Higher Resistance Index Research Articles

Microstructure and Mechanical Properties of 1,000 MPa Ultra-High Strength Hot-Rolled Plate Steel for Coal Mine Refuge Chamber

The 1,000 MPa ultra-high strength hot-rolled plate steel with low-carbon bainitic microstructure was developed in the laboratory for coal mine refuge chamber. The static recrystallization behavior, microstructure evolution, and mechanical properties of this hot-rolled plate steel were investigated by the hot compression, continuous cooling transformation, and tensile deformation test. The results show that the developed steel has excellent mechanical properties at both room and elevated temperature, and its microstructure mainly consists of lath bainite, granular bainite, and ferrite after thermal–mechanical control process (TMCP). The ultra-high strength plate steel is obtained by the TMCP process in hot rolling, strengthened by bainitic transformation, microstructure refinement, and precipitation of alloying elements such as Nb, Ti, Mo, and Cu. The experimental steel has relatively low welding crack sensitivity index and high atmospheric corrosion resistance index. Therefore, the developed steel has a good balance of strength and ductility both at room and elevated temperature, weldability and corrosion resistance, and it can suffice for the basic demands for materials in the manufacture of coal mine refuge chamber.

Anti-microbial resistance and molecular characterization of Salmonella serovars from man and animals

Varied samples (1,132) comprising poultry meat (212), poultry eggs (49), poultry droppings (60), autopsied poultry tissues (60), pork (156), pig faeces (189), cattle dung (105), buffalo dung (103), sheep faeces (11), goat faeces (31), deer faeces (2) and human stool (154) were screened for isolation of Salmonella spp. Total 50 Salmonella isolates were recovered from samples, viz. poultry meat (2), poultry eggs (1), poultry droppings (6), autopsied poultry tissues (16), pork (2), pig faeces (9), cattle dung (6), buffalo dung (3), sheep faeces (4) and human stool (1). The recovered Salmonella isolates belonged to 10 different serovars with most prevalent serovar S. Typhimurium (21) followed by S. Weltevreden (12), S. Ughelli (5), S. Essen (3), S. Elisabethville (2), S. Lagos (2), S. Drogana (2), S. Enteritidis (1), S. London (1) and un-typable Salmonella (1). Salmonella isolates showed extreme variation in resistance (0–100%) against anti-microbial agents. The maximum resistance was observed among Salmonella isolates against sulphamethizole and furazolidone (100% each) followed by kanamycin (50%), gentamicin (44%), nalidixic acid (14%), tobramycin (10%), amikacin, ampicillin, streptomycin and tetracycline (8% each), amoxicillin/ clavulanic acid (6%), norfloxacin (4%), ciprofloxacin and cefotaxime (2% each) and chloramphenicol (0%). A high level of sensitivity in Salmonella isolates was observed against chloramphenicol (100%) and tetracycline (92%). A high multiple antibiotic resistance (MAR) index in a range of 0.133–0.666 was observed in Salmonella serovars. Molecular characterization of Salmonella was performed by targeting amplification of invA gene primer fragment for confirmation of Salmonella spp. in which all isolates were found positive for this gene. Moreover, this gene encodes virulence factor in Salmonella spp. which was exhibited by all Salmonella isolates of the present study.

Postoperative haemodynamic changes in transplanted liver: Long-term follow-up with ultrasonography

To investigate haemodynamic changes in the transplanted liver without postoperative complications. Colour Doppler ultrasound was used to monitor recipients of liver transplants who had no postoperative complications. The haemodynamic data for the hepatic vasculature were compared at different time-points during the first 4 years after liver transplantation. A total of 144 liver transplant patients were enrolled in the study. Portal vein flow velocity decreased significantly from 72.1 ± 30.3 cm/s at 1 day to 44.2 ± 20.1 cm/s at 1 month after liver transplantation. Hepatic artery flow velocity was 61.4 ± 33.2 cm/s at day 1; it then decreased slowly but significantly to 48.3 ± 20.4 cm/s at 3 years after transplantation. There were 81 (56.3%) patients with high hepatic artery resistance index (HARI) (>0.80) and 19 (13.2%) with low HARI (<0.50) measured at least once during the 4-year follow-up examination. Decreased portal vein flow velocity was the typical change observed during the first month after liver transplantation. Abnormal haemodynamic Doppler results should be interpreted with caution because they may not be clinically significant and may improve spontaneously.

