Different Types Of Lesions Research Articles

Comparison between observer-based and AI-based reading of CBCT datasets: An interrater-reliability study

ObjectiveTo assess the performance of human observers and convolutional neural networks (CNNs) in detecting periodontal lesions in cone beam computed tomography (CBCT), a total of 38 datasets were examined. Three human readers and a CNN-based solution were employed to evaluate the presence of periodontal pathologies in these datasets. Materials and MethodsDatasets were acquired with a Veraview X800 L P (JMorita Mfg. Corp., Kyoto, Japan). Three general dentists, previously calibrated by a general principal investigator, read the datasets in 3D MPR mode using Horos(LGPL license at Horosproject.org and sponsored by Nimble Co LLC d/b/a Purview in Annapolis, MD, USA) as a DICOM reader. All pathological changes including vertical bone loss, furcation involvement, and periradicular osteolysis were detected. Furthermore, the same datasets were analyzed automatically by Diagnocat (Diagnocat LLC, Prague, Czech Republic), a deep CNN. Finally, the performance of the dentists and the CNN were compared and evaluated. ResultsThe CNN’s performance was significantly lower compared to the human readers in the search for different types of lesions. The human observers achieved good to very good interobserver agreement, except for the evaluation of the vertical lesions, which resulted in a moderate agreement. ConclusionThe CNN used in this study was found to be ineffective in identifying periodontal lesions and was not adequately trained to offer significant assistance in the automated evaluation of periodontal lesions in CBCT datasets.

P01.01.A THE IMPACT OF BRAIN LESIONS ON HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH WHO CNS GRADE 3 OR 4 GLIOMA: A LESION-FUNCTION AND RESTING-STATE FMRI ANALYSIS

Abstract BACKGROUND In glioma patients, tumor development and multimodality therapy are associated with changes in health-related quality of life (HRQoL). It is largely unknown how different types and locations of tumor- and treatment-related brain lesions, as well as their relationship to white matter tracts and functional brain networks, affect HRQoL. MATERIAL AND METHODS In 121 patients with pretreated gliomas of WHO CNS grades 3 or 4, structural MRI, O-(2-[18F]fluoroethyl)-L-tyrosine (FET) PET, resting-state functional MRI (rs-fMRI) and self-reported HRQoL questionnaires (EORTC QLQ-C30/BN20) were obtained. Resection cavities, T1-enhancing lesions, T2/FLAIR hyperintensities, and lesions with pathologically increased FET uptake were delineated. Effects of tumor lateralization, involvement of white matter tracts or resting-state network nodes by different types of lesions and within-network rs-fMRI connectivity were analyzed in terms of their interaction with HRQoL scores. RESULTS Right hemisphere gliomas were associated with significantly less favorable outcomes in physical, role, emotional and social functioning, compared with left-sided tumors. Most functional HRQoL scores correlated significantly with right-sided white-matter tracts involvement by T2/FLAIR hyperintensities and with loss of within-network functional connectivity of right-sided nodes. Tumors of the left hemisphere caused significantly more communication deficits. CONCLUSION In pretreated high-grade gliomas, right hemisphere lesions are associated with reduced HRQoL scores in most functional domains except communication ability, compared to tumors of the left hemisphere. These relationships are mainly observed for T2/FLAIR lesions involving structural and functional networks in the right hemisphere. The data suggest that sparing the right hemisphere from treatment-related tissue damage may improve HRQoL in glioma patients.

