Τετάρτη, 24 Ιανουαρίου 2018

Experimental study of sector and linear array ultrasound accuracy and the influence of navigated 3D-reconstruction as compared to MRI in a brain tumor model

Abstract

Purpose

Currently, intraoperative ultrasound in brain tumor surgery is a rapidly propagating option in imaging technology. We examined the accuracy and resolution limits of different ultrasound probes and the influence of 3D-reconstruction in a phantom and compared these results to MRI in an intraoperative setting (iMRI).

Methods

An agarose gel phantom with predefined gel targets was examined with iMRI, a sector (SUS) and a linear (LUS) array probe with two-dimensional images. Additionally, 3D-reconstructed sweeps in perpendicular directions were made of every target with both probes, resulting in 392 measurements. Statistical calculations were performed, and comparative boxplots were generated.

Results

Every measurement of iMRI and LUS was more precise than SUS, while there was no apparent difference in height of iMRI and 3D-reconstructed LUS. Measurements with 3D-reconstructed LUS were always more accurate than in 2D-LUS, while 3D-reconstruction of SUS showed nearly no differences to 2D-SUS in some measurements. We found correlations of 3D-reconstructed SUS and LUS length and width measurements with 2D results in the same image orientation.

Conclusions

LUS provides an accuracy and resolution comparable to iMRI, while SUS is less exact than LUS and iMRI. 3D-reconstruction showed the potential to distinctly improve accuracy and resolution of ultrasound images, although there is a strong correlation with the sweep direction during data acquisition.



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Texture analysis as a predictor of radiation-induced xerostomia in head and neck patients undergoing IMRT

Abstract

Purpose

Image texture analysis (TA) is a heterogeneity quantifying approach that cannot be appreciated by the naked eye, and early evidence suggests that TA has great potential in the field of oncology. The aim of this study is to evaluate parotid gland texture analysis (TA) combined with formal dosimetry as a factor for predicting severe late xerostomia in patients undergoing radiation therapy for head and neck cancers.

Methods

We performed a retrospective analysis of patients treated at our Radiation Oncology Unit between January 2010 and December 2015, and selected the patients whose normal dose constraints for the parotid gland (mean dose < 26 Gy for the bilateral gland) could not be satisfied due to the presence of positive nodes close to the parotid glands. The parotid gland that showed the higher V30 was contoured on CT simulation and analysed with LifeX Software©. TA parameters included features of grey-level co-occurrence matrix (GLCM), neighbourhood grey-level dependence matrix (NGLDM), grey-level run length matrix (GLRLM), grey-level zone length matrix (GLZLM), sphericity, and indices from the grey-level histogram. We performed a univariate and multivariate analysis between all the texture parameters, the volume of the gland, the normal dose parameters (V30 and Mean Dose), and the development of severe chronic xerostomia.

Results

Seventy-eight patients were included and 25 (31%) developed chronic xerostomia. The TA parameters correlated with severe chronic xerostomia included V30 (OR 5.63), Dmean (OR 5.71), Kurtosis (OR 0.78), GLCM Correlation (OR 1.34), and RLNU (OR 2.12). The multivariate logistic regression showed a significant correlation between V30 (0.001), GLCM correlation (p: 0.026), RLNU (p: 0.011), and chronic xerostomia (p < 0.001, R2:0.664).

Conclusions

Xerostomia represents an important cause of morbidity for head and neck cancer survivors after radiation therapy, and in certain cases normal dose constraints cannot be satisfied. Our results seem promising as texture analysis could enhance the normal dose constraints for the prediction of xerostomia.



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Distale Radiusfrakturen

Zusammenfassung

Distale Radiusfakturen gehen mit einer hohen individuellen und sozioökonomischen Relevanz einher. Zur individualisierten Therapieplanung ist die optimierte Diagnostik mittels Röntgen und oft auch der Computertomographie (CT) unerlässlich. Bei intraartikulären Radiusfrakturen ist eine native CT mit nachfolgender 3‑D-Darstellung und elektronischer Entfernung der Handwurzel und der Ulna zur Operationsplanung hilfreich. Beim Frakturverlauf auf das skapholunäre Kompartiment kann mittels direkter CT-Arthrographie (CTA) eine behandlungsbedürftige Bandverletzung präoperativ nachgewiesen oder ausgeschlossen werden. Die Bilddaten müssen standardisiert akquiriert und reproduzierbar einer morphometrischen Analyse unterzogen werden. In der Diagnostik distaler Radiusfrakturen ist eine von Radiologen und Chirurgen einheitlich verwendete Frakturklassifikation notwendig.



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Changes in Primary Care Health Care Utilization after Inclusion of Epidemiologic Data in Lumbar Spine MR Imaging Reports for Uncomplicated Low Back Pain.

Changes in Primary Care Health Care Utilization after Inclusion of Epidemiologic Data in Lumbar Spine MR Imaging Reports for Uncomplicated Low Back Pain.

Radiology. 2018 Jan 22;:170722

Authors: Fried JG, Andrew AS, Ring NY, Pastel DA

Abstract
Purpose To determine whether inclusion of an epidemiologic statement in radiology reports of lumbar magnetic resonance (MR) imaging influences downstream health care utilization in the primary care population. Materials and Methods Beginning July 1, 2013, a validated epidemiologic statement regarding prevalence of common findings in asymptomatic patients was included in all lumbar MR imaging reports at a tertiary academic medical center. Data were collected from July 1, 2012, through June 30, 2014, and retrospective analysis was completed in September 2016. The electronic medical record was reviewed to capture health care utilization rates in patients for 1 year after index MR imaging. Of 4527 eligible adult patients with low back pain referred for lumbar spine MR imaging during the study period, 375 patients had their studies ordered by in-network primary care providers, did not have findings other than degenerative disease, and had at least one follow-up encounter within the system within 1 year of index MR imaging. In the before-and-after study design, a pre-statement-implementation cohort was compared with a post-statement-implementation cohort by using univariate and multivariate statistical models to evaluate treatment utilization rates in these groups. Results Patients in the statement group were 12% less likely to be referred to a spine specialist (137 of 187 [73%] vs 159 of 188 [85%]; P = .007) and were 7% less likely to undergo repeat imaging (seven of 187 [4%] vs 20 of 188 [11%]; P = .01) compared with patients in the nonstatement group. The intervention was not associated with any change in narcotic prescription (53 of 188 [28%] vs 54 of 187 [29%]; P = .88) or with the rate of low back surgery (24 of 188 [13%] vs 16 of 187 [9%]; P = .19). Conclusion In this study, inclusion of a simple epidemiologic statement in lumbar MR imaging reports was associated with decreased utilization in high-cost domains of low back pain management. © RSNA, 2018.

PMID: 29361247 [PubMed - as supplied by publisher]



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Precision Matters in MR Imaging-targeted Prostate Biopsies: Evidence from a Prospective Study of Cognitive and Elastic Fusion Registration Transrectal Biopsies.

Precision Matters in MR Imaging-targeted Prostate Biopsies: Evidence from a Prospective Study of Cognitive and Elastic Fusion Registration Transrectal Biopsies.

Radiology. 2018 Jan 22;:162916

Authors: Cornud F, Roumiguié M, Barry de Longchamps N, Ploussard G, Bruguière E, Portalez D, Malavaud B

Abstract
Purpose To measure the precision in placement of a biopsy needle in a magnetic resonance (MR) imaging-detected target with transrectal ultrasonography (US), to document the clinical relevance of precision, and to report on the precision of cognitive and software-based registrations. Materials and Methods This prospective study was approved by the institutional review board and performed between June 2013 and September 2013. Patients provided informed verbal consent. Two cores each were obtained with cognitive and fusion techniques in 88 patients with a Prostate Imaging Reporting and Data System version 1 score of at least 3. Precision was measured with Euclidian geometry by using the Digital Imaging and Communications in Medicine archives of the biopsy as the distance from the core to the center (dCC) and the distance from the core to the surface of the target modeled as a sphere. To address clustering of data from multiple cores in the same patients, analyses of precision focused on the best shot for a patient or a technique. The Welch unequal variance t test and Yates corrected χ2 test were used as appropriate. Results Mean precision was 2.5 mm (95% confidence interval: 1.8 mm, 3.3 mm). Positive cores were closer to the center than were negative cores (dCC: 1.7 mm vs 3.1 mm, respectively; P = .025). More cancers were detected with on-target than off-target cores (33 of 71 cores [46.5%] vs three of 17 cores [17.6%]; P = .03). Cores obtained with the fusion technique achieved a higher precision than did cores obtained with the cognitive technique (dCC: 2.8 mm vs 7.1 mm, respectively; P < .0001). Targeted cores demonstrated cancer in 44 patients. Fewer cancers were detected with the cognitive technique than with the fusion technique (31 of 44 patients [70.5%] vs 40 of 44 patients [90.9%]; P = .03). Conclusion A deformable MR imaging/transrectal US image registration system achieved a higher precision and depicted cancer in more patients than did the cognitive freehand technique. © RSNA, 2018.

PMID: 29361246 [PubMed - as supplied by publisher]



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Brain Gliomas: Multicenter Standardized Assessment of Dynamic Contrast-enhanced and Dynamic Susceptibility Contrast MR Images.

Brain Gliomas: Multicenter Standardized Assessment of Dynamic Contrast-enhanced and Dynamic Susceptibility Contrast MR Images.

Radiology. 2018 Jan 22;:170362

Authors: Anzalone N, Castellano A, Cadioli M, Conte GM, Cuccarini V, Bizzi A, Grimaldi M, Costa A, Grillea G, Vitali P, Aquino D, Terreni MR, Torri V, Erickson BJ, Caulo M

Abstract
Purpose To evaluate the feasibility of a standardized protocol for acquisition and analysis of dynamic contrast material-enhanced (DCE) and dynamic susceptibility contrast (DSC) magnetic resonance (MR) imaging in a multicenter clinical setting and to verify its accuracy in predicting glioma grade according to the new World Health Organization 2016 classification. Materials and Methods The local research ethics committees of all centers approved the study, and informed consent was obtained from patients. One hundred patients with glioma were prospectively examined at 3.0 T in seven centers that performed the same preoperative MR imaging protocol, including DCE and DSC sequences. Two independent readers identified the perfusion hotspots on maps of volume transfer constant (Ktrans), plasma (vp) and extravascular-extracellular space (ve) volumes, initial area under the concentration curve, and relative cerebral blood volume (rCBV). Differences in parameters between grades and molecular subtypes were assessed by using Kruskal-Wallis and Mann-Whitney U tests. Diagnostic accuracy was evaluated by using receiver operating characteristic curve analysis. Results The whole protocol was tolerated in all patients. Perfusion maps were successfully obtained in 94 patients. An excellent interreader reproducibility of DSC- and DCE-derived measures was found. Among DCE-derived parameters, vp and ve had the highest accuracy (are under the receiver operating characteristic curve [Az] = 0.847 and 0.853) for glioma grading. DSC-derived rCBV had the highest accuracy (Az = 0.894), but the difference was not statistically significant (P > .05). Among lower-grade gliomas, a moderate increase in both vp and rCBV was evident in isocitrate dehydrogenase wild-type tumors, although this was not significant (P > .05). Conclusion A standardized multicenter acquisition and analysis protocol of DCE and DSC MR imaging is feasible and highly reproducible. Both techniques showed a comparable, high diagnostic accuracy for grading gliomas. © RSNA, 2018 Online supplemental material is available for this article.

