Area Of Segment Research Articles

O-01 A CASE OF LANGERHANS CELL HISTIOCYTOSIS WITH INVOLVEMENT OF THE HYPOTHALAMUS, BONE, AND LIVER

Abstract Introduction Langerhans cell histiocytosis (LCH) is a neoplastic disorder characterized by the abnormal infiltration of Langerhans cells, affecting multiple systems. Here, we report a rare case of LCH with involvement of the hypothalamus, liver, and bone. Clinical Case A 36-year-old female patient presented to the psychiatry department with complaints of anxiety, including sudden behavioral changes, headaches, increased forgetfulness, hypersomnia, and excessive thirst excessive eating, and memory lapses that persisted for three months. A contrast-enhanced pituitary MRI taken revealed a lobulated mass lesion, measuring 15x9x17 mm, extending into the interpeduncular cistern and anteriorly toward the optic chiasm, with cystic necrotic areas located at the base of the third ventricle (Figure 1A). Laboratory examinations indicated panhypopituitarism and central diabetes insipidus. Abdominal ultrasound revealed a hypoechoic area in liver segment 8.PET-CT showed a region of intense metabolic activity in the posterior section of the left mastoid bone (SUVmax: 12.4). In addition, a 14-mm focal area with increased fluorodeoxyglucose uptake was observed in liver segment 8 (SUVmax: 8.4) (Figure 1B).The temporal MRI showed a mass lesion extending to the petrous apex, filling the mastoid cells on the left side, with signal characteristics similar to the hypothalamic lesion (Figure 1C).Biopsy was performed on identified lesions. Both biopsy results were consistent with LCH. She was planned to administer two courses of cladribine therapy. Follow-up PET-CT after chemotherapy indicated that the liver and mastoid bone involvement had resolved. However, the patient’s neuropsychiatric symptoms did not improve following chemotherapy. Paraneoplastic autoimmune encephalitis was primarily suspected, and antibody testing was performed. Due to the progressive nature of the patient’s condition, intravenous immunoglobulin therapy was administered. On the fourth day of this treatment, the patient experienced increased agitation and delusions, and developed disorientation.50 mg of quetiapine was prescribed. Three days after starting quetiapine, the patient developed fever, tachypnea, muscle rigidity, increased confusion, and an acute increase in serum creatine kinase levels (29,000 U/L). The condition was evaluated as a neuroleptic malignant syndrome leading to the discontinuation of quetiapine. The patient was transferred to the intensive care unit (ICU).On the first day of ICU admission, the patient was intubated. Despite cardiac support, the patient died on the third day of ICU admission. Conclusion LCH is a rare but multisystemic inflammatory neoplasm. The absence of specific clinical features can lead to delays in diagnosis. Although LCH most commonly presents with bone and skin lesions, a multidisciplinary approach is crucial for an accurate diagnosis. Albeit rare, LCH should be considered in the differential diagnosis of patients presenting with hypothalamic masses.Figure 1:Magnetic resonance image of the hypothalamic mass (A), Magnetic resonance images revealing a mass lesion in the left mastoid bone (B) and a subcapsular lesion in liver segment 8 (C)

Establishing Reference Values in the Neuromuscular Ultrasound Laboratory Using the e-Norms Method: A Feasibility Study.

The standard procedure to establish reference values in a neuromuscular laboratory involves examining healthy controls, as nerve size varies with the population and muscle echo intensity (EI) is device-specific. We aimed to derive these reference values by extrapolation from a studied sample (the e-norms method), compare them with published reference values, and determine their diagnostic accuracy. We retrospectively analyzed data from consecutive patients who underwent nerve and/or muscle ultrasound in our ultrasound laboratory, which is a tertiary referral center for neuromuscular diseases in Southern Poland in the years 2018-2023. We plotted the cross-sectional area (CSA) of the nerve segments and EI of the individual muscles and derived descriptive statistics from the plateau of the e-norms curve. We compared the mean difference of the nerve size to other studies and determined the ability of the muscle EI to discriminate myopathic versus healthy subjects using receiver operator characteristics curves. We analyzed 1124 nerves and 1154 muscles from 109 and 99 subjects, respectively. The derived reference values for nerve CSA were mostly concordant with other studies, including all nerve segments in the legs and with the exception of compression sites and the most proximal nerve segments in the arms. Using the reference values for muscle EI established with the e-norms method, we were able to discriminate myopathic from healthy subjects with 85% sensitivity and 92% specificity. The e-norms is a feasible method to establish reference values in the neuromuscular ultrasound laboratory.

