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To retrospectively determine the incidence of intraosseous mandibular lesions among patients who attended the University dental clinic in Tanzania A retrospective study of histological results of the intraosseous mandibular lesions diagnosed between 2016 and 2021. The information gathered included the age and sex of the patient, and histological diagnosis. Data analysis was done using Statistical Package for the Social Sciences version 26 computer program. Out of 1824 reports of patients with oral and maxillofacial lesions retrieved, 475 (26 %) involved the intraosseous part of the mandible. Benign tumors comprised 68.2 % and malignant tumors 14.1 %. Ameloblastoma accounted for 54.3 % of the benign tumors, osteosarcoma comprised 37.3 % of the malignant tumors, and dentigerous cysts made up 70.4 % of mandibular cysts. Intraosseous mandibular lesions are common among patients who were biopsied at the university dental clinic. Although there is no sex predilection, young adults are more affected than other age groups. The majority of the lesions are benign and malignant tumors. [ABSTRACT FROM AUTHOR]

• In newly discovered focal liver lesions the main clinical problem is to determine their character as benign of malignant. • Quantitative measurements of liver lesions may add objectivity to the conventional visual assessment. • Quantitative measurements of liver lesions are a reliable tool for differentiating benign from malignant lesions, however caution must be taken in the case of hepatic adenomas, as their signal intensities fall closer to those of malignant lesions. • There are significant differences in the ROI values among different types of FLLs. For benign lesions, the ROI values in the T2-w, ADC, and in the T1-w postcontrast sequence were found significantly higher compared to their counterparts in malignant lesions. The study aims at assessing the quantitative features which distinguish focal liver lesions (FLLs) in gadoxetic acid (GA) enhanced liver MRI and at determining whether these features can accurately differentiate benign from malignant lesions. 107 patients with 180 unequivocal FLLs in previous examinations were included in a single-center retrospective study. All patients underwent a MRI test of the liver with GA. 99 benign and 74 malignant lesions were included. The group of benign lesions consisted of 60 focal nodular hyperplasias (FNH), 22 hemangiomas (HMG), 6 hepatic adenomas (HA), and 11 other benign lesions (1 angiomyolipioma, 6 lesions histopathology diagnoses as benign without further specification, or ones lacking features of malignancy, and 4 lesions radiologically diagnosed as benign which remained stable in the follow-up studies). The group of malignant lesions consisted of primary 51 hepatocellular carcinomas, 12 metastases, and 11 metastases from melanoma malignum (MM meta). 7 FLLs were excluded (4 cases of uncertain histopathological diagnosis, 2 cholangiocarcinomas, and 1 regenerative nodule). For the included lesions ROI (region of interest) measurements were taken by two observers in the T2-w, ADC (apparent diffusion coefficient) and in the T1-w sequence in the hepatobiliary phase (HBP). The interobserver agreement was evaluated with the Wilcoxon test. The Kruskal – Wallis, Mann – Whitney U and post hoc Dunn's tests were applied to assess if there were any significant differences in the ROI values between individual lesions. The variables with the p values of < 0.05 were considered statistically significant. We found significant differences in the ROI values between lesions with p < 0.0001. Strikingly high ROI values in the T2-w sequence were found for HMG. The lowest ADC values were encountered for metastases and MM metastases. The highest ROI values in the HBP were found for FNH, and the lowest for metastases. We also found statistically significant differences in the ROI values between benign and malignant lesions with benign lesions presenting statistically higher ROI values compared to malignant lesions. There were significant differences in the ROI values among different types of FLLs. The predominant quantitative feature in the T2-w sequence was a strikingly high ROI value for HMG. Benign lesions presented statistically higher ROI values in the T2-w, ADC, and HBP sequences compared to malignant lesions. This was true for all lesions except for HA. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine measures of phonation quotient (PQ) in two groups of persons with voice disorders using three different aerodynamic instruments representing low-tech and high-tech options. Prospective, repeated measures design. Two groups of patients with a diagnosis of vocal fold paralysis/paresis (n = 9) or benign vocal fold lesions (n = 8) were assessed for maximum phonation time and vital capacity obtained from three aerodynamic instruments: a hand-held analog windmill-type spirometer; a hand-held digital spirometer; and the Phonatory Aerodynamic System (PAS), Model 6600. PQ was calculated using vital capacity from each instrument along with maximum phonation time. Univariate ANOVAs were performed to test for the main effects of disorder and instrument on derived PQ. Paired samples t tests were performed post hoc to investigate any significant main effects. Pearson product-moment correlation was performed to assess measurement reliability (parallel forms) between the instruments. Statistically significant differences were found for measures of PQ as a function of disorder but not instrument type. There was not a significant interaction effect between disorder and instrument type. Strong positive correlations were present between all three instruments for measures of PQ. PQ was sensitive to differences in airflow as a function of disorder etiology (paralysis/paresis vs benign lesions). This clinical measure of laryngeal function can be used as a low-cost substitute in the absence of a pneumotachograph. These results are consistent with previous literature reporting data from adult male and female speakers with normal voice quality, and support the use of low-tech options for measurement of basic aerodynamic variables associated with voice production. [ABSTRACT FROM AUTHOR]

