Multiclass Classification of Pigmented Skin Lesions Using a Multimodal Large Language Model.

Background: Pigmented skin lesions span benign to malignant entities that often appear similar on standard clinical photographs, complicating accurate diagnosis without specialized imaging. Recently, multimodal large language models (MMLLMs) have attracted attention as image-based diagnostic aids and hold promise as decision-support tools in resource-limited settings where dermoscopy may be unavailable.

Objectives: This study aimed to determine whether a fine-tuned MMLLM can accurately classify eight common pigmented skin conditions using only clinical photographs, thereby providing a non-dermoscopic diagnostic support tool.

Deep Learning-Based Classification System for Facial Pigmented Lesions to Aid Laser Treatment Decisions.

The accurate diagnosis of facial pigmented lesions is essential for selecting appropriate treatment strategies and improving patient outcomes. Deep learning algorithms, particularly convolutional neural networks (CNNs), have shown promise in classifying skin lesions but have been underutilized in differentiating facial pigmented lesions, particularly in the context of laser treatment planning. The aim of this study is to develop and evaluate deep learning models using transfer learning to differentiate among five types of facial pigmented lesions and compare their diagnostic accuracy with that of expert and non-expert dermatologists.

[Skin toxicities following auto PBSCT with thiotepa-based conditioning in adult patients: a single-center retrospective analysis].

Autologous stem cell transplantation (ASCT) with thiotepa-based conditioning is known to be frequently associated with skin complications in children, but there are no comprehensive reports on skin reactions in adults. We retrospectively analyzed skin problems in 44 patients who underwent ASCT with thiotepa-based conditioning at our institution between January 2017 and April 2023. Skin problems were observed in 19 patients (43.

Cutaneous Rhabdomyosarcoma With FUS::TFCP2 Fusion: An Emerging Entity That Expands the Differential Diagnosis of ALK-Positive Spindle Cell Neoplasm of the Skin.

Rhabdomyosarcoma with EWSR1/FUS::TFCP2 fusion is an emerging subtype of rhabdomyosarcoma that rarely arises in skin. It is characterized by spindle and epithelioid morphology, and frequent expression of cytokeratin and anaplastic lymphoma kinase (ALK). We report a case of primary cutaneous rhabdomyosarcoma with FUS::TFCP2 fusion in a 59-year-old man who initially presented with an erythematous lesion on the chest that progressed to a mass-forming lesion 6 months before his hospital visit.

BCL-6-Positive Cutaneous Mantle Zone Hyperplasia: A Novel Subtype of B-Cell Cutaneous Lymphoid Hyperplasia.

Cutaneous lymphoid hyperplasia (CLH) is a benign lymphoid proliferation that may share features of skin lymphoma. Although reactive germinal centers (GCs) are common in B-cell CLH, cases with mantle zone hyperplasia (MZH), a rare phenomenon reported in reactive lymphadenopathy, have never been documented. We report a case of CLH with MZH showing weak BCL-6 expression, complicating its distinction from cutaneous B-cell lymphoma (CBCL).

Atypical Mechanism of Coronary Stenosis Due to TAVR in a Patient With Anomalous Coronary Anatomy.

Background: Transcatheter aortic valve replacement (TAVR) in patients with abnormal coronary anatomy remains challenging.

Case Summary: An 80-year-old man was referred to our hospital for TAVR. Computed tomography revealed an anomalous left coronary artery (LCA) originating from the right sinus of Valsalva.

Psoriasiform Dermatitis Following Kawasaki Disease: A Case Report and Literature Review.

Kawasaki disease (KD) is an idiopathic acute inflammatory illness that commonly affects children in Northeast Asian countries. In this case report, a psoriasiform eruption appeared on the face and extremities following the onset of KD. A review of previous reports identified 38 cases of psoriasiform eruptions following KD, typically appearing 4 days to 2 months after the onset of KD, unlike other skin manifestations associated with the disease.

Cerebral small vessel disease markers and long-term prognosis in spontaneous intracerebral hemorrhage: the HAGAKURE-ICH study.

We investigated the effects of individual and cumulative cerebral small vessel disease (SVD) markers on long-term clinical outcomes in spontaneous intracerebral hemorrhage (sICH) patients. This prospective, single-center cohort study was conducted from 2012 to 2019. SVD markers, including lacunae, cerebral microbleeds, white matter hyperintensity (WMH), and perivascular spaces in the basal ganglia, were assessed to calculate a summary SVD score.

Relationship between kinetic parameters of ultrafast dynamic contrast-enhanced (DCE) MRI and tumor-infiltrating lymphocytes (TILs) in breast cancer.

Purpose: To evaluate the relationship between kinetic parameters of ultrafast dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and tumor-infiltrating lymphocytes (TILs) in breast cancer.

Patients And Methods: This retrospective study was approved by an institutional review board and included 76 women (median age: 60) with 76 surgically proven breast cancers who underwent DCE MRI including ultrafast sequence. Based on the TILs level, we classified the patients into the low-TILs (< 10%) group and the high-TILs (≥ 10%) group.