Investigation of the Ocular Response and Corneal Damage Threshold of Exposure to 28 GHz Quasi-millimeter Wave Exposure.

Electromagnetic radiation energy at millimeter wave frequencies, typically 30 GHz to 300 GHz, is ubiquitously used in society in devices for telecommunications; radar and imaging systems for vehicle collision avoidance, security screening, and medical equipment; scientific research tools for spectroscopy; industrial applications for non-destructive testing and precise measurement; and military and defense applications. Understanding the biological effects of this technology is essential. We have been investigating ocular responses and damage thresholds comparing various frequencies using rabbit eyes and dedicated experimental apparatus. In this study we investigated the 28 GHz quasi-millimeter wave band (wavelength: 10.7 mm), a candidate for 5G communication. Similar to millimeter wave frequencies, ocular damage from exposure to 28 GHz for 6 min (400 mW cm-2) included corneal epithelial damage, corneal edema, and opacity. The incident power density threshold, indicating a 50% probability of ocular damage from exposure for 6 min, was found to be 359 mW cm-2 for 28 GHz. Comparing the ocular exposure area for various millimeter wave frequencies (40, 75, 95 GHz) and 28 GHz quasi-millimeter waves using a thermosensitive liquid crystal capsule, we found that for millimeter waves, even at identical incident power densities, the ocular exposure area decreases as the frequency increases (lens effect). However, this lens effect was not observed at 28 GHz, where the entire anterior segment area was exposed to radio waves.

Wild Tibetan Macaques Use a Route-Based Mental Map to Navigate in Large-Scale Space.

Many animals face significant challenges in locating and acquiring resources that are unevenly distributed in space and time. In the case of nonhuman primates, it remains unclear how individuals remember goal locations and whether they navigate using a route-based or a coordinate-based mental representation when moving between out-of-sight feeding and resting sites (i.e., large-scale space). Here, we examine spatial memory and mental map formation in wild Tibetan macaques (Macaca thibetana) inhabiting a mountainous, forested ecosystem characterized by steep terrain that limits direct vision to 25 meters. We used an instantaneous scan sampling technique at 10-min intervals to record the behavior and location of macaques on Mt. Huangshan, Anhui Province, China, from September 2020 to August 2023. Over 214 days, we obtained 7180 GPS points of the macaques' locations. Our study revealed that the macaques reused 1264 route segments (average length 204.26 m) at least four times each. The number of feeding and resting sites around the habitual route segment, terrain roughness, and dense vegetation areas significantly influenced the use of route segments by our study group. In addition, we found evidence that the monkeys reused 48 nodes to reorient their travel path. We found that monkeys approached a revisited foraging or resting site from the same limited set of directions, which is inconsistent with a coordinate-based spatial representation. In addition, the direction in which the macaques left a feeding or resting site was significantly different from the straight-line direction required to reach their next feeding or resting site, suggesting that the macaques frequently reoriented their direction of travel to reach their goal. Finally, on average, macaques traveled 24% (CI = 1.24) farther than the straight-line distance to reach revisited feeding and resting sites. From our robust data set, we conclude that Tibetan macaques navigate large spaces using a route-based mental representation that appears to help them locate food resources in dense, rugged montane forests and heterogeneous habitats.

Arsenic in water from the Bystre Thrust-Sheet (Outer Carpathians, Poland): Geological and environmental implications

The article focuses on the physicochemical parameters of water in streams, springs, boreholes, and intakes from the Bystre Thrust-Sheet (the Silesian Nappe, Fore-Dukla Zone), the only area in the Polish segment of the Outer Carpathians where arsenic minerals occur. These waters are characterized by the presence of arsenic, lithium, mercury, barium, strontium and usually high CO2 concentrations. The study aimed to determine the range of the geochemical anomaly of arsenic in water. An important aspect was to determine the origin of As and link its presence with the content of ions of other chemical elements dissolved in water. The sampling points were designated based on geological maps with a particular emphasis on the occurrence of tectonic dislocations and the configuration of the river network. In the selected places 47 samples of water were taken, and various elements were determined. Then, the range of occurrence of various types of water that differed from the average concentrations of selected ions was analysed. The potential relationship between the chemical composition of water and the geology of the Bystre Thrust-Sheet was also discussed. The high concentrations of arsenic were found only in springs and boreholes. In flowing waters, these concentrations quickly decreased due to dilution or precipitation and binding with the solid phase. Relatively high (max. 378.72 μg/L) arsenic concentration, which significantly exceeded the permissible value (50 μg/L), was detected in the Bystre 1 borehole. This water has a pH value of 7.85 indicating its alkaline nature. When considering water use for health purposes, it is necessary to monitor its arsenic content. The conditions prevailing in waters, mainly high pH, favour the immobilization of metals in sediments and suspended matter. The lower concentrations of arsenic in flowing waters may be attributed to the strongly calcareous nature of the Cieszyn beds which act as a natural barrier, limiting the migration of arsenic beyond the Bystre Thrust-Sheet.

