Frequent Recurrence Research Articles

Hydrogel for the Treatment of Diabetic Wounds: A Comprehensive Review

Abstract: The management of chronic wounds in diabetic patients is a tough challenge, compounded by elevated amputation rates, frequent recurrence, and increased mortality rates. Nonhealing wounds in people with diabetes are produced by a combination of variables that impede the clearance of injured tissue, stimulate the formation of healthy cell populations, and increase the risk of infection. Traditional wound dressings, such as gauze, films, and bandages, focused solely on hydration and infection prev ention. However, recent scientific investigation has shifted toward advancements in wound healing treatments to overcome the constraints inherent in old methodologies. Hydrogel dressings have surfaced as a particularly enticing and promising avenue for increasing wound healing prowess in the modern medical environment, owing to their remarkable ability for moisture retention, biocompatibility profiles, and therapeutic attributes. The pathophysiology of diabetes wounds has been better studied in recent decades, and a range of functionalized hydrogel dressings have been reported with favourable outcomes, indicating that they have significant potential in healing diabetic wounds. Our approach will comprise a systematic and comprehensive evaluation of the advancements in hydrogel dressing methods related to diabetic wounds. This review presents a strong theoretical foundation for advancing hydrogel dressing technologies and offers suggestions for treating diabetic wound-related problems.

P261 Co-infection of Clostridioides Difficile Aggravates Poor Outcomes in Inflammatory Bowel Disease with Cytomegalovirus Colitis

Abstract Background Inflammatory bowel disease (IBD) prognosis is adversely affected by both Cytomegalovirus (CMV) colitis and Clostridioides Difficile (CD) infection. This is the first study in Asia to investigate the clinical impact and risk factors associated with their co-infection in IBD patients. Methods We conducted a retrospective cohort study at Linkou Chang Gung Memorial Hospital from January 2000 to May 2021, involving 53 IBD patients diagnosed with CMV colitis through colonic CMV immunohistochemistry staining. Based on stool toxin A/B tests, patients were divided into two groups: CMV only and CMV+CD co-infection. We compared baseline characteristics, clinical manifestations, risk factors, and outcomes between these groups. Logistic regression was used to analyze independent risk factors, and Kaplan-Meier methods evaluated cumulative incidence of remission rates. Results The study included 53 patients (37 in the CMV group and 16 in the Co-infection group). Diarrhea (93.8%) and abdominal pain (87.5%) were more prevalent in the co-infection group. Compared to the CMV group, the co-infection group had higher hospitalization times (2.5 vs. 1, p=0.005), more frequent CMV recurrences (1 vs. 0, p<0.001), and longer durations to achieve clinical (5 vs. 1 months, p<0.001), steroid-free (10 vs. 4 months, p=0.001), endoscopic (17.5 vs. 8.3 months, p=0.011), and histological remission (18 vs. 11 months, p=0.021) (Table 1-1). Kaplan-Meier analysis also indicated similar trends in Figure 1. The use of biologics was identified as an independent risk factor for co-infection (Odds Ratio 13.33, Confidence Interval 1.52-117.15, P=0.02) (Table 1-2). Conclusion Co-infection with CMV and CD in IBD patients leads to significantly worse outcomes. Early identification and aggressive treatment of co-infection in high-risk patients are vital for improving their prognosis.

Outcome of 6 Cycles of Primary Intravenous Chemotherapy of Retinoblastoma Patients in Terms of Recurrence in a Tertiary Health Care Hospital

