Gastric duplication cyst: a challenging EUS differential diagnosis between subepithelial gastric lesion and exophytic pancreatic cystic neoplasm—a case report and a literature review

xlomafota.13 shared this article with you from Inoreader Gastric duplication cyst: a challenging EUS differential diagnosis between subepithelial gastric lesion and exophytic pancreatic cystic neoplasm—a case report and a literature review Via Latest Results for Clinical Journal of Gastroenterology Abstract Gastric duplication cysts are rare congenital malformation with a potential neoplastic progression and they may represent a challenge in differential diagnosis with exophytic pancreatic cyst neoplasm. We describe a case of a 38-year old man, complaining of recurrent epigastric pain due to a large abdominal mass, referred to our Hospital for EUS evaluation. Differential diagnosis was between gastric duplication cyst and exophytic pancreatic cyst because of FNA pointed out amylase 1280 UI/L and CEA 593.33 ng/mL. Despite antibiotic prophylaxis, an overinfection of the lesion occurred after the FNA, likely due to the technical failure to drain the cyst completely. Afterwards, the patient was referred to surgery and the pathologist confirmed the diagnosis of gastric duplication cyst. In this setting, EUS procedure has gained a leading play, complementary to traditional imaging tests, although its role has been not yet standardized in the reported literature. Here , we describe and discuss our demanding case, and we propose an algorithm to simplify and standardize the diagnostic workup. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Real-time eye state recognition using dual convolutional neural network ensemble

xlomafota.13 shared this article with you from Inoreader Real-time eye state recognition using dual convolutional neural network ensemble Via Latest Results for Journal of Real-Time Image Processing Abstract Automatic recognition of the eye states is essential for diverse computer vision applications related to drowsiness detection, facial emotion recognition (FER), human–computer interaction (HCI), etc. Existing solutions for eye state detection are either parameter intensive or suffer from a low recognition rate. This paper presents the design and implementation of a vision-based system for real-time eye state recognition on a resource-constrained embedded platform to tackle these issues. The designed system uses an ensemble of two lightweight convolutional neural networks (CNN), each trained to extract relevant information from the eye patches. We adopted transfer-learning-based fine-tuning to overcome the over-fitting issues when training the CNNs on small sample eye state datasets. Once trained, these CNNs are integrated and jointly fine-tuned to achieve enhanced performance. Experimental results manifest the effectiveness of the proposed eye state recognizer that is robust and computationally efficient. On the ZJU dataset, the proposed DCNNE model delivered the state-of-the-art recognition accuracy of 97.99% and surpassed the prior best recognition accuracy of 97.20% by 0.79%. The designed model also achieved competitive results on the CEW and MRL datasets. Finally, the designed CNNs are optimized and ported on two different embedded platforms for real-world applications with real-time performance. The complete system runs at 62 frames per second (FPS) on an Nvidia Xavier device and 11 FPS on a low-cost Intel NCS2 embedded platform using a frame size of 640 \(\times\) 480 pixels resolution. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The role of DHCR24 in the pathogenesis of AD: re-cognition of the relationship between cholesterol and AD pathogenesis

xlomafota.13 shared this article with you from Inoreader The role of DHCR24 in the pathogenesis of AD: re-cognition of the relationship between cholesterol and AD pathogenesis Via Latest Results for Acta Neuropathologica Communications Abstract Previous studies show that 3β-hydroxysterol-Δ24 reductase (DHCR24) has a remarked decline in the brain of AD patients. In brain cholesterol synthetic metabolism, DHCR24 is known as the heavily key synthetase in cholesterol synthesis. Moreover, mutations of DHCR24 gene result in inhibition of the enzymatic activity of DHCR24, causing brain cholesterol deficiency and desmosterol accumulation. Furthermore, in vitro studies also demonstrated that DHCR24 knockdown lead to the inhibition of cholesterol synthesis, and the decrease of plasma membrane cholesterol and intracellular cholesterol level. Obviously, DHCR24 could play a crucial role in maintaining cholesterol homeostasis via the control of cholesterol synthesis. Over the past two decades, accumulating data suggests that DHCR24 activity is downregulated by major risk factors for AD, suggesting a potential link between DHCR24 downregulation and AD pathogenesis. Thus, the brain cholesterol loss seems to be indu ced by the major risk factors for AD, suggesting a possible causative link between brain cholesterol loss and AD. According to previous data and our study, we further found that the reduced cholesterol level in plasma membrane and intracellular compartments by the deficiency of DHCR24 activity obviously was involved in β-amyloid generation, tau hyperphosphorylation, apoptosis. Importantly, increasing evidences reveal that the brain cholesterol loss and lipid raft disorganization are obviously linked to neuropathological impairments which are associated with AD pathogenesis. Therefore, based on previous data and research on DHCR24, we suppose that the brain cholesterol deficiency/loss might be involved in the pathogenesis of AD. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Colocalization of Coronary Plaque with Wall Shear Stress in Myocardial Bridge Patients

