-
Computational and Mathematical Methods... 2022This research was to explore the application value of three-dimensional computed tomography (CT) based on artificial intelligent algorithm in analyzing the... (Observational Study)
Observational Study
This research was to explore the application value of three-dimensional computed tomography (CT) based on artificial intelligent algorithm in analyzing the characteristics of skin lesions in children with psoriasis. In this study, 15 children with psoriasis were selected as the observation group, and 15 children with other skin diseases were selected as the control group. The CT images were optimized, and the feature selection was carried out based on artificial intelligent algorithm. Firstly, the results were compared with the results of simple skin three-dimensional CT to determine the effectiveness. Then, the two groups of three-dimensional skin CT image features of skin psoriasis-like hyperplasia, Munro microabscess, dermal papillary vascular dilation, and squamous epithelium based on intelligent algorithms were compared. After comparison, the detection rate of psoriasis-like hyperplasia, Munro microabscess, dermal papillary vascular dilation, and squamous epithelium in the observation group was higher than that in the control group, with significant difference and statistical significance ( < 0.05). In addition, the sensitivity of psoriasis-like hyperplasia, Munro microabscess, dermal papilla vascular dilatation, and squamous epithelium in children with psoriasis was 80.0%, 86.7%, 80.0%, and 93.3%, respectively. The specificity of psoriasis-like hyperplasia, Munro microabscess, dermal papilla vascular dilatation, and squamous epithelium in children with psoriasis was 86.7%, 93.3%, 60.0%, and 73.3%, respectively. The results showed that Munro microabscess and psoriasis-like hyperplasia had high sensitivity and specificity in all diagnostic items, which could be used as important features of skin lesion sites in the diagnosis of psoriasis in children. The research provides a basis for the clinical diagnosis of psoriasis in children, which is worthy of clinical promotion.
Topics: Abscess; Algorithms; Artificial Intelligence; Case-Control Studies; Child; Computational Biology; Computer Simulation; Dermis; Epithelium; Female; Humans; Hyperplasia; Imaging, Three-Dimensional; Male; Microscopy, Confocal; Psoriasis; Radiographic Image Interpretation, Computer-Assisted; Skin; Tomography, X-Ray Computed
PubMed: 35126635
DOI: 10.1155/2022/8195243 -
Acta Cirurgica Brasileira 2022To compare biological compatibility, hemostasis, and adhesion formation between oxidized regenerated cellulose and lyophilized hydrolyzed porcine collagen in liver...
PURPOSE
To compare biological compatibility, hemostasis, and adhesion formation between oxidized regenerated cellulose and lyophilized hydrolyzed porcine collagen in liver trauma.
METHODS
Forty male Wistar rats constituted two groups: group A (oxidized cellulose) and group B (lyophilized hydrolyzed collagen). Standardized liver trauma was made, and the hemostatic agent was applied. Animals in subgroups A7 and B7 were submitted to euthanasia and relaparotomy after seven days, and in subgroups A14 and B14 after 14 days. Macroscopic and microscopic results were evaluated.
RESULTS
There was no fluid in the cavity in any of the animals, and adhesions were present in all of them. In the analysis after seven days, the adhesions were grades 3 or 4 and consisted of omentum, small intestine, and abdominal wall (p<0.05). In both groups, the mesh was surrounded by a capsule, which was not observed after 14 days. In the evaluation after 14 days, adhesions were grades 2 or 3 (p>0.05). The microscopic examination showed subacute and chronic reactions, in both groups and in both timepoints, with similar frequency. The intensity of fibrosis always presented positive scores. Microabscesses and xanthomatous macrophages were observed in both groups.
CONCLUSIONS
There was no superiority of one agent over the other.
Topics: Animals; Cellulose, Oxidized; Gelatin; Hemorrhage; Liver Neoplasms; Male; Rats; Rats, Wistar; Swine; Tissue Adhesions
PubMed: 35019008
DOI: 10.1590/ACB361101 -
Case Reports in Rheumatology 2021A 49-year-old man developed acute aseptic arthritis of the nonmigratory and asymmetrical type in his knee, ankle, and bilateral metatarsal joints 13 days after treatment...
