In the new era of functional magnetic resonance imaging(MRI), the utility of chest MRI is increasing exponentially due to several advances, including absence of ionizing radiation, excellent tissue contrast and high c...In the new era of functional magnetic resonance imaging(MRI), the utility of chest MRI is increasing exponentially due to several advances, including absence of ionizing radiation, excellent tissue contrast and high capability for lesion characterization and treatment monitoring. The application of several of these diagnostic weapons in a multiparametric fashion enables to better characterize thymic epithelial tumors and other mediastinal tumoral lesions, accurate assessment of the invasion of adjacent structures and detection of pathologic lymph nodes and metastasis. Also, "do not touch lesions" could be identified with the associated impact in the management of those patients. One of the hotspots of the multiparametric chest MR is its ability to detect with acuity early response to treatment in patients with mediastinal malignant neoplasms. This has been related with higher rates of overall survival and progression free survival.Therefore, in this review we will analyze the current functional imaging techniques available(18 F-Fluorodeoxiglucose positron emission tomography/computed tomography, diffusion-weighted imaging, dynamic contrast-enhanced MRI, diffusion tensor imaging and MR spectroscopy) for the evaluation of mediastinal lesions, with a focus in their correct acquisition and post-processing. Also, to review the clinical applications of these techniques in the diagnostic approach of benign and malignant conditions of the mediastinum.展开更多
Major depressive disorder（MDD） is a significant cause of morbidity and mortality worldwide,correlating with genetic susceptibility and environmental risk factors.Molecular,functional,and structural imaging approache...Major depressive disorder（MDD） is a significant cause of morbidity and mortality worldwide,correlating with genetic susceptibility and environmental risk factors.Molecular,functional,and structural imaging approaches have been increasingly used to detect neurobiological changes,analyze neurochemical correlates,and parse pathophysiological mechanisms underlying MDD.We reviewed recent neuroimaging publications on MDD in terms of molecular,functional,and structural alterations as detected mainly by magnetic resonance imaging（MRI） and positron emission tomography.Altered structure and function of brain regions involved in the cognitive control of affective state have been demonstrated.An abnormal default mode network,as revealed by resting-state functional MRI,is likely associated with aberrant metabolicand serotonergic function revealed by radionuclide imaging.Further multi-modal investigations are essential to clarify the characteristics of the cortical network and serotonergic system associated with behavioral and genetic variations in MDD.展开更多
AIM: To assess the attenuation of non-calcified atherosclerotic coronary artery plaques with computed tomography coronary angiography (CTCA). METHODS: Four hundred consecutive patients underwent CTCA (Group 1: 200 pat...AIM: To assess the attenuation of non-calcified atherosclerotic coronary artery plaques with computed tomography coronary angiography (CTCA). METHODS: Four hundred consecutive patients underwent CTCA (Group 1: 200 patients, Sensation 64 Cardiac, Siemens; Group 2: 200 patients, VCT GE Healthcare, with either Iomeprol 400 or Iodixanol 320, respectively) for suspected coronary artery disease (CAD). CTCA was performed using standard protocols. Image quality (score 0-3), plaque (within the accessible non-calcified component of each non-calcified/mixed plaque) and coronary lumen attenuation were measured. Data were compared on a per-segment/per-plaque basis. Plaques were classified as fibrous vs lipid rich based on different attenuation thresholds. A P < 0.05 was considered significant. RESULTS: In 468 atherosclerotic plaques in Group 1 and 644 in Group 2, average image quality was 2.96 ± 0.19 in Group 1 and 2.93 ± 0.25 in Group 2 (P ≥ 0.05). Coronary lumen attenuation was 367 ± 85 Hounsfield units (HU) in Group 1 and 327 ± 73 HU in Group 2 (P < 0.05); non-calcified plaque attenuation was 48 ± 23 HU in Group 1 and 39 ± 21 HU in Group 2 (P < 0.05). Overall signal to noise ratio was 15.6 ± 4.7 in Group 1 and 21.2 ± 7.7 in Group 2 (P < 0.01). CONCLUSION: Higher intra-vascular attenuation modifies significantly the attenuation of non-calcified coronary plaques. This results in a more difficult characterization between lipid rich vs fibrous type.展开更多
Liver cancer is one of the major diseases with increased mortality in recent years,across the globe.Manual detection of liver cancer is a tedious and laborious task due to which Computer Aided Diagnosis(CAD)models hav...Liver cancer is one of the major diseases with increased mortality in recent years,across the globe.Manual detection of liver cancer is a tedious and laborious task due to which Computer Aided Diagnosis(CAD)models have been developed to detect the presence of liver cancer accurately and classify its stages.Besides,liver cancer segmentation outcome,using medical images,is employed in the assessment of tumor volume,further treatment plans,and response moni-toring.Hence,there is a need exists to develop automated tools for liver cancer detection in a precise manner.With this motivation,the current study introduces an Intelligent Artificial Intelligence with Equilibrium Optimizer based Liver cancer Classification(IAIEO-LCC)model.The proposed IAIEO-LCC technique initially performs Median Filtering(MF)-based pre-processing and data augmentation process.Besides,Kapur’s entropy-based segmentation technique is used to identify the affected regions in liver.Moreover,VGG-19 based feature extractor and Equilibrium Optimizer(EO)-based hyperparameter tuning processes are also involved to derive the feature vectors.At last,Stacked Gated Recurrent Unit(SGRU)classifier is exploited to detect and classify the liver cancer effectively.In order to demonstrate the superiority of the proposed IAIEO-LCC technique in terms of performance,a wide range of simulations was conducted and the results were inspected under different measures.The comparison study results infer that the proposed IAIEO-LCC technique achieved an improved accuracy of 98.52%.展开更多
