Large Swelling Research Articles

Perplexity of Preoperative Multimodal Investigations in a Case of Parotid MALToma.

Mucosa-associated lymphoid tissue(MALT) lymphoma is a distinct subtype of lymphoma, presenting as a diffuse gland involvement or a discrete mass. Pre-operative diagnosis is a challenge as Fine Needle Aspiration Cytology is often inconclusive and presently no radiological investigation is confirmatory, therefore final diagnosis is made after surgical resection and immunohistopathology. We report a case of MALT lymphoma, which clinically presented as a unilateral large diffuse swelling of the parotid gland with a diagnostic dilemma eventually underwent total parotidectomy to be finally diagnosed as MALT lymphoma of parotid gland and received field radiotherapy with complete cure and no recurrence in a 2-year follow-up.

Hollow Microneedle‐based Plasmonic Sensor for on Patch Detection of Molecules in Dermal Interstitial Fluid

AbstractInterstitial fluid (ISF) extraction and analysis are challenges that can be tackled by Hollow MicroNeedles (HMNs) technology, overcoming most of the difficulties associated with in situ detection. Herein, a plasmonic transducer, composed of gold nanoparticles embedded in poly(ethylene glycol) diacrylate (PEGDA) hydrogels, is integrated in the inner cavity of HMNs to detect biomarkers from the ISF‐based point‐of‐care. The wearable HMN‐based patch is used for minimally invasive pierce of the skin. The large swelling capability of the plasmonic transducer allows the uptake of ISF by capillarity. Biotin, as a small model molecule, is efficiently collected in the inner cavity of HMN and its high specificity with the streptavidin is exploited as a validation of the plasmonic nanocomposite functionality embedded within. The recognition of biotin is achieved in dual‐optical mode: the localized surface plasmon resonance (label‐free) and the metal‐enhanced fluorescence (label‐based). Overall, the proposed HMN‐based patch for target sensing in ISF can represent a novel point‐of‐use device for the detection of biomarkers as an alternative to conventional hospital or lab settings to help faster medical decision‐making.

A linear-elastic-nonlinear-swelling theory for hydrogels. Part 1. Modelling of super-absorbent gels

We introduce a new approach for modelling the swelling, drying and elastic behaviour of hydrogels, which leverages the tractability of classical linear-elastic theory whilst incorporating nonlinearities arising from large swelling strains. Relative to a reference state of a fully swollen gel, in which the polymer scaffold may only comprise less than$1\,\%$of the total volume, a constitutive model for the Cauchy stress tensor is presented, which linearises around small deviatoric strains corresponding to shearing deformations of the material whilst allowing for a nonlinear relation between stress and isotropic strains. Such isotropic strains are considered only to be a consequence of losses and gains of water, while the hydrogel is taken to be instantaneously incompressible. The dynamics governing swelling and drying are described by coupling the interstitial flow of the water through the porous gel with the elastic response of the gel. This approach allows for a complete description of gel behaviour using only three macroscopic polymer-fraction-dependent parameters: an osmotic modulus, a shear modulus and a permeability. It is shown how these three material parameters can, in principle, be determined experimentally using a simple rheometry experiment in which a gel is compressed between two plates surrounded by water and the total force on the top plate is measured. To illustrate our approach, we solve for the swelling of a gel under horizontal confinement and for a partially dried hydrogel bead placed in water.

Case Report: Zygomatic-Malar Abscess

We present a case of acute otitis media complicated by zygomatic-malar abscess in a 25-year-old patient with no previous medical/otorhinolaryngological history, who comes to consultation due to large left temporozygomatic swelling. Its atypical clinical presentation and the applied medical-surgical procedures are reported.

