PURPOSE: To compare the galactographic findings of malignant and benign disease in patients with pathologic nipple discharge and to analyze the features suggesting malignancy. MATERIALS AND METHODS: In 24 patients in whom pathologic nipple discharge had occurred, the findings of preoperative galactography were correlated with those of pathology. RESULTS: Nine of the 24 cases were malignant and the other 15 were benign. Intraductal calcification occurred in five malignant cases (56%) and two (13%) which were benign. Seven malignant cases (78%) involved the segmental ducts, and in eight (89%), the peripheral ducts below the subsegmental duct were involved. Five benign cases (33%) involved the lactiferous sinus, seven (47%) the segmental duct, and two (13%) the subsegmental duct. Distal duct dilatation occurred in four benign cases (27%), while ductal stenosis was noted in six cases (67%) and ductal distortion in seven (78%). A malignant tumor appeared as a multiple (n=5, 56%) or irregular (n=5, 56%) filling defect, and a benign tumor as a single (n=12, 80%), oval (n=6, 40%) or lobular (n=4, 27%) filling defect. CONCLUSION: At galactography, a malignant tumor frequently appeared as an irregular multiple intraductal filling defect in a peripheral duct. A benign tumor, on the other hand, appeared as an oval or lobular single lesion. The presence of ductal stenosis, distortion and intraductal microcalcifications not opacified by contrast material suggest possible malignancy.
Constriction, Pathologic ; Dilatation ; Hand ; Humans ; Nipples* ; Pathology

Confocal laser endomicroscopy (CLE) is a novel in vivo imaging technique that can provide real-time optical biopsies in the evaluation of pancreaticobiliary strictures and pancreatic cystic lesions (PCLs), both of which are plagued by low sensitivities of routine evaluation techniques. Compared to pathology alone, CLE is associated with a higher sensitivity and accuracy for the evaluation of indeterminate pancreaticobiliary strictures. CLE has the ability to determine the malignant potential of PCLs. As such, CLE can increase the diagnostic yield of endoscopic retrograde cholangiopancreatography and endoscopic ultrasound, reducing the need for repeat procedures. It has been shown to be safe, with an adverse event rate of ≤1%. Published literature regarding its cost-effectiveness is needed.
Biopsy ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic ; Pancreatic Cyst ; Pathology ; Ultrasonography

Caustic esophageal burn is a common ailment in clinical practice. In some patients, scar stricture was formed in the late stage of injury, and it seriously undermined quality of life of the patients. We adopted various clinical interventions at an early stage in order to relieve and alleviate the formation and development of corrosive esophageal stricture as a result of chemical injury as well as to avoid invasive operations to make it more acceptable for the patients. This article summarized the progress in etiology, pathological changes, identification, early prevention, and surgical management of corrosive esophageal stricture.
Burns ; complications ; pathology ; Constriction, Pathologic ; etiology ; pathology ; Esophageal Stenosis ; etiology ; pathology ; Esophagus ; injuries ; pathology ; Humans

Constriction, Pathologic ; diagnosis ; pathology ; therapy ; Humans ; Palate, Soft ; pathology ; Sleep Apnea, Obstructive ; diagnosis ; pathology ; therapy ; Tongue ; pathology ; Uvula ; pathology

Adolescent ; Constriction, Pathologic ; Female ; Fibromatosis, Aggressive ; complications ; pathology ; Humans ; Pharyngeal Diseases ; etiology ; pathology

BACKGROUND: The effect of arteriosclerotic intracranial arterial vessel wall enhancement (IAVWE) on downstream collateral flow found in vessel wall imaging (VWI) is not clear. Regardless of the mechanism underlying IAVWE on VWI, damage to the patient's nervous system caused by IAVWE is likely achieved by affecting downstream cerebral blood flow. The present study aimed to investigate the effect of arteriosclerotic IAVWE on downstream collateral flow. METHODS: The present study recruited 63 consecutive patients at the Second Hospital of Hebei Medical University from January 2021 to November 2021 with underlying atherosclerotic diseases and unilateral middle cerebral artery (MCA) M1-segment stenosis who underwent an magnetic resonance scan within 3 days of symptom onset. The patients were divided into 4 groups according to IAVWE and the stenosis ratio (Group 1, n = 17; Group 2, n = 19; Group 3, n = 13; Group 4, n = 14), and downstream collateral flow was analyzed using three-dimensional pseudocontinuous arterial spin labeling (3D-pCASL) and RAPID software. The National Institutes of Health Stroke Scale (NIHSS) scores of the patients were also recorded. Two-factor multivariate analysis of variance using Pillai's trace was used as the main statistical method. RESULTS: No statistically significant difference was found in baseline demographic characteristics among the groups. IAVWE, but not the stenosis ratio, had a statistically significant significance on the late-arriving retrograde flow proportion (LARFP), hypoperfusion intensity ratio (HIR), and NIHSS scores ( F = 20.941, P <0.001, Pillai's trace statistic = 0.567). The between-subject effects test showed that IAVWE had a significant effect on the three dependent variables: LARFP ( R2 = 0.088, F = 10.899, P = 0.002), HIR ( R2 = 0.234, F = 29.354, P <0.001), and NIHSS ( R2 = 114.339, F = 33.338, P <0.001). CONCLUSIONS: Arteriosclerotic IAVWE significantly reduced downstream collateral flow and affected relevant neurological deficits. It was an independent factor affecting downstream collateral flow and NIHSS scores, which should be a focus of future studies. TRIAL REGISTRATION ChiCTR.org.cn, ChiCTR2100053661.
Humans ; Constriction, Pathologic/pathology* ; Magnetic Resonance Imaging/methods* ; Middle Cerebral Artery/pathology* ; Tomography, X-Ray Computed

