Ancient Schwannoma Along the Patellar Tendon: Unveiling a Rare Clinical Phenomenon With Literature Review.

Ancient schwannoma, a rare subtype of schwannoma, a benign tumor originating from nerve sheaths, can arise from various nerves, except for the optic, olfactory, spinal, and autonomic nervous systems. Schwannomas are typically characterized by the presence of neoplastic Schwann cells and tend to develop eccentrically. Malignant transformations of schwannomas are exceptionally uncommon. In this case report, a 42-year-old male presented with a painful lump on the front of his left knee. The lump was described as an extra-articular swelling below the kneecap, situated over the patellar tendon. Initially, ultrasonography (USG) indicated the presence of a slow-flow vascular malformation in the infrapatellar region of the left knee. However, subsequent magnetic resonance imaging (MRI) revealed a well-defined mass in the subcutaneous plane below the knee, with minimal septations, leading to an initial suspicion of a large sebaceous cyst. Further investigation through histopathological analysis confirmed the diagnosis of an extra-articular schwannoma. This finding highlights the importance of thorough examination and diagnostic techniques in differentiating between various types of soft tissue masses. Schwannomas, although uncommon in certain locations, should be considered in the differential diagnosis of painful lumps, even in atypical anatomical sites such as the knee.

Thyroid abscess associated with transient hyperthyroidism in an adolescent girl: a rare case report and review of the literature.

OBJECTIVES: To report an unusual case of thyroid abscess associated with thyroid dysfunction in an adolescent girl who has a normal anatomic structure of the thyroid gland. CASE PRESENTATION: A 15-year-old adolescent girl presented with a history of fever, sore throat, and neck swelling for 10 days duration. Contrast-enhanced computed tomography neck showed findings suggestive of an abscess involving the left lobe of the thyroid gland. She had low TSH and elevated T3 and T4 levels. Here, we report a case of thyroid abscess associated with transient hyperthyroidism in an immunocompetent girl who was successfully managed with parental antibiotics without incision and drainage. CONCLUSIONS: Thyroid abscess can present with hyperthyroidism in children. So it is important to monitor all children who have thyroid abscesses for the development of permanent hypothyroidism later on. It's important to diagnose this condition as soon as possible and begin antibiotic therapy appropriately.

Measurement of Nasal Contour Landmarks in Septorhinoplasties with Special Regard to the Course of Postoperative Swelling Using a Three-Dimensional Camera.

The integration of three-dimensional (3D) cameras into clinical practice for pre-operative planning and post-operative monitoring of rhinoplasties remains controversial. However, this technology offers the advantage of capturing the 3D surface without exposing patients to potentially harmful radiation. Continuous assessment allows the follow-up of swelling patterns, cartilage alignment, and bone remodeling. The primary objective of our study was to quantify changes in nasal structure before and after rhinoplasty by using 3D photography. Our study cohort consisted of 29 patients who underwent open structural rhinoplasty. We used the Artec Space Spider camera to acquire a total of 103 3D images. We collected pre-operative and at least two or three post-operative follow-up scans, which were taken one, three, and six months after surgery. We evaluated paired scans that included various time intervals to improve our understanding of swelling behavior and to ensure an objective analysis of changes. Eleven specific anatomical landmarks were identified for measurement. Two independent raters determined the distances between these landmarks over time. The calculation of intraclass correlation coefficients showed low inter-rater variability. Statistically significant changes over time (p < 0.05) were observed for various anatomical landmarks, including soft tissue nasion, soft tissue orbitale right, soft tissue maxillofrontale left, soft tissue maxillofrontale right, nasal bridge, and nasal break point. Conversely, no significant changes (p > 0.05) were observed in the measurements of soft tissue orbitale left, pronasale, subnasale, alare right, or alare left. A visual assessment was conducted using surface distance maps. The results indicate that the complete decrease in swelling takes at least 6 months or even longer. Additionally, 3D photography can provide an objectively comparable analysis of the face and external contours. Furthermore, it allows for a comparison of external contours and therefore pre- and post-operative differences.

