• Title/Summary/Keyword: number of lesions

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Thromboembolic Events after Coil Embolization of Cerebral Aneurysms : Prospective Study with Diffusion-Weighted Magnetic Resonance Imaging Follow-up

  • Chung, Seok-Won;Baik, Seung-Kug;Kim, Yong-Sun;Park, Jae-Chan
    • Journal of Korean Neurosurgical Society
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    • v.43 no.6
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    • pp.275-280
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    • 2008
  • Objective : In order to assess the incidence of thromboembolic events and their clinical presentations, the present study prospectively examined routine brain magnetic resonance images (MRI) taken within 48 hours after a coil embolization of cerebral aneurysms. Methods : From January 2006 to January 2008, 163 cases of coil embolization of cerebral aneurysm were performed along with routine brain MRI, including diffusion-weighted magnetic resonance (DW-MR) imaging, within 48 hours after the embolization of the aneurysm to detect the silent thromboembolic events regardless of any neurological changes. If any neurological changes were observed, an immediate brain MRI follow-up was performed. High-signal-intensity lesions in the DW-MR images were considered as acute thromboembolic events and the number and locations of the lesions were also recorded. Results : Among the 163 coil embolization cases, 98(60.1%) showed high-signal intensities in the DW-MR imaging follow-up, 66 cases (67.0%) involved the eloquent area and only 6cases (6.0%) showed focal neurological symptoms correlated to the DW-MR findings. The incidence of DW-MR lesions was higher in older patients (${\geq}60$ yrs) when compared to younger patients (<60 yrs) (p=0.002, odd's ratio=1.043). The older patients also showed a higher incidence of abnormal DW-MR signals in aneurysm-unrelated lesions (p=0.0003, odd's ratio=5.078). Conclusion : The incidence of symptomatic thromboembolic attacks after coil embolization of the cerebral aneurysm was found to be lower than that reported in previous studies. While DW-MR imaging revealed a higher number of thromboembolic events, most of these were clinically silent and transient and showed favorable clinical outcomes. However, the incidence of DW-MR abnormalities was higher in older patients, along with unpredictable thromboembolic events on DW-MR images. Thus, in order to provide adequate and timely treatment and to minimize neurological sequelae, a routine DW-MR follow-up after coil embolization of cerebral aneurysms might be helpful, especially in older patients.

Deep Learning based Computer-aided Diagnosis System for Gastric Lesion using Endoscope (위 내시경 영상을 이용한 병변 진단을 위한 딥러닝 기반 컴퓨터 보조 진단 시스템)

  • Kim, Dong-hyun;Cho, Hyun-chong
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.67 no.7
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    • pp.928-933
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    • 2018
  • Nowadays, gastropathy is a common disease. As endoscopic equipment are developed and used widely, it is possible to provide a large number of endoscopy images. Computer-aided Diagnosis (CADx) systems aim at helping physicians to identify possibly malignant abnormalities more accurately. In this paper, we present a CADx system to detect and classify the abnormalities of gastric lesions which include bleeding, ulcer, neuroendocrine tumor and cancer. We used an Inception module based deep learning model. And we used data augmentation for learning. Our preliminary results demonstrated promising potential for automatically labeled region of interest for endoscopy doctors to focus on abnormal lesions for subsequent targeted biopsy, with Az values of Receiver Operating Characteristic(ROC) curve was 0.83. The proposed CADx system showed reliable performance.

Urinary Cytologic Findings of Urothelial Lesions (요로상피병변의 요세포학적 소견)

  • Choi, Yoon-Jung;Lee, Kwang-Gil
    • The Korean Journal of Cytopathology
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    • v.5 no.2
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    • pp.130-136
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    • 1994
  • Urinary cytology is increasingly accepted as a diagnostic tool in the detection and follow-up of patients with bladder cancer. However, its value is reduced by several limitations, especially by the lack of cytologic criteria specifically reflecting the morphology of low-grade urothelial neoplasm. We reviewed histologically proven 50 cases of urine cytology with emphasis on cytologic findings of benign atypia and differential findings of urothelial neoplasm according to the grade. The diagnoses included 17 benign lesions(including 5 cases of urine calculi) and 33 malignant lesions (including 28 transitional cell carcinomas, 3 squamous cell carcinomas, 1 adenocarcinoma and 1 prostate adenocarcinoma), Diagnostic accuracy was 92%. Important cytodiagnostic criteria for benign atypia and low grade malignancy were cellularity, number of cell clusters, and morphology and arrangement of urothelial cells. The cytologic findings of urothelial neoplasms according to histologic grade were relatively well correlated with the histologic findings. However, the cytologic criteria were not sufficient to readily distinguish grade I from grade II. In view of this, we think that cytologic nomenclature "low-grade" and "high-grade" is a more reliable criterion. Recognition of subtle cellular morphologic features specific for urothelial lesions(including benign or malignancy) and proper fixation, processing and staining of specimen can expand the role of urinary cytology In detection and follow-up of patients.