xlomafota.13 shared this article with you from Inoreader Colocalization of Coronary Plaque with Wall Shear Stress in Myocardial Bridge Patients Via Latest Results for Cardiovascular Engineering and Technology Abstract Purpose Patients with myocardial bridges (MBs) have a higher prevalence of atherosclerosis. Wall shear stress (WSS) has previously been correlated with plaque in coronary artery disease patients, but such correlations have not been investigated in symptomatic MB patients. The aim of this paper was to use a multi-scale computational fluid dynamics (CFD) framework to simulate hemodynamics in MB patient, and investigate the co-localization of WSS and plaque. Methods We identified N = 10 patients from a previously reported cohort of 50 symptomatic MB patients, all of whom had plaque in the proximal vessel. Dynamic 3D models were reconstructed from coronary computed tomography angiography (CCTA), intravascular ultrasound (IVUS) and catheter angiograms. CFD simulations were performed to compute WSS proximal to, within and distal to the MB. Plaque was quantified from IVUS images in 2 mm segments and registered to CFD model. Plaque area was compared to absolute and patient-normalized WSS. Results WSS was lower in the proximal segment compared to the bridge segment (6.1 ± 2.9 vs. 16.0 ± 7.1 dynes/cm2, p value < 0.01). Plaque area and plaque burden measured from IVUS peaked at 1–3 cm proximal to the MB entrance, coinciding with the first diagonal branch. Normalized WSS showed a statistically significant moderate correlation with plaque area (r = 0.41, p < 0.01). Conclusion WSS may be obtained non-invasively in MB patients and provides a surrogate marker of plaque area. Using CFD, it may be possible to non-invasively assess the extent of plaque area, and identify patients who could benefit from frequent monitoring or medical management. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laser‐Assisted Sialolithotripsy: A Correlation of Objective and Subjective Outcomes

xlomafota13 shared this article with you from Inoreader Laser‐Assisted Sialolithotripsy: A Correlation of Objective and Subjective Outcomes Via The Laryngoscope Objective To analyze the long-term symptomatic results of laser-assisted sialolithotripsy (LAS) in cases of obstructive sialolithiasis and correlate with objective criteria using diagnostic sialendoscopy (DS) as a method of examination. Methods This is a retrospective study comprising 50 consecutive patients who underwent holmium-YAG LAS and completed follow-up of at least 6 months. Symptom scoring and endoscopic scoring were done at 6 weeks and 6 months intervals for further study purposes. Results At the end of 6 weeks post-LAS, 70% patients were asymptomatic (A-sym) and only 30% had residual symptoms (Sym). However, obstructed duct (OB-duct) was observed on endoscopic scoring in 88% due to stenosis, residual stones, or both stenosis and residual stones. The obstructed ducts were treated in outpatient clinic and followed up over time, leading to 98% of patients being in A-sym group at the end of study period of 6 months. At the end of study, 82% of patients had clear duct (CL-duct). Conclusion Holmium LAS is a viable option for the management of intermediate-sized stones. LAS if used judiciously, and in properly selected cases, has high rate of stone fragmentation and symptom resolution. A vigilant postoperative protocol taking into account residual mealtime symptoms and altered salivary characteristics combined with early DS can help identify and treat patients with residual stone fragments and ductal stenosis. Level of Evidence 3 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bilateral asymmetry in bullfrog testes and fat bodies: correlations with steroidogenic activity, mast cells number and structural proteins

