Lumps and bumps

2020 ◽  
pp. 417-436
Keyword(s):  
Clinical Diagnosis ◽  
Malignant Tumours ◽  
Surface Changes

Visible and/or palpable swellings occur in numerous diseases and many are covered in other chapters. This chapter presents an approach to making a clinical diagnosis using observable signs together with a thorough history. These signs include colour, surface changes and texture, and symptoms such as itch and pain. Investigations such as imaging and histology may be needed. Some particular problems are addressed including rapidly enlarging red lesions, firm red lesions, warty lesions, lumps present at or shortly after birth, and malignant tumours.

Clinically latent and autopsy-verified inflammatory disorders and malignant tumours in transplant patients

2020 ◽  
pp. jclinpath-2020-207080
Author(s):  
Elias Mund ◽  
Johannes Salem ◽  
Hans H Kreipe ◽  
Kais Hussein
Keyword(s):  
Respiratory Failure ◽  
Clinical Diagnosis ◽  
Causes Of Death ◽  
Diagnostic Techniques ◽  
Class I ◽  
Malignant Tumours ◽  
Inflammatory Disorders ◽  
Autopsy Findings ◽  
Transplant Patients ◽  
Postmortem Examinations

AimsThe number of clinical autopsies decreases while the rate of missed relevant diagnoses is known to be 2%–20%. In this study, we focused on postmortem examinations of patients after transplantation of solid organs.MethodsA total of 122 cases were assessed for this study. Transplant organs included liver (LiTx; n=42/122, 34%), heart (n=8/122, 7%), lungs (n=32/122, 26%), kidney (KTx; n=38/122, 31%) and KTx+LiTx (n=2/122, 2%).ResultsThe most frequent autopsy-verified causes of death were cardiac or respiratory failure (together n=85/122, 70%). The frequency of malignant tumours that were identified at autopsy was 5% (n=6/122). In 3% (n=4/122) of cases, Goldman class I discrepancies between clinical diagnosis and autopsy findings were identified.ConclusionsThe rate of missed relevant diagnoses might be relatively low, but these cases nevertheless refute the contention that modern diagnostic techniques negate the need for autopsies in patients who died after transplantation.

scholarly journals A clinico-dermatoscopic study of 100 cases of melasma in a tertiary care hospital

2018 ◽  
Vol 4 (1) ◽  
pp. 41 ◽  
Author(s):  
Simplepreet Kaur ◽  
Jasleen Kaur ◽  
Saurabh Sharma ◽  
Manisha Sharma ◽  
Ameesha Mahajan ◽  
...  
Keyword(s):  
Distribution Pattern ◽  
Clinical Diagnosis ◽  
Therapeutic Efficacy ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Common Pattern ◽  
Non Invasive ◽  
Diagnosis And Prognosis ◽  
Surface Changes

<p class="abstract"><strong>Background:</strong> Melasma is one of the most common hyperpigmentary disorders seen among Indian patients. Dermatoscope is a non-invasive tool that helps in visualization of surface and sub-surface changes. Recognition of characteristic dermatoscopic patterns of melasma helps in differentiating it from other hyperpigmentary disorders. The present study was carried out to study clinical and dermatoscopic patterns of melasma.</p><p class="abstract"><strong>Methods:</strong> A total of 100 patients with clinical diagnosis of melasma were enrolled in this study. These patients were first examined clinically and then under dermatoscope. All the findings were recorded.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of total 100 patients, 91 were females and 9 were males. Mean age of presentation was 34.86 years. Malar distribution pattern was the most common pattern observed in 54% patients. On dermatoscopic examination, 58% cases had epidermal melasma, 23% had dermal melasma and 19% had mixed melasma. Accentuated pseudoreticular network was the most common pattern seen in 88% cases.</p><p><strong>Conclusions:</strong> Melasma is a distressing hyperpigmentary disorder. Dermatoscope helps in diagnosis and prognosis of melasma. Therapeutic efficacy of various modalities can be monitored using dermatoscope. It has reduced the need of invasive interventions like biopsy from face for histopathology. </p>

Forensic Identifications Aided by Scanning Electron Microscopy of Silicone-Epoxy Microreplicas of Calcified and Cornified Structures

1975 ◽  
Vol 33 ◽  
pp. 678-679 ◽  
Author(s):  
R.F. Sognnaes
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Forensic Science ◽  
George Washington ◽  
Epithelial Surface ◽  
Extended Application ◽  
Tissue Surfaces ◽  
Non Destructive ◽  
Scanning Electron ◽  
Surface Changes