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Toxicity of Styrene and Styrene-oxide in Embryos of the Japanese Medaka (Oryzias latipes) (Styrene 및 Styrene-oxide가 송사리 알의 초기발생 과정에 미치는 독성)

  • 박형숙;안혜원
    • Environmental Analysis Health and Toxicology
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    • v.15 no.3
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    • pp.61-67
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    • 2000
  • Toxic lesions of styrene in the Japanese Medaka (Oryzias latipes) were compared with those of styrene oxide, the active metabolite of styrene, using embryo-larval assays. The developmental stages of Japanese Medaka (Oryzias latipes) treated with both chemicals were not altered and progressed normally. However, styrene oxide was more toxic than styrene in terms of causing death and lesions . High concentrations of styrene (higher than 4.9 ppm) and styrene oxide (higher than 2.4 ppm), resulting in more than 50% mortality, caused similar lesions of cardiovascular system, craniofacial bone formation and spinal deformities, although a number of lesions were not observed by both chemicals . In the group treated with styrene, eyeball sizes and intereye distances were reduced, while, in the group treated with styrene oxide , the eyes and eye cups were not developed and two eyes were sometimes fused. In addition, styrene oxide caused the lesion which involved the posterior brain and brain stem were herniated through the spinal cord . The noticeable difference of toxic symptoms between these two chemicals was the time of onset. Toxicities of cardiovascular system and craniofacial bone formation appeared on day 3 of development in styrene oxide treated group, but, styrene treated group staned to show hemorrhages on day 3 and the craniofacial malformation were appeared on day 5, These differences between two chemicals may be due to the metabolism of styrene to styrene oxide, the reactive intermediate.

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Spinal Cord Injury without Radiographic Abnormalities in Children (소아의 척추 외상)

  • Yang, Hong-Ki;Doo, Jung-Hee
    • Physical Therapy Korea
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    • v.3 no.1
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    • pp.57-64
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    • 1996
  • Spinal cord injury in child often occurs without evidence of fracture or dislocation. The mechanisms of neural damage in this syndrome of spinal cord injury without radiographic abnormality(SCIWORA) include flexion, hyperextension, longitudinal distraction, and ischemia. Inherent elasticity of the vertebral column in infants and young children, among other age-related anatomical peculiarities, render the pediatric spine exceedingly vulnerable to deforming forces. The neurological lesions encountered in this syndrome include a high incidence of complete and severe partial cord lesions. Children younger than 8years old sustain more serious neurological damage and suffer a larger number of upper cervical cord lesions than children aged over 8 years. Of the children with SCIWORA. 52% have delayed onset of paralysis up to 4 days after injury, and most of these children recall transient paresthesia, numbness, or subjective paralysis. The long-term prognosis in cases of SCIWORA is grim. Most children with complete and severe lesions do not recover; only those with initially mild neural injuries make satisfactory neurological recovery.

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Mucosal incision-assisted biopsy versus endoscopic ultrasound-assisted tissue acquisition for subepithelial lesions: a systematic review and meta-analysis