PMID: 29361245 [PubMed - as supplied by publisher]



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Characterization of Prostate Cancer with Gleason Score of at Least 7 by Using Quantitative Multiparametric MR Imaging: Validation of a Computer-aided Diagnosis System in Patients Referred for Prostate Biopsy.

Characterization of Prostate Cancer with Gleason Score of at Least 7 by Using Quantitative Multiparametric MR Imaging: Validation of a Computer-aided Diagnosis System in Patients Referred for Prostate Biopsy.

Radiology. 2018 Jan 22;:171265

Authors: Dinh AH, Melodelima C, Souchon R, Moldovan PC, Bratan F, Pagnoux G, Mège-Lechevallier F, Ruffion A, Crouzet S, Colombel M, Rouvière O

Abstract
Purpose To determine the performance of a computer-aided diagnosis (CAD) system trained at characterizing cancers in the peripheral zone (PZ) with a Gleason score of at least 7 in patients referred for multiparametric magnetic resonance (MR) imaging before prostate biopsy. Materials and Methods Two institutional review board-approved prospective databases of patients who underwent multiparametric MR imaging before prostatectomy (database 1) or systematic and targeted biopsy (database 2) were retrospectively used. All patients gave informed consent for inclusion in the databases. A CAD combining the 10th percentile of the apparent diffusion coefficient and the time to peak of enhancement was trained to detect cancers in the PZ with a Gleason score of at least 7 in 106 patients from database 1. The CAD was tested in 129 different patients from database 2. All targeted lesions were prospectively scored at biopsy by using a five-level Likert score. The CAD scores were retrospectively calculated. Biopsy results were used as the reference standard. Areas under the receiver operating characteristic curves (AUCs) were computed for CAD and Likert scores by using binormal smoothing for per-lesion and per-lobe analyses, and a density function for per-patient analysis. Results The CAD outperformed the Likert score in the overall population and all subgroups, except in the transition zone. The difference was statistically significant for the overall population (AUC, 0.95 [95% confidence interval {CI}: 0.90, 0.98] vs 0.88 [95% CI: 0.68, 0.96]; P = .02) at per-patient analysis, and for less-experienced radiologists (<1 year) at per-lesion (AUC, 0.90 [95% CI: 0.81, 0.95] vs 0.83 [95% CI: 0.73, 0.90]; P = .04) and per-lobe (AUC, 0.92 [95% CI: 0.80, 0.96] vs 0.84 [95% CI: 0.72, 0.91]; P = .04) analysis. Conclusion The CAD outperformed the Likert score prospectively assigned at biopsy in characterizing cancers with a Gleason score of at least 7. © RSNA, 2018 Online supplemental material is available for this article.

PMID: 29361244 [PubMed - as supplied by publisher]



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Emphysematous and Nonemphysematous Gas Trapping in Chronic Obstructive Pulmonary Disease: Quantitative CT Findings and Pulmonary Function.

Emphysematous and Nonemphysematous Gas Trapping in Chronic Obstructive Pulmonary Disease: Quantitative CT Findings and Pulmonary Function.

Radiology. 2018 Jan 23;:171519

Authors: Occhipinti M, Paoletti M, Bigazzi F, Camiciottoli G, Inchingolo R, Larici AR, Pistolesi M

Abstract
Purpose To identify a prevalent computed tomography (CT) subtype in patients with chronic obstructive pulmonary disease (COPD) by separating emphysematous from nonemphysematous contributions to total gas trapping and to attempt to predict and grade the emphysematous gas trapping by using clinical and functional data. Materials and Methods Two-hundred and two consecutive eligible patients (159 men and 43 women; mean age, 70 years [age range, 41-85 years]) were prospectively studied. Pulmonary function and CT data were acquired by pulmonologists and radiologists. Noncontrast agent-enhanced thoracic CT scans were acquired at full inspiration and expiration, and were quantitatively analyzed by using two software programs. CT parameters were set as follows: 120 kVp; 200 mAs; rotation time, 0.5 second; pitch, 1.1; section thickness, 0.75 mm; and reconstruction kernels, b31f and b70f. Gas trapping obtained by difference of inspiratory and expiratory CT density thresholds (percentage area with CT attenuation values less than -950 HU at inspiration and percentage area with CT attenuation values less than -856 HU at expiration) was compared with that obtained by coregistration analysis. A logistic regression model on the basis of anthropometric and functional data was cross-validated and trained to classify patients with COPD according to the relative contribution of emphysema to total gas trapping, as assessed at CT. Results Gas trapping obtained by difference of inspiratory and expiratory CT density thresholds was highly correlated (r = 0.99) with that obtained by coregistration analysis. Four groups of patients were distinguished according to the prevalent CT subtype: prevalent emphysematous gas trapping, prevalent functional gas trapping, mixed severe, and mixed mild. The predictive model included predicted forced expiratory volume in 1 second/vital capacity, percentage of predicted forced expiratory volume in 1 second, percentage of diffusing capacity for carbon monoxide, and body mass index as emphysema regressors at CT, with 81% overall accuracy in classifying patients according to its extent. Conclusion The relative contribution of emphysematous and nonemphysematous gas trapping obtained by coregistration of inspiratory and expiratory CT scanning can be determined accurately by difference of CT inspiratory and expiratory density thresholds. CT extent of emphysema can be predicted with accuracy suitable for clinical purposes by pulmonary function data and body mass index. © RSNA, 2018 Online supplemental material is available for this article.

PMID: 29361243 [PubMed - as supplied by publisher]



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MR Imaging-based Estimation of Upper Motor Neuron Density in Patients with Amyotrophic Lateral Sclerosis: A Feasibility Study.

MR Imaging-based Estimation of Upper Motor Neuron Density in Patients with Amyotrophic Lateral Sclerosis: A Feasibility Study.

Radiology. 2018 Jan 23;:162967

Authors: Chen J, Kostenko V, Pioro EP, Trapp BD

Abstract
Purpose To determine if magnetic resonance (MR) imaging metrics can estimate primary motor cortex (PMC) motor neuron (MN) density in patients with amyotrophic lateral sclerosis (ALS). Materials and Methods Between 2012 and 2014, in situ brain MR imaging was performed in 11 patients with ALS (age range, 35-81 years; seven women and four men) soon after death (mean, 5.5 hours after death; range, 3.2-9.6 hours). The brain was removed, right PMC (RPMC) was excised, and MN density was quantified. RPMC metrics (thickness, volume, and magnetization transfer ratio) were calculated from MR images. Regression modeling was used to estimate MN density by using RPMC and global MR imaging metrics (brain and tissue volumes); clinical variables were subsequently evaluated as additional estimators. Models were tested at in vivo MR imaging by using the same imaging protocol (six patients with ALS; age range, 54-66 years; three women and three men). Results RPMC mean MN density varied over a greater than threefold range across patients and was estimated by a linear function of normalized gray matter volume (adjusted R2 = 0.51; P = .008; <10% error in most patients). When considering only sporadic ALS, a linear function of normalized RPMC and white matter volumes estimated MN density (adjusted R2 = 0.98; P = .01; <10% error in all patients). In vivo data analyses detected decreases in MN density over time. Conclusion PMC mean MN density varies widely in end-stage ALS possibly because of disease heterogeneity. MN density can potentially be estimated by MR imaging metrics. © RSNA, 2018 Online supplemental material is available for this article.

PMID: 29361242 [PubMed - as supplied by publisher]



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Thyroid Isthmus Length and Iodine Turnover as Predictors of Successful Radioactive Iodine Therapy in Patients with Graves' Disease.

Thyroid Isthmus Length and Iodine Turnover as Predictors of Successful Radioactive Iodine Therapy in Patients with Graves' Disease.

Int J Endocrinol. 2017;2017:7354673

Authors: Park SH, Hwang S, Han S, Shin DY, Lee EJ

Abstract
Radioactive iodine (RAI) therapy is an effective treatment option for Graves' disease. However, predicting treatment failures after RAI therapy remains controversial. The objective of this study was to investigate the factors associated with the success rate of RAI therapy for treatment of Graves' hyperthyroidism. Thyroid functional outcome, pre-RAI ultrasonographic features, and clinical parameters were evaluated retrospectively in 98 patients followed up for at least 12 months after RAI (mean RAI dose was 11.7 ± 1.8 mCi). Hypothyroidism was achieved in 59 patients (60.2%), and euthyroidism in 16 patients (16.3%), while 23 patients (23.5%) remained hyperthyroid. Age, sex, body mass index, pre-RAI thyroid function, or thyroid-stimulating immunoglobulin levels were not associated with treatment outcome. Length of thyroid isthmus (p = 0.028) and 2- to 24-hour iodine uptake ratios (p = 0.002) were significantly associated with treatment failure, which was defined as a persistent hyperthyroid status after RAI therapy. Patients with a longer isthmus had a higher risk of remaining hyperthyroid, with a threshold for isthmus length of 5.2 mm, with a sensitivity of 69.6% and specificity of 70.3% for treatment success. Measuring the length of the thyroid isthmus can be a simple and useful way to predict RAI treatment outcome.

PMID: 29358949 [PubMed]



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Science and Culture: Painting with invasive pigments [Environmental Sciences]

In the abandoned lots of the Bushwick neighborhood of Brooklyn, NY, dandelion, black nightshade, and dozens of other weedy plants thrive. Although some see hotbeds of invasive species, artist and Brooklyn local Ellie Irons sees a vibrant urban ecosystem. She also sees the makings of a unique color palette. Artist...

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Tea polyphenols inhibit the proliferation, migration, and invasion of melanoma cells through the down-regulation of TLR4.

Tea polyphenols inhibit the proliferation, migration, and invasion of melanoma cells through the down-regulation of TLR4.

