56 research outputs found

    Sphenoid Sinus Cholesteatoma—Complications and Skull Base Osteomyelitis: Case Report and Review of Literature

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    Introduction: Cholesteatoma of the paranasal sinuses is uncommon. Its clinical characteristics are an expanding growth of the affected paranasal sinuses consisting of keratinizing squamous epithelium with bony wall destruction. Among involved paranasal sinuses, sphenoid sinus cholesteatoma is the least common. Case presentation: An 82-year-old female diabetic patient presented with subacute onset of fever after experiencing chronic progressive headaches for more than 20 years. Nasal endoscopy found purulent discharge from left sphenoethmoidal recess. Computed tomography (CT) scan of the paranasal sinus showed soft tissue lesions that totally filled the left sphenoid sinus with posterior and inferior wall destruction. There was no evidence of connection to the left mastoid cavity. Management and outcome: Left sphenoidotomy was performed. Histopathology revealed cholesteatoma. Two months after surgery, she became worse and CT showed extensive skull base destruction. The patient underwent bilateral sphenoidectomy and craniotomy with surgical debridement of osteomyelitis of the skull base. She received long-term intravenous ertapenam and sitafloxacin for treating drug-resistant Klebsiella infection. The osteomyelitis could not be controlled, and she died. Discussion: Progressive headache can be caused by an uncommon disease such as sphenoid sinus cholesteatoma, which is a surgical condition. Complicating osteomyelitis of the skull base requires extensive debridement surgery and should be anticipated

    VE1 Immunohistochemistry Improves the Limit of Genotyping for Detecting BRAFV600E Mutation in Papillary Thyroid Cancer

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    Detection of BRAFV600E is useful for making diagnosis and risk stratification of papillary thyroid carcinoma (PTC). Molecular testing, however, is not always available for routine clinical use. To assess the clinical utility and reliability of VE1 immunohistochemistry (IHC) for detecting BRAFV600E mutation in PTC, VE1 IHC was performed on the tissue microarrays of 514 patients with PTC and was compared with Sanger sequencing results. Of 514 PTC cases, 433 (84.2%) were positive for VE1 expression. Among 6 discordant cases between VE1 IHC and Sanger sequencing, 3 initial VE1-false negative cases turned out to be true false negative on repeat testing, and 3 VE1-false positive cases showed BRAFV600E mutation using digital PCR analysis. PTCs with low variant allele fraction were positive for VE1 IHC but were not detected using sequencing. VE1 IHC showed 99.3% sensitivity, 100% specificity, 100% positive predictive value, and 96.4% negative predictive value. The BRAFV600E mutation was significantly associated with older age, multifocality, extrathyroidal extension, lymph node metastasis, and advanced tumor stage. In conclusion, VE1 IHC is a reliable method for detecting BRAFV600E mutation in PTC specimens

    Subject-Independent Emotion Recognition During Music Listening Based on EEG Using Deep Convolutional Neural Networks

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    Emotion recognition during music listening using electroencephalogram (EEG) has gained more attention from researchers, recently. Many studies focused on accuracy on one subject while subject-independent performance evaluation was still unclear. In this paper, the objective is to create an emotion recognition model that can be applied to multiple subjects. By adopting convolutional neural networks (CNNs), advantage could be gained from utilizing information from electrodes and time steps. Using CNNs also does not need feature extraction which might leave out other related but unobserved features. CNNs with three to seven convolutional layers were deployed in this research. We measured their performance with a binary classification task for compositions of emotions including arousal and valence. The results showed that our method captured EEG signal patterns from numerous subjects by 10-fold cross validation with 81.54% and 86.87% accuracy from arousal and valence respectively. The method also showed a higher capability of generalization to unseen subjects than the previous method as can be observed from the results of leave-one-subject-out validation

    Epstein–Barr virus-associated iris smooth muscle tumor with epithelioid morphology in AIDS patients: a case report