Enhancing Carbon Nanotube Yarns via Infiltration Filling with Polyacrylonitrile in Supercritical Carbon Dioxide.

Carbon nanotube (CNT) fibers are renowned for their exceptional axial tensile strength and modulus. However, in yarn form, they frequently encounter transverse loading in practical applications, which exposes their suboptimal mechanical attributes rooted in inadequate inter-tube interactions and yarn surface defects. Efforts to mitigate micro-slippage among CNTs have encompassed gap-filling methodologies with varied materials, yet the outcomes have fallen short of expectations. This work aimed to enhance the mechanical properties of CNT yarns via infiltration with polyacrylonitrile (PAN) under supercritical carbon dioxide (sc-CO2) conditions. PAN was strategically chosen for its capability to undergo pre-oxidation and subsequent carbonization, leading to robust graphitic reinforcement. Leveraging sc-CO2's swelling and high permeability properties, the infiltration process effectively plugged interstitial spaces, elevating the yarn's tensile strength to 277.50 MPa and Young's modulus to 5094.05 MPa. Additional enhancements were realized after pre-oxidation, conferring a dense, reinforced shell structure that augmented tensile strength by 96.93% and Young's modulus by 298.80%. Scanning electron microscopy (SEM) analyses revealed a homogeneous PAN distribution within the yarn matrix, corroborated by X-ray photoelectron spectroscopy (XPS) evidence of C-N bonding, indicative of a successfully interlaced network. Consequently, this investigation introduces a novel strategy to tackle micro-slippage in CNT yarns, thereby achieving substantial improvements in their mechanical resilience.

Effect of Complex Well Conditions on the Swelling and Tribological Properties of High-Acrylonitrile Stator Rubber in Screw Pumps.

The effects of complex well conditions in shale oil wells on the swelling and tribological properties of high-acrylonitrile stator rubber used in screw pumps were investigated in this study. Tests were conducted considering the combined effects of immersion medium, temperature, and duration. The key parameters measured included mass change rate, volume change rate, hardness, elongation at break, tensile strength, surface micro-morphology of the rubber after thermal expansion and swelling, friction coefficient, and wear quantity. The results indicated that in the actual well fluids, the mass change rate of high-acrylonitrile rubber ranged from -1.08% to 1.29%, with a maximum volume change rate of 2.78%. In diesel oil, the greatest mass change rate of the rubber was 4.68%, and the volume change rate did not exceed ±1%, indicating superior swelling resistance. In both actual well fluids and diesel oil, the maximum decreases in hardness were 8.7% and 9.5%, respectively. Tensile strength and elongation at break decreased with increasing immersion temperature, with elongation at break in 80 °C diesel oil decreasing by over 50%, indicating a significant decline in the tensile properties of the rubber. The average friction coefficient of rubber specimens immersed in actual well fluids at three temperatures, as well as in diesel oil at 25 and 50 °C, decreased compared with the high-acrylonitrile rubber without thermal expansion and swelling. However, the average friction coefficient of rubber specimens immersed in diesel oil at 80 °C increased. The wear quantity of the rubber increased following immersion in both media. Additionally, the friction coefficient and wear quantity of the rubber increased with increasing immersion temperatures. The results of the study can offer valuable insights into assessing the durability of properties in high-acrylonitrile stator rubber under complex well conditions.

Swelling, Protein Adsorption, and Biocompatibility of Pectin-Chitosan Hydrogels.