Int J Immunopathol Pharmacol. 2018 Jan-Dec;32:394632017739531

Authors: Chen X, Chang L, Qu Y, Liang J, Jin W, Xia X

Abstract
Melanoma is the most common skin cancer and malignant melanoma which can cause skin cancer-related deaths. Toll-like receptor 4 (TLR4) had been reported to play an important role in melanoma, and tea polyphenol (TP) is regarded as an anticancer substance. However, the relationship between TP and TLR4 in melanoma is not well explored. Therefore, our aim is to figure out how TP has an influence on melanoma. Melanoma cell lines (B16F10 and A375) were treated with TP and lipopolysaccharides (LPS). Western blot assay was used to examine TLR4 expression, and MTT assay was conducted to assess proliferation. Wound healing assay was conducted to evaluate the migration of melanoma cells, and transwell assay was used to examine the melanoma cells' invasiveness. Besides, in vivo experiments were practiced for TP function in mice with melanoma cells. TP inhibited the proliferation, migration and invasion ability of melanoma cells, which displayed a dosage and time dependence. TLR4 was highly expressed in melanoma cells compared with normal skin cells. TP could suppress TLR4 expression both in normal melanomas and in stimulated melanomas by TLR4 agonist LPS. Suppressing TLR4 in melanomas could inhibit cell function (proliferation, migration, and invasion), and blocking the expression of 67LR could abolish TP function on TLR4. TP can inhibit melanoma (B16F10) growth in vivo.

PMID: 29359608 [PubMed - in process]



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lncRNA profiling in NCI-H292 cells after stimulation with Dermatophagoides farinae extracts.

lncRNA profiling in NCI-H292 cells after stimulation with Dermatophagoides farinae extracts.

Int J Immunopathol Pharmacol. 2018 Jan-Dec;32:394632017750997

Authors: Wang L, Zhou Y, Cui Y

Abstract
Airway epithelium cells are the first line of defense against airborne allergens. When cultured, epithelial cells can be exposed to various allergens, providing an ideal model to investigate allergic disorders. This study sought to characterize the profile of long noncoding (lnc) RNAs, which can regulate gene expression and exert functions in diverse cellular processes, in airway epithelial cells exposed to house dust mite allergens. NCI-H292 cells were exposed to house dust mite extract for 24 h. RNA expression was profiled in exposed and unexposed cells. There were 270 lncRNAs that were differentially expressed (fold change ≥ 2, P < 0.05) in NCI-H292 cells after stimulation with Dermatophagoides farinae (house dust mite) extracts. Furthermore, 119 lncRNAs and 22 messenger RNAs were co-expressed. Gene Ontology analysis showed that these under-regulated and up-regulated lncRNAs were associated with biological process, cellular component, and molecular function. After bioinformatic analysis of significantly regulated signaling pathways, we found these lncRNAs may target 16 gene pathways, including glycolysis, axon guidance, ErbB signaling, and mitogen-activated protein kinases (MAPK) signaling. The identification of differentially regulated lncRNAs in NCI-H292 cells after stimulation with Dermatophagoides farinae extracts, as well as their target gene pathways, can provide insight to the etiology and pathogenesis of allergy.

PMID: 29357711 [PubMed - in process]



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Biosensors, Vol. 8, Pages 10: Investigating Colorimetric Protein Array Assay Schemes for Detection of Recurrence of Bladder Cancer

Biosensors, Vol. 8, Pages 10: Investigating Colorimetric Protein Array Assay Schemes for Detection of Recurrence of Bladder Cancer

Biosensors doi: 10.3390/bios8010010

Authors: Selma Gogalic Ursula Sauer Sara Doppler Claudia Preininger

A colorimetric microarray for the multiplexed detection of recurrence of bladder cancer including protein markers interleukin-8 (IL8), decorin (DCN), and vascular endothelial growth factor (VEGF) was established to enable easy and cheap read-out by a simple office scanner paving the way for quick therapy monitoring at doctors’ offices. The chip is based on the principle of a sandwich immunoassay and was optimized prior to multiplexing using IL8 as a model marker. Six different colorimetric assay formats were evaluated using a detection antibody (dAB) labeled with (I) gold (Au) nanoparticles (NPs), (II) carbon NPs, (III) oxidized carbon NPs, and a biotinylated dAB in combination with (IV) neutravidin–carbon, (V) streptavidin (strp)–gold, and (VI) strp–horseradish peroxidase (HRP). Assay Format (III) worked best for NP-based detection and showed a low background while the enzymatic approach, using 3,3′,5,5′-tetramethylbenzidine (TMB) substrate, led to the most intense signals with good reproducibility. Both assay formats showed consistent spot morphology as well as detection limits lower than 15 ng/L IL8 and were thus applied for the multiplexed detection of IL8, DCN, and VEGF in synthetic urine. Colorimetric detection in urine (1:3) yields reaction signals and measurement ranges well comparable with detection in the assay buffer, as well as excellent data reproducibility as indicated by the coefficient of variation (CV 5–9%).



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Advanced treatment of petrochemical wastewater by combined ozonation and biological aerated filter

Abstract

The secondary effluent from a petrochemical wastewater treatment plant was treated by biological aerated filter (BAF) before and after ozonation, namely BAF1 and BAF2, respectively. The results showed that BAF2 fed with the ozonized secondary effluent exhibited a high efficiency in degrading organic pollutants. The removal efficiency of COD and NH4-N was 6.0 ± 3.2 and 48.2~18.6% for BAF1 and 12.5 ± 5.8 and 62.1~40.9% for BAF2, respectively, during the whole operation. The integration system of ozonation and BAF could tolerate a higher organic loading rate. When HRT decreased from 4 to 1 h, COD removal efficiency decreased from 12 to 4% for the BAF1 system, but it kept almost unchanged at high levels of 27–32% for the ozonation-BAF2 system, with around 20% removal by ozonation. The biomass in BAF2 exhibited a higher activity of protease, DHA, and SOUR than that in BAF1. The organic pollutants in influent and effluent of BAF were mainly ester compounds, which were difficult to biodegrade by BAF. The predominant genera in BAF1 were Gemmatimonadaceae uncultured, Thauera, and Thiobacillus, while the dominant genera in BAF2 were Nitrospira, Gemmatimonadaceae uncultured, and Flexibacter, respectively. Overall, BAF2 performed better than BAF1 in organic pollutant removal and microbial activity. The ozonation process was vital for BAF to treat petrochemical secondary effluent.



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An assessment of emergy, energy, and cost-benefits of grain production over 6 years following a biochar amendment in a rice paddy from China

Abstract

Biochar soil amendment had been increasingly advocated for improving crop productivity and reducing carbon footprint in agriculture worldwide. However, the long-term benefits of biochar application with farming systems had not been thoroughly understood. This study quantified and assessed emergy, energy, and economic benefits of rice and wheat production throughout 6 rotation years following a single biochar amendment in a rice paddy from Southeastern China. Using the data from farm inventory, the quantified emergy indices included grain outputs, unit emergy value, and relative percentage of free renewable resources, environmental loading ratio, emergy yield ratio, and emergy sustainability index (ESI). The results indicated contrasting differences in these emergy values between biochar-amended and unamended production systems over the 6 years. The overall emergy efficiency of rice and wheat productions in biochar-amended system were higher by 11–28 and 15–47%, respectively, than that of unamended one of which the production being highly resource intensive. Moreover, ESI on average was 0.46 for rice and 0.63 for wheat in amended system, compared to 0.35 for rice and 0.39 for wheat in unamended one. Furthermore, over the 6 years following a single application, the ESI values showed considerable variation in the unamended system but consistently increasing in the amended system. Again, the biochar-amended system exerted significantly higher energy and economic return than the unamended one. Nonetheless, there was a tradeoff between rice and wheat in grain yield and net economic gain. Overall, biochar amendment could be a viable measure to improve the resilience of grain production while to reduce resource intensity and environment impacts in paddy soil from China.



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Plasmas ozone inactivation of Legionella in deionized water and wastewater

Abstract

The results show that ozone concentration determination using ultraviolet spectrophotometry (UV-2450) at 258 nm is easier than using indigo method at 600 nm. A strong linear relationship was found between purge time and O3 concentration in deionized water. Ozone concentration can be predicted in deionized water. A higher O3 flow rate or lower temperature led to a higher O3 concentration. Ozone concentration was stable in 60 min, so that ozone self-decomposition could be ignored at ozone concentrations below 0.4 mg L−1. A higher temperature led to a higher inactivation efficiency and rate, and that a lower temperature led to a lower ozone decay rate and inactivation efficiency even if ozone solubility increased when temperature decreased. The fastest inactivation rate occurred before c0t = 165 μg L−1 s, but the inactivation rate decreased after c0t = 165 μg L−1 s with tail phenomena. The tail phenomena were clearly observed and may be caused by oxidization of lipopolysaccharides (LPS), cell membrane, etc. The activation energy Ea = 55,404 ± 0.3 J mol−1 were obtained for Legionella inactivation with ozone in deionized water. Ozone maximum decay rate was positively proportional to COD concentration. COD impacted on ozone concentration seriously. Higher COD concentration resulted in higher ozone decay rate. COD could result in ozone concentration decrement rapidly to a steady value in 5 s. Higher initial ozone concentration resulted in higher germ inactivation rate. Higher initial COD concentration resulted in lower Legionella inactivation efficiency. COD was easier to react with ozone than Legionella. The relationship among the initial COD concentrations COD0, the initial O3 concentration c0, and the O3 contact time t necessary for a 99.999% reduction of Legionella in wastewater can be expressed in some equations. O3 disinfection time t necessary for a 99.999% reduction of Legionella can be predicted by Eqs. (10) and (11).

Graphical abstract



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Smoking cessation in workplace setting: quit rates and determinants in a group behaviour therapy programme

To capitalise on the opportunities that the smoking ban legislation in Switzerland offers for the prevention of tobacco-related diseases, a smoking cessation programme in a workplace setting was developed and implemented in companies across the language and cultural regions of Switzerland. Our goal was to identify factors associated with relapse into smoking that may be overcome during training sessions or that should be considered for the optimisation of future interventions.; Between 2006 and 2012, 1287 smokers aged 16 to 68 years voluntarily attended smoking cessation training at their workplace. The intervention was based on a cognitive behavioural group therapy combined with individual proactive telephone counselling. The evaluation consisted of three anonymised questionnaires (pre- and postintervention, and 12-month follow-up). In this prospective cohort study, we investigated the association of smoking quit rates with training and participant characteristics, including withdrawal symptoms, by use of multilevel logistic regression analysis with a random intercept for training courses.; The self-reported abstinence rate was 72.4% at the end of the training, and 18.6% 1 year later. The risk of relapse during the training was positively associated with the number of years and daily cigarettes smoked, and negatively with increased appetite, sleeping troubles and satisfaction with learned techniques. Failed abstinence within the first year was associated with younger age, higher numbers of daily smoked cigarettes and unsuccessful recent quit attempts.; Our evaluation suggests that younger and more addicted smokers attending smoking cessation trainings may need additional support to achieve long lasting abstinence rates. Offering smoking cessation training in a workplace setting can achieve reasonable long-term quit rates, but a subset of employees needs additional support at the group or personal level.; Group behaviour therapy could be an effective method to achieve long-term smoking abstinence. The workplace is an important setting to reach and encourage a large number of smokers to participate in a smoking cessation programme, but only few studies investigated its potential. The findings of this study of a modern real-life workplace-based smoking cessation programme endorse the effectiveness and viability of cognitive behavioural group therapy. This group-level intervention at the workplace may be insufficient for young and heavy smokers, as well as women with increased appetite after cessation, who potentially benefit from re-intervention and additional individual level counselling.