Objective: To determine the frequency of recurrence after 6 cycles of primary intravenous chemotherapy of retinoblastoma patients in a tertiary health care hospital.
 Materials and Methods: This study was conducted at the Department of Ophthalmology, Lahore General Hospital, Lahore from March 15, 2020 to September 15, 2020. A total of 81 patients were selected randomly from outpatient department. Performa designed was used to collect data including name, age, gender, registration number, laterality, age at diagnosis, group of disease, treatment given and outcomes of given treatment. International Intraocular Retinoblastoma Classification (IIRC) was used for classification of the disease. The chemotherapy regimen used was vincristine, etoposide and carboplatin (VEC). A total of 6 cycles were given at 3 weekly intervals. Serial monitoring of the tumors was done to rule out any local recurrence or side effects of therapy.
 Results: Total 81 children presenting with retinoblastoma were enrolled in this study. There were 52(64.2%) male and 29(35.8%) female. The mean age of patients was 3.41±1.45 year. Unilateral disease was in 61 (75.30%) patients while 20 (24.70%) patients had bilateral retinoblastoma. Among 81 children, 20(24.7%) had recurrence of the disease.
 Conclusion: Development of recurrence after intravenous chemotherapy was noted in 24.7 % of all retinoblastoma eyes. Younger patients with more advanced, posteriorly located tumors and subretinal seeds at presentation were at increased risk, but recurrence can often be managed with globe-sparing therapy.

The implication of failure patterns after neoadjuvant chemoradiotherapy with small involved-field in esophageal squamous cell carcinoma.

376 Background: In this study, we aimed to analyze failure patterns, the clinical and biological prognostic factors for treatment outcomes, and evaluate the feasibility of involved-field irradiation (IFI) in patients with esophageal squamous cell carcinoma (ESCC) undergoing neoadjuvant chemoradiotherapy (CCRT). Methods: We retrospectively reviewed the medical records of 511 patients diagnosed with ESCC and underwent neoadjuvant CCRT and radical esophagectomy between January 2016 and February 2022 at Samsung Medical Center. For IFI, the clinical target volume (CTV) was defined as the primary gross tumor volume (GTV) plus a 2.0-3.0 cm longitudinal margin and a 0.5-1.0 cm circumferential margin, as well as the GTV of lymph nodes (LN) plus a 0.5-1.0 cm margin. For elective nodal irradiation (ENI), the CTV encompassed supraclavicular, mediastinal, or abdominal LN regions based on the primary tumor location. IFI was applied in most cases (98%). The failure patterns, loco-regional control (LRC), and survival outcome were analyzed. Regional lymph nodes (LNs) were defined and classified according to the AJCC 8th edition. Non-regional LNs were defined as metastatic LNs in neck, thorax, abdominal area except regional LNs. Results: With a median follow-up of 44.4 months, 213 (41.7%) patients experienced recurrence. The first recurrent sites were locoregional (LR) in 98 patients (19.2%), non-regional LN in 81 (15.9%), and distant organs in 152 (29.7%). Among the 98 patients with LR recurrence, RT in-field failure occurred in 53 (10.4%) patients, in & out-field failure in 18 (3.5%), and out-field failure in 27 (5.3%). In 27 cases of out-field failure only, LR recurrent lesion could be included in the target volume in 7 (1.4%) cases if ENIs were applied. Among the 27 patients, 10 received salvage treatment and 2 did not experience further recurrence. The analysis for the detailed LN recurrence showed that the upper mediastinal and supraclavicular LNs were the most frequent area, regardless of the primary tumor location and other clinical factors. Among 213 recurrent cases, 54 (10.5%) recurred in upper paratracheal LN and 40 (7.8%) in supraclavicular LN. The 5-year LRC rates, disease-control rates, and overall survival (OS) rates were 77.5%, 53%, and 54.3%, respectively. Multivariate analysis revealed that gender, age, cStage, ypStage, and resection margin status were independent prognostic factors for OS. Conclusions: Neoadjuvant CCRT using IFI with a small margin showed favorable treatment outcomes and out-field recurrence that the traditional ENI field could cover accounted for a small portion; thus, it might be feasible in the neoadjuvant setting. However, we need to consider that the upper mediastinal and supraclavicular areas were the most frequent recurrence sites.

Magnetic resonance imaging in the diagnosis of glial brain tumors in the light of a new classification of central nervous system tumors

Glial tumors of the brain is still to be a pressing problem in oncology. They are usually characterized by rapid growth rates, invasiveness, frequent recurrence, and a poor prognosis. This literature review was made with the aim of introducing the diagnostic capabilities of MRI in recognizing glial tumors. It includes 44 sources written for the period from 2005 to 2023.

