Although it is well known that colorectal cancers can arise on a preexisting adenoma or de novo, the relative importance of these two pathways is still highly controversial. The authors studied the proportion of cancers with adenomatous remnants in a nonselected population‐based series of 1630 resected colorectal cancers, so that they could estimate by subsite the importance of the adenoma‐carcinoma sequence. Four factors appeared to be related independently to the presence of adenomatous tissue within cancers in a multiple logistic model: tumor extension, growth pattern, location, and size. It appeared that infiltrating and ulcero‐infiltrating tumors, which represented 39.8% of all resected colorectal cancers, very rarely displayed adenomatous tissue (0.5%), whereas it was more common in fungating and ulcero‐fungating cancers (25.8%; P < 0.001). In these exophytic cancers, the presence of adenomatous tissue was related very closely to the tumor size and extension, and it was seen in as many as 83% of small cancers (< 2 cm) limited to the mucosa or submucosa. Right colon cancer showed consistently fewer adenomatous remnants than left colon or rectal cancer. These figures suggest that there are roughly two types of colorectal cancers, one of the infiltrating or ulcero‐infiltrating type, which usually would arise de novo and account for approximately 40% of all colorectal cancer cases, and the exophytic type, which would mainly follow an adenoma‐carcinoma sequence, although some might be de novo cancers, in particular in the right colon. Cancer 1992; 69:883–888.
To improve medical image sharing in applications such as e-learning or remote diagnosis aid, we propose to make the image more usable by watermarking it with a digest of its associated knowledge. The aim of such a knowledge digest (KD) is for it to be used for retrieving similar images with either the same findings or differential diagnoses. It summarizes the symbolic descriptions of the image, the symbolic descriptions of the findings semiology, and the similarity rules that contribute to balancing the importance of previous descriptors when comparing images. Instead of modifying the image file format by adding some extra header information, watermarking is used to embed the KD in the pixel gray-level values of the corresponding images. When shared through open networks, watermarking also helps to convey reliability proofs (integrity and authenticity) of an image and its KD. The interest of these new image functionalities is illustrated in the updating of the distributed users' databases within the framework of an e-learning application demonstrator of endoscopic semiology.
The aim of this prospective study was to evaluate the incidence of viral respiratory infection in hospitalized premature newborn infants and to assess the role of coronaviruses. All hospitalized premature infants with a gestational age less than or equal to 32 weeks were included. Tracheal or nasopharyngal specimens were studied by immunofluorescence for coronaviruses, respiratory syncytial virus, adenoviruses, influenza and parainfluenza viruses. Forty premature infants were included; 13 samples were positive in 10 newborns (coronaviruses n = 10; influenza 1 n = 2; adenovirus n = 1). None was positive at admission. All premature infants infected with coronaviruses had symptoms of bradycardia, apnea, hypoxemia, fever or abdominal distension. Chest X-ray revealed diffuse infiltrates in two cases. However, no significant difference was observed between infected and non-infected premature infants for gestational age, birth weight, duration of ventilation, age at discharge, incidence of apnea or bradycardia. Nosocomial respiratory tract infection with coronaviruses appears to be frequent. The clinical consequences should be evaluated in a larger population.
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