Introduction: Urinary tract infection is one of the most frequent public health problems in the world and concerns all ages. Objective: To describe the epidemiological, clinical and biological profile of urinary tract...Introduction: Urinary tract infection is one of the most frequent public health problems in the world and concerns all ages. Objective: To describe the epidemiological, clinical and biological profile of urinary tract infection in the internal medicine unit of the Fousseyni Daou hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all outpatients and hospitalized patients presenting with a urinary tract infection during the study period. Results: We identified 79 cases of urinary tract infection out of 145 requests for ECBU, that is a positivity rate of 53.10% and out of a total of 1883 admissions that is a hospital prevalence of 4.19%. The age groups of 36 to 45 years and 46 to 55 years were more represented in 28 cases (35.44%) and 25 cases (31.64%) with an average age of 45 years ± 10. The female sex was predominant, 42 cases (53.16%) with a sex ratio of 0.88. Housewives were more represented 28 cases (34.44%). The majority of patients resided in rural areas 49 cases (62.03%). The history was dominated by the following pathologies: hypertension 48.10%, diabetes 36.70% and gastropathy 30.37%. The main clinical manifestations were: Urinary burning 67 cases (84.81%), Dysuria 65 cases (82.27%), Pelvic pain 59 cases (74.68%), Fever 57 cases (72.15%). The epidemiological profile of the isolated strains was dominated by enterobacteriaceae, followed by gram-positive cocci and gram-negative bacilli. The main bacteria responsible for urinary tract infections in order of frequency: Escherichia coli (45.56%), Klebsiella pneumoniae (11.39%), Pseudomonas aeruginosa (8.86%), Staphylococcus aureus (7.59%), Streptococcus sp (6.33%), Enterobacter cloacae (3.79%), Acinetobacter sp (3.79%). The study of the susceptibility and resistance profiles of the isolated strains showed significant sensitivity of enterobacteriaceae to colistin and resistance to amoxicillin and to the amoxicillin + clavulanic acid combination. Conclusion: Urinary tract infections are a major public health problem since they are responsible for significant morbidity and mortality and a high cost of care. Knowledge of the epidemiological-clinical and bacteriological profile of these infections is essential for efficient management.展开更多
Introduction: Anemia is one of the most common public health problems in the world and affects all ages. Objective: To describe the etiological and evolutionary profile of anemia in patients hospitalized in the Intern...Introduction: Anemia is one of the most common public health problems in the world and affects all ages. Objective: To describe the etiological and evolutionary profile of anemia in patients hospitalized in the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all anemic patients hospitalized during the study period. Results: We identified 91 cases of anemia out of 200 patients admitted to the Unit that is a hospital prevalence of 45.5%. The age group of 26 to 35 years was the most represented, that is to say 29 cases (31.87%) with an average age of 43.55 years ± 17.48 years, the female sex predominated, 51 cases (56.04%) with a sex ratio of 0.78. Housewives represented 41 cases (45.05%). The majority of patients resided in rural areas 48 cases (52.75%). The main manifestations were: asthenia 75 cases (78.02%), vertigo 68 cases (74.72%), dyspnea 62 cases (68.13%), headaches 59 cases (64.83%), palpitations 55 cases (60.44%), conjunctival pallor 53 cases (58.24%), tachycardia 43 cases (47.25%), systolic murmur 18 cases (19.78%) and IMO 11 cases (12.09%). The associated pathologies were: infected diabetic wounds 25.27%, followed by bacterial pleuro-pneumopathy 18.68%. Biologically, microcytic anemia was the most frequent 49 cases (53.84%), followed by normocytic anemia 35 cases (38.46%) and macrocytic anemia 7 cases (7.7%). Anemia was hypochromic, 53 cases (58.24%) were more encountered compared to normochromic anemia 38 cases (41.76%). The anemia was: severe in 43 cases (47.25%), moderate 29 cases (31.87%) and mild 19 cases (20.88%). Inflammatory anemia is the most common etiological diagnosis in 60% of cases, followed by vitamin B12 deficiency anemia observed in 21% of patients and then blood diseases in 7.33% of cases. The main causes of death were HIV (50%) and kidney failure (33.33%). Conclusion: Anemia is a frequent symptom in internal medicine. It constitutes a real diagnostic challenge for the internist and this sometimes in an emergency context. The use of specialized examinations and labile blood products is essential in our hospital.展开更多
Aseptic osteonecrosis of the femoral head is defined as the death of bone cells in the femoral epiphysis due to an interruption of blood supply. Most cases are linked to trauma, but non-traumatic cases also occur and ...Aseptic osteonecrosis of the femoral head is defined as the death of bone cells in the femoral epiphysis due to an interruption of blood supply. Most cases are linked to trauma, but non-traumatic cases also occur and can be associated with several known risk factors. This study aims to describe these risk factors identified in the former Katanga province, a region with significant mining activity. Method and Patients: This is a descriptive cross-sectional study conducted over a seven-year period (2017-2024), including all cases of aseptic osteonecrosis of the femoral head diagnosed in the orthopedic department of Medpark Clinic in Lubumbashi. The investigation of risk factors was based on the analysis of sociodemographic, clinical, radiological, and biological data. Results: Our study included a total of 110 patients with a mean age of 47.5 years. Among them, there were 46 women (41.82%) and 64 men (58.18%). Twenty-five patients (27.5%) reported a family history of osteonecrosis, and 24% were diagnosed with sickle cell disease. Chronic alcoholism was noted in 14 patients (12.73%), while diabetes was present in 8 (7.2%). Four patients (3.64%) were obese, and three were HIV-positive (2.72%). The use of nonsteroidal anti-inflammatory drugs (NSAIDs) was common, and prolonged corticosteroid use was documented in 5 patients (4.5%). Abnormally high cholesterol levels were found in 26 patients (23.6%). One patient had gout, and two suffered from acute rheumatic fever (1.8%). Regarding inflammatory markers, C-reactive protein levels and erythrocyte sedimentation rates were within normal limits for almost all patients. Electrolyte levels and phosphocalcic profiles showed no abnormalities. Furthermore, 33 patients (30%) did not exhibit any of the previously mentioned risk factors. Most of these patients lived in the regions of Kolwezi, Likasi, and Lubumbashi. Among this group, 25 patients reported performing physically demanding labor, particularly in mining operations. Conclusion: Our study highlighted well-known risk factors for osteonecrosis of the femoral head (ONFH). However, it also identified a significant number of cases without any identifiable risk factors, classified as idiopathic. Among these cases, some patients engaged in intense physical labor, often linked to mining exposure.展开更多
Acute massive duodenal bleeding is one of the most frequent complications of peptic ulcer disease.Endoscopy is the first-line method for diagnosing and treating actively bleeding peptic ulcers because its success rate...Acute massive duodenal bleeding is one of the most frequent complications of peptic ulcer disease.Endoscopy is the first-line method for diagnosing and treating actively bleeding peptic ulcers because its success rate is high.Of the small group of patients whose bleeding fails to respond to endoscopic therapy,increasingly the majority is referred for embolotherapy.Indeed,advances in catheter-based techniques and newer embolic agents,as well as recognition of the effectiveness of minimally invasive treatment options,have expanded the role of interventional radiology in the management of hemorrhage from peptic ulcers over the past decade.Embolization may be effective for even the most gravely ill patients for whom surgery is not a viable option,even when extravasation is not visualized by angiography.However,it seems that careful selection of the embolic agents according to the bleeding vessel may play a role in a successful outcome.The role of the surgeon in this clinical sphere is dramatically diminishing and will certainly continue to diminish in ensuing years,surgery being typically reserved for patients whose bleeding failed to respond all previous treatments.Such a setting has become extremely rare.展开更多