Tarsal Coalition in Children and Adolescent And Recurrent Sprain Frequency

Tarsal coalitions correspond to an abnormal fusion of one or more tarsal bones. Tarsal coalitions cause pain, stiffness, recurrent sprains, and contracted valgus flat feet in children and adolescents, detrimental to the functional prognosis. They can be difficult to diagnose on standard x-rays, so it is vital to be aware of the indirect radiological signs that may be suggestive. When in doubt, cross-sectional imaging techniques should be used. Despite the fact that it can cause radiation, CTscan is still the gold standard, providing a three-dimensional approach to the bone bridge and allowing comparative bilateral studies.
 We report the case of a 12-year-old boy with unilateral talo-calcaneal left-wing coalition, who presented with pain, a notion of repeated sprains, stiffness of the back foot with a significant limitation of daily activities and sports.

THE COMPARISON SOME MODELS (GAMMA, SLASHED QUASI-GAMMA, THREE PARAMETERS QUASI GAMMA, TWO PARAMETER GAMMA-EXPONENTIAL, AND MODIFIED LOG-LOGISTIC DISTRIBUTIONS) FOR DAILY TEMPERATURE DATA

With the increase in hot temperature events in recent years, there is growing interest in measuring the frequency of recurring temperature events. One of the basis for assessing the frequency of recurrence of temperature events is the probability distribution of temperature events, therefore temperature data is needed to produce statistical modeling, especially in determining the best probability distribution. The study intended to estimate the best-fitted probability model for the daily temperature at the Pekanbaru station in Indonesia from 2010 to 2020 using several statistical analyses. Five continuous probability distributions such as Gamma (GM), Slashed Quasi-Gamma (SQG), Three Parameters Quasi Gamma (TPQG), Two Parameter Gamma-Exponential (TPGE), and Modified Log-Logistic (MLL) distributions were fitted for these tasks using the maximum likelihood technique. To determine the model’s fit to the temperature data, several goodness-of-fit tests were applied, including the graphical methos test (density plot) and Numerical criteria method test (AIC, BIC, and -Log Likelihood). The GM and MLL distribution are found to be the best-fitted probability distribution based on goodness-of-fit tests for the daily temperature data at the Pekanbaru station

Postchemotherapy Retroperitoneal Lumpectomy in Patients with Nonseminoma Testicular Cancer: A Nationwide Study

Background and objectiveOptimal treatment outcomes in patients with metastatic nonseminoma testicular cancer are achieved with chemotherapy and subsequent surgery in cases with residual tumor. In Denmark, postchemotherapy retroperitoneal lumpectomy (RPLP) is performed in patients with residual tumors >1 cm. There is a need to clarify whether this surgical method provides acceptable treatment results. Our objective was to describe morbidity and oncological outcomes of postchemotherapy RPLP. MethodsThis was a retrospective population-based multicenter study including patients with nonseminoma testicular cancer and postchemotherapy RPLP performed in Denmark between 1990 and 2015. A total of 219 patients were eligible, with median follow-up of 19 yr. Postoperative complications were evaluated according to the Clavien-Dindo classification. The cumulative incidence of recurrence inside or outside the borders of a bilateral surgical template, progression-free survival (PFS), and overall survival estimates were calculated using the Kaplan-Meier method. Key findings and limitationsAfter median follow-up of 19 yr, 31/219 patients (14%) experienced a surgical complication, of which 5% were Clavien-Dindo grade ≥III. In total, 37 patients experienced a recurrence. The 5-yr, 10-yr, and 20-yr cumulative risk of recurrence inside a bilateral template was 4.3%, 5.9%, and 5.9%, respectively. The 10-yr PFS rate was 83% and the 10-yr overall survival rate was 96%. The main limitation of the study is the retrospective design. Conclusions and clinical implicationsWith few patients experiencing a major postoperative complication and a 10-yr cumulative rate of 5.9% for recurrence inside a bilateral surgical template, postchemotherapy RPLP appears to be a safe alternative to template surgery for disseminated nonseminoma. Patient summaryWe looked at minimal surgery to remove tumor tissue remaining after chemotherapy in patients with testicular cancer. We found a low frequency of complications, tumor recurrence, and death.