Increased angiogenic factor secretion by decidual natural killer cells from pregnancies with high uterine artery resistance alters trophoblast function

STUDY QUESTIONAre the concentrations of factors secreted by decidual natural killer (dNK) cells from pregnancies at high risk of poor spiral artery remodelling different to those secreted from pregnancies at low risk?SUMMARY ANSWERExpression levels of PLGF, sIL-2R, endostatin and angiogenin were significantly increased by dNK cells from high-risk pregnancies, and angiogenin and endostatin were found to alter trophoblast function.WHAT IS KNOWN ALREADYDuring early pregnancy, maternal uterine spiral arteries are remodelled from small diameter, low-flow, high-resistance vessels into larger diameter, higher flow vessels, with low-resistance. This change is essential for the developing fetus to obtain sufficient oxygen and nutrients. dNK cells have been implicated in this process.STUDY DESIGN, SIZE, DURATIONdNK cells were isolated from first trimester terminations of pregnancies (obtained with local ethical approval) screened for normal- or high-resistance index, indicative of cases least (<1%) and most (>21%) likely to have developed pre-eclampsia had the pregnancy not been terminated (n = 18 each group). Secreted factors and the effects of these on the trophoblast cell line, SGHPL-4, were assessed in vitro.PARTICIPANTS/MATERIALS, SETTING, METHODSA multiplex assay was used to assess dNK cell-secreted factors. SGHPL-4 cell functions were assessed using time-lapse microscopy, 3D invasion assays, endothelial-like tube formation ability and western blot analysis.MAIN RESULTS AND THE ROLE OF CHANCEThe expression levels of PLGF (P < 0.01), sIL-2R (P < 0.01), endostatin (P < 0.05) and angiogenin (P < 0.05) were significantly increased by dNK cells from high-risk pregnancies. Endostatin significantly decreased SGHPL-4 invasion (P < 0.05), SGHPL-4 tube formation (P < 0.05) and SGHPL-4 Aktser473 phosphorylation (P < 0.05). Angiogenin significantly decreased SGHPL-4 invasion (P < 0.05), but increased SGHPL-4 tube formation (P < 0.01) and decreased SGHPL-4 Aktser473 phosphorylation (P < 0.05).LIMITATIONS, REASONS FOR CAUTIONThe culture of dNK cells and protein concentrations in vitro may not fully represent the in vivo situation. Although SGHPL-4 cells are extravillous trophoblast derived, further studies would be needed to confirm the roles of angiogenin and endostatin in vivo.WIDER IMPLICATIONS OF THE FINDINGSThe altered expression of secreted factors of dNK cells may contribute to pregnancy disorders associated with poor spiral artery remodelling.STUDY FUNDING/COMPETING INTEREST(S)This study was supported by the Wellcome Trust (project reference 091550). R.F. was a recipient of a PhD studentship from the Division of Biomedical Sciences, St. George's, University of London. The authors have no conflict of interests.

The Use of Oral Sildenafil for Management of Right Ventricular Dysfunction After Pediatric Heart Transplantation

