Calcified Nodules Research Articles

Graphene quantum dots promote migration and differentiation of periodontal ligament stem cells.

Graphene and its derivatives have attracted much attention as nanomaterials in bone tissue engineering because of their remarkable ability to induce cell osteogenic differentiation. However, graphene quantum dots (GQDs), as graphene derivatives, little is known about their osteodifferentiation- and osteoinduction-promoting capabilities, especially in the restoration of bone defect caused by periodontitis. Therefore, there is a growing need to investigate the effect of GQDs on periodontal ligament stem cells (PDLSCs). Here, we postulated that GQDs are a promising biocompatible nanomaterial that facilitated the migration and differentiation of PDLSCs, and use laboratory methods like CCK-8, transwell experiments, qRT-PCR, Alizarin red staining and immunofluorescence staining to evaluate. Our experiments confirmed that GQDs did not inhibit cell viability, with most cells remaining viable even at GQDs concentrations of up to 30μgmL-1. Moreover, GQDs were found to significantly enhance PDLSC migration, with the peak effect observed at concentrations of 5 and 10μgmL-1. Furthermore, GQDs accelerated osteoblastic differentiation in PDLSCs and induced the mineralization of calcium nodules. Additionally, GQDs were shown to promote fibroblast differentiation in PDLSCs compared to the control group. Thus, GQDs not only possessed low cytotoxicity and good biocompatibility, but also displayed the beneficial capability to migration and differentiation of PDLSCs, which indicated GQDs might be a potential nanomaterial for bone regeneration.

Frequency of abnormal findings on chest radiograph after positive PPD in children and adolescents in an urban setting in the United States

BackgroundChest radiographs (CXR) for tuberculosis (TB) screening in children are valuable in high-burden settings. However, less certain in low prevalence contexts. In the United States, positive PPD is sufficient to treat for “latent” TB, or TB infection in asymptomatic patients. ObjectiveWe sought to determine frequency of abnormal CXR findings after a positive purified protein derivative (PPD) test at a tertiary pediatric center in the United States. MethodA retrospective evaluation was conducted of patients (0–18 years) with a CXR after a positive PPD (e.g., known exposure, employment, migratory requirements or before immunosuppression) between 2011 and 2021. Clinical information, demographics, and reason for PPD were recorded from health record. CXRs were evaluated using initial report and by a pediatric radiologist with special interest in TB and 8 years of experience. ResultOf 485 patients, median [interquartile range (IQR)] age 8.5[3.3–14.4], abnormal CXRs were described in 5 (1%). Most common reasons for PPD included: close contact with someone with TB or with high risk for TB. Most patients 373 (76.9%) received treatment for latent TB, and 111 (22.9%) no treatment. One patient (0.2%) received treatment for active disease. Radiographic findings included isolated lymphadenopathy (n = 2), consolidation (n = 1), pleural fluid/thickening (n = 1) and a patient with lymphadenopathy and a calcified nodule (n = 1). ConclusionIn our experience, prevalence of chest radiographs findings for patients with positive PPD was very low. Moreover, no cases of severe disease were seen and those with abnormal findings would not merit treatment change under current WHO guidelines.

Poor prognosis of patients with acute coronary syndrome presenting optical coherence tomography-defined calcified nodule at culprit lesions after emergent percutaneous coronary intervention