  • Suprabhat Giri;Shivaraj Afzalpurkar;Sumaswi Angadi;Sridhar Sundaram
    • Clinical Endoscopy
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    • v.55 no.5
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    • pp.615-625
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    • 2022
  • Background/Aims: Mucosal incision-assisted biopsy (MIAB) for tissue acquisition (TA) from subepithelial lesions (SELs) is emerging as an alternative to endoscopic ultrasound (EUS)-guided TA. Only a limited number of studies compared the diagnostic utility of MIAB and EUS for upper gastrointestinal (GI) SELs; therefore, we conducted this systematic review and meta-analysis. Methods: A comprehensive literature search from January 2020 to January 2022 was performed to compare the diagnostic accuracy and safety of MIAB and EUS-guided TA for upper GI SELs. Results: Seven studies were included in this meta-analysis. The pooled technical success rate (risk ratio [RR], 0.96; 95% confidence interval [CI], 0.89-1.04) and procedural time (mean difference=-4.53 seconds; 95% CI, -22.38 to 13.31] were comparable between both the groups. The overall chance of obtaining a positive diagnostic yield was lower with EUS than with MIAB for all lesions (RR, 0.83; 95% CI, 0.71-0.98) but comparable when using a fine-needle biopsy needle (RR, 0.93; 95% CI, 0.83-1.04). The positive diagnostic yield of MIAB was higher for lesions <20 mm (RR, 0.75; 95% CI, 0.63-0.89). Six studies reported no adverse events. Conclusions: MIAB can be considered an effective alternative to EUS-guided TA for upper GI SELs without an increased risk of adverse events.

AN IMMUNOHISTOCHEMICAL STUDY ON THE IMMUNOGLOBULINS OF EXPERIMENTALLY INDUCED RAT PERIAPICAL LESIONS (실험적 백서 치근단 병소에서의 면역글로불린 분포에 관한 면역조직화학적 연구)

  • Boo, Jung-Sun;Lim, Sung-Sam
    • Restorative Dentistry and Endodontics
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    • v.15 no.2
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    • pp.58-76
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    • 1990
  • This study was designed to elucidate the distribution of the immunoglobulins in the experimentally induced rat periapical lesions. The pulp exposure was performed in 80 molars from 40 rats and the animals were sacrificed at 15, 30, 60 and 90 days after the operation and examined and radiographed. Of the 80 samples, 56 samples were routinely sectioned ($4-6{\mu}$ in thickness) and stained with Hematoxylin-Eosin for the light microscopic examination and 50 samples were stained with toluidin blue for mast cells and 50 samples were stained using the Avidin-Biotin horseradish peroxidase for detecting the presence of Ig A, Ig E, Ig M and Ig G containing cells. The following results were obtained : 1. The periapical lesions could be observed in all of 80 teeth by radiogragh (100%) and the periapical lesions were detected in 50 samples of 51 samples by light microscopy (98%). The size of lesions increased with time lapse both by radiograph and by light microscopy(p<0.05). 2. Of the 50 samples, 19 samples were diagnosed as periapical abscesses, 18 as periapical granulomas, 10 as fibrous scar tissues and 3 cysts. 3. After pulp exposure, periapical granulomas were developed mostly in the 15 day group, with time lapse periapical abscesses and fibrous scar tissues increased. 4. In the 50 periapical lesions, the numbers of Ig G containing cell (57.2%) were prominent and the percentage of Ig A, Ig E and Ig M containing cells were 16.4%, 14.7% and 11.8% respectively. The numbers of all classes of immunoglobulin containing cell were highest in the periapical granulomas and lowest in the cysts(p<0.05). 5. The number of the mast cell and immunoglobulin containing cells decreased generally with time lapse after the pulp exposure and Ig A, Ig E, Ig M and Ig G containing cells and mast cells had the high correlation one another(>0.6).

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Locations and Clinical Significance of Non-Hemorrhagic Brain Lesions in Diffuse Axonal Injuries

  • Chung, Sang Won;Park, Yong Sook;Nam, Taek Kyun;Kwon, Jeong Taik;Min, Byung Kook;Hwang, Sung Nam
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.377-383
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    • 2012
  • Objective : Detection of focal non-hemorrhagic lesion (NHL) has become more efficient in diffuse axonal injury (DAI) patients using an MRI. The aims of this study are to find out the radiological distribution, progress of NHL and its clinical significance. Methods : Between September 2005 and October 2011, 32 individuals with NHLs on brain MRI were enrolled. NHLs were classified by brain location into 4 major districts and 13 detailed locations including cortical and subcortical, corpus callosum, deep nuclei and adjacent area, and brainstem. The severity of NHL was scored from grades 1 to 4, according to the number of districts involved. Fourteen patients with NHL were available for MRI follow-up and an investigation of the changes was conducted. Results : Thirty-two patients had 59 NHLs. The most common district of NHL was cortical and subcortical area; 15 patients had 20 NHSs. However the most common specific location was the splenium of the corpus callosum; 14 patients had 14 lesions. The more lesions patients had, the lower the GCS, however, this was not a statistically meaningful difference. On follow-up MRI in 14 patients, out of 24 lesions, 13 NHLs resolved, 5 showed cystic change, and 6 showed atrophic changes. Conclusion : NHLs were located most commonly in the splenium and occur frequently in the thalamus and the mesial temporal lobe. Because most NHS occur concomitantly with hemorrhagic lesions, it was difficult to determine their effects on prognosis. Since most NHLs resolve completely, they are probably less significant to prognosis than hemorrhagic lesions.