Early Bronze Age violence in Ojo Guareña (Merindad de Sotoscueva, Burgos, Spain). Perimortem modifications in two male individuals

This paper analyses the taphonomic modifications of the human remains identified within Cueva Palomera, the main entrance to Ojo Guareña karstic system (Merindad de Sotoscueva, Burgos, Spain). The human skeletons were found deposited over the cave floor of two high, narrow and hard-to-reach sectors called Terraza del Enterramiento de la Galería Principal and Galería Sepulcral de la Sima Dolencias. Both sites represent primary depositions, in anatomical association and preserved partial joints but without grave goods. These humans are directly dated between 2000–1750 cal BC, suggesting that both events took place within a short time frame during the Early Bronze Age. The anthropological and taphonomic studies show that two adult male individuals suffered different types of lesions in their cranium, clavicle, and ribs, including traumatisms and cut marks. Taphonomic techniques have identified diagenetic and biostratinomic modifications, helping the assessment of their postmortem and perimortem interval. The morphological features of these modifications confirm that both individuals suffered lesions performed during the perimortem interval, suggesting their likely cause of death. The concentration of the injuries and the contemporaneity of both individuals are coherent with intentional anthropic action, indicating that they could result from a violent conflict.

Teeth Lesion Detection Using Deep Learning and the Internet of Things Post-COVID-19.

With a view of the post-COVID-19 world and probable future pandemics, this paper presents an Internet of Things (IoT)-based automated healthcare diagnosis model that employs a mixed approach using data augmentation, transfer learning, and deep learning techniques and does not require physical interaction between the patient and physician. Through a user-friendly graphic user interface and availability of suitable computing power on smart devices, the embedded artificial intelligence allows the proposed model to be effectively used by a layperson without the need for a dental expert by indicating any issues with the teeth and subsequent treatment options. The proposed method involves multiple processes, including data acquisition using IoT devices, data preprocessing, deep learning-based feature extraction, and classification through an unsupervised neural network. The dataset contains multiple periapical X-rays of five different types of lesions obtained through an IoT device mounted within the mouth guard. A pretrained AlexNet, a fast GPU implementation of a convolutional neural network (CNN), is fine-tuned using data augmentation and transfer learning and employed to extract the suitable feature set. The data augmentation avoids overtraining, whereas accuracy is improved by transfer learning. Later, support vector machine (SVM) and the K-nearest neighbors (KNN) classifiers are trained for lesion classification. It was found that the proposed automated model based on the AlexNet extraction mechanism followed by the SVM classifier achieved an accuracy of 98%, showing the effectiveness of the presented approach.

The roles of non-productive complexes of DNA repair proteins with DNA lesions

A multitude of different types of lesions is continuously introduced into the DNA inside our cells, and their rapid and efficient repair is fundamentally important for the maintenance of genomic stability and cellular viability. This is achieved by a number of DNA repair systems that each involve different protein factors and employ versatile strategies to target different types of DNA lesions. Intriguingly, specialized DNA repair proteins have also evolved to form non-functional complexes with their target lesions. These proteins allow the marking of innocuous lesions to render them visible for DNA repair systems and can serve to directly recruit DNA repair cascades. Moreover, they also provide links between different DNA repair mechanisms or even between DNA lesions and transcription regulation. I will focus here in particular on recent findings from single molecule analyses on the alkyltransferase-like protein ATL, which is believed to initiate nucleotide excision repair (NER) of non-native NER target lesions, and the base excision repair (BER) enzyme hOGG1, which recruits the oncogene transcription factor Myc to gene promoters under oxidative stress.

Angiographic classification of pulmonary vascular lesion in Takayasu arteritis: A cohort study

BackgroundPercutaneous transluminal pulmonary angioplasty (PTPA) can significantly improve the haemodynamics and prognosis of patients with Takayasu arteritis and pulmonary artery involvement. However, the choice of PTPA is mainly based on clinical experience. We aim to classify pulmonary artery lesions in Takayasu arteritis according to pulmonary angiogram and evaluate the PTPA success rate and technical difficulty of different types of lesions. MethodsWe enrolled consecutive patients diagnosed with Takayasu arteritis and pulmonary artery involvement. Patients who underwent pulmonary angiography were included. ResultsA total of 365 pulmonary vascular lesions were observed in 63 patients based on pulmonary angiography. According to morphology, distal blood flow of the lesions and PTPA treatment success rate, we classified the pulmonary arterial lesions into 4 groups: type A, stenosis; type B, dilation; type C, subtotal occlusion; type D, total occlusion. Total occlusion was further subclassified as D1, cone-shape occlusion; D2, pocket-like occlusion; and D3, ostium occlusion. The success rate of PTPA was higher in stenosis and subtotal occlusion, whereas ostium occlusion had the lowest success rate. The 2-year survival rate was 97.3% in patients who underwent PTPA. ConclusionsThe morphology of pulmonary lesions in Takayasu arteritis had a significant impact on the PTPA success rate. The failure rate and technical difficulty of PTPA increased in the following order: stenosis, dilation, subtotal occlusion, and total occlusion. Our classification scheme could guide the performance of PTPA for pulmonary artery lesions in Takayasu arteritis.