Nano-scale synchrotron imaging of shale swelling in the presence of water

Swelling of shale in response to interaction with water is an important consideration within subsurface energy systems. In the case of waste disposal, swelling can provide important barriers around the waste and enhance the sealing ability of rocks. For shale gas exploration purpose, however, swelling may cause wellbore instability. Therefore, a careful study of shale swelling is critical for subsurface energy related applications. Here, the swelling effects of shale were imaged at nanoscale using an advanced synchrotron Transmission X-ray Microscopy (TXM) imaging technique for the first time, with a spatial resolution down to 40.9 nm. Organic matter and clays within the analysed sample were observed to display large swelling effects which resulted in a 50% reduction in porosity. Strain maps generated using Digital Volume Correlation (DVC) show deformation and significant strain were mostly localized to between the contact boundaries of sharp brittle minerals and softer organic matter and clays. This is the first study, to our knowledge, to directly image the swelling deformation of shale at the tens of nanometer scale and provide local information on the strain evolution.

A case of anterior abdominal wall tuberculosis

A rare case of a middle-aged woman who presented to our emergency department with a huge swelling over lower part of abdomen for 3 years that was associated with continuous purulent foul-smelling discharge from multiple sites over swelling for past 2 years and all her past history was irrelevant except for her significant loss of weight for 6 months and unable to ambulate due to huge swelling for 6 months. She is known diabetes mellitus type 2 for 6 years on oral hypoglycemic drugs. On examination she had stable vital signs, mild pallor, a large globular swelling of about grossly 30×30×20 cm extending from 2 cm below umbilicus superiorly till pubic symphysis inferiorly, bilaterally extending till anterior superior iliac spine, flanks not full, multiple dilated veins over skin. Multiple foul smelling pus discharging sinuses, prominence on leg raise test and absent cough impulse, rest of the abdomen is soft and non-tender with no organomegaly and present bowel sounds. Bilateral inguinal group of lymph nodes were palpable and matted. Swelling was exclusive extra peritoneal on computed tomography (CT) scan. Excision of swelling was done up to anterior rectus raw area open wound with bilateral inguinal lymph node excision was under general anesthesia was done. Histopathology showed granuloma with caseating necrosis from lymph nodes. Anti-tuberculosis therapy intensive phase was started post operative wound was healthy, and after 6 weeks of initiation of anti-tubercular treatment wound was closed with secondary suturing.

Large benign chondroid syringoma of the lower limb-an uncommon presentation of a rare disease

Chondroid syringoma (CS) is a sporadic skin appendage tumor that manifests as slow-growing, subcutaneous, non-tender, non-ulcerating dermal nodules, most often in the head and neck. The tumor is more common in men, has a biphasic age distribution, and usually attains a size of 0.5 to 3 cm. Larger lesions up to 9 cm in size have been recorded in the literature, with the majority of them containing malignancies. Rare cases of malignant CS have been described, with local recurrence and metastasis. We report a case of an 85-year-old man presenting with complaints of a significantly large swelling in the inner aspect of his right thigh for the past 25 years. Clinical and radiological differential diagnoses of a large uncomplicated dermoid cyst, sebaceous cyst, epidermal inclusion cysts, neurogenic tumours, or myxoid tumours with cystic degeneration were suggested. Under general anaesthesia, the lesion was completely excised with a 1 cm margin of healthy surrounding tissue. The histopathological examination of the complete surgical specimen was consistent with CS. Patient has been on regular follow-up and has shown excellent response to treatment, with no evidence of recurrence, metastasis, or disfigurement. With this paper, we report a case of benign CS in an unusual location, attaining a huge size (>10 cm) and, even then, not turning malignant. We hope to add to the current knowledge on CS, allowing for early and accurate diagnosis and successful disease management.

Conservative management of large unicystic ameloblastoma in a young patient: A case report

Objectives: Ameloblastoma is a benign neoplasm with origin from odontogenic epithelium. Unicystic ameloblastoma has clinical and radiographically features resemble to other odontogenic cysts but it has a typical ameloblastomatous epithelium lining the cyst cavity.
 Case: In this case report study, we presented a 9-year-old girl who was referred to Oral and Maxillofacial Surgery of Isfahan Dental School for the management of a large swelling on the right posterior mandiblular region. The histopathologic examination of the specimen showed mural type of unicystic ameloblastoma. In the first step, the patient was treated by decompression of the lesion. Five month after it, shrinkage of the lesion was observed and in the second stage of surgery, curettage of the remaining lesion and extraction of tooth buds in the areas of lesion was performed. After two years, radiographic image showed new bone formation and complete healing of the lesion. 
 Conclusion: Choosing the best treatment for children with unicystic ameloblastoma requires more attention and all clinical and histopathological parameters should be considered. Conservative treatment for ameloblastoma leads to reduce complications after treatment and affect the patient's quality of life.

