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diagnosis - Top 30 Publications

Pancreatic Lymphoepithelial Cysts Diagnosed with Endosonography-guided Fine Needle Aspiration.

Although lymphoepithelial cysts (LECs) of the pancreas are benign lesions, most of them have been treated with surgical resection due to diagnostic difficulty. We report a 66-year-old woman diagnosed with pancreatic LECs. Abdominal ultrasound revealed two masses in the pancreas, which were not visible on the abdominal computed tomography. In an abdominal magnetic resonance imaging, pancreas lesions showed solid tumors, which revealed a low signal intensity on T1-, moderate high signal intensity on T2 weighted images, and homogeneous delayed enhancement in the portal venous phase. Endosonography (EUS) revealed two hypoechoic round masses measuring 1.5 cm and 4.5 cm in the body and tail of the pancreas, respectively. EUS-guided fine needle aspiration (FNA) revealed squamous cells, amorphous keratinous debris, and lymphocytes. The patient was diagnosed with LECs of the pancreas. For the duration of the follow-up period of two years, imaging studies were unchanged. EUS-FNA is useful in making a definite diagnosis and avoiding unnecessary surgery. This is the first case of pancreatic LECs diagnosed with EUS-FNA in Korea.

Trichuris trichiura Infection in North Korean Defector Resulted in Chronic Abdominal Pain and Growth Retardation.

Trichuris trichiura infection is a common helminth infection, which is transmitted via soil, with worldwide distribution, especially in rural areas of developing countries. Occasionally, sporadic cases occur in non-endemic, developed areas due to the widespread of immigration. We experienced a case of Trichuris dysentery syndrome in a young North Korean defector, who had been suffering from chronic abdominal pain for 10 years. He is relatively short and thin compared with his older brother. Unexpectedly, the diagnosis, made by a colonoscopy, revealed numerous, small, white, and gently moving worms at the cecum and ascending colon. After 3 days of albendazole (400 mg once daily) administration, clinical symptoms subsided dramatically. On the follow-up colonoscopy, which was performed two months after the completion of his treatment, complete eradication was identified. Soil-transmitted helminths, including Trichuris trichiura, are disappearing becoming less prevalent in South Korea as a result of both national driving force and environmental improvement. However, these diseases should be considered when we meet foreign patients from developing countries, like North Korea, presenting chronic abdominal pain. Moreover, proper treatment of North Korean defectors and performing cohort studies of them would help to prepare for the possible unification era in the field of gastroenterology.

The Clinical Significance of Serum Alpha-fetoprotein in Diagnosing Hepatocellular Carcinoma in a Health Screening Population.

Serum alpha-fetoprotein (AFP) measurement is commonly included in a health check-up program in Korea. However, its benefits remain uncertain. We analyzed whether AFP measurement should be included in a general health check-up program to screen for hepatocellular carcinoma (HCC).

The Detection of Messenger RNA for Carcinoembryonic Antigen and Cytokeratin 20 in Peritoneal Washing Fluid in Patients with Advanced Gastric Cancer.

Peritoneal micrometastasis is known to play an important role in the recurrence of gastric cancer. However, its effects remain equivocal. Herein, we examine the messenger RNA (mRNA) as tumor markers, carcinoembryonic antigen (CEA), and cytokeratin 20 (CK20), in peritoneal washing fluid. Moreover, we evaluate whether these results could predict the recurrence of gastric cancer following curative resection.

The Role of MicroRNAs in Colorectal Cancer.

Colorectal cancer (CRC) is one of the leading causes of cancer related deaths in the world. Many oncogenes and tumor suppressor genes are involved in the development of CRC. MicroRNAs (miRNAs) are a class of small, non-coding, endogenous RNAs in animals and plants. Recent studies have shown that miRNAs are associated with the mediation process of tumorigenesis, including inflammation, cell cycle, stress response, differentiation, apoptosis, migration, and invasion in cancer. These miRNAs have been linked to the development of CRC and recently studied as new potential biomarkers in the diagnosis and treatment for CRC. Specific miRNAs expression patterns help distinguish CRC from other colon-related diseases, and miRNAs can target the oncogenes and regulatory molecular pathways. Recent studies have demonstrated the restoration of tumor suppressive miRNAs and inhibition of oncogenic miRNAs for CRC treatment. Herein, we describe the diagnostic and therapeutic roles of miRNAs in CRC.

Cytological features of warthin-like papillary thyroid carcinoma: A case report with review of previous cytology cases.

