Endoscopic surgery for inverted papilloma with carcinoma change of lacrimal drainage apparatus and nasal cavity

Dear Sir,Iam Dr.Yin-Hung Chang from the Department of Otolaryngology,Taipei Tzu Chi Hospital,the Buddhist Tzu Chi Medical Foundation.I would like to present a case of inverted papilloma with carcinoma change of lacrimal drainage apparatus and nasal cavity that had been successfully treated by endoscopic surgery.Lacrimal drainage apparatus tumors are rare but important

Clinical Variants, Rates of Post-Operative Recurrence and Malignant Transformation of Sino-Nasal Inverted Papilloma

Background: Inverted Papilloma (IP) is the most common benign neoplasms arising from the mucosal lining of the of the Sino-Nasal tract with single or multifocal attachment sites. The high propensity to recur, local aggressive behavior and possibility of malignant transformation attract considerable interest. Objective: To assess the factors affecting Sino-nasal IP, malignant transformation rate, and post-operative recurrence rate. Methods: A retrospective study was carried out on all cases diagnosed as Sino-Nasal Papilloma between January 2010 and December 2020 at Salmaniya Medical Complex, Bahrain. Data gathered from medical records were analyzed using SPSS. A total of 49 Sino-Nasal Papilloma cases were recorded of which 37 were IP. Factors affecting Sino-Nasal IPs are presented. Results: Sino-Nasal IP was recorded in 37 cases, composed of 28 males and 9 females with first presentation average age of 45.86 years. These involved 20 cases in the left side, 14 in the right side and 3 were bilateral. Recurrence in males and females was found to be 35.7% and 33%, respectively, with an average of 12.6 months. The symptoms include nasal blockage (97.3%), epistaxis and postnasal drip (13.5% each), headache (8.1%) and hyposmia and rhinorrhea (5.4%, each). The main recurrence was at stage T2 (60.5%), while in smokers (26.7%) and non-smokers (50%). Malignant transformation occurred in one patient only (2.6%). Conclusion: IP is the most common type of SNP with male predominance. The recurrence rate is high with an average of a year and the malignant transformation occurred in 2.6 % of the cases.

A Review of Inverted Papilloma at a Tertiary Centre: A Six-Year Experience

Objectives: To evaluate the clinical presentation and treatment outcome of all patients treated for inverted papilloma at the University Malaya Medical Centre, Malaysia. Methods: A retrospective review of 22 patients with inverted papilloma, treated at our centre, from 1st January 2005 to 31st August 2011. The demographic data, clinical features, radiological findings, surgical procedures, recurrent rate and malignant transformation were assessed. Result: The commonest presentation was a unilateral nasal blockage, comprising 77.3% cases. A total of 19 patients had undergone endoscopic surgery while three patients had open surgery performed. The mean duration of the follow-up period was 30.5 months. Seven (31.7%) patients were detected of tumour recurrence during the entire course of follow-up. However, throughout the follow-up period, none had demonstrated malignant transformation. Conclusion: Endoscopic medial maxillectomy is a well-accepted approach in treating inverted papilloma. Nevertheless, open surgery still plays an important role in extensive diseases and in cases of malignancy. Unilateral nasal obstruction is the most important symptom. Repeated pre-operative biopsy or perhaps frozen section of intraoperative biopsies is necessary to avoid misdiagnosis. Krouse stage II disease showed the highest recurrent rate of 18.2%. Lifelong follow-up and emphasis on adherence is mandatory for early detection of recurrence and malignant transformation.

Acute proptosis: Unusual initial presentation of sinonasal inverted papilloma

Inverted papilloma is an uncommon histopathological finding of maxillary sinus tumor. We reported here a rare case of inverted papilloma of maxillary sinus presented initially with ipsilateral proptosis. A middle-aged lady with history of having allergic rhinitis presented with progressive left eye proptosis. Assessment revealed presence of orbital mass arising from paranasal sinus, in which the histopathological examination was initially inconclusive, and later it turned up to be inverted papilloma, partly with malignant transformation. High index of suspicion is necessary especially in those patients with recurrent non-specific sinonasal symptoms, which may need repeated biopsy and histopathological examination. Ocular manifestation signifies a more advance disease.

