Benign Features Research Articles

Retrospectıve Analysis Of Risk Factors In The Development Of Biliary Fistula After Liver Hydatid Cyst Surgery

Abstract
 Background: Cystic echinococcosis (CE) of the liver is a parasitic disease caused by the larvae of Echinococcus granulosus. Although CE is a disease with benign characteristics, its morbidity is high in the presence of complicated cysts. The most important complications are fistulization of the biliary tract and intraperitoneal cyst ruptures
 Material Methods: Patients who underwent surgery for CE in Atatürk University Research Hospital between 2011 and 2021 were analyzed retrospectively. Demographic information, CE localization, cyst size, CE classification, surgical techniques and hospitalization time of all operated patients were recorded. The effect of all data types on the categorical variable was analyzed using binary logistic regression. 
 Results: Of the patients, 299 (60.2%) were female, and 198 (39.8%) were male. The mean age was 41 ± 15.48 and 41 ± 15.36 years in the group with and without bile fistula, respectively. We found a significant difference in mean cyst sizes between the two groups. Cyst location and cyst type according to WHO classification had a statistically significant effect on the cysto biliary communication (p: 0.00, p: 0.00, respectively. Analysis by cyst types showed that CE 1, CE2, CE3A, and CE3B cysts were statistically significantly effective on biliary fistula formation. CE 1 type cysts were more effective than other cyst types. CE 2, CE3A, and CE 3B cysts were less effective than CE1 
 Conclusion: The risk of bile leakage is higher in hepatic hydatid cysts located in the left lobe and in CE1 cysts. The incidence of bile leakage increases in large cysts.

Feasibility and Safety of Laparoscopic Surgery in Large Ovarian Masses

ABSTRACT Ovarian masses are relatively common conditions, with approximately 5%–10% of women requiring surgical treatment for an ovarian neoplasm during their lifetimes. A laparoscopic approach is the primary choice in surgical management of benign small ovarian masses; however, concerns remain about the feasibility and safety of laparoscopic surgery for large ovarian masses. Causes of concern include difficult visualization, potential for damage to intra-abdominal organs, and risk of an unintended rupture of occult malignancy leading to intraperitoneal spillage requiring subsequent adjuvant therapy. This retrospective cohort study aimed to assess the feasibility and safety of laparoscopic treatment for large ovarian masses with benign features. Patients that underwent laparoscopic surgery between 2017 and 2019 at a tertiary care center were included. Only patients with a low risk of malignancy (risk of malignancy index [RMI] <200 or increased serum cancer antigen 125 [CA-125] level with typical characteristics of endometrioma and mature cystic teratoma by ultrasonographic examination) were included. Women were divided into 2 groups based on ovarian mass diameter, with a large mass defined as ≥10 cm and a control group with ovarian masses <10 cm in diameter. Demographic and oncology parameters were compared between groups, as were outcomes including operating time, postoperative day 1 hemoglobin concentration, intraoperative and postoperative complications, conversion to laparotomy, length of hospital stay, and histopathological results. A Student t test was used for normally distributed continuous data, and Mann-Whitney U test was used for data not normally distributed. A total of 260 women underwent laparoscopic surgery for ovarian masses during the study period, 64 of whom had a large mass with 196 in the control group. The demographic and clinical characteristics were similar between groups, as were the serum CA-125 and RMIs (P < 0.05). Multilocular cystic appearances (45.3% vs 24.5%, P = 0.002) and intra-abdominal ascites (7.8% vs 1.5%, P = 0.024) were more common in the large mass cohort. The salpingo-oophorectomy rate (65.6% vs 44.4%, P = 0.003), conversion to laparotomy rate (7.8% vs 0.0%, P = 0.001), and aspiration of cyst contents rate (29.7% vs 5.1%, P < 0.001) were all significantly higher in patients with large masses than without. No differences were observed between groups in terms of laparoscopy technique, operation time, complication rate, intraoperative cyst rupture rate, preoperative and postoperative hemoglobin levels, or length of hospital stay. Histopathology results varied between groups, with mucinous cystadenoma (25.0% vs 9.2%, P = 0.001) being the most common benign pathology in the large-mass group and follicular cysts (22.4% vs 10.9%, P = 0.044) the most common in the control group. A total of 5 patients in the large-mass group were found to have unexpected malignant or borderline pathologies on frozen section, whereas none were found in the small-mass group (P = 0.001). The results of this study demonstrate that laparoscopic surgery of large ovarian masses is feasible in large adnexal tumors presumed benign and had comparable operation time and length of hospital stay compared with the control group. Although the rate of conversion to laparotomy was higher among the large-mass group, this was due to intraoperative pathology confirming a malignant mass rather than technical difficulties. Appropriate selection of patients with low suspicion for malignancy is of critical importance.

