Abstract Rationale: Lymphangiomas develop in the head, neck, and axilla of patients <2 years old in more than 90% of cases. They are rarely reported in adults. Patient concerns: Here, we report on a 37-year-old woman with a firm, hypoechoic 3.3 cm mass in the right upper, outer quadrant of the breast with discomfort, and swelling of the right axillary region. Diagnosis and interventions: She underwent wide excision of the right breast and axillary lesion and the lesion pathologic finding is lymphangioma of the breast. Outcomes: She was in good condition with no signs of postoperative complications and no evidence of recurrence at 6 months postsurgery. Lessons: Despite the rarity of breast cystic lymphangioma, its evaluation should be considered for prompt diagnosis and definitive treatment to prevent recurrence and complications. Furthermore, this is the first case of concomitant lymphangioma of the breast parenchyma and axillary region.
A colon lipoma is a remarkably rare tumor. In most cases, the tumors are asymptomatic and small in size, need to be differentiated from malignant tumors, and do not need any special treatment. Selection of the right surgical strategy depends on the status of bowel, as well as the size and the location of tumor. We encountered two patients with giant submucosal lipomas that had induced intussusceptions: one with a lipoma in the transverse colon and the other with a lipoma in the ascending colon. The diagnoses were made by using histological examinations. We report the clinical features, diagnoses, and treatments of, as well as our experience with, these two uncommon cases, and we present a review of the literature on this subject. Keywords: Colon; Intussusception; Laparoscopy; Lipoma
While extended cholecystectomy is recommended for T2 gallbladder cancer (GBC), the role of hepatic resection for T2 GBC is unclear. This study aimed to identify the necessity of hepatic resection in patients with T2 GBC. Data of 81 patients with histopathologically proven T2 GBC who underwent surgical resection between January 1999 and December 2017 were enrolled from a retrospective database. Of these, 36 patients had peritoneal-side (T2a) tumors and 45 had hepatic-side (T2b) tumors. To identify the optimal surgical management method, T2 GBC patients were classified into the hepatic resection group (n = 44, T2a/T2b = 20/24) and non-hepatic resection group (n = 37, T2a/T2b = 16/21). The recurrence pattern and role of hepatic resection for T2 GBC were then investigated. Mean age of the patients was 69 (range 36–88) years, and the male-to-female ratio was 42:39 (male, 51.9%; female, 48.1%). Hepatic-side GBC had a higher rate of recurrence than peritoneal-side GBC (44.4% vs. 8.3%, p = 0.006). The most common type of recurrence in T2a GBC was para-aortic lymph node recurrence (n = 2, 5.6%); the most common types of recurrence in T2b GBC were para-aortic lymph node recurrence (n = 7, 15.6%) and intrahepatic metastasis (n = 6, 13.3%). Hepatic-side GBC patients had worse survival outcomes than peritoneal-side GBC patients (76.0% vs. 96.6%, p = 0.041). Hepatic resection had no significant treatment effect in T2 GBC patients (p = 0.272). Multivariate analysis showed that lymph node metastasis was the only significant prognostic factor (p = 0.002). Hepatic resection is not essential for curative treatment in T2 GBC, and more systemic treatments are needed for GBC patients, particularly for those with T2b GBC.
The purpose of this study was to kinematically analyze the differences between short(2.17 m) and long(10.94 m) putting stroke motions. Thirteen male professional golfers were participated in this study. Experiment was conducted on the artificial grass mat in the gymnasium. Kinematic data were collected by the 60 Hz Kwon3D motion analysis system. Differences were compared by SPSS paired t-test and one-way ANOVA. Duncan was used for post-hoc test and a
Abstract Background We aimed to identify whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are more useful predictors after initial intention to treat than at the time of diagnosis. Methods We collected the medical data of 533 patients. The results of the peripheral blood sampling before the primary treatments were labeled as initial cohort, and those obtained between 24 and 36 months after initial treatment were defined as the 2nd cohort. Delayed metastasis has been defined as distant metastasis 2 years after treatment, and survival outcome was estimated and compared across groups. Results Median follow-up duration was 74 months (24–162 months), and 53 patients experienced delayed metastasis. In univariate analysis, metastasis-free survival, patient age at diagnosis, tumor size, axillary lymph node metastasis, HER-2 status, initial NLR and PLR, and 2nd NLR and PLR were found to be significantly associated with delayed metastasis. However, in multivariate analysis, only the 2nd NLR and PLR were found to be significantly associated with delayed metastasis, excluding initial NLR and PLR. Metastasis-free survival was analyzed through the pattern changes of NLR or PLR. The results revealed that patients with continued low NLR and PLR values at pre- and post-treatment (low initial values and 2nd values) showed a significantly better prognosis than those with a change in value or continued high NLR and PLR. Conclusions We identified that patients with persistent high NLR and PLR after initial treatment have significant worse prognosis in terms of late metastasis. Therefore, these results suggest that NLR and PLR are more useful in predicting prognosis post-treatment.
Forest canopy height is an important biophysical variable for quantifying carbon storage in terrestrial ecosystems. Active light detection and ranging (lidar) sensors with discrete-return or waveform lidar have produced reliable measures of forest canopy height. However, rigorous procedures are required for an accurate estimation, especially when using waveform lidar, since backscattered signals are likely distorted by topographic conditions within the footprint. Based on extracted waveform parameters, we explore how well a physical slope correction approach performs across different footprint sizes and study sites. The data are derived from airborne (Laser Vegetation Imaging Sensor; LVIS) and spaceborne (Geoscience Laser Altimeter System; GLAS) lidar campaigns. Comparisons against field measurements show that LVIS data can satisfactorily provide a proxy for maximum forest canopy heights (n = 705, RMSE = 4.99 m, and R2 = 0.78), and the simple slope correction grants slight accuracy advancement in the LVIS canopy height retrieval (RMSE of 0.39 m improved). In the same vein of the LVIS with relatively smaller footprint size (~20 m), substantial progress resulted from the physically-based correction for the GLAS (footprint size = ~50 m). When compared against reference LVIS data, RMSE and R2 for the GLAS metrics (n = 527) are improved from 12.74–7.83 m and from 0.54–0.63, respectively. RMSE of 5.32 m and R2 of 0.80 are finally achieved without 38 outliers (n = 489). From this study, we found that both LVIS and GLAS lidar campaigns could be benefited from the physical correction approach, and the magnitude of accuracy improvement was determined by footprint size and terrain slope.
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