Search

Differentiating intraparotid facial nerve schwannoma from other parotid tumors, particularly pleomorphic adenoma, is clinically crucial due to significant differences in treatment approaches. We report a case of a male patient in his 70s presenting with a left parotid mass. Magnetic Resonance Imaging (MRI) revealed a mass within the left parotid gland exhibiting the characteristic ``target sign''. The 3D double-echo steady-state with water excitation (3D-DESS-WE) MRI sequence demonstrated continuity between the mass and the facial nerve, a finding that significantly contributed to the diagnosis. Histopathological examination confirmed the diagnosis of schwannoma. This case highlights the potential of the 3D-DESS-WE sequence, in addition to conventional MRI signs, in improving the diagnostic accuracy of intraparotid facial nerve schwannomas.

Carcinoma ex pleomorphic adenoma is a carcinoma that arises from a primary or recurrent benign pleomorphic adenoma. The prevalence of epithelial-myoepithelial carcinoma is low, and this histological type accounting for only 1% of all salivary gland tumors. Here, we report a rare case of Epithelial-Myoepithelial Carcinoma ex pleomorphic adenoma of the parotid gland with a radiologic-pathologic correlation.

This systematic review article aims to investigate the clinical and radiological imaging characteristics of adrenal abnormalities in patients with thrombocytopenia, anasarca, fever, reticulin fibrosis, renal dysfunction, and organomegaly (TAFRO) syndrome. We searched the literature in PubMed, the Cochrane Library, and the Web of Science Core Collection. Ultimately, we analyzed 11 studies with 22 patients plus our 1 patient, totaling 23 patients. The mean age was 47.0 ± 12.6 years. There were 20 male and 3 female patients, respectively. The histopathological analysis of lymph nodes was conducted in 15 patients (65.2%), and the diagnosis was consistent with TAFRO syndrome in all 15 patients. Among the 23 patients, 11 patients (18 adrenal glands) showed adrenal ischemia/infarction, 9 patients (13 adrenal glands) showed adrenal hemorrhage, and 4 patients (7 adrenal glands) showed adrenomegaly without evidence of concurrent ischemia/infarction or hemorrhage. One patient demonstrated unilateral adrenal hemorrhage and contralateral adrenomegaly. In patients with adrenal ischemia/infarction, the adrenal glands displayed poor enhancement through contrast-enhanced computed tomography (CT). In patients with adrenal hemorrhage, the adrenal glands revealed high attenuation through non-enhanced CT and hematoma through magnetic resonance imaging. Adrenomegaly, with or without adrenal ischemia/infarction or hemorrhage, was observed in all patients (23/23, 100%). The subsequent calcification of the affected adrenal glands was frequently observed (9/14, 64.3%) when a follow-up CT was performed. Abdominal pain was frequent (15/23, 65.2%), all of which occurred after the disease’s onset, suggesting the importance of considering TAFRO syndrome as a cause of acute abdomen. Given the absence of evidence of adrenal abnormalities in non-TAFRO-idiopathic multicentric Castleman disease (iMCD), they may serve as diagnostic clues for differentiating TAFRO syndrome from non-TAFRO-iMCD.

The retropharyngeal carotid artery (RCA) is a relatively rare anatomical malposition, and positional changes in the RCA is also extremely rare. In addition, there are some reports of ''wandering carotid artery'' which means that the carotid artery reciprocate positional changes (wandering) between its normal position and retropharyngeal regions, during follow-up evaluations. A male patient in his 50s with a chief complaint of globus pharyngeus. A pulsatile swelling of the posterior pharyngeal wall of the right side was found on clinical examination. In this case, the right carotid artery showed the clinical course of a wandering carotid artery, which reciprocated between its normal position and the retropharyngeal space during three serial MR investigations. Interestingly, both the most recent MR study and the MR study performed 4 years ago showed that the carotid artery at the level of the hyoid bone moved laterally (positional normalization) during the single MR investigation. This is a first case which showed a rare clinical course of a wandering carotid artery on serial follow-up MR studies and positional changes of carotid artery within a single MR study. It is important for clinicians to be aware of these phenomena, in order to avoid fatal and unexpected complications during clinical procedures.

