Common Lesions Research Articles

Neoplastic and non-neoplastic lesions in biopsy samples from pet rabbits in Hong Kong: a retrospective analysis, 2019-2022.

Rabbits are popular pets in the urban environment of Hong Kong, ranking third behind cats and dogs. Here we describe the frequency of neoplastic and non-neoplastic lesions in biopsies from pet rabbits submitted to the CityU Veterinary Diagnostic Laboratory between 2019 and 2022, comprising 247 tissue samples from 243 rabbits collected by veterinarians in 19 veterinary clinics. Among the 243 rabbits, there were 128 females (65 spayed), 114 males (54 castrated); sex information was not provided for 1 rabbit. The rabbit breeds included 45 Lionhead, 35 Dwarf, 14 Lop, 11 Dwarf Lop, 5 French Lop, 3 Angora, 2 Dutch, 2 Holland Lop, and 1 each of Netherland Dwarf, Velveteen, Mini Lop, and New Zealand White. The mean ages of rabbits with neoplastic and non-neoplastic lesions were 7.1 and 5.7 y, respectively. The most common neoplastic lesions were adenocarcinoma (26.4%), trichoblastoma (21.4%), sarcoma (9.4%), and thymoma (8.2%). The most common non-neoplastic lesion was uterine cystic endometrial hyperplasia (14.8%), followed by dermal abscess formation in the ventral abdomen or skin of the head (12.5%). Although a broad spectrum of other lesions was described, our findings in biopsies from pet rabbits in Hong Kong are consistent with those in other jurisdictions.

The mechanism of low molecular weight fucoidan-incorporated nanofiber scaffolds inhibiting oral leukoplakia via SR-A/Wnt signal axis.

Oral leukoplakia (OLK) is the most common oral precancerous lesion, and 3%-17% of OLK patients progress to oral squamous cell carcinoma. OLK is susceptible to recurrence and has no effective treatment. However, conventional drugs have significant side effects and limitations. Therefore, it is important to identify drugs that target OLK. In this study, scavenger receptor A (SR-A) was found to be abnormally highly expressed in the oral mucosal epithelial cells of OLK patients, whereas molecular biology studies revealed that low molecular weight fucoidan (LMWF) promoted apoptosis of dysplastic oral keratinocytes (DOK) and inhibited the growth and migration of DOK, and the inhibitory effect of LMWF on OLK was achieved by regulating the SR-A/Wnt signaling axis and related genes. Based on the above results and the special situation of the oral environment, we constructed LMWF/poly(caprolactone-co-lactide) nanofiber membranes with different structures for the in-situ treatment of OLK using electrospinning technology. The results showed that the nanofiber membranes with a shell-core structure had the best physicochemical properties, biocompatibility, and therapeutic effect, which optimized the LMWF drug delivery and ensured the effective concentration of the drug at the target point, thus achieving precise treatment of local lesions in the oral cavity. This has potential application value in inhibiting the development of OLK.

A Boundary-Enhanced Decouple Fusion Segmentation Network for Diagnosis of Adenomatous Polyps.

Adenomatous polyps, a common premalignant lesion, are often classified into villous adenoma (VA) and tubular adenoma (TA). VA has a higher risk of malignancy, whereas TA typically grows slowly and has a lower likelihood of cancerous transformation. Accurate classification is essential for tailored treatment. In this study, we develop a deep learning-based approach for the localization and classification of adenomatous polyps using endoscopic images. Specifically, a pre-trained EGE-UNet is first adopted to extract regions of interest from original images. Multi-level feature maps are then extracted by the feature extraction pipeline (FEP). The deep-level features are fed into the Pyramid Pooling Module (PPM) to capture global contextual information, and the squeeze body edge (SBE) module is then used to decouple the body and edge parts of features, enabling separate analysis of their distinct characteristics. The Group Aggregation Bridge (GAB) and Boundary Enhancement Module (BEM) are then applied to enhance the body features and edge features, respectively, emphasizing their structural and morphological characteristics. By combining the features of the body and edge parts, the final output can be obtained. Experiments show the proposed method achieved promising results on two private datasets. For adenoma vs. non-adenoma classification, It achieved a mIoU of 91.41%, mPA of 96.33%, mHD of 11.63, and mASD of 2.33. For adenoma subclassification (non-adenomas vs. villous adenomas vs. tubular adenomas), it achieved a mIoU of 91.21%, mPA of 94.83%, mHD of 13.75, and mASD of 2.56. These results demonstrate the potential of our approach for precise adenomatous polyp classification.