A 49-year-old man developed acute aseptic arthritis of the nonmigratory and asymmetrical type in his knee, ankle, and bilateral metatarsal joints 13 days after treatment with antibiotics for acute tonsillitis. He was diagnosed with tonsillitis-related arthritis after other rheumatic diseases were ruled out. Treatment with salazosulfapyridine, methotrexate, and methylprednisolone for 3 months did not completely improve. Then, tonsillectomy was undertaken and arthritis rapidly improved. (previously ) was cultured from the microabscesses of the resected tonsils. After outpatient follow-up, the patient did not experience a relapse of arthritis for more than 2.7 years without any treatment. Poststreptococcal reactive arthritis (PSRA) is well described. However, up to 40% of patients with tonsillitis-related arthritis did not demonstrate evidence of streptococcal infection. It is noted that tonsillectomy is necessary to remove the tonsillar microabscesses and eradicate bacterial infection of the tonsils, especially for patients with a prolonged and/or recurrent course of PSRA and/or tonsillitis-related arthritis.
PubMed: 34976425
DOI: 10.1155/2021/2983267 -
The Neurohospitalist Jan 2022Neuromelioidosis is a severe tropical infection with high morbidity and mortality. Isolated myelitis is an extremely rare manifestation of melioidosis which may evade...
Neuromelioidosis is a severe tropical infection with high morbidity and mortality. Isolated myelitis is an extremely rare manifestation of melioidosis which may evade diagnosis. We report a 69-year-old diabetic male patient who presented with acute flaccid paraplegia and longitudinally extensive myelitis and no systemic symptoms. MRI of spinal cord showed lower dorsal cord and conus T2 hyperintensity and microabscesses with dural enhancement. The diagnosis was clinched with blood culture growing . He rapidly developed colitis, septicemia and multiorgan dysfunction and succumbed to the illness in spite of antibiotics and aggressive supportive care. The case highlights that melioidosis should be considered as a differential diagnosis of infectious myelitis, especially in the tropics. Presence of a neutrophilic blood and cerebrospinal fluid picture and microabscesses in spinal cord are important diagnostic clues. The outcome is dismal unless the diagnosis is considered early in the disease course and managed expeditiously with sensitive antibiotics.
PubMed: 34950401
DOI: 10.1177/19418744211025386 -
World Journal of Clinical Cases Nov 2021Thread rhinoplasty can trigger a reaction to thread material, which is a foreign body. We compared clinical features induced by absorbable and non-absorbable threads...
BACKGROUND
Thread rhinoplasty can trigger a reaction to thread material, which is a foreign body. We compared clinical features induced by absorbable and non-absorbable threads following thread rhinoplasty.
CASE SUMMARY
Two patients who underwent different thread materials showed different clinical courses and different Hounsfield unit (HU) values in computed tomography. Patients with absorbable thread showed high HU values similar to a metallic material, and the HU value of inflammation was similar to vascular tissues with a lot of water (250). In the intraoperative field, absorbable thread materials and micro-abscesses were observed. In contrast, in the case of a non-absorbable thread, an object presumed to be thread was seen on the computed tomography (CT), and the HU value of inflammatory tissues was less than 100. In both patients, post-operative HU decreased to less than 100 and the clinical course improved. In both cases, histopathologic findings revealed foreign body granuloma associated with inflammation.
CONCLUSION
Absorbable threads were more aggressive and are more easily detected on CT.
PubMed: 34877301
DOI: 10.12998/wjcc.v9.i31.9635 -
Archive of Clinical Cases 2019Psoriasiform dermatoses represent a wide spectrum of inflammatory conditions, with several major forms represented by psoriasis, as the prototype of this category,... (Review)
Review
Psoriasiform dermatoses represent a wide spectrum of inflammatory conditions, with several major forms represented by psoriasis, as the prototype of this category, followed by pustular psoriasis, Reiter's syndrome, pityriasis rubra pilaris, lichen simplex chronicus and large-plaques parapsoriasis. They create a diagnostic challenge, both clinical and histopathological, because of their complexity and frequent overlapping of the microscopical features. The characteristic histopathological features of psoriasiform reaction comprise extensive hyperkeratosis, with horizontally confluent but vertically intermittent parakeratosis, which alternate with orthokeratosis, thin granular layer, with relative frequent mitoses, uniform elongated and fused rete ridges, edematous superficial papillary dermis, with dilated capillaries, perivascular lymphocytic infiltrate, Munro's microabscesses, and spongiform pustules of Kogoj. Our paper aims to review the histopathology of major form of psoriasiform dermatoses and to emphasize the characteristic microscopical differences between them, for a better approach of the diagnosis as an important key for clinical and therapeutical management. Using the clinicopathological correlations, a thoroughly evaluation of the microscopical features and compartments distribution or special stainings and techniques, the range of differential diagnosis can be decreased and a more accurate diagnostic can be usually achieved. The insights into the pathogenic mechanisms can lead to new therapeutic opportunities targeted to the specific type of inflammatory lesion.
