A case of primary Hodgkin's lymphoma of the parotid gland. Case report and differentian diagnosis from Kuttner's Syndrom

Abstract We report a rare case of primary Hodgkin’s lymphoma (HL) of the submandibular gland, with initially diagnosis of Kuttner’s Syndrom. A 48 years old man was referred to our hospital foe evaluation of a submandibular mass. Although the initial Fine Needle Aspiration and subsequent cytology was highly suggestive for a cronic sialadenitis with lymphoid cells. After surgical gland removal we obtained a definitive diagnosis of Hodgkin’s lymphoma in submandibular gland a seat where the most common lymphoma tipe is B

A possible solution of the puzzling variation of the orbital period of MXB 1659-298

MXB 1659-298 is a transient neutron star Low-Mass X-ray binary system that shows eclipses with a periodicity of 7.1 hr. The source went to outburst in August 2015 after 14 years of quiescence. We investigate the orbital properties of this source with a baseline of 40 years obtained combining the eight eclipse arrival times present in literature with 51 eclipse arrival times collected during the last two outbursts. A quadratic ephemeris does not fit the delays associated with the eclipse arrival times and the addition of a sinusoidal term with a period of $2.31 \pm 0.02$ yr is required. We infer a binary orbital period of $P=7.1161099(3)$ hr and an orbital period derivative of $\dot{P}=-8.5(1.2) \times 10^{-12}$ s s$^{-1}$. We show that the large orbital period derivative can be explained with a highly non conservative mass transfer scenario in which more than 98\% of the mass provided by the companion star leaves the binary system. We predict an orbital period derivative value of $\dot{P}=-6(3) \times 10^{-12}$ s s$^{-1}$ and constrain the companion star mass between $\sim$0.3 and $0.9 \pm 0.3$ M$_{\odot}$. Assuming that the companion star is in thermal equilibrium the periodic modulation can be due to either a gravitational quadrupole coupling due to variations of the oblateness of the companion star or with the presence of a third body of mass M$_3 >21$ Jovian masses.Comment: 10 pages, 6 figures. Accepted by MNRA

The path curvature of the body centre of mass during walking as an index of balance control in patients with Multiple Sclerosis

BACKGROUND AND AIM: The path curvature of the centre of mass (CM), mechanically representative of the whole body system, may provide hints to detection of fall risk during walking. Here, an example is taken from results of an ongoing controlled study. It shows the comparison between the CM path in a healthy subject and in a fully autonomous patient with Multiple Sclerosis (MS). METHODS: A representative healthy subject (woman, 26 years, 1.55 m tall) and a MS patient (woman, 34 years, 1.65 m tall, with very mild left hemiparesis) are presented. Subjects walked on a force-sensorized treadmill (1) at 0.6 m/s. Data were averaged across 6 subsequent strides. The 3D displacements of the CM were computed via double integration of the ground reaction forces (Cavagna's Method). The path curvature of the CM during one stride was computed according to the Frenet-Serret formula (2). The instantaneous efficiency of the kinetic-potential, pendulum-like energy transfer of the CM was also computed (percent recovery, R: 100%=complete recovery, i.e. fully passive CM translation) (3). RESULTS: The left and right panels refer to the control and the MS subject, respectively. In the upper set of panels the human sketches on top of the figure help identifying the stride phases (% cycle) and give a frontal and a sagittal perspectives. The first and second rows of curves from the top give the instantaneous R and the path curvature of the CM during one stride. Each step begins with the single stance of the front leg (R=right; L=left). The horizontal bars under the curves mark the double and the single stance phases (continuous and dashed lines, respectively; grey tract=left step). The lower set of panels (closed curves) gives the planar projections of the CM path during the same stride. The space-time correspondence between the 2 sets of curves is facilitated by the shared A-D labeling of peak curvatures and the shared graphic conventions (dashed line=single stance; gray tract=left step). In both steps the curvature is peaking when R suddenly drops from 100 to 0, demonstrating that the passive pendulum-like mechanism of translation is briskly substituted by a short lasting, fully muscle-driven, propulsion. The highest peaks (A and C) are coincident with the lateral redirection during single stance. Of note, the patient's CM path is characterized by a 10-fold higher C peak (single stance, paretic-to-unaffected side redirection). This may be interpreted as a feature of "escape" limp, barely perceivable by clinical observation, when seen from the perspective of the body CM on the horizontal plane (bottom curves). CONCLUSIONS: Increased curvature peaks may reveal the attempt to shorten the stance on the affected side yet, placing at risk the lateral stability of the body. REFERENCES:[1] Tesio L, Rota V, Am J Phys Med Rehabil 2008;87:515-526 [2] Tesio L et al, J Biomech 2011;44:732-740 [3] Cavagna GA, J Appl Physiol 1975;39:174-179