Laryngeal metastasis is an extremely rare condition. To the best of our knowledge, there has been no previous report on a laryngeal metastasis from renal cell carcinoma, which describes on details of the CT and MR imaging findings. A male patient in his 80s. Laryngoscopy revealed reddish-colored masses in the right false vocal cord and in the subglottic larynx. CT and MR imaging of this case showed multiple hypervascularized lesions with a wash-out effect in the supra and subglottis of the larynx and in the right intervertebral foramen of the cervical spine. Angiography revealed a hypervascular tumor consistent with the subglottic lesion. The histopathology and immunohistochemistry findings were compatible with laryngeal metastasis from renal clear cell carcinoma. A history of postoperative renal clear cell carcinoma about 7 years ago was later confirmed, which was not stated at the time of the initial imaging evaluation. It is a possible differential diagnosis in cases of multiple hypervascular masses in the head and neck region with a history of renal carcinoma. In particular, if the contrast-enhancement pattern of the lesion on the dynamic CT is similar to that of renal cell carcinoma. It is also important to reconfirm the patient's medical history, including postoperative status.

Abstract Objective To investigate the predictability of ophthalmic artery involvement in maxillary sinus cancer using preprocedural contrast enhanced CT and MRI. Methods We analyzed advanced (T3, T4a, and T4b) primary maxillary sinus squamous cell carcinoma treated with super-selective intra-arterial cisplatin infusion and concomitant radiotherapy (RADPLAT) from Oct 2016 to Mar 2020. Two diagnostic radiologists evaluated the tumor invasion site around the maxillary sinus using preprocedural imaging. These results were compared with the angiographic involvement of the ophthalmic artery using statistical analyses. We also evaluated our RADPLAT quality using complication rate, response to treatment, local progressive free survival (LPFS), and overall survival (OS). Results Twenty patients were included in this study. There were ten cases of ophthalmic artery tumor stain and there was a correlation between ophthalmic artery involvement and invasion for ethmoid sinus with statistically significant differences. Other imaging findings were not associated with ophthalmic artery involvement. Conclusions Ethmoid sinus invasion on preprocedural imaging could suggest ophthalmic artery involvement in maxillary sinus cancer. It may be useful in predicting prognosis and treatment selection.

Three different silver nanoprisms (AgNPrs) were combined and used as light-trapping materials in organic solar cells (OSCs). These mixed AgNPrs (M-AgNPrs) increased the photocarrier generation in the OSCs due to the broadband absorption, which was attributed to mutual multiple plasmonic excitations covering the entire visible light region. The M-AgNPrs were incorporated into a poly(3,4-ethylenedioxythiophene): poly(styrenesulfonate) hole-transport layer in the OSCs. The UV–vis spectra, atomic force microscope images and current density versus voltage curves of the fabricated devices were recorded at different loading concentrations of the M-AgNPrs. Finite-difference time-domain simulation, impedance spectroscopy, and measurement of incident photon-to-current efficiency of the devices confirmed the effect of the multiple plasmonic excitations. The results suggest that, in an optimum condition, the efficiency of the OSCs loaded with M-AgNPrs was 7.9% higher than the reference OSC.