Abstract Background Optical coherence tomography (OCT) enables the diagnosis of underlying causes of acute coronary syndrome (ACS). Calcified nodule (CN) is reported to be a rare but important cause of ACS, although its prognostic impact on clinical outcomes after emergent percutaneous coronary intervention (EPCI) remains undetermined. TACTICS registry is an investigator-initiated, prospective, multicenter, observational study to be conducted at 22 hospitals in Japan to clarify the prevalence of underlying causes of ACS defined by OCT (plaque rupture [PR], plaque erosion [PE] and CN) and its impact on clinical outcomes, and assess the feasibility of OCT-guided emergent PCI (UMIN-CTR, ID 000039050). Purpose This study aimed to clarify the prevalence of CN at the culprit lesions in ACS patients and its prognostication after EPCI in a large prospective registry. Methods We assessed 702 patients enrolled in TACTICS registry who underwent OCT assessment of the culprit lesion during EPCI. Advanced chronic kidney disease (CKD) was defined as those with creatinine clearance <30 ml/min/1.73m2. The prevalence of OCT-defined CN and occurrence of MACE, defined as a composite of cardiovascular death, myocardial infarction, heart failure, or ischemia-driven unplanned revascularization at 1 year were compared between patients with and without advanced CKD. Result Patients with advanced CKD was found in 5.4% of a total cohort. The prevalence of CN was 3.0% in patients with non-advanced CKD and 21.1% in those with advanced CKD (p<0.001). In advanced CKD, MACE occurred most frequently in patients with CN (87.5%), followed by plaque rupture (11.8%) and plaque erosion (10.0%) (p<0.001). In Cox hazard analysis, CN was a significant predictor for MACE in advanced CKD (hazard ratio [HR], 12.94 (3.31-50.67), p<0.001). In contrast, CN was not significant predictor for MACE in non-advanced CKD (HR1.931 (0.706-5.281), p=0.200). Conclusion CN is significantly more frequently found at the culprit lesions of ACS in advanced CKD patients. CN was associated with poor outcome in advanced CKD patients.

Poor prognosis after successful primary PCI in STEMI patients with calcified nodule

Abstract Background The prognostic impact of the underlying causes of ST-elevation myocardial infarction (STEMI) diagnosed by optical coherence tomography (OCT) has not been systematically examined in real-world settings. Methods We executed a post-hoc analysis of the TACTICS/TACTICS background registry, an investigator-initiated, multicenter, observational study conducted at 22 Japanese hospitals, involving 1046 STEMI patients (symptom onset within 24 hours) who underwent primary PCI included 441 patients with OCT-guidance. Underlying causes of STEMI (plaque rupture [PR], plaque erosion [PE] and calcified nodule [CN]) were identified in 338 patients using established OCT definition at independent core-laboratory. Major adverse cardiac events (MACE: cardiovascular death, MI, heart failure, or ischemia-driven revascularization) at 1 year were adjudicated by an independent clinical event committee. Results Of 1046 patients with STEMI, 441 (42.2%) underwent OCT-guided primary PCI deemed for analysis. TIMI 3 flow grade was obtained in 95.0% of patients on final angiogram, and optimal post-PCI OCT findings (minimum lumen area ≥4.5 mm2 or ≥70% of the mean reference lumen area) was achieved in 77.9%. The prevalence of PR, PE, and CN was 68.3%, 24.2%, and 3.7%, respectively. One-year MACE occurred most frequently in patients with CN (31.2%), then PR (14.0%) and PE (2.8%) (log-rank P<0.0001). On multivariate Cox regression analysis, the underlying ACS cause was associated with 1-year MACE (CN [HR 9.98, 95%CI 1.99–50.1, p=0.005]; PR [HR 4.84, 95%CI 1.49–15.7, p=0.009]; PE as reference). Conclusion OCT-guided primary PCI for STEMI patients seemed feasible for optimizing PCI and stratifying risk for future MACE.Figure

Predictors of optical coherence tomography-defined calcified nodules in patients with acute coronary syndrome: a substudy from TACTICS registry

Abstract Background We investigated the clinical predictors of optical coherence tomography (OCT)-defined calcified nodules (CN) in patients with acute coronary syndrome in a prospective multicenter registry. Methods We investigated 695 patients enrolled in TACTICS registry who underwent OCT assessment of the culprit lesion during primary percutaneous coronary intervention. OCT-CN was defined as eruptive calcific nodules into the lumen with disruption of the fibrous cap and an underlying calcified plate. Patient characteristics were compared between patients with and without OCT-CN. Results OCT-CN was detected in 28 patients (4.0%). Patients with OCT-CN were older (75.0 ± 11.3 vs. 65.7 ± 12.7 years, p < 0.001) and had a higher prevalence of diabetes mellitus (50.0% vs. 29.4%, p = 0.034), hemodialysis (21.4% vs. 1.6%, p < 0.001) and heart failure (Killip 3/4, 21.4% vs. 5.7%, p = 0.003) than patients without OCT-CN. The angiographic SYNTAX score was higher in patients with OCT-CN than those without (median, 15 [interquartile range, 11, 25] vs. 11 [7, 19], p = 0.003). Multivariable analysis demonstrated that age (odds ratio [OR], 1.072; 95% confidence interval [CI], 1.033–1.116; p < 0.001), Killip class 3/4 (OR, 4.466; 95% CI, 1.472–11.943; p = 0.004) and hemodialysis (OR, 16.571; 95% CI, 4.946–52.863; p < 0.001) were significantly associated with the presence of OCT-CN. In non-dialysis patients (n=678), age (OR, 1.081; 95% CI, 1.035–1.135; p < 0.001), Killip class 3/4 (OR, 4.414; 95% CI, 1.327–12.709; p = 0.009) and diabetes mellitus (OR, 3.046; 95% CI, 1.251–7.594; p = 0.014) were significantly associated with the presence of OCT-CN. Conclusions TACTICS registry demonstrated the clinical predictors of OCT-CN, which may be associated with worse prognosis.