Clinicopathological Spectrum of Head and Neck Lesions By FNAC at a Tertiary Care Centre in Barpeta, Assam – A Retrospective Study

Background: Various neoplastic and non-neoplastic lesions arising from lymph nodes, salivary glands, thyroid gland, soft tissue and metastatic deposits comprises the wide spectrum of lesions in the head & neck region. The Foundation of Head and Neck Cancer (FHNC) helps in differentiating non-neoplastic lesions from neoplastic and further from benign and malignant lesions. The aim of this study was to evaluate the role and diagnostic accuracy of FNAC in diagnosis of palpable head and neck lesions. Materials and methods: A total of 360 cases were included in the study. Out of the 360 cases, 122 (33.89%) cases were sent for histopathological examination and the results were correlated histologically. Aspirations were done by using 10 ml syringe and 22/23-gauge needles. Smears were stained with May Grunwald Giemsa (MGG). Cytomorphological diagnosis was given. Results: Out of 360 patients of head and neck lesions studied, lymph node (40.56%) was the predominant site aspirated with reactive lymphoid hyperplasia being the commonest lesion. Soft tissue constitutes 31.11% cases followed by thyroid lesions with 19.72% cases, salivary gland 7.22% cases, and oral cavity 1.39% cases. FNAC was inconclusive in 4.17% cases. Conclusion: Head and neck lesions are common lesions located superficially that can be easily diagnosed on cytology. Although excisional biopsy is the gold standard for diagnosing head and neck malignant lesions, FNAC plays a vital role as a quick and inexpensive diagnostic procedure with high diagnostic accuracy. It distinguishes between inflammatory/infection and neoplastic lesions, avoiding needless procedures and expediting therapy. FNAC is a low-cost, accurate diagnostic method that may be used as a first-line examination.

Resolutive Treatment of Actinic Keratosis through Peptides Extracted from Zebrafish Conveyed Across Laser-assisted Transcutaneous Delivery (Cryopass Therapy).

Actinic keratoses (AKs) are humans' most common keratinocyte-derived precancerous lesions. They can be observed predominantly in fair-skinned individuals on sun-exposed surfaces. Another name for AKs is solar keratosis. The primary risk factor for AKs is cumulative UV exposure from sunlight and/or tanning salons. AKs may present on a patient as a few detectable lesions. Clinically, they present as scaly erythema lesions with various pigmentations. Surgery treatment is the only approach that can definitively resolve the illness. The research aims to demonstrate the effectiveness of treating relapsing AKs through the use of factors present during organogenesis extracted from zebrafish caviar conveyed through a cryopass therapy device (cryolaser phoresis). These factors are peptides present during specific phases of organogenesis and have shown the capacity to reverse cancer and neurodegeneration processes through gene, transcriptional, translational, and post-translational regulation. We found that 90% of patients responded. The percentage of responding patients was 100% among females and 80% among men. Our results confirm previous findings about the effectiveness of stem cell differentiation stage factors (SCDFs) in cancer and open new ways to integrate treatment.

Outcomes of Covid-19 Vaccine-Associated Glomerular Diseases (CVAGD) – A Case Series from India

Background Several cases of glomerular diseases following Covid-19 vaccination, especially mRNA vaccines, have been reported. However, there is little data on glomerular diseases associated with the two vaccines widely available in India (Covaxin and Covishield) and their long-term outcomes. Materials and Methods This was a prospective observational study conducted between May 2021 and May 2023. Patients with new-onset or relapse of proteinuria, hematuria, or renal failure within 30 days of Covid-19 vaccination were included. Data on pre-existing renal disease, vaccine type, symptomatology, laboratory reports, kidney biopsy findings, and treatment details were collected. The clinical course and long-term renal outcomes were studied. Results Sixteen patients with Covid-19 vaccine associated glomerular disease (CVAGD) were studied. The median age was 28 years (IQR 20.5–40) and median time of symptom onset was 14 days (IQR 10–16.5) after vaccination. Renal syndromes at presentation were nephrotic syndrome in seven patients (43.75%), nephritic syndrome in seven patients (43.75%), and rapidly progressive renal failure in two patients (12.5%). Kidney biopsy revealed minimal change disease in five patients (31.2%); IgA nephropathy in four patients (25%); C3 glomerulopathy, lupus nephritis, and focal segmental glomerulosclerosis in two patients each (12.5%); and pauci-immune glomerulonephritis (ANCA-associated vasculitis) in one patient (6.25%). Eleven patients were treated with immunosuppressive drugs. Median duration of follow-up was 20 months (IQR 18–21). At last follow-up, 11 patients had complete recovery of renal failure and proteinuria and 4 patients had partial recovery. Conclusion The most common lesions in this series were minimal change disease and IgA nephropathy. The overall long-term outcome of CVAGD appears good.