Warthin-like papillary thyroid carcinoma (WLPTC) is a rare morphological variant of papillary thyroid carcinoma which mimics various benign and malignant lesions on thyroid aspiration cytology. As correct cytological diagnosis is the cornerstone for appropriate patient management, awareness of the salient cytomorphological characteristics of this tumor is essential. Here, we present cytological features of a case of WLPTC along with discussion of the common differential diagnoses and a brief review of the literature to ascertain the most consistent cytological findings of WLPTC. The present case also harboured BRAFV600E mutation which is the commonest molecular alteration seen in WLPTC.

Sporadic versus syndromic keratocysts - Can we predict treatment outcome? A review of 102 cysts.

Keratocystic odontogenic tumor (KCOT) demonstrates variable growth mechanisms and biologic behavior, partly due to origin and histology. We looked for the most contributing factors in predicting outcome of treatment.

Effects of malnutrition on treatment-related morbidity and survival of children with cancer in Nicaragua.

Most children with cancer live in resource-limited countries where malnutrition is often prevalent. We identified the relationship between malnutrition and treatment-related morbidity (TRM), abandonment of therapy, and survival of children with cancer in Nicaragua to better inform targeted nutritional interventions.

Chinese consensus on the diagnosis and management of autoimmune hepatitis (2015): Chinese Society of Hepatology, Chinese Society of Gastroenterology & Chinese Society of Infectious Diseases.

Autoimmune hepatitis (AIH) is the inflammation of liver parenchyma mediated by the autoimmune response targeting hepatocytes, and is characterized by positive serum autoantibodies, high levels of immunoglobulin G (IgG) and/or hypergammaglobulinemia, and interface hepatitis in liver histology.

Current use of chromosomal microarray by Australian paediatricians and implications for the implementation of next generation sequencing.

Chromosomal microarray (CMA) is an important diagnostic test for children with multiple congenital anomalies or certain developmental behavioural problems suggestive of an underlying genetic diagnosis. However, there are medical and ethical complexities to its use and few Australian policies to guide practice. We aimed to describe the current practice of Australian paediatricians in relation to CMA testing. We hypothesised that there are knowledge gaps in their use of CMA.

Systematic review with meta-analysis: proximal disease extension in limited ulcerative colitis.

Disease extent in ulcerative colitis is one of the major factors determining prognosis over the long-term. Disease extent is dynamic and a proportion of patients presenting with limited disease progress to more extensive forms of disease over time.

Incident rate and Risk Factors for Tuberculosis among Patients with Type 2 Diabetes: Retrospective Cohort Study in Shanghai, China.

To examine the incident rate of tuberculosis (TB) and its associates among adults with type 2 diabetes in Shanghai, China.

Endoscopic features and genetic background of inflammatory bowel disease complicated with Takayasu arteritis.

Takayasu arteritis (TA) is occasionally complicated with inflammatory bowel disease (IBD). This study assessed the endoscopic and genetic features of IBD complicated with TA (IBD-TA).

miR-130A as a diagnostic marker to differentiate malignant mesothelioma from lung adenocarcinoma in pleural effusion cytology.

Malignant pleural mesothelioma is a rare tumor with a dismal prognosis, usually presenting with recurrent effusions. However, the majority of malignant pleural effusions are due to lung adenocarcinoma (AdC). The distinction between these tumors has considerable therapeutic and medicolegal implications and can be very challenging both histologically and cytologically. Appropriate immunohistochemistry (IHC) is required to support the diagnosis. MicroRNA (miRNA) expression analysis could be a viable diagnostic tool for distinguishing between these tumors. The purpose of the current study was to assess the reliability of miRNAs as diagnostic markers to differentiate epithelioid malignant mesothelioma (MM) from lung AdC.

Screening, diagnosis and management of human cysticercosis and T. solium taeniasis: Technical recommendations by the COHEMI project study group.

Neurocysticercosis, the central nervous system's localized form of cysticercosis, is considered to be the leading cause of epilepsy in the developing world. In Europe, the disease mainly imported and affects both immigrants and travellers. However, autochthonous cases of cysticercosis in low-endemic countries could also originate from T. solium carriers (migrants or travellers) who acquired taeniasis overseas. Management of cysticercosis is a challenge for European healthcare providers since they are often hardly aware of this infection and have little familiarity in managing this disease. This paper provides a summary of recommendations concerning screening, diagnosis and management of cysticercosis and T. solium taeniasis in Europe drawn up by nine experts in migrant health and imported diseases with experience in cysticercosis and T. solium taeniasis. This article is protected by copyright. All rights reserved.

