Cause Of Swelling Research Articles

Proton irradiation-induced cracking and microstructural defects in UN and (U,Zr)N composite fuels

Proton irradiation with a primary ion energy of 2 MeV was used to simulate radiation damage in UN and (U,Zr)N fuel pellets. The pellets, nominally at room temperature, were irradiated to peak levels of 0.1, 1, 10 dpa and 100.0 dpa resulting in a peak hydrogen concentration of at most 90 at. %. Microstructure and mechanical properties of the samples were investigated and compared before and after irradiation. The irradiation induced an increase in hardness, whereas a decrease in Young’s modulus was observed for both samples. Microstructural characterization revealed irradiation-induced cracking, initiated in the bulk of the material, where the peak damage was deposited, propagating towards the surface. Additionally, transmission electron microscopy was used to study irradiation defects. Dislocation loops and fringes were identified and observed to increase in density with increasing dose levels. The high density of irradiation defects and hydrogen implanted are proposed as the main cause of swelling and consequent sample cracking, leading simultaneously to increased hardening and a decrease in Young's modulus.

A Practical Approach to the Diagnosis of Lymphedema: A Narrative Review.

Lymphedema often presents as progressive, unremitting swelling and skin changes that are extremely distressing to patients. Hereditary lymphedema (HL) constitutes a type of primary lymphedema that is passed down through generations. The primary aims of this narrative review are to illustrate a framework to distinguish lymphedema from other causes of swelling and to differentiate the hereditary lymphedemas from each other. A literature search was undertaken using relevant search terms. The articles were evaluated to generate a diagnostic algorithm to approach the swelling of an extremity using clinical and laboratory data. First, the stemmer sign should be evaluated. If it is negative, other causes should be considered. History and additional physical exam findings suggest either a primary or secondary cause of lymph-edema. The hereditary lymphedemas have been classified by age of onset and then stratified by clinical criteria and genetic testing.

ANALISA LUMPUR PEMBORAN TERHADAP SWELLING CLAY PADA SUMUR “X” LAPANGAN “AFFIKAH”

In drilling operations, mud planning is one of the most important factors in supporting the success of drilling operations in oil wells. Planning for the use of drilling mud is used for maximum results in cutting and maintaining drilling wells. This study aims to determine the cause of swelling and what problems will be caused if swelling control is carried out less than optimally. In this study, we analyze the mud that will be used in drilling operations, so that it can prevent or minimize swelling of clay in the shale system by adjusting the polyamine content to be used. After doing the research, it was found that at the "X" well there was no swelling in each route because each route was dominated by alkaline mud which had a pH above 7 then the total polyamine used for the mud system in the "X" well was as much as 3654,903 gal with a concentration of 1.5%

The role of ultrasound in evaluating salivary glands swellings

BackgroundViral infection is the most common cause of salivary gland swelling as mumps which mainly affects the parotid glands. Sialolithiasis is another cause of obstruction of the salivary duct. A tumor is another cause of swelling. Around 70% of salivary gland tumors arise from the parotid glands. Benign lesions represent 57% of these tumors. Three to 5% of all tumors affecting the head and neck are represented in the salivary gland. Ultrasonography is considered a basic diagnostic tool in all salivary gland swellings. Our study is to evaluate the role of ultrasound in the evaluation of salivary glands swellings in comparison with a computed tomography scan.ResultsA total of 80 patients aged more than 1 year old with swellings affecting the salivary glands were collected from the out-patient clinic during the period from February 2020 to February 2021. All patients underwent ultrasonography and computed tomography examination of the neck. All submandibular gland lesions presented with sialolithiasis (40 cases) (100%), and 20 cases (50%) of parotid gland swellings presented as inflammation without stone (16 cases (40%) of acute inflammation and 4 cases (10%) with recurrent inflammation), while 4 patients only presented as sialolithiasis. Neoplastic lesions were diagnosed in 16 cases of the parotid gland group. Stones less than 3 mm were detected only by computed tomography in 5 patients (12.5%) of the submandibular group. Twenty-eight cases (70%) with stones ranged in size between 3 and 6 mm. Only 11 cases (27.5%) with stones ranged in size more than 6 mm. Of the 16 parotid swellings diagnosed with neoplastic lesions, 14 parotid cases (87%) showed well-defined margins by computed tomography and ultrasonography.ConclusionsSonography is the basic diagnostic tool in salivary glands swellings. Ultrasonography should be the initial imaging modality. Only in special cases, such as stones that could not be detected by ultrasonography or a neoplastic lesion in a deep location, or bone infiltration, computed tomography neck should be performed.