Mechanisms of very late stent thrombosis assessed by optical coherence tomographyin japanese patients

Abstract Background Although very late stent thrombosis (VLST) remains an important concern, the underlying etiology and clinical characteristics are not fully elucidated in Japanese patients who daily undergo intravascular imaging-guided percutaneous coronary intervention (PCI). Objectives The aim of this study was to explore the mechanisms of VLST in bare metal stents (BMSs) and drug eluting stents (DESs) in Japanese patients. Methods We identified 50 VLST lesions (BMS [n=16], 1ST generation DES [n=14], newer generation DES [n=20]) in patients managed in our institutes. The underlying mechanism of VLST was assessed by optical coherence tomography (OCT) and the major etiology of each lesion was determined. Results The median duration following stent implantation was 10 (range 1–20) years. The most frequent etiology of VLST was neoatherosclerotic rupture (44%) followed by neointimal erosion (24%). Edge disease (10%) and evagination (10%) were similarly observed. Malapposition (8%) was mostly acquired late by going back to the index procedure. Uncovered strut (2%) and in-stent calcified nodule (2%) were the least frequent etiologies. Regardless of etiology, signs of neoatherosclerosis were present in most (82%) lesions. Most patients received single (68%) or dual (8%) antiplatelet therapy or oral anticoagulation alone (4%), whereas considerable proportion of patients stopped any medication (20%). Regarding the treatment strategy, drug-coated balloon was the most frequent strategy (56%), followed by newer DES implantation (34%). Conclusion The mechanisms underlying VLST in Japanese patients were unique, with neoathersclerotic rupture and neointimal erosion accounting for two-thirds of cases of VLST. In these patients, biological responses seemed to be more relevant rather than index procedure-related factors.

A novel mouse model for mineral homeostasis disrupting induced calcific aortic valve stenosis

Abstract Background Calcific aortic valve disease (CAVD) is the most common valve disease that has been occurring with rapidly increasing morbidity. Chronic kidney disease (CKD) which disrupts mineral homeostasis due the impaired renal function, is one of the known factors, largely contributing to risk of CAVD, independent of atherosclerosis. To the best of our knowledge, there are few calcific aortic valve stenosis mouse models simulating conditions under CKD that develop hemodynamically significant stenosis as well as calcification, Purpose The purpose was to assess the feasibility to develop a mouse model of CAVD considering risks under CKD. Methods For this model, C57/BL6 mice were firstly underwent aortic valve wire injury by spring guidewires inserting into left ventricle via right common carotid artery. Vitamin D was subcutaneous injected on 3 consecutive days from the second day of aortic valve wire injury. Echocardiography was performed to evaluate aortic valve function at 7, 14 and 28 days. Then the mice were sacrificed and aortic valves were collected to make histological analysis. Results An obvious increase in aortic velocity was already observed at 7 days after injury by continuous echocardiographic assessment and remained stable from 14 days compared with sham mice. Alizarin red staining showed calcium nodules formation in valve leaflets 14 days after injury and became more conspicuous at 28 days. Aortic valve thickening, increased macrophage infiltration, fibrosis and remarkable osteogenic markers were found in aortic valves at 28 days after injury. Conclusions We develop a novel mouse model of CAVD, especially simulating risks under CKD and mineral homeostasis disrupting. This model may be a convenient and valuable tool to investigate the mechanism of CAVD and further explore potential therapeutic strategies.Fig1.Alizarin red staining aortic valvesFig2.Immunostaining of aortic valves