Pediatric melanoma.

Pediatric melanoma, although rare, is the most common skin cancer in children. Our current knowledge on pediatric melanoma incidence trends is expanding, as several studies have addressed this issue with conflicting results. Known risk factors for pediatric melanoma include family history of melanoma, a previous history of malignancy, large congenital nevi, numerous melanocytic nevi, sunburns, increased UV exposure and a sun-sensitive phenotype. In younger children melanoma more often presents with atypical features, such as a changing, amelanotic or uniformly colored, often bleeding lesion, not fulfilling in most cases the conventional ABCDE criteria. The major differential diagnoses are melanocytic nevi, proliferative nodules in congenital nevi and atypical Spitz tumors. Moreover, in the younger age group non Caucasian children are over-represented, tumors tend to be thicker and lymph nodes are often involved. Despite the frequent diagnosis at an advanced stage, the overall survival is fair in pediatric melanoma. Specific guidelines for management of melanoma in children do not exist, and most often the disease is treated similarly to melanoma in adults. This article is protected by copyright. All rights reserved.

Evaluation of the utility of (99m) Tc-MDP bone scintigraphy versus MIBG scintigraphy and cross-sectional imaging for staging patients with neuroblastoma.

Accurate staging of neuroblastoma requires multiple imaging examinations. The purpose of this study was to determine the relative contribution of (99m) Tc-methylene diphosphonate (MDP) bone scintigraphy (bone scan) versus metaiodobenzylguanidine scintigraphy (MIBG scan) for accurate staging of neuroblastoma.

Informant discrepancy defines discrete, clinically useful autism spectrum disorder subgroups.

Discrepancy between informants (parents and teachers) in severity ratings of core symptoms commonly arise when assessing autism spectrum disorder (ASD). Whether such discrepancy yields unique information about the ASD phenotype and its clinical correlates has not been examined. We examined whether degree of discrepancy between parent and teacher ASD symptom ratings defines discrete, clinically meaningful subgroups of youth with ASD using an efficient, cost-effective procedure.

Magnetic resonance imaging and computed tomographic characteristics of a glioma causing calvarial erosion in a dog.

An 8-year-old female Boxer was examined for acute onset of seizures. On magnetic resonance imaging (MRI), an intra-axial mass with imaging features consistent with glioma was observed in the right cerebral hemisphere. A defect in the temporal bone adjacent to the mass was observed. Postmortem computed tomography (CT) confirmed temporal bone osteolysis and necropsy demonstrated a glioblastoma with associated calvarial erosion. Although occasionally described in human medicine, to our knowledge, this is the first description of a brain glioma causing calvarial erosion in a dog. Glioma should be included as a differential diagnosis for intracranial lesions that could cause bony changes in the skull.

The impact of a sibling's life-limiting genetic condition on adult brothers and sisters.

It is estimated that rare diseases affect the lives of over three million people in the United Kingdom. Of these, a significant proportion are children and young people with genetic life-limiting or life-shortening conditions. This study used a qualitative approach with in-depth semi-structured interviews to explore the experiences of 10 adult siblings of a baby diagnosed with Trisomy 13 (Patau syndrome) or Trisomy 18 (Edward syndrome). Findings illustrate that parental grief from the time of their child's diagnosis onward is also experienced by siblings. Although young adults may have conflicting feelings as a bereaved sibling, there is evidence that the experience impacts on their world views and their attitudes about prospective and expectant parenthood. The study highlights the importance of providing siblings with short-term and long-term support from the time of their brother's or their sister's diagnosis onward and provides new understanding about benefit of professional and peer support in helping young adults develop resilience and coping strategies.

The risk of gastric cancer in patients with gastric intestinal metaplasia in 5-year follow-up.

Gastric intestinal metaplasia (GIM) is the premalignant stage of gastric cancer; however, consensus on its management has not been established.

A rising incidence and poorer male outcomes characterise early onset paediatric inflammatory bowel disease.

The incidence of paediatric inflammatory bowel disease diagnosed before age 10 years is reportedly increasing, but national data are limited.

Two cases of adenocarcinoma in situ arising in lobular endocervical glandular hyperplasia indicating localization of mucin on the cluster surface as an early cytological finding of malignant transformation.