PubMed: 34754910
DOI: 10.22551/2019.24.0603.10155 -
Cureus Sep 2021Herpes simplex virus (HSV) hepatitis is a rare complication of HSV infection, and a rare cause of hepatitis. It is often fatal, especially if the diagnosis and treatment...
Herpes simplex virus (HSV) hepatitis is a rare complication of HSV infection, and a rare cause of hepatitis. It is often fatal, especially if the diagnosis and treatment are delayed. Herein, we describe the case of a 31-year-old female with a history of receiving cytotoxic cancer chemotherapy five months prior who presented with a one-week history of worsening abdominal pain and fever. She was noted to have an outbreak of genital herpes at the time of presentation. Computed tomography (CT) scan of the abdomen showed innumerable hypodensities compatible with hepatic micro-abscesses. A specimen from a subsequent liver biopsy revealed HSV-type cytopathic changes and nuclear staining with an anti-HSV immunohistochemical stain. She was initially started on high-dose oral valacyclovir for genital herpes and was noted to have rapid clinical improvement prior to the histopathologic diagnosis of HSV hepatitis. She achieved full recovery while on oral valacyclovir. This is the first reported case of HSV hepatitis treated with oral valacyclovir and the third reported case of HSV hepatitis mimicking pyogenic abscesses on abdominal imaging. With the high mortality rate associated with HSV hepatitis, one should consider the diagnosis in all patients with multifocal liver lesions of unknown etiology, especially if genital herpes is present at the time of presentation, or in patients who are immunocompromised.
PubMed: 34659957
DOI: 10.7759/cureus.17744 -
Neuroradiology May 2022Imaging of brain involvement in infective endocarditis can drive the clinical management of this serious condition. MRI is very sensitive, but CT is more readily...
PURPOSE
Imaging of brain involvement in infective endocarditis can drive the clinical management of this serious condition. MRI is very sensitive, but CT is more readily available. In this retrospective study, we compared the detection rates of CT and MRI.
METHODS
After Ethics Committee approval, we retrospectively reviewed a series of 20 patients (13 males, median age 64 years) who underwent both CT and MRI either before or after cardiac surgery for definite infective endocarditis. Plain CT and MRI were evaluated for acute ischemic lesions, both punctuate and large, intraparenchymal hemorrhages, cerebral microbleeds, subarachnoid hemorrhages, abscesses, microabscesses, and meningitis. Qualitative assessment and McNemar test were performed. The value of contrast-enhanced scans (MRI, n = 14; CT, n = 9) and cognitive status were also assessed.
RESULTS
A total of 166 lesions were identified on either technique: 137 (83%) on MRI only, 4 (2%) on CT only, and 25 (15%) on both techniques (p < 0.001). For these last 25 lesions, concordance on lesion type was only 16/25 (64%). MRI detected more microbleeds and ischemic lesions, while the 4 CT-only findings were false positives. Contrast-enhanced scans identified 68 enhancing lesions, mainly abscesses and microabscesses, and allowed a better characterization for 61/117 lesions (52%) with MRI, and for 11/81 (14%) with CT. Follow-up identified mild cognitive impairment in 6/13 and dementia in 3/13 patients.
CONCLUSION
While CT rapidly excludes large hemorrhages in patients with infective endocarditis, MRI accurately distinguishes the whole spectrum of brain lesions, including small ischemic lesions, microbleeds, and microabscesses.
Topics: Abscess; Brain; Cardiac Surgical Procedures; Cerebral Hemorrhage; Endocarditis; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 34647143
DOI: 10.1007/s00234-021-02810-y -
Turk Patoloji Dergisi 2022Granulomatous mastitis (GM) is a challenging inflammatory disorder of the breast. In this study we aimed to present the detailed clinical and morphological features of...
