Effects and Mechanisms of Electroacupuncture at Zhongwan （CV12） on Gastric Nociceptive Response Induced by Gastric Acid Stimulation in Rats / 中医杂志

ObjectiveTo observe the effects of electroacupuncture at Zhongwan （CV12） on gastric nociceptive response induced by gastric acid stimulation and explore the underlying mechanisms associated with nuclei of the medullary viscerosensory and visceral motor neurons. MethodsTwenty SD rats were given intragastric administration of 0.5 mol/L diluted hydrochloric acid （0.5 ml/100 g） to induce gastric nociceptive response induction. Eight rats were randomly selected to record the gastric slow wave （GSW） area under the curve， and extracellular discharge frequency of neurons in the nucleus of the solitary tract （NTS） and dorsal motor nucleus of the vagus nerve （DMV） before intragastric administration and at 1， 5， 10， 15， 20， 25， 30， 35， 40， 45， 50， 55， and 60 minutes after intragastric administration. The remaining 12 rats received electroacupuncture intervention at Zhongwan within 5 to 25 minutes after intragastric administration of diluted hydrochloric acid， with a duration of one minute. The GSW area under the curve and extracellular discharge frequency of NTS and DMV neurons were compared between the 1-minute intervals before and after electroacupuncture intervention. ResultsCompared to the baseline before intragastric administration， the area under the curve of GSW significantly increased at 1， 5， 10， 15， 20， and 25 minutes after intragastric administration， and the extracellular discharge frequency of excitatory neurons in the NTS （accounting for 90%， 57/63） significantly increased at 1， 5， 10， 15， 20， 25， 30， 35， and 40 minutes， both reaching peak values at 1 minute after intragastric administration （P＜0.01 or P＜0.05）. The extracellular discharge frequency of inhibitory neurons in the DMV （accounting for 91%， 20/22） showed a non-significant increase at 1 minute after intragastric administration （P＞0.05）， but significantly decreased at other timepoints （P＜0.05）. Compared to the baseline before electroacupuncture intervention， the GSW area under the curve and the extracellular discharge frequency of excitatory neurons in the NTS significantly decreased （P＜0.05）， while the extracellular discharge frequency of inhibitory neurons in the DMV showed no significant difference （P＞0.05）. ConclusionElectroacupuncture at Zhongwan can improve gastric nociceptive response induced by gastric acid stimulation， possibly by reducing the transmission of visceral sensation and decreasing the excitability of NTS neurons in the medulla.

Local imaging to interpret tumor size in F18 fluorodeoxyglucose positron emission tomography/CT in lung cancers

SUMMARY OBJECTIVE: This study aimed to determine the thoracic and extra-thoracic extension of the disease in patients diagnosed with lung cancer and who had whole-body F18-fluorodeoxyglucose positron emission tomography/CT imaging and to investigate whether there is a relationship between tumor size and extrathoracic spread. METHODS: A total of 308 patients diagnosed with lung cancer were included in this study. These 308 patients were first classified as group 1 (SPN 30 mm>longest lesion diameter ≥10 mm) and group 2 (lung mass (longest lesion diameter ≥30 mm), and then the same patients were classified as group 3 (nodular diameter of ≤20 mm) and group 4 (nodular size of >20 mm). Group 1 was compared with group 2 in terms of extrathoracic metastases. Similarly, group 3 was compared with group 4 in terms of frequency of extrathoracic metastases. F18 fluorodeoxyglucose positron emission tomography/CT examination was used to detect liver, adrenal, bone, and supraclavicular lymph node metastasis, besides extrathoracic metastasis. RESULTS: Liver, bone, and extrathoracic metastasis in group 1 was statistically lower than in group 2 (p<0.001, p<0.01, and p=0.03, respectively). Liver, extrathoracic, adrenal, and bone metastasis in group 3 was statistically lower than that in group 4 (p<0.001, p=0.01, and p=0.04, p<0.01, respectively). The extrathoracic extension was observed in only one patient in group 3. In addition, liver, adrenal, and bone metastases were not observed in group 3 patients. CONCLUSION: Positron emission tomography/CT may be more appropriate for cases with a nodule diameter of ≤20 mm. Performing local imaging in patients with a nodule diameter of ≤20 mm could reduce radiation exposure and save radiopharmaceuticals used in positron emission tomography/CT imaging.

Variante incomum da síndrome de Herlyn- -Werner-Wunderlich: relato de caso / Unsual Herlyn-Werner-Wunderlich syndrome: case report

Malformações müllerianas correspondem a variações anatômicas do trato repro- dutor feminino. Comumente assintomáticas, o diagnóstico e a verdadeira incidên- cia são difíceis de determinar. A síndrome de Herlyn-Werner-Wunderlich, clas- sicamente descrita pela tríade útero didelfo, hemivagina cega e agenesia renal ipsilateral também pode ter variações diferentes. Em virtude da mesma origem embrionária dos tratos genital e urinário, anomalias renais devem ser investigadas nesses casos, sendo a mais comum a agenesia renal. Este artigo relata o caso de uma paciente de 18 anos, do sexo feminino, com história de piocolpo por cinco anos. Em propedêutica complementar, foi identificado útero com septação com- pleta associado a hemissepto de terço superior de vagina, formação de piocolpo e agenesia renal à direita. Apesar de não ser a definição clássica, o quadro está incluído nos casos de síndrome de Herlyn-Werner-Wunderlich.