Recurrent inverted papilloma coexisted with skull base lymphoma: A case report

BACKGROUND Inverted papilloma is an uncommon neoplasm in the nasal cavity.It is a histologically benign tumor,but has a high recurrence and local invasion rate.In addition,nasal or skull base lymphoma is another rare neoplasm.The coexistence of these two tumors in one case makes the diagnosis and related treatment difficult.CASE SUMMARY We report a case of an immunocompetent patient,who had a history of inverted papilloma 20 years ago.The patient presented with an infiltrated mass lesion in the nasal cavity with extension to the frontal base.The repeated biopsies revealed inverted papilloma without any malignant transformation.After the patient underwent a frontobasal craniotomy with total tumor excision,the final pathological examination revealed nasal inverted papilloma coexisting with diffuse large B-cell lymphoma of the skull base.CONCLUSION Based on this case report,while managing a case of an aggressive recurrent inverted papilloma,not only squamous cell carcinoma transformation,but also other invasive malignancy,such as lymphoma,should be considered.

A Case Report of an Inverted Papilloma of the Prostatic Urethra and a Synchronous Low-Grade Papillary Carcinoma of the Bladder

Inverted urothelial papilloma is a rare benign tumour and represents one of the urothelial lesions with inverted morphology. Accurate diagnosis and differentiation from other inverted lesions is important because its proper clinical management and expected clinical outcomes are distinctly different. Here we describe a case of a large inverted urothelial papilloma of the prostatic urethra and a synchronous non-invasive low-grade papillary urothelial carcinoma of the bladder in a 60 year-old man. We focus on the differential diagnosis of inverted urothelial papilloma.

Use of Diode Laser in Excising Bilateral Inverted Papilloma of Paranasal Sinuses

The inverted papilloma is an uncommon unilateral benign unilateral tumor of the nose & paranasal sinuses. Although a benign pathology, it is associated with aggressive local destruction and recurrence after removal and malignancy. The clinical picture presents non-specific signs and symptoms, such as unilateral nasal obstruction, anosmia and headache. Treatment is essentially surgical. This report has the objective of presenting an uncommon bilateral nasal inverted papilloma and the use of diode laser in surgical excision & making a literature review. The uniqueness in our case was the use of diode laser in excision of inverted papilloma.

Reduced-Order Observer-Based LQR Controller Design for Rotary Inverted Pendulum

The Rotary Inverted Pendulum(RIP)is a widely used underactuated mechanical system in various applications such as bipedal robots and skyscraper stabilization where attitude control presents a significant challenge.Despite the implementation of various control strategies to maintain equilibrium,optimally tuning control gains to effectively mitigate uncertain nonlinearities in system dynamics remains elusive.Existing methods frequently rely on extensive experimental data or the designer’s expertise,presenting a notable drawback.This paper proposes a novel tracking control approach for RIP,utilizing a Linear Quadratic Regulator(LQR)in combination with a reduced-order observer.Initially,the RIP system is mathematically modeled using the Newton-Euler-Lagrange method.Subsequently,a composite controller is devised that integrates an LQR for generating nominal control signals and a reduced-order observer for reconstructing unmeasured states.This approach enhances the controller’s robustness by eliminating differential terms from the observer,thereby attenuating unknown disturbances.Thorough numerical simulations and experimental evaluations demonstrate the system’s capability to maintain balance below50Hz and achieve precise tracking below1.4 rad,validating the effectiveness of the proposed control scheme.

Correlation analysis of human papillomavirus E6/E7 mRNA detection with diagnosis,prognosis and recurrence risk in patients with cervical epithelioma

BACKGROUND Cervical intraepithelial neoplasia(CIN)is an important precursor of cervical cancer.Early detection and treatment can reduce the incidence of cervical cancer.AIM To investigate the detection rate of human papillomavirus(HPV)E6/E7 mRNA in cervical tissue of patients with different types of epithelial cell neoplasia(CIN)and its relationship with CIN progression and diagnosis.METHODS One hundred women with HPV infection detected by cervical exfoliation cytology between January 2022 and January 2023 were retrospectively selected.These patients were graded CIN based on colposcopy and cervical pathology.The positive expression rates of HPV E6/E7 mRNA and HPV[polymerase chain reaction(PCR)-reverse dot crossing]were compared among all groups.Patients with HPV E6/E7 mRNA expression in the grade 1 CIN group were followed up for 1 yr.The relationship between atypical squamous epithelium and high malignant epithelial neoplasia was investigated by univariate and multivariate analysis.RESULTS The diagnostic sensitivity,specificity,and sensitivity of PCR-reverse point hybrid ization technology for secondary CIN were 70.41%,70.66%,and 0.714,respectively.Sensitivity and specificity for secondary CIN were 752%and 7853%,respectively,the area under the curve value was 0.789.Logistic Multifactorial model analysis revealed that the HPV positive rates and the HPV E6/E7 mRNA positive rates were independent risk factors of CIN grade I(P<0.05).In CIN grade I patients with positive for HPV E6/E7 mRNA,in its orientation to grade CIN patients,in its orientation to grade CIN patients,at 69.2%,compared with patients negative for HPV E6/E7 mRNA(30.8%),significant difference(P<0.05).CONCLUSION HPV E6/E7 mRNA and HPV(PCR-reverse dot hybrid)positive expression have a close relationship with CINgrade disease progression and is an independent risk factor for high-grade CIN lesions.

