Purpose: This study evaluated the feasibility of detecting peripheral arterial lesions in plane-reconstructed lower extremity CT angiograms using object detection algorithms. Methods: We retrospectively collected 1,241 contrast-enhanced lower extremity CT images from patients with peripheral arterial disease. One-stage (YOLOv5: v5s, v5m, v5l, v5x) and 2-stage (Faster R-CNN) detectors were used to classify stent, stenosis, and occlusion. A one-by-one comparison between manual test image annotations and algorithmic detection results was conducted to evaluate model performance and errors. Performance was evaluated by mean average precision (mAP@.5) and precision-recall curves. Results: Among YOLOv5 models, v5l showed the highest overall accuracy (77% mAP@.5). While stent classification was excellent (≥ 96.9% mAP@.5 in YOLOv5 and 99.8% in Faster R-CNN), classification accuracies for stenosis (53.8%–58.7% in YOLOv5 vs. 37.2% in Faster R-CNN) and occlusion (69%–80.9% in YOLOv5 vs. 67.7% in Faster R-CNN) were moderate.Stenosis was frequently missed, resulting in high false-negative rates. Occlusions at arterial bifurcations were often not detected, and stent edges were misclassified as occlusions. Overfitting emerged in some YOLOv5 models beyond 75 epochs. Conclusion This pilot study supports the feasibility of applying object detection algorithms as a preliminary step toward developing clinical decision support tools for peripheral arterial disease. Further refinements, including additional training data and more granular lesion annotation, are essential for improved classification of stenosis and occlusion.

Purpose: To investigate changes in the retinal layer thickness in rhegmatogenous retinal detachment (RRD) and intraocular foreign body (IOFB) patients undergoing successful pars plana vitrectomy (PPV) with silicone oil tamponade. Methods: This retrospective study included 28 eyes of 28 patients (RRD: 24 patients; IOFB: 4 patients) that were successfully repaired with PPV with silicone oil tamponade. The thickness measurements of the total retina, retinal nerve fiber layer (RNFL), and ganglion cell-inner plexiform layer (GC-IPL) were performed with swept-source optical coherence tomography in nine Early Treatment Diabetic Retinopathy Study subfields, using the wide three-dimensional mode before and after silicone oil tamponade removal. The measurements were compared and differences were analyzed with respect to normal fellow eyes. Results: The RNFL and GC-IPL thickness measurements decreased remarkably as the silicone oil tamponade period progressed, compared with the thickness of the total retinal layer. The average thicknesses of the total retina, RNFL, and GC-IPL were significantly greater in eyes in which the silicone oil had been removed than in those in which the silicone oil remained. Conclusions Silicone oil tamponade can change the thickness of the retina layer. The longer the silicone oil is tamponaded, the more significant the reduction in thickness of the inner retinal layer.

Purpose: To investigate changes in the retinal layer thickness in rhegmatogenous retinal detachment (RRD) and intraocular foreign body (IOFB) patients undergoing successful pars plana vitrectomy (PPV) with silicone oil tamponade. Methods: This retrospective study included 28 eyes of 28 patients (RRD: 24 patients; IOFB: 4 patients) that were successfully repaired with PPV with silicone oil tamponade. The thickness measurements of the total retina, retinal nerve fiber layer (RNFL), and ganglion cell-inner plexiform layer (GC-IPL) were performed with swept-source optical coherence tomography in nine Early Treatment Diabetic Retinopathy Study subfields, using the wide three-dimensional mode before and after silicone oil tamponade removal. The measurements were compared and differences were analyzed with respect to normal fellow eyes. Results: The RNFL and GC-IPL thickness measurements decreased remarkably as the silicone oil tamponade period progressed, compared with the thickness of the total retinal layer. The average thicknesses of the total retina, RNFL, and GC-IPL were significantly greater in eyes in which the silicone oil had been removed than in those in which the silicone oil remained. Conclusions Silicone oil tamponade can change the thickness of the retina layer. The longer the silicone oil is tamponaded, the more significant the reduction in thickness of the inner retinal layer.

Background: Unilateral peripheral facial nerve palsy may have a detectable cause (secondary facial nerve palsy) or may be idiopathic (Bell’s palsy). Facial palsy is attributable to various causes ranging from mild infection to severe neurological disorders. We investigated the prevalence and types of serious neurological disorders in patients with unilateral facial palsy. Methods: We reviewed the medical records of patients with unilateral facial nerve palsy and identified patients diagnosed with facial palsy secondary to serious or life-threatening causes. We investigated the clinical characteristics, as well as electrodiagnostic and imaging findings in these patients. Results: Of 924 patients with facial palsy, 11 patients (1.2%) were diagnosed with the following serious neurological disorders: acoustic schwannoma in two patients, facial nerve schwannoma, glossopharyngeal schwannoma, meningioma, epidermoid cyst, parotid gland tumor, pontine infarct, skull base osteomyelitis, brain metastasis, and pachymeningitis. Conclusions Although unilateral facial palsy is rarely associated with serious neurological disorders, early detection of the etiopathogenetic contributors is important for prompt initiation of optimal management. Therefore, clinicians should be mindful of disorders that can mimic Bell’s palsy.