Lymphoepthelial cyst of submandibular region: a case report

BackgroundThe oral lymphoepithelial cyst (LEC) is a rare, soft-tissue, developmental cyst, initially presented by Gold in 1962 as a “branchial cleft cyst”. It may occur in the pancreas, tongue, neck, and other regions of the oral cavity. No study has been reported in Pakistan and Karachi reporting a case of lymphoepithelial cyst in the submandibular region. This rare case of LEC has been reported to help the clinicians to bring LEC into their differential diagnosis for lesions affecting the submandibular region.Case presentationWe report a case of 57 years old female reported to the Maxillofacial OPD of a tertiary care hospital with the complaint of swelling on the right side of the neck for 3 weeks which was rapidly increasing in size. She was having difficulty in mastication. On extra-oral examination, there was swelling on the right side in the submandibular area. The overlying skin is normal with no evidence of pus and discharge. On palpation, the swelling was soft, non-tender, non-fluctuant, non-displaceable into the submandibular area. Lymph nodes were impalpable. Excision of the lesion performed under general anesthesia and biopsy revealed lymphoepithelial cyst associated with submandibular gland. Here we present an attention-grabbing case of swelling in the right submandibular region which was provisionally diagnosed as a malignant submandibular lymph node however later evidence histopathologically as a lymphoepithelial cyst of the submandibular gland.ConclusionAn unusual cause of swelling in the neck is lymphoepithelial cysts. Submandibular gland appearance is not usual and can prove to be a clinical problem.

Nuck cyst: a rare cause of inguinal swelling in infancy.

BACKGROUND Inguinal and/or inguino-scrotal swellings, such as hernia and hydrocele, are among the commonest anomalies in childhood. Hydrocele of the canal of Nuck is an uncommon diagnosis and a rare cause of swelling in women that occurs due to a patent vaginal process. METHODS From January 2001 to January 2016, 353 female patients 1-14 years of age were admitted to our university hospital division for inguinal swelling. We have performed 403 inguinal approaches, and of these, 399 (99%) had inguinal hernias, 3 (0.74%) had a cyst of the canal of Nuck, and 1 (0.24%) had a lipoma. All of the patients with Nuck cysts underwent surgical exploration of the swelling through a right inguinal skin crease incision. RESULTS The patients were between the ages of 1 and 8 years. The cyst sizes varied between 25 and 40 mm. All the patients exhibited right, tender, painless, non-reducible masses. In all patients, ultrasound confirmed the suspected diagnosis. The histological findings revealed fibrous-walled cystic formations with mild chronic inflammatory infiltrate that were covered by mesothelial epithelium. The patients' postoperative follow-ups at 1, 6 and 12 months revealed normally healed incisions with no recurrences. CONCLUSIONS The surgical findings and the histological demonstrations of serous epithelium seemed to validate the hypothesis that the patency of the inguinal canal combined with fluid secretion of the peritoneal serosa participated in the formation of the cysts. Surgery with high ligature of the vaginal process is considered the therapy of choice for this pathology.