Comparative analyses of mitogenomes in the social bees with insights into evolution of long inverted repeats in the Meliponini

The insect mitogenome is typically a compact circular molecule with highly conserved gene contents.Nonetheless,mitogenome structural variations have been reported in specific taxa,and gene rearrangements,usually the tRNAs,occur in different lineages.Because synapomorphies of mitogenome organizations can provide information for phylogenetic inferences,comparative analyses of mitogenomes have been given increasing attention.However,most studies use a very few species to represent the whole genus,tribe,family,or even order,overlooking potential variations at lower taxonomic levels,which might lead to some incorrect inferences.To provide new insights into mitogenome organizations and their implications for phylogenetic inference,this study conducted comparative analyses for mitogenomes of three social bee tribes(Meliponini,Bombini,and Apini)based on the phylogenetic framework with denser taxonomic sampling at the species and population levels.Comparative analyses revealed that mitogenomes of Apini and Bombini are the typical type,while those of Meliponini show diverse variations in mitogenome sizes and organizations.Large inverted repeats(IRs)cause significant gene rearrangements of protein coding genes(PCGs)and rRNAs in Indo-Malay/Australian stingless bee species.Molecular evolution analyses showed that the lineage with IRs have lower dN/dS ratios for PCGs than lineages without IRs,indicating potential effects of IRs on the evolution of mitochondrial genes.The finding of IRs and different patterns of gene rearrangements suggested that Meliponini is a hotspot in mitogenome evolution.Unlike conserved PCGs and rRNAs whose rearrangements were found only in the mentioned lineages within Meliponini,tRNA rearrangements are common across all three tribes of social bees,and are significant even at the species level,indicating that comprehensive sampling is needed to fully understand the patterns of tRNA rearrangements,and their implications for phylogenetic inference.

Control of GaN inverted pyramids growth on c-plane patterned sapphire substrates

Growth of gallium nitride(GaN)inverted pyramids on c-plane sapphire substrates is benefit for fabricating novel devices as it forms the semipolar facets.In this work,GaN inverted pyramids are directly grown on c-plane patterned sapphire substrates(PSS)by metal organic vapor phase epitaxy(MOVPE).The influences of growth conditions on the surface morphol-ogy are experimentally studied and explained by Wulff constructions.The competition of growth rate among{0001},{1011},and{1122}facets results in the various surface morphologies of GaN.A higher growth temperature of 985 ℃ and a lowerⅤ/Ⅲratio of 25 can expand the area of{}facets in GaN inverted pyramids.On the other hand,GaN inverted pyramids with almost pure{}facets are obtained by using a lower growth temperature of 930℃,a higherⅤ/Ⅲratio of 100,and PSS with pattern arrangement perpendicular to the substrate primary flat.

Efficient and Stable Inverted Perovskite Solar Modules Enabled by Solid-Liquid Two-Step Film Formation

A considerable efficiency gap exists between large-area perovskite solar modules and small-area perovskite solar cells.The control of forming uniform and large-area film and perovskite crystallization is still the main obstacle restricting the efficiency of PSMs.In this work,we adopted a solid-liquid two-step film formation technique,which involved the evaporation of a lead iodide film and blade coating of an organic ammonium halide solution to prepare perovskite films.This method possesses the advantages of integrating vapor deposition and solution methods,which could apply to substrates with different roughness and avoid using toxic solvents to achieve a more uniform,large-area perovskite film.Furthermore,modification of the NiO_(x)/perovskite buried interface and introduction of Urea additives were utilized to reduce interface recombination and regulate perovskite crystallization.As a result,a large-area perovskite film possessing larger grains,fewer pinholes,and reduced defects could be achieved.The inverted PSM with an active area of 61.56 cm^(2)(10×10 cm^(2)substrate)achieved a champion power conversion efficiency of 20.56%and significantly improved stability.This method suggests an innovative approach to resolving the uniformity issue associated with large-area film fabrication.

Large gastric hamartomatous inverted polyp accompanied by advanced gastric cancer:A case report

BACKGROUND Gastric hamartomatous inverted polyps(GHIPs)are benign polyps of the gastric submucosal layer.Currently there are 52 reported cases in the English literature.According to a literature review,approximately 27%of GHIPs show a coexisting carcinoma.CASE SUMMARY A 66-year-old man was referred to our institution with ulcerative lesions detected on esophagogastroduodenoscopy(EGD)during a regular check-up.Other medical findings were nonspecific.The lesions had borderline histologic features that could not exclude malignancy and were followed up with three EGDs and biopsies at intervals of 3 mo.The latest biopsy was revealed as an adenocarcinoma.A total gastrectomy was performed to remove the tumor.The surgical specimen revealed a 6.9 cm×4.5 cm sized GHIP with a coexisting 1.6 cm sized well-differentiated adenocarcinoma which extended to the muscularis propria.The malignancy did not originate from the GHIP but showed an overlap.CONCLUSION A large GHIP,which was unusually presented as an ulcerative lesion,was surgically removed,and was accompanied by advanced gastric cancer.Regular follow-up and thorough examinations of ulcerative lesions with equivocal biopsy have resulted in appropriate diagnosis and treatment.Therefore,aggressive intervention may be beneficial if GHIP is suspected.

Intrinsic thermal stability of inverted perovskite solar cells based on electrochemical deposited PEDOT

Thermal stability of perovskite materials is an issue impairing the long-term operation of inverted perovskite solar cells(PSCs). Herein, the thermal attenuation mechanism of the MAPb I3films that deposited on two different hole transport layers(HTL), poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate)(PEDOT:PSS) and poly(3,4-ethylenedioxythiophene)(PEDOT), is comprehensively studied by applying a heat treatment at 85℃. The thermal stress causes the mutual ions migration of I, Pb and Ag through the device, which leads to the thermal decomposition of perovskite to form Pb I2. Interestingly, we find that I ions tend to migrate more towards electron transport layer(ETL) during heating, which is different with the observation of I ions migration towards HTL when bias pressure is applied. Moreover, the use of electrochemical deposited PEDOT as HTL significantly decreases the defect density of MAPb I3films as compared to PEDOT:PSS supported one. The electrochemical deposition PEDOT has good carrier mobility and low acidity, which avoids the drawbacks of aqueous PEDOT:PSS. Accordingly, the inverted PSCs based on PEDOT show superior durability than that with PEDOT:PSS. Our results reveal detailed degradation routes of a new kind of inverted PSCs which can contribute to the understanding of the failure of thermal-aged inverted PSCs.

Enhancing performance of inverted quantum-dot light-emitting diodes based on a solution-processed hole transport layer via ligand treatment

The performance of inverted quantum-dot light-emitting diodes(QLEDs)based on solution-processed hole transport layers(HTLs)has been limited by the solvent-induced damage to the quantum dot(QD)layer during the spin-coating of the HTL.The lack of compatibility between the HTL’s solvent and the QD layer results in an uneven surface,which negatively impacts the overall device performance.In this work,we develop a novel method to solve this problem by modifying the QD film with 1,8-diaminooctane to improve the resistance of the QD layer for the HTL’s solvent.The uniform QD layer leads the inverted red QLED device to achieve a low turn-on voltage of 1.8 V,a high maximum luminance of 105500 cd/m2,and a remarkable maximum external quantum efficiency of 13.34%.This approach releases the considerable potential of HTL materials selection and offers a promising avenue for the development of high-performance inverted QLEDs.

Ecofriendly Hydroxyalkyl Cellulose Additives for Efficient and Stable MAPbI_(3)-Based Inverted Perovskite Solar Cells

Perovskite solar cells(PSCs)have been demonstrated to be one of the most promising technologies in the field of renewable energy.However,the presence of the defects in the perovskite films greatly limits the efficiency and the stability of the PSCs.The additive engineering is one of the most effective approaches to overcome this problem.Most of the successful additives are extracted from the petroleum-based materials,while the research on the biomass-based additives is still lagging behind.In this paper,two ecofriendly hydroxyalkyl cellulose additives,i.e.,hydroxyethyl cellulose(HEC)and hydroxylpropyl cellulose(HPC),are investigated on the performance of the MAPbl_(3)-based inverted PSCs.Due to the strong interaction between the hydroxyl groups of the cellulose and the divalent cations of the perovskite,these additives enhance the crystal grain orientation and significantly repair the defects of the perovskite films.Working as the additives,these two cellulose derivatives show a strong passivation ability,which significantly reduces the trap density and improves the optoelectronic feature of the PSCs.Compared with the average power conversion efficiency(PCE)of the control device(19.19%),an enhancement of~10%is achieved after the addition of HEC.The optimized device(PCE=21.25%)with a long-term stability(10:80 h,PCE=20.93%)is achieved by the incorporation of the HEC additives into the precursor solution.It is the best performance among the PSCs with the cellulose additives up to now.This research provides a novel choice to develop a cost-effective and renewable additive for the PSCs with high efficiency and excellent long-term stability.

Non-Fullerene-Based Inverted Organic Photovoltaic Device with Long-Term Stability

In this work,we developed the PM6:Y6-based inverted structure organic photovoltaic(i-OPV)with improved power conversion efficiency(PCE)and long-term stability by resolving the origins of the performance deterioration.The deep defects between the metal oxide-based electron transport layer and bulk-heterojunction photoactive layer interface were responsible for suboptimal PCE and facilitated degradation of devices.While the density of deep traps is increased during the storage of i-OPV,the penetrative oxygen-containing defects additionally generated shallow traps below the band-edge of Y6,causing an additional loss in the open-circuit voltage.The suppression of interfacial defects by chemical modification effectively improved the PCE and long-term stability of i-OPV.The modified i-OPV(mi-OPV)achieved a PCE of 17.42%,which is the highest value among the reported PM6:Y6-based i-OPV devices.Moreover,long-term stability was significantly improved:~90%and~80%retention of its initial PCE after 1200 h of air storage and illumination,respectively.

Recent progress of inverted organic-inorganic halide perovskite solar cells

In recent years,inverted perovskite solar cells(IPSCs)have attracted significant attention due to their low-temperature and cost-effective fabrication processes,hysteresis-free properties,excellent stability,and wide application.The efficiency gap between IPSCs and regular structures has shrunk to less than 1%.Over the past few years,IPSC research has mainly focused on optimizing power conversion efficiency to accelerate the development of IPSCs.This review provides an overview of recent improvements in the efficiency of IPSCs,including interface engineering and novel film production techniques to overcome critical obstacles.Tandem and integrated applications of IPSCs are also summarized.Furthermore,prospects for further development of IPSCs are discussed,including the development of new materials,methods,and device structures for novel IPSCs to meet the requirements of commercialization.

High frequency doubling efficiency THz GaAs Schottky barrier diode based on inverted trapezoidal epitaxial cross-section structure

A high-performance terahertz Schottky barrier diode(SBD)with an inverted trapezoidal epitaxial cross-sectional structure featuring high varactor characteristics and reverse breakdown characteristics is reported in this paper.Inductively coupled plasma dry etching and dissolution wet etching are used to define the profile of the epitaxial layer,by which the voltage-dependent variation trend of the thickness of the metal-semiconductor contact depletion layer is modified.The simulation of the inverted trapezoidal epitaxial cross-section SBD is also conducted to explain the physical mechanism of the electric field and space charge region area.Compared with the normal structure,the grading coefficient M increases from 0.47 to 0.52,and the capacitance modulation ratio(C^(max)/C_(min))increases from 6.70 to 7.61.The inverted trapezoidal epitaxial cross-section structure is a promising approach to improve the variable-capacity ratio by eliminating the accumulation of charge at the Schottky electrode edge.A 190 GHz frequency doubler based on the inverted trapezoidal epitaxial cross-section SBD also shows a doubling efficiency of 35%compared to that 30%of a normal SBD.

Increased expression of fascin associated with malignant transformation of sinonasal inverted papilloma

Background Fascin, an actin binding protein, usually expressed at a low level in normal epithelium, but is significantly increased in transformed epithelial cells and several common carcinomas. In this study, we examined the expression of fascin by immunohistochemistry in sinonasal epithelium with chronic inflammation （control group）, exophytic papilloma （EP）, inverted papilloma （IP） with dysplasia and cancerated IP （including caminoma in situ and invasive squamous cell carcinoma, SCC）, and furthermore investigated the relationship between fascin expression and formation of malignant IP. Methods Fascin expression was immunohistochemically detected using monoclonal antibody against fascin in 86 paraffin embedded tissues, including 10 cases of sinonasal mucosa with chronic inflammation, 10 of EP, 45 of IP with dysplasia （45 cases were divided into three groups： IP with mild dysplasia, IP with moderate dysplasia, and IP with severe dysplasia, 15 cases each）, and 21 of cancerated IP. Results The level of fascin expression was significantly higher in the neoplastic tissue than that in control group. Fascin expression increased gradually with the progression from sinonasal epithelium with chronic inflammation, IP with mild dysplasia, IP with moderate dysplasia, IP with severe dysplasia, to cancerated IP, and significant difference of fascin expression was observed between any two groups of the five. Conclusion Precancerous lesions of IP exhibit elevated levels of fascin that may be associated with carcinogenesis of IP. Fascin may play a role in the formation of IP and EP.