Effect Of Gypsum (CaSO4) On Soil Using California Bearing Ratio Test

Clay soil is a type of soil that has characteristics, namely low carrying capacity and large swelling and shrinkage, this makes clay soil a poor material for construction work. Civil building construction subgrade shear strength and California Bearing ratio (CBR) value influence the planning of a building. CBR is a comparison between the test load and the Standard Load and is expressed as a percentage. The CBR value was developed to measure the bearing capacity, soil load. The soil stabilization process includes mixing with gypsum material (C2SO4) to obtain the desired gradation so that soil properties become better with calcium levels which bind organic matter soil to clay and also absorb more water which is very useful for strengthening the soil. Testing the California Bearing Ratio (CBR) and direct shear strength of the soil (Direct Shear Test) by adding a different percentage of Gypsum (CaSO4) occurs in the addition of 6% Gypsum in 56 collisions with a value of 48%, in collisions 10 and 25 times the CBR value Optimum occurs in the percentage of 7% gypsum with a value of 27.48% and 28.5%, and the effect of adding gypsum on the cohesion value and the optimum internal friction angle occurs in the addition of 6% lime with a value of 0.017 MPa and 24.93o.

Unusually Large Nasopalatine Duct Cyst- A Case Report

Palatal swellings can at times be a challenging task for clinicians to diagnose, as they may result from various aetiological factors and can derive from the structures within palate or beyond it, either be congenital or acquired in origin. Nasopalatine duct cysts are the most common developmental non-odontogenic cysts account for 10% of maxillary cysts in oral cavity. Though exact aetiology is unknown, these cysts commonly arise from epithelial remnants of nasopalatine duct and usually present as asymptomatic swelling in anterior part of hard palate posterior to the palatal papilla. A unique case report of 28-year-old male patient manifested with a large palatal swelling in the middle of the hard palate with associated symptoms of burning sensation in nose, difficulty while swallowing and change in voice resonance. Radiographic findings revealed well-defined radiolucency in anterior maxilla causing disruption in nasal cavity with histopathological evidence of nasopalatine duct cyst is presented.

4D printed chiral metamaterials with negative swelling behavior

Soft adaptable materials and structures that change their shapes, volumes and properties in response to surrounding environment are important and ideal for scientific and engineering applications. Existing soft gels exhibit a dramatic volumetric swelling deformation when immersed in solution. Developing an innovative material system that can undergo large and actively negative swelling deformation driven by solution is an interesting challenge. In this work, a water-driven mechanical metamaterial with negative swelling is designed and fabricated based on the coupled responses of the swelling of hydrogels and deformation characteristics of chiral metamaterials. The constructed metamaterial utilizes deformation characteristics of 4D printed composite structure to convert the swelling deformation of the hydrogel into a bending deformation of flexible ligaments, resulting in a volume reduction of the entire metamaterial. Activated by surrounding solution, the metamaterial can achieve large and adjustable effective negative swelling behaviors with the desired isotropic characteristics. Based on experimental data and finite element simulation results, the customized metamaterials can be implemented to produce the desired negative swelling deformation by adjusting the lattice geometry and microstructural parameters. These design concepts exploit the capabilities of existing soft materials and have great potential in a variety of applications.