Pulmonary vein stenosis(PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become t...Pulmonary vein stenosis(PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become the main cause of the disease. PVS is characterized by a progressive lumen size reduction of one or more pulmonary veins that, when hemodynamically significant, may raise lobar capillary pressure leading to signs and symptoms such as shortness of breath, cough, and hemoptysis. Image techniques(transesophageal echocardiography, computed tomography, magnetic resonance and perfusion imaging) are essential to reach a final diagnosis and decide an appropriate therapy. In this regard, series from referral centers have shown that surgical and transcatheter interventions may improve prognosis. The purpose of this article is to review the etiology, assessment and management of PVS.展开更多
People with schizophrenia exhibit impaired social cognitive functions, particularly emotion regulation. Abnormal activations of the ventral medial prefrontal cortex （vMPFC） during emotional tasks have been demonstra...People with schizophrenia exhibit impaired social cognitive functions, particularly emotion regulation. Abnormal activations of the ventral medial prefrontal cortex （vMPFC） during emotional tasks have been demonstrated in schizophrenia, suggesting its important role in emotion processing in patients. We used the resting-state functional connectivity approach, setting a functionally relevant region, the vMPFC, as a seed region to examine the intrinsic functional interactions and communication between the vMPFC and other brain regions in schizophrenic patients. We found hypo-connectivity between the vMPFC and the medial frontal cortex, right middle temporal lobe （MTL）, right hippocampus, parahippocampal cortex （PHC） and amygdala. Further, there was a decreased strength of the negative connectivity （or anticorrelation） between the vMPFC and the bilateral dorsal lateral prefrontal cortex （DLPFC） and pre-supplementary motor areas. Among these connectivity alterations, reduced vMPFC-DLPFC connectivity was positively correlated with positive symptoms on the Positive and Negative Syndrome Scale, while vMPFC-right MTL/PHC/amygdala functional connectivity was positively correlated with the performance of emotional regulation in patients. These findings imply that communication and coordination throughout the brain networks are disrupted in schizophrenia. The emotional correlates of vMPFC connectivity suggest a role of the hypo-connectivity between these regions in the neuropathology of abnormal social cognition in chronic schizophrenia.展开更多
It is reported that a pancreatic disease may precede the diagnosis of inflammatory bowel disease(IBD) both in children and in adults.Idiopathic chronic pancreatitis,however,occasionally co-exists with the IBD,mainly a...It is reported that a pancreatic disease may precede the diagnosis of inflammatory bowel disease(IBD) both in children and in adults.Idiopathic chronic pancreatitis,however,occasionally co-exists with the IBD,mainly at pediatric age.We report a case of a patient who progressively developed the features of a chronic pancreatitis,before the diagnosis of Crohn's Disease(CD).Ten months after the onset of the first episode of pancreatitis the patient developed bloody diarrhea,mucus stools and biochemical findings of inflammation.The colonoscopy revealed a diffuse colitis without involvement of the last loop and the gastroscopy showed inflammation of the iuxta-papillary area.The histological findings confirmed the diagnosis of CD that involved the colon and the duodenum.In conclusion,in children the idiopathic chronic pancreatitis may be an unusual presentation of CD.Thus,if other known cause of chronic pancreatitis are not found,a not invasive work up to exclude the IBD should be warranted.An early coincidental diagnosis of the IBD may delay the progression of the pancreatic disease.展开更多
Objective:The present study aimed to evaluate the possibility of using coherent anti-Stokes Raman spectroscopy（CARS） microscopy to determine the specific molecular morphology of cholesteatoma by detecting the natura...Objective:The present study aimed to evaluate the possibility of using coherent anti-Stokes Raman spectroscopy（CARS） microscopy to determine the specific molecular morphology of cholesteatoma by detecting the natural vibrational contrast of the chemical bonds without any staining.Materials and methods:Specimens from the mastoid and tympanic membrane with and without cholesteatoma were analyzed using CARS microscopy,two-photon excited fluorescence（TPEF） microscopy,and the second harmonic generation（SHG） microscopy.Results:In cholesteatoma tissues from the mastoid,a strong resonant signal at 2845 cm;was observed by CARS,which indicated the detection of the CH;hydro-carbon lipid bonds that do not generate visible signals at 2940 cm;suggestive of CH;bonds in amino acids.A strong resonant signal at 2940 cm;appeared in an area of the same specimen,which also generated abundant signals by TPEF and SHG microscopy at 817 nm,which was suggestive of collagen.In the tympanic membrane specimen with cholesteatoma,a strong resonant signal with corrugated morphology was detected,which indicated the presence of lipids.A strong signal was detected in the tympanic membrane with chronic otitis media using TPEF/SHG at 817 nm,which indicated collagen enrichment.The CARS and TPEF/SHG images were in accordance with the histology results.Conclusion:These results suggest the need to develop a novel CARS microendoscope that can be used in combination with TPEF/SHG to distinguish cholesteatoma from inflammatory tissues.展开更多
AIM: To validate the feasibility of digital tomosynthesis of the abdomen(DTA) combined with contrast enhanced ultrasound(CEUS) in assessing complications after endovascular aortic aneurysm repair(EVAR) by using comput...AIM: To validate the feasibility of digital tomosynthesis of the abdomen(DTA) combined with contrast enhanced ultrasound(CEUS) in assessing complications after endovascular aortic aneurysm repair(EVAR) by using computed tomography angiography(CTA) as the gold standard.METHODS: For this prospective study we enrolled 163 patients(123 men; mean age, 65.7 years) referred for CTA for EVAR follow-up. CTA, DTA and CEUS were performed at 1 and 12 mo in all patients, with a maximum time interval of 2 d.RESULTS: Among 163 patients 33 presented complications at CTA. DTA and CTA correlated for the presence of complications in 32/33(96.96%) patients and for the absence of complications in 127/130(97.69%) patients; the sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and accuracy of DTA were 97%, 98%, 91%, 99%, and 98%, respectively. CEUS and CTA correlated for the presence of complications in 19/33(57.57%) patients and for the absence of complications in 129/130(99.23%) patients; the sensitivity, specificity, PPV, NPV and accuracy of CEUS were 58%, 99%, 95%, 90%, and 91%, respectively. Sensitivity, specificity and accuracy of combining DTA and CEUS together in detecting EVAR complications were 77%, 98% and 95%, respectively.CONCLUSION: Combining DTA and CEUS in EVAR follow-up has the potential to limit the use of CTA only in doubtful cases.展开更多