Influence of colorectal anastomotic leakage on time before the loop stoma closing

Background. Important task is determining the long-term consequences of colorectal anastomotic leakage. Leakage with clinical manifestations leads to a higher frequency of local recurrences of rectal cancer and increases the severity of manifestations of low anterior resection syndrome. How does the leakage of colorectal anastomosis affect the period before the closure of loop stoma?Aim. To determine the influence of anastomotic leakage on the term before closing the ileostomy.Methods. In this retrospective incomparable study were included 618 patients with rectal cancer who had been underwent anterior or low anterior resection with formation colorectal anastomosis and loop stoma.Results. Colorectal anastomotic leakage was detected in 86 from 618 patients (13.9 %). The loop stoma was closed in 513 from 618 (83 %) patients. The time to the preventive stoma closure in patients with anastomotic leakage was significantly higher than in patients without anastomotic leakage, p = 0.001. Reconstructive surgery in patients without anastomotic leakage was performed in 9 months after anterior resection. The median time before the stoma closure of patients with X – ray anastomosis leakage was 11 months, with clinical leakage – 17 months, p <0.001.Conclusion. Colorectal anastomotic leakage statistically increases the term before ileostomy closure.

Enhancement of targeted therapy in combination with metformin on human breast cancer cell lines

BackgroundBreast cancer remains a primary global health concern due to its limited treatment options, frequent disease recurrence, and high rates of morbidity and mortality. Thereby, there is a need for more effective treatment approaches. The proposal suggests that the combination of targeted therapy with other antitumoral agents could potentially address drug resistance. In this study, we examined the antitumoral effect of combining metformin, an antidiabetic drug, with targeted therapies, including tamoxifen for estrogen receptor-positive (MCF-7), trastuzumab for HER2-positive (SKBR-3), and antibody against ROR1 receptor for triple-negative breast cancer (MDA-MB-231).MethodsOnce the expression of relevant receptors on each cell line was confirmed and appropriate drug concentrations were selected through cytotoxicity assays, the antitumor effects of both monotherapy and combination therapy on colony formation, migration, invasion were assessed in in vitro as well as tumor area and metastatic potential in ex ovo Chick chorioallantoic membrane (CAM) models.ResultsThe results exhibited the enhanced effects of tamoxifen when combined with targeted therapy. This combination effectively inhibited cell growth, colony formation, migration, and invasion in vitro. Additionally, it significantly reduced tumor size and metastatic potential in an ex ovo CAM model.ConclusionsThe findings indicate that a favorable strategy to enhance the efficacy of breast cancer treatment would be to combine metformin with targeted therapies.Graphical

Analysis of reported cases of repeated violence in Espírito Santo.

Identify the frequency of recurrent violence in cases reported in Espírito Santo and the associated factors. Cross-sectional study. Which included data on violence in Espírito Santo from 2011 to 2018, from the Notifiable Diseases Information System, and, Statistical analyzes were performed using the chi-square test and Poisson regression. 54.2% (N:14.966) of reported cases of violence are repeated, and higher prevalences were associated with female sex (PR:1.54), child (PR: 1.29) or elderly victims (PR: 1.25), the presence of disabilities/disorders (PR:1.42) and occurrence in urban/peri-urban areas (PR: 1.10). Furthermore, there is a greater frequency of injuries caused by a single aggressor (PR: 1.20), man (PR: 1.28), aged 25 or over (PR: 1.09), known to the victim (PR: 2.81) and at home (PR: 1.69). The reported cases of violence showed a high frequency of recurrence, and were associated with the studied characteristics of the victim, the aggressor and the event.

Long-term results of nasolacrimal duct and inferior turbinate swing technique for inverted papilloma of the maxillary sinus.