Highlights • An effective and automated system for melanoma diagnosis. • Chroma based deformable models for localizing the skin lesions. • The system takes into account the global and dermoscopic features for differentiating the pigmented skin lesions. • Methodological classification between benign and malignant pigmented skin lesions using dynamic ensemble of classifiers. Abstract A clinically oriented Computer-Aided Diagnostic (CAD) system is of prime importance for the diagnosis of melanoma, since the deadly disease is associated with high morbidity and mortality. Unfortunately, the development of CAD tools is hampered by several issues, such as (i) smooth boundaries between the lesion and the surrounding skin, (ii) subtlety of features between the melanoma and non-melanoma skin lesions, and (iii) lack of reproducibility of CAD systems due to complexity. The proposed system aims to address the aforementioned issues. First, the lesion regions are localized by incorporating chroma based deformable models. Second, the lesion patterns are analyzed to detect various dermoscopic criteria. Further, a robust ensemble architecture is developed using dynamic classifier selection techniques to detect malignancy. Quantitative analysis is performed on two diverse datasets (ISBI and PH2) achieving an accuracy of 88% and 97%, sensitivity of 95% and 97% and specificity of 82% and 100% for ISBI and PH2 datasets respectively. [ABSTRACT FROM AUTHOR]

Highlights • Shedding light on the aggressive nature and rare incidence of Melanotic Neuroectodermal Tumour of Infancy (MNTI). • Detailing different clinical and radiographic features of MNTI. • Outlining the management of MNTI and postoperative follow-up regimen. • Emphasising the importance of early diagnosis and surgical intervention in Melanotic Neuroectodermal Tumour of Infancy. Abstract Introduction Melanotic neuroectodermal tumour of infancy (MNTI) is a benign tumour of infancy, most commonly affecting the head and neck region. First described in 1918, less than 500 cases have been reported in the literature. MNTI is aggressive in nature & has a high rate of recurrence. Presentation of cases In this retrospective case series, we report two cases of MNTI that presented at our unit; both cases were managed by wide excision and have been followed up uneventfully for over two years. Discussion MNTI has a recurrence rate of up to 20%. Patient's age can play a significant role in recurrence rate. Although this neural crest tumour is somewhat rare in the literature, there is a consensus with regards to surgical management; the gold standard remains to be wide excision with safety margin. Select cases may benefit from adjuvant and neoadjuvant therapy. Conclusion Owing to its locally aggressive nature and high recurrence rate, prompt diagnosis and surgical intervention is advised in cases of MNTI. Further understanding of this tumour is needed on a microscopic level in order to determine clear prognostic factors. [ABSTRACT FROM AUTHOR]

The diagnostic role of salivary gland fine-needle aspiration (SG-FNA) is well established in the preoperative evaluation of patients with salivary gland lesions. At present, most salivary SG-FNA specimens are diagnosed based on conventional diagnostic criteria. Nevertheless, there exists a lack of uniform reporting for these specimens to guide the clinical management of patients. This void motivated a group of experienced cytopathologists to spearhead the development of a uniform reporting system. This international panel, under the sponsorship of the American Society of Cytopathology (ASC) and the International Academy of Cytology (IAC), gathered in September 2015 at the European Congress of Cytology, held in Milan, Italy, to propose “The Milan System for Reporting Salivary Gland Cytopathology. This effort sparked the interest of many and brought forth an agreement to develop an evidence-based tiered classification consisting of 6 diagnostic categories. We hope that this standard reporting system will enhance the overall effectiveness of SG-FNA reporting across institutions, with the ultimate result being better communication and improved patient care. [ABSTRACT FROM AUTHOR]

Summary A customized mechanical tester that slices thin, soft samples was used to measure the fracture toughness of vocal fold tissue. Porcine vocal fold lamina propria was subjected to quasi-static, guillotine-like tests at three equally distanced regions along the anterior-posterior direction. The central one-third where high-velocity collisions between vocal folds occur was found to have the maximum fracture toughness. In contrast, the anterior one-third featured a lower toughness. Fracture toughness can be indicative of the risk of benign and malignant lesions in vocal fold tissue. [ABSTRACT FROM AUTHOR]

