Buried object characterization by data-driven surrogates and regression-enabled hyperbolic signature extraction.

This work addresses artificial-intelligence-based buried object characterization using FDTD-based electromagnetic simulation toolbox of a Ground Penetrating Radar (GPR) to generate B-scan data. In data collection, FDTD-based simulation tool, gprMax is used. The task is to estimate geophysical parameters of a cylindrical shape object of various radii, buried at different positions in the dry soil medium simultaneously and independently of each other. The proposed methodology capitalizes on a fast and accurate data-driven surrogate model developed for object characterization in terms of its vertical and lateral position, and the size. The surrogate is constructed in a computationally efficient manner as compared to methodologies using 2D B-scan image. This is achieved by operating at the level of hyperbolic signatures extracted from the B-scan data through linear regression, which effectively reduces the dimensionality and the size of data. The proposed methodology relies on reducing of 2D B-scan image to 1D data including variation of reflected electric fields' amplitudes with respect to the scanning aperture. The input of the surrogate model is the extracted hyperbolic signature obtained through linear regression executed on the background subtracted B-scan profiles. The hyperbolic signatures encode information about the geophysical parameters of the buried object, including depth, lateral position, and radius, all of which can be extracted using proposed methodology. Parametric estimation of the object radius and the estimation of the location parameters simultaneously is a challenging problem. Applying the application of processing steps on B-scan profiles incurs high computational costs, which is a limitation of the current methodologies. The metamodel itself is rendered using a novel deep-learning-based modified multilayer perceptron (M2LP) framework. The presented object characterization technique is favourably benchmarked against the state-of-the-art regression techniques, including Multilayer Perceptron (MLP), Support Vector Regression Machine (SVRM), and Convolutional Neural Network (CNN). The verification results demonstrate the average mean absolute error of 10 mm, and the average relative error of 8 percent, both corroborating the relevance of the proposed M2LP framework. In addition, the presented methodology provides a well-structured relation between the geophysical parameters of object and the extracted hyperbolic signatures. For the sake of supplementary verification under realistic scenarios, it is also applied for scenarios involving noisy data. The environmental and internal noise of the GPR system and their effect is analyzed as well. Furthermore, the proposed surrogate modeling approach is validated using measurement data, which is indicative of suitability of the approach to handle physical measurements as data sources.

Multiple Swaps Tested: Rehearsal for Triple and Five-Liver Paired Exchanges.

Despite several advances in living donor liver transplant (LDLT), many potential living liver donors cannot donate their organs to their relatives because of blood group incompatibility and unsuitable anatomy. Liver paired exchange (LPE) can be used to overcome incompatibilities between living donor-recipient pairs. In this study, we report the early and late results of 3 and 5 LDLTs performed simultaneously to initiate the more complex LPE program. By demonstrating that our center is capable of performing up to 5 LDLTs, we have taken an essential step for establishing a complex LPE program.

Deep learning model developed by multiparametric MRI in differential diagnosis of parotid gland tumors.

PURPOSE: To create a new artificial intelligence approach based on deep learning (DL) from multiparametric MRI in the differential diagnosis of common parotid tumors. METHODS: Parotid tumors were classified using the InceptionResNetV2 DL model and majority voting approach with MRI images of 123 patients. The study was conducted in three stages. At stage I, the classification of the control, pleomorphic adenoma, Warthin tumor and malignant tumor (MT) groups was examined, and two approaches in which MRI sequences were given in combined and non-combined forms were established. At stage II, the classification of the benign tumor, MT and control groups was made. At stage III, patients with a tumor in the parotid gland and those with a healthy parotid gland were classified. RESULTS: A stage I, the accuracy value for classification in the non-combined and combined approaches was 86.43% and 92.86%, respectively. This value at stage II and stage III was found respectively as 92.14% and 99.29%. CONCLUSIONS: The approach presented in this study classifies parotid tumors automatically and with high accuracy using DL models.

Radiomics and deep learning approach to the differential diagnosis of parotid gland tumors.

