Granulosa Cell Tumor of Scrotal Tunics: A Case Report

We report a case of adult granulosa cell tumor arising in the scrotal tunics. The patient was a 34-year-old man who presented with right scrotal swelling, first noticed four months previously. Under the initial clinical impression of epididymoorchitis, antibiotic treatment was instituted but there was no response. The paratesticular nodules revealed by ultrasound and magnetic resonance imaging mimicked intratesticular lesion, and radical orchiectomy was performed. Although several cases of adult testicular granulosa cell tumor, have been reported, the occurrence of this entity in the paratesticular area has not, as far as we are aware, been previously described

Prediction of ineffective elective cardioversion of atrial fibrillation: a retrospective multi-center patient cohort study

Background: Elective cardioversion (ECV) of atrial fibrillation (AF) is a standard procedure to restore sinus rhythm. However, predictors for ineffective ECV (failure of ECV or recurrence of AF within 30 days) are unknown.Methods: We investigated 1998 ECVs performed for AF lasting >48 h in 1,342 patients in a retrospective multi-center study. Follow-up data were collected from 30 days after ECV.Results: Median number of cardioversions was one per patient with a range of 1-10. Altogether 303/1998 (15.2%) ECVs failed. Long (>5 years) AF history and over 30 days duration of the index AF episode were independent predictors for ECV failure and low (60/min) ventricular rate, renal failure and antiarrhythmic agents at discharge were the independent predictors for recurrence. In total ECV was ineffective in 852 (42.6%) cases. Female gender (OR 1.44, CI95% 1.15-1.80, p 60/min (OR 1.92, CI95% 1.08-3.41, p = 0.03), antiarrhythmic medication at discharge (OR 1.48, CI95% 1.14-1.93, p < 0.01) and low (<60/ml/min) estimated glomerular filtration rate (OR 1.59, CI95% 1.08-2.33, p = 0.02) were predictors of ineffective ECV.Conclusions: Female gender, use of antiarrhythmic drug therapy and renal failure predicted both recurrence of AF and the composite end point. For the first time in a large real-life study several clinical predictors for clinically ineffective ECV were identified

Perineal hernia

A scoping review of secondary perineal hernia after pelvic surgery and its treatmen

Perception of basic emotion blends from facial expressions of virtual characters:pure, mixed, or complex?

As animated virtual characters in games, movies and other applications become more humanlike, it becomes more and more important to be able to imitate the complicated facial behaviour of a real human. So far, facial expression animation and research have been dominated by the basic emotions view, limited to the six universal expressions: anger, disgust, fear, joy, sadness and surprise. More complex facial expressions can be created by blending these basic emotions, but it is not clear how these blends are perceived. Are they still perceived as basic emotions or combinations of basic emotions, or are they perceived as expressions of more complex emotions? We used a series of online questionnaires to study the perception of all pairwise blends of basic emotions. The blends were produced as a sum of facial muscle activations in the two basic emotions, using a physically-based, animated face model. Our main finding is that several basic emotion blends with an opposite valence are perceived as complex emotions that are neither pure emotions nor their blends. Blends of basic emotions with a similar valence are typically perceived as pure basic emotions (e.g., a blend of anger and disgust is perceived as pure anger). Only one of the blends (joy+surprise) was perceived as a blend of two different basic emotions