High pulmonary vascular resistance index (PVRI) can lead to right ventricular dysfunction and failure of the donor heart early after pediatric heart transplantation. Oral pulmonary vasodilators such as sildenafil have been shown to be effective modifiers of pulmonary vascular tone. We performed a retrospective, observational study comparing patients treated with sildenafil ("sildenafil group") to those not treated with sildenafil ("nonsildenafil group") after heart transplantation from 2007 to 2012. Pre- and posttransplant data were obtained, including hemodynamic data from right heart catheterizations. Twenty-four of 97 (25%) transplant recipients were transitioned to sildenafil from other systemic vasodilators. Pretransplant PVRI was higher in the sildenafil group (6.8 ± 3.9 indexed Woods units [WU]) as compared to the nonsildenafil group (2.5 ± 1.7 WU, p=0.002). In the sildenafil group posttransplant, there were significant decreases in systolic pulmonary artery pressure, mean pulmonary artery pressure, transpulmonary gradient and PVRI (4.7 ± 2.9 WU before sildenafil initiation to 2.7 ± 1 WU on sildenafil, p=0.0007). While intubation time, length of inotrope use and time to hospital discharge were longer in the sildenafil group, survival was similar between both groups. Oral sildenafil was associated with a significant improvement in right ventricular dysfunction and invasive hemodynamic measurements in pediatric heart transplant recipients with high PVRI early after transplant.

A3.13 The high resistance index values are decreased in systemic lupus erythematosus patients – risk factors and clinical association

BackgroundHigh resistance index (HRI), evaluated on the basis of Doppler spectrum of popliteal arteries, enables detection of subclinical changes in small vessels in systemic lupus erythematosus (SLE) patients.ObjectiveTo evaluate the...

Nodal vascularity as an indicator of cervicofacial metastasis in oral cancer: A Doppler sonographic study.

Background:The objective of this study was to assess nodal vascularity by Doppler sonography and to find out the correlation between clinical and various Doppler sonographic features for the detection of the metastatic nodes in oral cancer patients.Patients and Methods:A total number of 55 patients of histopathologically proven oral cancer presenting with enlarged superficial cervicofacial lymph nodes were included in the study. Patients were subjected to clinical examination according to a specially designed proforma and the TNM staging was done. If more than one enlarged nodes were present, then the node with the largest diameter was chosen for further Doppler ultrasonographic examination followed by fine needle aspiration cytology test of the same node.Results:Correlations of patterns of color Doppler flow signals with cytological diagnosis showed that central type of vascular pattern was statistically significant parameter for benign lymph nodes and peripheral type of vascularity was highly significant parameter for malignant lymphadenopathy. It was found that the cut-off value of resistive index 0.6 was statistically significant in the assessment of metastatic node (P < 0.01) with a sensitivity of 45.5% and specificity of 93.9%. On comparison of the clinical features (TNM staging) with Doppler sonographic features, it was found that the characteristic features suggestive of malignant lymph nodes on Doppler sonography such as peripheral blood flow and high resistive index were more consistently and frequently associated with the higher sub-stages of T3 and T4 and N2b and N2c of TNM staging system.Conclusion:Nodal vascularity may be used to differentiate benign from malignant lymphadenopathy. Proper judicious use of non-invasive color Doppler ultrasonographic examination provides an opportunity to eliminate the need for biopsy in reactive nodes and provide treatment in a more precise manner.

Proof of the Concept to Use a Malignant B Cell Line Drug Screen Strategy for Identification and Weight of Melphalan Resistance Genes in Multiple Myeloma

In a conceptual study of drug resistance we have used a preclinical model of malignant B-cell lines by combining drug induced growth inhibition and gene expression profiling. In the current report a melphalan resistance profile of 19 genes were weighted by microarray data from the MRC Myeloma IX trial and time to progression following high dose melphalan, to generate an individual melphalan resistance index. The resistance index was subsequently validated in the HOVON65/GMMG-HD4 trial data set to prove the concept. Biologically, the assigned resistance indices were differentially distributed among translocations and cyclin D expression classes. Clinically, the 25% most melphalan resistant, the intermediate 50% and the 25% most sensitive patients had a median progression free survival of 18, 32 and 28 months, respectively (log-rank P-value = 0.05). Furthermore, the median overall survival was 45 months for the resistant group and not reached for the intermediate and sensitive groups (log-rank P-value = 0.003) following 38 months median observation. In a multivariate analysis, correcting for age, sex and ISS-staging, we found a high resistance index to be an independent variable associated with inferior progression free survival and overall survival. This study provides clinical proof of concept to use in vitro drug screen for identification of melphalan resistance gene signatures for future functional analysis.