Long-term Outcomes and Effectiveness of Treatment Methods for Vertebral Osteomyelitis With Different Types of Lesions According to the E. Pola Classification

Background. Treatment of vertebral osteomyelitis (VO) is accompanied by a number of organizational and tactical problems related to the multidisciplinary nature of the disease. Therefore, the use of classifications determining treatment tactics is necessary. The evaluation of treatment outcomes and efficacy should be conducted in accordance with the classification type of the lesion and decisions made based on the tactical algorithm.
 Aim of the study to identify the dependence of long-tenn treatment outcomes of vertebral osteomyelitis on the type of lesion according to the modified Russian version of the E. Pola classification and the methods of treatment used.
 Methods. The study analyzed the treatment results of 266 patients with vertebral osteomyelitis from 2006 to 2019. Type A lesions accounted for 24.1% (n = 64), type B 47.0% (n = 125), type C 26.3% (n = 70), and lesions of vertebral processes 2.6% (n = 7). Neurological disorders were detected in 53 observations (type C). Conservative treatment, debridement, and reconstructive surgeries were perfonned. The evaluation of results was carried out a year or more after discharge.
 Results. The maximum effectiveness of conservative treatment was noted in uncomplicated courses and minor bone destruction. Conservative treatment of type A lesions led to recovery in 97.4% of cases compared to reconstructive operations (p = 0.002) and recurrences (p = 0.034). Mortality was higher after reconstructive interventions (p = 0.001). The highest number of fatal outcomes after debridement of the focus was observed in type B lesions 15.8% (p = 0.022). Analysis of type C lesions did not reveal significant differences between the methods of treatment used. The maximum number of unsatisfactory results was registered in patients with sepsis: mortality was 17.4%, and in its absence 4.9% (p = 0.039), recurrences 21.7% versus 7.8% (p = 0.043), recovery 56.6% versus 83.5% (p = 0.004), respectively. There were no significant differences in the assessments according to the ODI, NDI, SF-36 scales in the long tenn. The overall survival rate was 84.4%, and the long-tenn one was 90.4%, which increased with conservative treatment compared to reconstructive interventions (p = 0.045).
 Conclusion. Conservative treatment and extra-focal fixation of the spine showed maximum effectiveness in low-destructive and uncomplicated lesions (type A). Reconstructive interventions lead to an increase in the number of recurrences and fatal outcomes. Debridement of the focus in septic course of type В lesions leads to an increase in hospital mortality. There were no statistically significant differences between the results of different treatment methods for type C lesions.

Pulmonary microbiota signatures adjacent to adenocarcinoma, squamous cell carcinoma and benign lesion.