PURPOSE OF REVIEW: Advances in computer technology and growing expectations from computer-aided systems have led to the evolution of artificial intelligence into subsets, such as deep learning and radiomics, and the use of these systems is revolutionizing modern radiological diagnosis. In this review, artificial intelligence applications developed with radiomics and deep learning methods in the differential diagnosis of parotid gland tumors (PGTs) will be overviewed. RECENT FINDINGS: The development of artificial intelligence models has opened new scenarios owing to the possibility of assessing features of medical images that usually are not evaluated by physicians. Radiomics and deep learning models come to the forefront in computer-aided diagnosis of medical images, even though their applications in the differential diagnosis of PGTs have been limited because of the scarcity of data sets related to these rare neoplasms. Nevertheless, recent studies have shown that artificial intelligence tools can classify common PGTs with reasonable accuracy. SUMMARY: All studies aimed at the differential diagnosis of benign vs. malignant PGTs or the identification of the commonest PGT subtypes were identified, and five studies were found that focused on deep learning-based differential diagnosis of PGTs. Data sets were created in three of these studies with MRI and in two with computed tomography (CT). Additional seven studies were related to radiomics. Of these, four were on MRI-based radiomics, two on CT-based radiomics, and one compared MRI and CT-based radiomics in the same patients.

The effects of residual parotid volume on symptom-specific quality of life and complications in patients undergoing parotid surgery.

PURPOSE: To measure postoperative residual parotid volumes in parotidectomy patients and to measure the effect of residual parotid volumes on the symptom-specific quality of life (SSQOL) and complications. METHODS: Between January 2010 and December 2016, 148 parotid gland surgeries were performed, and 74 patients were included in the study. Bilateral parotid gland volumes were measured by Magnetic Resonance Imaging (MRI). Parotidectomy Outcome Inventory-8 and aesthetic scale questionnaire were applied to the patients. The volumetric averages obtained were compared with the questions in the SSQOL scale, the aesthetic scale data, and complications. RESULTS: In the volumetric examination performed with MRI, the mean residual volumes of the operated parotid glands were 9.5 cm3, while the non-operated side was 28.8 cm3. The width of the surgery and the residual parotid tissue volume was inversely correlated. There was a statistically significant difference between the residual parotid gland volume and the pain related to the surgical area, depression in the surgical site, Frey's syndrome, incision scar, and numbness. As the residual parotid gland volumes decreased, the patients' cosmetic problems related to the surgical field increased significantly, and their SSQOL decreased. CONCLUSION: Postoperative residual parotid tissue volume could be an objective parameter to measure patients' SSQOL and complications. After parotidectomy, the maximum amount of disease-free tissue of the parotid gland should be left in place to increase patients' quality of life and minimize complications.

Endoscopic Transoral Resection of Tongue Base Ancient Schwannoma.

Schwannoma is a benign slow growing nerve sheath tumor that is typically encapsulated and composed of well-differentiated schwann cells. Schwannomas may take origin from different nerves such as cranial, spinal nerves, and the sympathetic chain. Approximately 25% to 45% of all occur in the head and neck only 1% of them are located in the oral cavity. However, it is quite rare to for schwannomas to form on the tongue base. Ancient schwannoma is the rarest, and also extremely rare in oropharynx. A 32-year-old female patient was admitted to our clinic with complaints of hoarseness, difficulty in swallowing, throat pain, snoring, and dyspnea. In examination, a smooth surfaced circumscribed mass, which originated from the tongue base was observed. In the magnetic resonance imaging, a 4.5 × 3 cm sized tongue base mass which narrowed the upper airway was detected. An endoscopic transoral excisional biopsy was performed. The histopathological diagnosis was determined as ancient schwannoma. The use of the endoscopic transoral approach can be suitable to protect the important anatomical structures, functions, and reduce the complications and esthetic concerns for the resection of tongue base schwannomas.

Postoperative Radiotherapy in Salivary Gland Carcinoma: A Single Institution Experience.