Vessel wall MRI evaluation for the safety of endovascular recanalization of non-acute intracranial anterior circulation artery occlusions

BackgroundVessel wall MRI (VWMRI) can reveal the morphological features of intracranial artery occlusion (ICAO). This study aimed to investigate the imaging features of ICAO on VWMRI and explore their correlation...

Spinal ischemia: the rehabilitation potential. А clinical case

BACKGROUND: Spinal myeloischemia is a rare but severe neurological disease, associated with high incapacitation level and high social-economical costs due to complications developing during the acute phase. The reasons for its development can include vascular malfomations, spinal stroke, extra- and intramedullary tumors, compression of the spinal cord in cases of vertebral fractures, intervertebral disc herniations, stenosis of the spinal canal at the cervical segment, medical manipulations and impaired segmental circulation during the anesthesia, lumbar puncture and surgical interventions. CLINICAL CASE DESCRIPTION: The presented clinical observation provides a description of the iatrogenic complication that has developed in a patient aged 52 years after discectomy and installation of the disc prosthesis due to the development of disco-radicular and spinal conflict, resulting due to the С5/С6 dorsomedial intervertebral hernia, the clinical manifestations of which, besides pain, included weakness in the left upper limb, causally related to the focus of intramedullary ischemia at the unilateral side. At the early post-surgery period, asymmetrical tetraparesis was revealed with the predominance in the distal segments of the left upper limb and with impaired functions of the pelvic organs, caused by the expansion of the ischemia zone in the gray and white matters in the anterior areas of the lower cervical segments of the spinal cord. CONCLUSION: The timely initiation of combined medication therapy and the staged rehabilitation, conducted by the multi-disciplinary team, have provided the restoration of the impaired functions and the quality of life for the patient. The proposed methods can be useful in the treatment of patients with compression-related and non-compression-related vascular myelopathies.

Heterogeneous development of liver fibrosis in chronic hepatitis C patients; assessment by extracellular volume fraction map generated from routine clinical CT data

ObjectivesTo clarify the heterogeneous development of liver fibrosis in patients with chronic hepatitis C (CHC) using extracellular volume fraction (ECV) map obtained from routine clinical CT data. MethodsBetween November 2012 and July 2020, patients with CHC were retrospectively recruited who had undergone four-phase CT and MR elastography (MRE) within one year. Patients were divided into 4 grades to represent different cirrhotic/fibrotic stage, using two different methods; one based on liver stiffness measured by MRE (MRE model), and the other by mALBI grades (mALBI model). Liver was anatomically divided into 16 sections, namely peripheral and central areas of each segment. ECV map was generated according to the previously reported method, and ECV was measured for the 16 sections. Estimated pathological fibrosis grade was assigned for each section based on the previously reported data. ResultsThere were 150 patients available. In each anatomical section, ECV significantly increases as cirrhotic /fibrotic stage progresses. The peripheral areas of segments 4,5 and 8 were the earliest to show F2 or F3-equivalent ECV (p < 0.05), followed by central areas or other segments. The central areas of segments 6 and 7 were the last to be involved by fibrosis both in MRE and mALBI models, finally almost all sections showing F4-equivalent ECV at the end stage fibrosis. ConclusionFibrosis starts at the peripheral areas of segments 4, 5, and 8, and spreads towards other parts of the liver, with the central areas of segments 6 and 7 being the last, in patients with CHC.