Number of External Anogenital Warts is Associated with the Occurrence of Abnormal Cervical Cytology

  • Chayachinda, Chenchit;Boriboonhirunsarn, Dittakarn;Thamkhantho, Manopchai;Nuengton, Chanon;Chalermchockcharoenkit, Amphan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1177-1180
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    • 2014
  • Background: Anogenital warts (AGWs) are common results of sexually transmitted infection (STI). Human papillomavirus (HPV) types 6 and 11, which are non-oncogenic types, account for 90% of the clinical manifestations. Although the quadrivalent HPV vaccine has been launched, AGW remains prevalent in some countries and shows association with abnormal cervical cytology. Objectives: To study the prevalence of abnormal cervical cytology (low grade squamous intraepithelial lesions or worse; LSIL+) in immunocompetent Thai women newly presenting with external AGWs. Materials and Methods: Medical charts of all women attending Siriraj STI clinic during 2007-2011 were reviewed. Only women presenting with external AGWs who were not immunocompromised (pregnant, human immunodeficiency virus positive or being on immunosuppressant drugs) and had not been diagnosed with cervical cancer were included into the study. Multivariate analysis was used to determine the association between the characteristics of the patients and those of AGWs and LSIL+. Results: A total of 191 women were eligible, with a mean age of $27.0{\pm}8.9$ years; and a mean body mass index of $20.6{\pm}8.9kg/m^2$. Half of them finished university. The most common type of AGWs was exophytic (80.1%). The posterior fourchette appeared to be the most common affected site of the warts (31.9%), followed by labia minora (26.6%) and mons pubis (19.9%). The median number of lesions was 3 (range 1-20). Around 40% of them had recurrent warts within 6 months after completing the treatment. The prevalence of LSIL+ at the first visit was 16.3% (LSIL 12.6%, ASC-H 1.1%, HSIL 2.6%). After adjusting for age, parity and miscarriage, number of warts ${\geq}5$ was the only factor associated with LSIL+(aOR 2.65, 95%CI 1.11-6.29, p 0.027). Conclusions: LSIL+ is prevalent among immunocompetent Thai women presenting with external AGWs, especially those with multiple lesions.

Genetic Abnormalities in Oral Leukoplakia and Oral Cancer Progression

  • Kil, Tae Jun;Kim, Hyun Sil;Kim, Hyung Jun;Nam, Woong;Cha, In-Ho
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.3001-3006
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    • 2016
  • Background: The cancer progression of oral leukoplakia is an important watchpoint in the follow-up observation of the patients. However, potential malignancies of oral leukoplakia cannot be estimated by histopathologic assessment alone. We evaluated genetic abnormalities at the level of copy number variation (CNV) to investigate the risk for developing cancer in oral leukoplakias. Materials and Methods: The current study used 27 oral leukoplakias with histological evidence of dysplasia. The first group (progressing dysplasia) consisted of 7 oral lesions from patients with later progression to cancer at the same site. The other group (non-progressing dysplasia) consisted of 20 lesions from patients with no occurrence of oral cancer and longitudinal follow up (>7 years). We extracted DNA from Formalin-Fixed Paraffin-Embedded (FFPE) samples and examined chromosomal loci and frequencies of CNVs using Taqman copy number assays. Results: CNV frequently occurred at 3p, 9p, and 13q loci in progressing dysplasia. Our results also indicate that CNV at multiple loci-in contrast to single locus occurrences-is characteristic of progressing dysplasia. Conclusions: This study suggests that genetic abnormalities of the true precancer demonstrate the progression risk which cannot be delineated by current histopathologic diagnosis.