We developed a technique to preserve the entire nasolacrimal duct and inferior turbinate, by swinging the nasolacrimal duct upward and the inferior turbinate backward; that is, a nasolacrimal duct and inferior turbinate swing technique for sinonasal inverted papilloma of the maxillary sinus. In this study, we evaluated the long-term results of this technique. A retrospective analysis was performed on the data for 53 consecutive pathologically confirmed inverted papilloma patients who were treated using nasolacrimal duct and inferior turbinate swing technique. The frequency of recurrence, the degree of nasolacrimal duct and inferior turbinate preservation, and the frequency of adverse events were assessed. The median follow-up period was 51 months (mean 62.5 months; range 10-187 months). No cases of recurrence within the maxillary sinus were observed among the cases treated using this technique, whereas three (5.7%) of the 53 cases experienced recurrence in areas other than the maxillary sinus. We could preserve the nasolacrimal duct in all cases. On the other hand, the inferior turbinate was resected during surgery in one case. No epiphora, dacryocystiits, numbness of the cheek, or collapse of the ala of the nose was observed. This nasolacrimal duct and inferior turbinate swing technique method is a safe and effective method for the excision of primary or recurrent inverted papilloma and demonstrates low rates of recurrence and complications.

Clinicodemographic Profile Of Recurrent Stroke And Secondary Prevention At Tertiary Care Centre Of North-West India

Background and Aims: Stroke is a major public health problem worldwide. The risk of recurrence is highest in the first year after the stroke, majority of the recurrent cases are due to atherosclerosis of the large arteries. The present study was conducted to evaluate clinico-bio-demographic profile of recurrent stroke patient in respect of risk factor and secondary prevention of stroke. Methods: A hospital-based cross-sectional study was conducted on 300 recurrent ischemic/hemorrhagic stroke (age 18-85 yrs.) from August 2015 to March 2017. Stroke mimic were excluded. Risk factors studied were hypertension, diabetes mellitus, hyperlipidemia, cardiac causes and cigarette smoking. Results: Mean age of recurrent stroke was 60±13 years with male preponderance (M: F=5.3). Ischemic stroke was found in 93% cases. About one third (33%) patients had their first recurrence within three months of index stroke. Active smoking, uncontrolled hypertension and diabetes were found in 71%, 62%, and 65 % cases respectively. There was association between first ever stroke and recurrence showing P value > .05, <.001 and <.01 for uncontrolled hypertension, diabetes and active smoking respectively. Extra cranial stenosis (>70%) was found in 29% of recurrent stroke. Out of all stroke cases 40% were drug defaulters. Conclusions: In our study commonest cause of recurrent stroke was active smoking followed by uncontrolled diabetes, uncontrolled hypertension, poor drug compliance and symptomatic carotid stenosis. Frequency of recurrence was more within 3 months.

Predicting response to iron supplementation in patients with active inflammatory bowel disease (PRIme): a randomised trial protocol

IntroductionIron deficiency anaemia (IDA) is the most common systemic manifestation of inflammatory bowel disease (IBD) that has detrimental effects on quality of life (QoL) and disease outcomes. Iron deficiency (ID),...

The Benefit of the Optimized Formula of Yinxieling in Psoriasis Vulgaris via Regulation on Autophagy Based on microRNA Expression Profile and Network Pharmacology Analysis.

Psoriasis is a widespread chronic, immune-mediated skin disease with frequent recurrences, and is extremely harmful to the physical and mental health of patients, causing enormous suffering and exerting considerable economic burdens on the health care system as a whole. In more than a decade of clinical use, the optimized formula of Yinxieling (PSORI-CM01) has consistently demonstrated its effectiveness for treating psoriasis. However, its underlying mechanism remains largely unexplored. The network pharmacology analysis was conducted to predict the mechanism and protective effect of PSORI-CM01 in treating psoriasis. Subsequently, we collected blood samples from 21 patients with psoriasis as part of a randomized, double-blind, and double-dummy clinical trial for microRNA expression profiling. Finally, it was experimentally confirmed that PSORI-CM01 improved psoriasis by regulating miR-20a-3p and miR-3184-3p expression. As a result of the network pharmacology analysis, PSORI-CM01 improved psoriasis through the regulation of autophagy, cellular apoptosis, cellular proliferation, and anti-inflammatory processes. In the target-miRNA regulatory network, these key targets were mainly associated with the regulation of hsa-miR-20a-3p, hsa-miR-155-5p, has-miR-3184-3p, hsa-miR-328-3p and hsa-miR-124-3p. Based on the microRNA expression profiling results, the PSORI-CM01 treatment group exhibited five up-regulated genes and 16 down-regulated genes compared with the healthy control group. In particular, miR-20a-3p and miR-3184-3p were the primary differentially expressed microRNAs, and they were significantly enriched in the signaling pathways involving autophagy, apoptosis, proliferation, and anti-inflammation. Further experiments confirmed that PSORI-CM01 effectively regulates miR-20a-3p and miR-3184-3p, resulting in increased autophagy. We demonstrated by combining network pharmacology and clinical studies of miRNA expression profiles in PBMCs that PSORI-CM01 effectively modulated miR-20a-3p and miR-3184-3p, leading to an increase in autophagy and a decrease in keratinocyte proliferation.