Cysticercosis of Masseter Muscle: A Diagnostic Dilemma

The masseter muscle cysticercosis is a rare soft tissue entity. Among so many causes of swelling of face this entity is very rare and making diagnosis difficult. Infestation of larvae of Taenia solium (tapeworm) causes cysticercosis in humans. Here, we have reported a case of cysticecosis inside masseter muscle, presenting with recurrent painful swelling of face. Diagnosis was confirmed after high resolution ultrasonography (HRUSG) and magnetic resonance imaging (MRI) and it was managed conservatively. How to cite this article: Ram H, Kumar S, Atam I, Sonkar SK, Bharti H, Mohammad S. Cysticercosis of Masseter Muscle: A Diagnostic Dilemma. J Adv Res Med 2019; 6(4): 16-19. DOI: https://doi.org/10.24321/2349.7181.201920

Unusual Sites for Extracranial Head-Neck Schwannomas.

Schwannomas are a frequent cause of swellings in the head and neck region. Due to the abundance of peripheral, cranial and autonomic nerves in this region, schwannomas can present in variety of locations, posing a diagnostic and therapeutic challenge to the surgeon. Unusual sites in head and neck region can have varied presentation depending on the site of origin. We identified unusual extracranial locations of head and neck schwannomas, their presenting features and surgical management. Retrospective review of cases of extracranial head and neck schwannomas operated in the Department of Otolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, a tertiary referral centre between July 2015 and June 2019. A total of 42 cases of extracranial head and neck schwannomas were operated. Among them, 9 cases were found to arise from uncommon sites, such as parotid gland (n = 1), infratemporal fossa (n = 2), external auditory canal (n = 1), subglottis (n = 1), false vocal cord (n = 1), frontal recess (n = 1), maxillary sinus (n = 1) and retromolar trigone (n = 1). All patients underwent excision via relevant approaches. Nerve of origin was identified in 4/9 cases. One case had postoperative neurological deficit. No recurrences were noted in mean follow-up of 19months. Schwannomas ought to be considered as a differential diagnosis for swellings/ mass in any part of head and neck region. Comprehensive evaluation with appropriate imaging and histology should be done in all cases. Preoperative counselling and consent regarding neurological deficit pertaining to possible nerve of origin is required in each case.

The diagnostic unreliability of classic physical signs of lymphedema

ObjectiveIn most communities, the diagnosis of lymphedema in the lower extremity currently rests on clinical signs. Lymphoscintigraphy, which is objective, is performed infrequently to confirm the clinical suspicion. Given absence of a curative option for lymphedema, it is essential to obtain an accurate diagnosis before committing the patient to lifelong conservative therapy. The aim of this study was to evaluate the diagnostic accuracy of clinical signs in comparison to lymphoscintigraphy, the current objective standard. MethodsRetrospective review of contemporaneously collected data of 636 consecutive limbs with swelling (318 left, 318 right) that underwent initial evaluation during a 12-month period between 2016 and 2017 was performed. All limbs were assessed for classic clinical signs of lymphedema including dorsal hump of the foot, square toes, Kaposi-Stemmer sign, and nonpitting edema. Lymphoscintigraphy was routinely performed for objective evaluation. The 436 patients who underwent the study were scored positive for lymphedema on the basis of transit time delay for the radioisotope in minutes, presence of dermal backflow, presence of collateral channels, intensity of uptake in the main channel and lymph nodes, number of nodes in the groin, and presence of popliteal nodes. Analysis was carried out to determine sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the clinical signs in determining whether a patient had lymphedema. In addition, regression analysis was carried out to evaluate the predictive value of different clinical signs in determining lymphedema. Patients with positive clinical signs but with normal findings on lymphoscintigraphy who did not have a medical cause for swelling underwent workup to determine a possible venous cause. ResultsOf 636 limbs with swelling, 436 (69%) underwent lymphoscintigraphy, the findings of which were normal in 178 (41%) and abnormal in 258 (59%). Of the 636 swollen limbs, 96 (15%) had clinical signs of lymphedema; 95% had dorsal hump, 37% had square toes, 32% had presence of Kaposi-Stemmer sign, and 12% had nonpitting edema. Of these 96, lymphoscintigraphy was performed on 66 (69%); 45 of 66 (68%) patients with clinical signs were positive for lymphedema; the remaining 32% were normal. Conversely, among 258 swollen limbs with abnormal findings on lymphoscintigraphy, only 45 (17%) had one or more of the clinical signs. Sensitivity and specificity of clinical signs in predicting lymphoscintigraphy-confirmed lymphedema were 17% and 88%, respectively. Overall accuracy was 47%. Of the clinical signs, only the Kaposi-Stemmer sign was a significant predictor of lymphedema (odds ratio, 7.9; P = .02). In patients with positive clinical signs but normal findings on lymphoscintigraphy, venous obstruction was the most common cause of swelling. ConclusionsClinical signs of lymphedema appear to be unreliable in making a correct diagnosis of lymphedema in one-third of patients. Conversely, in lymphoscintigraphy-confirmed lymphedema, only 17% had positive clinical signs. Of the clinical signs, only Kaposi-Stemmer sign has some predictability in determining lymphoscintigraphy-confirmed lymphedema. Venous obstruction is the most common cause of clinical signs in patients without lymphedema. Routine use of lymphoscintigraphy is recommended in patients to make an objective diagnosis of lymphedema.