Abstract 19038: Insights of Optical Coherence Tomography Into the Safety and Efficacy of Coronary Intravascular Lithotripsy for Calcified Nodule Modification During Percutaneous Coronary Intervention

Background: Among calcified lesions, nodular calcium is the most challenging subset to deal with during percutaneous coronary intervention (PCI), as there are limited options available for its modification. This study was done to assess the safety, efficacy and impact of coronary intravascular lithotripsy (IVL) on calcified nodule (CN) using optical coherence tomography (OCT). Methods: A total of 17 patients with 40 CN undergoing PCI using coronary intravascular lithotripsy were prospectively enrolled in the study. OCT parameters studied were pre-IVL minimum lumen area (MLA), calcium (Ca) score, number of CN, proximal and distal reference diameter, post-IVL gain in MLA, calcium fracture, major dissection, post-PCI minimum stent area (MSA), stent expansion, apposition, edge dissection and spherical index at CN. Spherical index was calculated by dividing the shortest and longest diameter at CN after stent placement. The primary safety endpoint was freedom from major adverse cardiovascular events (death, MI and target vessel revascularization) during hospitalisation and at 30 days. Primary efficacy endpoints were gain in MLA after stent placement and stent expansion. Results: Pre-IVL mean MLA at CN was 3.87±2.25mm 2 , Ca score was 3.94±0.24, Ca arc 190.59±54.02 o , Ca depth 0.97±0.31mm, Ca length 22.73±9.87mm and CN height-1.04±0.30 mm. All 17 (100%) patients developed Ca fractures, post-IVL MLA at CN was 5.20±2.31mm 2 , CN height 0.83±0.19mm and luminal gain at CN was 0.76 ± 1.71mm 2 . 10 (58.8%) patients developed fractures at base of CN and rest developed fractures at apex. Patients with fractures at base showed decrease in luminal area after IVL due to luminal shift of nodule, but all these patients had good stent expansion, likely due to Ca softening. Post-IVL OCT showed minor dissections in 5 (29.4%) and major in 3 (17.6%) patients. There was no perforation, slow flow or abrupt vessel closure. Stent expansion and MSA at CN was 107.12 ± 18.98% and 8.57±2.54 mm 2 respectively with spherical index of 0.83±0.12. All patients were free of MACE during hospitalization and at 30 days. Conclusion: Coronary intravascular lithotripsy is safe and effective for modification of coronary calcified nodules during percutaneous coronary intervention.

Abstract 18938: Identification and Diagnosis of Culprit Lesions by Optical Coherence Tomography (OCT) in Patients With Non-ST Elevated Acute Coronary Syndromes

Introduction and Hypothesis: Optical coherence tomography (OCT) is a reliable imaging modality for plaque characterization in patients with acute coronary syndromes (ACS). While numerous studies have provided insight into the utility of OCT in ST-elevated ACS patients, our study sought to evaluate the frequency and morphological characters of lesions in patients with non-ST elevated acute coronary syndromes (Unstable angina (UA) and Non-ST elevated myocardial infarction (NSTEMI)). Methods: This multi-center, observational study included 170 patients admitted with a working diagnosis of NST-elevated ACS from October 2021 to January 2023. OCT imaging was obtained during coronary angioplasty for lesion characterization and morphology. Frequencies were compared between UA and NSTEMI sub-groups. Results: OCT imaging in patients with non-ST elevated acute coronary syndromes showed plaque erosion in 46% (n= 78), plaque rupture in 35% (n= 60), tight stenosis in 13% (n= 22), and calcified nodules in 6% (n= 10). Sub-group comparative analysis showed a statistically significant increase in plaque erosion in NSTEMI compared to UA (p<0.005), while tight stenosis was significantly more common in UA (p=0.017). Morphological analysis showed a high presence of calcified nodules and red thrombus in NSTEMI patients compared to UA patients (p<0.005). Conclusions: Our study concluded that optical coherence tomography is reliable in identifying and characterizing lesions in patients with non-ST elevated ACS. NSTEMI patients have a higher occurrence of plaque erosion, plaque rupture, calcified nodules, and red thrombus than patients with unstable angina.

