Misato Haneda
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Isaku Okamoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan;
| | - Akira Shimizu
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Sayaka Arai
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Tatsuya Yamakura
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | | | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
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200
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Kato T, Sakagami H. Augmentation of Therapeutic Efficacy of Extraction of Causative Teeth by Irrigation for Odontogenic Maxillary Sinusitis. In Vivo 2024; 38:1236-1242. [PMID: 38688640 PMCID: PMC11059924 DOI: 10.21873/invivo.13560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND/AIM Odontogenic maxillary sinusitis is a clinically popular disease, but radical surgery and endoscopic surgery are often required. In the present study, we compared for the first time the therapeutic efficacy of the extraction of causative teeth with or without irrigation of the extraction fossa. PATIENTS AND METHODS A total of 60 patients underwent extraction of causative tooth. Among them, 34 patients underwent irrigation, while other 26 patients did not. Based on computed tomography (CT) images, treatment efficacy was quantified by the percentage of the remaining maxillary sinus mucosal lesions. The extent of therapeutic efficacy was evaluated following five grades, based on the percentage of remaining lesions: Grade 1 (0%) (disappearance of lesions), Grade 2 (roughly 10%), Grade 3 (roughly 30%), Grade 4 (approximately 50%) and Grade 5 (100%) (no improvement of the lesions). RESULTS Irrigation significantly augmented the therapeutic efficacy of tooth extraction for maxillary sinus mucosal lesions (mean grade: decreasing from 3.27 to 1.35). CONCLUSION The combination of tooth extraction and irrigation may contribute to the reduction of the necessity of surgery for the maxillary sinuses.
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Affiliation(s)
- Takao Kato
- Department of Oral and Maxillofacial Surgery, Kanazawa Medical University, Ishikawa, Japan;
| | - Hiroshi Sakagami
- Meikai University Research Institute of Odontology, Saitama, Japan
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