The Seismic Surface Rupture Zone in the Western Segment of the Northern Margin Fault of the Hami Basin and Its Causal Interpretation, Eastern Tianshan

The Eastern Tianshan region, influenced by the far-field effect of northward compression and expansion of the Qinghai-Xizang block, features highly developed Late Quaternary active faults that exhibit significant neotectonic activity. Historically, the Barkol-Yiwu Basin, located to the north of the Eastern Tianshan, experienced two major earthquakes in 1842 and 1914, each with a magnitude of M71/2. In contrast, the Hami Basin on the southern margin of the Eastern Tianshan has no historical records of any major earthquakes, and its seismic potential, mechanisms, and future earthquake hazards remain unclear. Based on satellite image interpretation and field surveys, this study identified a relatively recent and well-preserved seismic surface rupture zone with good continuity in the Liushugou area of the western segment of the Northern Margin Fault of the Hami Basin (HMNF), which is the seismogenic structure responsible for the rupture. The surface rupture zone originates at Kekejin in the east, extends intermittently westward through Daipuseke Bulake and Liushugou, and terminates at Wuzun Bulake, with a total length of approximately 21 km. The rupture zone traverses the youngest geomorphic surface units, such as river beds or floodplains and first-order terraces (platforms), and is characterized by a series of single or multiple reverse fault scarps. The morphology of fault scarps is clear, presenting a light soil color with heights ranging from 0.15 m to 2.13 m and an average displacement of 0.56 m, suggesting that this surface rupture zone likely represents the most recent seismic event. Comparison with historical earthquake records in the Eastern Tianshan region suggests that the rupture zone may have been formed simultaneously with the Xiongkuer rupture zone by the 1842 M71/2 earthquake along the boundary faults on both sides of the Barkol Mountains, exhibiting a flower-like structural pattern. Alternatively, it might represent a separate, unrecorded seismic event occurring shortly after the 1842 earthquake. The estimated magnitude of the associated earthquake is about 6.6~6.9. Given that surface-rupturing earthquakes have already occurred in the western segment, the study indicates that the Erdaogou–Nanshankou section of the HMNF has surpassed the average recurrence interval for major earthquakes, indicating a potential future earthquake hazard.

Leveraging pre-trained machine learning models for islet quantification in type 1 diabetes

Human islets display a high degree of heterogeneity in terms of size, number, architecture, and endocrine cell-type compositions. An ever-increasing number of immunohistochemistry-stained whole slide images (WSIs) are available through the online pathology database of the Network for Pancreatic Organ donors with Diabetes (nPOD) program at the University of Florida (UF). We aimed to develop an enhanced machine learning-assisted WSI analysis workflow to utilize the nPOD resource for analysis of endocrine cell heterogeneity in the natural history of type 1 diabetes (T1D) in comparison to donors without diabetes. To maximize usability, the user-friendly open-source software QuPath was selected for the main interface. The WSI data were analyzed with two pre-trained machine learning models (i.e., Segment Anything Model (SAM) and QuPath's pixel classifier), using the UF high-performance-computing cluster, HiPerGator. SAM was used to define precise endocrine cell and cell grouping boundaries (with an average quality score of 0.91 per slide), and the artificial neural network-based pixel classifier was applied to segment areas of insulin- or glucagon-stained cytoplasmic regions within each endocrine cell. An additional script was developed to automatically count CD3+ cells inside and within 20 μm of each islet perimeter to quantify the number of islets with inflammation (i.e., CD3+ T-cell infiltration). Proof-of-concept analysis was performed to test the developed workflow in 12 subjects using 24 slides. This open-source machine learning-assisted workflow enables rapid and high throughput determinations of endocrine cells, whether as single cells or within groups, across hundreds of slides. It is expected that the use of this workflow will accelerate our understanding of endocrine cell and islet heterogeneity in the context of T1D endotypes and pathogenesis.

Local Morphologic and Hemodynamic Analyses for the Prediction of Abdominal Aortic Aneurysm Rupture Based on Patient-Specific CTA and Computational Modeling.

