Pulmonary embolectomy with use of pediatric bronchoscope for the detection of residual emboli: an innovative surgical technique

Pulmonary embolectomy in the treatment of massive pulmonary embolus has been in doubt since the introduction of thrombolytic therapy. Recent indications for surgical intervention are- contraindication to thrombolysis, failed medical treatment and severe Right Ventricular (RV) dysfunction. A 54-year male came to us with complaints of palpitation, tachypnea and repeated syncope . Transthoracic echocardiography and Computed Tomography pulmonary angiogram demonstrated- Biatrial mass with right atrial mass extending into right ventricle and main pulmonary artery. Pulmonary embolectomy was performed. Residual emboli of bilateral pulmonary arteries were detected with a fiberoptic pediatric bronchoscope and removed. Bronchoscopic evaluation appears to be safe and useful for direct visual detection of emboli.     

Orthopaedic surgeon＇s nightmare： iatrogenic fractures of talus and medial malleolus following tibial nailing

Intramedullary interlocking nailing is the gold standard for treatment of tibial shaft fractures.The growing use of intramedullary nailing has resulted in an increased number of tibial nailing in daily...     

Psychological distress in men with prostate cancer receiving adjuvant androgen-deprivation therapy

ObjectivesTo compare the occurrence of depression, anxiety, self body image perception, sleep disturbances, and diminished quality of life in prostate cancer patients undergoing adjuvant androgen-deprivation therapy (ADT) as opposed to patients in follow-up alone.Methods and materialsHospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, Restless Legs Syndrome Study Group essential diagnostic criteria, Body Image Scale and Functional Assessment of Cancer Therapy Prostate were administered to consecutive prostate cancer patients who underwent radical prostatectomy or radiation therapy and are presently either under adjuvant ADT or included in a follow-up program.ResultsOf the 103 patients enrolled, 49 (47.6%) were receiving adjuvant ADT and 54 (52.4%) were not. Compared with the controls, the patients undergoing ADT showed higher levels of depression (P = 0.002), worse self body image perception (P = 0.001), worse quality of life (P = 0.0001) and worse sleep quality (P = 0.04). ADT was significantly associated with depression at multivariate analysis after adjustment for age, stage, Gleason score, as well as demographic and social variables (P = 0.001). Depression scores showed a strong inverse correlation with quality of life scores (P < 0.01).ConclusionsAdjuvant ADT is associated with depression, worse quality of life, and altered self body image in prostate cancer patients.     

MicroRNAs in an oral cancer context - from basic biology to clinical utility

Oral cancer is one of the most commonly diagnosed malignancies worldwide. Its dismal five-year survival rate of ~50% has barely changed for decades. A better understanding of the molecular basis of tumorigenesis - with particular emphasis on disease initiation and progression - is needed to improve clinical outcomes, since this will facilitate the development of drugs and management strategies based on the specific genetic changes underpinning disease behaviors. MicroRNAs (miRNAs), a class of short non-coding RNAs that down-regulate gene expression, have been demonstrated to play essential roles in human cancers. miRNA deregulation has been observed in many tumor types and is implicated in oncogenic cell processes, including proliferation, survival, apoptosis, metastasis, and chemoresistance. In addition, miRNA alterations have been associated with specific clinical phenotypes such as disease progression or recurrence, development of metastases, and post-operative survival. Recent studies have explored the utility of miRNAs as diagnostic and prognostic tools and as potential therapeutic targets. Herein, we discuss miRNA biology and provide a summary of the key findings on the role of miRNAs in oral malignancies.     

Epilepsy classification using optimized artificial neural network

ABSTRACT

Objectives: An Electroencephalogram (EEG) is the result of co-operative actions performed by brain cells. In other words, it can be defined as the time course of extracellular field potentials that are generated due to the synchronous action of cells. It is widely used for the analysis and diagnosis of several conditions. But this clinical data use to be multi-dimensional, context-dependent, complex, and it causes a concoction of various computing related research challenges. The objective of this study was to develop a computer-aided diagnosis system for epilepsy detection using EEG signals to ease the diagnosis process.

Materials: In this study, EEG datasets for epilepsy disease detection were taken from a public domain (Bonn University, Germany). These EEG recordings contain 100 single-channel EEG signals with maximum duration of 23.6 seconds. This data set was recorded intra-cranially and extra-cranially with the help of a 128-channel amplifier system using a common reference point.

Results: For a unique set of EEG signal features, the Optimized Artificial Neural Network model for classification and validation was developed with optimum neurons in the hidden layer. Results were tested on the basis of accuracy, sensitivity, precision, and specificity for all classes. The proposed Particle Swarm Optimized Artificial Neural Network provided 99.3% accuracy for EEG signal classification.

Discussion: Our results indicate that artificial neural network has efficiency to provide higher accuracy for epilepsy detection if the statistical features are extracted carefully. It is also possible to improve results for real time diagnosis by using optimization technique for error reduction.

Abbreviations: EEG: Electroencephalogram CAD: Computer-Aided Diagnosis ANN: Artificial Neural Network PSO: Particle Swarm Optimization FIR: Finite Impulse Response IIR: Infinite Impulse Response MSE: Mean Square Error.     

Chondrosarcoma of the mandible: a case report

Chondrosarcomas are malignant tumours of cartilaginous origin. They range from a well-differentiated growth resembling a benign cartilage tumour to a high-grade malignancy with aggressive local behaviour and the potential to metastasize. Only 5% to 10% of chondrosarcomas are known to occur in the head and neck region. A case of chondrosarcoma of the anterior region of the mandible is presented, along with a review of the relevant literature.     

Clinical,hematological, and imaging observations in a 25-year-old woman with abetalipoproteinemia

Abetalipoproteinemia is an uncommon cause of ataxia and retinitis pigmentosa (RP). Most of the neurological and ocular manifestations occur secondary to deficiency syndromes that is consequent to fat malabsorption from the small intestine. In this report, we have described the phenotype of a young adult female who manifested with recurrent diarrheal illness in her first decade, followed by anemia, RP, and neurological involvement with progressive deafness, cerebellar and sensory ataxia, and subclinical neuropathy in her second decade of life. While RP and sensory ataxia due to vitamin E deficiency are well-recognized features of abetalipoproteinemia, deafness is rarely described. In addition, we have highlighted the abnormal posterior column signal changes in the cervical cord in this patient. Early recognition avoids unnecessary investigations and has a potential to retard the disease progression by replacing some of the deficient vitamins.