Summary Objectives Vocal fold tissue is biphasic and consists of a solid extracellular matrix skeleton swelled with interstitial fluid. Interactions between the liquid and solid impact the material properties and stress response of the tissue. The objective of this study was to model the movement of liquid during vocal fold vibration and to estimate the volume of liquid accumulation and stress experienced by the tissue near the anterior-posterior midline, where benign lesions are observed to form. Methods A three-dimensional biphasic finite element model of a single vocal fold was built to solve for the liquid velocity, pore pressure, and von Mises stress during and just after vibration using the commercial finite element software COMSOL Multiphysics (Version 4.3a, 2013, Structural Mechanics and Subsurface Flow Modules). Vibration was induced by applying direct load pressures to the subglottal and intraglottal surfaces. Pressure ranges, frequency, and material parameters were chosen based on those reported in the literature. Postprocessing included liquid velocity, pore pressure, and von Mises stress calculations as well as the frequency-stress and amplitude-stress relationships. Results Resulting time-averaged velocity vectors during vibration indicated liquid movement toward the midline of the fold, as well as upward movement in the inferior-superior direction. Pore pressure and von Misses stresses were higher in this region just after vibration. A linear relationship was found between the amplitude and pore pressure, whereas a nonlinear relationship was found between the frequency and pore pressure. Conclusions Although this study had certain computational simplifications, it is the first biphasic finite element model to use a realistic geometry and demonstrate the ability to characterize liquid movement due to vibration. Results indicate that there is a significant amount of liquid that accumulates at the midline; however, the role of this accumulation still requires investigation. Further investigation of these mechanical factors may lend insight into the mechanism of benign lesion formation. [ABSTRACT FROM AUTHOR]

Abstract: Aim: This article reviews the literature on the clinical features, diagnosis and management of primary intrapulmonary thymoma. Methods: Medline, Embase and Cochrane Library searches were performed on all relevant Anglo-Saxon language articles. The search words included “primary pulmonary thymoma” and “intrapulmonary thymoma”. Secondary references were obtained from key articles. Prognostic and treatment strategies were analyzed by the Kaplan–Meier method, comparisons between curves were made using log rank test. Results: The searches yielded 25 cases of primary intrapulmonary thymoma. Median follow-up was 9 months (1 day to 13 years). At follow-up, 14 patients were tumor free, one patient had a local recurrence 8 years after radiotherapy, one patient responded favorably to radiotherapy, six patients died and three patients were lost to follow-up. The presence of a paraneoplastic syndrome decreased survival (P =0.02), however, histological subgroup (P =0.216), clinical stage (P =0.63) and tumor size (P =0.288) did not affect survival. Survival in surgically managed patients was significantly better than in conservatively managed patients (P =0.039). Adjuvant radiotherapy did not provide any benefit (P =0.4). Conclusion: Complete resection of primary intrapulmonary thymomas appears sufficient in non-malignant tumors. Because of the risk of late local recurrence, long-term regular clinical follow-up is warranted. [Copyright &y& Elsevier]

Abstract: Objective. – Analysis of the consequence of the preoperative information delivered orally to patients requiring surgery for benign pathology of the thyroid gland from various perspective (head and neck surgeon, physician, judge, lawyer). Methods. – Prospective study conducted in an academic tertiary care referral center. Inception cohort of 123 patients with benign pathology of the thyroid gland consecutively informed orally and by the same surgeon during the years 2003–2004. Analysis of the consequences of the preoperative information, degree of memorization regarding the surgical related risks as well as the patient''s opinion regarding this information. Results. – Due to the information regarding the risks related to surgery 14.6% of patients refused to undergo surgery. None of the patients remembered more than 4 out of the 6 main surgical risks. 68.8% of patients remembered only one or two surgical related risks. 12.2% of patients did not remember a single surgical related risk, 85.5% of patients remembered the risk of a unilateral laryngeal nerve paralysis, 41.1% the risk of death related to the completion of a general anesthesia and 21.1% the risk of a bilateral laryngeal nerve paralysis. Less than 11% of patients remembered the other risks (general risks related to any open field surgical approach, hypocalcemia and loss of breast feeding) Among the patients who had an opinion postoperatively, 87.6% had a positive opinion and 41.9% a negative opinion regarding the preoperative information related to the surgical related risks. Also, 28.4% of patients expressed simultaneously a positive and a negative opinion. Conclusion. – Oral information of the patient regarding the surgical risks resulted in an important stress for the patient and modified the relation patient-surgeon. Due to the information, a non-neglectable group of patients elicited not to follow the advice of the surgeon. Various measures are discussed since the information on the surgical related risks is a must from a legal point of view but is also highly appreciated and requested by most of the patients. [Copyright &y& Elsevier]