AIM: To evaluate the feasibility of coronary artery calcium score(CACS) on low-dose non-gated chest CT(ngCCT).METHODS: Sixty consecutive individuals(30 males; 73 ± 7 years) scheduled for risk stratification by me...AIM: To evaluate the feasibility of coronary artery calcium score(CACS) on low-dose non-gated chest CT(ngCCT).METHODS: Sixty consecutive individuals(30 males; 73 ± 7 years) scheduled for risk stratification by means of unenhanced ECG-triggered cardiac computed to-mography(gCCT) underwent additional unenhanced ngCCT. All CT scans were performed on a 64-slice CT scanner(Somatom Sensation 64 Cardiac, Siemens, Germany). CACS was calculated using conventional methods/scores(Volume, Mass, Agatston) as previ-ously described in literature. The CACS value obtained were compared. The Mayo Clinic classification was used to stratify cardiovascular risk based on Agatston CACS. Differences and correlations between the two methods were compared. A P-value < 0.05 was considered sig-nificant.RESULTS: Mean CACS values were significantly higher for gCCT as compared to ngCCT(Volume: 418 ± 747 vs 332 ± 597; Mass: 89 ± 151 vs 78 ± 141; Agatston: 481 ± 854 vs 428 ± 776; P < 0.05). The correlation between the two values was always very high(Volume: r = 0.95; Mass: r = 0.97; Agatston: r = 0.98). Of the 6 patients with 0 Agatston score on gCCT, 2(33%) showed an Agatston score > 0 in the ngCCT. Of the 3 patients with 1-10 Agatston score on gCCT, 1(33%) showed an Agatston score of 0 in the ngCCT. Overall, 23(38%) patients were reclassified in a different car-diovascular risk category, mostly(18/23; 78%) shifting to a lower risk in the ngCCT. The estimated radiation dose was significantly higher for gCCT(DLP 115.8 ± 50.7 vs 83.8 ± 16.3; Effective dose 1.6 ± 0.7 mSv vs 1.2 ± 0.2 mSv; P < 0.01).CONCLUSION: CACS assessment is feasible on ngCCT; the variability of CACS values and the associated re-stratification of patients in cardiovascular risk groups should be taken into account.展开更多
Introduction: Hysterosalpingography is an important tool in the investigation of the causes of female infertility. In developing countries such as the Democratic Republic of Congo, the HSG is the basic tool for perfor...Introduction: Hysterosalpingography is an important tool in the investigation of the causes of female infertility. In developing countries such as the Democratic Republic of Congo, the HSG is the basic tool for performing first-line anatomical (pelvic) assessment. The aim of this study is to determine the prevalence of the different lesions observed in hysterosalpingography carried out during the assessment of infertile women monitored in Kisangani. The study set also out to look for differences in these lesions according to the type of infertility. Methods: This cross-sectional study was conducted in Kisangani from June 2016 to December 2018. The 130 cases of hysterosalpingography performed for female infertility assessment during the study period were included, of which 33.07% for primary infertility and 66.93% for secondary infertility. Results: The mean age of the patients was 33.52 ± 6.01 years;the history of pelvic inflammatory disease was noted with a predominance for secondary infertility (11% vs. 4.65%). Using hysterosalpingography, 7 (5.38%) patients had a normal result;94 (72.31%) had tubal obstruction;25 (19.23%) had hydrosalpinx;11 (8.46%) had uterine fibroids;pelvic adhesions were suspected in 12.64% of cases. There was no obvious association between all these lesions and the type of infertility. Conclusion: We found that tubal obstructions were the most prevalent lesions in this study, regardless of the type of infertility. These lesions would reflect the high prevalence of septic abortions and sexually transmitted infections in developing countries such as the Democratic Republic of the Congo.展开更多
Multi-photon microscopy(MPM)and coherent anti-Stokes Raman scattering(CARS)are two advanced nonlinear optical imaging techniques,which provide complementary information and have great potential in combination for noni...Multi-photon microscopy(MPM)and coherent anti-Stokes Raman scattering(CARS)are two advanced nonlinear optical imaging techniques,which provide complementary information and have great potential in combination for noninvasive in vrito biomedical applications.This paper provides a detailed discussion of the basics,development and applications of these technologies for in vrivo skin research,covering the following topics:The principle and advantage of MPM and CARS,instrumentation development for in vino applications,MPM and CARS of normal skin,application of MPM and CARS in skin cancer and disease diagnosis;application of MPM in skin disease intervention,ie.,imaging guided two-photon photothermolysis.展开更多
Penile fracture is a rare urological emergency. It occurs mainly in young adults during sexual intercourse. In many instances, one of the corpora carvanosus is involved though bilateral injuries with or without corpus...Penile fracture is a rare urological emergency. It occurs mainly in young adults during sexual intercourse. In many instances, one of the corpora carvanosus is involved though bilateral injuries with or without corpus spongiosus involvement is not uncommon. However, isolated injury to corpus spongiosus is extremely rare. We report a case of isolated rupture of corpus spongiosum secondary to penile injury during coitus in a 43-year-old man that presented to University Hospital Souro Sanou of Bobo Dioulasso. He presented with history of persistence bleeding per urethra following penile injury during sexual intercourse. The Retrograde urethrography (RUG) showed a partial rupture of urethra, Moore type 3. Complementary penile ultrasound revealed extensive contusion of the urethra with circumferential hematoma and rupture of the distal 1/3 of the corpus spongiosus. He had gentle per urethral catheterization which was left for one month. Penile ultrasound sound done after removal of catheter showed residual injury and narrowing of the urethra.展开更多
Emphysematous cystitis is a severe urinary tract infection which threatens patients’ life. Thus, it requires early diagnosis and computed tomography (CT) is the reference medical exam used to address it. However, ult...Emphysematous cystitis is a severe urinary tract infection which threatens patients’ life. Thus, it requires early diagnosis and computed tomography (CT) is the reference medical exam used to address it. However, ultrasound, which is a non-ionizing and very accessible technique, may also contribute to diagnosis. The aim of this study was to illustrate the contribution of ultrasound to the diagnosis of emphysematous cystitis. We report three cases of emphysematous cystitis diagnosed by ultrasound. In all the cases, ultrasound identified basic signs showing presence of gas, including a hyperechoic cystic parietal thickening, repeat echoes and dirty shadow cones of intraluminal focus. Diagnostic confirmation was made in two cases through X-ray and in one case by means of computed tomography. Through simple basic signs, ultrasound directs most usefully towards an emphysematous urinary tract infection. CT enables a more accurate diagnostic work-up of lesions and differential diagnosis with vesico-digestive fistula.展开更多