BACKGROUND: Salivary gland carcinoma are rare tumors and the main treatment is surgical. The addition of radiotherapy to surgery decreases locoregional relapses in high risk patients. Aim of our study is to retrospectively evaluate local control and survival and the factors affecting them in patients who received postoperative radiotherapy. MATERIALS AND METHODS: The medical records of 30 patients with salivary gland tumors operated on and referred to our clinic for adjuvant RT between January 2004 and June 2015 were retrospectively evaluated. RT was applied to the primary tumor or its lymphatics in a median dose of 60 Gy (48-66 Gy) in 1.8-2 Gy/fraction. The number of patients receiving concomitant chemotherapy was 8 (27%) and 22 (73%), respectively. RESULTS: The mean duration of follow-up was 47 months (range: 3-132 months). The mean duration between surgery and RT was 51 days and mean duration of RT was 43 days. Tumors were located in the parotid gland in 25 patients (83%), in the submandibular gland in four patients (14%), and in the sublingual gland in one patient (3%). Histopathologically, the most common tumor was adenoid cystic carcinoma (27%), followed by mucoepidermoid carcinoma (20%), and skin SCC metastatic to the parotid gland. Five-year overall survival (OS), five-year disease specific survival (DSS), and five-year disease free survival (DFS) were 50%, 50%, and 54%, respectively. Regional recurrence and distant organ metastasis developed in 5 (17%) and 9 (30%) patients, respectively. OS, DSS, and DFS were significantly decreased in patients with lymph node metastasis compared to the patients with no metastasis (p=0.002). DFS was better in Stage 1-2 patients compared to Stage 3-4 patients (p=0.019). OS and DFS were significantly in radiotherapy time in less than 45 days (p=0.01). A duration between surgery and radiotherapy of more than 42 days was associated with low DFS (p=0.042). No prognostic significance of age, gender, type of the salivary gland, T stage, tumor diameter, surgical margin, PNI, LVI, and extracapsular involvement was found among the other variables. CONCLUSION: Adjuvant RT is an efficacious and safe method of treatment in high risk patients operated on for salivary gland tumor.

Endoscopic Transoral Resection of Parapharyngeal Osteoma: A Case Report.

Osteoma is a benign, mesenchymal, slow-growing, osteogenic tumor commonly occurring in the craniofacial bones and is characterized by the proliferation of compact or cancellous bone. Solitary osteomas can be classified as peripheral (parosteal, periosteal, or exophytic) when arising from the periosteum or central (endosteal) when arising from soft tissue. Peripheral osteoma occurs most frequently in the paranasal sinuses. Other locations include the orbital wall, temporal bone, pterygoid processes, external ear canal, and, rarely, the mandible. Osteomas in the oromandibular region often appear in the jaw in the canine fossa, hard palate, and maxillary sinus and in the lower jaw in the inner mandible and outer circumference and lingual side of the molar region. At radiologic imaging, a peripheral osteoma of the mandible appears as a well-circumscribed, round to oval, mushroom-like radiopaque mass with distinct borders. Computed tomography is the best imaging modality for determining the location and actual extension of the lesion. Parapharyngeal space tumors are rare tumors of the head and neck region. Benign tumors of the parapharyngeal space are more common than malignant tumors. A foreign body sensation in the pharynx, difficulty with deglutition, and hoarseness are symptoms generally related to the position of the tumor. Upper airway obstruction, painful throat, unilateral tinnitus, trismus, dysarthria, glossopharyngeal neuralgia, and cranial nerve palsies are other reported symptoms. This report presents the case of a huge osteoma of the left mandibular condyle extending to the parapharyngeal space.

Pediatric Sudden Sensorineural Hearing Loss.

Sudden sensorineural hearing loss is defined as sudden unilateral or bilateral sensorineural hearing loss with at least 30 dB decrease in threshold in 3 contiguous test frequencies occurring over 72 hours or less. It is rare among children. The mechanism of the process and prognosis of the disorder remains unclear. The current incidence of sudden sensorineural hearing loss among pediatric population is unknown. The authors carried out a retrospective chart analysis of patients under 15 years of age from 2004 to 2015, who consulted to the Otolaryngology Head and Neck Surgery Department of Inonu University Medical Faculty. Age, sex, number of affected ear and side, audiometric evaluations, medical follow-up, treatment method, duration of treatment recovery, associated complaints; tinnitus and/or vertigo, presence of mumps disease were recorded for each patient. A 4-frequency pure-tone average (500, 1000, 2000, and 4000 Hz) was calculated for each ear. Complete recovery, defined as some hearing level compared with the nonaffected ear, was observed in 3 patients (21.4 %) and there was no partial hearing recovery. The hearing loss of 11 patient remained unchanged after prednisolone treatment. Two of the 11 patients had bilaterally total sensorineural hearing loss and evaluated as appropriate for cochlear implantation. Sex of patient and laterality of hearing loss were not correlated with hearing recovery. Sensorineural hearing loss among pediatrics has been the issue of otolaryngologists. The incidence, etiology, and treatment methods should be more studied.