Bioadhesive and drug-loaded cellulose nanofiber/alginate film for healing oral mucosal wounds

Recurrent oral ulcers are common oral mucosal lesions that severely reduce patients' quality of life. Commercial mucoadhesive films are easily disrupted due to oral movement and complex wet environments, thus reducing drug utilization and even causing toxic side effects. Herein, we report a mucoadhesive film composed of Ca2+-crosslinked carboxymethylated cellulose nanofibers and alginate, in which two drugs of dexamethasone (DXM) and dyclonine hydrochloride (DYC) are loaded for the treatment of oral ulcers. The wet films have a high Young's modulus of 7.1 ± 2.6 MPa and a large strain of 53.6 ± 9.8 % and adhere to tissue strongly, which allows them to resist the deformation caused by frequent oral movement. The films also have nice durability against water and excellent biocompatibility. Moreover, the drug release was controlled at different rates. The fast release of DYC facilitates the quick relief of pain, while the slow release of DXM benefits the long-term treatment of wounds. Finally, the animal experiment demonstrates the films displayed excellent therapeutic efficacy in healing oral ulcers.

Preoperative planning of craniectomy and reconstruction using three-dimension-printed cranioplasty for treatment of calvarial lesion.

Common calvarial lesions include fibrous dysplasia (FD), intraosseous meningioma, osteoma, Langerhans cell histiocytosis (LCH), intraosseous hemangioma, dermoid and epidermoid cyst, and malignancy. Surgical removal with removal of the involved skull is the choice of treatment for these lesions. Previously, the skull defect was repaired using allograft, and alloplastic materials have been replaced with newer polyetheretherketone (PEEK) material, which is more resistant, biocompatible, and can be 3-dimension (3D)--printed. High-resolution 3D printing uses very fine extruders to put materials in fine layers to recreate patients' anatomy authentically, which gives superior cosmetic outcomes. Our objectives were preoperative planning of craniectomy and reconstruction for calvarial lesions and reconstruction of skull defects using 3D-printed cranioplasty with PEEK materials. In this series, we describe 11 cases in which skull lesions were removed and reconstructed in the same sitting using a 3D-printed PEEK implant designed preoperatively using high-resolution computer tomography. All the cases were done in the neurosurgery department of Bangabandhu Sheikh Mujib Medical University from 2021 to 2023. Patients were followed up for 6 months after surgery. Regarding 11 cases, six cases were FD, three cases were intraosseous meningioma, one case was intraosseous hemangioma, and one case was LCH. Average lesion size were 12.73-5.77 cm. Cranioplasty was done with PEEK material. Minor complications were treated conservatively. Seroma, postoperative fever, and nausea were among these. The human bone-like biocompatibility and resistance to physical forces leads to more frequent use of PEEK, which enables to repair of complex craniofacial defects with better cosmesis. Despite some limitations, the PEEK cranioplasty implant continued to thrive and showed its promise to be an excellent material. Further, research and investment should be put into developing the technique.