Lobular endocervical glandular hyperplasia (LEGH) is an endocervical glandular hyperplastic lesion containing pyloric gland-like mucin, and has recently been recognized as a precursor lesion of malignant glandular lesions of the endocervix. The pyloric gland-like mucin contained in LEGH and gastric-type adenocarcinoma is observed as golden-yellowish by Papanicolaou staining. However, to our knowledge, the chronological course of the endocervical cytology of LEGH, eventually resulting in malignancy, has never been demonstrated to date. Here, we report two cases of gastric-type adenocarcinoma in situ (AIS) arising in LEGH, together with an analysis of their cytological course. In both cases, localization of mucin on the surface of glandular cell clusters was observed prior to nuclear atypia in endocervical cytology. In addition, the diagnosis of gastric-type AIS arising in LEGH was confirmed by pathological diagnosis of hysterectomy specimens in both cases. Histologically, all glandular cells of the LEGH without nuclear atypia contained a large amount of PAS-positive mucin. On the other hand, in atypical glandular cells, localization of the mucin on the luminal surface was observed, although mucin was abundant throughout the cytoplasm in some areas. Our cases show the course of acquirement of cytological atypia of LEGH, and indicate the significance of localization of mucin on the surface of glandular cell clusters as an early finding of the malignant transformation of LEGH in endocervical cytology. Our results indicate that the distribution of mucin in glandular cells should be analyzed together with nuclear atypia in the endocervical cytology of suspected cases of LEGH.

Dermoscopy use by Canadian dermatologists and dermatology residents: a cross sectional nationwide study.

Dermoscopy has demonstrated clinical benefits in improving early melanoma diagnosis and reducing unnecessary biopsies. Despite this, the prevalence of dermoscopy use by dermatologists varies from 81% to 98% worldwide, with a lack of training being a commonly cited reason for non-use of dermoscopy. To date there are no studies examining the prevalence of dermoscopy use in Canada. Our study aimed to examine the use and learning of dermoscopy by Canadian dermatologists and dermatology residents, as well as the current state of dermoscopy teaching within Canadian dermatology residency programs. This article is protected by copyright. All rights reserved.

Analysis of Liver Tumors Using Preoperative and Intraoperative Contrast-Enhanced Ultrasound (CEUS/IOCEUS) by Radiologists in Comparison to Magnetic Resonance Imaging and Histopathology.

Purpose To evaluate the diagnostic significance of preoperatively and intraoperatively performed contrast-enhanced ultrasound (CEUS/IOCEUS) in the diagnosis of liver tumors in comparison to magnetic resonance imaging (MRI) and histopathology. Materials and Methods Retrospective analysis of 70/317 patients who underwent surgery for liver tumors between January 2012 and October 2015. Findings of CEUS and IOCEUS were compared to MRI. CEUS and IOCEUS were performed using multifrequency linear probes (1 - 5, 6 - 15 MHz) after bolus injection of 1 - 5 ml sulfur hexafluoride microbubbles. The histopathology after surgical resection, MRI morphology (T1, T2, VIBE, diffusion sequences) and wash-in/wash-out kinetics of CEUS were evaluated. Results In 70 analyzed patient cases, 64 malignant liver lesions could be detected. 6 patients had benign liver lesions. Among the 64 malignant lesions, there were 28 metastases, 24 hepatocellular carcinomas (HCC), 9 cholangiocellular carcinomas (CCC) and 3 gallbladder carcinomas. 2 of the 6 benign liver lesions were hemangiomas, 2 were adenomas, 1 was an FNH and 1 was a complicated cyst. There was no significant difference when determining the lesion's malignancy/ benignity (p = 1.000). Furthermore, there was no statistical significance between preoperative CEUS and MRI regarding the general differential diagnosis of a tumor (p = 0.210) and the differential diagnosis classification between HCCs (p = 0.453) and metastases (p = 0.250). There was no statistical significance in tumor size (10 mm - 151 mm; mean 49 mm SD +/- 31 mm) and location (tumor size p = 0.579; allocation to liver lobes p = 0.132; segment diagnosis p = 0.121) between preoperatively performed CEUS and MRI. The combination of preoperative MRI and CEUS for lesion detection showed significant differences compared to CEUS or MRI only (p < 0.001 for CEUS; p = 0.004 for MRI). IOCEUS offered the substantial advantage of locating additional liver lesions (p = 0.004 compared to preoperative MRI, p = 0.002 compared to preoperative CEUS). In 10/37 cases (27 %) IOCEUS could locate further liver lesions which had not been identified during CEUS and/or MRI preoperatively, so that operative therapy was adapted accordingly and resection was extended if necessary. Conclusion CEUS proves to be a dynamic imaging method for preoperative diagnosis of liver tumors showing high diagnostic significance in the characterization of a tumor's microvascularization, its entity and its size. During liver operations CEUS plays an important role in surgical therapy decisions. Citation Format · Huf S, Platz Batista da Silva N, Wiesinger I et al. Analyse von Lebertumorentitäten mittels präoperativer und intraoperativer Kontrastmittelsonografie (CEUS/IOCEUS) durch Radiologen im Vergleich zur Magnetresonanztomografie und zur Histopathologie. Fortschr Röntgenstr 2017; 189: 431 - 440.