Sufficient experience has been gained during the past five years to suggest an extended application of microreplication and scanning electron microscopy to problems of forensic science. The author's research was originally initiated with a view to develop a non-destructive method for identification of materials that went into objects of art, notably ivory and ivories. This was followed by a very specific application to the identification and duplication of the kinds of materials from animal teeth and tusks which two centuries ago went into the fabrication of the ivory dentures of George Washington. Subsequently it became apparent that a similar method of microreplication and SEM examination offered promise for a whole series of problems pertinent to art, technology and science. Furthermore, what began primarily as an application to solid substances has turned out to be similarly applicable to soft tissue surfaces such as mucous membranes and skin, even in cases of acute, chronic and precancerous epithelial surface changes, and to post-mortem identification of specific structures pertinent to forensic science.

Cell surface changes during aging of human bladder epithelium examined by lectin probes and SEM

1990 ◽  
Vol 48 (3) ◽  
pp. 966-967
Author(s):  
J. Jacob ◽  
M.F.M. Ismail
Keyword(s):  
The Elderly ◽  
Ultrastructural Changes ◽  
Pokeweed Mitogen ◽  
Asymmetric Structure ◽  
Luminal Surface ◽  
Bladder Epithelium ◽  
Aldehyde Groups ◽  
Cell Surface Changes ◽  
Phosphate Buffered Saline ◽  
Surface Changes

Ultrastructural changes have been shown to occur in the urinary bladder epithelium (urothelium) during the life span of humans. With increasing age, the luminal surface becomes more flexible and develops simple microvilli-like processes. Furthermore, the specialised asymmetric structure of the luminal plasma membrane is relatively more prominent in the young than in the elderly. The nature of the changes at the luminal surface is now explored by lectin-mediated adsorption visualised by scanning electron microscopy (SEM).Samples of young adult (21-31 y old) and elderly (58-82 y old) urothelia were fixed in buffered 2% glutaraldehyde for 10 m and washed with phosphate buffered saline (PBS) containing Ca++ and Mg++ at room temperature. They were incubated overnight at 4°C in 0.1 M ammonium chloride in PBS to block any remaining aldehyde groups. The samples were then allowed to stand in PBS at 37°C for 2 h before incubation at 37°C for 30 m with lectins. The lectins used were concanavalin A (Con A), wheat germ agglutinin (WGA), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) at a concentration of 500 mg/ml in PBS at pH 7.A.

Study on erythrocytes by SEM photogrammetry (SEMP) technique

1990 ◽  
Vol 48 (3) ◽  
pp. 724-725
Author(s):  
Tong Wensheng ◽  
Lu Lianhuang ◽  
Zhang Zhijun
Keyword(s):  
Quantitative Analysis ◽  
Cell Membrane ◽  
Clinical Diagnosis ◽  
Human Body ◽  
Blood Cells ◽  
Three Dimensional ◽  
Normal Person ◽  
Blood Disease ◽  
Computation Technique ◽  
Important Basis

This is a combined study of two diffirent branches, photogrammetry and morphology of blood cells. The three dimensional quantitative analysis of erythrocytes using SEMP technique, electron computation technique and photogrammetry theory has made it possible to push the study of mophology of blood cells from LM, TEM, SEM to a higher stage, that of SEM P. A new path has been broken for deeply study of morphology of blood cells.In medical view, the abnormality of the quality and quantity of erythrocytes is one of the important changes of blood disease. It shows the abnormal blood—making function of the human body. Therefore, the study of the change of shape on erythrocytes is the indispensable and important basis of reference in the clinical diagnosis and research of blood disease.The erythrocytes of one normal person, three PNH Patients and one AA patient were used in this experiment. This research determines the following items: Height;Length of two axes (long and short), ratio; Crevice in depth and width of cell membrane; Circumference of erythrocytes; Isoline map of erythrocytes; Section map of erythrocytes.