Which is the most accurate diagnostic procedure in Tamoxifen treated breast cancer patients

Purpose: The aim of this study was to evaluate the diagnostic accuracy of bi-dimensional (2D) and three-dimensional (3D) transvaginal ultrasound (TVUS), hysterosonography (HSSG) and hysteroscopy in the detection of endometrial pathology in women treated with tamoxifen (TMX) for breast cancer. Methods: Forty-two patients, affected by breast cancer under treatment with TMX, underwent 2D-3D TVUS, HSSG and hysteroscopy completed by biopsy, after abnormal findings following a routine 2D TVUS examination. Results: 3D-TVUS was more accurate than 2D-TVUS in the detection of atrophic endometrium confirmed by biopsy and in the detection of endometrial polyps. HSSG and hysteroscopy detected atrophic endometrium and endometrial polyps significantly better than ultrasound scan. Endometrial carcinoma was detected in two cases, and in both HSSG and hysteroscopy were 100% diagnostic. Conclusion: In TMX treated breast cancer patients, HSSG and hysteroscopy provide more accurate diagnosis than 2D-3D ultrasound in the detection of treatment related endometrial lesions

Zygomatic implant penetration to the central portion of orbit: a case report

Background: Zygomatic implants have been proposed in literature for atrophic maxillary fixed oral rehabilitations. The aim of the present research was to evaluate, by a clinical and tomography assessment, a surgical complication of a zygomatic implant penetration to the orbit. Case presentation: A 56 year-old female patient was visited for pain and swelling in the left orbit after a zygomatic implant protocol. The orbit invasion of the zygomatic implant screw was confirmed by the CBCT scan. The patient was treated for surgical implant removal and the peri- and post-operative symptoms were assessed. No neurological complications were reported at the follow-up. The ocular motility and the visual acuity were well maintained. No purulent secretion or inflammatory evidence were reported in the post-operative healing phases. Conclusion: The penetration of the orbit during a zygomatic implant positioning is a surgical complication that could compromise the sight and movements of the eye. In the present case report, a zygomatic implant removal resulted in an uneventful healing phase with recovery of the eye functions

Aeroacoustics of sawtooth trailing-edge serrations under aerodynamic loading

The impact of aerodynamic loading on a serrated trailing edge is studied experimentally. Aerodynamic and acoustic measurements are conducted on a sawtooth-shaped trailing edge, retrofitted to a flat plate featuring a trailing-edge flap, and placed at incidence to the free-stream flow. The turbulent flow across the trailing edge is inspected by time-resolved three-dimensional velocity field measurements obtained from 4D-PIV, while the wall-pressure fluctuations are measured with surface-embedded microphones. Results discuss the relation between the velocity fluctuations over the serrations, the surface pressure fluctuations, and the far-field noise spectra. The aerodynamic analysis discusses the effect of counter-rotating vortex pairs, generated by the pressure imbalance across the edges of the serrations under loading. It is shown that the interaction of these vortices with the incoming turbulence affects the intensity of the wall-pressure spectrum at the outer rim of the serration surface. On the suction side, the intensity of the pressure fluctuations from the incoming boundary layer dominates over that induced by the vortex pairs. On the pressure side, instead, the velocity gradient prescribed by the vortex pairs produces a significant increase of the pressure fluctuations around the edges. The resulting spatial distribution of the wall-pressure fluctuations directly affects the far-field noise. Scattering predictions carried out with the wall-pressure fluctuations in the centre and root (on the suction side) exhibit good agreement with the measured noise in the low-frequency range, whereas using the surface pressure data at the tip of the serration (on the pressure side) yields a better prediction in the high-frequency range