Cellulose nanofibrils reinforced chitosan-gelatin based hydrogel loaded with nanoemulsion of oregano essential oil for diabetic wound healing assisted by low level laser therapy

Diabetic foot ulcers are imperfections in the process of wound healing due to hyperglycemic conditions. Here, a nanoemulgel fabricated with oregano essential oil nanoemulsion, assisted by low-level laser therapy, was investigated for its efficacy in diabetic wound healing. A hydrogel- based healing patch, fabricated using biological polymers namely chitosan and gelatin and, polyvinyl pyrollidone. The hydrogel was reinforced with cellulose nanofibrils for enhanced stability and barrier properties. Nanoemulsion of oregano essential oil, with an average particle size of 293.7 ± 8.3 nm, was prepared via homogenization with chitosan as the coating agent. Nanoemulsion impregnated hydrogel, termed as the nanoemulgel, was assessed for its physio-mechanical properties and healing efficiency. The strong linkages in nanoemulgel demonstrated its large swelling capacity, high mechanical strength, and maximum thermal stability. The optimized conditions for low-level laser therapy using 808 nm were 1 W. cm−2 and 5 min. The optimized drug concentration of 128 μg. mL−1 exhibited viability of NIH/3 T3 fibroblasts as 75.5 ± 1.2 % after 24 h. Cell migration assay demonstrated that dual therapy facilitated wound healing, with a maximum closure rate of 100 % at 48 h. In vivo results revealed the rapid healing effects of the dual therapy in diabetic rat models with foot ulcers: a maximum healing rate of 97.5 %, minimum scar formation, increased granulation, enhanced reepithelialization, and a drastic decrease in inflammation and neutrophil infiltration within the treatment period compared to monotherapy and control. In summary, the combinatorial therapy of nanoemulgel and low-level laser therapy is a promising regimen for managing diabetic foot ulcers with a rapid healing effect.

In vitro effects of 2-methyl-3-propylbutane-1,4-diol purified from Alstonia boonei on erythrocyte membrane stabilization and mitochondrial membrane permeabilization.

A recent review on the ethnomedicinal, chemical, pharmacological, and toxicological properties of Alstonia boonei revealed the plant's potential in the treatment and management of a range of diseases. However, most of these pharmacological effects are only traceable to the crude form of the plant extract and not specific natural products. Phytochemical investigation of the methanol fraction of the methanol extract of the stem-bark of Alstonia boonei led to the isolation and identification of 2-methyl-3-propylbutane-1,4-diol. The structures were elucidated by the application of 1D-, and 2D-NMR spectroscopic analyses and by comparison with literature data. In this study, the membrane stabilizing activity, mitochondrial membrane permeability transition pore opening, cytochrome c release, mitochondrial ATPase activity, and prevention of mitochondrial lipid peroxidation activity of 2-methyl-3-propylbutane-1,4-diol (MPBD) isolated from A. boonei were determined. The results showed that MPBD significantly (p < .05) prevented peroxidation of mitochondrial membrane lipids and hemolysis using both the heat-induced and hypotonic solution-induced membrane stabilization assays. On the contrary, the compound caused large amplitude swelling of rat liver mitochondria in the absence of calcium, significant (p < .05) cytochrome c release and enhancement of mitochondrial ATPase activity in vitro. Our findings suggest that MPBD showed characteristic biological properties useful in modulating cell death.

Two new species of Diderma (Physarales, Didymiaceae) from northern China

Diderma is one of the most abundant species in Myxomycetes. Based on the study of morphology and phylogeny, two new species—Diderma liaoningensis (is characterized by grouped sporocarps, the sporocyst with dehiscence lines, capillitium with large brown swelling, spore encircled by a pale line) and Diderma verrucocapillitia (is characterized by depressed plasmodiocarps, verrucose capillitium, red-brown spores)—collected from Liaoning province and Jilin province were introduced. Detailed descriptions and illustrations are presented as well as comparisons to similar species. Phylogenetic analyses were carried out using Maximum Likelihood and Bayesian inference based on small subunit ribosomal RNA sequences (SSU rRNA) of Diderma and related genera. These analyses confirmed the placement of two new species in the genus Diderma. A key to 19 species of Diderma from China is also provided. Holotype specimens have been housed in the Herbarium of the Mycological Institute of Jilin Agricultural University (HMJAU), Changchun, China.

