scholarly journals Clinical images: Latency of polyarteritis nodosa until a critical occurrence

2008 ◽  
Vol 58 (7) ◽  
pp. 2141-2141
Author(s):  
Yoshinori Taniguchi ◽  
Yoshitaka Kumon ◽  
Kozo Hashimoto ◽  
Shoichi Ozaki
2000 ◽  
Vol 33 (4) ◽  
pp. 677-683 ◽  
Author(s):  
Andreas Erhardt ◽  
Abdurrahman Sagir ◽  
Loic Guillevin ◽  
Eva Neuen-Jacob ◽  
Dieter Haussinger

Author(s):  
Hiroo Kimura ◽  
Akira Toga ◽  
Taku Suzuki ◽  
Takuji Iwamoto

Abstract Background Fracture-dislocations of all four ulnar (second to fifth) carpometacarpal (CMC) joints are rare hand injuries and frequently overlooked or missed. These injuries can be treated conservatively when closed reduction is successfully achieved, though they are sometimes irreducible and unstable. Case Description We report the case of a 17-year-old boy involved in a vehicular accident. Clinical images showed dorsal dislocation of all four ulnar CMC joints of the left hand associated with a fracture of the base of the fourth metacarpal. Although closed reduction was attempted immediately, the affected joints remained unstable and easily redislocated. Therefore, we performed open reduction and percutaneous fixation of all ulnar CMCs. He showed excellent recovery after 1 year postoperatively, reported no pain, and demonstrated complete grip strength and range of motion of the affected wrist and fingers. Literature Review Accurate clinical diagnosis of this lesion is difficult because of polytrauma, severe swelling masking the dislocated CMC joint deformity, and overlapping of adjacent metacarpals and carpal bones on radiographic examination. As for the treatment strategy, it has yet to obtain a consensus. Some reports value open reduction to guarantee anatomical reduction, and it is definitely needed in the patients with interposed tissues to be removed or with subacute and chronic injuries. Clinical Relevance Delayed diagnosis or treatment could lead to poor outcomes. Therefore, surgeons must be aware that precise preoperative assessment is critical, and anatomical open reduction of interposed bony fragments, like our case, may be required even in an acute phase.


2000 ◽  
Vol 42 (3) ◽  
pp. 505
Author(s):  
Ho Jun Yu ◽  
June Sik Cho ◽  
Kyung Suk Shin ◽  
Kyu Sang Song

1998 ◽  
Vol 38 (3) ◽  
pp. 441
Author(s):  
Young Lan Seo ◽  
Chul Soon Choi ◽  
Ho Chul Kim ◽  
Sang Hoon Bae ◽  
Eil Seong Lee ◽  
...  

2013 ◽  
Vol 75 (1) ◽  
pp. 7-10 ◽  
Author(s):  
Madoka IIKAWA ◽  
Eiji MUROI ◽  
Yukichika ISHII ◽  
Kousuke MOCHIDA ◽  
Mitsuru SETOYAMA ◽  
...  

2020 ◽  
Author(s):  
Xiaoyu He ◽  
Juan Su ◽  
Guangyu Wang ◽  
Kang Zhang ◽  
Navarini Alexander ◽  
...  

BACKGROUND Pemphigus vulgaris (PV) and bullous pemphigoid (BP) are two rare but severe inflammatory dermatoses. Due to the regional lack of trained dermatologists, many patients with these two diseases are misdiagnosed and therefore incorrectly treated. An artificial intelligence diagnosis framework would be highly adaptable for the early diagnosis of these two diseases. OBJECTIVE Design and evaluate an artificial intelligence diagnosis framework for PV and BP. METHODS The work was conducted on a dermatological dataset consisting of 17,735 clinical images and 346 patient metadata of bullous dermatoses. A two-stage diagnosis framework was designed, where the first stage trained a clinical image classification model to classify bullous dermatoses from five common skin diseases and normal skin and the second stage developed a multimodal classification model of clinical images and patient metadata to further differentiate PV and BP. RESULTS The clinical image classification model and the multimodal classification model achieved an area under the receiver operating characteristic curve (AUROC) of 0.998 and 0.942, respectively. On the independent test set of 20 PV and 20 BP cases, our multimodal classification model (sensitivity: 0.85, specificity: 0.95) performed better than the average of 27 junior dermatologists (sensitivity: 0.68, specificity: 0.78) and comparable to the average of 69 senior dermatologists (sensitivity: 0.80, specificity: 0.87). CONCLUSIONS Our diagnosis framework based on clinical images and patient metadata achieved expert-level identification of PV and BP, and is potential to be an effective tool for dermatologists in remote areas in the early diagnosis of these two diseases.


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