Antimicrobial Susceptibility Pattern of Escherichia coli Isolated from Uninary Tract Infected Patients Attending Bir Hospital

Correction: on 23/08/2014, the spelling of 'Uninary' in the title was changed to 'Urinary'.Antibiotic resistance among uropathogens is emerging public health problem. This study was done for assessing antibiotic and multidrug resistance (MDR) patterns of Escherichia coli at Bir Hospital, Kathmandu, among suspected urinary tract infection (UTI) patients from January to March, 2011. Altogether, 739 urine samples were analysed by semi-quantitative culture method and uropathogens were identified by conventional methods. E. coli was tested (109 samples) for antimicrobial susceptibility by Kirby Bauer disc diffusion method as per Clinical and Laboratory Standard Institute (CLSI) guidelines. Out of 739 samples, 27.3% gave significant growth of E. coli while 3.1% and 29.2% samples gave mixed and non-significant growth respectively. E. coli was found to be most predominant isolate (54.0%) followed by coagulase negative Staphylococci (CoNS) (21.3%) and Enterococcus spp. (7.3%). Nitrofurantoin was found to be the most effective antibiotic followed by ciprofloxacin and ofloxacin while cephalexin was least effective. Out of 109 E. coli isolates, 90.8% were MDR strains and most of the isolates had a very high multiple antibiotic resistance (MAR) index, suggesting the origin of the isolates to be of high antibiotic usage. E. coli showed higher rate of resistance towards commonly used oral antibiotics. However, nitrofurantoin is still active against organisms. Thus, nitrofurantoin could be the choice for empirical therapy of UTI. Nepal Journal of Science and Technology Vol. 14, No. 1 (2013) 177-184 DOI: http://dx.doi.org/10.3126/njst.v14i1.8938

Does graft mass impact on pediatric kidney transplant outcomes?

The aim of this study is to assess the evolution of renal size and function in pediatric transplant patients according to the graft mass/recipient size ratio. Fifty pediatric renal transplant recipients were followed over 2 years. Grafts were weighed, and three different graft mass/m(2) ratios were determined: (1) low graft mass (58 g/m(2), range 31-57 g/m(2)), (2) median (142 g/m(2), range 59-141 g/m(2)) and high (267 g/m(2), range 143-353 g/m(2)). Patients underwent repeated ultrasound Doppler scans and repeated measurements of estimated glomerular filtration rate (eGFR; 1 week and 1, 6, 12 and 24 months), urinary retinol-binding protein (RBP) and proteinuria (1 week and 6, 12 and 24 months). The volume of renal tissue increased by 12 ± 5.6 cm(3) at 24 months (p = 0.035) in the low graft mass and decreased by -14 ± 7 cm(3) (p = 0.046) in the high graft mass. The eGFR increased when either low (30 ± 5 ml/min/1.73 m(2), p < 0.001) or median (19 ± 4 ml/min/1.73 m(2), p < 0.001) graft mass was transplanted but remained stable when high graft mass was transplanted. The resistive index (RI) presented a significant decrease throughout early follow-up in the transplants involving low and median graft mass, whereas a slight rise was observed in those involving high graft mass. A significant difference was apparent 6 months post-transplant. Transplants of low and median graft mass were associated with an initial higher urinary RBP. No significant differences in proteinuria were detected. Small kidneys undergo increases in volume and function without escalation of either proteinuria or urinary RBP, characterizing an adequate adaptation to the recipient. Children receiving larger kidneys present a reduction in volume, stable GFR and higher RI at 6 months.