A surgical case of ciliated muconodular papillary tumor of the lung

Ciliated muconodular papillary tumor (CMPT) is a rare type of tumor with both benign and malignant characteristics. Herein, we report the surgical case of a 65-year-old man with CMPT. Chest computed tomography revealed a solitary cavitary lesion with a maximum diameter of 11-mm in S10b of the right lower lung. A thoracoscopic lung wedge resection was subsequently performed. On microscopic examination, the tumor was composed of highly columnar cells with tubular-to-papillary and cystic growth patterns. On immunostaining, it was positive for the epidermal growth factor receptor. The tumor was diagnosed as a CMPT, exhibiting no recurrence after two years of follow-up.

Characteristics of dental cysts

Introduction: lesions of odontogenic origin such as cysts with benign characteristics can cause great facial destruction and deformities. Cysts" become a type of benign affectation, forming either lumps or a pathological cavity with liquid or semi-liquid content and covered by epithelium on the inside and by connective tissue on the outside. Objective: to describe the characteristics and how dental cysts manifest themselves. Methods: a literature review was performed, through an electronic search in the main databases (PubMed, Taylor & Francis, Scopus and ScienceDirect). Articles published between 2016 and 2022 were included. Results: The characteristics of cysts were identified that present asymptomatically and slow growth can cause dental migration and alteration of adjacent roots. There are different types, but the most common were odontogenic and dentigerous cysts. Conclusions: It is concluded that there are different characteristics of dental cysts due to the increase in volume and location of the cyst, these present themselves asymptomatically and cause facial inflammation with asymmetry, depending on their manifestations, clinic, radiography. Different types of odontogenic cysts can be found (radicular cyst and collateral inflammatory cyst) and non-odontogenic (nasopalatine duct cyst)

Enchondroma Presenting with an Acutely Painful Hand

Enchondromas are intramedullary cartilage neoplasms with benign imaging features that constitute approx. 90% of benign tumours in the hands.
 We present a 25-year-old previously fit and well female patient with Enchondroma of the metacarpal bone with characteristic imaging and pathologic fracture to increase its awareness for early diagnosis and treatment.

One-pot fabrication of SF-DA@PVDF membrane for dye adsorption and oil-in-water emulsion separation

With industry development, the reuse of water and oil resources has become an urgent problem. At present, the evolution of simple-minded approaches to attain modification on the membrane surface for a more complex circumstance, such as oily wastewater and dyes at the same time, has become a red-hot but challenging topic for research. Membrane separation technology has successfully built up to cope with these issues, such as oil-in-water emulsion separation and dye adsorption owning to its benign mechanical characteristics and low power consumption. Therefore, we report a simple-minded one-step approach for uses in oil-in-water emulsion separation and dye adsorption. In this work, a new multifunctional membrane surface is constructed via the concurrent incorporation of silk fibroin (SF) and dopamine hydrochloride (DA) in co-deposition to reach a large flux for complex wastewater separation. The qualified membrane has super hydrophilic in the air and has brilliant oil adhesion resistance underwater. It works comfortably on oil-in-water emulsions (over 10400 L m−2 h−1 bar−1) or dyes (above 3738.68 mg m−2). More importantly, excellent adsorption efficiency (>99%) and extensive adsorption capability (over 2071.91 mg m−2) were achieved by the oil-in-dye emulsion that stabilized with surfactant. It not only possesses a broad span of use outlooks but also enlightens imports for the evolution of functional coating in the future.