Maternal alcohol use during pregnancy and offspring attention-deficit hyperactivity disorder (ADHD): a prospective sibling control study.

Maternal alcohol use during pregnancy has repeatedly been associated with development of attention-deficit hyperactivity disorder (ADHD) in the offspring. It is, however not known whether this reflects a direct casual intra-uterine effect or a non-causal relationship due to confounding. We used three different approaches to control for measured and unmeasured confounding: statistical adjustment for covariates, negative control comparison against maternal pre-pregnancy alcohol use, and comparison among differentially exposed siblings.

Sex and Diffusion Tensor Imaging of White Matter in Schizophrenia: A Systematic Review Plus Meta-analysis of the Corpus Callosum.

Sex is considered an understudied variable in health research. Schizophrenia is a brain disorder with known sex differences in epidemiology and clinical presentation. We systematically reviewed the literature for sex-based differences of diffusion properties of white matter tracts in schizophrenia. We then conducted a meta-analysis examining sex-based differences in the genu and splenium of the corpus callosum in schizophrenia. Medline and Embase were searched to identify relevant papers. Studies fulfilling the following criteria were included: (1) included individuals with a diagnosis of schizophrenia, (2) included a control group of healthy individuals, (3) included both sexes in the patient and the control groups, (4) used diffusion tensor imaging, and (5) involved analyzing metrics of white matter microstructural integrity. Fractional anisotropy (FA) was used as the measure of interest in the meta-analysis. Of 730 studies reviewed, 75 met the inclusion criteria. Most showed no effect of sex, however, those that did found either that females have lower FA than males, or that the effect of disease in females is larger than that in males. The findings of the meta-analysis in the corpus callosum supported this result. There is a recognized need for studies on schizophrenia with a sufficient sample of female patients. Lack of power undermines the ability to detect sex-based differences. Understanding the sex-specific impact of illness on neural circuits may help inform development of new treatments, and improvement of existing interventions.

Migrant women living with HIV in Europe: are they facing inequalities in the prevention of mother-to-child-transmission of HIV?: The European Pregnancy and Paediatric HIV Cohort Collaboration (EPPICC) study group in EuroCoord.

In pregnancy early interventions are recommended for prevention of mother-to-child-transmission (PMTCT) of HIV. We examined whether pregnant women who live with HIV in Europe and are migrants encounter barriers in accessing HIV testing and care. Four cohorts within the European Pregnancy and Paediatric HIV Cohort Collaboration provided data for pooled analysis of 11 795 pregnant women who delivered in 2002-12 across ten European countries. We defined a migrant as a woman delivering in a country different from her country of birth and grouped the countries into seven world regions. We compared three suboptimal PMTCT interventions (HIV diagnosis in late pregnancy in women undiagnosed at conception, late anti-retroviral therapy (ART) start in women diagnosed but untreated at conception and detectable viral load (VL) at delivery in women on antenatal ART) in native and migrant women using multivariable logistic regression models. Data included 9421 (79.9%) migrant women, mainly from sub-Saharan Africa (SSA); 4134 migrant women were diagnosed in the current pregnancy, often (48.6%) presenting with CD4 count <350 cells/µl. Being a migrant was associated with HIV diagnosis in late pregnancy [OR for SSA vs. native women, 2.12 (95% CI 1.67, 2.69)] but not with late ART start if diagnosed but not on ART at conception, or with detectable VL at delivery once on ART. Migrant women were more likely to be diagnosed in late pregnancy but once on ART virological response was good. Good access to antenatal care enables the implementation of PMTCT protocols and optimises both maternal and children health outcomes generally.

Corrigendum to: Diagnosis and management of acute deep vein thrombosis: a joint consensus document from the european society of cardiology working groups of aorta and peripheral circulation and pulmonary circulation and right ventricular function Eur Heart J 2017; DOI: 10.1093/eurheartj/ehx003.