A 54-year-old man was referred for ablation of symptomatic drug-refractory long-lasting persistent atrial fibrillation. His past medical history was negative for cardiac disease but included a diagnosis of esophageal ...A 54-year-old man was referred for ablation of symptomatic drug-refractory long-lasting persistent atrial fibrillation. His past medical history was negative for cardiac disease but included a diagnosis of esophageal achalasia. The patient underwent an ablation procedure, guided by barium esophagram, including isolation of the pulmonary veins, ablation of complex fractionated left atrial electrograms recorded on the sep-tal wall and, finally, linear ablation of the cavo-tricuspid isthmus. The ablation procedure was performed with multielectrode ablation catheters using duty-cycled bipolar/unipolar radiofrequency energy. During 6 months of follow-up no recurrences of atrial fibrillation were documented. The reported case demonstrates how an ablation procedure for long-standing persistent AF may be safely performed even in a patient presenting with a achalasia, outlining the mega-esophagus position with a simple barium paste.展开更多
文摘In the new era of functional magnetic resonance imaging(MRI), the utility of chest MRI is increasing exponentially due to several advances, including absence of ionizing radiation, excellent tissue contrast and high capability for lesion characterization and treatment monitoring. The application of several of these diagnostic weapons in a multiparametric fashion enables to better characterize thymic epithelial tumors and other mediastinal tumoral lesions, accurate assessment of the invasion of adjacent structures and detection of pathologic lymph nodes and metastasis. Also, "do not touch lesions" could be identified with the associated impact in the management of those patients. One of the hotspots of the multiparametric chest MR is its ability to detect with acuity early response to treatment in patients with mediastinal malignant neoplasms. This has been related with higher rates of overall survival and progression free survival.Therefore, in this review we will analyze the current functional imaging techniques available(18 F-Fluorodeoxiglucose positron emission tomography/computed tomography, diffusion-weighted imaging, dynamic contrast-enhanced MRI, diffusion tensor imaging and MR spectroscopy) for the evaluation of mediastinal lesions, with a focus in their correct acquisition and post-processing. Also, to review the clinical applications of these techniques in the diagnostic approach of benign and malignant conditions of the mediastinum.
基金supported by the National Natural Science Foundation of China (81425015 and 81271601)the International S&T Cooperation Program of China (2015DFG32740)the Zhejiang Provincial Natural Science Foundation of China (LR13H180001)
文摘Major depressive disorder（MDD） is a significant cause of morbidity and mortality worldwide,correlating with genetic susceptibility and environmental risk factors.Molecular,functional,and structural imaging approaches have been increasingly used to detect neurobiological changes,analyze neurochemical correlates,and parse pathophysiological mechanisms underlying MDD.We reviewed recent neuroimaging publications on MDD in terms of molecular,functional,and structural alterations as detected mainly by magnetic resonance imaging（MRI） and positron emission tomography.Altered structure and function of brain regions involved in the cognitive control of affective state have been demonstrated.An abnormal default mode network,as revealed by resting-state functional MRI,is likely associated with aberrant metabolicand serotonergic function revealed by radionuclide imaging.Further multi-modal investigations are essential to clarify the characteristics of the cortical network and serotonergic system associated with behavioral and genetic variations in MDD.
基金Supported by An unrestricted grant from GE Healthcare
文摘AIM: To assess the attenuation of non-calcified atherosclerotic coronary artery plaques with computed tomography coronary angiography (CTCA). METHODS: Four hundred consecutive patients underwent CTCA (Group 1: 200 patients, Sensation 64 Cardiac, Siemens; Group 2: 200 patients, VCT GE Healthcare, with either Iomeprol 400 or Iodixanol 320, respectively) for suspected coronary artery disease (CAD). CTCA was performed using standard protocols. Image quality (score 0-3), plaque (within the accessible non-calcified component of each non-calcified/mixed plaque) and coronary lumen attenuation were measured. Data were compared on a per-segment/per-plaque basis. Plaques were classified as fibrous vs lipid rich based on different attenuation thresholds. A P < 0.05 was considered significant. RESULTS: In 468 atherosclerotic plaques in Group 1 and 644 in Group 2, average image quality was 2.96 ± 0.19 in Group 1 and 2.93 ± 0.25 in Group 2 (P ≥ 0.05). Coronary lumen attenuation was 367 ± 85 Hounsfield units (HU) in Group 1 and 327 ± 73 HU in Group 2 (P < 0.05); non-calcified plaque attenuation was 48 ± 23 HU in Group 1 and 39 ± 21 HU in Group 2 (P < 0.05). Overall signal to noise ratio was 15.6 ± 4.7 in Group 1 and 21.2 ± 7.7 in Group 2 (P < 0.01). CONCLUSION: Higher intra-vascular attenuation modifies significantly the attenuation of non-calcified coronary plaques. This results in a more difficult characterization between lipid rich vs fibrous type.
基金The Deanship of Scientific Research(DSR)at King Abdulaziz University,Jeddah,Saudi Arabia has funded this project,under grant no.(FP-206-43).
文摘Liver cancer is one of the major diseases with increased mortality in recent years,across the globe.Manual detection of liver cancer is a tedious and laborious task due to which Computer Aided Diagnosis(CAD)models have been developed to detect the presence of liver cancer accurately and classify its stages.Besides,liver cancer segmentation outcome,using medical images,is employed in the assessment of tumor volume,further treatment plans,and response moni-toring.Hence,there is a need exists to develop automated tools for liver cancer detection in a precise manner.With this motivation,the current study introduces an Intelligent Artificial Intelligence with Equilibrium Optimizer based Liver cancer Classification(IAIEO-LCC)model.The proposed IAIEO-LCC technique initially performs Median Filtering(MF)-based pre-processing and data augmentation process.Besides,Kapur’s entropy-based segmentation technique is used to identify the affected regions in liver.Moreover,VGG-19 based feature extractor and Equilibrium Optimizer(EO)-based hyperparameter tuning processes are also involved to derive the feature vectors.At last,Stacked Gated Recurrent Unit(SGRU)classifier is exploited to detect and classify the liver cancer effectively.In order to demonstrate the superiority of the proposed IAIEO-LCC technique in terms of performance,a wide range of simulations was conducted and the results were inspected under different measures.The comparison study results infer that the proposed IAIEO-LCC technique achieved an improved accuracy of 98.52%.