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    Yanin Suwan,1 Duangnate Rojanaporn,1 Chaiwat Teekhasaenee,1 Somboon Keelawat2 1Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 2Department of Pathology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand Importance: Report of an acquired immunodeficiency syndrome (AIDS) patient with Epstein–Barr virus (EBV)-associated iris smooth muscle tumor. Observations: A 14-year-old African American female diagnosed with AIDS developed a painless iris mass in the right eye for 10 months. Iridocyclectomy was performed, and the pathology indicated EBV-associated iris smooth muscle tumor with epithelioid morphology. Immunohistochemical stains and in situ hybridization for EBV-encoded ribonucleic acid are very useful diagnostic tools for definite diagnosis. At 14-month follow-up, the patient did not have any tumor recurrence. Conclusion: This is the case report of EBV-associated iris smooth muscle tumor in a person diagnosed with AIDS with a unique epithelioid morphologic feature. Keywords: human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), iris tumor, Epstein–Barr virus, smooth muscle tumor, leiomyosarcoma&nbsp

    A Comparative Study of Window Size and Channel Arrangement on EEG-Emotion Recognition Using Deep CNN

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    Emotion recognition based on electroencephalograms has become an active research area. Yet, identifying emotions using only brainwaves is still very challenging, especially the subject-independent task. Numerous studies have tried to propose methods to recognize emotions, including machine learning techniques like convolutional neural network (CNN). Since CNN has shown its potential in generalization to unseen subjects, manipulating CNN hyperparameters like the window size and electrode order might be beneficial. To our knowledge, this is the first work that extensively observed the parameter selection effect on the CNN. The temporal information in distinct window sizes was found to significantly affect the recognition performance, and CNN was found to be more responsive to changing window sizes than the support vector machine. Classifying the arousal achieved the best performance with a window size of ten seconds, obtaining 56.85% accuracy and a Matthews correlation coefficient (MCC) of 0.1369. Valence recognition had the best performance with a window length of eight seconds at 73.34% accuracy and an MCC value of 0.4669. Spatial information from varying the electrode orders had a small effect on the classification. Overall, valence results had a much more superior performance than arousal results, which were, perhaps, influenced by features related to brain activity asymmetry between the left and right hemispheres

    Current Status of Thyroid Fine-Needle Aspiration Practice in Thailand

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    Thyroid carcinoma is one of the leading malignancies in Thailand increasingly prevalent in the female population. Fine-needle aspiration (FNA) cytology is a widely used diagnostic tool for evaluation of thyroid nodules and thyroid cancer. Thyroid FNA is a routine procedure universally performed in Thai hospitals by a variety of clinical specialists. Manual guidance is the first-line choice complemented by ultrasound assistance in selected cases. Despite national guidelines recommendations, the diagnostic criteria and terminology of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was slowly adopted in the local settings. Currently, the Bethesda system is actively promoted by the local professional societies as a uniform reporting system. Experience with thyroid FNA has been rarely reported to date—only a handful of publications are available in local journals. Our review, in addition to presenting various aspects of thyroid FNA in Thailand, established for the first time national references for a certain statistical outputs of TBSRTC based on the original multi-institutional cohort. The risk of malignancy in 2,017 operated thyroid nodules collected from three tertiary thyroid cancer centers was 21.7%, 14.7%, 35.9%, 44.4%, 76.7%, and 92.6% for categories I to VI, respectively. The malignancy risk in several diagnostic categories (II to IV) was higher than the risk estimated by TBSRTC and recent meta-analysis studies. We endorse the use of uniform terminology of the Bethesda system in Thailand, which will help facilitate communication among diverse medical professionals involved in the management of patients with thyroid nodules, to share local experience with the international audience

    Human papillomavirus-related multiphenotypic sinonasal carcinoma: First case report associated with an intermediate-risk HPV type and literatures review

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    HPV-related Multiphenotypic sinonasal carcinoma (previously known as HPV-related carcinoma with adenoid cystic carcinoma-like features) is very rare tumor of which only 55 cases are reported. All cases to date are related to high-risk types of HPV including 16, 31, 33, 35 and 56. We report of a case of a nasal mass in a 50-year-old female. Biopsy demonstrated typical features of an HPV-related multiphenotypic sinonasal carcinoma, with both basaloid and ductal type cells. Tumor cells were arranged in lobulated sheets, with focal cribriform and microcystic growth patterns. The majority of tumor cells expressed myoepithelial markers (S-100 protein, smooth muscle actin and p63) and the ductal cells were immunopositive for CD117. Polymerase chain reaction and sequencing identified HPV type 26. HPV 26 becomes the first intermediate risk type that may be associated with HPV-related multiphenotypic sinonasal carcinoma. Keywords: HPV, Type 26, Sinonasal carcinoma, Multiphenotypi
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