Mullerian malformations correspond to anatomical variations of the female repro- ductive tract. Commonly asymptomatic, the diagnosis and true incidence are difficult to determine. The Herlyn-Werner-Wunderlich syndrome, classically described by the triad: uterus didelphus, blind hemivagina and ipsilateral renal agenesis, can also have different variations. Due to the same embryonic origin of the genital and urinary tracts, renal anomalies must be investigated in these cases, the most common being renal agenesis. This article reports the case of an 18-year-old female patient with a 5-year history of pyocolpus. In complementary exams, a uterus with complete septa- tion was identified, associated with a hemiseptum in the upper third of the vagina, formation of pyocolpus and renal agenesis on the right side. Despite not being the classic definition, it is included in the cases of Herlyn-Werner-Wunderlich syndrome.

Tumor fibroso solitario cerebral: A propósito de un caso / Solitary fibrous tumor of the brain: A case report

RESUMEN Introducción: Los tumores fibrosos solitarios (TFS) son neoplasias raras de origen mesenquimal que, aunque generalmente se desarrollan en la pleura visceral, ocasionalmente se presentan en la cavidad intracraneal. Además, se caracterizan por altas tasas de metástasis y recurrencia. Caso clínico: Se presenta el caso de un paciente masculino de 59 años con cuadro de 3 meses de cefalea y bradipsiquia. La tomografía reveló una tumoración neoformativa que infiltra cavidad nasal, celdillas etmoidales, y fosa craneal anterior, comprometiendo lóbulo frontal izquierdo. El paciente fue sometido a dos craniectomías exploratorias donde se realizaron los diagnósticos sugestivos de neoplasia glial de alto grado y TFS. Para la precisión diagnóstica se realizó inmunohistoquímica que fue compatible con tumor fibroso solitario. Se analiza el caso centrándose particularmente en los aspectos histopatológicos, localización inusual de este tumor y sus manifestaciones clínicas variables.

ABSTRACT Introduction: Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms that, although typically develop in the visceral pleura, occasionally occur in the intracranial cavity. Furthermore, they are characterized by high rates of metastasis and recurrence. Case Report: We present the case of a 59-year-old male patient with a 3-month history of headache and bradyphrenia. Computed tomography revealed a neoformative tumor infiltrating the nasal cavity, ethmoid sinuses, and anterior cranial fossa, involving the left frontal lobe. The patient underwent two exploratory craniectomies, during which diagnoses suggestive of high-grade glial neoplasia and SFT were made. For precise diagnosis, immunohistochemistry was performed, which was consistent with solitary fibrous tumor. The case is analyzed, focusing particularly on histopathological aspects, the unusual location of this tumor, and its variable clinical manifestations.

Infantile (congenital) anaplastic intracranial solitary fibrous tumor/hemangiopericytoma—A case report with brief literature review

Solitary fibrous tumor/hemangiopericytoma (SFT/HPC) is a rare primary central nervous system (CNS) tumor, included in the World Health Organization (WHO) 2016 classification. Very few cases have been described in the literature so far, especially the infantile type. It is a mesenchymal tumor of the fibroblastic type, characterized by the fusion of NAB 2 and STAT 6 genes. A 10-month-old boy presented to our neurosurgery department with complaints of increasing head circumference since 1 month of age. The magnetic resonance imaging (MRI) showed a space-occupying lesion measuring 8.2 cm × 7 cm × 6.9 cm in the fronto-temporo-parietal region with a clinical diagnosis of glioma/atypical teratoid rhabdoid tumor (ATRT). The microscopy revealed a spindle cell tumor arranged in a patternless pattern with variable cellularity, increased mitosis, and areas of coagulative necrosis. The immunohistochemistry showed vimentin, CD 34, STAT6, CD99 positivity whereas Glial fibrillary acidic protein, Epithelial membrane antigen, and S-100 negativity. Hence, a diagnosis of anaplastic SFT/HPC (grade-III) was rendered. The patient improved after gross total resection (GTR). The primary intracranial congenital SFT/HPC are extremely rare, often a clinico-radiologically misdiagnosed entity. Thus, the immunohistochemistry/molecular study in addition to histology is mandatory for accurate diagnosis.