Clinical profile of patients with atrial fibrillation in an outpatient setting of a hospital in India: A cross-sectional study

Abstract Background: There has been an increasing trend of prevalence of atrial fibrillation (AF) globally. As per estimates, there is a possibility of doubling or tripling of AF cases by 2050. Early diagnosis by common symptom screening can help prevent complications in patients with AF. Objective: The objective of this study was to study the causes, symptoms, and complications of AF. Materials and Methods: A hospital-based cross-sectional study was carried out among 100 cases of AF who presented to the outpatient department for follow-up. History, thorough clinical examination, and investigations such as electrocardiogram (ECG) and echocardiogram were carried out for all cases. For all cases, 12-lead ECG was recorded. M-mode two-dimension echocardiography was done in all cases. Results: As age increased, the proportion of AF increased. The most important and leading cause of AF across all age groups and both sexes was rheumatic heart disease (RHD). There was a slight female preponderance. The most common valvular lesion in RHD was a combination of mitral stenosis and mitral regurgitation in 40%. The most common symptom was dyspnea (92%) followed by palpitations (84%). The most common complication was heart failure (40%) followed by left atrial clots (10%). Conclusion: RHD was the most common cause of AF. Mitral valve was affected in almost all cases. Dyspnea and palpitations were the most common presenting symptoms. Heart failure was the most common complication. Screening for AF in all cases with dyspnea and palpitations can help with early diagnosis and prompt treatment of AF and can prevent further complications.

Selective anti-tumor activity of glutathione-responsive abasic site trapping agent in anaplastic thyroid carcinoma

Anaplastic thyroid carcinoma (ATC) is a rare but highly aggressive thyroid cancer with poor prognosis. Killing cancer cells by inducing DNA damage or blockage of DNA repair is a promising strategy for chemotherapy. It is reported that aldehyde-reactive alkoxyamines can capture the AP sites, one of the most common DNA lesions, and inhibit apurinic/apyrimidinic endonuclease 1(APE1)-mediated base excision repair (BER), leading to cell death. Whether this strategy can be employed for ATC treatment is rarely investigated. The aim of this study is to exploit GSH-responsive AP site capture reagent (AP probe-net), which responses to the elevated glutathione (GSH) levels in the tumor micro-environment (TME), releasing reactive alkoxyamine to trap AP sites and block the APE1-mediated BER for targeted anti-tumor activity against ATC. In vitro experiments, including MTT andγ-H2AX assays, demonstrate their selective cytotoxicity towards ATC cells over normal thyroid cells. Flow cytometry analysis suggests that AP probe-net arrests the cell cycle in the G2/M phase and induces apoptosis. Western blotting (WB) results show that the expression of apoptotic protein increased with the increased concentration of AP probe-net. Further in vivo experiments reveal that the AP probe-net has a good therapeutic effect on subcutaneous tumors of the ATC cells. In conclusion, taking advantage of the elevated GSH in TME, our study affords a new strategy for targeted chemotherapy of ATC with high selectivity and reduced adverse effects.

Epigenetic alterations affecting hematopoietic regulatory networks as drivers of mixed myeloid/lymphoid leukemia

Leukemias with ambiguous lineage comprise several loosely defined entities, often without a clear mechanistic basis. Here, we extensively profile the epigenome and transcriptome of a subgroup of such leukemias with CpG Island Methylator Phenotype. These leukemias exhibit comparable hybrid myeloid/lymphoid epigenetic landscapes, yet heterogeneous genetic alterations, suggesting they are defined by their shared epigenetic profile rather than common genetic lesions. Gene expression enrichment reveals similarity with early T-cell precursor acute lymphoblastic leukemia and a lymphoid progenitor cell of origin. In line with this, integration of differential DNA methylation and gene expression shows widespread silencing of myeloid transcription factors. Moreover, binding sites for hematopoietic transcription factors, including CEBPA, SPI1 and LEF1, are uniquely inaccessible in these leukemias. Hypermethylation also results in loss of CTCF binding, accompanied by changes in chromatin interactions involving key transcription factors. In conclusion, epigenetic dysregulation, and not genetic lesions, explains the mixed phenotype of this group of leukemias with ambiguous lineage. The data collected here constitute a useful and comprehensive epigenomic reference for subsequent studies of acute myeloid leukemias, T-cell acute lymphoblastic leukemias and mixed-phenotype leukemias.

