Ameloblastic Fibroma: a Case Report With Five Years Follow-Up

Svrha ovog rada bila je opisati rijedak slučaj dugo praćenoga ameloblastičnog fibroma (AF-a) na atipičnoj lokalizaciji. Ameloblastični fibrom dosta je rijedak benigni miješani odontogeni tumor koji se vrlo rijetko može naći u prednjoj regiji gornje čeljusti. Čini samo 1 do 2 posto svih odontogenih tumora i češći je kod muškaraca negoli kod žena. Češći je u donjoj čeljusti negoli u gornjoj. Većina ameloblastičnih fibroma nalazi se u stražnjem području donje čeljusti, bezbolni su, sporo rastu i uglavnom su asimptomatski, ali mogu proširiti čeljust. Prikaz slučaja: trogodišnja djevojčica bila se žalila na bezbolnu oteklinu u području desne gornje čeljusti. Radiološka pretraga pokazala je dobro ograničenu, veliku leziju. Prema histopatološkim nalazima, dijagnosticirana je kao ameloblastični fibrom. Liječena je enukleacijom te nije bio uočen recidiv na kontrolnom pregledu nakon pet godina. Nakon toga razdoblja radiološke snimke pokazale su da se kirurški defekt ispunio novom kosti. Konzervativni pristup, uključujući enukleaciju i mehaničku kiretažu okolnog tkiva, pokazao se uspješnim za pacijenta. Iako je recidiv ameloblastičnog fibroma rijedak, redoviti pregledi – kako bi se pratio rast i razvoj - potrebni su zbog velike mogućnosti recidiva.The purpose of this article is to describe a rare case of Ameloblastic Fibroma (AF) with atypical localization with long term follow-up period. The AF is a relatively rare benign mixed odontogenic tumour, which is extremely uncommon in the anterior maxillary region. It represents only 1-2% of all odontogenic tumors and males are slightly more frequently affected than females. It presents more frequently in the mandible than maxilla. The majority of AF’s are found in the posterior area of the mandible and painless, slow growing and usually asymptomatic but eventually expand the jaw. A 3 year-old girl with a chief complaint of painless swelling on the right maxillar area. Radiological evaluation revealed a well-circumscribed large lesion. The lesion was diagnosed as AF according to the histopathological fi ndings. She was treated by enucleation with no recurrence observed after a follow-up period of 5 years. After fi ve years, radiographs showed that the surgical defect had fi lled with new bone. A conservative approach, including enucleation and mechanical curettage of the surrounding tissue appeared to be successful for the patient. Although recurrence of AF is rare, regular reviews to monitor growth and development are required for the high potential of recurrence rates

DTWN: Q-learning-based Transmit Power Control for Digital Twin WiFi Networks

Interference has always been the main threat to the performance of traditional WiFi networks and next-generation moving forward. The problem can be solved with transmit power control(TPC). However, to accomplish this, an information-gathering process is required. But this brings overhead concerns that decrease the throughput. Moreover, mitigation of interference relies on the selection of transmit powers. In other words, the control scheme should select the optimum configuration relative to other possibilities based on the total interference, and this requires an extensive search. Furthermore, bidirectional communication in real-time needs to exist to control the transmit powers based on the current situation. Based on these challenges, we propose a complete solution with Digital Twin WiFi Networks (DTWN). Contrarily to other studies, with the agent programs installed on the APs in the physical layer of this architecture, we enable information-gathering without causing overhead to the wireless medium. Additionally, we employ Q-learning-based TPC in the Brain Layer to find the best configuration given the current situation. Consequently, we accomplish real-time monitoring and management thanks to the digital twin. Then, we evaluate the performance of the proposed approach through total interference and throughput metrics over the increasing number of users. Furthermore, we show that the proposed DTWN model outperforms existing schemes

Small inhibitor of Bcl-2, HA14-1, selectively enhanced the apoptotic effect of cisplatin by modulating Bcl-2 family members in MDA-MB-231 breast cancer cells

Inhibition or downregulation of Bcl-2 represents a new therapeutic approach to by-pass chemoresistance in cancer cells. Therefore, we explored the potential of this approach in breast cancer cells. Cisplatin and paclitaxel induced apoptosis in a dose-dependent manner in MCF-7 (drug-sensitive) and MDA-MB-231 (drug-insensitive) cells. Furthermore, when we transiently silenced Bcl-2, both cisplatin and paclitaxel induced apoptosis more than parental cells. Dose dependent induction of apoptosis by drugs was enhanced by the pre-treatment of these cells with HA14-1, a Bcl-2 inhibitor. Although the effect of cisplatin was significant on both cell lines, the effect of paclitaxel was much less potent only in MDA-MB-231 cells. To further understand the distinct role of drugs in MDA-MB-231 cells pretreated with HA14-1, caspases and Bcl-2 family proteins were studied. The apoptotic effect of cisplatin with or without HA14-1 pre-treatment is shown to be caspase-dependent. Among pro-apoptotic Bcl-2 proteins, Bax and Puma were found to be up-regulated whereas Bcl-2 and Bcl-x(L) were down-regulated when cells were pretreated with HA14-1 followed by paclitaxel or cisplatin. Enforced Bcl-2 expression in MDA-MB-231 cells abrogated the sensitizing effect of HA14-1 in cisplatin induced apoptosis. These results suggest that the potentiating effect of HA14-1 is drug and cell type specific and may not only depend on the inhibition of Bcl-2. Importantly, alteration of other pro-apoptotic or anti-apoptotic Bcl-2 family members may dictate the apoptotic response when HA14-1 is combined with chemotherapeutic drugs