Decidual Natural Killer Cell Interactions with Trophoblasts Are Impaired in Pregnancies at Increased Risk of Preeclampsia

Transformation of the uterine spiral arteries (SAs) during pregnancy is critical to support the developing fetus, and is impaired in some pregnancy disorders, including preeclampsia. Decidual natural killer (dNK) cells play a role in SA remodeling, although their interactions with fetal trophoblast remain unclear. A uterine artery Doppler resistance index (RI) in the first trimester of pregnancy can be used as a proxy measure of the extent of SA remodeling; we have used this technique to characterize dNK cells from pregnancies with normal (normal RI) and impaired (high RI) SA remodeling, which display least and highest risk of developing preeclampsia, respectively. We examined the impact of dNK cell secreted factors on trophoblast motility, chemoattraction, and signaling pathways to determine the contribution of dNK cells to SA transformation. We demonstrated that the chemoattraction of the trophoblast by dNK cells is impaired in pregnancies with high RI, as is the ability to induce trophoblast outgrowth from placental villous explants. These processes are dependent on activation of the extracellular signal-regulated kinase 1/2 and phosphatidylinositol 3-kinase-Akt signaling pathways, which were altered in trophoblasts incubated with secreted factors from dNK cells from high RI pregnancies. Therefore, by characterizing pregnancies using uterine artery Doppler RI before dNK cell isolation, we have identified that impaired dNK-trophoblast interactions may lead to poor placentation. These findings have implications for pregnancy pathological conditions, such as preeclampsia.

Role of efflux pumps and intracellular thiols in natural antimony resistant isolates of Leishmania donovani.

BackgroundIn view of the recent upsurge in the phenomenon of therapeutic failure, drug resistance in Leishmania , developed under natural field conditions, has become a great concern yet little understood. Accordingly, the study of determinants of antimony resistance is urgently warranted. Efflux transporters have been reported in Leishmania but their role in clinical resistance is still unknown. The present study was designed to elucidate the mechanism of natural antimony resistance in L. donovani field isolates by analyzing the functionality of efflux pump(s) and expression profiles of known genes involved in transport and thiol based redox metabolismMethodology/Principal FindingsWe selected 7 clinical isolates (2 sensitive and 5 resistant) in addition to laboratory sensitive reference and SbIII resistant mutant strains for the present study. Functional characterization using flow cytometry identified efflux pumps that transported substrates of both P-gp and MRPA and were inhibited by the calmodulin antagonist trifluoperazine. For the first time, verapamil sensitive efflux pumps for rhodamine 123 were observed in L. donovani that were differentially active in resistant isolates. RT-PCR confirmed the over-expression of MRPA in isolates with high resistance index only. Resistant isolates also exhibited consistent down regulation of AQP1 and elevated intracellular thiol levels which were accompanied with increased expression of ODC and TR genes. Interestingly, γ-GCS is not implicated in clinical resistance in L. donovani isolates.Conclusions/SignificanceHere we demonstrate for the first time, the role of P-gp type plasma membrane efflux transporter(s) in antimony resistance in L. donovani field isolates. Further, decreased levels of AQP1 and elevated thiols levels have emerged as biomarkers for clinical resistance.

RETINAL DETACHMENT AND PROLIFERATIVE VITREORETINOPATHY

To analyze if endothelin 1 may have an effect on central retinal artery (CRA) blood flow velocities and intraocular pressure (IOP) in retinal detachment. Using radioimmunoassay, immunoreactive endothelin 1 levels were tested in both plasma and subretinal fluid specimens from patients with retinal detachment, while only plasma specimens from healthy subjects were tested. Central retinal artery Doppler sonography parameters and IOP were measured in eyes with retinal detachment, with and without proliferative vitreoretinopathy, their respective healthy fellow eyes, and normal eyes. Retinal detachment eyes had lower CRA peak systolic velocity and end-diastolic velocity, lower IOP, and higher plasma immunoreactive endothelin 1 levels than normal eyes (P < 0.0001). Eyes with proliferative vitreoretinopathy had lower CRA peak systolic velocity and end-diastolic velocity, higher resistivity index, lower IOP, higher plasma immunoreactive endothelin 1 levels, and higher subretinal fluid immunoreactive endothelin 1 than eyes without proliferative vitreoretinopathy (P < 0.0001). A statistically significant linear correlation was found among CRA parameters, IOP, and subretinal fluid immunoreactive endothelin 1 measurements. Endothelin 1 has shown a close relationship with IOP and CRA blood flow changes associated to retinal detachment as well as with proliferative vitreoretinopathy complications.