NECK SWELLINGS;

NECK SWELLINGS;

Perineal and scrotal lymphangioma in a 3-year-old male patient: An unusual case report

Lymphangioma is a rare cause of swelling in the perineal and scrotal regions. This case report describes the clinical, ultrasonographic, and histopathological findings of a 3-year-old pediatric patient with a diagnosis of perineal and scrotal lymphangioma.

Nuck cyst: a rare cause of inguinal swelling in infancy.

Inguinal and/or inguino-scrotal swellings, such as hernia and hydrocele, are among the commonest anomalies in childhood. Hydrocele of the canal of Nuck is an uncommon diagnosis and a rare cause of swelling in women that occurs due to a patent vaginal process. From January 2001 to January 2016, 353 female patients 1-14 years of age were admitted to our university hospital division for inguinal swelling. We have performed 403 inguinal approaches, and of these, 399 (99%) had inguinal hernias, 3 (0.74%) had a cyst of the canal of Nuck, and 1 (0.24%) had a lipoma. All of the patients with Nuck cysts underwent surgical exploration of the swelling through a right inguinal skin crease incision. The patients were between the ages of 1 and 8 years. The cyst sizes varied between 25 and 40 mm. All the patients exhibited right, tender, painless, non-reducible masses. In all patients, ultrasound confirmed the suspected diagnosis. The histological findings revealed fibrous-walled cystic formations with mild chronic inflammatory infiltrate that were covered by mesothelial epithelium. The patients' postoperative follow-ups at 1, 6 and 12 months revealed normally healed incisions with no recurrences. The surgical findings and the histological demonstrations of serous epithelium seemed to validate the hypothesis that the patency of the inguinal canal combined with fluid secretion of the peritoneal serosa participated in the formation of the cysts. Surgery with high ligature of the vaginal process is considered the therapy of choice for this pathology.

HAE Pathophysiology and Underlying Mechanisms.