Extensive research has focused on the evaluation of rupture risks in abdominal aortic aneurysms (AAAs) through comprehensive morphologic and hemodynamic analyses, primarily considering the AAA as a whole entity. This study tried to identify the high-risk rupture sites of AAAs more precisely before the fatal process based on morphologic and hemodynamic analyses at the local segment. Computed tomography angiography of a specific AAA patient was conducted at the follow-up 4 months before rupture, 1 day before rupture, the day of the rupture, and 15 days after endovascular aortic repair. The evolution of local morphology and the hemodynamic characteristics at these critical timepoints were investigated based on patient-specific reconstructions and computational fluid dynamics. The morphologic and hemodynamic parameters of the rupture region vary continuously in the process of AAA development and rupture. The surface area and volume of the rupture segment were gradually enlarged at the follow-up 4 months before rupture (47.33 cm2; 67.35 mL), 1 day before rupture (57.23 cm2; 85.24 mL), and on the day of the rupture (62.41cm2; 104.73ml). A prominent decrease in time-averaged wall shear stress and velocity for the rupture segment is observed. The percentages of the lowest time-averaged wall shear stress (<0.1 Pa) area are increased in the AAA region (20.42%, 33.85%, and 53.00%, separately). The results based on precisely rebuilt geometries for the complete follow-ups of patient-specific computed tomography angiography demonstrate that notable morphologic and hemodynamic evolutions have occurred in the local segment of the AAA, which was further proved at the rupture site. The significant changes occurring at the local segment may provide valuable information for the evaluation of aneurysm rupture risk and locate the most probable site of rupture. Capturing the entire process of AAA rupture through CTA imaging is a rare occurrence in clinical practice. The evolution of morphology and hemodynamic characteristics observed in the illustrated results provides valuable insights for clinicians to monitor the state of AAA from a different perspective. These findings suggest that variations in morphology and hemodynamics within the local segment of the AAA might serve as an alternative approach for predicting the rupture risk of AAA.

A hybrid method for delineating homogeneous forest segments from LiDAR data in Catalonia (Spain)

ABSTRACT Laser scanning data are increasingly used to segment forests into homogeneous units, called segments or stand compartments. Region growing and region merging have been traditionally employed for this purpose. Recently, alternative methods such as cellular automata (CA), self-organizing maps (SOM), and combinatorial optimization have emerged, promising more homogeneous stand delineations. However, these newer methods often require fine-tuning due to rugged stand boundaries. To address this, we propose and assess a novel hybrid approach that combines two segmentation algorithms, resulting in smoother boundaries and homogeneous stands. Our hybrid method outperforms traditional fine-tuning techniques, particularly using CA or SOM for initial segmentation and then refining it with another cellular automaton (CA’), adjusted to produce smooth boundaries. The new two-step hybrid method resulted in better segmentation results than the one-step algorithm combined with previously suggested fine-tuning methods. SOM-CA’ showed the highest degree of explained variance (R2) of the LiDAR metrics used in the segmentation. CA-CA’ reached almost the same R2 values with a larger average segment area. When the R2 of the LiDAR metrics was used as the criterion, the segments produced by the hybrid method outperformed the stand delineations of the current Spanish forest map with a clear margin.

Mechanical and Geometric Characterization of a Novel 2-Ply Vacuum-Pressed Biological Scaffold Patch Design for Posterior Mitral Valve Reconstruction.

To assess the mechanical properties of small intestinal submucosal extracellular matrix (SIS-ECM) iterations and choose the optimal version for evaluating functional geometrics after posterior mitral valve reconstruction. Four SIS-ECM versions (2- and 4-ply vacuum-pressed and lyophilized) underwent uniaxial tensile testing. A posterior mitral valve reconstruction patch was developed based on MRI scans (n = 5). Posterior mitral valve reconstruction using 2-ply vacuum-pressed SIS-ECM was performed (n = 7), and geometrics were evaluated using a modified left heart simulator. The vacuum-pressed iterations displayed superior maximum stress values compared to lyophilized (2-ply: median [IQR], 15.8 [15.2-19.0] vs 7.9 [7.3-8.3] MPa, p < 0.001; 4-ply: median (IQR), 15.8 -[14.6-22.0] vs 7.9 [7.6-8.4] MPa). All reconstructed valves were competent with preserved total leaflet area, but individual leaflet segment areas were redistributed. Posterior mitral valve reconstruction with our 2-ply vacuum-pressed SIS-ECM patch design was feasible in vitro. Further in vivo evaluation is warranted.

AI-based automated breast cancer segmentation in ultrasound imaging based on Attention Gated Multi ResU-Net.