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Author’s response to Letter-to-the-editor regarding “Are the Epworth Sleepiness Scale and Stop-Bang Model effective at predicting the severity of obstructive Sleep Apnoea (OSA); in particular OSA requiring treatment?”



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Reply to the letter concerning “Revision adenoidectomy in children: a population-based cohort study in Taiwan”



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Cytochrome b 5 impacts on cytochrome P450-mediated metabolism of benzo[ a ]pyrene and its DNA adduct formation: studies in hepatic cytochrome b 5 /P450 reductase null (HBRN) mice

Abstract

Benzo[a]pyrene (BaP) is an environmental pollutant that, based on evidence largely from in vitro studies, exerts its genotoxic effects after metabolic activation by cytochrome P450s. In the present study, Hepatic Reductase Null (HRN) and Hepatic Cytochrome b5 /P450 Reductase Null (HBRN) mice have been used to study the role of P450s in the metabolic activation of BaP in vivo. In HRN mice, cytochrome P450 oxidoreductase (POR), the electron donor to P450, is deleted specifically in hepatocytes. In HBRN mice the microsomal haemoprotein cytochrome b5 , which can also act as an electron donor from cytochrome b5 reductase to P450s, is also deleted in the liver. Wild-type (WT), HRN and HBRN mice were treated by i.p. injection with 125 mg/kg body weight BaP for 24 h. Hepatic microsomal fractions were isolated from BaP-treated and untreated mice. In vitro incubations carried out with BaP-pretreated microsomal fractions, BaP and DNA resulted in significantly higher BaP–DNA adduct formation with WT microsomal fractions compared to those from HRN or HBRN mice. Adduct formation (i.e. 10-(deoxyguanosin-N2-yl)-7,8,9-trihydroxy-7,8,9,10-tetrahydro-BaP [dG-N2-BPDE]) correlated with observed CYP1A activity and metabolite formation (i.e. BaP-7,8-dihydrodiol) when NADPH or NADH was used as enzymatic cofactors. BaP–DNA adduct levels (i.e. dG-N2-BPDE) in vivo were significantly higher (~ sevenfold) in liver of HRN mice than WT mice while no significant difference in adduct formation was observed in liver between HBRN and WT mice. Our results demonstrate that POR and cytochrome b5 both modulate P450-mediated activation of BaP in vitro. However, hepatic P450 enzymes in vivo appear to be more important for BaP detoxification than its activation.



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Irritant-induced asthma to hypochlorite in mice due to impairment of the airway barrier

Abstract

Inhalation of commonly present irritants, such as chlorine and chlorine derivatives, can cause adverse respiratory effects, including irritant-induced asthma (IIA). We hypothesize that due to airway barrier impairment, exposure to hypochlorite (ClO-) can result in airway hypersensitivity. C57Bl/6 mice received an intra-peritoneal (i.p.) injection of the airway damaging agent naphthalene (NA, 200 mg/kg body weight) or vehicle (mineral oil, MO). In vivo micro-computed tomography (CT) images of the lungs were acquired before and at regular time points after the i.p. treatment. After a recovery period of 14 days an intranasal (i.n.) challenge with 0.003% active chlorine (in ClO-) or vehicle (distilled water, H2O) was given, followed by assessment of the breathing frequency. One day later, pulmonary function, along with pulmonary inflammation was determined. Lung permeability was assessed by means of total broncho-alveolar lavage (BAL) protein content and plasma surfactant protein (SP)-D levels. In vivo micro-CT imaging revealed enlargement of the lungs and airways early after NA treatment, with a return to normal at day 14. When challenged i.n. with ClO-, NA-pretreated mice immediately responded with a sensory irritant response. Twenty-four hours later, NA/ClO- mice showed airway hyperreactivity (AHR), accompanied by a neutrophilic and eosinophilic inflammation. NA administration followed by ClO- induced airway barrier impairment, as shown by increased BAL protein and plasma SP-D concentrations; histology revealed epithelial denudation. These data prove that NA-induced lung impairment renders the lungs of mice more sensitive to an airway challenge with ClO-, confirming the hypothesis that incomplete barrier repair, followed by irritant exposure results in airway hypersensitivity.



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Heavy Water Shedding Light on Antigen-Specific T Cell Responses

Publication date: Available online 24 January 2018
Source:Trends in Immunology
Author(s): Liv Eidsmo, Carmen Gerlach
CD8 T cells are crucial for long-term immunity. Nevertheless, the in vivo differentiation of human naïve CD8 T cells into effector and memory populations remains ill-defined. A recent study assesses the in vivo turnover of human antigen-specific CD8 T cells and suggests that long-lived memory cells arise from effector cells.



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Metagenomic Analysis of the Jinding Duck Fecal Virome

Abstract

Ducks play an important role in transmitting and maintaining mammalian viruses in nature, and are a reservoir host of many animal viruses. We analyzed the fecal virome of four strains (A, B, C, and D) of ducks living in isolation by using metagenomic analysis. The feces of the ducks tested contained 18 animal virus families. The percentage values of RNA virus reads, compared to the total animal virus reads in each of the four strains were 96.96% (A), 97.30% (B), 98.01 (C), and 67.49% (D), and were mainly from Orthomyxoviridae, Mimiviridae, Bunyaviridae, Picobirnaviridae, and Reoviridae. Meanwhile, the minority of DNA virus reads were related to Herpesviridae, Adenoviridae, Iridoviridae, and other, low abundance viral families. The percentage values of Orthomyxoviridae, Mimiviridae, Bunyaviridae, Picobirnaviridae, and Herpesviridae reads were not significantly different among strains A, B, and C; however, there were marked differences in the abundance of these reads in strain D. In summary, this study provides an unbiased examination of the viral diversity in the feces of four strains of ducks in specific-pathogen-free periods, and highlights the variation in the percentage of viral families present. These results can be used as a reference for detecting duck viral pathogens and predicting zoonotic potential.



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The Changes of Colonic Bacterial Composition and Bacterial Metabolism Induced by an Early Food Introduction in a Neonatal Porcine Model

Abstract

The impact of an early food introduction on the microbiota composition and microbial metabolism in colon was investigated using a new-born piglet model. At day 4 after birth, 10 litters of piglets were randomly allocated to a sow-rearing group (SR group) and a milk-replacer supplementing group (MRS group) (n = 5). A commercial milk replacer was given to the suckling piglets in the MRS group from the 4th day to the 28th day. Pyrosequencing of the V3–V4 region of the 16S rRNA genes showed that the milk replacer supplementation significantly decreased the relative abundance of Lactobacillus, Clostridium XI, Blautia, Clostridium sensustricto and Escherichia (p = 0.08) in the colon of the piglets, but significantly increased the relative abundance of Paraprevotella on the 28th day. In addition, the abundance of Rumminococcus, Clostridium XlVa, Succiniclasticum, Clostridium IV tended to increase in the MRS group. The concentrations of acetate, propionate, butyrate, valerate and branch-chain fatty acids (BCFAs) in the colonic digesta increased with the milk replacer supplementary in the MRS group. In addition, the milk replacer supplementary increased the expression level of Toll-like receptor 4 (TLR4), but decreased the expression level of interleukin-6 (IL-6) in the colonic mucosa of the piglets. In conclusion, an early food introduction can influence the gut bacterial composition and metabolism, and may further affect the intestinal health by modifying the gene transcription related to the colonic function. These findings may provide some guidelines for the early nutrition supplementation for infants during the lactation period.



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Alteration of putaminal fractional anisotropy in Parkinson’s disease: a longitudinal diffusion kurtosis imaging study

Abstract

Purpose

In Parkinson's disease (PD), pathological microstructural changes occur that may be detected using diffusion magnetic resonance imaging (dMRI). However, there are few longitudinal studies that explore the effect of disease progression on diffusion indices.

Methods

We prospectively included 76 patients with PD and 38 healthy controls (HC), all of whom underwent diffusion kurtosis imaging (DKI) as part of the prospective Swedish BioFINDER study at baseline and 2 years later. Annualized rates of change in DKI parameters, including fractional anisotropy (FA), mean diffusivity (MD), and mean kurtosis (MK), were estimated in the gray matter (GM) by placing regions of interest (ROIs) in the basal ganglia and the thalamus, and in the white matter (WM) by tract-based spatial statistics (TBSS) analysis.

Results

When adjusting for potential confounding factors (age, gender, baseline-follow-up interval, and software upgrade of MRI scanner), only a decrease in FA in the putamen of PD patients (β = − 0.248, P < .01) over 2 years was significantly different from the changes observed in HC over the same time period. This 2-year decrease in FA in the putamen in PD correlated with higher l-dopa equivalent dose at baseline (Spearman's rho = .399, P < .0001).

Conclusion

The study indicates that in PD microstructural changes in the putamen occur selectively over a 2-year period and can be detected with DKI.



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Atrial septal defect in a patient with congenital disorder of glycosylation type 1a: a case report

Atrial septal defect often become more severe when encountered in genetic syndromes. Congenital disorder of glycosylation type 1a is an inherited metabolic disorder associated with mutations in PMM2 gene and can ...

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Modeling and Characteristic Analysis of Wireless Ultrasonic Vibration Energy Transmission Channels through Planar and Curved Metal Barriers

Wireless ultrasonic vibration energy transmission systems through metal barriers based on piezoelectric transducers have drawn a lot of focus due to the advantage of nonpenetration of the barriers, thus maintaining the integrity of sealed structures. It is meaningful to investigate appropriate modeling methods and to characterize such wireless ultrasonic energy transmission channels with different geometric shapes. In this paper, equivalent circuit modeling and finite element modeling methods are applied to the planar metal barrier channel, and a 3-dimensional finite element modeling method is applied to the cylindrical metallic barrier channel. Meanwhile, the experimental setup is established and measurements are carried out to validate the effectiveness of the corresponding modeling methods. The results show that Leach’s equivalent circuit modeling method and finite element modeling method are nearly similarly effective in characterizing the planar metal barrier channel. But for a cylindrical metal barrier, only the three-dimensional finite element modeling method is effective. Furthermore, we found that, for the planar barrier, the effect of standing waves on the efficiency of wireless energy transmission is dominated. But for the curved barrier, only the resonant phenomenon of the piezoelectric transducer exists.