OBJECTIVE
Granulomatous mastitis (GM) is a challenging inflammatory disorder of the breast. In this study we aimed to present the detailed clinical and morphological features of GM cases, diagnostic clues for specific and idiopathic etiologies, the difficulties in evaluating trucut biopsies, and the results of different therapeutic approaches.
MATERIAL AND METHOD
We retrospectively analysed the clinical, radiological and morphological features of 114 GM cases diagnosed with fine needle aspiration, and trucut, incisional, and excisional biopsy.
RESULTS
The mean age was 35.8. Only eight cases were older than 45 years. Bilateral involvement was observed in 4 (3.5%) cases. The most common clinical symptoms were breast mass/abscesses, tenderness, and skin changes. Microbiological culture was positive in 4 cases for gram-positive bacteria. Only 3 cases showed a positive tuberculin/PCR test for tuberculosis. The major USG finding was a hypoechoic well-defined or ill-defined mass/abscess; MRI finding was heterogeneous non-mass contrast enhancement. Cases diagnosed with cytology (35 cases) did not have breast malignancy either in their history or clinical follow up period. Fine needle aspiration cytology materials revealed epitheloid granulomas mixed with neutrophils, lymphocytes accompanied by giant cells, and suppurative necrosis. Histopathological reevaluation of 65 trucut/incisional/ excisional biopsies revealed granuloma formation in 65 (100%), Langhans type giant cells in 59 (90.7%), microabscess formation in 41 (63%), caseous necrosis in 1 (1.5%), neutrophilic cysts in 30 (46.1%), eosinophilic infiltration in 48 (73.8%), interlobular inflammation in 14 (21.5%), fat necrosis in 5 (7.6%), ductal ectasia in 6 (9.2%), and lactational changes in 4 (6.1%) cases. Granulomas were lobulocentric in 58 cases, foreign body type/fat necrosis-related in 6 case, and periductular in 1 case. Cystic neutrophilic granulomatous mastitis was observed in one case. We also evaluated the histochemical stains of these 65 biopsies. Only one sample was positive for acido-resistant bacilli (ARB) by the EZN method and one sample was positive for gram-positive bacilli by gram stain.
CONCLUSION
Small, superficial trucut biopsies may cause difficulties in determining the etiology and differential diagnosis of granulomatous mastitis. For optimal management and timing the appropriate therapy, the ideal biopsy procedure, special stains, and a multidisciplinary team consisting of the surgeon, pathologist, and radiologist are the most important issues.
Topics: Adult; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Breast; Female; Granulomatous Mastitis; Humans; Retrospective Studies
PubMed: 34558655
DOI: 10.5146/tjpath.2021.01554 -
Annals of Hepato-biliary-pancreatic... Aug 2021For years, neoadjuvant chemotherapy for locally advanced pancreatic cancer is being investigated and radical surgical resection with laparoscopic approach is getting up...
For years, neoadjuvant chemotherapy for locally advanced pancreatic cancer is being investigated and radical surgical resection with laparoscopic approach is getting up to speed. Pathological complete remission is known as a predictive marker for a good prognosis for various carcinomas. Although there are a few case reports about pathological complete remission, there has been no case report of pathological complete remission resulted from successful extensive resection by laparoscopic surgery after a neoadjuvant modified FOLFIRINOX chemotherapy. A 68-year-old male patient was admitted due to a palpable abdominal mass which turned out to be 16-cm-sized huge locally advanced left-sided pancreatic cancer with possible stomach, left adrenal gland, left kidney, and colon invasion. After administration of 10th modified FOLFIRINOX chemotherapy, the tumor had decreased and he underwent laparoscopic radical distal pancreatectomy with splenectomy, left adrenalectomy, wedge resection of stomach, and segmental resection of transverse colon. Although patient had a postoperative micro-abscess around the colon anastomosis site, he was successfully managed with conservative treatment and discharged on 12 days postoperatively. The final pathology reported complete tumor regression. We hereby emphasize the oncologic significance of neoadjuvant chemotherapy in huge left-sided pancreatic cancer and the potential role of laparoscopic conversion surgery.
PubMed: 34402441
DOI: 10.14701/ahbps.2021.25.3.390