The occurrence and progression of lung cancer are influenced by pulmonary microbiota, yet the relationship between changes in the pulmonary microbiota and lung cancer remains unclear. To investigate the correlation between pulmonary microbiota and the signature of lung lesions, we analyzed the microbial composition at sites adjacent to the stage 1 adenocarcinoma, squamous carcinoma and benign lesion tissues in 49 patients by using 16S ribosomal RNA gene sequencing. We then conducted Linear discriminant analysis, receiver operating characteristic (ROC) curve analysis and PICRUSt prediction based on 16S sequencing results. Overall, the microbiota composition at sites close to lung lesions showed significant differences between different lesion types. Based on the results of LEfSe analysis, Ralstonia, Acinetobacter and Microbacterium are the dominant genera of lung adenocarcinoma (LUAD), lung squamous carcinoma (LUSC) and benign lesions (BENL), respectively. Furthermore, we determined the diagnostic value of the abundance ratio of Ralstonia to Acinetobacter in adenocarcinoma patients through ROC curve analysis. The PICRUSt analysis revealed 15 remarkably different metabolic pathways in these lesion types. In LUAD patients, the increase of the pathway associated with xenobiotic biodegradation may be due to the continuous proliferation of microbe with degradation ability of xenobiotics, which implied that LUAD patients are often exposed to harmful environment. The abundance of Ralstonia was related to the development of lung cancer. By measuring the abundance of microbiota in diseased tissues, we can distinguish between different types of lesions. The differences in pulmonary microbiota between lesion types are significant in understanding the occurrence and development of lung lesions.

Effect of pulse parameters on ablation efficiency in dual-frequency HIFU therapy

High-intensity focused ultrasound (HIFU) has now been widely used to ablate various benign and malignant tumors. But it is still critical to increase the ablation efficiency in many clinical applications. Dual-frequency HIFU has been proven to be more efficient in ablation, but the principle on selecting the pulse parameters in this method remains to be explored. In this study, the in vitro lesion areas under different pulse repetition frequencies (PRFs), duty ratios, and frequency differences were compared, cavitation activity was also monitored during HIFU exposure. The results showed that different pulse parameters caused different types of lesions. In HIFU therapy, those pulse parameters that maximize the thermal effect, reduce heat dissipation and generate sufficient cavitation activities should be considered. But the method of evaluating or predicting the damage by using the cavitation dose is only applicable to mechanical damage.

Individualized Statistical Modeling of Lesions in Fundus Images for Anomaly Detection.

Anomaly detection in fundus images remains challenging due to the fact that fundus images often contain diverse types of lesions with various properties in locations, sizes, shapes, and colors. Current methods achieve anomaly detection mainly through reconstructing or separating the fundus image background from a fundus image under the guidance of a set of normal fundus images. The reconstruction methods, however, ignore the constraint from lesions. The separation methods primarily model the diverse lesions with pixel-based independent and identical distributed (i.i.d.) properties, neglecting the individualized variations of different types of lesions and their structural properties. And hence, these methods may have difficulty to well distinguish lesions from fundus image backgrounds especially with the normal personalized variations (NPV). To address these challenges, we propose a patch-based non-i.i.d. mixture of Gaussian (MoG) to model diverse lesions for adapting to their statistical distribution variations in different fundus images and their patch-like structural properties. Further, we particularly introduce the weighted Schatten p-norm as the metric of low-rank decomposition for enhancing the accuracy of the learned fundus image backgrounds and reducing false-positives caused by NPV. With the individualized modeling of the diverse lesions and the background learning, fundus image backgrounds and NPV are finely learned and subsequently distinguished from diverse lesions, to ultimately improve the anomaly detection. The proposed method is evaluated on two real-world databases and one artificial database, outperforming the state-of-the-art methods.

Cytostéatonécrose après reconstruction mammaire par lambeau graisseux avec ou sans préconditionnement ischémique