The study aims to determine how chitosan impacts pectin hydrogel's ability to attach peritoneal leukocytes, activate complement, induce hemolysis, and adsorb blood proteins. The hydrogels PEC-Chi0, PEC-Chi25, PEC-Chi50, and PEC-Chi75 were prepared by placing a mixture solution of 4% pectin and 4% chitosan in a ratio of 4:0, 3:1, 2:2, and 1:3 in a solution of 1.0 M CaCl2. Chitosan was found to modify the mechanical properties of pectin-calcium hydrogels, such as hardness and cohesiveness-to-adhesiveness ratio. Chitosan in the pectin-calcium hydrogel caused pH-sensitive swelling in Hanks' solution. The PEC-Chi75 hydrogel was shown to adsorb serum proteins at pH 7.4 to a greater extent than other hydrogels. PEC-Chi75's strong adsorption capacity was related to lower peritoneal leukocyte adherence to its surface when compared to other hydrogels, showing improved biocompatibility. Using the optical tweezers approach, it was shown that the force of interaction between pectin-chitosan hydrogels and plasma proteins increased from 10 to 24 pN with increasing chitosan content from 0 to 75%. Thus, the properties of pectin-calcium hydrogel, which determine interactions with body tissues after implantation, are improved by the addition of chitosan, making pectin-chitosan hydrogel a promising candidate for smart biomaterial development.

Nynrin preserves hematopoietic stem cell function by inhibiting the mitochondrial permeability transition pore opening.

Mitochondria are key regulators of hematopoietic stem cell (HSC) homeostasis. Our research identifies the transcription factor Nynrin as a crucial regulator of HSC maintenance by modulating mitochondrial function. Nynrin is highly expressed in HSCs under both steady-state and stress conditions. The knockout Nynrin diminishes HSC frequency, dormancy, and self-renewal, with increased mitochondrial dysfunction indicated by abnormal mPTP opening, mitochondrial swelling, and elevated ROS levels. These changes reduce HSC radiation tolerance and promote necrosis-like phenotypes. By contrast, Nynrin overexpression in HSCs diminishes irradiation (IR)-induced lethality. The deletion of Nynrin activates Ppif, leading to overexpression of cyclophilin D (CypD) and further mitochondrial dysfunction. Strategies such as Ppif haploinsufficiency or pharmacological inhibition of CypD significantly mitigate these effects, restoring HSC function in Nynrin-deficient mice. This study identifies Nynrin as a critical regulator of mitochondrial function in HSCs, highlighting potential therapeutic targets for preserving stem cell viability during cancer treatment.

A Case of Painless Elderly-Onset Rheumatoid Arthritis.

Rheumatoid arthritis (RA) has multiple manifestations. Patients present with a variety of symptoms and varying levels of severity. Elderly-onset rheumatoid arthritis (EORA) is described as RA with onset after 60 years of age. EORA can present with different clinical and laboratory findings compared to RA in a younger patient, making awareness of the condition important. Diagnosing inflammatory arthritis can be especially challenging in an elderly population where symptoms are poorly reported and communication is often difficult. We report the case of an elderly patient whose presentation with persistent tachycardia and raised inflammatory markers led to a diagnosis of EORA. This case details an atypical presentation of EORA with convincing diagnostic features for the disease without any joint symptoms reported. Clinicians should be aware of the differences in the typical presentation of EORA versus RA, the challenges of diagnosing inflammatory arthritis in elderly, isolated patients, and the importance of early diagnosis.

Compressive elasticity of epoxy functionalized Chitosan-based semi-IPN cryobeads of N-alkyl methacrylate esters: Validity of the Hertzian model with experiments.

In situ forming poly(dimethylaminoethyl methacrylate-co-glycidylmethacrylate)/Chitosan, P(DMAEMA-co-GMA)/Chitosan, (PDG/CS) cryobeads based on "dropwise freezing into cryogenic liquid method" combined with "blending with polymer method" are promising for applications due to their pH-responsiveness and stability under physiological conditions. Based on classical contact mechanics, Hertzian elasticity of semi-interpenetrated network (semi-IPN) cryobeads was analyzed to examine whether there is a direct correlation between elastic properties of single particle and its macroscopic behavior. A one-step procedure has been proposed to design chitosan-interpenetrated cryobeads with a cationic nature via combination of structural properties as well as functionality of chitosan containing primary and secondary hydroxyl and amino groups. The study is focused on characterization of network formation kinetics in different shapes and how different production variables affect the elasticity/swelling performance of cross-linked system. The elastic properties of semi-IPN cryobeads were improved by both adding chitosan to copolymer PDG structure and lowering the gelation temperature to cryogelation conditions. The results obtained highlighted the importance of composition to modulate elasticity, the influence of preparation temperature and shape of cryobeads on their elasticity. Findings regarding the topography-dependent local elastic properties of chitosan-incorporated semi-IPN gels offer possibilities for modulating the behavior of chitosan-based soft materials.

