46 research outputs found
Intrahepatic Cholangiocarcinoma with Sarcomatous Changes
A 61-year-old Japanese male was seen at an outside hospital with abdominal pain and distention. An intraabdominal mass was found on abdominal computed tomography (CT), and he was referred for further evaluation. He was afebrile, with mild tenderness in the upper abdomen and massive distention. Routine blood work showed severe inflammation and anemia. Repeat CT showed a large solitary heterogeneous mass, 25 cm in diameter, in the left upper quadrant with evidence of intratumoral bleeding and irregular enhancement peripherally. There was no clear distinction between the mass and the peripheral organs. Surgery was performed with persistent anemia and exacerbation of abdominal pain. Lateral segmentectomy, total gastrectomy, cholecystectomy and partial resection of the diaphragm and parietal peritoneum were performed. The final diagnosis was cholangiocarcinoma with sarcomatous changes. On the 16th postoperative day a CT scan revealed recurrent tumor. The patient died on the 34th postoperative day from rapid tumor progression
Predicting rectal cancer T stage using circumferential tumor extent determined by computed tomography colonography
SummaryBackground and aimPatients with stage T3 or T4 rectal cancer are candidates for neoadjuvant chemoradiation therapy. The aim of this study is to clarify the usefulness of circumferential tumor extent determined by computed tomography (CT) colonography in differentiating T3 or T4 from T1 or T2 rectal cancer.MethodsSeventy consecutive rectal cancer patients who underwent curative-intent surgery were enrolled in this study. All patients underwent colonoscopy and CT colonography on the same day. The circumferential tumor extent was estimated in 10% increments. The pathological T stage was used as the reference.ResultsThe median circumferential tumor extent evaluated by colonoscopy for T1 (n = 6), T2 (n = 21), and T3/T4 (n = 43) were 10%, 30%, and 80%, respectively (T1/T2 vs. T3/T4, p < 0.0001). The median circumferential tumor extent evaluated by CT colonography for T1, T2, and T3/T4 is 10%, 30%, and 70%, respectively (T1/T2 vs. T3/T4, p < 0.0001). The correlation coefficient between colonoscopy and CT colonography was very high (0.94). By defining a circumferential tumor extent ≥50% by CT colonography as the criterion for stage T3 or T4, the sensitivity, specificity, positive predictive value and accuracy were 72%, 88%, 91%, and 79%, respectively.ConclusionCircumferential tumor extent ≥50% determined by CT colonography is a simple and potentially useful marker to identify candidates for neoadjuvant chemoradiation therapy
Ex-vivo porcine organs with a circulation pump are effective for teaching hemostatic skills
Surgical residents have insufficient opportunites to learn basic hemostatic skills from clinical experience alone. We designed an ex-vivo training system using porcine organs and a circulation pump to teach hemostatic skills. Residents were surveyed before and after the training and showed significant improvement in their self-confidence (1.83 ± 1.05 vs 3.33 ± 0.87, P < 0.01) on a 5 point Likert scale. This training may be effective to educate residents in basic hemostatic skills
A Systematic Review of Strong Gravitational Lens Modeling Software
Despite expanding research activity in gravitational lens modeling, there is
no particular software which is considered a standard. Much of the
gravitational lens modeling software is written by individual investigators for
their own use. Some gravitational lens modeling software is freely available
for download but is widely variable with regard to ease of use and quality of
documentation. This review of 13 software packages was undertaken to provide a
single source of information. Gravitational lens models are classified as
parametric models or non-parametric models, and can be further divided into
research and educational software. Software used in research includes the
GRAVLENS package (with both gravlens and lensmodel), Lenstool, LensPerfect,
glafic, PixeLens, SimpLens, Lensview, and GRALE. In this review, GravLensHD,
G-Lens, Gravitational Lensing, lens and MOWGLI are categorized as educational
programs that are useful for demonstrating various aspects of lensing. Each of
the 13 software packages is reviewed with regard to software features
(installation, documentation, files provided, etc.) and lensing features (type
of model, input data, output data, etc.) as well as a brief review of studies
where they have been used. Recent studies have demonstrated the utility of
strong gravitational lensing data for mass mapping, and suggest increased use
of these techniques in the future. Coupled with the advent of greatly improved
imaging, new approaches to modeling of strong gravitational lens systems are
needed. This is the first systematic review of strong gravitational lens
modeling software, providing investigators with a starting point for future
software development to further advance gravitational lens modeling research