Observational Study on the Preparation of the Implant Site with Piezosurgery vs. Drill: Comparison between the Two Methods in terms of Postoperative Pain, Surgical Times, and Operational Advantages

Purpose. Recent advances show that ultrasonic implant site osteotomy is related to a decreased trauma and a better postoperative healing of the surgical site when compared to traditional drilling techniques. The micrometric bone cutting control and the operative advantages related to the piezoelectric approach are also characterized by a learning curve for the clinician in surgical practice and an increased operative duration of the procedure. The aim of this investigation is to compare the operative time, the postoperative pain, and the amount of painkillers taken by the patient during the healing period. Methods. A total of 65 patients were treated at the Unit of Oral Surgery (Department of Medical Sciences, Surgery and Health, University of Trieste, Italy) using a split mouth model: 75 drill-inserted implants (G1) and 75 piezoelectric device-inserted implants (G2) were placed. The Visual Analogue Scale (VAS) was performed to evaluate the postoperative pain at 15 days from surgery. The operative time and frequency of intake of painkillers were measured. Results. The G1 and G2 groups showed a significant difference with a higher use of painkillers observed for G1. The G2 patients showed a lower level of pain (VAS) at all experimental times between 8 hours to 7 days (p<0.01) postsurgery. At 15 days, the pain levels were similar for both groups. No differences were found in site preparation duration between the study groups. Conclusions. The evidence supports the application of the piezoelectric approach compared to the drill's osteotomy as a useful technique for implant site preparation. This trial is registered with NCT03978923

Signature of the presence of a third body orbiting around XB 1916-053

The ultra-compact dipping source \object{XB 1916-053} has an orbital period of close to 50 min and a companion star with a very low mass (less than 0.1 M$_{\odot}$). The orbital period derivative of the source was estimated to be $1.5(3) \times 10^{-11}$ s/s through analysing the delays associated with the dip arrival times obtained from observations spanning 25 years, from 1978 to 2002. The known orbital period derivative is extremely large and can be explained by invoking an extreme, non-conservative mass transfer rate that is not easily justifiable. We extended the analysed data from 1978 to 2014, by spanning 37 years, to verify whether a larger sample of data can be fitted with a quadratic term or a different scenario has to be considered. We obtained 27 delays associated with the dip arrival times from data covering 37 years and used different models to fit the time delays with respect to a constant period model.We find that the quadratic form alone does not fit the data. The data are well fitted using a sinusoidal term plus a quadratic function or, alternatively, with a series of sinusoidal terms that can be associated with a modulation of the dip arrival times due to the presence of a third body that has an elliptical orbit. We infer that for a conservative mass transfer scenario the modulation of the delays can be explained by invoking the presence of a third body with mass between 0.10-0.14 M$_{\odot}$, orbital period around the X-ray binary system of close to 51 yr and an eccentricity of $0.28 \pm 0.15$. In a non-conservative mass transfer scenario we estimate that the fraction of matter yielded by the degenerate companion star and accreted onto the neutron star is $\beta = 0.08$, the neutron star mass is $\ge 2.2$ M$_{\odot}$, and the companion star mass is 0.028 M$_{\odot}$. (Abridged)Comment: 13 pages, 9 figures. Accepted for publication in A&