Solitary fibrous tumor: Two cases report with a focus on the differential diagnosis / Tumor Fibroso Solitário: Relato de dois casos com foco no diagnóstico diferencial

Solitary fibrous tumor (SFT) is a neoplasm of fibroblastic/myofibroblastic origin with intermediate biological behavior. We report here two cases of SFT affecting an unusual anatomical site in 58-year-old and 40-year-old female patients and discuss the differential diagnosis of this lesion. In case 01, the lesion showed the clinical appearance of an asymptomatic "blister" with normal color, rubbery consistency, measuring 0.3 cm, and affected the lower lip; while in case 02, a symptomatic red nodular lesion with a soft consistency and measuring 0.5 cm affected the floor of the mouth. Excisional biopsies were performed. Microscopically, two well-delimited benign neoplasms were observed, exhibiting the proliferation of ovoid to spindle-shaped mesenchymal cells, vascular spaces with staghorn arrangement, and the absence of mitosis figures. Immunohistochemistry was performed in case 01 to assist in the diagnosis. Weak and diffuse immunostaining was observed for α-SMA and intense and diffuse immunopositivity for Bcl-2 and CD34. Based on histopathological and immunohistochemical features, a diagnosis of SFT was rendered in both cases. The low occurrence and nonspecific clinical features of oral SFT may make its clinical diagnosis difficult. Also, morphological and immunohistochemical are essential for differential diagnosis with other mesenchymal neoplasms.(AU)

O tumor fibroso solitário (TFS) é uma neoplasia de origem fibroblástica/miofibroblastica com comportamento biológico intermediário. Nesse artigo relatamos dois casos de TFS afetando sítios anatômicos incomuns em pacientes do sexo feminino de 58 anos e 40 anos e discutir os seus diagnósticos. No caso 01 clinicamente a lesão apresentou um aspecto de "bolha" assintomática, coloração normal da mucosa, consistência borrachoide medindo 0,3 cm, em região de lábio inferior, enquanto que no caso 02, como uma lesão sintomática, vermelha, nodular com consistência mole e medindo 0,5 cm afetando o assoalho bucal. As biópsias excecionais foram realizadas. Microscopicamente, observamos duas lesões neoplásicas bem delimitadas exibindo uma proliferação de células mesenquimais variando de ovoides a fusiformes, vasos sanguíneos em formato de "chifre de veado", com ausência de figuras de mitoses. No caso 01 foi realizado análise imuno-histoquímica para auxiliar no diagnóstico. Foi observado uma marcação fraca e difusa de α-SMA e uma intensa e difusa imunopositividade para o Bcl-2 e CD34.Baseado nos achados histopatológicos e imuno-histoquímicos o diagnóstico de TFS foi estabelecido em ambos os casos. A baixa ocorrência e os achados clínicos inespecíficos do TFS oral podem dificultar o diagnóstico clínico. Além disso, as análises morfológicas e imuno-histoquimicas são essenciais para realização do diagnóstico diferencial com outras neoplasias mesenquimais.(AU)_

Primer registro de la abeja colectora de óleo Centris (Odontoxys) melanochlaena Smith, 1874 (Hymenoptera, Apidae) en Nicaragua

Se presenta el primer reporte de la abeja colectora de óleo Centris (Odontoxys) melanochlaena Smith, 1874 en Nicaragua. Esta especie se distribuye en varios países de Centroamérica y México, siendo este el primer reporte en el occidente de Nicaragua. Este registro contribuye al conocimiento del rango de distribución de esta especie, así como también incrementa la lista de especies de abejas nativas de Nicaragua.

The first report of the oil-collecting bee Centris (Odontoxys) melanochlaena Smith, 1874 in Nicaragua is presented. This species occurs in several Central American countries and Mexico, being this the first record from western Nicaragua. This record contributes to the knowledge of the distribution range of this species, as well as increases the list of native bees occurring in Nicaragua.

Tumor fibroso solitario (TFS) parafaríngeo: reporte de caso y revisión de literatura / Parapharyngeal solitary fibrous tumor (SFT): case report and literature review

El espacio parafaríngeo es una región donde puede surgir un amplio espectro de tumores, que son poco frecuentes y comprenden solo el 0,5 al 1,5% de las neoplasias de cabeza y cuello. Generalmente, son hallazgos y suelen presentarse como masas asintomáticas. Incluye neoplasias primarias, extensión directa de regiones adyacentes y enfermedad metastásica. La literatura describe múltiples patologías e histologías que pueden surgir de esta zona, entre ellas, tenemos los tumores fibrosos solitarios, que son un espectro de neoplasias mesenquimatosas fibroblásticas de histogénesis incierta, que generalmente involucran la pleura. Son lesiones muy poco frecuentes y su localización parafaríngea es excepcional, siendo su primer reporte en la literatura en 1993. Se presenta el caso de un tumor fibroso solitario del espacio parafaríngeo evaluado en nuestro centro, con su enfrentamiento diagnóstico, resolución quirúrgica y seguimiento respectivo, con el objetivo de presentar esta patología poco frecuente a nuestros colegas y contribuir al conocimiento médico.

The parapharyngeal space is a region where a wide spectrum of tumors can arise, which are rare and comprise only 0.5% to 1.5% of head and neck neoplasms. They are generally findings and usually present as asymptomatic masses. Includes primary neoplasms, direct extension from adjacent regions, and metastatic disease. The literature describes multiple pathologies and histologies that can arise from this area, among them, we have solitary fibrous tumors, which are a spectrum of fibroblastic mesenchymal neoplasms of uncertain histogenesis, which are generally the pleura. It is a very rare lesion and its parapharyngeal location is exceptional, being its first report in the literature in 1993. We present the case of a solitary fibrous tumor of the parapharyngeal space evaluated in our center, with its diagnos- tic confrontation, surgical resolution and respective follow-up, with the aim of presenting this rare pathology to our colleagues and contributing to medical knowledge.