Comparing Predictors Influencing Restenosis Following High-Dose Drug-Coated Balloon Angioplasty and Fluoropolymer-Based Drug-Eluting Stenting in Femoropopliteal Artery Lesions.

Despite widespread use of anti-restenosis devices, drug-coated balloons (DCBs) and drug-eluting stents (DESs), their appropriate use for femoropopliteal (FP) lesions has not been well investigated and the risk factors for restenosis have not been compared. To investigate risk factors associated with restenosis after endovascular therapy using DCB and DES for contemporary FP lesions. This single-center, retrospective, observational study evaluated 378 FP lesions in 273 patients treated with DCB (278 lesions in 193 patients) or DES (120 lesions in 106 patients). The DCB used was high-dose DCB (IN.PACT, Admiral. Medtronic, Inc.) and DES was fluoropolymer-based DES (ELUVIA, Boston Scientific). Vessel preparation failure was defined as a residual stenosis of ≥50% and a dissection grade of D or greater on pre-dilatation angiography. The outcome measure was restenosis, and factors associated with restenosis in the DCB and DES groups were assessed using a Cox proportional hazards model. The 2-year restenosis rate was not significantly different between the DCB and DES groups (29%±4% vs. 24%±5%, p=0.42). Interaction analysis demonstrated that popliteal lesions and plaque burden of ≥50% were restenosis-related factors for DES but not for DCB, whereas vessel preparation failure was a factor for DCB but not for DES (p<0.05). Vessel diameter of <6 mm and nodular calcification were risk factors in both groups (p<0.05). In contemporary FP lesions, smaller vessels and nodular calcification were shared restenosis-related factors for high-dose DCB and fluoropolymer-based DES. Popliteal lesions and plaque burden of ≥50% were restenosis-related factors for fluoropolymer-based DES and vessel preparation failure for high-dose DCB. Shared and differential restenosis-related factors after endovascular therapy using high-dose drug-coated balloons (DCBs) and fluoropolymer-based drug-eluting stents (DESs) in contemporary femoropopliteal (FP) lesions are unclear. This single-center retrospective study included 378 FP lesions in 273 patients with lower-extremity arterial disease (high-dose DCB, 278 lesions in 193 patients; fluoropolymer-based DES, 120 lesions in 106 patients). Smaller vessels and calcified nodules were shared restenosis-related factors for both high-dose DCB and fluoropolymer-based DES, whereas popliteal lesions and plaque burden of ≥50% were restenosis-related factors for fluoropolymer-based DES and vessel preparation failure for high-dose DCB.

Abstract 13212: Prevention of Delayed Coronary Obstruction Following Transcatheter Aortic Valve Replacement Using Intravascular Ultrasound and "Modified" Snorkeling Stent Technique

Introduction: Coronary obstruction (CO) is a potentially fatal complication that can occur after transcatheter aortic valve replacement (TAVR). Here we report a successful management of a TAVR patient at risk of delayed CO using intravascular ultrasound (IVUS) and a "modified" snorkeling stent technique. Case presentation: An 88-year-old woman presented with severe symptomatic aortic stenosis. Despite the left coronary artery (LCA) being not low, a Multidetector Computed Tomography scan identified a relatively long leaflet of the left coronary cusp (LCC) and a calcified nodule on the cusp (Figure 1A), indicating a high CO risk. A transfemoral TAVR was conducted using a 26mm Evolut FX (Medtronic, IL, USA) protecting the LCA with a 6-F Judkins left (JL) 4.0 guiding catheter, a 0.014 inch coronary guide wire, and a guide-extension catheter. Upon reaching the point of no recapture, LCA blood flow was maintained, and hemodynamics was stable. However, IVUS revealed the calcified nodule on the LCC was close to the left main (LM) ostium (Figure 1B), indicating a high risk of delayed CO.We continued and completed the prosthesis deployment protecting the LCA. Following the deployment, We introduced another guiding catheter (6-F JL3.5) into the prosthesis and engaged it with the LCA via the prosthesis frame, utilizing a double-guiding catheter technique. Subsequently, we placed a coronary stent from the LM to the prosthesis (Figure 1C). After the TAVR procedure, we verified that a JL3.5 catheter could easily engage the implanted coronary stent (Figure 1F). This "modified" snorkeling stent technique appears feasible and provides easier coronary access compared to the "Chimney" snorkeling stent technique.