Involvement of the nigrostriatal system in Gerstman-Sträussler-Scheinker disease with the PRNP-P102L mutation.

Introduction: Gerstmann-Sträussler-Scheinker disease (GSS) is an autosomal-dominant inherited prion disease most often associated with the human prion protein gene (PRNP)-P102L mutation. Although patients manifest considerable phenotypic heterogeneity, the involvement of the nigrostriatal system has not been well-studied.

Methods: We performed dopamine transporter single-photon emission computed tomography (DAT-SPECT) using I-ioflupane to investigate the nigrostriatal system function in nine patients with the PRNP-P102L mutation.

MRI features of ovarian teratomas with somatic-type malignancy and mature cystic teratomas.

Purpose: We evaluated the magnetic resonance imaging (MRI) features of ovarian teratomas with somatic-type malignancy (TSMs) and benign ovarian mature cystic teratomas (MCTs) to determine the diagnostic contribution of the MRI findings for differentiating these two teratomas.

Methods: We compared the MRI findings between ovarian TSMs (n = 10) and MCTs (n = 193), and we conducted a receiver operating characteristic (ROC) analysis to determine the MRI findings' contribution to the differentiation of TSMs from MCTs.

Results: The maximum diameters of whole lesion and the largest solid component in the TSMs were larger than those of the MCTs (p = 0.

Post-marketing surveillance of quetiapine fumarate extended-release tablets in patients with bipolar depression.

Aim: This study aimed to verify the real-world efficacy and safety of quetiapine fumarate extended-release tablets (Bipresso® 50 mg and 150 mg; marketing authorization holder is KYOWA Pharmaceutical Industry Co., Ltd., Osaka, Japan) in patients with bipolar depression.

[RECOMMENDATION FOR ITCH ASSESSMENT FROM THE ATOPIC ITCH CONSENSUS MEETING (AICOM)].

Background: Itch is the most troublesome symptom of atopic dermatitis, and it is important to assess it appropriately for optimal treatment. We discussed issues regarding itch and the most appropriate methods of assessment at the Atopic Itch Consensus Meeting (AICOM), attended by physicians and researchers with expertise in itch treatment and research.

Methods: The AICOM participants prepared a draft consensus statement that addressed the most appropriate itch assessment methods for age groups <2 years, 2-6 years, 7-14 years, and ≥15 years.

Hypertension, cerebral Amyloid, aGe Associated Known neuroimaging markers of cerebral small vessel disease Undertaken with stroke REgistry (HAGAKURE) prospective cohort study: Baseline characteristics and association of cerebral small vessel disease with prognosis in an ischemic stroke cohort.

Introduction: Cerebral small vessel disease (SVD) is one of the leading causes of stroke; each neuroimaging marker of SVD is correlated with vascular risk factors and associated with poor prognosis after stroke. However, longitudinal studies investigating the association between comprehensive SVD burden scoring system, "total SVD score" - which encompasses the established neuroimaging markers of lacunae, cerebral microbleeds (CMBs), white matter hyperintensities (WMH) including periventricular hyperintensities, and perivascular spaces in basal ganglia- and clinical outcomes are limited. The aim of this study is to determine the association between SVD burden and long-term prognosis in patients with ischemic stroke.

Dual segmentation models for poorly and well-differentiated hepatocellular carcinoma using two-step transfer deep learning on dynamic contrast-enhanced CT images.

The aim of this study was to develop dual segmentation models for poorly and well-differentiated hepatocellular carcinoma (HCC), using two-step transfer learning (TSTL) based on dynamic contrast-enhanced (DCE) computed tomography (CT) images. From 2013 to 2019, DCE-CT images of 128 patients with 80 poorly differentiated and 48 well-differentiated HCCs were selected at our hospital. In the first transfer learning (TL) step, a pre-trained segmentation model with 192 CT images of lung cancer patients was retrained as a poorly differentiated HCC model.

Time to enhancement of breast lesions and normal breast parenchyma in light of menopausal status and menstrual cycle for ultrafast dynamic contrast-enhanced MRI using compressed sensing.

Purpose: To assess the dependency of the Time to enhancement (TTE) of breast lesions and normal breast parenchyma from menopausal status and menstrual cycle using ultrafast compressed sensing (CS) -accelerated dynamic contrast-enhanced (DCE) MRI.

Methods: This institutional review board approved retrospective study included 89 breast cancers, 22 benign lesions and 131 normal breast parenchymal foci. A prototypical ultrafast DCE sequence obtained 30 phases with 2.

A case of congenital capillary proliferation of the kidney (CCPK).

We report a case of congenital capillary proliferation of the kidney (CCPK) along with the multimodality imaging findings. Four-day-old boy who had managed due to his mother's gestational diabetes underwent abdominal ultrasound and a mass was detected in the right kidney. On gray scale ultrasound, the mass exhibited a hyperechoic, slight lobulated shape and a circumscribed margin.