Πέμπτη 12 Αυγούστου 2021

Automatic Registration and Precise Tumor Localization Method for Robot‐assisted Puncture Procedure under Inconsistent Breath‐holding Conditions

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Abstract

Background

During percutaneous puncture procedure, breath holding is subjectively controlled by patients, and it is difficult to ensure consistent tumor position between the preoperative CT scanning phase and the intraoperative puncture phase. In addition, the manual registration process is time-consuming and has low accuracy.

Methods

We have proposed an automatic registration method using optical markers and a tumor breath-holding position estimation model based on the support vector regression algorithm. A robot system and a tumor respiratory motion simulation platform are built to perform puncture tests under different breath-holding states.

Results

The experimental results show that automatic registration has higher accuracy than manual registration, and with the tumor breath-holding position estimation model, the targeting accuracy of puncture under inconsistent breath-holding conditions is greatly improved.

Conclusions

The proposed automatic registration and tumor breath-holding position estimation model can improve the accuracy and efficiency of puncture under inconsistent breath-holding conditions.

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Acral Peeling in Nagashima Type Palmo‐plantar Keratosis Patients Reveals the Role of Serine Protease Inhibitor B 7 in Keratinocyte Adhesion

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Abstract

Acral peeling skin syndrome (APSS) is a heterogenous group of genodermatoses, manifested by peeling of palmo-plantar skin, occasionally associated with erythema and epidermal thickening. A subset of APSS is caused by mutations in protease inhibitor encoding genes, resulting in unopposed protease activity and desmosomal degradation and/or mis-localization, leading to enhanced epidermal desquamation. We investigated two Arab-Muslim siblings with mild keratoderma and prominent APSS since infancy. Genetic analysis disclosed a homozygous mutation in SERPINB7, c.796C>T, which is the founder mutation in Nagashima type palmo-plantar keratosis (NPPK). Although not previously formally reported, APSS was found in other patients with NPPK. We hypothesized that loss of SERPINB7 function might contribute to the peeling phenotype through impairment of keratinocyte adhesion, similar to other protease inhibitor mutations that cause APSS. Mis-localization of desmosomal components was obse rved in a patient plantar biopsy compared to a biopsy from an age and gender matched healthy control. Silencing of SERPINB7 in normal human epidermal keratinocytes led to increased cell sheet fragmentation upon mechanical stress. Immunostaining showed reduced expression of Desmoglein 1 and Desmocollin 1. This study shows that in addition to stratum corneum perturbation, loss of SERPINB7 disrupts desmosomal components, which could lead to desquamation, manifested by skin peeling.

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The Otoscopic, Radiological and Audiological Study of Contralateral Ear in Unilateral Chronic Otitis Media

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Abstract

Chronic otitis media is a disease developing due to Eustachian tube dysfunction secondary to any insult in nasopharynx which is likely to be bilateral with different stages of disease in both ear. The objective of this study was to examine contralateral ear through otoscopic, radiological and audiological study. Study was conducted between December 2018 and July 2020 in Otorhinolaryngology and Head and Neck Suregery Department. The Contralateral ear was defined as the ear with no tympanic membrane perforation and with no symptoms in patients of unilateral chronic otitis media. Otoscopy, Pure tone audiometry and HRCT temporal bone were done. Results were recorded and analysed. Descriptive stastical analysis was done using SPSS software version 22 of Windows 7. Grade1 pars tensa retraction which is most common abnormal finding in contralateral ear on otoscopy in both unilateral mucosal and squamosal COM patients. On otoscopy of contralateral ear 71.43% squamosal CO M patients were having abnormal tympanic membrane. Hearing loss was seen in 25.71% patients of mucosal COM and 22.9% patients of squamosal COM patients. 17.1% patients of mucosal COM and 20% patients of squamosal COM show mastoid sclerosis of contralateral ear on HRCT temporal bone. Majority of patients with unilateral COM have initial findings of pathogenesis of COM in contalateral ear. These findings in contralateral ear are more common in patients with squamosal COM than patients with mucosal COM