Rapid Batch Surface Modification of 3D-Printed High-Strength Polymer Scaffolds for Enhanced Bone Regeneration In Vitro and In Vivo

In the emergency treatment of acute injuries in orthopedics, 3D-printing technology shows great promise due to its ability to rapidly and mass production of implants with complex structures. However, further surface modification on 3D-printed implants can often be complicated and time-consuming, leading to a prolonged timeframe from manufacturing to implantation. Therefore, there is an urgent need for rapid batch surface modification technology that can be effectively integrated with 3D-printing technology within the field of orthopedics. In this study, air-plasma treatment was used to rapidly modify 3D-printed polyetherimide (PEI) porous scaffolds and compared it with sulfonation treatment. Both methods achieved rapid surface modification of complex porous scaffolds in seconds to minutes (10 minutes), helping establish a cell-friendly surface morphology that encourages osteogenesis. Some new functional groups such as -OH and -SO3H were also introduced to promote osteogenesis. Interestingly, the air-plasma treated group enhanced cell adhesion, as indicated by a 1.6-fold increase in the number of cells compared to the control group. While sulfonation treatment accelerated the osteogenesis process, evidenced by a 1.7-fold increase in the number of calcium nodules in the sulfonation treated group compared to the control group in 7 days. To combine the advantages of air-plasma treatment and sulfonation treatment, the biological properties of their combined application were studied in vitro and in vivo for the first time. It was surprising to find that the combined application actually decreased the biological property of the material, which was associated with the generation of new free radicals. The results of this study will hopefully be applied to the rapid batch surface modification in 3D-printed porous implants to enhance their biological activity and improve the efficiency from manufacturing to implantation.

Plaque histological characteristics in individuals with sudden coronary death

Coronary artery disease (CAD) remains the leading cause of death in the Western world in individuals >20 years of age. CAD is the most common substrate underlying sudden cardiac death (SCD) in the Western world, being responsible for 50–75% of SCDs. In individuals dying suddenly with coronary thrombosis, plaque rupture occurs in 65%, plaque erosion in 30% and calcified nodule in 5%. We evaluated the extent of calcification in radiographs of hearts from patients dying of SCD and showed that calcification is absent in nearly 50% of erosion cases whereas only 10% of plaque rupture show no calcification. Conversely, stable plaques with >75% cross-sectional area luminal narrowing show the severest calcification (moderate to severe) in nearly 50% of cases. Identifying individuals who are susceptible to atherosclerosis may help reduce the incidence of SCD. The identification of coronary calcifications by noninvasive tools, however, only captures a fraction of complicating coronary lesions.

Tracheobronchopathia osteochondroplastica: a case report highlighting the importance of clinico-radiologic correlation

Tracheobronchopathia osteochondroplastica (TBPO) is a rare and benign idiopathic disease of the tracheobronchial tree, characterized by osseous, and/or cartilaginous submucosal nodules involving the anterior and lateral walls of the airways with sparing of the posterior wall. We present a case of a 51-year-old non-smoker female, presenting with a 2-year history of gradually enlarging anterior neck mass with foreign body sensation, frequent throat clearing, and occasional hoarseness. She was initially diagnosed with recurrent respiratory papillomatosis due to the presence of nodules on flexible laryngoscopy. A plain neck and chest CT then showed irregularity of the tracheal walls with calcified nodules projecting into the lumen, sparing the posterior wall, consistent with TBPO. Fiberoptic bronchoscopy with biopsy was also done which confirmed the inferior extent of the nodules down to the level of the carina, and the presence of fragments of mature bone tissue within the nodules.

Differential diagnosis of eyelid tumors in children: subepidermal calcified nodule

Differential diagnosis of eyelid tumors in children: subepidermal calcified nodule

Automatic Detection of Thyroid Nodule Characteristics From 2D Ultrasound Images.