文摘Introduction: Urinary tract infection is one of the most frequent public health problems in the world and concerns all ages. Objective: To describe the epidemiological, clinical and biological profile of urinary tract infection in the internal medicine unit of the Fousseyni Daou hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all outpatients and hospitalized patients presenting with a urinary tract infection during the study period. Results: We identified 79 cases of urinary tract infection out of 145 requests for ECBU, that is a positivity rate of 53.10% and out of a total of 1883 admissions that is a hospital prevalence of 4.19%. The age groups of 36 to 45 years and 46 to 55 years were more represented in 28 cases (35.44%) and 25 cases (31.64%) with an average age of 45 years ± 10. The female sex was predominant, 42 cases (53.16%) with a sex ratio of 0.88. Housewives were more represented 28 cases (34.44%). The majority of patients resided in rural areas 49 cases (62.03%). The history was dominated by the following pathologies: hypertension 48.10%, diabetes 36.70% and gastropathy 30.37%. The main clinical manifestations were: Urinary burning 67 cases (84.81%), Dysuria 65 cases (82.27%), Pelvic pain 59 cases (74.68%), Fever 57 cases (72.15%). The epidemiological profile of the isolated strains was dominated by enterobacteriaceae, followed by gram-positive cocci and gram-negative bacilli. The main bacteria responsible for urinary tract infections in order of frequency: Escherichia coli (45.56%), Klebsiella pneumoniae (11.39%), Pseudomonas aeruginosa (8.86%), Staphylococcus aureus (7.59%), Streptococcus sp (6.33%), Enterobacter cloacae (3.79%), Acinetobacter sp (3.79%). The study of the susceptibility and resistance profiles of the isolated strains showed significant sensitivity of enterobacteriaceae to colistin and resistance to amoxicillin and to the amoxicillin + clavulanic acid combination. Conclusion: Urinary tract infections are a major public health problem since they are responsible for significant morbidity and mortality and a high cost of care. Knowledge of the epidemiological-clinical and bacteriological profile of these infections is essential for efficient management.
文摘Introduction: Anemia is one of the most common public health problems in the world and affects all ages. Objective: To describe the etiological and evolutionary profile of anemia in patients hospitalized in the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all anemic patients hospitalized during the study period. Results: We identified 91 cases of anemia out of 200 patients admitted to the Unit that is a hospital prevalence of 45.5%. The age group of 26 to 35 years was the most represented, that is to say 29 cases (31.87%) with an average age of 43.55 years ± 17.48 years, the female sex predominated, 51 cases (56.04%) with a sex ratio of 0.78. Housewives represented 41 cases (45.05%). The majority of patients resided in rural areas 48 cases (52.75%). The main manifestations were: asthenia 75 cases (78.02%), vertigo 68 cases (74.72%), dyspnea 62 cases (68.13%), headaches 59 cases (64.83%), palpitations 55 cases (60.44%), conjunctival pallor 53 cases (58.24%), tachycardia 43 cases (47.25%), systolic murmur 18 cases (19.78%) and IMO 11 cases (12.09%). The associated pathologies were: infected diabetic wounds 25.27%, followed by bacterial pleuro-pneumopathy 18.68%. Biologically, microcytic anemia was the most frequent 49 cases (53.84%), followed by normocytic anemia 35 cases (38.46%) and macrocytic anemia 7 cases (7.7%). Anemia was hypochromic, 53 cases (58.24%) were more encountered compared to normochromic anemia 38 cases (41.76%). The anemia was: severe in 43 cases (47.25%), moderate 29 cases (31.87%) and mild 19 cases (20.88%). Inflammatory anemia is the most common etiological diagnosis in 60% of cases, followed by vitamin B12 deficiency anemia observed in 21% of patients and then blood diseases in 7.33% of cases. The main causes of death were HIV (50%) and kidney failure (33.33%). Conclusion: Anemia is a frequent symptom in internal medicine. It constitutes a real diagnostic challenge for the internist and this sometimes in an emergency context. The use of specialized examinations and labile blood products is essential in our hospital.
文摘Aseptic osteonecrosis of the femoral head is defined as the death of bone cells in the femoral epiphysis due to an interruption of blood supply. Most cases are linked to trauma, but non-traumatic cases also occur and can be associated with several known risk factors. This study aims to describe these risk factors identified in the former Katanga province, a region with significant mining activity. Method and Patients: This is a descriptive cross-sectional study conducted over a seven-year period (2017-2024), including all cases of aseptic osteonecrosis of the femoral head diagnosed in the orthopedic department of Medpark Clinic in Lubumbashi. The investigation of risk factors was based on the analysis of sociodemographic, clinical, radiological, and biological data. Results: Our study included a total of 110 patients with a mean age of 47.5 years. Among them, there were 46 women (41.82%) and 64 men (58.18%). Twenty-five patients (27.5%) reported a family history of osteonecrosis, and 24% were diagnosed with sickle cell disease. Chronic alcoholism was noted in 14 patients (12.73%), while diabetes was present in 8 (7.2%). Four patients (3.64%) were obese, and three were HIV-positive (2.72%). The use of nonsteroidal anti-inflammatory drugs (NSAIDs) was common, and prolonged corticosteroid use was documented in 5 patients (4.5%). Abnormally high cholesterol levels were found in 26 patients (23.6%). One patient had gout, and two suffered from acute rheumatic fever (1.8%). Regarding inflammatory markers, C-reactive protein levels and erythrocyte sedimentation rates were within normal limits for almost all patients. Electrolyte levels and phosphocalcic profiles showed no abnormalities. Furthermore, 33 patients (30%) did not exhibit any of the previously mentioned risk factors. Most of these patients lived in the regions of Kolwezi, Likasi, and Lubumbashi. Among this group, 25 patients reported performing physically demanding labor, particularly in mining operations. Conclusion: Our study highlighted well-known risk factors for osteonecrosis of the femoral head (ONFH). However, it also identified a significant number of cases without any identifiable risk factors, classified as idiopathic. Among these cases, some patients engaged in intense physical labor, often linked to mining exposure.
文摘Acute massive duodenal bleeding is one of the most frequent complications of peptic ulcer disease.Endoscopy is the first-line method for diagnosing and treating actively bleeding peptic ulcers because its success rate is high.Of the small group of patients whose bleeding fails to respond to endoscopic therapy,increasingly the majority is referred for embolotherapy.Indeed,advances in catheter-based techniques and newer embolic agents,as well as recognition of the effectiveness of minimally invasive treatment options,have expanded the role of interventional radiology in the management of hemorrhage from peptic ulcers over the past decade.Embolization may be effective for even the most gravely ill patients for whom surgery is not a viable option,even when extravasation is not visualized by angiography.However,it seems that careful selection of the embolic agents according to the bleeding vessel may play a role in a successful outcome.The role of the surgeon in this clinical sphere is dramatically diminishing and will certainly continue to diminish in ensuing years,surgery being typically reserved for patients whose bleeding failed to respond all previous treatments.Such a setting has become extremely rare.