Current barriers and recommendations on the diagnosis of transthyretin amyloid cardiomyopathy: a Delphi study

ObjectivesThis study has been conducted to investigate the non-invasive diagnostic journey of patients with a transthyretin amyloid cardiomyopathy (aTTR-CM) in Turkey, identify the challenges and uncertainties encountered on the path to diagnosis from the perspectives of expert physicians, and develop recommendations that can be applied in such cases.MethodsThis study employed a three-round modified Delphi method and included 10 cardiologists and five nuclear medicine specialists. Two hematologists also shared their expert opinions on the survey results related to hematological tests during a final face-to-face discussion. A consensus was reached when 80% or more of the panel members marked the “agree/strongly agree” or “disagree/strongly disagree” option.ResultsThe panelists unanimously agreed that the aTTR-CM diagnosis could be established through scintigraphy (using either 99mTc-PYP, 99mTc-DPD, or 99mTc-HMPD) in a patient with suspected cardiac amyloidosis (CA) without a further investigation if AL amyloidosis is ruled out (by sFLC, SPIE and UPIE). In addition, scintigraphy imaging performed by SPECT or SPECT-CT should reveal a myocardial uptake of Grade ≥2 with a heart-to-contralateral (H/CL) ratio of ≥1.5. The cardiology panelists recommended using cardiovascular magnetic resonance (CMR) and a detailed echocardiographic scoring as a last resort before considering an endomyocardial biopsy in patients with suspected CA whose scintigraphy results were discordant/inconclusive or negative but still carried a high clinical suspicion of aTTR-CM.ConclusionThe diagnostic approach for aTTR-CM should be customized based on the availability of diagnostic tools/methods in each expert clinic to achieve a timely and definitive diagnosis

Stress and deformation analysis in stents

ÖZETSTENTLERDE GERİLME VE DEFORMASYON ANALİZİStent, ağ örgülü yapıya sahip (ızgara gibi) silindirik tüp şeklinde tıpta çeşitli amaçlar için kullanılan biomedikal üründür. Stentler genellikle temel amacı daralmış yada tıkanık olan koroner (yada çevresel) damarların onarılması olan anjiyoplastide kullanılır. Prostatik tıkanıklık ve üriner sistemi semptomları oluştuğu takdirde idrar yolunda tıkanıklıkla sonuçlanır ve idrara çıkma zorlaşır. Stentler aynı zamanda idrar yolunun açılması için kullanılır ve idrara çıkmayı mümkün kılar. Stentlerin kullanıldığı bir diğer alan ise abdominal aortta (şahdamarı) meydana gelen mekaniksel bütünlüğün kaybolması ve genişlemesi anlamına gelen halk arasında baloncuk oluşumu olarak bilinen abdominal aort anevrizma tedavisinde uygulanır. Damar duvarında oluşan yaralanmaların, balon anjiyoplasti esnasında stenti destekleyen ve toplardamar arasında oluşan temas gerilimlerinden kaynaklandığı varsayılmaktadır ve bunun yanısıra içsel elastic laminanın (ince tabakanın) kesilmesi ve kopmasıyla stentin restenoz olması da muhtemeldir. Stentin rijiditesi, damar ve stent içinde meydana gelen restenoz arasındaki ilişki, daha iyi bir stent tasarımı ile çözüm ortaya koymak için araştırma alanında aktif bir konudur. Stentlerle ilgili bir diğer sorun ise yorulmadan kaynaklanan çökme, bozulmadır. Stentlerde gerilim ve deformasyon analizinin önemli ve etkin bir araştırma alanıdır. Bu alandaki araştırma faaliyetleri ekseriyetle sonlu eleman yöntemine dayanır. İlk olarak bu çalışmada EN ISO 25539-2:2008 - Vaskülar stentler standardına göre bazı mekanik testler gerçekleştirildi. İkinci olarak sonlu elemanlar yöntemiyle stentler için önemli olan bazı mekaniksel özellikler irdelenmiştir. ABSTRACTSTRESS AND DEFORMATION ANALYSIS IN STENTSA stent is A mesh (like a grid) cylindrical tube that is used in medicine for various purposes. It is commonly used in angioplasty where the basic aim is to restore the blood flow in a narrowed or blocked coronary (or peripheral) arteries. In case of prostatic obstruction and lower urinary tract symptoms the urethra is blocked resulting difficulty urination. Stents are also used to keep the urethra open to make urinating possible again. Another area where the stents are used is to treat the abdominal aortic aneurysm where the abdominal aorta looses its mechanical integrity and dilation occurs locally. Despite the high success rate of stent applications, stents are subject to an extensive research and development activities. One group of these research and development activities on stents are directly related with their deformation characteristics. One of the major drawbacks of the stent implantation is the in-stent restenosis which remains a major problem. It was reported that in-stent restenosis occurs in 20-35% of the patients for bare metal stents and 5-10% for drug eluting stents. Vascular wall injury caused by the contact stresses between the struts of a stent and the vein the during the balloon angioplasty is hypothesized as a possible cause of in-stent restenosis as well as the deep wall injury with rupture of the internal elastic lamina. The stress and deformation analysis in stents are important and an active research area. First, the major emphasis of the present study was on some mechanical testing of reletad to the stent according to the EN ISO 25539-2:2008 - Vascular stents. Second, the major emphasis of the present study was to investigate some mechanical analysis of stent with the help of Finite Element Analysis method. FEA has proven to be a powerful technique to study the mechanical behaviour of stents