Thyroid cancer is one of the common types of cancer worldwide, and Ultrasound (US) imaging is a modality normally used for thyroid cancer diagnostics. The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TIRADS) has been widely adopted to identify and classify US image characteristics for thyroid nodules. This paper presents novel methods for detecting the characteristic descriptors derived from TIRADS. Our methods return descriptions of the nodule margin irregularity, margin smoothness, calcification as well as shape and echogenicity using conventional computer vision and deep learning techniques. We evaluate our methods using datasets of 471 US images of thyroid nodules acquired from US machines of different makes and labeled by multiple radiologists. The proposed methods achieved overall accuracies of 88.00%, 93.18%, and 89.13% in classifying nodule calcification, margin irregularity, and margin smoothness respectively. Further tests with limited data also show a promising overall accuracy of 90.60% for echogenicity and 100.00% for nodule shape. This study provides an automated annotation of thyroid nodule characteristics from 2D ultrasound images. The experimental results showed promising performance of our methods for thyroid nodule analysis. The automatic detection of correct characteristics not only offers supporting evidence for diagnosis, but also generates patient reports rapidly, thereby decreasing the workload of radiologists and enhancing productivity.

Preparation, properties and in vitro osteogensis of self-reinforcing injectable hydrogel

As an attractive biomaterial for bone reconstruction, injectable biomaterials have many prominent characteristics such as good biocompatibility and bone-filling ability. However, there are weak as load-bearing scaffolds. In this study, polyvinyl alcohol (PVA) and bioactive glass (BAG) were interpenetrated into sodium alginate (SA) network to obtain self-enhanced injectable hydrogel. The optimum ratio of PVA/SA/BAG hydrogel was determined based on injectability, gelation time and chemical characterization. Results showed that the selected ratio had the shortest gelation time of 3.5min, and the hydrogel had a rough surface and good coagulation property. The hydrogel was capable of carrying 1kg of weight by mineralization for 14 d The compressive strength, compressive modulus, and fracture energy of the hydrogel reached 0.12MPa, 0.376MPa and 17.750kJ m−2, respectively. Meanwhile, the hydrogel had high moisture content and dissolution rate, and it was sensitive to temperature and ionic strength. Hydroxyapatite was generated on the hydrogel surface, and the hydrogel pores increased, and the pore size enlarged. The biocompatibility of PVA/SA/BAG hydrogel was analyzed using hemolysis and cytotoxicity assays. Results revealed its good biocompatibility with low hemolysis rate and no cytotoxicity to MC3T3-E1 cells. The hydrogel was also found to promote the differentiation of MC3T3-E1 cells with significantly increased in ALP activity and expression of relevant differentiation factors. In vitro mineralization assay showed an increase in calcium nodules and calcification area, indicating the ability of hydrogel to promote mineralization MC3T3-E1 cells. These findings indicated that PVA/SA/BAG hydrogel had potential uses in the field of irregular bone-defect repair due to its injectability, cytocompatibility, and tailorable functionality.

Low-energy LED red light inhibits the NF-κB pathway and promotes hPDLSCs proliferation and osteogenesis in a TNF-α environment in vitro.

There are few studies on the effect of low-energy LED red light on periodontal tissue regeneration in an inflammatory environment. In this study, Cell Counting Kit-8(CCK-8) assays were used to detect the effects of TNF-α at three different concentrations (0, 10ng/ml, and 20ng/ml) on the proliferation of human periodontal ligament stem cells (hPDLSCs), and 10ng/ml was selected as the subsequent experimental stimulation concentration. CCK-8 assays were used to detect the effect of LED red light with energy density of 1J/ cm2, 3J/ cm2, and 5J/cm2 on the proliferation of hPDLSCs. The promotion effect of energy density of 5J/cm2 on the proliferation of hPDLSCS was the most obvious (p < 0.05). Set CON group, ODM group, ODM + 10ng/ml TNF-α group, and ODM + 10ng/ml TNF-α + 5J/ cm2 LED red light group. Alkaline phosphatase staining and activity detection, alizarin red staining and calcium nodules quantitative detection of osteoblast differentiation products, real-time fluorescence quantitative PCR detection of osteoblast gene expression (Runx2, Col-I, OPN, OCN). The results showed that ODM showed the strongest osteoblast ability, followed by ODM + 10ng/ml TNF-α + 5J/ cm2 LED red light group. The osteoblast ability of ODM + 10ng/ml TNF-α was decreased, but was not found in CON group. Western blot was used to detect the expression of NF-κB pathway protein and osteoblast-related proteins (Runx2, Col-I, OPN, OCN) after addition of PDTC inhibitor. The results showed that the expression of p-IκBα was increased and the expression of IκBα was decreased (p < 0.05). The expression of osteoblast protein increased after the addition of inhibitor (p < 0.05). Therefore, in an inflammatory environment constructed by 10ng/ml TNF-α, 5J/cm2 LED red light can upregulate the proliferation and osteogenesis of hPDLSCs by inhibiting NF-κB signaling pathway.