Remarkable progress in understanding the pathophysiology and underlying mechanisms of hereditary angioedema has led to the development of effective treatment for this disorder. Progress in three separate areas has catalyzed our understanding of hereditary angioedema. The first is the recognition that HAE type I and type II result from a deficiency in the plasma level of functional C1 inhibitor. This observation has led to a detailed understanding of the SERPING1 mutations responsible for this deficiency as well as the molecular regulation of C1 inhibitor expression and function. The second is that the fundamental cause of swelling is enhanced contact system activation leading to increased generation of bradykinin. Substantial progress has been made in defining the parameters regulating bradykinin generation and catabolism as well as the receptors that transduce the biologic effects of kinins. The third is the understanding that tissue swelling in hereditary angioedema primarily involves the function of endothelial cell adherens junctions. This knowledge is driving increased attention to the role of endothelial biology in determining disease activity in hereditary angioedema. While there has been considerable progress made, large gaps still remain in our knowledge. Important areas that remain poorly understood include the factors that lead to very low plasma functional C1 inhibitor levels, the triggers of contact system activation in hereditary angioedema, and the role of the bradykinin B1 receptor. The phenotypic variability of hereditary angioedema has been extensively documented but never understood. The mechanisms discussed in this chapter likely contribute to this variability. Future progress in understanding these mechanisms should provide new means to improve the diagnosis and treatment of hereditary angioedema.

Assessment of Severity Level for Diabetic Macular Oedema Using Machine Learning Algorithms

The macula is an imperative part present in our human visual system which is most responsible for clear and colour vision. For the people suffering from diabetes, the various parts of the body including the retina of the eye are affected. These retinal damages cause swelling and other abnormalities nearby macula. The pathologies in macula due to diabetes are called Diabetic Macular oEdema (DME). It affects patients’ vision that may lead to vision loss. It can be overcome by advance identification of causes for swelling. The major causes for the swelling are neovascularization and other abnormalities occurring in the blood vessels nearby the macula. The aim of this work is to avoid vision loss by detecting the presence of abnormalities in macula in advance. The pathologies present in the abnormal images are detected by image segmentation technique viz. Fuzzy K-means algorithm. The classification is done by two different classifiers namely Cascade Neural Network and Partial Least Square which are employed to identify whether the image is normal or abnormal. The results of both the classifiers are compared with respect to classifier accuracy, sensitivity and specificity. The classifier accuracies of Cascade Neural Network and Partial Least Square are 96.84% and 94.36%, respectively. The information about the severity of the disease and the localization of pathologies are very useful to the ophthalmologist for diagnosing the disease and apply proper treatments to the patients to avoid the formation of any lesion and prevent vision loss.

English

INTRODUCTION: Palpable masses of head and neck regions are quite common, affecting all age groups. The lumps are worrisome for both, clinicians and patients as the diagnostic spectrum ranges from innocuous inflammation to life threatening malignancies. Fine needle aspiration cytology plays a vital role in solving all this issues, and fine needle aspiration cytology is now being recognized as a rapid diagnostic technique because of its simplicity and high accuracy. AIM: This retrospective study was carried out at the Department of Pathology, BSR Hospital and diagnostic Centre Rajnandgaon (C.G.) for a period of one year from April 2013 to March 2014. The aim was to know the pattern and frequency of head and neck swelling in rural Indian population, and also to know the distribution of these lesions in relation to age and sex. RESULT: A total of 241cases of head and neck swelling were observed during this period. Age of presentation varied from 1 year to 82 years with male to female ratio of 1 to 1.23. Lymph node enlargement was the commonest cause (48.54%), followed by thyroid lesions (23.65%). Salivary gland lesions comprised 5.8% of all lesions. Tuberculosis/Granulomatous lymphadenitis and Non-specific lymphadenitis were the most common lesion observed constituting 22.4 %( n=54) each. Other common cause of swelling in region observed were due to Colloid goiter n=44 (18.25%), Cystic lesion n=20 (8.29%) and Abscess/inflammatory lesion n=16 (6.63%). CONCLUSION: During the first three decades, most of the swelling of the head and neck region was either due to Tuberculosis/Granulomatous lymphadenitis or due to Reactive lymphadenitis. Among thyroid swellings both colloid goiter and thyroditis were found to be common in females. Fine needle aspiration cytology is useful in diagnosis and differentiating Neoplastic and Non Neoplastic lesions.