FIXED DOSE COMBINATION OF OFLOXACIN AND ORNIDAZOLE WITH CROSSSENSITIVITY TO METRONIDAZOLE INDUCED FIXED DRUG ERUPTION

Fixed drug eruption (FDE) is a recurrent, clearly dened lesion that consistently develops at the same location after taking the offending substance [1]. The lips, face, hands, feet, and genitalia are the typical sites for the lesions [2]. It can be identied by its benign character, short latency, and recurrence at the same places on rechallenge. Resting FDE lesions contain CD8+ T-cells with a memory characteristic that were situated at the dermal-epidermal junction and are silent until the drug is re-challenged after healing. Most FDE cases have excellent prognoses and are selflimiting. After the acute incident, post-inammatory hyperpigmentation can be noticeable and last for several months. Ooxacin is a uoroquinolone of second-generation that prevents the synthesis of microbial DNA. Ornidazole is a 5- nitroimidazole with antibacterial and antiparasitic properties. Metronidazole has broad-spectrum cidal action against anaerobic protozoa. It is frequently given in combination with other antimicrobial agents to treat polymicrobial infections with aerobic and anaerobic bacteria. The most frequent combination causing xed drug eruption among the anti-microbial FDC is uoroquinolones + nitroimidazole. We report a case of ornidazole with cross-sensitivity to metronidazole-induced xed drug eruption in an adult male of thirties treated for diarrhea.

Providencia alcalifaciens—Assisted Bioremediation of Chromium-Contaminated Groundwater: A Computational Study

In Saudi Arabia, seawater desalination is the primary source of acquiring freshwater, and groundwater contains a high concentration of toxic heavy metals. Chromium (Cr) is one of the heavy metals that is widely distributed in the environment, particularly in the groundwater of Madinah. Diverse techniques are employed to eliminate the toxicity of heavy metals from the environment, but, lately, the focus has shifted to biological remediation systems, due to their higher removal efficiencies, lower costs, and more ecologically benign characteristics than the conventional methods. Providencia bacteria engage in a variety of adsorption processes to interact with heavy metals. In this study, we aim to investigate the role of potential active site residues in the bioengineering of chromate reductase (ChrR) from Providencia alcalifaciens to reduce the Cr to a lesser toxic form by employing robust computational approaches. This study highlights Cr bioremediation by providing high-quality homology-modeled structures of wild type and mutants and key residues of ChrR for bioengineering to reduce the Cr toxicity in the environment. Glu79 is found to be a key residue for Cr binding. The mutant models of Arg82Cys, Gln126Trp, and Glu144Trp are observed to establish more metallic interactions within the binding pocket of ChrR. In addition, the wild type ChrR (P. alcalifaciens) has been found to be unstable. However, the mutations stabilized the structure by preserving the metallic contacts between the critical amino acid residues of the identified motifs and the Cr(VI). Therefore, the mutants discovered in the study can be taken into account for protein engineering to create reliable and effective enzymes to convert Cr(VI) into a lesser toxic form.

Attitudes of Practicing Radiologists Toward the Management of Palpable Circumscribed Breast Masses.

To investigate the attitudes of radiologists toward palpable breast masses with benign features on US and to determine the factors influencing their decision. A 20-question online questionnaire was sent to radiologists with membership of the Iranian Society of Radiology and included questions regarding demographics, practice experience, and management approach to palpable circumscribed breast masses based on patient age and risk factors. Radiologists' management choice for masses in themselves or close relatives/friends was also queried. In total, 151 radiologists participated (response rate 16%). For palpable breast masses with benign imaging features in women at high risk, the majority of radiologists selected MRI (95/151, 62.9%) and core-needle biopsy (110/151, 72.8%). In average-risk patients, radiologists with >5 years of practice experience selected biopsy more frequently (33/79, 41.8%) than less experienced radiologists (17/79, 23.6%) for patients ≥40 years old (P < 0.001) and patients <40 years old (20/79, 25.3%; 11/72, 15.3%, respectively) (P = 0.014). Similarly, selecting biopsy was more common in radiologists who completed a breast imaging fellowship for patients ≥40 years old (23/45, 51.1% vs 27/106, 25.5%) (P = 0.04), as well as for patients <40 years old (18/45, 40% vs 13/106, 12.3%) (P = 0.02). Radiologists who were <40 years old selected biopsy more frequently if evaluating a mass in themselves (22/86, 25.6%) compared to patients (15/86, 17.4%) (P < 0.001). Radiologist experience and educational background, as well as patient baseline breast cancer risk, can predispose radiologists to choose biopsy for palpable breast masses despite a benign appearance on imaging.