The VASCERN-VASCA working group diagnostic and management pathways for lymphatic malformations

Lymphatic malformations (LMs) are developmental defects of lymphatic vessels. LMs are histologically benign lesions, however, due to localization, size, and unexpected swelling, they may cause serious complications that threaten vital functions such as compression of the airways. A large swelling of the face or neck may also be disfiguring and thus constitute a psychological strain for patients and their families. LMs are also highly immunologically reactive, and are prone to recurrent infections and inflammation causing pain as well as chronic oozing wounds.The European Reference Network on Rare Multisystemic Vascular Diseases (VASCERN) is dedicated to gathering the best expertise in Europe. There are only few available guidelines on management and follow up of LMs, which commonly focus on very specific situations, such as head and neck LM (Zhou et al., 2011). It is still unclear, what constitutes an indication for treatment of LMs and how to follow up the patients. The Vascular Anomalies Working Group (VASCA-WG) of VASCERN decided to develop a diagnostic and management pathway for the management of LMs with a Nominal Group Technique (NGT), a well-established, structured, multistep, facilitated group meeting technique used to generate consensus statements. The pathway was drawn following 2 face-to-face meetings and multiple web meetings to facilitate discussion, and by mail to avoid the influence of most authoritative members.The VASCA-WG has produced this opinion statement reflecting strategies developed by experts and patient representatives on how to approach patients with lymphatic malformations in a practical manner; we present an algorithmic view of the results of our work.

Malunion of Mandible Fracture: A Case Report

Radicular cysts are the most common odontogenic cystic lesions of jaws. They are asymptomatic lesions associated with the root apex of a non-vital tooth that slowly progresses rarely to large symptomatic swelling. Here we describe a patient with large radicular cyst involving maxillary sinus secondary to traumatized non-vital tooth 21 treated by surgical enucleation. Key words: Maxillary sinus, Radicular cyst, Surgical enucleation

NOT ALL JAW LESIONS WITH IMPACTED TOOTH ARE DENTIGEROUS CYST- A CASE REPORT OF BENIGN ODONTOGENIC TUMOUR

Jaw lesions with impacted tooth lets us suppose dentigerous cyst as most common diagnosis. However there is much more to this clinical entity and nearly ten other histological and radiological diagnosis could be made of such lesion. There is paucity of literature on these alternative diagnosis . We present here a case of benign odontogenic tumour of maxilla in a female in her early twenties which we initially thought was a dentigerous cyst. Dentigerous cyst is type of developmental odontogenic cyst seen most commonly associated with mandible molars(80%) followed by maxillary canine(20%). It is second most common odontogenic cyst after periradicular cyst which is inammatory infectious cyst. We present a case report of a very large benign odontogenic tumour associated with left maxillary canine causing large maxillary swelling and ballooning of anterolateral wall of maxillary sinus and oroantral stula. These tumour have a very indolent course and subtle symptoms but when neglected causes maxillofacial deformity and asymmetry of face. A 21 year female presented with maxillary swelling on left side of midface causing facial deformity and asymmetry. The swelling was of the size of a cricket ball extending from inferior orbital margin to upper alveolus of left side inferiorly and from lateral wall of nose medially to anterolateral wall of maxilla laterally. The swelling caused loosening of two teeth and broadening of upper jaw on left side and rounding of inferior orbital margin due to pressure expansion and thinning of bony cortex all around. A CECT of PNS along with USG and FNAC was done for maxillary swelling which conrmed our diagnosis. Enucleation of cyst with curettage was done via Caldwell Luc approach.