Histological verification of non-specific aorta-arteritis (Takayasu's arteritis) using percutaneous transluminal atherectomy

VASA ◽  
2004 ◽  
Vol 33 (4) ◽  
pp. 247-251 ◽  
Author(s):  
Zeller ◽  
Koch ◽  
Frank ◽  
Bürgelin ◽  
Schwarzwälder ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Axillary Artery ◽  
Takayasu’S Arteritis ◽  
Giant Cells ◽  
Interventional Therapy ◽  
Takayasu's Arteritis ◽  
New Device ◽  
First Case ◽  
Anti Inflammatory ◽  
Percutaneous Transluminal

Diagnosis of non-specific aorto-arteritis (NSAA, Takaysu's arteritis) is typically based on clinical and investigational parameters. We report here about two patients with clinically suspected diagnosis of a Takayasu's arteritis already under anti-inflammatory therapy in whom percutaneous transluminal atherectomy of subclavian and axillary artery stenoses was performed to relief the patients from symptoms – intermittent dyspraxia of the arms – and to verify the clinical diagnosis by histology. In the first case aorto-arteritis could be histologically confirmed through the analysis of plaque material including media structures excised from the subclavian and axillary arteries using a new device for atherectomy. The biopsy showed diffuse inflammation and granulomatous lesions with giant cells typically for Takayasu's disease. In the second patient, biopsy showed no acute or chronic inflammatory signs but only atherosclerotic lesions. Percutaneous transluminal atherectomy is therefore not only an interventional but also a diagnostic tool and should be used in every case of interventional therapy of suspected aorto-arteritis to make the clinical diagnosis and as a major consequence the initiation of an aggressive anti-inflammatory medical therapy more reliable.

Sonography of subcutaneous tissue cannot determine causes of lower limb edema

VASA ◽  
2015 ◽  
Vol 44 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Mandy Becker ◽  
Tom Schilling ◽  
Olga von Beckerath ◽  
Knut Kröger
Keyword(s):  
Clinical Diagnosis ◽  
Lower Limb ◽  
Subcutaneous Tissue ◽  
Hepatic Disease ◽  
Clinical Use ◽  
Single Image ◽  
Heart Insufficiency ◽  
Chronic Hepatic Disease ◽  
Limb Edema ◽  
Venous Disorders

Background: To clarify the clinical use of sonography for differentiation of edema we tried to answer the question whether a group of doctors can differentiate lymphedema from cardiac, hepatic or venous edema just by analysing sonographic images of the edema. Patients and methods: 38 (70 ± 12 years, 22 (58 %) females) patients with lower limb edema were recruited according the clinical diagnosis: 10 (26 %) lymphedema, 16 (42 %) heart insufficiency, 6 (16 %) venous disorders, 6 (16 %) chronic hepatic disease. Edema was depicted sonographically at the most affected leg in a standardised way at distal and proximal calf. 38 sets of images were anonymised and send to 5 experienced doctors. They were asked whether they can see criteria for lymphedema: 1. anechoic gaps, 2. horizontal gaps and 3. echoic rims. Results: Accepting an edema as lymphedema if only one doctor sees at least one of the three criteria for lymphatic edema on each single image all edema would be classified as lymphatic. Accepting lymphedema only if all doctors see at least one of the three criteria on the distal image of the same patient 80 % of the patients supposed to have lymphedema are classified as such, but also the majority of cardiac, venous and hepatic edema. Accepting lymphedema only if all doctors see all three criteria on the distal image of the same patients no edema would be classified as lymphatic. In addition we separated patients by Stemmers’ sign in those with positive and negative sign. The interpretation of the images was not different between both groups. Conclusions: Our analysis shows that it is not possible to differentiate lymphedema from other lower limb edema sonographically.

Picture Recognition Errors in the Differential Diagnosis of Alzheimer’s Disease

2019 ◽  
Vol 30 (3) ◽  
pp. 157-168
Author(s):  
Helmut Hildebrandt ◽  
Jana Schill ◽  
Jana Bördgen ◽  
Andreas Kastrup ◽  
Paul Eling
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Differential Diagnosis ◽  
Clinical Diagnosis ◽  
Response Bias ◽  
Recognition Task ◽  
Discriminatory Power ◽  
False Alarms ◽  
Picture Recognition ◽  
Recognition Errors

Abstract. This article explores the possibility of differentiating between patients suffering from Alzheimer’s disease (AD) and patients with other kinds of dementia by focusing on false alarms (FAs) on a picture recognition task (PRT). In Study 1, we compared AD and non-AD patients on the PRT and found that FAs discriminate well between these groups. Study 2 served to improve the discriminatory power of the FA score on the picture recognition task by adding associated pairs. Here, too, the FA score differentiated well between AD and non-AD patients, though the discriminatory power did not improve. The findings suggest that AD patients show a liberal response bias. Taken together, these studies suggest that FAs in picture recognition are of major importance for the clinical diagnosis of AD.

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