Cholesteatoma is a progressive middle ear disease that can only be treated surgically but with a high recurrence rate. Depending on the extent of the disease, a surgical approach, such as microsurgery with a retroarticular incision or transcanal endoscopic surgery, is performed. However, the current examination cannot sufficiently predict the progression before surgery, and changes in approach may be made during the surgery. Large amounts of data are typically required to train deep neural network models; however, the prevalence of cholesteatomas is low (1-in-25, 000). Developing analysis methods that improve the accuracy with such a small number of samples is an important issue for medical artificial intelligence (AI) research. This paper presents an AI-based system to automatically detect mastoid extensions using CT. This retrospective study included 164 patients (80 with mastoid extension and 84 without mastoid extension) who underwent surgery. This study adopted a relatively lightweight neural network model called MobileNetV2 to learn and predict the CT images of 164 patients. The training was performed with eight divided groups for cross-validation and was performed 24 times with each of the eight groups to verify accuracy fluctuations caused by randomly augmented learning. An evaluation was performed by each of the 24 single-trained models, and 24 sets of ensemble predictions with 23 models for 100% original size images and 400% zoomed images. Fifteen otolaryngologists diagnosed the images and compared the results. The average accuracy of predicting 400% zoomed images using ensemble prediction model was 81.14% (sensitivity = 84.95%, specificity = 77.33%). The average accuracy of the otolaryngologists was 73.41% (sensitivity, 83.17%; specificity, 64.13%), which was not affected by their clinical experiences. Noteworthily, despite the small number of cases, we were able to create a highly accurate AI. These findings represent an important first step in the automatic diagnosis of the cholesteatoma extension.

Summary: Generally, CT and MR images of antiresorptive agent-related osteonecrosis of the jaw (ARONJ)/medication-related osteonecrosis of the jaw (MRONJ) show nonspecific findings as seen in active osteomyelitis．However, there are some characteristics as follows; unilateral maxillary sinusitis adjacent to ipsilateral maxillary ARONJ/MRONJ, DRONJ presenting larger sequestrum and periosteal reaction more frequently than BRONJ, BRONJ resulting from intravenous administration of the drug presenting larger and more frequent buccolingual cortical bone perforations than BRONJ from oral administration, and better diagnostic accuracy of extent of perilesional soft tissue inflammation on MR imaging than CT. The CT and MR imaging features of ARONJ/MRONJ are summarized in this report. Keywords: Antiresorptive agent-related osteonecrosis of the jaw, Medication-related osteonecrosis of the jaw, CT, MR imaging, Bisphosphonate, Denosumab

We studied the effect of gold quantum dots (AuQDs)/grating-coupled surface plasmon resonance (GC-SPR) in inverted organic solar cells (OSCs). AuQDs are located within a GC-SPR evanescent field in inverted OSCs, indicating an interaction between GC-SPR and AuQDs' quantum effects, subsequently giving rise to improvement in the performance of inverted OSCs. The fabricated solar cell device comprises an ITO/TiO2/P3HT : PCBM/PEDOT : PSS : AuQD/silver grating structure. The AuQDs were loaded into a hole transport layer (PEDOT : PSS) of the inverted OSCs to increase absorption in the near-ultraviolet (UV) light region and to emit visible light into the neighbouring photoactive layer, thereby achieving light-harvesting improvement of the device. The grating structures were fabricated on P3HT:PCBM layers using a nanoimprinting technique to induce GC-SPR within the inverted OSCs. The AuQDs incorporated within the strongly enhanced GC-SPR evanescent electric field on metallic nanostructures in the inverted OSCs improved the short-circuit current and the efficiency of photovoltaic devices. In comparison with the reference OSC and OSCs with only green AuQDs or only metallic grating, the developed device indicates enhancement of up to 16% power conversion efficiency. This indicates that our light management approach allows for greater light utilization of the OSCs because of the synergistic effect of G-AuQDs and GC-SPR.

Cerebrospinal fluid (CSF) leaks associated with endoscopic sinus surgery (ESS) are a rare complication affecting approximately 0.09% of patients. Although meningitis is a well-known complication of CSF leaks, the case we present is a rare and cautionary case of CSF leakage associated with ESS leading to aspiration pneumonia. A 43-year-old man with CSF leaks after ESS was referred to our hospital. After the operation, sometimes, he reported having a serous nasal discharge from the right side when he bent over, and he woke up choking on something every day. He also experienced headache, fever, fatigue, and cough. Interestingly, chest computed tomography (CT) showed a consolidation and ground-glass opacity in the posterior segments of the right upper lobes and superior segments of the bilateral lower lobes. These CT imaging findings were similar to those of aspiration pneumonia in bedridden patients who are always in a supine position. These findings suggest that CSF caused aspiration pneumonia. To the best of our knowledge, no case of aspiration pneumonia caused by CSF during endoscopic sinus surgery has been reported until now. If a patient with CSF leakage after ESS experiences fever, cough, or fatigue, physicians should consider aspiration pneumonia in addition to meningitis.