xlomafota13 shared this article with you from Inoreader Bilateral asymmetry in bullfrog testes and fat bodies: correlations with steroidogenic activity, mast cells number and structural proteins Via histochem Acta Histochem. 2022 Mar 11;124(3):151873. doi: 10.1016/j.acthis.2022.151873. Online ahead of print. ABSTRACT In seasonal breeders, such as amphibians, testicular functions depend on complex processes that change according to seasonality, including Leydig cell (LC) differentiation and lipid-dependent steroidogenesis, extracellular proteins remodeling and actin-dependent cellular dynamics. Speculating that fat bodies (FB) could support some of these processes in L. catesbeian us, we evaluated bilaterally the FB weights, correlating them to testicular parameters such as weight, testosterone (T) immunoexpression, mast cells (MC) number, vascularization and structural proteins. In an attempt to better understand the testicular asymmetry in amphibians, correlations between these different testicular parameters were also established. Right testes (RT), left testes (LT) and associated FB of bullfrogs were weighed, and testes were processed for light and transmission electron microscopy. Collagen content (COL) and MC number were quantified. T and actin immunoexpressions and vascular areas were measured. Statistical analyses and Pearson's correlation were performed. The LT and its associated FB were heavier than the right ones, and showed intense T and actin immunoexpressions, numerous lipid-rich LC, and greater MC number, COL and vascularization than the RT. Positive correlations were detected between: a) FB and testis weights, b) T immunoexpression and testis and FB weights, c) T and actin immunoexpressions and COL. Otherwise, MC number was inversely correlated to T immunoexpression and COL. In right and left sides, the proportional correlation between T immunoexpression and FB weight suggests that FB-stored lipid amount depends on the steroidogenic demand of its associated testis. Thus, the asymmetry in the testes and FB may be associated, at least in part, to the LC steroidogenic activity, which tends to be more intense in LT than in RT. The results also point to a role of COL and mast cells in the LC differentiation and steroidogenesis. Actin was also greater in LT and correlated with T immunoexpression, indicating that the amount of this structural protein depends on androgenic control. Therefore, the testicular asymmetry in bullfrogs seems to be associated to different morphofunctional processes occurring, bilaterally, at different intensities. In this case, there is a tendency of LT, in association with its FB, to be more active th an RT. The findings highlight the FB-testis interplay for the comprehension of reproduction in amphibians. PMID:35287007 | DOI:10.1016/j.acthis.2022.151873 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Coblation intracapsular tonsillectomy: a cohort study of NHS practice in England using Hospital Episode Statistics

xlomafota13 shared this article with you from Inoreader Coblation intracapsular tonsillectomy: a cohort study of NHS practice in England using Hospital Episode Statistics Via Clinical Otolaryngology Abstract Objectives To identify paediatric intracapsular Coblation tonsillectomy procedures from routine administrative data in England, and determine their safety. Design Retrospective observational cohort study of four ENT centres using routine data from Hospital Episode Statistics (HES). Setting Acute NHS trusts in England conducting exclusively intracapsular Coblation tonsillectomy Participants Children (≤16 years old) undergoing bilateral intracapsular Coblation tonsillectomy Main outcome measures Number of procedures, readmissions for pain, readmissions for bleeding and requirement for additional surgery for regrowth. Results 5525 procedures were identified. The median patient age was 4 (IQR 2-5). In-hospital complications occurred in 1%, with 0.1% returning to theatre for arrest of primary tonsil bleeding. Almost half of the procedures were conducted as a day-case (44%), with only a small proportion staying in hospital more than one night (7%). Within 28 days, 1.2% of patients were readmitted with bleeding, 0.7% with infection and 0.3% with pain. 0.2% of patients required return to theatre for control of secondary haemorrhage. Longitudinal follow-up has found that revision tonsil surgery is 0.3% at 1 year (n=4498), 1.1% at 2 years (n=2938), 1.7% at 3 years (n=1781), 1.9% at 4 years (n=905), 2.2% at 5 years (n=305) Conclusions Intracapsular coblation tonsillectomy safety outcomes in this study show primary and secondary bleed rates and emergency return to theatre rates are lower than all tonsillectomy techniques reported in the National Prospective Tonsillectomy Audit and also lower than previously published Hospital Episode Statistics analysis of tonsillectomy procedures. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