The Effect of Dexpanthenol on Ototoxicity Induced by Cisplatin.

OBJECTIVES: This study was aimed to investigate the protective effects of dexpanthenol (Dxp) on against cisplatin-induced ototoxicity. METHODS: To examine this effect, distortion product otoacoustic emissions (DPOAEs) measurements and serum levels of oxidative and antioxidant status (including malondialdehyde, superoxide dismutase, catalase, glutathione, glutathione peroxidase, total oxidant status, total antioxidant status, and oxidative stress index) were evaluated. Thirty-two adult female Wistar albino rats were randomly divided into 4 equal groups; control (K), cisplatin (C), cisplatin plus Dxp (CD), and Dxp (D). In all groups DPOAEs measurements, between 996 and 10,078 Hz as DPOAEs and input/output functions, were performed on days 0, 1th, 5th, and 12th. Prior to death, the last DPOAEs measurements and blood samples were taken. RESULTS: In the C group, statistically significant differences were detected at all frequencies between 0 and 5 days and 0 and 12 days measurements (P<0.05). Serum level of oxidant and antioxidant status were detected statistically significantly changed in this group versus K group (P<0.05). Contrary to the C group, in the CD group hearing ability was seen largely preserved at many frequencies and serum levels of all biochemical parameters were shifted toward normal values, similar to the K group. No significant differences were detected in the either D or K group's measurements. CONCLUSION: According to these results, Dxp may prevent cisplatin-induced ototoxicity.

[Giant desmoid tumor in the neck]. / Boyunda dev desmoid tümör.

Desmoid tumor is a benign tumor which originates from musculoaponeurotic system, can reach greater sizes with local invasion among facial plans, and cause severe deformities, morbidity and even mortality by compression of adjacent structures. These tumors are rarely seen in the head and neck region. The treatment of advanced desmoid tumors of head and neck region is surgery and radiotherapy. In this paper, we present -to the best of our knowledge- the greatest desmoid tumor case of the head and neck region in the literature.

Congenital muscular torticollis in older children: treatment with Z-plasty technique.

Congenital muscular torticollis (CMT) is a common congenital disorder of the musculoskeletal system in neonates and infants. The aim of this study was to evaluate the results of inferior Z-plasty in older children with CMT. They had mean age of 10 years (range, 5-14 years) and were followed up for 1 to 6 years. Postoperative protocol included a neck exercise program composed of active and passive movements in all cases and immobilization with a cervical collar in only 4 patients. This study concluded that surgical management of older children with CMT using Z-lengthening gives excellent clinical and functional results. The procedure is much more effective than other techniques and relatively complication-free and safe. Postoperative cervical collar and a well-planed physiotherapy protocol go a long way toward ensuring good to excellent results. Early diagnosis and treatment are necessary for good results.

The protective role of molsidomine on the Cisplatin-induced ototoxicity.

This experimental study was designed to investigate the protective effects of molsidomine (MOL) on against cisplatin-induced ototoxicity (CIO). To examine this effect, distortion product otoacoustic emissions (DPOAEs) measurements and serum levels of oxidative and antioxidant status [including malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), glutathione peroxidase (GPX), total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI)] were evaluated. Thirty-two female wistar albino rats were divided into four groups including; control (Group K), cisplatin (Group C), cisplatin plus MOL group (Group CM), and MOL group (Group M). DPOAEs measurements between 0.9961 and 8.0003 Hz as DP-gram and input/output (I/O) functions were performed in the same (left) ear of all rats on days 0, 1st, 5th and 12th. Prior to death, the last DPOAEs measurements and blood samples were taken. In the C group, statistically significant DPOAE amplitude reductions were detected at 2.5195, 3.1758, 3.9961, 5.0391, 6.3516 and 8.0039 Hz frequencies (p < 0.05) between 0th and 1st, 0th and 5th and 0th and 12th days' measurements (p < 0.05). Serum level of MDA, TAC and OSI levels were significantly higher in the C group versus K group (p < 0.05). In the CM group, there were no significant differences at all frequencies between 0th and other days' measurements (p > 0.05) and the serum levels of all biochemical parameters were shifted toward normal values, similar to the K group (p < 0.05). No significant differences were detected in the either M or K group's measurements. According to these results, cisplatin-related ototoxicity has been significantly prevented by MOL.