Could mean platelet volume among complete blood count parameters be a surrogate marker of metabolic syndrome in pre-pubertal children?

Interest in childhood metabolic syndrome (MetS) has increased substantially due to the increasing prevalence of childhood obesity on a global scale. Early recognition of MetS is critical in order to delay the development of cardiovascular disease (CVD). In this study, we evaluated the relationship between complete blood count (CBC) parameters and MetS among pre-pubertal children which may provide evidence in support of using low cost, readily available clinical haematological parameters for the detection of MetS. A retrospective analysis was carried out on 330 (125 lean vs. 205 overweight) Turkish pre-pubertal children who attend to a paediatric outpatient clinic. Age, gender, puberty, body mass index, CBC parameters, cardiometabolic risk factors including lipid profiles, high sensitive serum reactive protein (hsCRP) and insulin resistance index calculated by homeostasis model assessment (HOMA-IR) were evaluated and compared among lean, overweight children and children with MetS. The mean age of the study population was 7.4 ± 1.9 years. In both gender, the mean values of mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were significantly lower and red blood cell (RBC), platelet (PLT) counts were significantly higher in overweight children. Overall, 8.4% (n = 28) of patients met the criteria of MetS. Children with MetS had higher levels of PLT and lower levels of mean platelet volume (MPV). Of all the haematological parameters analysed, PLT was positively, whereas MPV was negatively correlated with MetS in girls. In addition, MPV was inversely correlated with fasting blood glucose, HOMA-IR, low density lipoprotein-cholesterol (LDL-C) and low density lipoprotein-cholesterol/high density lipoprotein-cholesterol (LDL-C/HDL-C) ratio in girls after adjusting for confounding factors. The risk analyses of MetS in terms of MPV quartiles showed that the adjusted OR (95% CI) for the lowest vs. the highest quartile was 7.71 (1.45–40.89) in girls. These data might suggest that MPV could be another feature of MetS in pre-pubertal girls and might be used as a surrogate marker for MetS in clinical settings.

Serotonin Production by Human and Mouse Trophoblast: Involvement in Placental Development and Function

Serotonin Production by Human and Mouse Trophoblast: Involvement in Placental Development and Function

The placental expression of Human Leukocyte Antigen HLA-F and HLA-E in early normal placentation

The placental expression of Human Leukocyte Antigen HLA-F and HLA-E in early normal placentation

Uterine artery blood flow characteristics assessed during oestrus and the early luteal phase of pregnant and non-pregnant bitches

The aim of this study was to measure uterine artery blood velocity daily using Doppler ultrasonography in 10 young and 10 older clinically normal bitches throughout oestrus.Typical arterial waveforms identified in young bitches were characterised by a systolic peak and subsequent flow throughout diastole, whereas in older bitches, flow was sometimes absent in diastole. For 3days immediately prior to ovulation, at the time of declining plasma oestrogen and increasing progesterone concentrations, resistance index (RI) increased, principally associated with decreased diastolic velocity; in some bitches there was absent late diastolic flow during this time. In older bitches, the waveform appearance was more variable, with absent late and early diastolic flow observed in some cases. Mean RI was higher throughout oestrus for older bitches compared with young bitches, although both groups had a similar 3-day duration increase before ovulation. Nine of the young bitches and five of the older bitches became pregnant; litter size was smaller for the older bitches. Non-pregnant bitches: (1) were significantly older; (2) had fewer waveforms with continuous diastolic flow 2days before ovulation; (3) had lower end diastolic velocity, higher RI and fewer waveforms with continuous diastolic flow 2days after ovulation, and (4) had lower plasma progesterone concentrations 5days after ovulation. These are the first detailed observations of uterine artery blood velocity and waveform appearance throughout oestrus in bitches, and this is the first description of a link between impaired diastolic flow and reduced fertility. Assessment of uterine artery velocity could be useful to promote understanding of physiological mechanisms and could also become an important tool to assess potential infertility.