Pink and Blue of Bones- A Histopathological Analysis of Bony Neoplasm in a Tertiary Hospital of Bihar

Background: Bone lesions have low incidence with diverse presentation and due to the presence of their limited studies it has become a challenging task to reach an accurate diagnosis. Aim and Objective: This study aims in studying variety of bony lesions observed clinically and histopathologically. Further categorizing into non neoplastic, tumour-like, benign tumour or malignant tumour and determining its correlation with the age and gender predisposition of these lesions. Materials and Methods: An ambispective study was executed in Pathology department , PMCH, Patna from May 2020 to April 2024 in which a total of 102 cases were collected. The necessary information for the retrospective analysis, such as the patient's age, sex, lesion location, and diagnosis, was obtained from the requisition form and the histopathology data kept in the department of pathology from May 2020 to May 2022. And for prospective study all the radiological proven bony lesions which were excised during period of May 2022 to April 2024 and were sent for histopathological examination were examined. Results: Non-neoplastic lesions were more common than neoplastic lesions among the 102 specimens that underwent histological examination (53 versus 49). With 21.5% of cases, tuberculous osteomyelitis was the most prevalent non-neoplastic lesion. The most common benign neoplastic lesion detected was a giant cell tumor of the bone (11.76%), while the most common malignant lesion found was osteosarcoma (2.94%). Conclusion: To improve patient management and diagnosis accuracy, it is advised to utilize clinical, radiological, and histological findings in an integrated manner.

Comparative Clinical Trial of Dermapen Microneedling and Platelet-Rich Plasma versus Dermapen Microneedling Alone in the Treatment of Stretch Marks in Egyptian Adults

Abstract Background Striae distensae are common skin lesions affecting up to 90% of pregnant women, and many adolescents and men. They pose a psychological burden to many people and no known treatment is completely effective for them. The current treatment options are limited by significant side effects, operator skill, cost, prolonged treatment period, or a combination thereof. Platelet-rich plasma (PRP), along with microneedling (MN), are promising dermatologic procedures with a wide range of applications, excellent safety profiles, yet only partially understood mechanisms of action. Aim of the Work to evaluate the effectiveness and side effects of MN with PRP versus MN alone in the treatment of striae distensae. This work included 40 patients who were divided into left-side lesions (MN alone) versus right-side lesions (PRP + MN). PRP was prepared using single-spin technique, and applied topically just before MN on right-side lesions. An automated MN pen device was used on both sides. Patients and Methods This was a prospective case control study with a split-body design which included 40 adult patients with striae distensae. The patients were recruited from the outpatient dermatology clinic in Ain Shams University hospitals, Cairo. Miravex Antera TM 3D Camera system measured the efficacy by indentation and roughness indices, and patients’ subjective improvement and reported side effects were recorded and analysed. Results A significant improvement was illustrated in both MN and MN + PRP sides in both the indentation and roughness indices measured by the Antera 3D camera system, and most patients reported subjective improvement in color (62.5%), smoothness (97.5%), size (82.5% vs 85%), and general appearance (92.5% vs 90%). Side effects including pain and erythema affected virtually all cases, while pruritis, edema, bleeding, and tram-tracking were less common and short-lasting. Post-inflammatory hyperpigmentation affected about 20% of patients and lasted more than one month in about half of those affected. No significant difference was found between MN and MN + PRP in efficacy or side effects. Conclusion Microneedling offers an effective, cheap, and relatively safe treatment option for striae distensae. Miravex Antera TM 3D Camera system is a powerful objective method of documenting lesions and following up the treatment process. Platelet-rich plasma did not offer additional benefit over microneedling alone.

Transmediastinale migratie van een Kirschner-pin na fixatie van een proximale humerusfractuur: een casus

Transmediastinal migration of a Kirschner pin after fixation of a proximal humeral fracture: a case report Fractures of the proximal humerus are common lesions in the elderly population. In some cases, they are surgically stabilized via a minimally invasive technique, namely percutaneous osteosynthesis with fixation pins. Intrathoracic migration of these pins or wire is a rare complication after percutaneous osteosynthesis of a proximal humeral fracture. In this article, the authors describe an extremely rare transmediastinal migration of a Kirschner pin from the humeral head. The purpose of this case report is to call for awareness and to open a debate in which appropriate prevention can be freely discussed. The consideration of a conservative management, the choice of alternative osteosynthesis techniques, the use of a sling bandage to restrict the shoulder movement, the use of fixation pins with a threaded tip, bending of the external free end of the pin and an appropriate time to remove the pin are possible recommendations from the literature. Furthermore, it is important to provide additional information and awareness to health care providers in rehabilitation centers, geriatricians and orthopedists concerning the possibility of such a life-threatening postoperative complication. Thus, specific policies for clinical and radiographic monitoring of the position of fixation pins should be developed in hospitals and rehabilitation centers with the aim of prevention, early detection and prompt action when this life-threatening complication is suspected.