文摘Pulmonary vein stenosis(PVS) is rare condition characterized by a challenging diagnosis and unfavorable prognosis at advance stages. At present, injury from radiofrequency ablation for atrial fibrillation has become the main cause of the disease. PVS is characterized by a progressive lumen size reduction of one or more pulmonary veins that, when hemodynamically significant, may raise lobar capillary pressure leading to signs and symptoms such as shortness of breath, cough, and hemoptysis. Image techniques(transesophageal echocardiography, computed tomography, magnetic resonance and perfusion imaging) are essential to reach a final diagnosis and decide an appropriate therapy. In this regard, series from referral centers have shown that surgical and transcatheter interventions may improve prognosis. The purpose of this article is to review the etiology, assessment and management of PVS.
基金supported by grants from the Beijing Municipal Science & Technology Commission(D0906001040191,D101107047810005,D101100050010051)the Beijing Natural Science Foundation(7102086)+3 种基金the Fund for Capital Medical Development and Research(2007-3059)the National Natural Science Foundation of China(81171409)Startup Foundation for Distinguished Research Professors of the Institute for Psychology(Y0CX492S03)Fund for Outstanding Talents in Beijing(2012D003034000003)
文摘People with schizophrenia exhibit impaired social cognitive functions, particularly emotion regulation. Abnormal activations of the ventral medial prefrontal cortex （vMPFC） during emotional tasks have been demonstrated in schizophrenia, suggesting its important role in emotion processing in patients. We used the resting-state functional connectivity approach, setting a functionally relevant region, the vMPFC, as a seed region to examine the intrinsic functional interactions and communication between the vMPFC and other brain regions in schizophrenic patients. We found hypo-connectivity between the vMPFC and the medial frontal cortex, right middle temporal lobe （MTL）, right hippocampus, parahippocampal cortex （PHC） and amygdala. Further, there was a decreased strength of the negative connectivity （or anticorrelation） between the vMPFC and the bilateral dorsal lateral prefrontal cortex （DLPFC） and pre-supplementary motor areas. Among these connectivity alterations, reduced vMPFC-DLPFC connectivity was positively correlated with positive symptoms on the Positive and Negative Syndrome Scale, while vMPFC-right MTL/PHC/amygdala functional connectivity was positively correlated with the performance of emotional regulation in patients. These findings imply that communication and coordination throughout the brain networks are disrupted in schizophrenia. The emotional correlates of vMPFC connectivity suggest a role of the hypo-connectivity between these regions in the neuropathology of abnormal social cognition in chronic schizophrenia.
文摘It is reported that a pancreatic disease may precede the diagnosis of inflammatory bowel disease(IBD) both in children and in adults.Idiopathic chronic pancreatitis,however,occasionally co-exists with the IBD,mainly at pediatric age.We report a case of a patient who progressively developed the features of a chronic pancreatitis,before the diagnosis of Crohn's Disease(CD).Ten months after the onset of the first episode of pancreatitis the patient developed bloody diarrhea,mucus stools and biochemical findings of inflammation.The colonoscopy revealed a diffuse colitis without involvement of the last loop and the gastroscopy showed inflammation of the iuxta-papillary area.The histological findings confirmed the diagnosis of CD that involved the colon and the duodenum.In conclusion,in children the idiopathic chronic pancreatitis may be an unusual presentation of CD.Thus,if other known cause of chronic pancreatitis are not found,a not invasive work up to exclude the IBD should be warranted.An early coincidental diagnosis of the IBD may delay the progression of the pancreatic disease.
基金supported by grants from Ministry of Science and Technology of China,China-EU collaborative project(Grant No.0S2014GR0137)
文摘Objective:The present study aimed to evaluate the possibility of using coherent anti-Stokes Raman spectroscopy（CARS） microscopy to determine the specific molecular morphology of cholesteatoma by detecting the natural vibrational contrast of the chemical bonds without any staining.Materials and methods:Specimens from the mastoid and tympanic membrane with and without cholesteatoma were analyzed using CARS microscopy,two-photon excited fluorescence（TPEF） microscopy,and the second harmonic generation（SHG） microscopy.Results:In cholesteatoma tissues from the mastoid,a strong resonant signal at 2845 cm;was observed by CARS,which indicated the detection of the CH;hydro-carbon lipid bonds that do not generate visible signals at 2940 cm;suggestive of CH;bonds in amino acids.A strong resonant signal at 2940 cm;appeared in an area of the same specimen,which also generated abundant signals by TPEF and SHG microscopy at 817 nm,which was suggestive of collagen.In the tympanic membrane specimen with cholesteatoma,a strong resonant signal with corrugated morphology was detected,which indicated the presence of lipids.A strong signal was detected in the tympanic membrane with chronic otitis media using TPEF/SHG at 817 nm,which indicated collagen enrichment.The CARS and TPEF/SHG images were in accordance with the histology results.Conclusion:These results suggest the need to develop a novel CARS microendoscope that can be used in combination with TPEF/SHG to distinguish cholesteatoma from inflammatory tissues.
文摘AIM: To validate the feasibility of digital tomosynthesis of the abdomen(DTA) combined with contrast enhanced ultrasound(CEUS) in assessing complications after endovascular aortic aneurysm repair(EVAR) by using computed tomography angiography(CTA) as the gold standard.METHODS: For this prospective study we enrolled 163 patients(123 men; mean age, 65.7 years) referred for CTA for EVAR follow-up. CTA, DTA and CEUS were performed at 1 and 12 mo in all patients, with a maximum time interval of 2 d.RESULTS: Among 163 patients 33 presented complications at CTA. DTA and CTA correlated for the presence of complications in 32/33(96.96%) patients and for the absence of complications in 127/130(97.69%) patients; the sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and accuracy of DTA were 97%, 98%, 91%, 99%, and 98%, respectively. CEUS and CTA correlated for the presence of complications in 19/33(57.57%) patients and for the absence of complications in 129/130(99.23%) patients; the sensitivity, specificity, PPV, NPV and accuracy of CEUS were 58%, 99%, 95%, 90%, and 91%, respectively. Sensitivity, specificity and accuracy of combining DTA and CEUS together in detecting EVAR complications were 77%, 98% and 95%, respectively.CONCLUSION: Combining DTA and CEUS in EVAR follow-up has the potential to limit the use of CTA only in doubtful cases.