Gastroprotective activity of the galactomannan extracted from cassia grandis seeds: an in vivo study

Peptic ulcer is a common disease with a high clinical incidence and frequent recurrences. The well-characterized galactomannan-type polysaccharide, extracted from Cassia grandis seeds, can accelerate the stages of wound healing and improve the remodeling of the extracellular matrix of injured tissues; this way, the gastroprotective potential of the galactomannan was proposed to be evaluated in the treatment of rat peptic ulcers induced by ethanol. Galactomannan was extracted by ethanol precipitation and prepared at 0.1, 1.0, and 10 mg/kg concentrations. Male Wistar rats were randomly divided into groups (n = 5) and orally treated with saline (negative control, NC), galactomannan at 0.1 mg/Kg (G0.1), galactomannan at 1.0 mg/Kg (G1), galactomannan at 10 mg/Kg (G10), and lansoprazole 30 mg/Kg (positive control, CP). Ethanol (1 mL/100g of body mass) was administered 1 h after the treatments and, after another hour, the animals were euthanized. The stomachs were removed, fixed between Petri dishes, and photographed to calculate the percentage of the injured regions by computerized software. Histological analysis and the quantification of lipid peroxidation and reduced glutathione (GSH) were also performed. G1 and G10 reduced the injured area (P < 0.001) by 40 and 36%, respectively, concerning NC. It was observed the preservation of the gastric mucosa in all of the animals treated with galactomannan, in addition to reduced (P < 0.001) lipid peroxidation and GSH levels higher (P < 0.05) than NC. The galactomannan extracted from C. grandis seeds showed gastroprotective activity at 1.0 and 10 mg/kg by reducing the area of ulceration and oxidative stress.

Potential clinical application of microRNAs in bladder cancer.

Bladder cancer (BC) is the tenth most prevalent malignancy globally, presenting significant clinical and societal challenges because of its high incidence, rapid progression, and frequent recurrence. Presently, cystoscopy and urine cytology serve as the established diagnostic methods for BC. However, their efficacy is limited by their invasive nature and low sensitivity. Therefore, the development of highly specific biomarkers and effective non-invasive detection strategies is imperative for achieving a precise and timely diagnosis of BC, as well as for facilitating an optimal tumor treatment and an improved prognosis. microRNAs (miRNAs), short noncoding RNA molecules spanning around 20-25 nucleotides, are implicated in the regulation of diverse carcinogenic pathways. Substantially altered miRNAs form robust functional regulatory networks that exert a notable influence on the tumorigenesis and progression of BC. Investigations into aberrant miRNAs derived from blood, urine, or extracellular vesicles indicate their potential roles as diagnostic biomarkers and prognostic indicators in BC, enabling miRNAs to monitor the progression and predict the recurrence of the disease. Simultaneously, the investigation centered on miRNA as a potential therapeutic agent presents a novel approach for the treatment of BC. This review comprehensively analyzes biological roles of miRNAs in tumorigenesis and progression, and systematically summarizes their potential as diagnostic and prognostic biomarkers, as well as therapeutic targets for BC. Additionally, we evaluate the progress made in laboratory techniques within this field and discuss the prospects.