Colonoscopy follow-up in patients with simultaneous multiple primary colorectal cancer and patients with sporadic colorectal cancer: a matched-pair study / 中华消化杂志

Objective:To investigate the incidences of metachronous advanced adenoma (MAA) in patients with simultaneous multiple primary colorectal cancer (CRC) and patients with sporadic CRC.Methods:From January 1, 2008 to September 30, 2022, at Beijing Shijitan Hospital, Capital Medical University, CRC patients who underwent surgery and 3 years follow-up with endoscopy were enrolled. The patients completed colonoscopy at least 2 times during follow-up in 6 to 36 months after surgery, and the interval between the 2 times colonoscopies was over 6 months. Clinical data including age, gender, and tumor location, stage, pathological features, combined underlying diseases, preoperative carcinoembryonic antigen, hemoglobin and other laboratory results, baseline colonoscopy results, and detection of MAA were collected. According to age (±2 years old), gender, location of primary lesion and stage of tumor, patients with simultaneous CRC or sporadic CRC were matched at 1∶1 ratio by propensity score matching. The cumulative risks of MAA in patients with simultaneous multiple primary CRC and patients with sporadic CRC were calculated. Cox proportional hazard regression was used to analyze the influencing factors in the occurrence of MAA.Results:A total of 814 CRC patients were enrolled and matched. After paired matching, there were 36 cases of simultaneous multiple primary CRC (78 lesions) and 78 cases of sporadic CRC (78 lesions). The cumulative incidences of MAA at 1, 2 and 3 years of simultaneous CRC group were 11.1%(4/36), 22.2%(8/36) and 33.3%(12/36), respectively. The cumulative incidences of MAA at 1-, 2- and 3-year of sporadic CRC group were 3.8%(3/78), 12.8%(10/78) and 20.5%(16/78), respectively.Simultaneous CRC was correlated with an increase in the 3-year cumulative incidence of MAA ( HR=4.163, 95% confidence interval(95% CI) 1.032 to 4.721, P=0.047). Especially in left-sided CRC, the risk of MAA in simultaneous CRC increased ( HR=7.186, 95% CI 1.602 to 20.787, P=0.010). The results of multivariate cox-regression analysis indicated that detection of simultaneous advanced adenoma at baseline endoscopy was an independent risk factor of MAA ( HR=3.175, 95% CI 1.411 to 7.142, P=0.005). Conclusion:Colouoscopy follow-up should be strengthened in patients with simultaneous multiple primary CRC and simultaneous advanced adenomas.

Analysis on Biomechanical Relationship Between Calcaneal Cyst Lesion Size and Pathological Fracture / 医用生物力学

Objective To investigate the relationship between lesion size of solitary bone cyst ( SBC) and pathological fracture of calcaneus, so as to provide references for the treatment of SBC. Methods The three dimensional (3D) finite element model of foot and ankle was established based on CT images. Four models with gradient spherical bone defects were constructed in the focal area to simulate different SBC lesion sizes, and the biomechanical characteristics of calcaneus in different gait phases were analyzed. Results With the increasement of SBC size, the kinematics of calcaneus did not change significantly, but the peak stress of calcaneus increased gradually. When the SBC size exceeded 75% of the calcaneal width, the stress in calcaneal sulcus and cortical bone below SBC increased by 1. 48 times and 7. 74 times, respectively. Conclusions The risk of pathological fracture increases when the SBC diameter exceeds 75% of the calcaneal width, and early surgical intervention should be recommended. The calcaneal sulcus and the cortex bone below SBC are stress concentration regions and can be used as important areas to evaluate pathological fractures.

Added value of PET Bayesian penalized likelihood reconstruction algorithm in the diagnosis of solitary pulmonary nodules/masses / 中华核医学与分子影像杂志

