538 research outputs found
Melanosis of the lower lip subverted by filler injection: a simulator of early mucosal melanoma
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Gold Mine Wooden Artefacts: Multianalytical Investigations for the Selection of Appropriate Consolidation Treatments
Environmental conditions present in mines generally are very favourable to decay; high temperature, high humidity, variable oxygen content, numerous metal-wood connections and the presence of a high content of inorganic compounds typical of mines have a significant impact on the biotic and abiotic degradation factors. The state of conservation of wooden artefacts from the Zloty Stok (Poland) gold mine was investigated using a multi-analytical approach. The aim was to select the conservation treatments that would stop decay and improve the conditions and dimensional stability of the wood. FT-IR and Py-GC/MS were used to assess the state of preservation of lignocellulosic material. ED-XRF and SEM-EDS were used to determine-and XRD to identify crystalline phases-salts and minerals in the wood structure or efflorescence on the surface. Highly degraded lignocellulosic material that had undergone depolymerisation and oxidation was found to be severely contaminated by iron-based mineral substances, mainly pyrite, and in some cases greigite and magnetite. The presence of inorganic salts made it difficult to choose the best consolidating material to reduce the level of decay and improve the dimensional stability of the wood
A prospective study on contrast-enhanced magnetic resonance imaging of testicular lesions: distinctive features of Leydig cell tumours
OBJECTIVES:
Up to 20 % of incidentally found testicular lesions are benign Leydig cell tumours (LCTs). This study evaluates the role of contrast-enhanced magnetic resonance imaging (MRI) in the identification of LCTs in a large prospective cohort study.
MATERIALS AND METHODS:
We enrolled 44 consecutive patients with at least one solid non-palpable testicular lesion who underwent scrotal MRI. Margins of the lesions, signal intensity and pattern of wash-in and wash-out were analysed by two radiologists. The frequency distribution of malignant and benign MRI features in the different groups was compared by using the chi-squared or Fisher's exact test. Sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy were calculated.
RESULTS:
The sensitivity of scrotal MRI to diagnose LCTs was 89.47 % with 95.65 % specificity; sensitivity for malignant lesions was 95.65 % with 80.95 % specificity. A markedly hypointense signal on T2-WI, rapid and marked wash-in followed by a prolonged washout were distinctive features significantly associated with LCTs. Malignant lesions were significantly associated with blurred margins, weak hypointense signal on T2-WI ,and weak and progressive wash-in. The overall diagnostic accuracy was 93 %.
CONCLUSIONS:
LCTs have distinctive contrast-enhanced MRI features that allow the differential diagnosis of incidental testicular lesions.
KEY POINTS:
• MRI is able to characterize testicular lesions suggesting a specific diagnosis. • Rapid and marked wash-in is a common feature of Leydig cell tumours. • Markedly hypointense T2-WI signal is significantly correlated with benign lesions. • Blurred margins and weak hypointense T2-WI signal are correlated with malignant tumours. • Weak and progressive wash-in features are present in 85 % of seminomatous lesions
Role of contrast-enhanced ultrasound (CEUS) in paediatric practice: an EFSUMB position statement
The use of contrast-enhanced ultrasound (CEUS) in adults is well established in many different areas, with a number of current applications deemed off-label, but the use supported by clinical experience and evidence. Paediatric CEUS is also an off-label application until recently with approval specifically for assessment of focal liver lesions. Nevertheless there is mounting evidence of the usefulness of CEUS in children in many areas, primarily as an imaging technique that reduces exposure to radiation, iodinated contrast medium and the patient-friendly circumstances of ultrasonography. This position statement of the European Federation of Societies in Ultrasound and Medicine (EFSUMB) assesses the current status of CEUS applications in children and makes suggestions for further development of this technique
Road Infrastructure Safety Management. Proactive Safety Tools to Evaluate Potential Conditions of Risk
