A simple interview on history of facial flushing after alcohol intake can be useful for identifying patients at high risk for synchronous or metachronous cancers of the UGI tract.
A carefully targeted physical examination and performing a fine needle aspiration are essential to establish a diagnosis for the etiology of an unknown neck mass. In performing an open biopsy, the effect of an incisional biopsy on patients' survival was no worse than that of an excisional biopsy, despite the latter being theoretically preferable.
The aging Japanese population has led to an increase in the number of accidentally swallowed dentures. Therefore, we report the case of an elderly Japanese woman with dementia who accidentally and sequentially swallowed two dentures. The patient presented to our hospital with a diagnosis of a single impacted denture in her hypopharynx although we subsequently identified a second impacted denture in her rectum after taking a careful clinical history. Open surgery was required to remove the second denture from her rectum. This case highlights the importance of carefully considering the patient's history if there is a possibility of latent swallowed dentures.
Background and Objectives Cervical lymph node enlargement is observed in various diseases, including malignant lymphoma (ML). Open biopsy of the enlarged lymph node is frequently required for diagnosis, especially when ML is suspected. Serum levels of soluble interleukin 2 receptor (sIL-2R) may be useful as a biomarker of ML. This study aimed to determine whether the measurement of serum sIL-2R levels might be useful to diagnose ML.
Materials and Methods We retrospectively reviewed the data of 281 patients who had undergone open cervical lymph node biopsy at our institution between 2015 and 2019, including 157 males and 124 females (age range, 5–90 years). Data on the patients' age, final diagnosis, and serum sIL-2R levels were obtained from their medical records.
Results Overall, 184 cases of MLs and 97 cases of other diseases (non-MLs [NMLs]) were recorded. The mean age was significantly higher and mean serum sIL-2R levels were significantly higher in the ML group than in the NML group. In the ML group, the serum sIL-2R levels were significantly higher in patients with T cell lymphoma than in those with B cell lymphoma. The area under the receiver operating characteristic curve of the serum sIL-2R level for predicting ML was 0.711, and a serum sIL-2R level of 1,246 U/mL was associated with the maximum value of the sensitivity + specificity for the diagnosis of ML. Multivariate analysis revealed that the area under the receiver operating characteristic curve increased to 0.758 for patients aged >61 years and patients with serum sIL-2R levels of >1,246 U/mL.
Conclusions Among patients presenting with cervical lymphadenopathy, the measurement of serum sIL-2R levels could be useful for distinguishing between patients with and without ML, with a cutoff level of 1,246 U/mL for the diagnosis of ML.
A craniofacial penetrating injury can be severe when a foreign object reaches the skull base, causing an intracranial hemorrhage or a pseudoaneurysm. We report a case of sharp craniofacial injury in which a thin wooden rod moved from the orbit to the internal carotid artery. With a multidisciplinary team consisting of neurosurgeons, plastic surgeons, and otolaryngologists, the foreign body was safely removed, and the patient healed without complications or sequelae. Careful risk management is necessary when treating a case of craniofacial penetrating injury because the depth of the foreign body cannot be determined from the external appearance, making it challenging to decide on the severity of the damage from the injury.
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