Objective:To investigate the effects of silicon photomutipliers (SiPM) detector and Bayesian penalized likelihood (BPL) reconstruction algorithm on semiquantitative parameters of 18F-FDG PET/CT and diagnostic efficiency for solitary pulmonary nodules/masses compared with traditional photomultiplier tube (PMT) and ordered subsets expectation maximization (OSEM). Methods:From March 2020 to January 2022, 118 patients (76 males, 42 females, age (63.0±10.1) years) newly diagnosed with solitary pulmonary nodules/masses in First Hospital of Shanxi Medical University were prospectively enrolled and underwent 18F-FDG PET/CT imaging with two different PET/CT scanners successively. The images were divided into PMT+ OSEM, SiPM+ OSEM and SiPM+ BPL groups according to PET detector and reconstruction algorithms. The SUV max, SUV mean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of pulmonary nodules/masses were measured, then signal-to-noise ratio (SNR) and signal-to-background ratio (SBR) were calculated. One-way analysis of variance and Kruskal-Wallis rank sum test were performed to compare differences of above parameters among groups. ROC curve analysis was used to analyze the optimal threshold of SUV max for the differential diagnosis of pulmonary nodules/masses and AUCs were obtained. Results:There were 83 malignant nodules and 35 benign nodules. The image quality of SiPM+ BPL group (4.23±0.64) was better than that of SiPM+ OSEM group (3.57±0.50) or PMT+ OSEM group (3.58±0.51; F=54.85, P<0.001). There were significant differences in SUV max (7.57(3.86, 15.61) vs 4.95(2.22, 10.48)), SUV mean (4.43(2.28, 9.12) vs 2.84(1.21, 5.71)), MTV (3.54(1.57, 7.67) vs 5.09(2.83, 11.79)), SNR (28.12(12.55, 54.38) vs 20.16(8.29, 41.45)) and SBR (4.03(1.83, 7.75) vs 2.32(0.96, 5.03)) between SiPM+ BPL and SiPM+ OSEM groups ( H values: 16.63-37.05, all P<0.001). The optimal threshold values of SUV max in SiPM+ BPL, SiPM+ OSEM and PMT+ OSEM were 3.31, 2.21, 2.05 with AUCs of 0.686, 0.689, 0.615 for nodules < 2 cm, and were 10.29, 6.49, 4.33 with AUCs of 0.775, 0.782, 0.774 for nodules/masses ≥2 cm. Conclusions:Image quality and parameters of pulmonary nodules/masses are mainly affected by the reconstruction algorithms. BPL can improve SUV max, SUV mean, SBR and SNR, but reduce MTV without significant effect on liver parameters. SiPM+ BPL has a higher diagnostic threshold of SUV max than SiPM+ OSEM and PMT+ OSEM.

Application value of CT plain scan and dynamic enhanced scan in the diagnosis of solitary pulmonary nodules / 中国医师杂志

Objective:To explore the application value of computed tomography (CT) plain scan and dynamic enhanced scan in the diagnosis of solitary pulmonary nodules.Methods:The clinical data of 120 patients with solitary pulmonary nodules detected by physical examination in Baoding First Central Hospital from January 2018 to December 2020 were retrospectively reviewed. All patients were confirmed by surgery and pathology, including 77 benign lesions and 43 malignant lesions; All patients underwent CT plain scan and dynamic enhanced scan before operation. The accuracy of the two examination methods in the diagnosis of benign and malignant lesions of solitary pulmonary nodules was analyzed and compared. The detection rate of CT dynamic enhanced scan imaging characteristics (vacuole sign, ground glass sign, spinous sign, lobulation sign, hair prick sign, blood vessel cluster, pleural depression) of benign and malignant lesions of solitary pulmonary nodules was compared, and the diagnostic value of CT plain scan and dynamic enhanced scan in the differential diagnosis of benign and malignant solitary pulmonary nodules was evaluated based on the results of surgical pathological diagnosis. The manifestations and characteristic curves of CT dynamic enhanced scan of solitary pulmonary nodules was analyzed.Results:The diagnostic accuracy of CT dynamic enhanced scan for solitary pulmonary nodules was 80.00% (96/120), which was higher than that of CT plain scan (63.33%) (76/120) ( P<0.05). The sensitivity, specificity, and negative predictive value of CT dynamic enhanced scan for the diagnosis of benign and malignant lesions of solitary pulmonary nodules were higher than those of CT plain scan (all P<0.05). Among the imaging characteristics of CT dynamic enhanced scans of malignant lesions, the ground glass sign, spinous process sign, lobulation sign, spiculation sign, vascular clustering and pleural indentation were detected more frequently than those of benign lesions (all P<0.05). Benign lesions usually showed homogeneous enhancement, and a few showed heterogeneous enhancement; Malignant nodules often showed uneven enhancement, and a few had even enhancement. The time density curves of dynamic enhanced CT values in the regions of interest of benign and malignant solitary pulmonary nodules were different. Conclusions:The value of dynamic enhanced CT scan in the differential diagnosis of benign and malignant lesions of solitary pulmonary nodules is higher than that of CT plain scan, and the imaging features are obvious, with higher sensitivity and specificity, which is worthy of application.

Diagnostic value of thin-layer three-dimensional reconstruction technology combined with personalized scanning for benign and malignant solid solitary pulmonary nodules / 中国基层医药

Objective:To investigate the diagnostic value of thin-layer three-dimensional reconstruction technology combined with personalized scanning for benign and malignant solid solitary pulmonary nodules.Methods:The clinical data of 140 patients with solid solitary pulmonary nodules admitted to Jiangshan People's Hospital form January 2020 to July 2021 were retrospectively analyzed. These patients consisted of 40 patients with benign solid solitary pulmonary nodules (benign group) and 100 patients with malignant solid solitary pulmonary nodules (malignant group). All patients underwent thin-layer three-dimensional reconstruction combined with personalized scanning. The pulmonary nodule signs achieved by thin-layer three-dimensional reconstruction combined with personalized scanning and the diagnostic performance of the combined technology were compared between benign and malignant groups.Results:The proportions of patients with lung cavity sign, lobular sign, vascular convergence sign, vacuole sign, emphysema distribution sign, split pleura sign, and distal perforating vascular sign in the malignant group were 11.0%, 81.0%, 77.0%, 49.0%, 6.0%, 10.0% and 31.0%, respectively, and they were 42.5%, 62.5%, 55.0%, 27.5%, 20.0%, 32.5%, and 5.0%, respectively in the benign group ( χ2 = 15.80, 5.00, 5.66, 4.55, 4.76, 8.96, 9.33, all P < 0.05). The most sensitive sign was lobular sign, which had the highest efficiency, up to 82.0%, in differentiating benign and malignant pulmonary nodules. Conclusion:Lung cavity sign, lobular sign, vascular convergence sign, vacuole sign, emphysema distribution sign, split pleura sign, and distal perforating vascular sign differ greatly between patients with benign and malignant solid solitary pulmonary nodules. Lobular sign has the highest sensitivity in differentiating benign and malignant solid solitary pulmonary nodules. Thin-layer three-dimensional reconstruction combined with personalized scanning has a diagnostic value for benign and malignant solid solitary pulmonary nodules.