Elastic, tough and switchable swelling hydrogels with high entanglements and low crosslinks for water remediation

Developing hydrogel adsorbents with both high mechanical property and high adsorption capacity is a big challenge. At the same time, the swelling-adsorption is in conflict. Swelling expands the polymer network and facilitates the exposure of adsorption sites and the diffusion of pollutants. On the other hand, swelling causes the hydrogel to increase in volume and soften, which increases the difficulty of operation and regeneration. Hence, we promote a method of preparation advanced hydrogel adsorbent by high entanglements and low crosslinks. The entanglements work as additional crosslinks, reducing swelling and making the hydrogel tough. Unlike crosslinks, entanglements are like springs, which are flexible and can efficiently transmit and store stress. Therefore, highly entangled hydrogel exhibits high elasticity, low hysteresis, and good fatigue resistance. Abundant carboxyl functional groups are introduced by copolymerizing acrylic acid. The carboxyl groups are not only sites for adsorbing cationic pollutants, but also a smart switch for regulation of swelling. When adsorbing pollutants, the carboxyl groups are deprotonated, and the flexible entanglements allow large swelling of the hydrogel while maintaining good rigidity, which efficiently facilitates adsorption. Compared with highly crosslinked hydrogel with similar polymer content and carboxyl abundance, the adsorption capacity and rate of highly entangled hydrogel increased by more than ten times. While regeneration, the highly entangled hydrogel de-swells efficiently under the tension of entanglements, significantly improving the operability of regeneration. This study provides a novel strategy for developing smart hydrogel adsorbent.

Granular Cell Tumor of the Deep Lobe of the Parotid Gland Presenting With Respiratory Obstruction: Clinicopathologic Report of a Rare Presentation

Background Granular cell tumor (GCT) is a very rare, slow-growing, benign neoplasm with a controversial etiology, recently believed to be derived from Schwann cells. Hardly grows large and is also infrequently seen in children. Seventy percent of this tumor is seen in the head and neck with 1/3 in other parts of the body. Seldom occurs in the parotid gland and more so, the deep lobe of the parotid, where it may initially be asymptomatic but when large, it may result in respiratory obstruction. Case report : An 8-year-old female presented with a large right lateral upper neck-facial swelling of 3 months duration with a change in voice, difficulty swallowing, and respiratory distress. We reported an uncommon case of GCT of the deep lobe of parotid in a child with respiratory distress due to tumor obstruction of the airway. Tumor excision with preservation of the facial nerve was successfully performed. The histopathological report confirms the diagnosis of GCT. The child recovered to full general health with no signs of recurrence. Conclusion Granular cell tumor is a rare neoplasm, treatment is local surgical excision. Recurrence is uncommon, even if the lesion is not entirely removed. Microscopically this tumor may mimic a malignancy because of pseudoepitheliomatous hyperplasia of the overlying epithelium. The pathologist should be aware of this possibility to avoid a mistaken diagnosis of cancer.

Multisite evaluation of fire ant venom immunotherapy safety and efficacy.

Imported fire ant (IFA) venom immunotherapy (VIT) is the only disease-modifying treatment reported to be effective at decreasing the risk of systemic reactions (SRs) to IFA stings. Our aims were to determine the baseline rates of IFA sensitization in subjects, describe IFA VIT prescribing patterns across the military health system (MHS), and retrospectively evaluate the safety and efficacy of IFA VIT. We prospectively compared IFA sensitization in participants with and without an SR to flying Hymenoptera venom. Separately, IFA VIT prescription records were extracted from a centralized repository, and rates were described across the MHS. Additionally, we retrospectively reviewed the clinical course of patients being treated with IFA VIT at 11 military treatment facilities. The invitro IFA sensitization rates in our prospective cohort ranged from 19.1% to 24.1%. Sensitization rates did not differ statistically between the subjects with or without an SR to flying Hymenoptera venom. We found that 60.9% of all MHS IFA VIT prescriptions (491 of 806) were from the 11 facilities in this study. We retrospectively identified 137 subjects actively undergoing IFA VIT. Among the subjects actively undergoing IFA VIT, 28 reported an SR to IFA venom and repeat stings by IFAs after reaching VIT maintenance, and 85.7% (24 of 28) of the subjects noted symptoms no worse than a large swelling reaction after a repeat IFA sting. Notably, only 2.9% of the subjects (4 of 137) had an SR due to VIT. This study's results align with those of prior IFA sensitization reports. Asubstantial proportion of patients undergoing IFA VIT experienced protection against anaphylaxis with reexposure, with relatively few adverse events.