Breast cancer is a leading cause of death among women worldwide, making early detection and diagnosis critical for effective treatment and improved patient outcomes. Ultrasound imaging is a common diagnostic tool for breast cancer, but interpreting ultrasound images can be challenging due to the complexity of breast tissue and the variability of image quality. This study proposed an Attention Gated Multi ResU-Net model for medical image segmentation tasks, that has shown promising results for breast cancer ultrasound image segmentation. The model's multi-scale feature extraction and attention-gating mechanism enable it to accurately identify and segment areas of abnormality in the breast tissue, such as masses, cysts, and calcifications. The model's quantitative test showed an adequate degree of agreement with expert manual annotations, demonstrating its potential for improving early identification and diagnosis of breast cancer. The model's multi-scale feature extraction and attention-gating mechanism enable it to accurately identify and segment areas of abnormality in the breast tissue, such as masses, cysts, and calcifications, achieving a Dice coefficient of 0.93, sensitivity of 93%, and specificity of 99%. These results underscore the model's high precision and reliability in medical image analysis.

Unequal segment areas and corner positions with the enveloping surface method for sound power determination

The standardised methods for the determination of the sound power level according to the enveloping surface methods require a measurement of the sound pressure or sound intensity level on the enveloping surface. While the subdivision of the enveloping surface into unequal segment areas is correctly standardised for the intensity method (ISO 9614, all parts), the sound pressure methods (e.g. ISO 3744) reveal some fuzziness. The reason is the necessary allocation of partial surfaces to measurement points which are normatively located at corners or edges of the parallelepiped measurement surfaces. This effect is especially important with the proposed local increase of the measurement point density in regions of increased sound radiation. The contribution shows which effects unequal areas have and how a correct surface averaging can be implemented in these cases.

Interpreting the Projected Frontal Area in Front Crawl: Determining the Projected Frontal Area of Each Body Segment.

This study aimed to provide evidence for the interpretation of the projected frontal area (PFA) during front crawl. To achieve this goal, we developed a method for calculating the PFA of each body segment using digital human technology and compared the pressure drag under two calculation conditions: a combination of the PFA with and without accounting for the horizontal velocity of each body segment. Twelve competitive male swimmers performed a 15-meter front crawl at 1.20 m·s-1. The three-dimensional positions of the reflective markers attached to the swimmer's body were recorded using an underwater motion-capture system. Based on the body shape of each swimmer obtained from the photogenic body scanner, individual digital human body models were created with the color of the model's vertices divided into eight body segments. The time series of the volumetric swimming motion was reconstructed using inverse kinematics. The PFA of each body segment was then calculated by the automatic processing of a series of parallel frontal images. The pressure drag index, defined as the value excluding the drag coefficient while simultaneously considering the PFA and the horizontal velocity, was calculated under two conditions: the static condition (accounting for only the PFA of each body segment) and the dynamic condition (accounting for the PFA and horizontal velocity of each body segment). Notably, the pressure drag index was higher under the static condition than under the dynamic condition for the humerus, ulna, and hand segments (p < 0.001). The results obtained using our methodology indicate that the PFA of the upper limb segments overestimates their contribution to pressure drag during front crawl under the static condition.

Comparison of laparoscopic liver resection for the ventral versus the dorsal areas of segment 8.

The technical difficulties of laparoscopic liver resection (LLR) are greatly associated with the location of liver tumors. Since segment 8 (S8) contains a wide area, the difficulty of LLR for S8 tumors may vary depending on the location within the segment, such as the ventral (S8v) and dorsal (S8d) area, but the difference is unclear. We retrospectively investigated 30 patients who underwent primary laparoscopic partial liver resection for liver tumors in S8 at Kobe University Hospital between January 2018 and June 2023. Thirteen and 17 patients underwent LLR for S8v and S8d, respectively. The operation time was significantly longer (S8v 203[135-259] vs. S8d 261[186-415] min, P = 0.002) and the amount of blood loss was significantly higher (10[10-150] vs. 10[10-200] mL, P = 0.034) in the S8d group than in the S8v group. No significant differences were observed in postoperative complications or postoperative length of hospital stay. Additionally, intraoperative findings revealed that the rate at which the case performed partial liver mobilization in the S8d group was higher (2[15.4%] vs. 8[47.1%], P = 0.060) and the median parenchymal transection time of the S8d group was longer (102[27-148] vs. 129[37-175] min, P = 0.097) than those in the S8v group, but there were no significant differences. The safety of LLR for the S8d was comparable to that of LLR for S8v, although LLR for S8d resulted in longer operative time and more blood loss. B230165 (approved at December 26, 2023).