Postoperative Radiotherapy in Curatively Resected Esophageal Squamous Cell Carcinoma With Occult Recurrent Laryngeal Nerve Lymph Node Metastasis.

Surgery is the mainstream treatment for early-stage esophageal squamous cell carcinoma (ESCC) and occult recurrent laryngeal nerve lymph node metastasis (RLNM) is not uncommon among those with R0 resection. The clinical value of postoperative radiotherapy (PORT) in patients with RLNM only is still controversial. Consecutive patients with early-stage ESCC treated with R0 resection and pathologically confirmed RLNM only from June 2012 to July 2022 were retrospectively reviewed. PORT, covering the supraclavicular and superior mediastinum area (small T-field) at a dose of 50.4Gy for 28 fractions, was performed in some patients. Propensity score matching (PSM) was performed to balance the baseline characteristics between patients with or without PORT. Pattern of failure, disease-free survival (DFS), and overall survival (OS) were compared. Among the 189 patients identified, 69 (35.5%) received PORT and the other 120 (63.5%) did not. After PSM, 154 patients were included in the matched cohort, including 62 in the PORT group and 92 in the non-PORT group. With a median follow-up of 48 (95% CI: 40.3-55.7) months, 69 patients developed their initial disease recurrence in the whole population and PORT significantly decreased the frequency of local recurrence (61.2% vs 21.4%) among those with recurrent disease. Additionally, in the PSM matched cohort, PORT significantly prolonged patients' DFS (HR 0.393, P = 0.002) and OS (HR 0.462, P = 0.020). Moreover, PORT remained as the independent factor associated with improved DFS (HR 0.360, P = 0.001) and OS (HR 0.451, P = 0.021) after multivariate Cox analyses. In addition, tumor location and pathological TNM stage were found to be independent prognostic factors associated with survival outcomes. PORT is associated with improved DFS and OS in ESCC patients with R0 resection and RLNM only, which warrants future validation.

A Case of Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Mimicking Hashimoto’s Thyroiditis

Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma (DSV-PTC) is a rare and aggressive subtype of Papillary Thyroid Carcinoma (PTC) The prognosis of this variant is as good as classic PTC, but close follow-up is necessary because of frequent tumour recurrence. The authors report a case of a 30-year-old female who presented with a 6-month history of gradually progressive midline neck swelling. Antithyroid antibodies were elevated, and radiology was suggestive of a colloid goitre. Total thyroidectomy was done along with anterior compartment lymph node removal for confirmation. Interestingly, histopathology showed a picture reminiscent of Hashimoto’s Thyroiditis (HT), but the lymph node showed tumour metastasis. Thereafter, additional sections were taken to establish the diagnosis of DSV-PTC in the thyroid. The present case highlights the importance of extensive sampling in histopathology for a suspected case of malignancy, as it can be misdiagnosed as a benign aetiology.

RPFNet: Recurrent Pyramid Frequency Feature Fusion Network for Instance Segmentation in Side-Scan Sonar Images

Side-scan sonar (SSS) is an essential acoustic sensor device for obtaining underwater information. The instance segmentation of sonar images can effectively locate and detect underwater objects. Although various CNN-based frameworks have achieved promising results in natural image instance segmentation, the noise interference, highlight shadow, and blurred edge in sonar images bring more significant challenges for sonar image instance segmentation. To solve these problems, we propose a novel recurrent pyramid frequency feature fusion network (RPFNet), which mainly consists of the pyramid frequency feature fusion network (PFN), recurrent residual attention mechanism (RRAM), mask prediction module, and semantic segmentation module. By enhancing and fusing different frequency features of SSS images, PFN can effectively extract fine-grained features and reduce background information interference. The RRAM uses residual structure and attention mechanism to enhance the correlation of different frequency features and improve nonlinear feature representation ability. The mask prediction and semantic segmentation modules are used to discriminate object instance categories and generate corresponding semantic segmentation results. We extensively evaluate the proposed framework on the real-scenes sonar image dataset. The evaluation results demonstrate that the proposed method outperforms the state-of-the-art methods in various evaluation metrics. Code is available at <uri xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">https://github.com/darkseid-arch/SonarRPFNet</uri> .