A flexible glucose biosensor modified by reduced-swelling and conductive zwitterionic hydrogel enzyme membrane.

This paper reports a flexible glucose biosensor which is modified by a reduced-swelling and conductive zwitterionic hydrogel enzyme membrane that contains two forms of chemical cross-links. One chemical cross-linking is induced by thermal initiators and forms the basal network of the hydrogel. Another cross-linking is achieved by the coordination interactions between the multivalent metal ion Al3+ and anionic group -COO- of zwitterionic poly-carboxy betaine (pCBMA), which significantly increase the cross-linking density of the zwitterionic hydrogel, improving the reduced-swelling property and reducing the pore size. The better reduced-swelling property and reduced diameters of pores within the zwitterionic hydrogel make less glucose oxidase (GOx) leakage, thus significantly improving the enzyme membrane's service life. By introducing the Al3+ and Cl-, the conductivity of the zwitterionic hydrogel is enhanced approximately 10.4-fold. According to the enhanced conductivity, the reduced-swelling property, and the high GOx loading capacity of the zwitterionic hydrogel, the sensitivity of the biosensor with GOx/pCBMA-Al3+ is significantly improved by 5 times and has a long service life. Finally, the proposed GOx/pCBMA-Al3+ biosensor was applied in non-invasive blood glucose detection on the human body, verifying the capability in practice.

A case report of genital Crohn's disease with a brief review of Indian cases reported.

Crohn's disease (CD) is a type of inflammatory bowel disease, which presents with extraintestinal manifestations in some cases, skin being one of the organs involved. Vulvar and perianal involvement leads to significant morbidity and has an adverse effect on the quality of life. We report a case of genital CD affecting the vulva, perianal region, and oral cavity, due to its rarity and diagnostic difficulty.

Dercum's Disease: The Clinical Presentation, Diagnosis, Radiological Findings, and Treatment of a Rare, Debilitating Inflammatory Disorder.

Introduction: Dercum's disease, also known as adiposis dolorosa, is a rare syndrome characterized by the growth of multiple, and painful, subcutaneous adipose tissues that commonly present in the abdomen and extremities. The scientific community hypothesizes that Dercum's disease is a combination of neurologic and endocrine disorders. Patients commonly describe it as chronic adipose pain, which manifests as sporadic painful flares throughout their history with the disease. Case Presentation: We share the case of a 32-year-old woman who presented to the emergency department for an acute episode of left lower extremity pain and swelling associated with a previously diagnosed history of Dercum's disease. The patient had similar events in the past, with her last episode being 3 months earlier. A diagnosis is based on clinical presentation, findings on imaging, and the exclusion of other diseases that are associated with lipomas. While there is no standard approach to treatment, healthcare professionals focus on pain management. Conclusion: Dercum's disease is a chronic debilitating disorder, with multiple types that are diagnosed through imaging. The treatment of Dercum's disease is predicated on the patient's symptoms and the effectiveness of medications that vary based on the patient's needs.

Enhancing the properties of swelling soils with lime, fly ash, and expanded polystyrene -A review.