Cytosteatonecrosis (CTN) is a frequent postoperative complication after breast autologous reconstruction using DIEP (deep inferior epigastric perforator) flap. CTN radiological diagnostic reveals different types of lesions, as nodes or extended fat necrosis, which become in some cases infected, or pass for tumor recurrence after breast cancer treatment. CTN is caused by intraoperative ischemia of the flap, and no current method can prevent postoperative CTN development after DIEP breast reconstruction. Mechanical ischemic preconditioning, consisting in intraoperative briefs consecutive cycles of ischemia reperfusion using vascular clamp upon the graft pedicle, is used in transplantation surgery. This procedure improves the graft tolerance towards ischemic surgical lesions. The aim of this retrospective observational study was to assess PCIM effects on CTN development after DIEP surgery, comparing CTN occurrence after breast reconstruction using DIEP flap with or without intraoperative PCIM. All patients breats reconstructed using DIEP flap between novembre 2020 and may 2022, presenting 6 months postoperative breast echography were retrospectively included. Primary outcome was the ultrasonic existence of CTN, according to the Wagner classification. Clinical data, postoperative outcomes such as infection, hematoma or surgical revision, and length of stay in hospital were also recorded. Twenty nine patients among which 8 PCIM were included. CTN occurrence rate after PCIM (25%) was quite lower than CTN rate without PCIM (71,4%), although the difference was not significant (P=0,088). Other postoperative complications rates were not significantly different with or without PCIM. PCIM seems to improve CTN occurrence after DIEP breast reconstruction, improving fat flap tolerance to ischemic perioperative lesions. Those preliminary results need to be confirmed with clinical prospective study.

Cerebral nasitremiasis in a Blainville's beaked whale (Mesoplodon densirostris) stranded in the Canary Islands

Ten species within the genus Nasitrema (subfamily Nasitrematinae, family Brachycladiidae) have been reported infecting a wide variety of odontocetes worldwide, although there is still a lack of information about their presence in beaked whales (BWs). Nasitrema spp. are commonly described inhabiting the pterygoid sinus, the tympanic cavities, and the middle and inner ear; although aberrant migrations through the brain have been also reported. This trematode may cause different type of lesions, ranging from mild to severe saculitis, neuritis, otitis, and/or meningoencephalitis that may impede cetaceans to survive in the wild, resulting in incoordination, loss of equilibrium, and echolocation dysfunction ending in a stranding event. The presence of Nasitrema sp. was found in an adult female Blainville beaked whale stranded death in Fuerteventura, Canary Islands, on November 2016. The most relevant gross finding was a severe chronic-active multifocal pyogranulomatous and necrotizing encephalitis. Histologically, multiple areas of necrosis, pyogranulomatous and eosinophilic inflammation, haemorrhages and occasional cholesterol crystals were found associated with parasitic structures compatible with an adult trematode and its eggs. Molecular analysis, based on a quantitative polymerase chain reaction (qPCR) of the brain tissue sample detected 99% homology with a partial sequence of the NADH dehydrogenase subunit 3 (ND3) gene of Nasitrema delphini. In addition, liver, kidney, prescapular lymph node and brain samples were positive to herpesvirus (conventional nested PCR). Evidence of the presence of this parasite was not found in any of the 54 beaked whales (n = 54) stranded on the Canary Islands between 1999 and 2017, specifically 35 Cuvier's BWs and 19 specimens belonging to the Mesoplodon genus. To our knowledge, the current study represents the first description of a nasitremiasis in a member of the Ziphiidae family.

Microstructural alterations in different types of lesions and their perilesional white matter in relapsing-remitting multiple sclerosis based on diffusion kurtosis imaging.

