Articles: ninos.
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Comparative Study
Difficulty in distinguishing malignant gastric lymphoma from advanced gastric cancer: Focusing on endoscopic findings of the Borrmann type.
Malignant gastric lymphoma (MGL) accounts for a small proportion (upto 5%) of gastric malignancies. However, unlike for advanced gastric cancer (AGC) that requires surgical treatment, the standard treatments for MGL are chemotherapy and radiotherapy. Hence, the initial impression of the endoscopist is critical for the differential diagnosis and for planning future treatment. ⋯ The experts tended to have a higher endoscopic diagnostic accuracy. Distinguishing MGL from AGC based on endoscopic findings is difficult, especially for the beginners. Even if the endoscopic impression is AGC, it is important to consider MGL in the differential diagnosis.
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This study aimed to assess the impact of family history (FH) on prostate cancer (PCa) development among a general Korean population. We conducted a prospective cohort study based on the registry records of 211,789 participants in the database of the Korean Genome and Epidemiology Study from 2001 to 2013. A total of 69,693 men with appropriate records were evaluated by being categorizing into 2 groups; a PCa group (100) and control group (69,593). ⋯ There was no difference in the impact of FH on PCa development between different age groups at PCa diagnosis (<60 vs ≥60 years). To our knowledge, this study represents the first prospective cohort study based on the registry data of a Korean population showing the significance of FH on PCa development. Additionally, the effect of FH on the early onset of PCa has not been confirmed in our analysis.
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Tension gastrothorax is a serious condition that can cause acute respiratory failure, which is mostly related to congenital diaphragmatic hernia (CDH) in pediatric cases. It is uncommon in late-onset CDH patients, and is difficult to diagnose due to atypical presentation. It is often misdiagnosed as tension pneumothorax or pleural effusion, leading to delayed treatment and potentially fatal outcome. In this study, we are reporting our experience of diagnosis and treatment of tension gastrothorax in a late-onset CDH patient. ⋯ Tension gastrothorax in late-onset CDH is a life-threatening condition that requires rapid diagnosis and treatment. When the diagnosis is unclear by chest x-ray, chest computed tomography should be performed to confirm the diagnosis. A nasogastric tube should be inserted whenever possible for diagnosis and gastric decompression. Although laparotomy is the most preferred approach, we recommend that surgeons consider taking a thoracotomy approach in unstable patients that cannot undergo gastric decompression before operation.
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Comparative Study
A machine-learning based approach to quantify fine crackles in the diagnosis of interstitial pneumonia: A proof-of-concept study.
Fine crackles are frequently heard in patients with interstitial lung diseases (ILDs) and are known as the sensitive indicator for ILDs, although the objective method for analyzing respiratory sounds including fine crackles is not clinically available. We have previously developed a machine-learning-based algorithm which can promptly analyze and quantify the respiratory sounds including fine crackles. In the present proof-of-concept study, we assessed the usefulness of fine crackles quantified by this algorithm in the diagnosis of ILDs. ⋯ In addition, the increased mean FCQV was associated with the presence of traction bronchiectasis (P = .003) and honeycombing (P = .004) in HRCT. Furthermore, in discriminating ILDs in HRCT, an FCQV-based determination of the presence or absence of fine crackles indicated a higher sensitivity compared to a chest X-ray-based determination of the presence or absence of ILDs. We herein report that the machine-learning-based quantification of fine crackles can predict the HRCT findings of lung fibrosis and can support the prompt and sensitive diagnosis of ILDs.
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Fetal adenocarcinoma of the lung (FLAC) is an extremely rare tumor. Due to its rarity, most of the knowledge about FLAC comes from case reports. FLAC is an invasive adenocarcinoma that is similar to the fetal lung in the pseudo-glandular stage (8-16 weeks of gestation). Owing to the differences in histopathology and clinical process, FLAC has been further divided into low-level (L-FLAC) and high-level (H-FLAC). H-FLAC is usually associated with other conventional types of lung adenocarcinoma. Lung adenocarcinoma that produces alpha-fetoprotein (AFP) is a rare type of lung cancer. Its characteristics have not been fully elucidated. ⋯ Presently, specific tumor markers for the diagnosis of lung cancer have not been established. To the best of our knowledge, this is the first case of abnormal AFP expression in a patient with H-FLAC. It may provide a basis for the clinical diagnosis of H-FLAC, a rare tumor, and AFP may be considered as a specific tumor marker.