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The purpose of this work was to evaluate the performance of an existing commercially available artificial intelligence (AI) software system in differentiating malignant and benign lung nodules. The AI tool consisted of a vessel-suppression function and a deep-learning-based computer-aided-detection (VS-CAD) analyzer. Fifty patients (32 females, mean age 52 years) with 75 lung nodules (47 malignant and 28 benign) underwent low-dose computed tomography (LDCT) followed by surgical excision and the pathological analysis of their 75 nodules within a 3 month time frame. All 50 cases were then processed by the AI software to generate corresponding VS images and CAD outcomes. All 75 pathologically proven lung nodules were well delineated by vessel-suppressed images. Three (6.4%) of the 47 lung cancer cases, and 11 (39.3%) of the 28 benign nodules were ignored and not detected by the AI without showing a CAD analysis summary. The AI system/radiologists produced a sensitivity and specificity (shown in %) of 93.6/89.4 and 39.3/82.1 in distinguishing malignant from benign nodules, respectively. AI sensitivity was higher than that of radiologists, though not statistically significant (p = 0.712). Specificity obtained by the radiologists was significantly higher than that of the VS-CAD AI (p = 0.003). There was no significant difference between the malignant and benign lesions with respect to age, gender, pure ground-glass pattern, the diameter and location of the nodules, or nodules <6 vs. ≥6 mm. However, more part-solid nodules were proven to be malignant than benign (90.9% vs. 9.1%), and more solid nodules were proven to be benign than malignant (86.7% vs. 13.3%) with statistical significance (p = 0.001 and <0.001, respectively). A larger cohort and prospective study are required to validate the AI performance. [ABSTRACT FROM AUTHOR]

Iophendylate is an oil-based contrast agent used in conventional myelography before the 1980s. We report an unusual case of an 82-year-old woman with iophendylate migration into the intracranial cerebrospinal fluid space after myelography 40 years ago. The patient was treated conservatively and followed up regularly. [ABSTRACT FROM AUTHOR]

Background: Surgical smoke generated by energy devices poses health risks to medical staff. During laparoscopic surgery, the smoke aggregating around the camera obstructs the visual field, forcing surgeons to interrupt surgery, and may increase surgical risk. We propose a proximal smoke evacuation method to improve surgical quality by effectively eliminating surgical smoke., Methods: A smoke evacuation device was designed to attach to a laparoscopic electrode and create a channel for smoke to be suctioned directly from near the tip of the electrode (proximal evacuation). An animal study was conducted to collect videos of electrocautery with proximal (device) evacuation, distal (trocar) evacuation, and no evacuation. We used a computer vision-based model to compare in-screen smoke density and image quality between different evacuation pathways., Results: Compared with distal and no evacuation, proximal evacuation had significantly lower estimated in-screen smoke density and higher image quality (p < 0.001). The pneumoperitoneum pressure remained above 8 mmHg throughout the procedure with proper suction pressure setting. A total of 62 trials performed by 15 surgeons produced consistent results, supporting the core findings of this study. On average, proximal evacuation can eliminate 85.47% of the smoke around operative fields within 10 s., Conclusions: Proximal smoke evacuation is capable of maintaining a clean surgical field and high image quality during laparoscopic surgery. The device can help avoid interrupting surgeries to wait for the smoke to clear or clean the camera lens., Competing Interests: Declaration of competing interest Yung-Chien Chou, Tzu-Chia Tung, Patricia Wanping Wu, Been-Ren Lin and Shuo-Lun Lai have no conflicts of interest or financial ties to disclose., (Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Congenital tuberculosis is rare, even where tuberculosis (TB) is endemic. A 14-day-old girl presented with a 3-day history of fever and respiratory distress. Her mother was diagnosed with a disseminated TB infection immediately after the delivery which was confirmed by a positive TB-polymerase chain reaction (TB-PCR) and subsequent culture from ascites and sputum. The infant was separated from her mother at birth. Her chest radiograph showed bilateral miliary nodules. Congenital TB was strongly suspected because of the symptoms, signs and maternal TB history, and was confirmed by TB-PCR and culture from the gastric lavage. Timely administration of standard anti-TB therapy resulted in a good outcome. The case highlights the importance of maternal TB history and typical miliary pattern on chest radiography for early diagnosis of congenital or neonatal TB which in turn facilitates prompt treatment and the prognosis.