Building a model for the differential diagnosis of non-tuberculous mycobacterial lung disease and pulmonary tuberculosis: A case-control study based on immunological and radiological features

BackgroundAlthough the incidence of non-tuberculous mycobacterial pulmonary disease (NTM-PD) is increasing annually, it is easily misdiagnosed as pulmonary tuberculosis (PTB). This study aimed to screen and identify the immunological and radiological characteristics that differentiate NTM-PD from PTB and to construct a discriminatory diagnostic model for NTM-PD, providing new tools for its differential diagnosis. MethodsHospitalised patients diagnosed with NTM-PD or PTB between January 2019 and June 2023 were included in the study. Immunological and radiological characteristics were compared between the two groups. Based on the selected differential features, a logistic regression algorithm was used to construct a discriminatory diagnostic model for NTM-PD, and its diagnostic performance was preliminarily analysed. ResultsPatients with NTM-PD were significantly older than those with PTB and the tuberculosis-specific interferon-gamma release assay (TB-IGRA) positivity rate was significantly lower in the NTM-PD group. Moreover, the absolute counts of total T lymphocytes, CD4+ T lymphocytes, CD8+ T lymphocytes, NK cells, and B lymphocytes were significantly lower in patients with NTM-PD and PTB than in healthy controls. Additionally, patients with NTM-PD had a significantly lower absolute count of B lymphocytes than the PTB group. Radiological analysis revealed significant differences between patients with NTM-PD and PTB in terms of cavity wall thickness, bronchial dilation, lung consolidation, pulmonary nodule size, pulmonary emphysema, lung bullae, lymph node calcification, pleural effusion, mediastinal and hilar lymphadenopathy, and the tree-in-bud sign. Bronchial dilation was identified as the predominant risk factor of NTM-PD, whereas TB-IGRA positivity, lymph node calcification, pleural effusion, and mediastinal and hilar lymphadenopathies were protective factors. Based on this, we constructed a discriminatory diagnostic model for NTM-PD. Its receiver operating characteristic curve demonstrated good diagnostic performance, with an area under the curve of 0.938. At the maximum Youden index of 0.746, the sensitivity and specificity were 0.835 and 0.911, respectively. ConclusionsPatients with NTM-PD and PTB exhibited impaired humoral and cellular immune functions as well as significant differences in radiological features. The constructed NTM-PD diagnostic model demonstrated good diagnostic performance. This study provides a new tool for the differential diagnosis of NTM-PD.

Effects of tension on mitochondrial autophagy and osteogenic differentiation of periodontal ligament stem cells.

This study aimed to explore the osteogenic ability and mitochondrial autophagy of periodontal ligament stem cells (PDLSCs) under cyclic tensile stress (CTS). Primary PDLSCs were isolated from the periodontal membrane and cultured by passage. Alizarin red staining, alkaline phosphatase detection, reverse transcription polymerase chain reaction (RT-PCR), and Western blotting were used to detect the osteogenic differentiation level of PDLSCs. Mitochondrial autophagy in PDLSCs after CTS was measured using a mitochondrial autophagy detection kit, and the expression levels of autophagy-related proteins LC3B, LAMP1 and Beclin1 were measured using cellular immunofluorescence technology, RT-PCR and Western blot. After applying CTS, the osteogenic differentiation ability of PDLSCs was significantly improved, and the expression of alkaline phosphatase on the surface of the cell membrane and the formation of calcium nodules in PDLSCs were significantly increased respectively. We also studied the relevant mechanism of action and found that applying CTS can promote the osteogenic differentiation of PDLSCs and is related to the activation of mitochondrial autophagy. This study provides new insights into the mechanism of increased osteogenic differentiation on the tension side of orthodontic teeth and provides new experimental evidence for the involvement of mitochondrial autophagy in the regulation of osteogenic differentiation.