Consideration of Definition of Solitary Death, and Changes before and after Coronavirus Pandemic: A Survey of Post-mortem Examination Cases in Shizuoka City / 日本プライマリ・ケア連合学会誌

Introduction: The aim of this study was to consider the definition of solitary death by examining characteristics of cases, and to explore the impact of the coronavirus pandemic.Methods: Subjects were individuals with post-mortem examination and autopsy imaging data recorded between 2017 and 2022. Subjects were classified by whether they passed away at home (solitary). We investigated differences between groups in their causes of death, time elapsed between death and discovery, presence or absence of housemates, and prior symptoms.Results: There were 129 cases (79.9%) of solitary death and 41 cases (24.1%) of death outside the home. Solitary death cases were significantly younger. Among these, less than half were discovered more than a day after death, lived alone, or were older adults. Older adults and those discovered more than a day after death were more likely to have trauma as their official cause of death. The frequency and characteristics of solitary death did not change before or after the coronavirus pandemic.Conclusion: Preventive measures for solitary death should not be limited to older adults or those living alone. In particular, deaths from diseases other than sudden death, trauma in older adults, and cases where symptoms were present or medical attention was sought before death are potentially preventable. Countermeasures for solitary death are important in the post-coronavirus pandemic period.

Detection of subsolid nodules on chest CT scans during the COVID-19 pandemic / Detecção de nódulos subsólidos na TC de tórax durante a pandemia de COVID-19

ABSTRACT Objective: To investigate the detection of subsolid nodules (SSNs) on chest CT scans of outpatients before and during the COVID-19 pandemic, as well as to correlate the imaging findings with epidemiological data. We hypothesized that (pre)malignant nonsolid nodules were underdiagnosed during the COVID-19 pandemic because of an overlap of imaging findings between SSNs and COVID-19 pneumonia. Methods: This was a retrospective study including all chest CT scans performed in adult outpatients (> 18 years of age) in September of 2019 (i.e., before the COVID-19 pandemic) and in September of 2020 (i.e., during the COVID-19 pandemic). The images were reviewed by a thoracic radiologist, and epidemiological data were collected from patient-filled questionnaires and clinical referrals. Regression models were used in order to control for confounding factors. Results: A total of 650 and 760 chest CT scans were reviewed for the 2019 and 2020 samples, respectively. SSNs were found in 10.6% of the patients in the 2019 sample and in 7.9% of those in the 2020 sample (p = 0.10). Multiple SSNs were found in 23 and 11 of the patients in the 2019 and 2020 samples, respectively. Women constituted the majority of the study population. The mean age was 62.8 ± 14.8 years in the 2019 sample and 59.5 ± 15.1 years in the 2020 sample (p < 0.01). COVID-19 accounted for 24% of all referrals for CT examination in 2020. Conclusions: Fewer SSNs were detected on chest CT scans of outpatients during the COVID-19 pandemic than before the pandemic, although the difference was not significant. In addition to COVID-19, the major difference between the 2019 and 2020 samples was the younger age in the 2020 sample. We can assume that fewer SSNs will be detected in a population with a higher proportion of COVID-19 suspicion or diagnosis.

RESUMO Objetivo: Investigar a detecção de nódulos subsólidos na TC de tórax de pacientes ambulatoriais antes e durante a pandemia de COVID-19, bem como correlacionar os achados de imagem com dados epidemiológicos. Nossa hipótese foi a de que nódulos não sólidos (pré) malignos foram subdiagnosticados durante a pandemia de COVID-19 em virtude da sobreposição de achados de imagem de nódulos subsólidos e pneumonia por COVID-19. Métodos: Estudo retrospectivo no qual foram incluídas todas as imagens de TC de tórax realizadas em pacientes ambulatoriais adultos (com idade > 18 anos) em setembro de 2019 (antes da pandemia de COVID-19) e em setembro de 2020 (durante a pandemia de COVID-19). As imagens foram reavaliadas por um radiologista torácico, e os dados epidemiológicos foram extraídos de questionários preenchidos pelos pacientes e de encaminhamentos clínicos. Modelos de regressão foram usados para controlar fatores de confusão. Resultados: Foram reavaliadas 650 e 760 imagens de TC de tórax nas amostras de 2019 e 2020, respectivamente. Foram encontrados nódulos subsólidos em 10,6% dos pacientes que compuseram a amostra de 2019 e em 7,9% daqueles que compuseram a amostra de 2020 (p = 0,10). Nódulos subsólidos múltiplos foram encontrados em 23 e 11 dos pacientes que compuseram as amostras de 2019 e 2020, respectivamente. As mulheres constituíram a maioria da população do estudo. A média de idade foi de 62,8 ± 14,8 anos na amostra de 2019 e de 59,5 ± 15,1 anos na amostra de 2020 (p < 0,01). A COVID-19 foi responsável por 24% de todos os encaminhamentos para a realização de TC em 2020. Conclusões: Foram detectados menos nódulos subsólidos na TC de tórax de pacientes ambulatoriais durante a pandemia de COVID-19 do que antes da pandemia, embora a diferença não tenha sido significativa. Além da COVID-19, a principal diferença entre as amostras de 2019 e 2020 foi o fato de que a amostra de 2020 era mais jovem. Podemos supor que menos nódulos subsólidos serão detectados numa população com maior proporção de suspeita ou diagnóstico de COVID-19.