文摘AIM: To evaluate the feasibility of coronary artery calcium score(CACS) on low-dose non-gated chest CT(ngCCT).METHODS: Sixty consecutive individuals(30 males; 73 ± 7 years) scheduled for risk stratification by means of unenhanced ECG-triggered cardiac computed to-mography(gCCT) underwent additional unenhanced ngCCT. All CT scans were performed on a 64-slice CT scanner(Somatom Sensation 64 Cardiac, Siemens, Germany). CACS was calculated using conventional methods/scores(Volume, Mass, Agatston) as previ-ously described in literature. The CACS value obtained were compared. The Mayo Clinic classification was used to stratify cardiovascular risk based on Agatston CACS. Differences and correlations between the two methods were compared. A P-value < 0.05 was considered sig-nificant.RESULTS: Mean CACS values were significantly higher for gCCT as compared to ngCCT(Volume: 418 ± 747 vs 332 ± 597; Mass: 89 ± 151 vs 78 ± 141; Agatston: 481 ± 854 vs 428 ± 776; P < 0.05). The correlation between the two values was always very high(Volume: r = 0.95; Mass: r = 0.97; Agatston: r = 0.98). Of the 6 patients with 0 Agatston score on gCCT, 2(33%) showed an Agatston score > 0 in the ngCCT. Of the 3 patients with 1-10 Agatston score on gCCT, 1(33%) showed an Agatston score of 0 in the ngCCT. Overall, 23(38%) patients were reclassified in a different car-diovascular risk category, mostly(18/23; 78%) shifting to a lower risk in the ngCCT. The estimated radiation dose was significantly higher for gCCT(DLP 115.8 ± 50.7 vs 83.8 ± 16.3; Effective dose 1.6 ± 0.7 mSv vs 1.2 ± 0.2 mSv; P < 0.01).CONCLUSION: CACS assessment is feasible on ngCCT; the variability of CACS values and the associated re-stratification of patients in cardiovascular risk groups should be taken into account.
文摘Introduction: Hysterosalpingography is an important tool in the investigation of the causes of female infertility. In developing countries such as the Democratic Republic of Congo, the HSG is the basic tool for performing first-line anatomical (pelvic) assessment. The aim of this study is to determine the prevalence of the different lesions observed in hysterosalpingography carried out during the assessment of infertile women monitored in Kisangani. The study set also out to look for differences in these lesions according to the type of infertility. Methods: This cross-sectional study was conducted in Kisangani from June 2016 to December 2018. The 130 cases of hysterosalpingography performed for female infertility assessment during the study period were included, of which 33.07% for primary infertility and 66.93% for secondary infertility. Results: The mean age of the patients was 33.52 ± 6.01 years;the history of pelvic inflammatory disease was noted with a predominance for secondary infertility (11% vs. 4.65%). Using hysterosalpingography, 7 (5.38%) patients had a normal result;94 (72.31%) had tubal obstruction;25 (19.23%) had hydrosalpinx;11 (8.46%) had uterine fibroids;pelvic adhesions were suspected in 12.64% of cases. There was no obvious association between all these lesions and the type of infertility. Conclusion: We found that tubal obstructions were the most prevalent lesions in this study, regardless of the type of infertility. These lesions would reflect the high prevalence of septic abortions and sexually transmitted infections in developing countries such as the Democratic Republic of the Congo.
文摘Multi-photon microscopy(MPM)and coherent anti-Stokes Raman scattering(CARS)are two advanced nonlinear optical imaging techniques,which provide complementary information and have great potential in combination for noninvasive in vrito biomedical applications.This paper provides a detailed discussion of the basics,development and applications of these technologies for in vrivo skin research,covering the following topics:The principle and advantage of MPM and CARS,instrumentation development for in vino applications,MPM and CARS of normal skin,application of MPM and CARS in skin cancer and disease diagnosis;application of MPM in skin disease intervention,ie.,imaging guided two-photon photothermolysis.
文摘Penile fracture is a rare urological emergency. It occurs mainly in young adults during sexual intercourse. In many instances, one of the corpora carvanosus is involved though bilateral injuries with or without corpus spongiosus involvement is not uncommon. However, isolated injury to corpus spongiosus is extremely rare. We report a case of isolated rupture of corpus spongiosum secondary to penile injury during coitus in a 43-year-old man that presented to University Hospital Souro Sanou of Bobo Dioulasso. He presented with history of persistence bleeding per urethra following penile injury during sexual intercourse. The Retrograde urethrography (RUG) showed a partial rupture of urethra, Moore type 3. Complementary penile ultrasound revealed extensive contusion of the urethra with circumferential hematoma and rupture of the distal 1/3 of the corpus spongiosus. He had gentle per urethral catheterization which was left for one month. Penile ultrasound sound done after removal of catheter showed residual injury and narrowing of the urethra.
文摘Emphysematous cystitis is a severe urinary tract infection which threatens patients’ life. Thus, it requires early diagnosis and computed tomography (CT) is the reference medical exam used to address it. However, ultrasound, which is a non-ionizing and very accessible technique, may also contribute to diagnosis. The aim of this study was to illustrate the contribution of ultrasound to the diagnosis of emphysematous cystitis. We report three cases of emphysematous cystitis diagnosed by ultrasound. In all the cases, ultrasound identified basic signs showing presence of gas, including a hyperechoic cystic parietal thickening, repeat echoes and dirty shadow cones of intraluminal focus. Diagnostic confirmation was made in two cases through X-ray and in one case by means of computed tomography. Through simple basic signs, ultrasound directs most usefully towards an emphysematous urinary tract infection. CT enables a more accurate diagnostic work-up of lesions and differential diagnosis with vesico-digestive fistula.
文摘A 54-year-old man was referred for ablation of symptomatic drug-refractory long-lasting persistent atrial fibrillation. His past medical history was negative for cardiac disease but included a diagnosis of esophageal achalasia. The patient underwent an ablation procedure, guided by barium esophagram, including isolation of the pulmonary veins, ablation of complex fractionated left atrial electrograms recorded on the sep-tal wall and, finally, linear ablation of the cavo-tricuspid isthmus. The ablation procedure was performed with multielectrode ablation catheters using duty-cycled bipolar/unipolar radiofrequency energy. During 6 months of follow-up no recurrences of atrial fibrillation were documented. The reported case demonstrates how an ablation procedure for long-standing persistent AF may be safely performed even in a patient presenting with a achalasia, outlining the mega-esophagus position with a simple barium paste.