Are Prostate Cancer Screenings Performed in Compliance with Cancer Guidelines?

Objective: This study aims to examine whether our region's Prostate Cancer (PCa) screening programs comply with the European Association of Urology (EAU) Guidelines. Method: This study was conducted as a retrospective, cross-sectional study between April 2014 and July 2022. Two hundred seventy patients who applied to our clinic for various reasons and were diagnosed with PCa were included in the study. Characteristics of the patients, such as age at diagnosis, comorbidities, age at first PSA examination, and PSA values, were recorded. Results: The mean age of the patients at the time of cancer diagnosis was 67.42±8.64 (43-91) years. PSA value (median±IQR) at the diagnosis was 9.58±19.43 (1.83-3437) ng/ml. When the distribution of cancer according to different decades of life was examined, there were 5 (%1.8) patients in the 40-50 age range, 44 (16.1%) in the 50-60 age range, 111 (40.7%) in the 60-70 age range, 86 (31.5%) in the 70-80 age range, and 24 (8.8%) after the age of 80. While 138 patients (51.1%) had local and benign tumor features, 59 (21.9%) patients were diagnosed with metastatic findings. Only 31.3% (61/195) of the patients were under regular follow-up by a specific urology doctor. Conclusion: It was found that the screening of prostate cancer, the most common type of cancer in men, was not performed by the guidelines, and as a result, diagnosis and treatment were delayed. It was determined that many patients lost the chance of curative treatment. In this disease, where early diagnosis is vital for effective treatment and preservation of quality of life, it is essential to follow up with aging men in accordance with the guidelines. It may be beneficial to periodically train and follow up with all health professionals interested in this issue.

Denosumab salvage therapy in an 11-year-old boy with locally recurrent unresectable giant cell tumor of the lumbar spine after surgery

Giant cell tumors (GCTs) of the bone are locally aggressive primary bone tumors with a benign character. Spinal involvement is rare which accounts for approximately 5% of all primary bone tumors and it is quite rare in the lumbar spine. An 11-year-old boy patient presented with pain of low back and bilateral low extremities. Lumbar CT and MRI revealed a lytic lesion of the L4 vertebra corpus. The patient earned remarkable and timely recovery with 2 surgical interventions and the use of denosumab. Surgical resection for GCTs is still preferable as the initial treatment, denosumab should be utilized after tumor resection whether based on the purpose of prevention or treatment of tumor recurrence.

Myoepithelioma of parotid gland: a case report

Myoepithelioma (ME) is a benign tumor, arising predominantly from major and minor salivary glands (SG). Clinically, it presents as a painless mass with a slow growth. In our case report, this lesion occurred in a 51-year-old man, and presented as a well-defined oval mass on the right parotid region. The magnetic resonance imaging study confirmed the presence of a lesion with benign features that was excised surgically by partial superficial parotidectomy. The histopathological and immunohistochemical analysis confirmed the diagnosis of parotid ME. Other SG tumors such as pleomorphic adenoma are differential diagnoses of ME. Complete surgical excision reduces the rate of recurrence.