Balloon-expandable cobalt chromium stent versus self-expandable nitinol stent for the Atherosclerotic Iliac Arterial Disease (SENS-ILIAC Trial) Trial: a randomized controlled trial.

Iliac artery angioplasty with stenting is an effective alternative treatment modality for aortoiliac occlusive diseases. Few randomized controlled trials have compared the efficacy and safety between self-expandable stent (SES) and balloon-expandable stent (BES) in atherosclerotic iliac artery disease. In this randomized, multicenter study, patients with common or external iliac artery occlusive disease were randomly assigned in a 1:1 ratio to either BES or SES. The primary end point was the 1-year clinical patency, defined as freedom from any surgical or percutaneous intervention due to restenosis of the target lesion after the index procedure. The secondary end point was a composite event from major adverse clinical events at 1year. A total of 201 patients were enrolled from 17 major cardiovascular intervention centers in South Korea. The mean age of the enrolled patients was 66.8 ± 8.5years and 86.2% of the participants were male. The frequency of critical limb ischemia was 15.4%, and the most common target lesion was in the common iliac artery (75.1%). As the primary end point, the 1-year clinical patency as primary end point was 99% in the BES group and 99% in the SES group (p > 0.99). The rate of repeat revascularization at 1year was 7.8% in the BES group and 7.0% in the SES group (p = 0.985; confidence interval, 1.011 [0.341-2.995]). In our randomized study, the treatment of iliac artery occlusive disease with self-expandable versus balloon-expandable stent was comparable in 12-month clinical outcomes without differences in the procedural success or geographic miss rate regardless of the deployment method in the distal aortoiliac occlusive lesion (ClinicalTrials.gov, NCT01834495).

Prevalence and Pattern of Mandibular Condensing Osteitis Lesions in Saudi Population at Qassim Region

ABSTRACT Background: Condensing osteitis (CO) is a common radiopaque lesion observed in the jaws, often detected incidentally on panoramic radiographs. Understanding the prevalence and characteristics of CO is essential for early detection and appropriate management. Objective: To determine the prevalence and characteristics of condensing osteitis among the Saudi population in the Qassim region. Methods: A retrospective study was conducted using 876 digital panoramic radiographs. The presence of CO was identified based on specific radiographic features, and data were collected regarding gender, age, lesion localization, lesion shape, and associated dental status. Results: The prevalence of CO was found to be 2.3% (n = 20) in the study population, with a higher predilection in females (1.4%) compared to males (0.9%). The most commonly affected age group was 30–39 years for males and 10–19 and 30–39 years for females. The mandibular molar region was predominantly affected (90%), with a ‘U’ shape observed in 55% of the lesions. Root canal treatment was the most commonly associated dental status (75%), followed by deep caries (20%) and large restorations (5%). Conclusion: The study highlights a 2.3% prevalence of CO in the Saudi population of the Qassim region, with a higher predilection in females and a predominant localization in the mandibular molar region. Dental practitioners should be vigilant in identifying CO, especially in at-risk populations, to facilitate timely diagnosis and appropriate management.

Intra-articular Osteoid Osteomas: Imaging Manifestations and Mimics.

Osteoid osteoma (OO) is the third most prevalent benign bone neoplasm in children. Although it predominantly affects the diaphysis of long bones, OO can assume an intra-articular location in the epiphysis or the intracapsular portions of bones. The most common location of intra-articular OO is the hip joint. The presentation of intra-articular OOs often poses a diagnostic enigma, both from clinical and radiologic perspectives. Initial symptoms are often vague and nonspecific, characterized by joint pain, stiffness, and limited range of motion, which frequently contributes to a delayed diagnosis. Radiographic findings range from normal to a subtle sclerotic focus, which may or may not have a lucent nidus. In contrast to their extra-articular counterparts, intra-articular lesions have distinct features at MRI, including synovitis, joint effusion, and bone marrow edema-like signal intensity. While CT remains the standard for identifying the nidus, even CT may be inadequate in visualizing it in some cases, necessitating the use of bone scintigraphy or fluorine 18-labeled sodium fluoride PET/CT for definitive diagnosis. Radiologists frequently play a pivotal role in suggesting this diagnosis. However, familiarity with the unique imaging attributes of intra-articular OO is key to this endeavor. Awareness of these distinctive imaging findings of intra-articular OO is crucial for avoiding diagnostic delay, ensuring timely intervention, and preventing unnecessary procedures or surgeries resulting from a misdiagnosis. The authors highlight and illustrate the different manifestations of intra-articular OO as compared with the more common extra-articular lesions with respect to clinical presentation and imaging findings. ©RSNA, 2024 Supplemental material is available for this article.