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Modern Myoma Treatment in the Last 20 Years: A Review of the Literature

Myomas, also known as fibroids, are a specific characteristic of the human species. No other primates develop fibroids. At a cellular level, myomas are benign hyperplastic lesions of uterine smooth muscle cells. There are interesting theoretical concepts that link the development of myomas in humans with the highly specific process of childbirth from an upright position and the resulting need for greatly increased “expulsive” forces during labor. Myomas might be the price our species pays for our bipedal and highly intelligent existence. Myomas affect, with some variability, all ethnic groups and approximately 50% of all women during their lifetime. While some remain asymptomatic, myomas can cause significant and sometimes life-threatening uterine bleeding, pain, infertility, and, in extreme cases, ureteral obstruction and death. Traditionally, over 50% of all hysterectomies were performed for fibroids, leading to a significant healthcare burden. In this article, we review the developments of the past 20 years with regard to multiple new treatment strategies that have evolved during this time.

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UE-Initiated Cell Reselection Game for Cell Load Balancing in a Wireless Network

A user changes its serving cell if the quality of experience (QoE) provided by the current serving cell is not satisfactory. Since users reselect cells to increase their QoEs selfishly, the system resource efficiency can be deteriorated and a system can be unstable if users are not driven to cooperate appropriately. In this paper, inspired by the minority game (MG) model, we design a UE-initiated cell reselection policy. The MG has a salient characteristic that the number of players who win the game converges to a prespecified value even though players act selfishly without knowing the actions taken by the other players. Using the MG model, we devise a rule by which each UE plays a cell reselection game. We also design a criterion that a system controller uses to determine the result of a game and public information sent by a system controller to induce implicit cooperation among UEs. The simulation results show that compared with noncooperative method the proposed method increases not only the system performance, such as cell load balance index and system utility, but also the performance of UEs in terms of a downlink data rate and an outage probability received from a system.

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Efficacy and Safety of the Injection of the Traditional Chinese Medicine Puerarin for the Treatment of Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis of 53 Randomized Controlled Trials

Objective. The injection of the traditional Chinese patent medicine puerarin has been widely used in the treatment of various diseases such as angina pectoris or ischemic stroke. We aim to evaluate the efficacy and safety of puerarin injection for the treatment of diabetic peripheral neuropathy (DPN). Methods. A systematic literature search was performed in seven medical databases from their inception until June 2017. 53 studies with RCTs, totaling 3284 patients, were included in this meta-analysis. The included studies were assessed by the Cochrane risk of bias and analyzed by Review Manager 5.3 software. Results. The meta-analysis showed that puerarin injection for the treatment of DPN was significantly better compared with the control group in terms of the total effective rate. The result showed that puerarin injection for the treatment of DPN can significantly increase the probability of sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) of the median and peroneal nerves. Conclusions. This meta-analysis demonstrated that puerarin injection may be more effective and safe for the treatment of DPN. However, further and higher quality RCTs are required to prove its efficacy and provide meaningful evidence for clinical treatment due to the poor methodological quality.

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Antipsoriatic Effects of Wannachawee Recipe on Imiquimod-Induced Psoriasis-Like Dermatitis in BALB/c Mice

Psoriasis is a common immune-mediated chronic inflammatory skin disease characterized by thick and erythema raised plaques with adherent silvery scales. T-cells are activated via the IL-23/Th17 axis which is involved in psoriasis pathogenesis. Conventional treatments of psoriasis have adverse events that influence patients’ adherence. Wannachawee Recipe (WCR) is Thai traditional medicine that is known to be effective for psoriasis patients; however, preclinical evidence is still lacking. This study investigated the therapeutic potential of WCR on antiproliferant activity using imiquimod- (IMQ-) induced psoriasis-like dermatitis in a mouse model. Psoriasis-like dermatitis was induced on the shaved dorsal skin and right ear pinna of BALB/c mice by topical application of IMQ for 15 consecutive days after which WCR was administered to the mice by oral gavage for 10 days. Phenotypical observations, histopathological examinations, and ELISA of skin and blood samples were conducted. WCR significantly ameliorated development of IMQ-induced psoriasis-like dermatitis and reduced levels of Th17 cytokines (IL-17A, IL-22, and IL-23) in both serum and dorsal skin. Histopathological findings showed a decrease in epidermal thickness and inflammatory T-cell infiltration in the WCR-treated groups. The WCR has pharmacological actions which regulate Th17 related cytokines suggesting that it is a potential alternative therapeutic strategy for psoriasis.

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Hot Topics and Challenges of Regenerative Nanoceria in Application of Antioxidant Therapy

As a new antioxidant, nanoceria is of significant importance in applications of medical and biological fields. In comparison with conventional organic antioxidants, nanoceria has multienzyme mimetic activity by redox cycle. This unique regenerative/autocatalytic property has been widely used in the aspects of free-radical scavenger, radiation protection, oxidative-stress-related disease, drug delivery, biosensor, tissue engineering, cancer biomarker, and anti-inflammatory. This paper reviews the latest breakthrough of nanoceria as an antioxidant in applications of medical and biological fields on the base of the authors’ research works on resistance to oxidation and cytotoxicity. The challenges of nanoceria encountered in applications in medical and biological fields are commented as well.

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Mean-Square Stability of Split-Step Theta Milstein Methods for Stochastic Differential Equations

The fundamental analysis of numerical methods for stochastic differential equations (SDEs) has been improved by constructing new split-step numerical methods. In this paper, we are interested in studying the mean-square (MS) stability of the new general drifting split-step theta Milstein (DSSM) methods for SDEs. First, we consider scalar linear SDEs. The stability function of the DSSM methods is investigated. Furthermore, the stability regions of the DSSM methods are compared with those of test equation, and it is proved that the methods with are stochastically A-stable. Second, the nonlinear stability of DSSM methods is studied. Under a coupled condition on the drifting and diffusion coefficients, it is proved that the methods with can preserve the MS stability of the SDEs with no restriction on the step-size. Finally, numerical examples are given to examine the accuracy of the proposed methods under the stability conditions in approximation of SDEs.

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Bushenkangshuai Tablet Reduces Atherosclerotic Lesion by Improving Blood Lipids Metabolism and Inhibiting Inflammatory Response via TLR4 and NF-κB Signaling Pathway

Bushenkangshuai tablet (BSKS) is a Chinese herbal compound which has been used for the treatment of cardiovascular and cerebrovascular diseases in China for decades. This study intends to explore the molecular mechanism of BSKS against atherosclerosis in ApoE−/− mice. ApoE−/− mice were fed with western-type diet for 6 weeks and then were given BSKS for 6 weeks. The results showed that BSKS attenuated the size of the atherosclerotic lesion, reduced visceral adipose content, and decreased blood lipids. We also found that BSKS promoted the expression of adiponectin and its receptors, inhibited the expression of Toll-like receptor 4 and nuclear factor-kappa B, decreased the levels of interleukin-1 beta, monocyte chemotactic protein-1, and vascular cell adhesion molecule-1, and increased the levels of interleukin-10 and adiponectin. Our data provided evidence that BSKS exerted an antiatherosclerotic effect by lowering blood lipids and inhibiting inflammatory response via TLR4 and NF-κB signaling pathway.

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Ischemic Colitis in Sickle Cell Disease: A Case Report of a Diagnostic Challenge

Microvascular occlusion serves as the underlying mechanism for the multitude of clinical manifestations of sickle cell disease, one of the most prevalent hemoglobinopathies worldwide. Recurrent painful episodes are the hallmark of this condition. Abdominal pain attributed to an acute painful episode can be indistinguishable from a separate and/or more serious intra-abdominal disease process, representing a significant diagnostic dilemma for clinicians. Here we present a rare case of ischemic colitis due to vascular occlusion in a 28-year-old man with sickle cell disease.

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A Description of Pseudorapidity Distributions of Charged Particles Produced in Au+Au Collisions at RHIC Energies

In heavy ion collisions, charged particles come from two parts: the hot and dense matter and the leading particles. In this paper, the hot and dense matter is assumed to expand according to the hydrodynamic model including phase transition and decouples into particles via the prescription of Cooper-Frye. The leading particles are as usual supposed to have Gaussian rapidity distributions with the number equaling that of participants. The investigations of this paper show that, unlike low energy situations, the leading particles are essential in describing the pseudorapidity distributions of charged particles produced in high energy heavy ion collisions. This might be due to the different transparencies of nuclei at different energies.

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The Maximum Height and Attenuation of Impulse Waves Generated by Subaerial Landslides

High-speed landslides that flow into reservoirs can cause impulsive water waves. To study the characteristics of the maximum impulse wave’s height and its attenuation, 25 sets of flume experiments were conducted using orthogonal theory and 6 main influencing factors were considered. Taking the impulse wave heights as the evaluation criteria and analyzing the 6 influencing factors at 5 different levels, the characteristics of the maximum impulse wave’s height and its attenuations were obtained. Then, statistical relationships between the maximum wave height and the controlling factors were proposed. Then, by combining the continuity equation and the hydrodynamic open channel transient flow movement equation, the process of landslide wave height attenuation was studied, and it was found that the attenuation of the wave is consistent with exponential attenuation. Then, combined with the data obtained from the orthogonal experiments, an attenuation equation for the surge was derived. Finally, the proposed equation was validated by applying it to the landslides that took place along the shore of the Zipingpu reservoir, which were triggered by the Wenchuan earthquake, and the results indicate that the calculated results are very close to the observed results.