The Low Back Pain - Looking For a Physiotherapeutic Approach

BACKGROUND: Low back pain (LBP) is one of the most common neurological complaints. It affects young people but has a slow progression even at a later age. LBP is a condition with a rich clinical picture – pain, severely limited range of motion in the spinal column (especially in the area of the L4-L5 segment) and sacro-iliac joints, difficulty walking. Physiotherapy has an essential role in maintaining the general condition and improving the quality of life for this contingent of patients. AIM: The aim of the present study is to create and approve a physiotherapy methodology for pain reduction in patients diagnosed by a neurologist – radiculitis of the lumbo-sacral plexus. METHODS: 20 clinically proven patients divided into two groups were included in the study. After signing informed consent declarations and assessment of anthropometric data (age, height, and weight), the subjects were evaluated with neurological tests such as Lasegue test and dolorimetry. Results were also reported on the Barthel index scale. RESULTS: The dynamics of dolorimetry results, quality of life, and mobility in the spine area (especially the lumbar segment) were monitored in the two studied groups, with the results in the experimental group demonstrating better values (p &lt; 0.0001). CONCLUSION: There is no unified system for pain reduction in patients with LBP. As a result of applied physiotherapy, including modern techniques for myofascial massage, a faster increase in joint mobility in the area of the spine and sacroiliac joints, an improvement in muscle strength and, above all, a reduction in pain symptoms were found.

Three-Dimensional Anthropometric Analysis of the Effect of Lip Reconstructive Surgery on Children with Cleft Lip and Palate at Three Different Times.

This investigation aimed to assess the optimal timing for lip repair in children with cleft lip and palate via 3D anthropometric analysis to evaluate their maxillofacial structures. The sample comprised 252 digitized dental models, divided into groups according to the following timing of lip repair: G1 (n = 50): 3 months; G2 (n = 50): 5 and 6 months; G3 (n = 26): 8 and 10 months. Models were evaluated at two-time points: T1: before lip repair; T2: at 5 years of age. Linear measurements, area, and Atack index were analyzed. At T1, the intergroup analysis revealed that G1 had statistically significant lower means of I-C', I-C, C-C', and the sum of the segment areas compared to G2 (p = 0.0140, p = 0.0082, p = 0.0004, p < 0.0001, respectively). In addition, there was a statistically significant difference when comparing the cleft area between G2 and G3 (p = 0.0346). At T2, the intergroup analysis revealed that G1 presented a statistically significant mean I-C' compared to G3 (p = 0.0461). In the I-CC' length analysis, G1 and G3 showed higher means when compared to G2 (p = 0.0039). The I-T' measurement was statistically higher in G1 than in G2 (p = 0.0251). In the intergroup growth rate analysis, G1 and G2 showed statistically significant differences in the I-C' measurement compared to G3 (p = 0.0003). In the analysis of the Atack index, there was a statistically significant difference between G1 and the other sample sets (p < 0.0001). Children who underwent surgery later showed better results in terms of the growth and development of the dental arches.

Learning carotid vessel wall segmentation in black-blood MRI using sparsely sampled cross-sections from 3D data.

Atherosclerosis of the carotid artery is a major risk factor for stroke. Quantitative assessment of the carotid vessel wall can be based on cross-sections of three-dimensional (3D) black-blood magnetic resonance imaging (MRI). To increase reproducibility, a reliable automatic segmentation in these cross-sections is essential. We propose an automatic segmentation of the carotid artery in cross-sections perpendicular to the centerline to make the segmentation invariant to the image plane orientation and allow a correct assessment of the vessel wall thickness (VWT). We trained a residual U-Net on eight sparsely sampled cross-sections per carotid artery and evaluated if the model can segment areas that are not represented in the training data. We used 218 MRI datasets of 121 subjects that show hypertension and plaque in the ICA or CCA measuring in ultrasound. The model achieves a high mean Dice coefficient of 0.948/0.859 for the vessel's lumen/wall, a low mean Hausdorff distance of , and a low mean average contour distance of on the test set. The model reaches similar results for regions of the carotid artery that are not incorporated in the training set and on MRI of young, healthy subjects. The model also achieves a low median Hausdorff distance of on the 2021 Carotid Artery Vessel Wall Segmentation Challenge test set. The proposed method can reduce the effort for carotid artery vessel wall assessment. Together with human supervision, it can be used for clinical applications, as it allows a reliable measurement of the VWT for different patient demographics and MRI acquisition settings.