Allicin and Probiotics: Double-edged sword for the management of Striae distensae

Striae distensae (SD), commonly known as Stretch marks or striae, are one of the most common benign dermal lesions frequently seen in females that often cause a significant physical and psychological impact. A number of treatment modalities ranging from topicals to invasive approaches are commercially available, however, none of the available options is capable of complete eradication of SD. As effectiveness of most of the available topical formulations for SD is attributed to the combined effects of their antioxidant, anti-inflammatory and proliferative effects, allicin and probiotic based topical formulations are hypothesized to be effective in treatment and prevention of SD. Both allicin and probiotics are able to reduce the inflammatory response via suppression of transcription factor i.e., nuclear factor (NF)-κB, and pro-inflammatory cytokines and chemokines levels. Moreover, the antioxidant effect of allicin and probiotics is considered to decrease the reactive oxygen species induced fragmentation of collagen. Also, the effects of allicin on the collagen and elastin tissue as well as beneficial effects of probiotics and their metabolites on skin elasticity and skin hydration are expected to provide multiple target approach for the management of SD. Altogether, a combination formulation containing both allicin and probiotics is considered to be novel approach for the prevention and management of SD.

Independent Risk Factors for Postoperative Recurrence of Patients with Primary Extramammary Paget's Disease: A Retrospective Analysis.

Extramammary Paget's disease (EMPD) is a rare skin cancer with unclear pathogenesis, insidious progression, and high recurrence rate. The purpose of this study was to investigate the clinical features and postoperative recurrence factors of primary EMPD. We retrospectively analyzed the medical records of 40 patients with primary EMPD who underwent wide local excision surgery at a single medical center between 2009 and 2019. Risk factors for recurrence of primary EMPD were analyzed using multivariate binary logistic regression. The study included 40 patients with primary EMPD, comprising 31 males (77.5%) and 9 females (22.5%), with a median age of 75.52 years (range 52-99 years). The most common lesion location was the scrotum (22 cases, 55.0%), followed by the vulva, penis, scrotum, underarm and anus. Multivariable regression analysis revealed significant differences in the presence of ill-defined tumour borders, exudation and nodules in the primary lesion affecting the relapse of primary EMPD (p<0.05). Our findings indicate that ill-defined tumour borders, exudation and nodules in the primary site should be considered as independent risk factors for disease recurrence, which may provide useful suggestions for the diagnosis, treatment and follow-up of primary EMPD.

Effectiveness of respiratory management for mechanical ventilator weaning in traumatic spinal cord injury patients with prolonged ventilation

Background. Traumatic spinal cord injury is a medical condition which often results in disability and mortality. The most common lesion was cervical level, which is around 60-75% of all cases, where at this level there is a risk of respiratory problems which often require mechanical ventilation. Case report. In the case discussed, a 28-years-old male was referred from other hospital with traumatic cervical spinal cord injury (C5-C6) ASIA score A with a history of falling from a height of 3 meters. The patient underwent decompressive laminectomy on the tenth day of onset, followed by mechanical ventilation. During treatment, the patient received pharmacological therapy, tracheostomy, acupuncture, physiotherapy, and neuromuscular electrical stimulation for ventilator weaning. The patient was hospitalized for 66 days, with mechanical ventilation duration for 32 days. Conclusions. Factors that can influence the duration of ventilation weaning are the level and severity of spinal cord injury, time of transfer to a health facility, and complications related to ventilator installation. Multidisciplinary management, including pharmacological, physiotherapy, acupuncture, surgical, neuromuscular electrical stimulation, can increase the chances and decreasing the duration of mechanical ventilation, and reducing complications related to spinal cord injury and prolonged ventilation.