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External anal sphincter electromyography in multiple system atrophy:implications for diagnosis,clinical correlations,and novel insights into prognosis

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Neural Regeneration Research 2023年第9期18卷 1903-1907页

作者： Massimiliano Todisco Giuseppe Cosentino Enrico Alfonsi Translational Neurophysiology Research Unit IRCCS Mondino FoundationPaviaItaly Movement Disorders Research Center IRCCS Mondino FoundationPaviaItaly Department of Brain and Behavioral Sciences University of PaviaPaviaItaly

Multiple system atrophy is a sporadic,progressive,adult-onset,neurodegenerative disorder characte rized by autonomic dysfunction symptoms,parkinsonian features,and cerebellar signs in va rious *** early diagnosis of multiple system atrophy is of utmost impo rtance for the proper prevention and management of its potentially fatal complications leading to the poor prognosis of these *** current diagnostic criteria incorporate several clinical red flags and magnetic resonance imaging marke rs supporting diagnosis of multiple system ***,especially in the early disease stage,it can be challenging to differentiate multiple system atrophy from mimic disorders,in particular Parkinson’s *** of the external anal sphincter represents a useful neurophysiological tool for diffe rential diagnosis since it can provide indirect evidence of Onuf’s nucleus degeneration,which is a pathological hallmark of multiple system ***,the diagnostic value of external anal sphincter electromyography has been a matter of debate for three decades due to controve rsial reports in the *** this review,after a brief ove rview of the electrophysiological methodology,we first aimed to critically analyze the available knowledge on the diagnostic role of external anal sphincter *** discussed the conflicting evidence on the clinical correlations of neurogenic abnormalities found at external anal sphincter electro ***,we repo rted recent prognostic findings of a novel classification of electromyography patterns of the external anal sphincter that could pave the way toward the implementation of this neurophysiological technique for survival prediction in patients with multiple system atrophy.

关键词： bowel dysfunction differential diagnosis dysautonomia electrophysiology multiple system atrophy Onuf’s nucleus degeneration parkinsonism Parkinson’s disease prognostic prediction urogenital symptoms

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Trauma-induced“Macklin effect”with pneumothorax and large pneumomediastinum,disguised by allergy

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Frontiers of Medicine 2013年第3期7卷 386-388页

作者： Salomone Di Saverio Kenji Kawamukai Andrea Biscardi Silvia Villani Luca Zucchini Gregorio Tugnoli Departments of Emergency and Surgery Emergency Surgery and Trauma Surgery UnitTrauma CenterMaggiore Hospital-Bologna Local Health DistrictBolognaItaly Department of Thoracic Surgery Trauma CenterMaggiore HospitalBolognaItaly Accident and Emergency Trauma CenterMaggiore HospitalBolognaItaly

A 56-year-old man presented spontaneously to the Emergency Department complaining of facial and neck oedema after assumption of nonsteroidal anti-inflammatory drugs(NSAIDS).The triage nurse assigned the patient to Accident&Emergency(A&E)doctor as probable allergic reaction to *** X-ray(CXR),ordered after 24 hours,revealed a huge subcutaneous chest and neck emphysema without clearly visible *** chest CT scan showed a small left pneumothorax and a large amount of air in the *** patient was conservatively treated since he was eupnoeic and hemodynamically *** pathophysiology of pneumomediastinum was first described by Macklin in *** Macklin effect involves alveolar ruptures with air dissection along bronchovascular sheaths to the *** this case the patient did not report in his history a recent blunt thoracic trauma and the initial suspicion of an allergic reaction has prevented physicians to immediately achieve the correct diagnosis.

关键词： thoracic trauma differential diagnosis critical care pneumothorax pneumomediastinum CT scan pitfalls lung and airways physiology

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Intrapancreatic accessory spleen:A case report and review of the literature

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World Journal of Gastroenterology 2009年第9期15卷 1141-1143页

作者： Wei Guo Wei Han Jun Liu Lan Jin Jian-She Li Zhong-Tao Zhang Yu Wang Department of General Surgery Beijing Friendship Hospital Capital Medical University Beijing 100050 China

Here,we report a case of intrapancreatic accessory spleen confirmed by pathologic diagnosis and discuss its differential diagnosis and surgical management with a review of the literature.