In multiple sclerosis (MS), contrast enhancement lesions and chronic active lesions have been demonstrated to have different degrees of inflammation. Accordingly, they exist different degrees of tissue damage, one is short and acute, and another is slow and longstanding. This study aimed to explore whether diffusion parameters can differentiate different types of lesions, and investigate the microstructural damage between different types of MS lesions by using diffusion magnetic resonance imaging (dMRI) and its correlation with clinical biomarkers of disability and cognitive states. We retrospectively identified 77 contrast enhancement lesions (CELs), 384 iron rim lesions (IRLs), 393 non-iron rim lesions (NIRLs), their corresponding perilesional white matter (PLWM), and 68 normal-appearing white matter (NAWM) from 68 relapsing-remitting MS (RRMS). Additionally, 44 white matter in healthy controls (WM in HCs) were also enrolled in this study. The DTI and DKI parameters were measured in the above white matter, including kurtosis fractional anisotropy (KFA), fractional anisotropy (FA), mean kurtosis (MK), and mean diffusivity (MD). All the patients were assessed with the Digital Span Test (DST), the Symbol Digit Modalities Test (SDMT), the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Expanded Disability Status Scale (EDSS). The lowest KFA, FA, MK values and the highest MD values were found in CELs, followed by IRLs, NIRLs, NAWM, and WM in HCs. In KFA and FA values, there were significant differences between each type of lesion, as well as each type of PLWM (P < 0.05). The MK values of CELs and IRLs were significantly lower than NIRLs, but inversely for MD (P < 0.05). There were no differences between CELs and IRLs for MK (P=1) and MD (P=0.261). The results of MK and MD values in CELs-PLWM and IRLs-PLWM were similar to the CELs and IRLs. There were no significant differences between NAWM and WM in HCs in all the enrolled diffusion parameters (P >0.05) and the FA values between NIRLs-PLWM and NAWM or between NIRLs-PLWM and WM in HCs were no significant differences (P >0.05). The KFA and MD values in IRLs-PLWM (r =0.443, P =0.021; r =-0.518, P =0.006) were correlated with the DST scores and the KFA of CELs-PLWM (r =0.396, P =0.041) was correlated with SDMT scores. Our findings demonstrate that the KFA values have the potential to distinguish different types of MS white matter tissues. Furthermore, the diffusion parameters can reflect the microstructure abnormalities in different MS lesions and might help us better understand the pathological mechanism and lesion evolution.

Site matters: Central neuropathic pain characteristics and somatosensory findings after brain and spinal cord lesions.

It is unknown if different etiologies or lesion topographies influence central neuropathic pain (CNP) clinical manifestation. We explored the symptom-somatosensory profile relationships in CNP patients with different types of lesions to the central nervous system to gain insight into CNP mechanisms. We compared the CNP profile through pain descriptors, standardized bedside examination, and quantitative sensory test in two different etiologies with segregated lesion locations: the brain, central poststroke pain (CPSP, n=39), and the spinal cord central pain due to spinal cord injury (CPSCI, n=40) in neuromyelitis optica. Results are expressed as median (25th to 75th percentiles). CPSP presented higher evoked and paroxysmal pain scores compared to CPSCI (p < 0.001), and lower cold thermal limen (5.6°C [0.0-12.9]) compared to CPSCI (20.0°C [4.2-22.9]; p=0.004). CPSCI also had higher mechanical pain thresholds (784.5 mN [255.0-1078.0]) compared to CPSP (235.2mN [81.4-1078.0], p=0.006) and higher mechanical detection threshold compared to control areas (2.7 [1.5-6.2] vs. 1.0 [1.0-3.3], p=0.007). Evoked pain scores negatively correlated with mechanical pain thresholds (r=-0.38, p < 0.001) and wind-up ratio (r=-0.57, p < 0.001). CNP of different etiologies may present different pain descriptors and somatosensory profiles, which is likely due to injury site differences within the neuroaxis. This information may help better design phenotype mechanism correlations and impact trial designs for the main etiologies of CNP, namely stroke and spinal cord lesions. This study provides evidence that topography may influence pain symptoms and sensory profile. The findings suggest that CNP mechanisms might vary according to pain etiology or lesion topography, impacting future mechanism-based treatment choices.

The impact of brain lesions on health-related quality of life in patients with WHO CNS grade 3 or 4 glioma: a lesion-function and resting-state fMRI analysis