Hemorrhagic presentation of previously silent brain tumors

Introduction and objectivesAcute presentation with intracranial hemorrhage owing to a previously silent brain tumor (BT) is rare. Although any BT can bleed, the frequency and type of bleeding varies across tumor types. Materials and methodsWe aimed to retrospectively review our experience with 55 patients with BTs presenting with ICH. ResultsSigns of increased intracranial pressure were the most common symptoms. The temporal lobe was the most common lesion site (n=22). Hemorrhages were mainly confined to the tumor margins (HCTs) (n=34). Extensive intraparenchymal hemorrhages (EIHs) were mainly associated with moderately/severely decreased levels of consciousness (LOCs) (n=15/16). High-grade glioma (HGGT) (n=25) was the leading pathological diagnosis followed by metastasis (MBT) (n=16/55). The hemorrhage type was associated with the pathological diagnosis of the tumor. Patients with HGGT (n=19/25) and MBT (n=9/16) mainly presented with HCTs, whereas low-grade gliomas (LGGT) primarily caused EIHs (n=6/7). ConclusionsHemorrhagic presentation is a rare occurrence in BTs. Among all, MBT and HGGT are responsible for majority of the cases. Importantly, despite their relatively benign characteristics, LGGTs mainly result in extensive parenchymal destruction once they bleed. Maximum surgical resection of hemorrhagic BTs and decompression of the affected brain regions followed by histological confirmation of the diagnosis should be the main goals of treatment in cases with hemorrhagic BTs.

Acute Necrotizing Encephalopathy Following Presumed COVID-19 Infection: The First Iranian Report in Children

In the fifth’s SARS-CoV-2 infection peak, although extended vaccination, still there is some reports of neurologic complications of covid-19 in children like adult. Though often we expose to benign neurologic features but sometimes there is unusual clinicoradiologic presentation. Thus, report of uncommon neurologic manifestations can help us to better understand of main pathophysiology in pediatric brain involvement. In this report, we present a five-year- old previously healthy girl that arrive to our hospital with fever, vomiting and loss of consciousness, on lumbar puncture there was mild protein elevation without poleocytosis and nasopharyngeal swap PCR for COVID-19 was positive. Brain imaging 10 hours after admission, revealed findings suggestive of acute necrotizing encephalopa thy (ANE). In spite of extensive brain involvement, after prompt initiation of high dose methylprednisolone and IV immunoglobulin, there was dramatic improvement after 3 months’ follow-up. To our knowledge, this is the first Iranian report and the second report on the world.

Validation of a deep neural network-based algorithm supporting clinical management of adnexal mass.

Conservative management of adnexal mass is warranted when there is imaging-based and clinical evidence of benign characteristics. Malignancy risk is, however, a concern due to the mortality rate of ovarian cancer. Malignancy occurs in 10-15% of adnexal masses that go to surgery, whereas the rate of malignancy is much lower in masses clinically characterized as benign or indeterminate. Additional diagnostic tests could assist conservative management of these patients. Here we report the clinical validation of OvaWatch, a multivariate index assay, with real-world evidence of performance that supports conservative management of adnexal masses. OvaWatch utilizes a previously characterized neural network-based algorithm combining serum biomarkers and clinical covariates and was used to examine malignancy risk in prospective and retrospective samples of patients with an adnexal mass. Retrospective data sets were assembled from previous studies using patients who had adnexal mass and were scheduled for surgery. The prospective study was a multi-center trial of women with adnexal mass as identified on clinical examination and indeterminate or asymptomatic by imaging. The performance to detect ovarian malignancy was evaluated at a previously validated score threshold. In retrospective, low prevalence (N = 1,453, 1.5% malignancy rate) data from patients that received an independent physician assessment of benign, OvaWatch has a sensitivity of 81.8% [95% confidence interval (CI) 65.1-92.7] for identifying a histologically confirmed malignancy, and a negative predictive value (NPV) of 99.7%. OvaWatch identified 18/22 malignancies missed by physician assessment. A prospective data set had 501 patients where 106 patients with adnexal mass went for surgery. The prevalence was 2% (10 malignancies). The sensitivity of OvaWatch for malignancy was 40% (95% CI: 16.8-68.7%), and the specificity was 87% (95% CI: 83.7-89.7) when patients were included in the analysis who did not go to surgery and were evaluated as benign. The NPV remained 98.6% (95% CI: 97.0-99.4%). An independent analysis set with a high prevalence (45.8%) the NPV value was 87.8% (95% CI: 95% CI: 75.8-94.3%). OvaWatch demonstrated high NPV across diverse data sets and promises utility as an effective diagnostic test supporting management of suspected benign or indeterminate mass to safely decrease or delay unnecessary surgeries.