This paper discusses efforts made by past researchers to steady the expansive (problematic) soils using mechanical and chemical techniques - specifically with EPS beads, lime and fly ash. Administering swelling of problematic soils is critical for civil engineers to prevent structural distress. This paper summarizes studies on reduction of swelling potential using EPS, lime and fly ash individually. Chemical stabilization with lime and fly ash are conventional methods for expansive soil stabilization, with known merits and demerits. This paper explores the suitability of different materials under various conditions and stabilization mechanisms, including cation exchange, flocculation, and pozzolanic reactions. The degree of stabilization is influenced by various factors such as the type and amount of additives, soil mineralogy, curing temperature, moisture content during molding, and the presence of nano-silica, organic matter, and sulfates. Additionally, expanded polystyrene (EPS) improves structural integrity by compressing when surrounded clay swells, reducing overall swelling. Thus, EPS addresses limitations of chemicals by mechanical means. Combining EPS, lime and fly ash creates a customized system promoting efficient, long-lasting, cost-effective and eco-friendly soil stabilization. Chemicals address EPS limitations like poor stabilization. This paper benefits civil engineers seeking to control expansive soil swelling and prevent structural distress. It indicates potential of an EPS-lime-fly ash system and concludes by identifying research gaps for further work on such combinatorial stabilizer systems.

Cerebral Venous Sinus Thrombosis with Bilateral Optic Disc Swelling and Bilateral Sixth Nerve Palsies in the Absence of Headache: A Case Report.

Introduction: We report a case of cerebral venous sinus thrombosis (CVST) that presented with bilateral optic disc swelling and diplopia in the absence of headaches. Case Presentation: A 54-year-old woman with no relevant medical history presented with a 2-week history of diplopia and no loss of visual acuity in each eye. Eye movements revealed bilateral abduction deficits, and fundoscopic examination revealed bilateral optic disc swelling. Non-contrast computed tomography of the head showed no abnormalities. Magnetic resonance venography revealed the absence of flow in the superior sagittal and left transverse sinuses as a consequence of thrombosis. The patient was diagnosed with intracranial hypertension associated with abducens nerve palsies secondary to CVST and was initiated on anticoagulant therapy. CVST can lead to stroke even in younger individuals. Conclusion: CVST should be considered in differential diagnosis when bilateral papilledema and abducens nerve palsies are present, even in the absence of headache or other neurological findings.

Chronic Expanding Hematoma in the Upper Extremity: A Case Report on Diagnostic and Management Challenges.

Hematomas are a common occurrence in clinical practice, often resulting from trauma or underlying bleeding disorders. They can manifest with various symptoms depending on their location and size. While hematomas are typically straightforward to diagnose and manage, specific presentations can pose diagnostic challenges. We present the case of a growing post-traumatic right upper extremity mass in a 67-year-old male on anticoagulant medication, Xarelto (rivaroxaban) 20mg, with no history of bleeding disorders. Differential diagnoses include a benign lipoma or possible soft-tissue malignancy. The mass was surgically excised and sent to pathology, which confirmed it was a hematoma and led to a diagnosis of a chronic expanding hematoma. Ultrasonography, computed tomography, and magnetic resonance imaging are diagnostic modalities that can help distinguish different presentations. Despite the commonality of hematomas in clinical practice, atypical hematomas may also present unique challenges in diagnosis and management due to their varied clinical presentations and locations. This report underlines the importance of understanding hematomas' diverse etiologies, presentations, and imaging characteristics for appropriate treatment and diagnosis.

A Rare Case of Calcinosis Cutis Presenting to a Tertiary Care Hospital in Rural Maharashtra.

Calcinosis cutis is a common ailment of the skin, caused by the accumulation of calcium salts in the subcutaneous regions, though there are rare case reports from rural Maharashtra region. This condition is usually asymptomatic and might manifest as a single growth or several different-sized growths. Its clinical presentation is observed as nodules or plaques without causing injury to underlying tissues. The condition is reported to be a secondary presentation to trauma, malignancies, and connective tissue diseases and has multifactorial underlying etiologies. Recommendation for treatments including both medical and surgical procedures is contingent upon the manifestation and severity of the condition. The final decision can be based on the results obtained from diagnostic modalities like fine needle aspiration and radiological imaging. This is the case of a 35-year-old male with a swelling on his left foot for the past two years without any associated medical history. The patient was managed by surgical incision and had a good recovery.

Long-term 23-year Global Post-marketing Safety Surveillance Review of Delayed Complications with a Supportive Hyaluronic Acid Filler for Infraorbital Hollow Rejuvenation.