PurposeIn glioma patients, tumor development and multimodality therapy are associated with changes in health-related quality of life (HRQoL). It is largely unknown how different types and locations of tumor- and treatment-related brain lesions, as well as their relationship to white matter tracts and functional brain networks, affect HRQoL.MethodsIn 121 patients with pretreated gliomas of WHO CNS grades 3 or 4, structural MRI, O-(2-[18F]fluoroethyl)-L-tyrosine (FET) PET, resting-state functional MRI (rs-fMRI) and self-reported HRQoL questionnaires (EORTC QLQ-C30/BN20) were obtained. Resection cavities, T1-enhancing lesions, T2/FLAIR hyperintensities, and lesions with pathologically increased FET uptake were delineated. Effects of tumor lateralization, involvement of white matter tracts or resting-state network nodes by different types of lesions and within-network rs-fMRI connectivity were analyzed in terms of their interaction with HRQoL scores.ResultsRight hemisphere gliomas were associated with significantly less favorable outcomes in physical, role, emotional and social functioning, compared with left-sided tumors. Most functional HRQoL scores correlated significantly with right-sided white-matter tracts involvement by T2/FLAIR hyperintensities and with loss of within-network functional connectivity of right-sided nodes. Tumors of the left hemisphere caused significantly more communication deficits.ConclusionIn pretreated high-grade gliomas, right hemisphere lesions are associated with reduced HRQoL scores in most functional domains except communication ability, compared to tumors of the left hemisphere. These relationships are mainly observed for T2/FLAIR lesions involving structural and functional networks in the right hemisphere. The data suggest that sparing the right hemisphere from treatment-related tissue damage may improve HRQoL in glioma patients.

Choosing the right treatment for the right lesion, part I: a narrative review of the role of plain balloon angioplasty in dialysis access maintenance.

The majority of patients with end-stage renal disease (ESRD) requiring hemodialysis (HD) do so via an arteriovenous fistula (AVF) or graft. Both of these accesses are complicated by dysfunction related to neointimal hyperplasia (NIH) and subsequent stenosis. Percutaneous balloon angioplasty using plain balloons is the first line treatment for clinically-significant stenosis, with excellent initial response rates, however, with poor long-term patency and need for frequent reintervention. Recent research has sought to improve patency rates utilizing antiproliferative drug-coated balloons (DCBs), however, their role in treatment has not yet been fully determined. In part one of this two-part review, we aim to provide a comprehensive overview of the mechanisms of arteriovenous (AV) access stenosis, the evidence behind their treatment with high-quality plain balloon angioplasty techniques, and treatment considerations for specific stenotic lesions. An electronic search was performed on PubMed and EMBASE to identify relevant articles from 1980 to 2022. The highest available level of evidence regarding stenosis pathophysiology, angioplasty techniques, and approaches to treating different types of lesions within fistulas and grafts were included as part of this narrative review. NIH, and subsequent stenoses, develop via a combination of upstream events, causing vascular damage, and downstream events, representing the subsequent biologic response. The large majority of stenotic lesions can be treated utilizing high-pressure balloon angioplasty, with the addition of ultra-high pressure balloon (UHPB) angioplasty for resistant lesions and prolonged angioplasty with progressive balloon upsizing for elastic lesions. Additional treatment considerations must be taken into account when treating specific lesions, including cephalic arch and swing point stenoses in fistulas and graft-vein anastomotic stenoses in grafts, amongst others. High-quality plain balloon angioplasty, performed utilizing the available evidence-basis regarding technique and considerations for specific lesion locations, is successful in treating the large majority of AV access stenoses. While initially successful, patency rates remain non-durable. Part two of this review will discuss the evolving role of DCBs, which seek to improve angioplasty outcomes.

STUDY OF HISTOMORPHOLOGICAL PATTERN OF LIVER DISEASES IN AUTOPSY CASES: A RETROSPECTIVE STUDY AT A TERTIARY CARE HOSPITAL

Introduction: Liver is affected by a variety of diseases, primary as well as secondary. The majority of chronic liver diseases may remain undiagnosed as some lesions have no clinical signs and symptoms. They are found incidentally during general health check-ups or at autopsy. Aims &amp;Objective:- To study the histomorphological spectrum of liver lesions at autopsy irrespective of the cause of death., To assess the frequency of the different types of lesions. The present study was conducted on 400 liver autopsy Material And Methods: specimens received in the department of Pathology, Medical College, Baroda, Gujarat. Tissue sections from representative areas were processed, stained, and examined under the light microscope. Out of 400 specimens, 36 (9%) cases were autolyzed, 164(41%)cases showed conge Result: stion, followed by 110 (27.5%) cases of hepatic steatosis. Normal histology was found in 40(10%) cases, 20(5%) cases showed cirrhosis. Other ndings included periportal inammation in 10 (2.5%)cases, tuberculous granuloma in 5(1.25%)cases, metastatic tumor in 5(1.25%)cases, and 3(0.75%) cases showed the presence of sickle-shaped RBCs in blood vessels of the liver. Males predominated the study with a Male: Female ratio of 3.16:1. Maximum cases was in the age group of 31-40 years. Autopsy examination of liver is a valuable tool to identify silent Conclusion: liver diseases. In the present study, liver pathology is more common in males, the most common age group is 31-40 years, congestion and steatosis comprise signicant ndings

Probing the damage-sensing mechanism(s) of a DNA repair helicase.

XPD (xeroderma pigmentosum group D) helicase serves as a prototype for 5’-3’ superfamily 2 helicases and has homologs in archaea, bacteria, and all eukaryotes. The helicase activity of eukaryotic XPD is vital to nucleotide excision repair (NER). In addition, some variants of XPD have been shown to have damage-sensing capabilities. In particular, mutation of specific residues in human XPD and in XPD from the archaeon Ferroplasma acidarmanus (FacXPD) compromises recognition of DNA damage in vivo and in vitro, respectively. However, many questions remain on XPD damage verification. Despite a number of studies, there is a lack of consensus on the mechanism by which XPD responds to different types of lesions or modifications and to the DNA strand they reside on. One study has suggested that distinct types of lesions are sensed through different mechanisms.

Post-mortem freshwater animal predation—a case report

BackgroundPost-mortem animal predation affects human corpses in various ways. Lesions are a characteristic of the type of terrestrial or aquatic predators. These lesions can be misinterpreted and may be challenging for the forensic pathologist. Different species in freshwater cause different types of lesions depending on their feeding habits. There is a paucity in the literature about post-mortem lesions caused by freshwater animals.Case presentationA 24-year-old man had accidentally drowned while fishing in the River Cauvery. His body was recovered after 3 days. Though the cause of death was drowning, post-mortem animal activity was observed during autopsy, and a live juvenile crab was also found along with the body. Distinct post-mortem lesions caused by decapods Oziotelphusa wagrakarowensis and small fishes Hypselobarbus dubius and Dawkinsia arulius are described.ConclusionsAquatic predators and their activity on the corpse are different from that of terrestrial predators. Knowledge of the local fauna is required to correlate the lesions on the body to the predator.

Brain Tumors Affecting the Orbit Globe and Orbit Tumors Affecting the Brain.

Brain tumors affecting the orbit and orbital tumors affecting the brain are a heterogeneous group of lesions, with histological features, behaviors, diagnostic criteria, and treatments varying from each other. Dermoid cyst and cavernous hemangiomas are considered the most frequent benign lesions, while non-Hodgkin lymphoma is the most common malignant tumor in this region. Sharing the same anatomical region, clinical manifestations of orbital lesions may be often common to different types of lesions. Imaging studies are useful in the differential diagnosis of orbital lesions and the planning of their management. Lesions can be classified into ocular or extra-ocular ones: the latter can be further differentiated into extraconal or intraconal, based on the relationship with the extraocular muscles. Surgical therapy is the treatment of choice for most orbital lesions; however, based on the degree of removal, their histology and extension, other treatments, such as chemotherapy and radiotherapy, are indicated for the management of orbital lesions. In selected cases, chemotherapy and radiotherapy are the primary treatments. This chapter aimed to discuss the orbital anatomy, the clinical manifestations, the clinical testing and the imaging studies for orbital lesions, and the principal pathological entities affecting the orbit together with the principles of orbital surgery.