The differential diagnosis of lentigo maligna (LM) from pigmented actinic keratosis (PAK) and solar lentigines (SL) remains a challenge for clinicians, especially in the early stages of LM when there ...are no distinctive dermoscopic features. Objective of this study was to evaluate the frequencies of selective dermoscopic criteria in LM, PAK, and SL and to find the specific combination of distinguishing dermoscopic criteria for LM. Dermoscopists blinded to histopathological diagnosis evaluated 42 LM, 107 PAK, and 16 SL for the presence of predefined dermoscopic criteria. The differences in the presence of dermoscopic criteria between LM and others were evaluated with the chi-squared test or Fisher’s exact test as appropriate. Multivariate logistic regression analysis with the forward conditional stepwise method were performed and odds ratios and corresponding 95% confidence intervals for LM, PAK, and SL were calculated. LM, PAK, and SL showed many common dermoscopic findings. In multivariate logistic regression analysis, darkening at dermoscopic examination (sevenfold), gray circles (sevenfold), target-like pattern (sixfold), gray rhomboids (sixfold), and slate-gray dots/globules (threefold) represented the strongest predictors of LM, while hyperkeratosis (thirteenfold), white circles (twelvefold), and red rhomboids (sixfold) represented the strongest predictors of PAK. The dermoscopic diagnosis of a given lesion should be based on the presence of the combination of specific dermoscopic criteria rather than a single benign or malignant criterion. Our results suggest that the presence of darkening at dermoscopic examination, gray circles, target-like pattern, gray rhomboids, and slate-gray dots/globules should be considered supportive findings for the diagnosis of early LM.
Due to the recent increasing mortality rates in 1- to 4-month-old Thoroughbred foals with Rhodococcus equi infection in Turkey, serum samples from 454 foals between 30 and 60 days on studfarms of the ...Marmara Region, where the Thoroughbred foal population is concentrated, were investigated by ELISA for early diagnosis of the infection. The Tween 20-extracted antigen of the R. equi ATCC 6939 strain was used in the ELISA. Two hundred and nine (46%) of the 454 foals were found to be ELISA-positive. Optical density (OD) values of 0.3 (positive limit) or higher were detected in 43% of foals aged 30-40 days, 40% of those aged 41-50 days and 78% of those aged 51-60 days. Of the 209 ELISA-positive foals, 126 (60%) showed a variety of clinical signs. All ELISA-positive foals were treated with a combination of erythromycin and rifampin. Of the 126 ELISA-positive foals with clinical signs, 122 (97%) recovered, but 4 of the foals died during the treatment period. The OD values of the 4 dead foals were over 0.3. Necropsy confirmed that they had R. equi infection. Three of the 4 had lung abscesses and the remaining had abdominal abscesses. In addition, 2 foals died on 2 different studfarms unrelated with this ELISA surveillance study, and they had lung abscesses. Virulent R. equi was isolated from lesions of the 6 dead foals. All the isolates had 15- to 17- kDa antigens and 85 kb type-I virulence plasmids. These results indicated that virulent R. equi, which contained 85 kb type-I plasmid, is widespread in Thoroughbred foals in the Marmara Region and ELISA is useful for the early diagnosis of R. equi infection in foals.
This study aims to discuss the management and the follow-up approach in patients with epistaxis.
A total of 367 patients with epistaxis (209 males, 158 females; mean age 52.6±18.3 years; range 18 to ...85 years) admitted to the Adult Emergency Department of a university hospital between January 2000 and December 2004 were retrospectively analyzed.
Of patients, 56.7% had an idiopathic bleeding. A significantly higher number of patients aged >50 years had high blood pressure on admission. Of 141 patients (38.49%) presenting without bleeding on admission, 20 required medical intervention for recurrent epistaxis. Conservative approaches were effective in stopping bleeding in 97.8% patients. The hospitalization ratio was 5.7%.
Our study result show that endonasal endoscopic mucosal cauterization is an effective method for resistant-to-treatment cases and inactive bleeding on admission is not a restraint for further examination.
Complications of Chronic Otitis Media Ahmet Ömer İkiz; Enis Alpin Güneri; Taner Kemal Erdağ ...
Turkish Archives of Otorhinolaryngology,
09/2001, Letnik:
39, Številka:
3
Journal Article
Odprti dostop
Medical records of 17 patients were reviewed to investigate the complications of chronic otitis media (COM). All complications were seen in acute exacerbations of the disease and most of them (n=15) ...were in patients having COM with cholesteatoma. There were 3 patients with double complications with a total number of 20 complications; 14 (70%) being intratemporal and 6 (30%) intracranial. The most frequent intratemporal and intracranial complications were facial paralysis (6 cases) and brain abscess (3 cases) respectively. Radical mastoidectomy was performed in ears with cholesteatoma and in cases of intracranial complications the operation was extended with appropriate interventions if required. Simple mastoidectomy was found to be sufficient in two cases without cholesteatoma, one with facial paralysis and the other with mastoiditis. There was no mortality and treatment associated morbidity in our series. Disease related morbidity rate was 17.65%, with two cases of permanent facial paralysis and one case of abducent nerve paralysis in a patient with lateral sinus thrombosis.
This research studied the accuracy and feasibility of cotton fiber length measurement by image processing as an alternative to existing systems. Current systems have some weaknesses especially in ...Short Fiber Content (SFC) determination, which is becoming an important length parameter in industry. Seventy-two treatments of five factors were analyzed for length and time measurements by our own computer program. The factors are: Sample preparation (without fiber crossover and with fiber crossover), lighting (backlighting and frontlighting), resolution (37-micron, 57-micron, 106-micron, and 185-micron), preprocessing (4-neighborhood and 8-neighborhood), and processing (outlining, thinning, and adding broken skeletons). The best results in terms of accuracy, precision and analysis time for images without fiber crossovers were: 106-micron resolution with frontlighting using an 8-neighborhood thresholding algorithm and using an outline algorithm for length determination. With fiber crossovers, 57-micron resolution with backlighting using an 8-neighborhood thresholding algorithm and using a thinning algorithm combined with an adding algorithm for combining broken skeletons. Using the above conditions, 1775 cm2 area can be analyzed using our current equipment in 15 seconds. In the case of images with crossovers, only 117 cm2 can be analyzed in 15 seconds. This research demonstrates that successful sample preparation without fibre crossovers would create the best fibre length measurement technique, however with fiber crossovers the system efficiency has been proven as well.
Objectives:To prospectively evaluate the incidence of syndrome of inappropriate ADH secretion (SIADH) in the postoperative period after neck dissections.Materials and Methods:The following parameters ...were obtained in the preoperative and postoperative period from 18 patients who had neck dissections with diagnoses of head and neck squamous cell carcinoma and also from 7 patients who were operated for various otolaryngological reasons. Personal files, tumor location, stage, surgical treatment, type of neck dissection, preservation or ligation of internal jugular vein (IJV) were recorded in the neck dissection group. In each group, Na+, K+, glucose, creatinine, BUN, uric acide, urine sodium, blood osmolarity and urine osmolarity levels were recorded preoperatively, as well as postoperatively during the first consecutive 7 days after the operation. The diagnosis of SIADH was established by evaluating the obtained laboratory data.Results:Postoperatively, SIADH was developed in 4 of 18 patients (22%) who had neck dissections whereas none of the 7 patients in the control group had an evidence of SIADH.Conclusion:Internal jugular vein was unilaterally ligated in all of 4 patients who developed SIADH. The ligation of the IJV was shown to increase the risk of SIADH development significantly, while this risk was found to be almost significant for patients with cervical metastasis.
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