Diverticulitis cecal. A propósito de un caso / Cecal Diverticulitis. A Case Report

La diverticulosis cecal es una entidad poco común, representando el 3,6% de los casos de enfermedad diverticular y su complicación más frecuente es la diverticulitis. Caso clínico : Presentamos el caso de un paciente de 79 años quien consultó por presentar dolor en fosa ilíaca derecha, náuseas y escalofríos; laboratorio leucocitos 16900uL (neutrófilos 79%), proteína C reactiva 4,51mg/l. Se realiza laparoscopia evidenciando tumor de ciego de 2 x 3cm de coloración violácea con signos de inflamación pericecal, se realizó hemicolectomía derecha. El informe histopatológico informó divertículo verdadero isquémico de ciego. Conclusión : La diverticulitis cecal es una patología poco frecuente que puede presentarse como un abdomen agudo, por lo que se debe mantener un alto índice de sospecha en pacientes mayores de 40 años de edad. El abordaje laparoscópico es un método seguro y eficaz para el diagnóstico y tratamiento de estos pacientes(AU)

Cecal diverticulosis is an uncommon condition, representing 3.6% of diverticular disease cases, with its most common complication being diverticulitis. Case report: We present the case of a 79-year-old patient who consulted for right iliac fossa pain, nausea, and chills; laboratory findings showing a white blood cell count of 16,900/µL (neutrophils 79%) and C-reactive protein of 4.51 mg/L. Laparoscopy revealed a 2 x 3 cm purple-colored cecal tumor with signs of pericecal inflammation, right hemicolectomy was performed. Histopathological analysis confirmed a true ischemic cecal diverticulum. Conclusion: Cecal diverticulitis is an infrequent condition that can mimic an acute abdomen, necessitating a high index of suspicion, especially in patients over 40 years of age. Laparoscopic approach proves to be a safe and effective method for diagnosis and treatment in these patients(AU)

Tumor fibroso solitario de próstata: informe de caso y revisión de la literatura / Solitary fibrous tumor of the prostate: case report and literature review

El tumor fibroso solitario (TFS) es una neoplasia mesenquimatosa de tipo fibroblástico que, a pesar de ser localizado principalmente en pleura, se ha observado en otros órganos como la próstata. Por su parte, el tumor fibroso solitario de la próstata es una neoplasia de baja incidencia, crecimiento lento y potencial maligno incierto, que generalmente se compone de células fusiformes de apariencia citológicamente benignas, dispuestas en una arquitectura desorganizada, mezcladas con colágeno y pequeños vasos sanguíneos. Establecer su diagnóstico se ha vuelto más reproducible desde la identificación de la fusión de los genes NAB2-STAT6 por biología molecular, que lleva a la sobreexpresión de STAT6 por inmunohistoquímica, el cual es un marcador muy sensible y específico para TFS. Presentamos el caso clínico de un paciente que debutó con síntomas de compresión vesical, en quien se identificó una masa con epicentro en la próstata que infiltraba la vejiga y llegaba a la pared rectal, y que luego de estudios de patología, inmunohistoquímica y pruebas moleculares se clasificó como un TFS de la próstata, finalmente tratado con cistoprostatectomía radical más derivación urinaria

Solitary fibrous tumor (SFT) is a mesenchymal neoplasm of fibroblastic type, which despite being located mainly in the pleura, has been observed in other organs such as the prostate. On the other hand, solitary fibrous tumor of the prostate is a rare neoplasm, slow growing, and of uncertain malignant potential, which is generally composed of spindle cells of cytologically benign appearance, arranged in a disorganized architecture, mixed with collagen and small blood vessels. Establishing its diagnosis has become more reproducible since the identification of the NAB2-STAT6 gene fusion by molecular biology, leading to the overexpression of STAT6 by immunohistochemistry, a very sensitive and specific marker for SFT. We present a clinical report of a patient who consulted with symptoms of bladder compression, in whom a mass was identified with the epicenter in the prostate infiltrating into the bladder and reaching the rectal wall. Following histopathology study, immunohistochemistry and molecular tests it was classified as a SFT of the prostate, finally treated with radical cystoprostatectomy plus urinary shunt