BACKGROUND: Pontine infarction extending to the basal surface has been reported to possess different characteristics from deep pontine infarction without extending to the basal surface. METHODS AND RESULTS: We studied 54 patients ; 30 patients with pontine infarction extending to the basal surface (group SE) and 24 patients with deep pontine infarction without extension (group DL) based on the site of the infarcts on precontrast sagittal T2WI. We assessed angiographic findings(MRA, 54; DSA, 31), risk factors, clinical features and the effectiveness of the intraluminal signal changes on spin-echo MRI in the diagnosis of occlusion or stenosis of the basilar artery. The incidence of basilar artery stenosis or occlusion in MRA or DSA in group SE(60%) was significantly more frequent than group DL(12.5%), whereas the incidence of vertebral artery stenosis or occlusion was not different between two groups. A noteworthy finding was that five patients (17%) of the group SE had not been extended to the basal surface on axial T2WI. The risk factors were similarly distributed between the two groups. The effectiveness of abnormal signal void of axial MRI was poor in the diagnosis of basilar artery occlusion or stenosis. CONCLUSIONS: Our results suggest that the two types of pontine infarction may be caused by different arterial pathology. Although the presence of abnormal flow void on MRI cannot predict the stenosis or occlusion of basilar artery, sagittal T2WI and angiographic study help to evaluate the patients with pontine infarction.
Basilar Artery* ; Constriction, Pathologic ; Diagnosis ; Humans ; Incidence ; Infarction* ; Magnetic Resonance Imaging ; Pathology ; Risk Factors ; Vertebrobasilar Insufficiency

OBJECTIVETo assess the reproducibility of 3.0 T high-resolution magnetic resonance imaging (HR MRI) for evaluation of atherosclerotic stenosis in the middle cerebral artery (MCA).

METHODSFrom February, 2011 to December, 2013, 66 consecutive patients with MCA-M1 atherosclerotic stenosis (50%-99%) confirmed by digital subtractive angiography (DSA) received examinations with 3.0 T HR MRI for measurement of the vessel area (VA) and lumen area (LA) at the maximum narrow site (VA(narrow) and LA(narrow)) and the reference site (VA(reference) and LA(reference)) as well as the plaque distribution (ventral, dorsal, superior, and inferior). Two independent readers reviewed all the images and one reader reevaluated these images 4 weeks later. The inter- and intra-observer reproducibility was evaluated using the intraclass correlation coefficient (ICC).

RESULTSThe measurements of VA(narrow), VA(reference), and LA(reference) using HR MRI showed excellent inter- (ICC=0.801, 0.843, and 0.808, respectively) and intra-observer reproducibility (ICC=0.811, 0.916, and 0.958, respectively), but the measurement of LA(narrow) had only moderate inter- and intra-observer reproducibility (ICC=0.584 and 0.625, respectively). For plaque distribution analysis (ventral, dorsal, superior, and inferior plaques), HR MRI also showed excellent inter- (ICC=0.856, 0.836, 0.791, and 0.905, respectively) and intra-observer reproducibility (ICC=0.876, 0.827, 0.825, and 0.950, respectively).

CONCLUSIONHR MRI shows good inter- and intra-observer reproducibility in identifying MCA-M1 atherosclerotic plaque distribution and vessel and lumen measurements, but its reliability for lumen area measurement at the maximum narrowing site needs to be improved.

Occlusion or stenosis of subclavian artery by atherosclerosis is uncommon pathology compare to atherosclerosis of lower extremity. Most of the cases involve left subclavian artery and show vertebral-basilic ischemia and/or arm ischemia. Surgical intervention including bypass or transposition are performed to relieve the symptoms of obstruction but percutaneous intraluminal angioplasty and insertion of stent also be done with comparable results. Here we report 4 cases of symptomatic subclavian artery occlusion which have been managed by authors, and summarize all the cases reported in korean literature.
Angioplasty ; Arm ; Arteries ; Atherosclerosis ; Constriction, Pathologic ; Extremities ; Ischemia ; Lower Extremity ; Pathology ; Stents ; Subclavian Artery*

The lateral lumbar interbody fusion (LLIF) is a relatively new technique that allows the surgeon to access the intervertebral space from a direct lateral approach either anterior to or through the psoas muscle. This approach provides an alternative to anterior lumbar interbody fusion with instrumentation, posterior lumbar interbody fusion, and transforaminal lumbar interbody fusion for anterior column support. LLIF is minimally invasive, safe, better structural support from the apophyseal ring, potential for coronal plane deformity correction, and indirect decompression, which have has made this technique popular. LLIF is currently being utilized for a variety of pathologies including but not limited to adult de novo lumbar scoliosis, central and foraminal stenosis, spondylolisthesis, and adjacent segment degeneration. Although early clinical outcomes have been good, the potential for significant neurological and vascular vertebral endplate complications exists. Nevertheless, LLIF is a promising technique with the potential to more effectively treat complex adult de novo scoliosis and achieve predictable fusion while avoiding the complications of traditional anterior surgery and posterior interbody techniques.
Adult ; Congenital Abnormalities ; Constriction, Pathologic ; Decompression ; Humans ; Pathology ; Psoas Muscles ; Scoliosis ; Spondylolisthesis