Effects of topical phenytoin on nasal wound healing after mechanical trauma: An experimental study.

OBJECTIVES/HYPOTHESIS: Impaired postoperative wound healing is the second most common morbidity after synechia formation in endoscopic sinus surgery. The aim of this experimental study was to investigate the potential effects of topical phenytoin on wound healing after nasal mucosal trauma in rats. STUDY DESIGN: An experimental study at the Inonu University Faculty of Medicine. METHODS: Twenty-four rats were randomized into three groups: 1) phenytoin group (n = 8), 2) control group (n = 8), and 3) vehicle group (n = 8). After damaging the right nasal cavity, in the phenytoin group, 1% topical phenytoin cream was applied for 7 days. The rats in the control group did not receive any treatment. The vehicle group was treated with daily topical cold cream for 1 week. The rats were sacrificed at the end, and the nasal cavities were excised. Tissue edema and inflammatory cell infiltration were compared among the groups. Additionally, proliferating cell nuclear antigen (PCNA) and cluster of differentiation 31 (CD31) immunoexpression levels were evaluated. Furthermore, in biochemical analysis, the tissue levels of vascular endothelial growth factor and (EGF) of the groups were investigated. RESULTS: In the phenytoin group, tissue edema and inflammatory cell infiltration were significantly decreased, and PCNA and CD31 immunoexpression levels were more prominent (P < .001) and the tissue EGF levels were significantly higher (P < .01). CONCLUSIONS: Topical phenytoin treatment may alter the nasal wound healing after mechanical trauma. The potential beneficial effects of topical phenytoin on nasal mucosa should be investigated by further experimental and human trials. LEVEL OF EVIDENCE: NA.

Follicular dendritic cell sarcoma associated with hyaline-vascular Castleman's disease.

Follicular dendritic cell sarcoma (FDCS) of the head and neck region, associated with Castleman's disease (CD), is an extremely rare entity. To the best of our knowledge, we report the first case demonstrating the transformation of the former into the latter as documented in the same lymph node disection material. A 45-year-old female presented to our hospital with right sided neck swelling. Radiologic imaging showed a well defined 3.5 x 3.5 cm mass of soft tissue at the right side of the neck with multiple bilateral cervical lymph nodes. Excision of the right neck mass with lymph node disection was performed. Microscopic examination and immunohistochemical findings showed features of follicular dendritic cell sarcoma. The associated lymph nodes exhibited changes consistent with hyaline-vascular type CD, follicular dendritic cell hyperplasia and foci of overgrowth in which FDCS possibly evolved. This report confirms the evolving of FDCS in the setting of follicular dendritic cell hyperplasia occurring in Castleman's disease.

Acquired capillary hemangioma with features of tufted angioma in the external auditory canal.

Tufted angiomas may occur in the head and neck region, but the external auditory canal is a previously undefined localization. There are only 19 cases of hemangiomas reported in this unique localization. However, this case is the first capillary hemangioma of the tufted variant being reported with a recurrence after 7 years after surgical excision in a 47-year-old male patient.

Inflammatory myofibroblastic tumor: a rare tumor in the tongue.

Inflammatory myofibroblastic tumor is composed of myofibroblast and inflammatory cell infiltration of the tissue. Malign transformation and recurrence rate of this tumor is rare and accepted as benign fibroinflammatory disease. The main etiology is unclear, but infection, trauma, and immunologic event are accused. In this study, we presented a 75-year-old man with a mass on his tongue, which was diagnosed as "inflammatory myofibroblastic tumor." This type of tumor is rarely seen in the tongue and might be difficult to diagnose. Complete mass excision was provided for an adaquete treatment.

Well-differentiated neuroendocrine tumor: a rare tumor of the larynx.

Neuroendocrine tumors of the larynx are rarely seen neoplasms. Atypical carcinoid tumor is the most common type of the neuroendocrine tumors of the larynx, whereas the typical carcinoid tumor is the most infrequent type. Preferable treatment in typical carcinoid tumor is particularly conservative surgery without neck dissection. Radio-chemotherapy is ineffective. In this report, we present a 61-year-old female case of typical carcinoid tumor of the larynx with histological findings and applied treatment modality.