The identification of highly critical sections in a road network is possible by examining the network operation, with the goal of determining the risk factors and observe the critical issues, in order to better plan possible improvements. Therefore, this study proposes a method to evaluate the coherence of existing road layouts, through the analysis of the geometric characteristics, theoretical speeds and drivers operating speeds, under different environmental and flow conditions. The analysis focuses on the road network managed by ANAS SpA in the Veneto Region, for which the reconstruction of the road axes geometry, the curvature graph and the theoretical design speed profile have been obtained, according to the indications of the Italian Ministerial Decree 05/11/2001. The theoretical design speed profile has then been compared with the information relating to the road users' mobility, in terms of the 85th percentile speeds, obtained from the extraction and analysis of the Floating Car Data (FCD). The data were processed by reconstructing the continuous profile of operating speeds with a specific regression function known as "smoothing cubic spline". The comparison with the theoretical design speeds allows to observe whether the users assume a behavior close to or distant from what is expected, based on the technical and geometrical characteristics of the road layout. The proposed methodology can contribute to the implementation of a proactive road safety check, aimed at recognizing and assessing the potential risk conditions for road traffic, with particular attention to the point of view of the road user
Natural History and Management of Familial Paraganglioma Syndrome Type 1: Long-Term Data from a Large Family
Head and neck paragangliomas are the most common clinical features of familial paraganglioma syndrome type 1 caused by succinate dehydrogenase complex subunit D (SDHD) mutation. The clinical management of this syndrome is still unclear. In this study we propose a diagnostic algorithm for SDHD mutation carriers based on our family case series and literature review. After genetic diagnosis, first evaluation should include biochemical examination and whole-body imaging. In case of lesion detection, nuclear medicine examination is required for staging and tumor characterization. The study summarizes the diagnostic accuracy of different functional imaging techniques in SDHD mutation carriers. 18F-3,4-dihydroxyphenylalanine (18F-DOPA) positron emission tomography (PET)-computed tomography (CT) is considered the gold standard. If it is not available, 123I-Metaiodobenzylguanidine (MIBG) could be used also for predicting response to radiometabolic therapy. 18F-fluoro-2-deoxy-D-glucose (18F-FDG) PET-CT has a prognostic role since high uptake identifies more aggressive cases. Finally, 68Ga-peptides PET-CT is a promising diagnostic technique, demonstrating the best diagnostic accuracy in our and in other published case series, even if this finding still needs to be confirmed in larger studies. Periodic follow-up should consist of annual biochemical and ultrasonographic screening and biannual magnetic resonance examination to identify biochemical silent tumors early
Clinical presentation, management and follow-up of 83 patients with Leydig cell tumors of the testis: a prospective case-cohort study
LCTs are more frequent than generally believed, are associated with male infertility, cryptorchidism and gynecomastia, and should be treated conservatively (in compliant patients) with active surveillance, which appears to be a safe alternative to surgical enucleation. WHAT IS KNOWN ALREADY Increasing referrals for testicular imaging have led to an increase in findings of LCTs. The features and natural history of these tumors remain largely unknown, as the available studies are small and heterogeneous. LCTs were previously treated aggressively and follow-up data are lacking. STUDY DESIGN, SIZE, DURATION A case-cohort study of consecutive patients diagnosed with LCTs over a 10-year period was prospectively enrolled from 2009 to 2018 and compared to matched cohorts of patients with seminomas or no testicular lesions screened in the same timeframe. PARTICIPANTS/MATERIALS, SETTING, METHODS Of the 9949 inpatients and outpatients referred for scrotal ultrasound, a total of 83 men with LCTs were included. Enrolled subjects underwent medical history and clinical examination and were asked to undergo routine blood tests, hormone investigations (FSH, LH, total testosterone, estradiol, inhibin B, sex hormone-binding globulin (SHBG), prolactin), and semen analysis. Patients who consented also underwent contrast-enhanced ultrasound, elastography, gadolinium-enhanced scrotal magnetic resonance imaging, and hCG stimulation test (5000 IU i.m.) with serum total testosterone and estradiol measured at 0, 24, 48, and 72 hours. MAIN RESULTS AND THE ROLE OF CHANCE In total, 83 patients diagnosed with LCTs were compared against 90 patients diagnosed with seminoma and 2683 patients without testicular lesions (NoL). LCTs were diagnosed by enucleation (48.2%), orchiectomy (13.3%), or clinical surveillance (38.5%). Testicular volume, sperm concentration, and morphology were lower (P = 0.001, P = 0.001, and P < 0.001, respectively) in patients with LCTs than in the NoL group. FSH, LH, and SHBG were higher and the testosterone/LH ratio was lower in LCTs than in the NoL group (P < 0.001). The LCT group showed higher SHBG (P = 0.018), lower sperm concentration (P = 0.029), and lower motility (P = 0.049) than the seminoma group. Risk factors for LCTs were cryptorchidism (χ2 = 28.27, P < 0.001), gynecomastia (χ2 = 54.22, P < 0.001), and low testicular volume (χ2 = 11.13, P = 0.001). Five cases were recurrences or bilateral lesions; none developed metastases during follow-up (median, 66 months). LIMITATIONS, REASONS FOR CAUTION This study has some limitations. First, hCG and second-line diagnostic investigations were not available for all tumor patients. Second, ours is a referral center for infertility, thus a selection bias may have altered the baseline features of the LCT population. However, given that the comparison cohorts were also from the same center and had been managed with a similar protocol, we do not expect a significant effect. WIDER IMPLICATIONS OF THE FINDINGS LCTs are strongly associated with male infertility, cryptorchidism, and gynecomastia, supporting the hypothesis that testicular dysgenesis syndrome plays a role in their development. Patients with LCTs are at a greater risk of endocrine and spermatogenesis abnormalities even when the tumor is resected, and thus require long-term follow-up and prompt efforts to preserve fertility after diagnosis. LCTs have a good oncological prognosis when recognized early, as tissue-sparing enucleation is curative and should replace orchiectomy. Conservative surgery and, in compliant patients, active surveillance through clinical and radiological follow-up are safe options, but require monitoring of testicular failure and recurrence
Materials study to implement a 3D printer system to repair road pavement potholes
InfraRob is a research project funded by the European Commission's research programme Horizon 2020 that aims to maintain integrity, performance, and safety of the road infrastructure through autonomous robotized solutions and modularization. A specific task of the project is focused on the development of a system 3D printer able to extrude a specific mixture for filling in small cracks and potholes, to be integrated with an existing small autonomous carrier. The first step of the research deals with the definition of the optimal parameters of the system 3D printer/mixture, by studying in parallel the material design and the printer design. This paper presents the study performed on a mixture chosen among those commonly used for road potholes repair. The mixture is studied to achieve and balance the different conflicting performances: consistence, flowability homogeneity, and internal structure. In addition to the basic components, the use of special additives has also been explored to improve the plasticity and adhesivity of the mixture. The first phase of tests is conducted to define the main printing controls: i) Extrudability control: materials for 3D printing need to have an acceptable degree of extrudability, which is related to the capacity of a material to pass continuously through the printing head; ii) Flowability control, to ensure the mixture can be easy-pumpable in the delivery system and easy-usable on the crack or the pothole to be filed-in; iii) Setting time control: printing material requires a certain setting time to maintain a consistent flow rate for good extrudability, thus appropriate additives are needed to control the setting time. The second phase includes in situ tests to verify the compaction of the mixture under the traffic loads. The paper presents the results of the lab and in situ tests, and the features of the chosen mix, suitable to be managed by the 3D printer
Interventional Techniques for Head and Neck Cancer Pain
One of the most feared consequences of cancer is the possibility of severe and uncontrolled pain in patients with advanced cancer. Patients with head and neck cancer (HNC) have the highest prevalence of pain among patients with cancer,and it is often one of the major reasons for seeking care. A subspecialty approach that incorporates anatomical and technical knowledge to alleviate pain through minimally invasive procedures is relatively recent. The purpose of this chapter is to present different interventional techniques which are used for the treatment of pain in HNC patients when drug treatment is unsuccessful
Calcium carbonate crystallizations on hypogean mural paintings: a pilot study of monitoring and diagnostics in Roman catacombs
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