CircEIF5 contributes to hyperproliferation and inflammation of keratinocytes in psoriasis via p‐NFκB and p‐STAT3 signaling pathway

xlomafota13 shared this article with you from Inoreader CircEIF5 contributes to hyperproliferation and inflammation of keratinocytes in psoriasis via p‐NFκB and p‐STAT3 signaling pathway Via Experimental Dermatology Abstract Psoriasis is a chronic, immune mediated skin disease accompanied by hyperproliferation and inflammation of keratinocytes. Circular RNAs (circRNAs) as new players regulating the development of psoriasis have been reported in recent years. However, its mechanism has not yet been fully revealed. In this study we identified that hsa_circ_0033469 (circEIF5) was highly expressed in psoriasis tissues compared to the normal skin. We investigated the functional roles of circEIF5 in proliferation and inflammatory of HaCat cells under M5-stimulated inflammatory condition. By using a approach of knockdown and overexpression of circEIF5, we showed that circEIF5 could promote proliferation by facilitating the G1/S transition and increase secretion of chemokines in HaCat cells. These moderating effects of circEIF5 were associated with the activating of the NF-κB and STAT3 signaling pathways. Moreover, NF-κB and STAT3 inhibition abrogated circEIF5 induced promotion of cell proliferation and che mokine secretion. These results indicated that through NF-κB and STAT3 signaling pathways, circEIF5 regulated the proliferation and chemokine secretion of HaCat cells and contributed to the pathogenesis of psoriasis, which might become a potent target for psoriasis treatment. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Preservation, reconstruction, and rehabilitation of the facial nerve

xlomafota13 shared this article with you from Inoreader Preservation, reconstruction, and rehabilitation of the facial nerve Via hno HNO. 2022 Mar 14. doi: 10.1007/s00106-022-01148-y. Online ahead of print. ABSTRACT Handling of the facial nerve during surgery for parotid cancer is relevant for the patient's long-term quality of life. In about two thirds of cases, the facial nerve is not affected by the tumor. In these cases, in addition to complete tumor resection, identification and preservation of the facial nerve are important components of a successful operation. If the nerve is infiltrated by the tum or, the affected part must be resected during radical parotidectomy. When possible, primary nerve reconstruction leads to the best long-term cosmetic and functional outcomes. Individual selection of the optimal treatment concept is based on clinical examination of facial muscle mobility, preoperative imaging to understand the positional relationship between tumor and nerve, and on the basis of an electrophysiological examination of nerve function. Intraoperatively, standardized dissection helps to identify and preserve the facial nerve. If radical parotidectomy is indicated, in addition to one-step reconstruction, preoperative diagnostic tests can help to plan postoperative adjuvant therapy. The aim of rehabilitation is restoration of facial tone, facial symmetry, and movement of the paralyzed face. Restoration of eye closure is of high importance. The surgical treatment of facial paralysis has seen many improvements in recent years. The present work provides an overview of the most recent advances in diagnostics, surgical techniques, and further possibilities for preventing damage to the normal facial nerve during parotid cancer treatment. Furthermore, the options for rehabilitation of the tumor-infiltrated facial nerve in the context of treatment of salivary gland malignancies are described. PMID:35288765 | DOI:10.1007/s00106-022-01148-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic Treatment of Sellar Arachnoid Cysts via a Simple Cyst-Opening Technique: Long-Term Outcomes From a Single Center

