in English, Italian La neoplasia papillare-tubulare intracholecistica (ICPN) è un tumore raro caratterizzato da crescita papillare intraluminale che può essere associata a carcinoma invasivo. In questo studio, abbiamo mirato a presentare al paziente la diagnosi patologica finale dell’ICPN allo stadio terminale presentando la diagnosi preliminare del carcinoma della cistifellea.BACKGROUND Automatic segmentation of pulmonary airway tree is a challenging task in many clinical applications, including developing computer-aided detection and diagnosis schemes of lung diseases. OBJECTIVE To segment the pulmonary airway tree from the computed tomography (CT) chest images using a novel automatic method proposed in this study. METHODS This method combines a two-pass region growing algorithm with gray-scale morphological reconstruction and leakage elimination. The first-pass region growing is implemented to obtain a rough airway tree. The second-pass region growing and gray-scale morphological reconstruction are used to detect the distal airways. Finally, leakage detection is performed to remove leakage and refine the airway tree. RESULTS Our methods were compared with the gold standards. Forty-five clinical CT lung image scan cases were used in the experiments. Statistics on tree division order, branch number, and airway length were adopted for evaluation. The proposed method detected up to 12 generations of bronchi. On average, 148.85 branches were extracted with a false positive rate of 0.75%. CONCLUSIONS The results show that our method is accurate for pulmonary airway tree segmentation. The strategy of separating the leakage detection from the segmenting process is feasible and promising for ensuring a high branch detected rate with a low leakage volume.INTRODUCTION To report the management and outcome of one case of pediatric patient sustaining high-grade blunt renal trauma. We present and discuss the clinical characteristics and radiologic features of the patient. PATIENTS AND METHODS A 10 years old child was admitted for serious blunt renal trauma formed a huge urinoma in the right renal after injury gradually in 2018. We treated the patient with synchronous percutaneous nephrostomy drainage and retrograde ureteral catheterization. see more A retrospective review was performed of this case, including the clinical features, imaging studies and short-term follow-up. A literature review was also performed to highlight the principals of diagnosis and treatment of severe blunt renal trauma in children. RESULTS After drainage, the symptoms of abdominal distension gradually disappeared, and the physical examination shows that the abdomen gradually reduced to normal. The huge urinoma was cured by synchronous drainge. No complications occurred in short-term follow-up. COMMENTS The choice of surgical treatment is based on the degree and location of renal trauma. Grade IV injuries are a heterogeneous group and management should be tailored to the patient, especially among pediatric patients. Persistent urinary extravasation and/or symptomatic urinoma is a common complication of high-grade renal trauma, which will be amenable to ureteral stent placement or percutaneous drainage. For huge urinoma, synchronous percutaneous nephrostomy drainage and retrograde ureteral catheterization can relieve symptoms quickly.BACKGROUND Low dose computed tomography (LDCT) reduces radiation damage to patients. However, with the decrease of radiation dose, LDCT images of the lung often appear some serious problems such as poor contrast, noise and streak artifacts. OBJECTIVE To improve the quality of lung LDCT images, this study proposed and investigated a new denoising method based on classification training structure combined dictionary for lung LDCT images. METHODS First, top-hat transform and anisotropic diffusion with a shock filter (ADSF) algorithm are used to enhance the image contrast and image details. Second, an adaptive dictionary is trained and used for noise reduction. Third, more image details are extracted from the residual image by using the atom activity measurement. The final result is obtained by combining the dictionary denoising result with the extracted detail information. The proposed method is then validated by both simulated and clinical lung LDCT images. Four metrics including Contrast-to-Noise Ratio (CNR), Noise Suppression Index (NSI), Edge Preserving Index (EPI), and Blurring Index (BI) are computed to quantitatively evaluate image quality. RESULTS The results showed that the CNR, NSI, EPI, and BI of our method reached 8.953, 0.9500, 0.7230 and 0.0170, respectively. Noise and streak artifacts can be removed from lung LDCT images while keeping and retaining more details. CONCLUSIONS Comparing with the results of other methods tested using the same dataset, this study demonstrated that our new method significantly improved quality of the lung LDCT images.BACKGROUND Both 1 Hz repetitive transcranial magnetic stimulation (rTMS) and intermittent theta-burst stimulation (iTBS) are reported to benefit upper limb motor function rehabilitation in patients with stroke. However, the efficacy of combining 1 Hz rTMS and iTBS has not been adequately explored. OBJECTIVE We aimed to compare the effects of 1 Hz rTMS and the combination of 1 Hz rTMS and iTBS on the upper limb motor function in the subacute phase post-stroke. METHODS Twenty-eight participants were randomly assigned to three groups Group A (1 Hz rTMS over the contralesional primary motor cortex (M1) and iTBS over the ipsilesional M1), Group B (contralesional 1 Hz rTMS and ipsilesional sham iTBS), and Group C (contralesional sham 1 Hz rTMS and ipsilesional sham iTBS). The participants received the same conventional rehabilitation accompanied by sessions of transcranial magnetic stimulation for two weeks (5 days one week). Motor-evoked potential (MEP), upper extremity Fugl-Meyer Assessment (UE-FMA), and Barthel Index (BI) were performed before and after the sessions. RESULTS Group A showed greater UE-FMA, BI, and MEP amplitude improvement and more significant decrement in MEP latency compared to Group B and Group C in testable patients. Correlation analyses in Group A revealed a close relation between ipsilesional MEP amplitude increment and UE-FMA gain. CONCLUSIONS The combining of 1 Hz rTMS and iTBS protocol in the present study is tolerable and more beneficial for motor improvement than the single use of 1 Hz rTMS in patients with subacute stroke.