AB0089 The association of interleukin 23 concentration with clinical course of systemic lupus erythematosus

BackgroundCytokine-mediated immunity plays a crucial role in the pathogenesis of various autoimmune diseases including systemic lupus erythematosus (SLE). Interleukin 23 (IL-23) may be involved in pathogenesis of SLE. Moreover, recent...

Erectile dysfunction may be the first clinical sign of insulin resistance and endothelial dysfunction in young men

The purpose of this study is to investigate the possible underlying pathogenesis of erectile dysfunction (ED) without well-known etiology in young men under the age of 40 years. 192 patients and 33 normal controls were enrolled. ED was evaluated by using the International Index of Erectile Function-5 (IIEF-5) questionnaire. Traditional cardiovascular risk factors, hormone levels, and vascular parameters were measured. Insulin resistance (IR) was measured by homeostasis model assessment (HOMA). Patients with ED had significantly higher levels of systolic blood pressure (SBP), high-sensitivity C-reactive protein (Hs-CRP), high Insulin resistance index (HOMA-IR) and carotid intima-media thickness (IMT), compared with controls. The brachial artery endothelium-dependent flow-mediated vasodilation (FMD) values were significantly lower in ED patients. By multivariate logistic regression analysis, FMD, SBP, Hs-CRP and HOMA-IR were significantly associated with ED. In receiver-operating characteristic (ROC) analysis, FMD was a significant predictor of ED (area under the curve (AUC) 0.933, p < 0.001). The cutoff value of FMD <10.4 % had sensitivity of 81.3 % and specificity of 100 %. HOMA-IR was also proven to be predictor of ED (AUC of HOMA-IR 0.759, p < 0.001). ED may be the first clinical sign of endothelial dysfunction and a clinical marker of cardiovascular and metabolic diseases. Subclinical endothelial dysfunction and insulin resistance may be the underlying pathogenesis of ED in young patients without well-known etiology. Measurement of FMD, HOMA-IR can improve our ability to predict and treat ED, as well as subclinical cardiovascular disease early in young men.

English

Thyroid lesions are found in 3-7% of population worldwide. The overwhelming majority of thyroid nodules are benign in nature. Thyroid cancers are rare; however thyroid carcinoma is the most common malignancy involving the endocrine glands and is responsible for approximately 1.5% of new cancer cases annually. The clinical challenge is to distinguish the few clinically significant malignant nodules from the many benign nodules because malignant thyroid lesions shows good long term prognosis after surgical excision. Aims : To Assess the sensitivity and specificity of sonographic findings in differentiation of benign and malignant thyroid lesion. Method: A hospital based prospective study was done on 100 patients with palpable thyroid nodules using high resolution ultrasonography and findings correlated with fine needle aspiration cytology. Result: Sensitivity and Specificity of sonography to differentiate benign and malignant thyroid lesions (FNAC correlation) was 70.59 % & 96.39 % respectively. Presence of non shadowing echogenic cholesterol crystals showed high sensitivity of 58.70 % and specificity of 83.33 % for benign thyroid nodules. Sensitivity and Specificity of absence of thin peripheral halo around malignant lesions were 70.4 % & 65.8% respectively. Sensitivity and Specificity of hypoechogenicity for malignant lesions were 64.71 % and 98.80 %.Presence of fine calcification was showing high Sensitivity & Specificity of 64.71 % and 93.98 % respectively in malignant lesions. Predominant intra-nodular colour flow pattern in solid nodules was predictive of malignancy with Sensitivity 82.35 and Specificity 84.34 %. Higher RI value (greater than 0.77) were significantly found in malignant lesions with sensitivity of 78.57 % and specificity of 92.31%. Solid and predominantly solid lesions show high Sensitivity, Specificity for being a malignant lesion 70.59 % & 55.42 respectively but less Positive Predictive Value of24.49 %. Conclusion: Sonographic characteristics of marked hypoechoic echotexture, solid and predominantly solid nature, absence of peripheral halo, presence of cholesterol crystals, fine calcification, and internal vascularity with high resistive index show high diagnostic accuracy to differentiate benign and malignant lesions.