1,720,964 research outputs found
Squamous-cell Carcinoma of the Gallbladder
No full textPure squamous cell carcinoma is an infrequent histologic type of gallbladder cancer. Its incidence ranges from 0 to 15% of all gallbladder neoplasms. A case of squamous cell carcinoma of the gallbladder is described and the essential diagnostic, clinical and therapeutic aspects of the primitive gallbladder cancer are discussed
Mediastinal angiofollicular lymph node hyperplasia, hyaline-vascular type with mucocutaneous manifestations.
No full textA never previously reported association between mediastinal angiofollicular lymph node hyperplasia (ALNH) of the hyaline vascular type and mucocutaneous manifestations in a twenty-one-year-old man is described. Mucocutaneous lesions, unresponsive to medical therapy, promptly disappeared after resection of the mediastinal mass, indicating, as suggested for the plasmacell type, a close relationship between the systemic manifestations and ALNH
Hydro-CT in patients with gastric cancer: preoperative radiologic staging
No full textA total of 35 patients (age range 35-78 years) with gastric tumors on the lesser curve, or in the antro-pyloric region, underwent angio-CT in the prone position after filling the stomach with 500 ml of water and intravenous administration of glucagon. The films were reviewed by three radiologists independently, staging each tumor according to the TNM classification preoperatively. The overall accuracy of tumor staging ranged between 66-77 %, overstaging between 17-25 %, and understaging between 3-8.5 %. The diagnostic sensitivity, specificity, and accuracy for serosal invasion ranged between 90 and 100, 76 and 84, and 80-88 %, respectively, and the overall accuracy for N staging was 46, 48, and 51 % for the three observers. If, however, N1 and N2 tumors were considered as a single group, N-stage accuracy increased, ranging between 63 and 77 %. The "K test" for analyzing the interobserver agreement was 60 %, i. e., the diagnostic results are reproducible. Water filling of the stomach optimizes visualization of the gastric wall on contrast-enhanced CT. The prone position and drug-induced hypotony allows for good distension without any disturbing artifact reduction obscuring the lower gastric body
Duodenal pancreatic heterotopy diagnosed by magnetic resonance cholangiopancreatography: report of a case
No full textWe describe herein the case of a heterotopic pancreas that caused stenosis in the second portion of the duodenum. A 46-year-old man presented with upper abdominal pain and a 12-month history of intermittent vomiting. There was no history of melena, hematochezia, hematemesis, clay-colored stools, jaundice, or hepatitis and he did not describe any food dyscrasias, although fatty foods and alcohol seemed to make the symptoms worse. No specific medication or change in position relieved the pain. An initial diagnosis of chronic pancreatitis with multiple pseudocysts was made on the basis of elevated serum amylase and lipase levels, and abdominal ultrasonography and computed tomography (CT) findings. Medical treatment with octreotide was given for 8 weeks, but without any marked effect. Double-contrast barium examination and esophagogastroduodenoscopy were not diagnostic. Magnetic resonance (MR) cholangiopancreatography revealed findings indicative of cystic dystrophy of a heterotopic pancreas (CDHP), and an endoscopy supported this diagnosis. A pancreatoduodenectomy was performed and pathological examination confirmed a diagnosis of CDHP. In our opinion, MR cholangiopancreatography is the diagnostic tool of choice when CDHP is suspected
Accuracy Rates of US-guided Vacuum-assisted Breast Biopsy
No full textPurpose: This paper reports a prospective study designed to measure the accuracy of mammography, ultrasonography, fine needle aspiration cytology and one of the most recently introduced techniques, vacuum biopsy, in the diagnosis of breast cancer.
Experimental Design: A sample of 146 breast lesions on 135 patients were examined at our Breast Centre. The lesions had been examined previously at different outpatient centres, without any definite conclusion being reached. The design of the study made it possible to compare MRx, US, FNAC and VB directly, because it excluded several confounding variables. The histological diagnosis on surgical specimen, when available (45 cases), was considered as the gold standard. In the other 101 cases the biopsy results complemented by the negative clinical results of the follow-up were taken to be the true outcome. Statistical indicators (sensitivity, specificity, predictive values PPV and NPV, FN and FP rates, suspicious plus indeterminate rate and likelihood ratios) have been calculated.
Results: The NPV of MRx and US are remarkably high (92.4% and 97.9% respectively), confirming previous reports. Complete sensitivity of FNAC turns out to be 80%, while specificity and LR of positive test were 99.1% and 88.8 %. The combined score of FNAC, US and MRx results in a good increase in complete sensitivity (97.1%), if compared with the results of the single diagnostic tests evaluated separately. Absolute sensitivity of VB is 97.1% and specificity is 100%.
Conclusions: Considered together, MRx, Us and FNAC appear to be reliable diagnostic procedures and when they are all negative the possibility of a cancer is extremely low (NPV = 0.988 in our sample of women) although it cannot be completely ruled out. The VB test, obviously, has the highest absolute sensitivity among all methods compared and is significantly more sensitive than the Combined Score. Therefore, this technique could be considered conclusive in diagnostic doubtful cases, avoiding open surgical biopsy.
1. Introduction
Breast cancer accounts for one-third of cancer diagnoses (more than 192,200 new cancer cases in 2001) and 15% of cancer deaths in U.S. women1,2 and is believed to be the most common cause of malignancy for women in most other Western countries too. In Europe breast cancer accounts for 34% of all prevalent cancers in females and in Italy over 33000 new breast cancer cases are expected in 20023.
Over the last 25 years the diagnostic approaches and therapeutic strategies for breast cancer have changed dramatically and mortality rates have fallen by 21% as a result of earlier detection and improved treatment. The diagnostic tools have gradually become more diversified and sophisticated, with a consequent improvement in their resolution limits and accuracy, the tools referred to being digital mammography, ultrasound (US associated with Colour Doppler, Power Doppler, Contrast Agents), magnetic resonance, fine needle aspiration biopsy (FNAC), Core Biopsy (CB), Vacuum Biopsy (VB) and advanced breast biopsy instrument (ABBI). A crucial role has been played by the introduction of national screening programmes4.
At present, according to the European Quality Assurance Guidelines in Mammography screening5 the “Triple Approach” is recommended: combined physical examination, mammography (MRx) and FNAC. By introducing mammography screening programmes, however, the size of detected breast lesions has become smaller and the diagnostic problems greater6 so that it seems necessary to redefine the conditions and indications in the use of the new diagnostic tools recently developed.
The aim of this paper is to describe a prospective study carried out in a well defined clinical and experimental setting in order to report the accuracy of certain well-established techniques, such as MRx, US and FNAC in our sample of women, and to measure the accuracy of a recently introduced one, VB, in the diagnosis of breast cancer
[Endoscopic retrograde transparietojejunal approach in hepatico-jejunostomy. An experimental model using fibrin glue].
No full textThe Authors describe an experimental model that makes feasible to endoscopically approach a Roux-en Y hepatico-jejunostomy through a percutaneous transjejunal route. Potentials for its clinical application are briefly discussed
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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