Mad scientists in H. G. Wells's early fiction

This article analyses six mad scientist characters from H. G. Wells's early fiction. The analysed mad scientists are as follows – the Bacteriologist from "The Stolen Bacillus", Hapley from "A Moth – Genus Novo", the Time Traveller from The Time Machine, Doctor Moreau from The Island of Doctor Moreau, Griffin from The Invisible Man, and Cavor from The First Men in the Moon. The article uses a broader definition of the mad scientist, one that includes not only evil scientific geniuses but also other, more benign characters, as long as they are eccentric enough to be considered mad. The said mad scientists are divided into three different categories, depending on whether they are evil, benign or neither of the two. The article shows that the analysed mad scientists reflect the early Wells's disbelief in the power of science to change the world for the better. It is also argued that Wells's varied body of mad scientists enriched and diversified the mad scientist trope in the history of the SF genre.

Detection of Android Malware Based on Deep Forest and Feature Enhancement

Detecting Android malware in its spread or download stage is a challenging work, which can realize early detection of malware before it reaches user side. In this paper, we propose a two-stage detection framework based on feature enhancement and cascade deep forest. This method can detect the traffic generated in the encrypted transmission process of Android malware. The first stage realizes the binary classification of benign and malicious software. The second stage realizes the multi-classification of different categories of malware. To enhance data representation, convolutional neural networks is used to extract benign and malicious features in the first stage, and the principal component analysis method is used to extract the malicious features in the second stage. Theses extracted features are spliced with the payload part of the traffic to form fusion features for classification task. In order to adapt to different scale of samples, especially for the small-scale sample, cascaded deep forest method is proposed to construct the classification model. In this model, many layers that consist of base classifiers are cascaded and the number of layers can be automatically adjusted according to the scale of the samples. With different combinations of base classifiers in each layer, the optima detection accuracy is archived in the two stages. The experimental results on several datasets prove that the proposed method is effective for encrypted transmission detection of Android malware. It is also suitable for the detection of unknown attacks.

Two Cases of Solitary Fibrous Tumor of the Thyroid

Solitary fibrous tumor (SFT) is a spindle-cell neoplasm that rarely arises from the thyroid gland. The first ever case of thyroid SFT was reported in 1993. Since then, 42 cases have been reported in the literature. The tumor showed benign clinical characteristics in all of the cases, except one, where the patient presented with a local recurrence and distant metastasis.

Differential Analysis of Triggers and Benign Features for Black-Box DNN Backdoor Detection

Differential Analysis of Triggers and Benign Features for Black-Box DNN Backdoor Detection

A TROJAN HORSE NEVER TO BE MISSED IN ELDERLY – AN INTRESTING CASE OF RIGHT ILIAC FOSSA MASS

We report a case of an elderly patient presenting with the right iliac fossa mass. The provisional diagnosis included an inammatory appendicular mass or abdominal wall mass. Interestingly, initial non-contrast computed tomography (CT) of the abdomen and pelvis, lap parameters and colonoscopy guided biopsy demonstrated the inammatory changes. Follow up imaging by contrast CT threw light on a new path towards the neoplastic etiology. Even after the follow up imaging the subsequent colonoscopy guided biopsy showed features suspicious for malignancy whereas cystoscopy guided biopsy showed benign features. Intra-operatively bowel neoplasm with bladder invasion was seen and right hemicolectomy with partial cystectomy done. Post-operative specimen nally revealed mucinous adenocarcinoma of caecum with urinary the bladder invasion. In the presented case, non-contrast CT ndings and clinico-pathological reports suggestive of a benign etiology were misleading. This could have been prevented if the patient was subjected to contrast study in view of her elderly age. This case highlights the importance of imaging in patient management. Therefore, we feel that it is important to share our experience of the successful management of the presented case.