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Outcomes of endoscopic chemo- and laser-cauterizations and open fistulectomy for pyriform sinus fistula

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Acute suppurative thyroiditis through the congenital pyriform sinus fistula (PSF) often recurs if the fistula is not resected. Although endoscopic chemo-cauterization (ECC) to obliterate the orifice of the fis...
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Localization Studies for Parathyroid Surgery

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Surgery for primary hyperparathyroidism (pHPT) is usually highly rewarding both for the surgeon and for the patient. Successful parathyroid surgery cures the disease and improves kidney and skeletal function. Finding the diseased gland(s) can be difficult, however, and even high-volume, experienced surgeons are sometimes unable to cure their patients. Accurate preoperative localization improves outcomes, shortens operation times, and simplifies operation room planning. Yet, there is still no imaging modality that in all patients identifies all diseased parathyroid glands. In the meta-analysis by Lee et al, positron emission tomography with the radiotracer 18F-fluoromethyl-dimethyl-2-hydroxyethyl-ammonium combined with positron emission tomography and computed tomography (FCH PET/CT) was demonstrated to have superior accuracy in identifyi ng diseased parathyroid glands, both on the lesion and on the patient level.
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Association of COVID-19 Vaccination and Facial Nerve Palsy

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This case-control study examines whether the Pfizer-BioNTech BNT162b2 vaccine is associated with an increased risk of acute-onset peripheral facial nerve palsy.
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A Spontaneous Chyle Leak

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This case report describes a woman in her 40s who presented with a rapidly enlarging neck mass and was subsequently diagnosed with a chyle leak.
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Bell Palsy and COVID-19

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The emergency use authorization of the first 2 messenger RNA COVID-19 vaccines in the US has given rise to a fascinating study of otolaryngological medical and social influence issues. As of May 1, 2020, the COVID-19 pandemic has resulted in more than 151 million cases and 3.2 million deaths worldwide. In the US, these statistics include 32.4 million cases (9757 per 100 000 population) and 576 000 deaths (173 per 100 000 population). The cold sterility of numbers is difficult to put into context. Likewise, when Pfizer-BioNTech and Moderna revealed cases of Bell palsy in their vaccine trials, concerns grew regarding the potential of the vaccines to cause Bell palsy. Numbers thrown out to either demonstrate or refute safety are likewise difficult for the public to contextualize. Epidemiologically, linking the vaccine with an adverse event requires accurate estimation of event incidence in association with the vaccine, comparison with a nonvaccinated group, and understanding of the background incidence.
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Perineural Spread of Melanoma Into the Orbit With Inflammatory Response and Nonsurgical Treatment

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This case report describes a patient with glabellar melanoma who was previously treated with immune therapy and presented with perineural spread recurrence with inflammatory features associated with prior immune therapy.
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Instrumented Gait Analysis to Identify Persistent Deficits in Adults With Chronic Vestibular Loss

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This cross-sectional study investigates the use of an instrumented 2-minute walk test in adults with vestibular loss to assess whether those with chronic vestibular loss have enduring gait deficits.
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Early Intervention for the Treatment of Acute Laryngeal Injury After Intubation

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To the Editor We read with great interest the recently published article by Lowery AS et al in JAMA Otolaryngology–Head & Neck Surgery, where it was shown that early intervention for patients with postintubation laryngeal injury was associated with a decreased duration of tracheostomy dependence, a higher rate of decannulation, and fewer surgical procedures compared with late intervention. Patients who underwent early intervention also avoided open reconstruction. We appreciate the important information presented in this study and we wish to comment on some associated issues.
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Associations Between Tinnitus and Mental Health in Middle-aged and Elderly Persons

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This cohort study with cross-sectional analyses and 4-year follow-up assesses whether the presence of tinnitus that interferes or does not interfere with daily life is associated with symptoms of depression, anxiety, or poor sleep quality in a population-based sample of individuals 40 years or older who reside in the Netherlands.
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Aberrant Hypoglossal Nerve During Neck Dissection

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This case report describes a woman in her 50s who presented with a right buccal squamous cell carcinoma and was found to have an abnormal course of the hypoglossal nerve.
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