Mucinous borderline ovarian tumors (BOTs) occur most often in women between the ages of 20 and 30. Early-stage detection of the condition has a more favorable prognosis. In this case report, the authors present an elderly 93-year old woman who visited our hospital due to severe abdominal pain after being diagnosed with a pelvic mass 2 years ago and not undergoing any treatment since the diagnosis was made. She underwent emergency left salpingo-oophorectomy and was diagnosed with mucinous BOT according to biopsy results.
Abdominal Pain ; Aged ; Biopsy ; Diagnosis ; Emergencies ; Female ; Humans ; Mucins* ; Ovarian Neoplasms ; Prognosis

Salmonella usually invades the Peyer's patch of the terminal ileum or ascending colon. A 55-year old female was referred to our hospital for general weakness and sustained fever. On the abdominal contrast computed tomography (CT) scan, we found symmetric circular hypertrophy of the intestinal wall and multiple hypertrophied lymph nodes in the terminal ileum. The positron emission tomography computed tomography (PET-CT) scan showed skipped areas of wall thickening and intense fluorodeoxyglucose (FDG) uptake in the terminal ileum and the ileocecal valve with adjacent lymphadenopathies. On the colonoscopy, multiple mass forming variable-sized ulcers on the terminal ileum were found, so a biopsy specimen and the colonic luminal fluid were obtained, and we made a diagnosis of lymphoma. However, the blood and colonic luminal fluid culture for Salmonella paratyphi-A was reported as positive, and therefore we corrected the diagnosis to Salmonella infection. We report here on a case of Salmonella infection in the terminal ileum, which looked like malignant lymphoma on the baseline radiologic image studies, including the CT and PET-CT.
Biopsy ; Colon ; Colon, Ascending ; Colonoscopy ; Female ; Fever ; Humans ; Hypertrophy ; Ileocecal Valve ; Ileum ; Lymph Nodes ; Lymphoma ; Phenobarbital ; Positron-Emission Tomography ; Salmonella ; Salmonella Infections ; Ulcer

Ovarian leiomyoma is a rare type of tumor that only takes about 1% of benign ovarian tumor. It mostly does not induce any symptoms and is often found by chance during a surgical operation in abdominal cavity. It is microscopically observed that smooth muscle cells with an identical shape and a small nucleus grow in a bundle or in a storiform configuration, and they need to be distinguished from other tumors of the smooth-muscle origin that can occur in ovary such as fibroma/thecoma and extragastrointestinal stromal tumor. Using immunohistochemistry staining on desmin, smooth muscle actin (SMA), alpha-inhibin, c-kit, etc can help with distinguishing these tumors. Recently, the authors experienced in this hospital a primary ovarian leiomyoma of a 43-year-old female patient and hereby report the case with a review of literatures.
Abdominal Cavity ; Actins ; Adult ; Desmin ; Female ; Humans ; Immunohistochemistry ; Leiomyoma* ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Ovary

Colonic ischemia is the most prevalent form of gastrointestinal ischemia and causes 3~9% of all acute lower intestinal bleeding. Most common cause is known to be cardiac embolus. A 67-year-old female patient presented with rectal bleeding. The patient had cerebral infarction 15 days ago. A colonoscopy showed a large ulcer with hemorrhage in the rectum. Computed tomography showed deep vein thrombosis from the left popliteal vein to infrarenal inferior vena cava. Transthoracic echocardiography was carried out, but no abnormal feature was found. Then, transesophageal echocardiography, with agitated saline contrast to find out a right to left shunt, was performed, patent foramen ovale was found. This patient was treated with anticoagulation and inferior vena cava filtering. We suggest this ischemic colitis may be due to arterial embolization from deep vein thrombosis through PFO.
Aged ; Cerebral Infarction ; Colitis, Ischemic* ; Colon ; Colonoscopy ; Dihydroergotamine ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Female ; Foramen Ovale, Patent* ; Hemorrhage ; Humans ; Ischemia ; Popliteal Vein ; Rectum ; Ulcer ; Vena Cava, Inferior ; Venous Thrombosis*