Stress and deformation analysis in stents

STENTLERDE GERİLME VE DEFORMASYON ANALİZİ Stent, ağ örgülü yapıya sahip (ızgara gibi) silindirik tüp şeklinde tıpta çeşitli amaçlar için kullanılan biomedikal üründür. Stentler genellikle temel amacı daralmış yada tıkanık olan koroner (yada çevresel) damarların onarılması olan anjiyoplastide kullanılır. Prostatik tıkanıklık ve üriner sistemi semptomları oluştuğu takdirde idrar yolunda tıkanıklıkla sonuçlanır ve idrara çıkma zorlaşır. Stentler aynı zamanda idrar yolunun açılması için kullanılır ve idrara çıkmayı mümkün kılar. Stentlerin kullanıldığı bir diğer alan ise abdominal aortta (şahdamarı) meydana gelen mekaniksel bütünlüğün kaybolması ve genişlemesi anlamına gelen halk arasında baloncuk oluşumu olarak bilinen abdominal aort anevrizma tedavisinde uygulanır. Damar duvarında oluşan yaralanmaların, balon anjiyoplasti esnasında stenti destekleyen ve toplardamar arasında oluşan temas gerilimlerinden kaynaklandığı varsayılmaktadır ve bunun yanısıra içsel elastic laminanın (ince tabakanın) kesilmesi ve kopmasıyla stentin restenoz olması da muhtemeldir. Stentin rijiditesi, damar ve stent içinde meydana gelen restenoz arasındaki ilişki, daha iyi bir stent tasarımı ile çözüm ortaya koymak için araştırma alanında aktif bir konudur. Stentlerle ilgili bir diğer sorun ise yorulmadan kaynaklanan çökme, bozulmadır. Stentlerde gerilim ve deformasyon analizinin önemli ve etkin bir araştırma alanıdır. Bu alandaki araştırma faaliyetleri ekseriyetle sonlu eleman yöntemine dayanır. İlk olarak bu çalışmada EN ISO 25539-2:2008 - Vaskülar stentler standardına göre bazı mekanik testler gerçekleştirildi. İkinci olarak sonlu elemanlar yöntemiyle stentler için önemli olan bazı mekaniksel özellikler irdelenmiştir. ABSTRACT STRESS AND DEFORMATION ANALYSIS IN STENTS A stent is A mesh (like a grid) cylindrical tube that is used in medicine for various purposes. It is commonly used in angioplasty where the basic aim is to restore the blood flow in a narrowed or blocked coronary (or peripheral) arteries. In case of prostatic obstruction and lower urinary tract symptoms the urethra is blocked resulting difficulty urination. Stents are also used to keep the urethra open to make urinating possible again. Another area where the stents are used is to treat the abdominal aortic aneurysm where the abdominal aorta looses its mechanical integrity and dilation occurs locally. Despite the high success rate of stent applications, stents are subject to an extensive research and development activities. One group of these research and development activities on stents are directly related with their deformation characteristics. One of the major drawbacks of the stent implantation is the in-stent restenosis which remains a major problem. It was reported that in-stent restenosis occurs in 20-35% of the patients for bare metal stents and 5-10% for drug eluting stents. Vascular wall injury caused by the contact stresses between the struts of a stent and the vein the during the balloon angioplasty is hypothesized as a possible cause of in-stent restenosis as well as the deep wall injury with rupture of the internal elastic lamina. The stress and deformation analysis in stents are important and an active research area. First, the major emphasis of the present study was on some mechanical testing of reletad to the stent according to the EN ISO 25539-2:2008 - Vascular stents. Second, the major emphasis of the present study was to investigate some mechanical analysis of stent with the help of Finite Element Analysis method. FEA has proven to be a powerful technique to study the mechanical behaviour of stents