xlomafota13 shared this article with you from Inoreader Endoscopic Treatment of Sellar Arachnoid Cysts via a Simple Cyst-Opening Technique: Long-Term Outcomes From a Single Center Via leak of cerebrospinal fluid World Neurosurg. 2022 Feb 23:S1878-8750(22)00219-4. doi: 10.1016/j.wneu.2022.02.072. Online ahead of print. ABSTRACT BACKGROUND: Sellar arachnoid cysts (SACs) are rare lesions that require treatment only if symptomatic. The endoscopic endonasal approach has been widely used. Despite their simple cystic appearance and the straight-forward surgical intervention, important associated risks exist, with cerebrospinal fluid (CSF) leak the prevalent risk. METHODS: A retrospective analysis of patients with pathologically confirmed SAC between January 2006 and December 2019 was conducted. A homogeneous simple cyst-opening technique and skull base reconstruction with nasoseptal flaps was used. RESULTS: A total of 10 patients were identified (7 women and 3 men; median age, 54.5 years; range, 20-77 years). Of the 10 patients, 8 had had newly diagnosed SACs and 2 patients had had recurrence from a previously microsurgically fenestrated SAC. Ei ght patients had presented with visual symptoms, one with visual symptoms and fatigue, and one with intractable headaches. Neuro-ophthalmological and endocrinological assessments had revealed visual field deficits in 6, visual acuity decline in 5, and hypopituitarism in 2 patients. The median calculated volume was 1.71 mL (range, 0.27-2.54 mL). Postoperatively, no CSF leak and no further surgical complications were noted. The visual field had improved in 4 of 6 patients and visual acuity had improved in 4 of 5 patients. Anterior pituitary function had improved in 1, worsened in 1, and remained stable in 8 patients. One patient had developed diabetes insipidus. One recurrence was recorded at 54 months postoperatively. CONCLUSIONS: The results from the present study have shown that SACs can be effectively treated using a simple cyst-opening technique. The routine use of nasoseptal flaps significantly reduced the risk of CSF leakage without compromising nasal quality of life in t he long term or mandating additional incisions. Long-term follow-up is important to monitor for late recurrence. PMID:35217229 | DOI:10.1016/j.wneu.2022.02.072 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Local estrogen for nonsurgical recontouring of auricular cartilage

xlomafota13 shared this article with you from Inoreader Local estrogen for nonsurgical recontouring of auricular cartilage Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Feb 18:S1748-6815(22)00073-0. doi: 10.1016/j.bjps.2022.02.002. Online ahead of print. ABSTRACT INTRODUCTION: 5% of children are born with auricular deformities. Permanent recontouring can be achieved through splinting during early infancy. Beyond this time, splinting is ineffective, and patients require surgical correction. Neonatal cartilage malleability is hypothesized to be secondary to retained maternal estrogens, increasing hyaluronic acid concentration. In this article, we evaluate the efficacy of local estrogen treatments for the nonsurgical recontouring of mature auricular cartilage. METHODS: Ears of New Zealand rabbits were folded and splinted and then were randomly assigned to an experimental group, n = 10 (injected estrogen, topical estrogen, saline, or untreated). Treatment ears received injected estrogen or saline twice weekly or topical estrogen daily for 4 weeks. Two weeks post-t reatment, splints were removed, and ear angles were measured. Biopsies were taken for histologic and mechanical analysis, and systemic estrogen levels were assayed. RESULTS: Ear angles stabilized by 9 days post-splinting. Topical estrogen led to a significantly smaller resting angle (121.6° ± 13.5°) compared with saline and control (135.9° ± 11.2° and 145.3° ± 13.0°, respectively). Injected estrogen led to the most pronounced angle decrease (64.5° ± 35.3°). Ears injected with estrogen also showed a significant increase in cartilage thickness. Hyaluronic acid concentration was increased in both estrogen treatment groups compared with saline. At 3 weeks post-treatment, there was no significant differences in the elastic modulus of the cartilage or serum estrogen levels among the groups. CONCLUSION: Results show the potential result of local estrogen treatment to achieve a stable nonsurgical remodeling of mature auricular cartilage. Further study is needed to ev aluate the molecular mechanism and improve the transdermal estrogen delivery to optimize treatment regimen. PMID:35288037 | DOI:10.1016/j.bjps.2022.02.002 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.