Laparoscopic myomectomy may become a cause to increase intraoperative hemorrhage. The purpose of this investigation was to study the relationship between clinical features, MR imaging findings and intraoperative hemorrhage during laparoscopic myomectomy. This study included 126 patients clinically and pathologically diagnosed as uterine leiomyoma between 2010 and 2015. These findings were statistically compared between significant intraoperative hemorrhage group (greater than 300 ml) and nonsignificant intraoperative hemorrhage group (less than 300 ml). Correlation between the maximum diameter of resected leiomyomas and the maximum diameter leiomyomas on MR imaging were also evaluated. Significant hemorrhage group showed larger maximum diameter of resected leiomyoma (p = 0.01), larger maximum diameter of leiomyoma on MR imaging (p = 0.01) and have cellular leiomyomas on MR imaging more frequently (p = 0.03) than nonsignificant intraoperative hemorrhage group. The maximum diameter of resected leiomyomas significantly correlated with that of leiomyomas on MR imaging (Spearman’s rho = 0.797, p

Positional change in the retropharyngeal carotid artery, a rare phenomenon over time, is even rarer in previous reports, and it is important to be aware of this before any neck surgical procedure. A woman in her 50s underwent an anterior maxillectomy for upper gingival cancer, without neck dissection. The patient had medical histories of diabetes mellitus and liver dysfunction, with unremarkable family histories. Serial neck contrast-enhanced computed tomography for detecting locoregional recurrence had been performed as a follow-up during 4 years. A radiological course of moving carotid arteries in serial computed tomography studies showed reciprocating positional changes (wandering) between normal and retropharyngeal regions. There was no locoregional recurrence of the gingival cancer. This is the first case to describe a so-rare presentation of wandering carotid arteries. It is important for clinicians to be aware of a wandering carotid artery to avoid potentially fatal complications.

The initiation mechanism and its reduction method for combustion driven oscillation of industrial boilers with a center firing gas burner have been investigated experimentally and numerically. Eight fuel injection nozzles are arranged radially at the burner. The burner with two different diameter nozzles, main nozzle and sub nozzle, arranged alternately is proposed. When the burner proposed is set in the burner, the flame base becomes much stable compared with the standard burner in which the diameter of all fuel injection nozzles is the same because the small flame of sub nozzles is formed around the flame base of large flame of main nozzles. The ratio of diameters of main nozzle and sub nozzle and the angles of main nozzle and sub nozzle are important parameters on flame base structure. Numerical simulation confirms the stability mechanism experimentally observed.

Key Clinical Message A history of frequent surfing can be a key finding when a patient comes in with subcutaneous lesions on bilateral anterior lower chest. MR imaging could lead to the diagnosis with its characteristic finding for collagenous mass lesions, though most cases do not require imaging unless with atypical presentation. This enables clinicians to avoid unnecessary invasive procedures.

The heavy rain disaster occurred in July 2017, in northern Kyushu, Japan. The river environment greatly changed due to sediment moving accompanied by erosion. It is important regarding disaster prevention to localize watersheds where sediment transportation is active. In this study, the sediment dynamics were discussed on the basis of our investigation about the stored sediment, water-flow, and silica fluxes from sub-basins. As a result, the sediment survey revealed that many sediments consist of sand or gravel and were moved secondarily by water-flow. By the hydrological survey, it was confirmed that the trend of the dissolved silica concentrations varied between the right and the left bank tributaries. It was suggested that the left bank tributaries have a various process of water-flow. Considering the distribution of collapsed slopes, the right bank tributaries have more collapsed slopes than the left bank tributaries. As suggested by the results, the range of the silica flux is wider at the left bank tributaries because the sedimentation shows various distributions. On the other hand, the right bank tributaries were estimated topographically stable since the value of the silica flux is about the same.