关键词： Accessory spleen Pancreas differential diagnosis Surgical management Congenital defect

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Focal peliosis hepatis in a colon cancer patient resembling metastatic liver tumor

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World Journal of Gastroenterology 2012年第41期18卷 5999-6002页

作者： Wu-Jun Xiong Li-Juan Hu Yi-Cheng Jian Yi He Wei Zhou Xin-Lai Guo Ya-Xin Zheng Departmentof Gastroenterology Shanghai East Hospital Affiliated to TongjiUniversity Shanghai 200120 China Department of Surgery Shanghai East Hospital Affiliated to Tongji University Shanghai200120 China

Peliosis hepatis(PH) is a rare benign condition characterized by the presence of multiple,randomly distributed,blood filled cystic areas of variable size within the liver *** is difficult to recognize and may be mistaken for neoplasm,metastases or multiple abscesses.A 75-year-old female with a previous history of colon cancer was admitted when a liver mass in the right liver lobe was found 11 mo after surgery during the follow-up *** tomography and magnetic resonance imaging scan of the abdomen were *** initial possible diagnosis was metastatic hepatocellular *** patient underwent excision of the hepatic segment where the nodule was *** pathological diagnosis of the surgical specimen was *** should be considered in the differential diagnosis of new liver lesions in patients whose clinical settings do not clearly favor *** and radiologists must recognize these lesions to minimize the probability of misdiagnosis and inappropriate treatment.

关键词： differential diagnosis Metastatic liver tumor Peliosis hepatis

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Plasmablastic lymphoma of the small intestine:Case report and literature review

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World Journal of Gastroenterology 2012年第45期18卷 6677-6681页

作者： Hong-Wei Wang Wen Yang Jun-Zhong Sun Jiang-Yang Lu Min Li Lin Sun Department of Pathology the First Affiliated Hospital of General Hospital of People's Liberation Army Department of Gynaecology and Obstetrics the General Hospital of People's Liberation Army Department of Pathology Peking University Health Science Center

Plasmablastic lymphoma(PBL) is a rare aggressive B-cell lymphoproliferative disorder,which has been characterized by the World Health Organization as a new *** PBL is most commonly seen in the oral cavity of human immunodeficiency virus(HIV)-positive patients,it can also be seen in extraoral sites in immunocompromised patients who are *** we present a rare case of PBL of the small intestine in a 55-year-old HIV-negative *** examination of the excisional lesion showed a large cell lymphoma with plasmacytic differentiation diffusely infiltrating the small intestine and involving the surrounding *** neoplastic cells were diffusely positive for CD79a,CD138 and CD10 and partly positive for CD38 and epithelial membrane *** 80% of the tumor cells were positive for Ki-67.A monoclonal rearrangement of the kappa light chain gene was *** patient died approximately 1.5 mo after diagnosis in spite of receiving two courses of the CHOP chemotherapy *** a review of the literature,this is the first case report of PBL with initial presentation in the small intestine without HIV and Epstein-Barr virus infection,and a history of hepatitis B virus infection and radiotherapy probably led to the iatrogenic immunocompromised state.

关键词： Plasmablastic lymphoma Small intestine Human immunodeficiency virus differential diagnosis

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Laugier-Hunziker syndrome:a report of three cases and literature review

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International Journal of Oral Science 2012年第4期4卷 226-230页

作者： Wen-Mei Wang Xiang Wang Ning Duan Hong-Liu Jiang Xiao-Feng Huang Department of Oral Medicine Institute and Hospital of StomatologyNanjing University Medical School Department of Oral Pathology Institute and Hospital of StomatologyNanjing University Medical School

Laugier-Hunziker syndrome （LHS） is an acquired pigmentary condition affecting lips, oral mucosa and acral area, frequently associated with longitudinal melanonychia. There is neither malignant predisposition nor underlying systemic abnormality associated with LHS. Herein, we present three uncommon cases of LHS with possibly new feature of nail pigmentation, which were diagnosed during the past 2 years. We also review the clinical and histological findings, differential diagnosis, and treatment of the syndrome in published literature.