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Formyl Met-Leu-Phe-Stimulated FPR1 Phosphorylation in Plate-Adherent Human Neutrophils: Enhanced Proteolysis but Lack of Inhibition by Platelet-Activating Factor

N-formyl-Met-Leu-Phe (fMLF) is a model PAMP/DAMP driving human PMN to sites of injury/infection utilizing the GPCR, FPR1. We examined a microtiter plate format for measurement of FPR1 phosphorylation in adherent PMN at high densities and found that a new phosphosensitive FPR1 fragment, 25K-FPR1, accumulates in SDS-PAGE extracts. 25K-FPR1 is fully inhibited by diisopropylfluorophosphate PMN pretreatment but is not physiologic, as its formation failed to be significantly perturbed by ATP depletion, time and temperature of adherence, or adherence mechanism. 25K-FPR1 was minimized by extracting fMLF-exposed PMN in lithium dodecylsulfate at 4°C prior to reduction/alkylation. After exposure of adherent PMN to a 5 log range of PAF before or after fMLF, unlike in suspension PMN, no inhibition of fMLF-induced FPR1 phosphorylation was observed. However, PAF induced the release of 40% of PMN lactate dehydrogenase, implying significant cell lysis. We infer that PAF-induced inhibition of fMLF-dependent FPR1 phosphorylation observed in suspension PMN does not occur in the unlysed adherent PMN. We speculate that although the conditions of the assay may induce PAF-stimulated necrosis, the cell densities on the plates may approach levels observed in inflamed tissues and provide for an explanation of PAF’s divergent effects on FPR1 phosphorylation as well as PMN function.

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Short-Term Outcome of Patients with Cirrhosis and Concurrent Portal Cavernoma Presenting with Acute Variceal Bleeding

Background and Aim. The outcome of cirrhotic patients with main portal vein occlusion and portal cavernoma after the first episode of acute variceal bleeding (AVB) is unknown. We compared short-term outcomes after AVB in cirrhotic patients with and without portal cavernoma. Methods. Between January 2009 and September 2014, 28 patients with cirrhosis and portal cavernoma presenting with the first occurrence of AVB and 56 age-, sex-, and Child-Pugh score-matched cirrhotic patients without portal cavernoma were included. The primary endpoints were 5-day treatment failure and 6-week mortality. Results. The 5-day treatment failure rate was higher in the cavernoma group than in the control group (32.1% versus 12.5%; ). The 6-week mortality rate did not differ between the cavernoma and control group (25% versus 12.5%, ). Multivariable Cox proportional hazard regression analyses revealed that 5-day treatment failure (HR = 1.223, 95% CI = 1.082 to 1.384; ) independently predicted 6-week mortality. Conclusions. Cirrhotic patients with AVB and portal cavernoma have worse short-term prognosis than patients without portal cavernoma. The 5-day treatment failure was an independent risk factor for 6-week mortality in patients with cirrhosis and portal cavernoma.

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Image Segmentation Using a Trimmed Likelihood Estimator in the Asymmetric Mixture Model Based on Generalized Gamma and Gaussian Distributions

Finite mixture model (FMM) is being increasingly used for unsupervised image segmentation. In this paper, a new finite mixture model based on a combination of generalized Gamma and Gaussian distributions using a trimmed likelihood estimator (GGMM-TLE) is proposed. GGMM-TLE combines the effectiveness of Gaussian distribution with the asymmetric capability of generalized Gamma distribution to provide superior flexibility for describing different shapes of observation data. Another advantage is that we consider the spatial information among neighbouring pixels by introducing Markov random field (MRF); thus, the proposed mixture model remains sufficiently robust with respect to different types and levels of noise. Moreover, this paper presents a new component-based confidence level ordering trimmed likelihood estimator, with a simple form, allowing GGMM-TLE to estimate the parameters after discarding the outliers. Thus, the proposed algorithm can effectively eliminate the disturbance of outliers. Furthermore, the paper proves the identifiability of the proposed mixture model in theory to guarantee that the parameter estimation procedures are well defined. Finally, an expectation maximization (EM) algorithm is included to estimate the parameters of GGMM-TLE by maximizing the log-likelihood function. Experiments on multiple public datasets demonstrate that GGMM-TLE achieves a superior performance compared with several existing methods in image segmentation tasks.

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Modification of Aluminium 6063 Microstructure by Adding Boron and Titanium to Improve the Thermal Conductivity

This study aimed to improve the thermal conductivity of the Aluminium 6063 for heat sinks applications used in Central Processing Unit (CPU) of computers. Several studies had used different additional elements for this goal. In this paper, we studied the influence of Titanium and Boron addition on the thermal conductivity of Aluminium 6063. Several casting alloys samples were prepared with different percentage of addition elements and then heat-treated by homogenization and aging treatments. The results showed an important modification in thermal conductivity value per rapport to the reference metal, depending on the element of addition and its percentage. The bigger evolution was by using Boron in small percentage. More than 13% of the improvement was realized in the thermal conductivity with the addition of only 0.05% of Boron.

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Linearized and Kernelized Sparse Multitask Learning for Predicting Cognitive Outcomes in Alzheimer’s Disease

Alzheimer’s disease (AD) has been not only the substantial financial burden to the health care system but also the emotional burden to patients and their families. Predicting cognitive performance of subjects from their magnetic resonance imaging (MRI) measures and identifying relevant imaging biomarkers are important research topics in the study of Alzheimer’s disease. Recently, the multitask learning (MTL) methods with sparsity-inducing norm (e.g., -norm) have been widely studied to select the discriminative feature subset from MRI features by incorporating inherent correlations among multiple clinical cognitive measures. However, these previous works formulate the prediction tasks as a linear regression problem. The major limitation is that they assumed a linear relationship between the MRI features and the cognitive outcomes. Some multikernel-based MTL methods have been proposed and shown better generalization ability due to the nonlinear advantage. We quantify the power of existing linear and nonlinear MTL methods by evaluating their performance on cognitive score prediction of Alzheimer’s disease. Moreover, we extend the traditional -norm to a more general -norm (). Experiments on the Alzheimer’s Disease Neuroimaging Initiative database showed that the nonlinear -MKMTL method not only achieved better prediction performance than the state-of-the-art competitive methods but also effectively fused the multimodality data.

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Nonoperative Management of Multiple Penetrating Cardiac and Colon Wounds from a Shotgun: A Case Report and Literature Review

Introduction. Surgery for cardiac trauma is considered fatal and for wounds of the colon by associated sepsis is normally considered; however, conservative management of many traumatic lesions of different injured organs has progressed over the years. Presentation of the Case. A 65-year-old male patient presented with multiple shotgun wounds on the left upper limb, thorax, and abdomen. On evaluation, he was hemodynamically stable with normal sinus rhythm and normal blood pressure, no dyspnea, or abdominal pain. Computed tomography (CT) scan of the chest shows hematoma around the aorta without injury to the blood vessel wall with an intramyocardial projectile without pericardial effusion. CT scan of the abdomen showed pellets in the transverse colon and descending colon endoluminal without extravasation of contrast medium or intra-abdominal fluid. The patient remains hemodynamically stable, and nonsurgical procedure was established. Discussion. Patients with asymptomatic intramyocardial projectiles can be safely managed without surgery. Nonsurgical management is only possible in asymptomatic patients with trauma of the colon through close surveillance and with very selective patients since standard management is surgery. Conclusion. Nonsurgical management of cardiac trauma, as well as colon penetrating trauma, can be performed in carefully selected patients with proper clinical follow-up, imaging, and laboratory studies.

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Free Subspaces of Free Locally Convex Spaces

If and are Tychonoff spaces, let and be the free locally convex space over and , respectively. For general and , the question of whether can be embedded as a topological vector subspace of is difficult. The best results in the literature are that if can be embedded as a topological vector subspace of , where , then is a countable-dimensional compact metrizable space. Further, if is a finite-dimensional compact metrizable space, then can be embedded as a topological vector subspace of . In this paper, it is proved that can be embedded in as a topological vector subspace if is a disjoint union of a countable number of finite-dimensional locally compact separable metrizable spaces. This is the case if It is also shown that if and denote the Cantor space and the Hilbert cube , respectively, then (i) is embedded in if and only if is a zero-dimensional metrizable compact space; (ii) is embedded in if and only if is a metrizable compact space.

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Interactions of Bargaining Power and Introduction of Online Channel in Two Competing Supply Chains

This paper studies the effect of dual-channel format on supply chain’s competition ability and the effect of different bargaining powers on the competition between two supply chains and the optimal pricing decisions of all supply chain members when one supply chain introduces an online retailing channel. We develop four game models and obtain the optimal pricing decisions in closed form of these models and give some sensitivity analysis through numerical approach. Some new managerial insights are obtained as follows: Regardless of the two supply chain members’ bargaining forms, the optimal price, the maximal demand, and the maximal profit decrease as the self-price sensitivity decreases. The industry holds advantage in getting higher profit when the supply chain without online retailing channel is led by the retailer. In addition, we find that a manufacturer as a leader of its supply chain can get more profit when the competing supply chain’s leader is the manufacturer than when the competing supply chain’s leader is the retailer.

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Alteration of putaminal fractional anisotropy in Parkinson’s disease: a longitudinal diffusion kurtosis imaging study

Abstract

Purpose

In Parkinson's disease (PD), pathological microstructural changes occur that may be detected using diffusion magnetic resonance imaging (dMRI). However, there are few longitudinal studies that explore the effect of disease progression on diffusion indices.

Methods

We prospectively included 76 patients with PD and 38 healthy controls (HC), all of whom underwent diffusion kurtosis imaging (DKI) as part of the prospective Swedish BioFINDER study at baseline and 2 years later. Annualized rates of change in DKI parameters, including fractional anisotropy (FA), mean diffusivity (MD), and mean kurtosis (MK), were estimated in the gray matter (GM) by placing regions of interest (ROIs) in the basal ganglia and the thalamus, and in the white matter (WM) by tract-based spatial statistics (TBSS) analysis.

Results

When adjusting for potential confounding factors (age, gender, baseline-follow-up interval, and software upgrade of MRI scanner), only a decrease in FA in the putamen of PD patients (β = − 0.248, P < .01) over 2 years was significantly different from the changes observed in HC over the same time period. This 2-year decrease in FA in the putamen in PD correlated with higher l-dopa equivalent dose at baseline (Spearman's rho = .399, P < .0001).

Conclusion

The study indicates that in PD microstructural changes in the putamen occur selectively over a 2-year period and can be detected with DKI.



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Magnetic resonance imaging-based morphological and alignment assessment of the patellofemoral joint and its relationship to proximal patellar tendinopathy

Abstract

Objective

To assess the differences in morphology and alignment of the knee between patients with proximal patellar tendinopathy (PPT) and a control group, using MRI and focusing on the patellofemoral joint.

Methods

We retrospectively included 35 patients with clinically diagnosed and unequivocal findings of PPT on knee MRI, the case group. For the control group, we included 70 patients who underwent knee MRI for other reasons, with no clinical or MRI evidence of PPT. Patients and controls were matched for age and gender, with all subjects reporting frequent physical activity. MRIs were evaluated by two musculoskeletal radiologists, who assessed parameters of patellar morphology, trochlear morphology, patellofemoral alignment, and tibiofemoral alignment. The differences in parameters between cases and controls were assessed using Student's t test. Logistic regression was applied to assess the associations between the MRI parameters and the presence of PPT.