In this study, we demonstrate a long-range surface plasmon resonance (LR-SPR) biosensor for the detection of whole cell by captured antigens A and B on the surface of red blood cells (RBCs) as a model. The LR-SPR sensor chip consists of high-refractive index glass, a Cytop film layer, and a thin gold (Au) film, which makes the evanescent field intensity and the penetration depth longer than conventional SPR. Therefore, the LR-SPR biosensor has improved capability for detecting large analytes, such as RBCs. The antibodies specific to blood group A and group B (Anti-A and Anti-B) are covalently immobilized on a grafting self-assembled monolayer (SAM)/Au surface on the biosensor. For blood typing, RBC samples can be detected by the LR-SPR biosensor through a change in the refractive index. We determined that the results of blood typing using the LR-SPR biosensor are consistent with the results obtained from the agglutination test. We obtained the lowest detection limits of 1.58 × 105 cells/ml for RBC-A and 3.83 × 105 cells/ml for RBC-B, indicating that the LR-SPR chip has a higher sensitivity than conventional SPR biosensors (3.3 × 108 cells/ml). The surface of the biosensor can be efficiently regenerated using 20 mM NaOH. In summary, as the LR-SPR technique is sensitive and has a simple experimental setup, it can easily be applied for ABO blood group typing.

The electropolymerization process and doping/dedoping properties of poly(3-aminobenzoic acid) (PABA) thin films on gold-coated commercial BD-R and DVD-R grating substrates were simultaneously studied by the combination of electrochemical technique and transmission surface plasmon resonance (TSPR) spectroscopy. The optical property as a function of the applied potentials and time dependence during electropolymerization were studied. The obtained TSPR wavelength scan spectra after electropolymerization showed that the maximum wavelength slightly shifted to longer wavelength indicating the increase of film thickness. In addition, the change during construction of PABA-based immunosensor for label-free detection of human immunoglobulin G can be observed.

Au-loaded TiO2 nanoparticles were synthesized by the modified sol-gel method together with the impregnation method. Anatase phase of TiO2 was obtained in all samples with an average particle size of 20 nm. For the enhancement of DSSCs, the dye-sensitized solar cells composed of the ITO/Au-loaded TiO2/N-719/electrolyte/Pt were fabricated. Au-loaded TiO2 films were deposited by using squeegee method. Finally, the fabricated cells were studied upon an irradiation of solar light to study the performance. The fabricated cell with up to 1.0 mol% Au-loaded TiO2 could enhance the performance by localized surface plasmon effect and scattering property.

In recent years, conducting polymers have emerged as one of the most promising transducers for both chemical, sensors and biosensors owing to their unique electrical, electrochemical and optical properties that can be used to convert chemical information or biointeractions into electrical or optical signals, which can easily be detected by modern techniques. Different approaches to the application of conducting polymers in chemo- or biosensing applications have been extensively studied. In order to enhance the application of conducting polymers into the area of biosensors, one approach is to introduce functional groups, including carboxylic acid, amine, sulfonate, or thiol groups, into the conducting polymer chain and to form a so-called “self-doped” or by doping with negatively charged polyelectrolytes. The functional conducting polymers have been successfully utilized to immobilize enzymes for construction of biosensors. Recently, the combination of SPR and electrochemical, known as electrochemical-surface plasmon resonance (EC-SPR), spectroscopy, has been used for in situ investigation of optical and electrical properties of conducting polymer films. Moreover, EC-SPR spectroscopy has been applied for monitoring the interaction between biomolecules and electropolymerized conjugated polymer films in biosensor and immunosensor applications. In this paper, recent development and applications on EC-SPR in biosensors will be reviewed.