关键词： differential diagnosis Laugier-Hunziker syndrome longitudinal melanonychia oral pigmentation

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Suture granuloma of the abdominal wall with intra-abdominal extension 12 years after open appendectomy

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World Journal of Gastroenterology 2009年第32期15卷 4083-4086页

作者： Goran Augustin Dragan Korolija Mate Skegro Jasminka Jakic-Razumovic Department of Surgery Division of Abdominal SurgeryUniversity Hospital Center ZagrebKipatieva 1210000 ZagrebCroatia Department of Pathology University Hospital Center Zagreb Kipatieva 1210000 ZagrebCroatia

Most complications after appendectomy occur within ten days; however, we report the unusual case of a suture granuloma 12 years after open appendectomy. The afebrile 75-year-old woman presented with a slightly painful palpable mass in the right lower abdomen. There was no nausea or vomiting and bowel movements were normal. She lost 10 kg during the 3 mo before presentation. The patient had undergone an appendectomy 12 years previously. Physical examination revealed a tender mass, 10 cm in diameter, under the appendectomy scar. The preoperative laboratory findings, tumor markers and plain abdominal radiographs were normal. Multi-slice computed tomography scanning showed an inhomo-genous abdominal mass with minimal vascularization in the right lower abdomen 8.6cm×8cm×9 cm in size which communicated with the abdominal wall. The abdominal wall was thickened, weak and bulging. The abdominal wall mass did not communicate with the cecum or the ascending colon. Complete excision of the abdominal wall mass was performed via median laparotomy. Histopathological examination revealed a granuloma with a central abscess. This case report demonstrates that a preoperative diagnosis of abdominal wall mass after open appendectomy warrants the use of a wide spectrum of diagnostic modalities and consequently different treatment options.

关键词： Appendectomy differential diagnosis Postoperative complication Suture granuloma

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Development and validation of an endoscopic images-based deep learning model for detection with nasopharyngeal malignancies

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Cancer Communications 2018年第1期38卷 632-642页

作者： Chaofeng Li Bingzhong Jing Liangru Ke Bin Li Weixiong Xia Caisheng He Chaonan Qian Chong Zhao Haiqiang Mai Mingyuan Chen Kajia Cao Haoyuan Mo Ling Guo Qiuyan Chen Linquan Tang Wenze Qiu Yahui Yu Hu Liang Xinjun Huang Guoying Liu Wangzhong Li Lin Wang Rui Sun Xiong Zou Shanshan Guo Peiyu Huang Donghua Luo Fang Qiu Yishan Wu Yijun Hua Kuiyuan Liu Shuhui Lv Jingjing Miao Yanqun Xiang Ying Sun Xiang Guo Xing Lv State Key Laboratory of Oncology in South China Collaborative Innovation Center of Cancer MedicineGuangzhou 510060P.R.China Department of Information Sun Yat-Sen University Cancer CenterGuangzhou 510060P.R.China Department of Radiology Sun Yat-Sen University Cancer CenterGuangzhou 510060P.R.China Department of Nasopharyngeal Carcinoma Sun Yat-Sen University Cancer CenterGuangzhou 510060P.R.China Precision Medicine Center Sun Yat-Sen University Cancer CenterGuangzhou 510060P.R.China Department of Radiotherapy Sun Yat-Sen University Cancer CenterGuangzhou 510060P.R.China Guangdong Key Laboratory of Nasopharyngeal Carcinoma diagnosis and Therapy Guangzhou 510060P.R.China

Background:Due to the occult anatomic location of the nasopharynx and frequent presence of adenoid hyperpla-sia,the positive rate for malignancy identification during biopsy is low,thus leading to delayed or missed diagnosis for nasopharyngeal malignancies upon initial ***,we aimed to develop an artificial intelligence tool to detect nasopharyngeal malignancies under endoscopic examination based on deep ***:An endoscopic images-based nasopharyngeal malignancy detection model(eNPM-DM)consisting of a fully convolutional network based on the inception architecture was developed and fine-tuned using separate training and validation sets for both classification and ***,a total of 28,966 qualified images were *** these images,27,536 biopsy-proven images from 7951 individuals obtained from January 1st,2008,to December 31st,2016,were split into the training,validation and test sets at a ratio of 7:1:2 using simple ***,1430 images obtained from January 1st,2017,to March 31st,2017,were used as a prospective test set to compare the performance of the established model against oncologist *** dice similarity coef-ficient(DSC)was used to evaluate the efficiency of eNPM-DM in automatic segmentation of malignant area from the background of nasopharyngeal endoscopic images,by comparing automatic segmentation with manual segmenta-tion performed by the ***:All images were histopathologically confirmed,and included 5713(19.7%)normal control,19,107(66.0%)nasopharyngeal carcinoma(NPC),335(1.2%)NPC and 3811(13.2%)benign *** eNPM-DM attained an overall accuracy of 88.7%(95%confidence interval(CI)87.8%-89.5%)in detecting malignancies in the test *** the prospective comparison phase,eNPM-DM outperformed the experts:the overall accuracy was 88.0%(95%CI 86.1%-89.6%)vs.80.5%(95%CI 77.0%-84.0%).The eNPM-DM required less time(40 s vs.110.0±5.8 min)and exhibited encouraging performance in

