Massive hemoptysis and deep venous thrombosis presenting in a woman with Hughes-Stovin syndrome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hughes-Stovin syndrome is a very rare disease with fewer than 30 cases reported in the literature. The disease is thought to be a variant of Behcet's disease and is defined by the presence of pulmonary artery aneurysm in association with peripheral venous thrombosis.</p> <p>Case presentation</p> <p>A previously healthy 23-year-old Saudi woman presented with massive hemoptysis a day prior to her admission to our hospital. She had a six-month history of recurrent fever, cough, dyspnea, and recurrent oral ulceration. Contrast-enhanced computed tomography scan of her chest and pulmonary angiogram demonstrated a single right-lower lobe pulmonary artery aneurysm. She underwent thoracotomy and right lower lobe resection. Her postoperative course was complicated by deep vein thrombosis. She also developed headache and papilledema, while a magnetic resonance imaging of her brain suggested vasculitis. Based on these clinical presentations, she was diagnosed and treated with Hughes-Stovin syndrome.</p> <p>Conclusion</p> <p>The majority of cases of Hughes-Stovin syndrome are reported among men, with only two cases occurring in women. A case of Hughes-Stovin syndrome occurring in a woman is presented in this report. She was treated successfully with multimodality treatment that includes surgery, steroids and cytotoxic agents.</p

Multidetector row computed tomography evaluation of the micropig kidney as a potential renal donor

Multidetector row computed tomography (MDCT) provides anatomical information about the kidney and other internal organs. Presently, the suitability of 64-channel MDCT to assess the kidney of healthy micropigs was evaluated. Morphological evaluations of the kidney and the major renal vessels of six healthy micropigs were carried out using MDCT, recording kidney volume and the diameter and length of renal arteries and veins. The mean diameters and lengths of the renal artery were 0.44 ± 0.05 and 4.51 ± 0.55 cm on the right side and 0.46 ± 0.06 and 3.36 ± 0.27 cm on the left side, respectively. The mean diameters and lengths of the renal vein were 1.44 ± 0.52 and 4.22 ± 1.29 cm on the right side and 1.38 ± 0.17 and 5.15 ± 0.87 cm on the left side, respectively. The mean volume of the right kidney was 79.3 ± 14.5 mL and of the left kidney was 78.0 ± 13.9 mL. The data presented in this study suggest that the MDCT offers a noninvasive, rapid, and accurate method for the evaluation of the renal anatomy in living kidney donors. It also provides sufficient information about extra-renal anatomy important for donor surgery and determination of organ suitability

Support vector machine model for diagnosis of lymph node metastasis in gastric cancer with multidetector computed tomography: a preliminary study

<p>Abstract</p> <p>Background</p> <p>Lymph node metastasis (LNM) of gastric cancer is an important prognostic factor regarding long-term survival. But several imaging techniques which are commonly used in stomach cannot satisfactorily assess the gastric cancer lymph node status. They can not achieve both high sensitivity and specificity. As a kind of machine-learning methods, Support Vector Machine has the potential to solve this complex issue.</p> <p>Methods</p> <p>The institutional review board approved this retrospective study. 175 consecutive patients with gastric cancer who underwent MDCT before surgery were included. We evaluated the tumor and lymph node indicators on CT images including serosal invasion, tumor classification, tumor maximum diameter, number of lymph nodes, maximum lymph node size and lymph nodes station, which reflected the biological behavior of gastric cancer. Univariate analysis was used to analyze the relationship between the six image indicators with LNM. A SVM model was built with these indicators above as input index. The output index was that lymph node metastasis of the patient was positive or negative. It was confirmed by the surgery and histopathology. A standard machine-learning technique called k-fold cross-validation (5-fold in our study) was used to train and test SVM models. We evaluated the diagnostic capability of the SVM models in lymph node metastasis with the receiver operating characteristic (ROC) curves. And the radiologist classified the lymph node metastasis of patients by using maximum lymph node size on CT images as criterion. We compared the areas under ROC curves (AUC) of the radiologist and SVM models.</p> <p>Results</p> <p>In 175 cases, the cases of lymph node metastasis were 134 and 41 cases were not. The six image indicators all had statistically significant differences between the LNM negative and positive groups. The means of the sensitivity, specificity and AUC of SVM models with 5-fold cross-validation were 88.5%, 78.5% and 0.876, respectively. While the diagnostic power of the radiologist classifying lymph node metastasis by maximum lymph node size were only 63.4%, 75.6% and 0.757. Each SVM model of the 5-fold cross-validation performed significantly better than the radiologist.</p> <p>Conclusions</p> <p>Based on biological behavior information of gastric cancer on MDCT images, SVM model can help diagnose the lymph node metastasis preoperatively.</p

Differential diagnosis of a probable case of non-adult thalassaemia from 4th century AD Romano-British Colchester, UK

Our current understanding of immigration and diasporic disease in Roman Britain has been greatly enhanced by the recent identification of thalassaemia in the non-adult skeletal record. The wide phenotypic variation in the clinical expression of β-thalassaemia, however, means that additional cases may go unrecognised. A probable diagnosis for β-thalassaemia intermedia or a mild form of major in a 1.0-1.5 year old skeleton from Butt Road, Colchester, dating to the 4th century AD is discussed here. The assessment was undertaken using macroscopic and radiographic analysis. Several conditions were apparent, including trauma and probable β-thalassaemia and active vitamin D deficiency. Diagnosis proved difficult due to the challenges that non-adult thalassaemia poses for identification in the skeletal record, as in the absence of the cranium only ‘rib-within-a-rib’ is currently considered as pathognomonic of the condition. This case demonstrates the variations in expression of this type of genetic anaemia and adds emphasis to a more widespread presence of this important condition in Roman Britain

Postoperative imaging of gastrointestinal tract cancers

Assessment in postoperative complications of gastrointestinal cancers via imaging modalities is of significant importance as diagnosing the cancer. Complications can be considered as an indicator for the success of surgical procedure, and has a vital importance for the patient. In this article the implications of CT, MR, ultrasonography and PET in these indications and their benefits are discussed. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved

Multidetector row CT of the pancreas

Multidetector CT (MDCT) has gained a great role in clinical imaging practice in a short time. Its major advantages are faster image acquisition and improved z-axis resolution. In spite of the advent of other imaging modalities CT is still the gold standard for the evaluation of pancreatic pathology. In this article, a review of the utility of MDCT in pancreatic applications is given with emphasis on acquisition techniques tailored to contrast material pharmacokinetics to improve lesion detection and characterization. (C) 2004 Elsevier Ireland Ltd. All rights reserved

Carcinoma of stomach and duodenum: radiologic diagnosis and staging

Gastric carcinoma is one of the leading causes of cancer mortality worldwide. Accurate preoperative staging of gastric cancer is important in planning the most effective therapy toward cure or palliation. This article reviews the radiologic diagnosis and staging of gastric cancer. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved