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1

Factors affecting the effectiveness of conservative management of appendicular mass

100%

Almoamin H. H. A.

Polish Journal of Surgery

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2021

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vol. 93

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issue 3

17-21

EN

Introduction: Acute appendicitis is the most common surgical emergency in children. Appendicular mass is a relatively common complication in improperly treated patients. The management of appendicular mass remains controversial. Aim: This study aims at determining factors affecting the effectiveness of conservative management of appendicular mass. Material and methods: This was a retrospective study of 71 children younger than 15 years with appendicular mass managed at Basra Children’s Specialty Hospital during the period between 2015 and 2019. Factors like age of the patient, duration of symptoms prior to hospital admission, size of the mass, complications, hospital stay and outcome are reviewed. Results: Appendicular mass complicates 3.9% of all cases of acute appendicitis. Conservative management of appendicular mass was effective in 84.5%. Appendicular mass occurred most frequently in children aged 5–10 years (48%). Male is more frequently affected than female with a ratio of 1.4. Regarding age effect on the efficacy of conservative management of appendicular mass, there is a significant association with P-value = 0.017. Duration of symptoms or size of the mass has no significant association with the success of conservative management. No mortality or major surgical complications are encountered. Although effective, conservative management prolongs the length of hospital stay. Conclusion: Conservative management of appendicular mass in children should be revised particularly in children younger than 5 years old, wherein operative treatment may be the first option. The reasons for that are high rate of failure of conservative management with early progress to appendicular abscess. These could be explained by the underdevelopment of the greater omentum lacking its protective effect in limiting the spread of inflammation. In addition, early appendectomy has the following advantages: decreased risk of adhesive intestinal obstruction, shortening of hospital stay (i.e, less economic burden), and avoidance of second readmission for interval appendectomy

2

Origins of mass

100%

Wilczek F.

Open Physics

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2012

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vol. 10

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issue 5

1021-1037

EN

Newtonian mechanics posited mass as a primary quality of matter, incapable of further elucidation. We now see Newtonian mass as an emergent property. That mass-concept is tremendously useful in the approximate description of baryon-dominated matter at low energy - that is, the standard “matter” of everyday life, and of most of science and engineering - but it originates in a highly contingent and non-trivial way from more basic concepts. Most of the mass of standard matter, by far, arises dynamically, from back-reaction of the color gluon fields of quantum chromodynamics (QCD). Additional quantitatively small, though physically crucial, contributions come from the intrinsic masses of elementary quanta (electrons and quarks). The equations for massless particles support extra symmetries - specifically scale, chiral, and gauge symmetries. The consistency of the standard model relies on a high degree of underlying gauge and chiral symmetry, so the observed non-zero masses of many elementary particles (W and Z bosons, quarks, and leptons) requires spontaneous symmetry breaking. Superconductivity is a prototype for spontaneous symmetry breaking and for mass-generation, since photons acquire mass inside superconductors. A conceptually similar but more intricate form of all-pervasive (i.e. cosmic) superconductivity, in the context of the electroweak standard model, gives us a successful, economical account of W and Z boson masses. It also allows a phenomenologically successful, though profligate, accommodation of quark and lepton masses. The new cosmic superconductivity, when implemented in a straightforward, minimal way, suggests the existence of a remarkable new particle, the so-called Higgs particle. The mass of the Higgs particle itself is not explained in the theory, but appears as a free parameter. Earlier results suggested, and recent observations at the Large Hadron Collider (LHC) may indicate, the actual existence of the Higgs particle, with mass m H ≈ 125 GeV. In addition to consolidating our understanding of the origin of mass, a Higgs particle with m H ≈ 125 GeV could provide an important clue to the future, as it is consistent with expectations from supersymmetry.

3

Ocena ultrasonograficzna guzów tkanek miękkich ręki

58%

Teh J.

Journal of Ultrasonography

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2012

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vol. 12

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issue 51

381-401

EN

Most soft tissue mass lesions of the hand are benign. Ganglia are the commonest lesions encountered, followed by giant cell tumors of the tendon sheath. Malignant tumors are rare. Often a specific diagnosis can be achieved on imaging by considering the location and anatomical relations of the lesion within the hand or wrist, and assessing its morphology. Magnetic resonance imaging is an excellent modality for evaluating soft tissue tumors with its multiplanar capability and ability to characterize tissue. Ultrasound plays a complementary role to MRI. It is often the initial modality used for assessing masses as it is cheap and available, and allows reliable differentiation of cystic from solid lesions, along with a real time assessment of vascularity. This review describes the US appearances of the most frequently encountered soft tissue masses of the wrist and hand, correlating the findings with MRI where appropriate.

PL

Większość guzów tkanek miękkich ręki ma łagodny charakter. Do najczęstszych należą gangliony oraz guzy olbrzymiokomórkowe pochewki ścięgnistej. Zmiany złośliwe występują rzadko. W wielu przypadkach ustalenie rozpoznania jest możliwe w badaniach obrazowych na podstawie oceny lokalizacji i morfologii zmian oraz stosunków anatomicznych w obrębie ręki. Rezonans magnetyczny jest doskonałą metodą oceny guzów tkanek miękkich dzięki możliwości wielopłaszczyznowego obrazowania oraz określenia charakteru tkanek. Ultrasonografia stanowi uzupełnienie badania techniką rezonansu magnetycznego. Często jest badaniem pierwszego wyboru z uwagi na niższy koszt i większą dostępność w porównaniu z rezonansem magnetycznym. Pozwala na wiarygodne odróżnienie przestrzeni płynowych od zmian litych oraz na ocenę unaczynienia zmian. Niniejszy artykuł przedstawia obrazy ultrasonograficzne najczęstszych zmian guzowatych tkanek miękkich ręki w korelacji z obrazami rezonansu magnetycznego.

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Factors affecting the effectiveness of conservative management of appendicular mass

Origins of mass

Ocena ultrasonograficzna guzów tkanek miękkich ręki