HARES is a supportive (high G') HA filler with a low degree of water affinity (gel swelling) and modification (<1% BDDE) that has a well-established safety and efficacy profile in the literature, especially for infraorbital hollow (IOH) rejuvenation. To further support the safety of this product, a long-term review of delayed-onset adverse events of interest (DAEIs) related to HARES was conducted using reports from a global post-marketing safety surveillance database over the past 23 years. This review demonstrated low reporting frequencies of delayed-onset nodules and inflammatory events, establishing a long-term safety profile for HARES that supports its continued use in clinical practice, especially for IOH rejuvenation.

Recovering high-quality glass fibers from end-of-life wind turbine blades through swelling-assisted low-temperature pyrolysis.

The recycling of end-of-life wind turbine blades has become a global environmental challenge driven by the rapid growth of wind power. Pyrolysis is a promising method for recovering glass fibers from these discarded blades, but traditional pyrolysis is often operated at high temperatures, which degrades the mechanical properties of recovered fibers. To address this issue, a swelling-assisted pyrolysis method was proposed to recover high-quality glass fibers from end-of-life wind turbine blades at low temperatures. The results confirmed that the decomposition of the resin matrix within the blade was significantly promoted at low temperatures in the swelling-assisted pyrolysis process, achieving a resin decomposition ratio of 76.8 % at 350 °C. This improvement was attributed to enhanced heat transfer and co-pyrolysis with acetic acid. Swelling could physically disrupt the cross-linked structure of the blade, creating a more porous and layered structure, thereby enhancing heat transfer during the pyrolysis process. Simultaneously, the co-pyrolysis with acetic acid could generate hydrogen radicals, which promoted the cracking of macromolecular oligomers into lighter products or gaseous alkanes. Consequently, the formation of pyrolysis char within the solid pyrolysis product was reduced, shortening the oxidation duration to 30 min. In comparison to traditional pyrolysis, the swelling-assisted pyrolysis process effectively suppressed the diffusion of surface defects over the recovered fibers, leading to promising improvements in their flexibility, elasticity, and mechanical properties, with tensile strength notably increased by 27.5 %. These findings provided valuable insights into recovering high-quality glass fibers from end-of-life wind turbine blades.

[Mechanism of Mailuo Shutong Pills on posterior limb muscle swelling caused by femoral fracture in rats based on network pharmacology and experimental verification].

This study aims to investigate the mechanism of Mailuo Shutong Pills(MLST) on posterior limb muscle swelling caused by femoral fracture(SCFF) through network pharmacology and animal experiments. The plasma components of MLST were analyzed by LC-MS, and the target and signal pathway of SCFF were predicted by network pharmacology and verified by molecular docking. SCFF model rats were established through animal experiments, and different doses of MLST were administered to detect the degree of limb swelling. Hematoxylin-eosin(HE) staining was used to observe pathological changes in muscle tissue, and interleukin-6(IL-6), interleukin-1ß(interleukin-1ß), and tumor necrosis factor-α(TNF-α) in peripheral blood were determined by enzyme-linked immunosorbent assay(ELISA). The expression of relevant signaling pathways was measured by Western blot. Network pharmacological results showed that MLST and SCFF had a total of 153 disease targets, and the key targets were IL-6, TNF, etc., involving mitogen-activated protein kinase(MAPK) signaling pathway, phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT) signaling pathway, etc. The binding energies of the main components and key targets were lower than-7.0 kcal·mol~(-1), indicating that the network analysis results were reliable. The results of animal experiments showed that MLST could reduce the swelling degree and pathological damage of the posterior limb muscles of SCFF rats compared with the model group. ELISA results showed that MLST could reduce the levels of IL-6, IL-1ß, and TNF-α in the serum of SCFF rats. Western blot results showed that MLST can reduce the expression of p-AKT, p-PI3K, p-NF-κB, p-p38 MAPK, and p-ERK in SCFF rats. MLST may reduce the content of inflammatory factors in serum by regulating the expression of PI3K/AKT and MAPK-related signaling pathway protein and improving posterior limb muscle SCFF in rats.