关键词： Nasopharyngeal malignancy Deep learning differential diagnosis Automatic segmentation

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Enlarged pancreas: not always a cancer

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Hepatobiliary & Pancreatic Diseases International 2015年第1期14卷 107-108页

作者： Lucia Calculli Davide Festi Raffaele Pezzilli Departments of Radiology Sant'Orsola-Malpighi Hospital Digestive Diseases Sant'Orsola-Malpighi Hospital Internal Medicine Sant'Orsola-Malpighi Hospital

Pancreatic fat accumulation has been described with various terms including pancreatic lipomatosis, pancreatic steatosis, fatty replacement, fatty infiltration, fatty pancreas, lipomatous pseudohypertrophy and nonalcoholic fatty pancreas disease. It has been reported to be associated with type 2 diabetes mellitus, acute pancreatitis, pancreatic cancer and the formation of pancreatic fistula. The real incidence of this condition is still unknown. We report a case of pancreatic steatosis in a non-obese female patient initially diagnosed with a mass in the head of the pancreas. Magnetic resonance imaging（MRI） was carried out to define the characteristics of the pancreatic mass. MRI confirmed the diagnosis of fat pancreas. Enlarged pancreas is not always a cancer, but pancreatic steatosis is characterized by pancreatic enlargement. MRI could give a definite diagnosis of pancreatic steatosis or cancer.

关键词： pancreatic steatosis magnetic resonance image computer tomography IgG4 differential diagnosis clinical course

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Foreign body granuloma in the tongue differentiated from tongue cancer:A case report

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World Journal of Clinical Cases 2022年第18期10卷 6247-6253页

作者： Zhen-Hua Jiang Ran Xv Li Xia Department of Otolaryngology-Head and Neck Surgery Mianyang Central HospitalSchool of MedicineUniversity of Electronic Science and Technology of ChinaMianyang 621000Sichuan ProvinceChina

BACKGROUND Embedded foreign bodies in the tongue are rarely seen in clinical *** untreated foreign body can cause a granuloma which often presents as an enlarged tongue ***,if foreign body ingestion status is unknown,physical examination and magnetic resonance imaging(MRI)tend to lead to suspicion of tongue cancer,especially in older ***,differential diagnosis of an enlarged tongue mass is important,especially because it is closely related to the choice of treatment *** SUMMARY A 61-year-old woman was admitted to the hospital with pain and noticeable swelling in the tongue that had persisted for over 1 *** had no previous medical *** revealed abnormal signal intensities that were indicative of a ***,the oral surgeon and radiologist arrived at a primary diagnosis of tongue *** patient visited the Ear Nose and Throat Department for further consultation and underwent an ultrasound examination of the *** ultrasonography was consistent with a linear hyperechoic foreign body which was indicative of an embedded foreign body(bone)in the tongue,even though the patient denied any history of foreign body *** surgical enucleation of the lesion was *** mass which included a fish bone was completely *** post-operative pathological examination confirmed that the mass was a granuloma containing collagen fibers,macrophages and chronic inflammatory *** patient recovered without complications over a 2 mo follow-up *** We report a rare case of foreign body granuloma in the tongue that was primarily diagnosed as tongue *** MRI and ultrasound examinations revealed a piece of bone in the left lateral aspect of the *** granuloma,which contained a fish bone,was completely removed via surgery and confirmed via *** diagnosis of the enlarged tongue mass was critical to the selection of treatment method.

关键词： Tongue Foreign body Granuloma Cancer differential diagnosis Case report

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