Systemic Tumor Seeding Secondary to Peritonitis due to the Immediate Postoperative Intravesical Instillation of Pirarubicin After Intravesical Explosion Induced Bladder Perforation During Bipolar Transurethral Resection of Bladder Tumors
Bibliographic record
Abstract
An 82-year-old man with multiple nonmuscle-invasive bladder cancer underwent transurethral resection (TUR) of bladder tumor by using the transurethral resection in saline (TURis) system. Intravesical explosion occurred during the resection of a tumor of the bladder dome, but no bladder perforation was detected. Immediate postoperative intravesical instillation of 30 mg pirarubicin in 30 mL saline was administered after the TURis. After this procedure, the patient complained of severe lower abdominal pain. A computed tomography (CT) scan after cystography revealed a collection of fluid in the abdominal cavity with signs of urine leakage. It was determined that instillation of pirarubicin led to leakage outside the bladder through a near perforation on the bladder that occurred during TURis. An indwelling 20 Fr Foley catheter was placed for 8 days. His condition improved without additional surgery. After the patient was discharged, gross hematuria appeared. A residual tumor was confirmed near the perforation area. Therefore, 3.5 months after the first TURis, he underwent a second TURis. Dyspnea appeared 1 month after the second TURis. Positron emission tomography and computed tomography (PET/CT) imaging revealed systemic tumor seeding. Five months after surgery, the patient died because of acute respiratory failure. J Med Cases. 2019;10(4):101-105 doi: https://doi.org/10.14740/jmc3277
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".