Results

The patellar height Insall–Salvati ratio was different between cases and controls (1.37 ± 0.21 vs. 1.24 ± 0.19; p = 0.003). The subchondral Wiberg angle was higher in cases than controls (136.8 ± 7.4 vs. 131.7 ± 8.8; p = 0.004). After applying logistic regression, significant associations with PPT were found [odds ratios (95% CI)] for patellar morphology [1.1 (1.0, 1.2)] and patellar height [1.3 (1.0, 1.7)].

Conclusions

Patellar height and the subchondral patellar Wiberg angle were greater in patients with PPT and significantly associated with PPT.



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Muscular sarcoidosis involving the chest and abdominal walls: case report with MR imaging

Abstract

Sarcoidosis is an inflammatory disorder that is characterized by the presence of noncaseating granulomas in tissues, involving many organs and tissues. Extra-pulmonary, especially muscular sarcoidosis is a rare condition. The most common location of the muscular sarcoidosis is known to be the proximal muscles of the extremities; however, there have been no cases of diffuse involvement of the chest and abdominal wall muscles. Here, we report a rare muscular sarcoidosis with infiltrative pattern in the chest and abdominal wall muscles and describe the MR imaging findings that were mistaken as lymphoma at initial diagnosis. Although our case did not show characteristic MR findings of muscular sarcoidosis, clinicians or radiologists who are aware of these imaging features can perform early systemic survey for sarcoidosis. Also muscle biopsy is very important to confirm the sarcoidosis and distinguish it from other tumors.



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Browser’s Notes



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Early detection of metastases using whole-body MRI for initial staging and routine follow-up of myxoid liposarcoma

Abstract

Objective

To define the role of whole-body MRI (WBMRI) for initial staging and routine follow-up of myxoid liposarcoma (MLS).

Materials and methods

A retrospective review of all the patients with MLS who underwent WBMRI for initial staging and routine follow-up at our institution between October 1, 2006, and September 30, 2016 was performed. Patient demographics, clinical presentation, imaging findings, tumor histology, and occurrence and location of metastatic disease were recorded. Thirty-three patients who underwent a total of 150 WBMRI examinations were included in the study.

Results

Nine patients (27%) were diagnosed with metastases between 0 and 60 months (median 10; interquartile range, 7–13) from the diagnosis of the primary tumor. The initial site of metastatic disease was extrapulmonary in all patients. Only two patients developed pulmonary metastases, which were diagnosed by CT chest 9 and 29 months after the diagnosis of extrapulmonary metastases. The first metastasis was diagnosed by WBMRI in seven patients (78%), by thoracic CT in one patient, and by abdominal CT in one patient. Eight of nine patients (89%) were asymptomatic at the time of diagnosis of the metastases. In seven patients (78%), WBMRI demonstrated metastases included within the field of view of, but occult on a contemporaneous CT scan.

Conclusion

Our 10-year institutional experience demonstrates that WBMRI facilitates early detection of extrapulmonary MLS metastases before the onset of clinical symptoms and pulmonary metastases. WBMRI also depicts extrapulmonary metastases that are occult on CT scans. The current surveillance strategies are insufficient for screening for extrapulmonary MLS metastases.



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Hyaline fibromatosis syndrome (juvenile hyaline fibromatosis): whole-body MR findings in two siblings with different subcutaneous nodules distribution

Abstract

Hyaline fibromatosis syndrome (juvenile hyaline fibromatosis) is a rare, progressive, autosomal recessive disorder whose main hallmark is the deposition of amorphous hyaline material in soft tissues, with an evolutionary course and health impairment. It may present involvement of subcutaneous or periskeletal soft tissue, or may develop as a visceral infiltration entity with poor prognosis. Very few radiological data about this inherited condition have been reported, due to the extreme rarity of disease. We herein present a case of two siblings, affected by different severity of the disease, with different clinical features. They were examined by whole-body MR (WBMR) in order to assess different lesions localization, to rule out any visceral involvement and any other associated anomalies and to define patients' management.



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Primary synovial chondromatosis of the subtalar joint: case report and review of the literature

Abstract

Primary synovial chondromatosis is a rare benign condition of uncertain etiology manifested by synovial proliferation. In the radiology literature, there is only 1 prior case report of primary synovial chondromatosis involving the subtalar joint with only partial description of the imaging appearance. We present a 28-year-old female with primary synovial chondromatosis of the subtalar joint and conduct a literature review of the imaging features of primary synovial chondromatosis presenting in the feet.



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An uncommon variant of the Essex-Lopresti injury

Abstract

The Essex-Lopresti injury is an extremely rare condition combining radial head or neck fracture, distal radio-ulnar joint dislocation and rupture of the interosseous membrane. However, there are rare or unusual varieties or associated injuries. We report a case of a 46-year-old woman with a posterior dislocation of the radio-humeral joint, a radial shaft fracture, and a distal radio-ulnar joint dislocation. She underwent open reduction and internal fixation of the radial shaft fracture followed by an immobilization by a long elbow splint in supination for 6 weeks. At 18 months of follow-up, she was asymptomatic and she had a full range of elbow and wrist motion and had resumed thoroughly her previous job. The Essex-Lopresti injury results from a complex injury to the forearm axis with resultant longitudinal instability, which can be challenging to treat. There are some variations that can lead to a missed diagnosis resulting in persistent pain and instability of the wrist. The best outcomes are reached with early diagnosis and prompt management.



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Diffusion weighted imaging demystified: the technique and potential clinical applications for soft tissue imaging

Abstract

Diffusion-weighted imaging (DWI) is a fast, non-contrast technique that is readily available and easy to integrate into an existing imaging protocol. DWI with apparent diffusion coefficient (ADC) mapping offers a quantitative metric for soft tissue evaluation and provides information regarding the cellularity of a region of interest. There are several available methods of performing DWI, and artifacts and pitfalls must be considered when interpreting DWI studies. This review article will review the various techniques of DWI acquisition and utility of qualitative as well as quantitative methods of image interpretation, with emphasis on optimal methods for ADC measurement. The current clinical applications for DWI are primarily related to oncologic evaluation: For the assessment of de novo soft tissue masses, ADC mapping can serve as a useful adjunct technique to routine anatomic sequences for lesion characterization as cyst or solid and, if solid, benign or malignant. For treated soft tissue masses, the role of DWI/ADC mapping in the assessment of treatment response as well as recurrent or residual neoplasm in the setting of operative management is discussed, especially when intravenous contrast medium cannot be given. Emerging DWI applications for non-neoplastic clinical indications are also reviewed.



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Multifocal metastatic chordoma to the soft tissues of the fingertips: a case report including sonographic features and a review of the literature

Abstract

Chordoma is a rare, locally aggressive tumor which commonly metastasizes, most often to the lung, liver, and spine. In this case report, a 59-year-old male with history of sacral chordoma and pulmonary metastases presented to the emergency department with swelling and discoloration of multiple left fingertips. The initial radiographs led to a presumptive diagnosis of gout, which did not respond to medical therapy. An ultrasound demonstrated multiple solid masses with vascular hyperechoic septations which were subsequently biopsied and proven to be metastatic chordoma. Metastatic disease to the hand is a well documented but rare manifestation of many malignancies. The clinical presentation and radiographic features of multifocal hand metastases may mimic entities such as systemic deposition and granulomatous diseases. To the best of our knowledge, this is the first case report of soft tissue chordoma metastases to the fingertips as well as the first reported sonographic description of chordoma metastases.



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A 4-year-old with a non-tender dorsal phalangeal lump



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Academic musculoskeletal radiology: influences for gender disparity

Abstract

Introduction

Research productivity is one of the few quintessential gauges that North American academic radiology departments implement to determine career progression. The rationale of this study is to quantify the relationship of gender, research productivity, and academic advancements in the musculoskeletal (MSK) radiology to account for emerging trends in workforce diversity.

Methods

Radiology residency programs enlisted in the Fellowship and Residency Electronic Interactive Database (FREIDA), Canadian Resident Matching Service (CaRMS) and International Skeletal Society (ISS) were searched for academic faculty to generate the database for gender and academic profiles of MSK radiologists. Bibliometric data was collected using Elsevier's SCOPUS archives, and analyzed using Stata version 14.2.

Results

Among 274 MSK radiologists in North America, 190 (69.34%) were men and 84 (30.66%) were women, indicating a statistically significant difference (χ2 = 6.34; p value = 0.042). The available number of female assistant professors (n = 50) was more than half of the male assistant professors (n = 88), this ratio however, plummeted at higher academic ranks, with only one-fourth of women (n = 11) professors compared to men (n = 45). The male MSK radiologist had 1.31 times the odds of having a higher h-index, keeping all other variables constant.

Conclusions

The trend of gender disparity exists in MSK radiology with significant underrepresentation of women in top tiers of academic hierarchy. Even with comparable h-indices, at the lower academic ranks, a lesser number of women are promoted relative to their male colleagues. Further studies are needed to investigate the degree of influence research productivity has, in determining academic advancement of MSK radiologists.



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Can FDG-PET/CT replace blind bone marrow biopsy of the posterior iliac crest in Ewing sarcoma?

Abstract

Objective

To determine and compare the value of 18F–fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) to blind bone marrow biopsy (BMB) of the posterior iliac crest in detecting metastatic bone marrow involvement in newly diagnosed Ewing sarcoma.

Materials and methods

This retrospective study included 20 patients with newly diagnosed Ewing sarcoma who underwent pretreatment FDG-PET/CT and a total of 38 blind BMBs (two unilateral and 18 bilateral) of the posterior iliac crest. FDG-PET/CT scans were evaluated for bone marrow involvement, both in the posterior iliac crest and other sites, and compared to blind BMB results.

Results

FDG-PET/CT was positive for bone marrow involvement in 7/38 posterior iliac crests, whereas BMB was positive in 5/38 posterior iliac crests. FDG-PET/CT and BMB results in the posterior iliac crest agreed in 36/38 cases (94.7%, 95% confidence interval [CI]: 82.7–98.5%). On a patient level, FDG-PET/CT was positive for bone marrow involvement in 4/20 patients, whereas BMB of the posterior iliac crest was positive in 3/20 patients. On a patient level, FDG-PET/CT and BMB results agreed in 19/20 patients (95.0%, 95% CI: 76.4–99.1%). The only discrepancies between FDG-PET/CT and BMB were observed in two BMBs of one patient. Both BMBs in this patient were negative, whereas FDG-PET/CT indicated bilateral posterior iliac crest involvement and also extensive bone marrow involvement elsewhere.

Conclusions

FDG-PET/CT appears to be a valuable method for metastatic bone marrow assessment in newly diagnosed Ewing sarcoma. The routine use of blind BMB of the posterior iliac crest should be reconsidered when FDG-PET/CT is available.



