Transendoscopic miniprobe and cardial stenosis
Bibliographic record
Abstract
A 67-year-old male, an ex-smoker with a history of chronic bronchitis, heartburn, type-2 diabetes mellitus, and prostatic hypertrophy presents to hospital for assessment of dysphagia to both solids and liquids.He is endoscopically diagnosed with distal esophageal stenosis with cardial-level ulceration, which suggests a reflux-related peptic lesion with negative biopsies; an initial dilation using bougies is attempted.A month later a new dilation for restenosis is performed, and further endoscopic biopsies still showed no malignity.He was admitted for severe cardial stenosis assessment.Echoendoscopy using a 12.5 MHz (2 mm in diameter, less than 30 mm in penetration) miniprobe within the distal esophagus detected a round though asymmetric, submucosal hypoechogenic mass (arrows) involving the submucosal and muscularis propria layers (linitis-type carcinoma), or the muscularis propria layer (leiomyosarcoma) with no adenopathies (Fig. 1).With this information, both a computerized tomographic (CT) scan and an endoscopy were performed.The CT scan showed a mass suggestive of distal esophageal neoplasm.Videogastroscopy demonstrated a stenotic area that did not allow the endoscope through.It was dilated using bougies 7 mm and 10.5 mm in diameter.Biopsies performed still were repeatedly negative.A surgical procedure is decided upon, and an intrathoracic esophago-gastrectomy and left lateral thoracotomy is carried out, with a diagnosis of cardial neoplasm with esophageal involvement.Pathology offered a diagnosis of intestinal-type cardial adenocarcinoma (Fig. 2) infiltrating the whole of the gastric wall and involving the submucosal, muscularis, and periesophageal fat layers.Perineural, vascular, and lymphatic involvement was extensive.Adenocarcinoma metastases were seen in 1/21 resected lymph nodes.pT3-N1-M0.Cases of tumor-related pseudoachalasia have been recently reported in our country (1,2).The authors state that "endoscopy must be the technique of choice for the early diagnosis of tumor-related pseudoachalasia in patients under assessment for suspected primary esophageal motor disorder" (3).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".