Heamangioma in parotid gland encroaching on the temporomandibular joint: A case report

The majority of swellings in the parotid region are sialadenitis, neoplastic lesion or lymph node. Vascular malformation is a rare cause of swelling of the parotid gland. Parotid heamangioma usually presents as a cystic swelling in the preauricular area but may mimic sialadenitis making the diagnosis difficult. We are reporting, to our knowledge, the first case of parotid gland heamangioma with its clinical presentation, radiological and surgical features which extended medially to the temporomandibular joint. The rarity of such condition in head and neck region and misdiagnosis or failing to diagnose make this case more interesting to the maxillofacial surgeon.

Localized hypertrophy of the semimembranosus muscle in a young athlete: A case report

Popliteal fossa and distal thigh swellings have many causes in young active adult. Cysts are the main cause, but they may also evolve from fatty tissue, lymph nodes or the popliteal artery. Semimembranosus muscle hypertrophy, found in athletes and young active adults, is only rarely the main or only cause of swelling, and only four such cases are reported in the literature. The present article reports our experience in the management of a case of semimembranosus hypertrophy as the only cause of a swelling above the popliteal fossa, and its favorable evolution.

Identification of Clostridium butyricum as the bacteria causing soy sauce explosion and leakage and its control using nisin

The cause of leakage and explosion of bottled soy sauce was determined by isolating gas-forming bacteria from leaking soy sauce samples, and identifying them as Clostridium butyricum. This is the first report of the isolation of C. butyricum from bottled soy sauce and identification of gas production by the bacteria as the cause of swelling and leakage in soy sauce. Their gas production was further confirmed by inoculating uncontaminated soy sauce with the C. butyricum isolated from a leaking bottle of soy sauce. The source of C. butyricum contamination could be traced back to the ingredient monosodium glutamate (MSG) with C. butyricum spores. Nisin (50 mg/L) was successfully employed to prevent C. butyricum from spoilage. The incidence of leakage of bottled soy sauce was markedly reduced after 50 mg/L nisin was added. The isolation and identification work assist food industry to control the leakage of soy sauce, and the strategy utilized in this work should assist in the characterization of spoilage organisms in other food systems.

Isolated unilateral temporalis muscle hypertrophy

Isolated unilateral temporalis muscle hypertrophy is an extremely rare cause of swelling in the temple region, with only 7 cases reported in the literature. The authors report the eighth case of this unique occurrence in a 17-year-old boy and review the current literature.

PREDICTING SUCCESSFUL OUTCOMES OF WRIST AND FINGER GANGLIA

Ganglia are the commonest cause of swellings of the hand and wrist; the documented success of outcomes varies considerably. There is little published data to help predict patients likely to benefit from each treatment modality. We sought to identify factors predicting success of each intervention to provide an evidence basis to inform referral criteria and treatment decisions. A retrospective series of 140 serial patients referred with confirmed hand and wrist ganglia between June 2005 and January 2011 was studied to a minimum of 12-month follow-up to determine predictors of successful treatment. Treatment was deemed to be successful if the patient did not develop recurrence. Analysis was completed for predictors of successful treatment at presentation; examining gender, presence of pain, duration of symptoms, anatomic location and treatment modality. Treatment success rate following aspiration was 34% for wrist and 58% for finger ganglia and for surgical excision 7% for wrist and 4% for finger ganglia. Surgical excision was significantly more successful than aspiration (p < 0.01). Duration of symptoms greater than one year was significantly associated with increased recurrence rates (relative risk 2.33, p < 0.05) and male sex was associated with lower recurrence (relative risk: 0.54, p = 0.14). Subgroup analysis of different varieties of soft tissue ganglia did not show any statistically significant factors predictive of recurrence, although both painless presentation and male sex were of borderline significance. Duration of symptoms less than one year and male sex can be used to identify patients likely to benefit from interventional treatments and guide treatment decisions. Surgical excision was significantly more successful than aspiration (p < 0.01).