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Stener-like lesion of the lateral collateral ligament of the first metatarsophalangeal joint

Abstract

Displaced ulnar collateral ligament injuries of the metacarpophalangeal joint of the thumb, also known as Stener lesions, are a well-recognized clinical entity, requiring surgical intervention because of the trapped location of the torn lateral collateral ligament superficial to the adductor aponeurosis of the thumb. We report a similar lesion located at the first metatarsophalangeal joint, to our knowledge the first ever described in the literature. In our patient, magnetic resonance imaging showed a full-thickness tear of the lateral collateral ligament of the first metatarsophalangeal joint, as well as a full-thickness tear of the extensor hood, with dislocation of the proximal part of the ruptured lateral collateral ligament to a position superficial to the extensor hood. Analogous to true Stener lesions, we are convinced these patients also need early surgical repair. Therefore, we would like to raise awareness about their existence to ensure adequate management of these lesions, in order to prevent possible long-term complications like chronic pain, instability, and joint degeneration.



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Highlights of the 21th Annual Scientific Meeting of the Australasian Musculoskeletal Imaging Group (AMSIG) 2017, Melbourne, Australia



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A 4-year-old with a non-tender dorsal phalangeal lump: diagnosis and discussion



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Annual Meeting Abstracts of the Society of Skeletal Radiology (SSR) 2018, Austin, Texas, USA



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MRI findings in bucket-handle tears of the triangular fibrocartilage complex

Abstract

The triangular fibrocartilage complex (TFCC) is an intricate ligamentous and cartilaginous structure that helps transmit axial load across the wrist, and provide stability to the ulnocarpal and distal radioulnar joints (DRUJ). Because the blood supply to the TFCC varies depending on location, certain types of tears are more amenable to surgical repair than others. Since Palmer proposed his classification system of TFCC tears in 1989, only 1 case of a "bucket-handle" type tear has been reported. In this article, we describe two new cases of bucket-handle tears of the TFCC. In both cases, the torn fragment was displaced into a previously undescribed location (intra-articular DRUJ and prestyloid recess). Because this type of injury pattern has not been previously well characterized in the literature and such cases rarely reported, MRI findings have not been fully described and its implications on clinical management have largely yet to be determined.



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Comparison of qualitative and quantitative CT and MRI parameters for monitoring of longitudinal spine involvement in patients with multiple myeloma

Abstract

Purpose

To compare qualitative and quantitative computed tomography (CT) and magnetic resonance imaging (MRI) parameters for longitudinal disease monitoring of multiple myeloma (MM) of the axial skeleton.

Materials and methods

We included 31 consecutive patients (17 m; mean age 59.20 ± 8.08 years) with MM, who underwent all baseline (n = 31) and at least one or more (n = 47) follow-up examinations consisting of multi-parametric non-enhanced whole-body MRI (WBMRI) and non-enhanced whole-body reduced-dose thin-section MDCT (NEWBMDCT) between 06/2013 and 09/2016. We classified response according to qualitative CT criteria into progression (PD), stable(SD), partial/very good partial (PR/VGPR) and complete response(CR), grouping the latter three together for statistical analysis because CT cannot reliably assess PR and CR. Qualitative MR-response criteria were defined and grouped similarly to CT using longitudinal quantification of signal-intensity changes on T1w/STIR/ T2*w and calculating ADC-values. Standard of reference was the hematological laboratory (M-gradient).

Results

Hematological response categories were CR (14/47, 29.7%), PR (2/47, 4.2%), SD (16/47, 34.0%) and PD (15/47, 29.9%). Qualitative-CT-evaluation showed PD in 12/47 (25.5%) and SD/PR/VGPR/CR in 35/47 (74.5%) cases. These results were confirmed by quantitative-CT in all focal lytic lesions (p < 0.001). Quantitative-CT at sites with diffuse bone involvement showed significant increase of maximum bone attenuation (p < 0.001*) and significant decrease of minimal bone (p < 0.002*) in the SD/PR/VGPR/CR group. Qualitative MRI showed PD in 14/47 (29.7%) and SD/PR/VGPR/CR in 33/47 (70.3%). Quantitative MRI diagnosis showed a statistically significant decrease in signal intensity on short tau inversion recovery sequences (STIR) in bone marrow in patients with diffuse bone marrow involvement achieving SD/PR/VGPR/CR (p < 0.001*).

Conclusion

Imaging response monitoring using MRI is superior to CT only if qualitative parameters are used, whereas there was no definite benefit from using quantitative parameters with either CT or MRI.



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Skeletal Radiology: The Year in Review 2017



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Hyperintense signal alteration in the suprapatellar fat pad on MRI is associated with degeneration of the patellofemoral joint over 48 months: data from the Osteoarthritis Initiative

Abstract

Objective

To analyze associations of suprapatellar fat pad (SPFP) hyperintense signal alterations and mass effect with progression of patellofemoral osteoarthritis (OA) and clinical symptoms over 48 months.

Materials and methods

Subjects from the Osteoarthritis Initiative (n = 426; 51.8 ± 3.8 years; 49.8% women) without radiographic tibiofemoral OA underwent 3T-MRI of their right knees and clinical evaluation using the Knee Injury and Osteoarthritis Outcome Score at baseline and at 48 months. Elevated SPFP signal was assessed on intermediate-weighted, fat-saturated turbo spin-echo (TSE) images. Mass effect was defined as a convex posterior contour. Patellofemoral cartilage, bone marrow lesions (BML), and subchondral cysts were assessed using the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Associations of SPFP imaging findings with MRI and clinical progression were assessed using general linear models and logistic regressions.

Results

Baseline SPFP signal alterations were found in 51% of the subjects (n = 217), of whom 11% (n = 23) additionally had a mass effect. Progression of cartilage lesions was significantly higher in subjects with signal alteration versus without (adjusted mean increases, 95% CI; patella: 0.29, −0.07 to 0.64 vs −0.04, −0.40 to 0.31; p < 0.001; trochlea: 0.47, 0.16 to 0.77 vs 0.31, 0.01 to 0.61; p = 0.007). BML progression was also more likely in subjects with signal alteration (OR 1.75, 95% CI 1.09 to 2.82; p = 0.021). Mass effect was not associated with joint degeneration and SPFP findings were not associated with clinical worsening (p > 0.18 for all).

Conclusion

Patellofemoral joint degeneration over 48 months was significantly increased in subjects with SPFP signal alteration, suggesting an association between SPFP abnormalities and the progression of patellofemoral OA.



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IJMS, Vol. 19, Pages 345: Late-Onset N-Acetylglutamate Synthase Deficiency: Report of a Paradigmatic Adult Case Presenting with Headaches and Review of the Literature

IJMS, Vol. 19, Pages 345: Late-Onset N-Acetylglutamate Synthase Deficiency: Report of a Paradigmatic Adult Case Presenting with Headaches and Review of the Literature

International Journal of Molecular Sciences doi: 10.3390/ijms19020345

Authors: Catia Cavicchi Chiara Chilleri Antonella Fioravanti Lorenzo Ferri Francesco Ripandelli Cinzia Costa Paolo Calabresi Paolo Prontera Francesca Pochiero Elisabetta Pasquini Silvia Funghini Giancarlo la Marca Maria Donati Amelia Morrone

N-acetylglutamate synthase deficiency (NAGSD) is an extremely rare urea cycle disorder (UCD) with few adult cases so far described. Diagnosis of late-onset presentations is difficult and delayed treatment may increase the risk of severe hyperammonemia. We describe a 52-year-old woman with recurrent headaches who experienced an acute onset of NAGSD. As very few papers focus on headaches in UCDs, we also report a literature review of types and pathophysiologic mechanisms of UCD-related headaches. In our case, headaches had been present since puberty (3–4 days a week) and were often accompanied by nausea, vomiting, or behavioural changes. Despite three previous episodes of altered consciousness, ammonia was measured for the first time at 52 years and levels were increased. Identification of the new homozygous c.344C&gt;T (p.Ala115Val) NAGS variant allowed the definite diagnosis of NAGSD. Bioinformatic analysis suggested that an order/disorder alteration of the mutated form could affect the arginine-binding site, resulting in poor enzyme activation and late-onset presentation. After optimized treatment for NAGSD, ammonia and amino acid levels were constantly normal and prevented other headache bouts. The manuscript underlies that headache may be the presenting symptom of UCDs and provides clues for the rapid diagnosis and treatment of late-onset NAGSD.



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IJMS, Vol. 19, Pages 344: Lycopene Attenuates Tulathromycin and Diclofenac Sodium-Induced Cardiotoxicity in Mice

IJMS, Vol. 19, Pages 344: Lycopene Attenuates Tulathromycin and Diclofenac Sodium-Induced Cardiotoxicity in Mice

International Journal of Molecular Sciences doi: 10.3390/ijms19020344

Authors: Mohamed Abdel-Daim Rasha Eltaysh Azza Hassan Shaker Mousa

Recent experiments showed a potential cardiotoxic effect of the macrolide antibiotic (tulathromycin). This study was performed to investigate whether diclofenac sodium (DFS) potentiates the cardiotoxicity of tulathromycin and increases the cardioprotective effects of lycopene against DFS and tulathromycin. Seven groups (eight per group) of adult Swiss albino mice received saline (control), tulathromycin (a single subcutaneous dose of 28 mg/kg/bw on day 14), DFS (a single oral dose of 100 mg/kg/bw on day 14), tulathromycin plus DFS, or lycopene (oral, 10 mg/kg/bw daily for 15 d) combined with tulathromycin, DFS, or both. Compared to the control group, the administration of tulathromycin or DFS (individually or in combination) caused significantly elevated (p &lt; 0.05) serum levels of Creatine kinase-myocardial B fraction (CK-MB), lactate dehydrogenase, and cardiac-specific troponin-T and tissue levels of nitric oxide and malondialdehyde that were accompanied by significantly decreased tissue reduced glutathione content and glutathione peroxidase, superoxide dismutase, and catalase antioxidant enzyme activity. Upon histopathological and immunohistochemical examination, the mean pathology scores and the percentages of caspase-3-, Bax-, and CK-positive regions were significantly higher in the tulathromycin- and/or DFS-treated groups than in control mice. For all these parameters, the pathological changes were more significant in the tulathromycin–DFS combination group than in mice treated with either drug individually. Interestingly, co-administration of lycopene with tulathromycin and/or DFS significantly ameliorated the changes described above. In conclusion, DFS could potentiate the cardiotoxic effects of tulathromycin, whereas lycopene can serve as a cardioprotective agent against DFS and tulathromycin.



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