Solitary Plasmacytoma of Mandible – A Rare Dyscrasia- Case Report and Review of Literature

Introduction: The plasma cell neoplasms may present in soft tissue as extramedullary plasmacytomas, bone as a solitary plas- macytoma of bone, or as part of the multifocal disseminated disease multiple myeloma. Aim of study: The study aims to report solitary plasmacytoma in the gnatic bone oral cavity, which is also mimicking as malig- nant neoplasm of bone, seen in a female patient. Case Report: A 38-year-old female patient reported to the outpatient department of our hospital complaining of pain and swelling over the left lower one-third region of the face for one month CBCT analysis shows a hypodense area involving 35 regions extending towards ascending rami of the mandible. Conclusion: Plasmacytoma, despite being a lesion with slow, asymptomatic growth, can assume large volumes, making proper treatment difficult. When there is no bone involvement and it is diagnosed early, the success of treatment is generally higher. The treatment of choice is radiotherapy, with good results for the remission of the lesion

Evaluation of Enhancement Pattern of Malignant Lung Lesion During Contrast Enhanced Computed Tomography - Cross Sectional Study.

Background: At present, lung cancer is a leading cause of cancer death in the world. Most of the patients are asymptomatic at the early stages of the disease and manifest at the advanced stage. It is broadly classified into two types based on histopathology, Non-small cell lung cancer (NSCLC), the predominant type, and Small cell lung cancer (SCLC). Â Our study aimed to evaluate the enhancement pattern of malignant lung lesion during contrast-enhanced computed tomography. Methodology: A cross-sectional study was conducted on 34 patients with lung cancer after clearance from the Institutional Ethical Committee. Contrast enhanced computed tomography (CECT) Thorax was performed by 16 slice Multi-Detector computed tomography (MDCT )machine, and the tumor's pre and post-contrast Hounsfield Unit (HU) value was measured in the area of highest density. Results: Out of the 34 patients, Squamous cell carcinoma and adenocarcinoma were seen in 15 patients in each group, whereas small cell carcinoma was found in 4 patients. Pre and post-contrast mean HU value was 39.5 (SD= 2.95) HU and 72.13 (SD= 4.21) HU for adenocarcinoma, 34.6 (SD=2.61) HU and 63.8(SD=2.88) HU for squamous cell carcinoma and 31.00 (SD=1.41) HU and 55.7 (SD=2.75) HU for small cell carcinoma. The significant of density difference was measured using paired t-test (p<0.05). Conclusion: All histopathological subtypes of lung cancer showed significant post-contrast enhancement (>20HU) during the CECT study. Evaluation of enhancement pattern of lung mass by measuring pre and post-contrast HU value will help the radiologist to predict the histopathological type of lung cancer.

Riñón único funcionante y su seguimiento en Pediatría

Contexto: el riñón único funcionante (RUF) es una entidad que puede ser de tipo congénito y es causada por una agenesia renal unilateral o un riñón displásico multiquístico, o adquirido de forma secundaria a una nefrectomía unilateral, condicionando al paciente a un seguimiento estricto rutinario, así como en la implementación de algunas pautas de prevención en los pacientes pediátricos. Objetivo: analizar la importancia del seguimiento en los pacientes pediátricos con RUF. Metodologí:a se hace una revisión de la literatura mostrando desde la embriología, fisiología, etiología, aspectos clínicos y estudios diagnósticos en pacientes con RUF para así, posteriormente, ofrecer unas pautas de seguimiento y manejo en pacientes pediátricos. Resultados: los pacientes con RUF pueden presentar hiperfiltración glomerular compensatoria, seguida de lesión glomerular con hipertensión, albuminuria y reducción de la tasa de filtración glomerular, sin embargo, para prevenir el daño renal se deben realizar seguimientos clínico, paraclínico e imagenológico cuidadosos de todo paciente con RUF, según la condición lo amerite. Conclusiones: se hace necesaria la unificación de pautas de seguimiento en los pacientes pediátricos con RUF y hacer énfasis en aquellos factores de riesgo que predisponen a compromiso renal.

Background: The Solitary functioning kidney (SFK) is an entity that can be congenital type caused by unilateral renal agenesis or multicystic dysplastic kidney, or acquired secondary to unilateral nephrectomy conditioning to a strict routine follow-up, as well as the implementation of some prevention guidelines in pediatric patients. Purpose: To analyze the importance of follow-up in pediatric patients with a single functioning kidney. Methodology: A review of the literature is made showing embryology, physiology, etiology, clinical aspects and diagnostic studies in patients with SFK in order to subsequently offer guidelines for follow-up and management in pediatric patients. Results: Patients with SFK may present compensatory glomerular hyperfiltration, followed by glomerular injury with hypertension, albuminuria and reduced glomerular filtration rate, however, to prevent renal damage a careful clinical, paraclinical and imaging follow-up of every patient with SFK should be performed as the condition warrants. Conclusions: It is necessary to unify follow-up guidelines in pediatric patients with SFK and to emphasize those risk factors that predispose to renal compromise.