Maximum Dimension Research Articles

X-ray Reflectivity Probing the Structural Evolution of Sunflower Proteins Adsorbed at the Air-Water Interface.

The study delves into the adsorption of sunflower proteins at the air/water interface using specular X-ray reflection. The research involved fitting models of the protein films to the reflectivity data, resulting in detailed images of the X-ray scattering length density profiles perpendicular to the air/water interface. The sunflower protein isolate that is examined consists of multiple components, and the study proposes a transition from a 1-slab model to a 4-slab model to represent the changing layer structure over time. This transition is significant as it reflects the increasing complexity of the protein film as more proteins adsorb at the interface. Initially, sunflower proteins form a monolayer at the air/water boundary, consisting of a protein-rich, hydrophobic portion closest to the interface and a more diffuse, hydrophilic portion extending into the bulk aqueous phase. The structural changes at the interface over time depend on the bulk protein concentration in the solution. For solutions at relatively low concentrations (C ≤ 0.5 g/L), a lower amount of adsorption results in a larger, more extensive interface area for each species and a thinner protein adsorption layer. The overall thickness of a saturated monolayer is approximately 100 Å, which is close to the maximum dimension of sunflower globulins, with the thickness of the corresponding hydrophobic portion being about 20 Å. For solutions at relatively high concentrations (C ≥ 1.0 g/L), even after forming a saturated monolayer, structural evolution continues within the experimental time frame, occurring on both hydrophilic and hydrophobic sides. Additional proteins from the bulk diffuse toward the interface, forming an extra layer in the water phase and causing an increase in the overall thickness. Furthermore, a distinct sublayer develops next to the air phase, indicating a further structuration of the hydrophobic portion.

Clinicopathological Characteristics of Neutrophil-Rich Hepatocellular Carcinoma: An Uncommon Subtype of Primary Liver Cancer.

Introduction. Neutrophil-rich hepatocellular carcinoma (HCC) is an extremely uncommon subtype of HCC with an overall incidence of <1%. Neutrophil-rich HCC shows poor cellular differentiation and sarcomatoid transformation in most patients. There is prominent neutrophilic inflammatory cell infiltration in the tumor. These tumors are associated with poor prognosis, high rate of recurrence, and metastasis. Methods. Herein, we investigated 4 patients with neutrophil-rich HCC reported at our center. Clinical, radiological, and pathological findings were reviewed. Immunophenotypic characterization of the tumors were done. Granulocyte colony-stimulating factor (G-CSF), programmed cell death ligand 1 (PD-L1), and mismatch repair immunostains were performed in all 4 tumors. Results. We report 4 neutrophil-rich HCCs in 3 male patients and one female patient with an age range of 43 to 64 years. Three underwent living donor liver transplantation and one underwent right hepatectomy. Tumor measured 0.5 cm to 12 cm in maximum dimension. Histologically, tumors demonstrated moderate to marked cellular pleomorphism. Spindle cell transformation was noted in 3 tumors. Three tumors showed vascular invasion, and one tumor showed bile duct invasion. Immunopositivity for Hep Par-1, arginase-1, and glypican-3 was present in all tumors. Tumors also expressed stemness markers including KRT19 and EpCAM. Cytoplasmic positivity for G-CSF and immunoexpression of PD-L1 was demonstrated. We also report proficient mismatch repair by immunohistochemistry in all tumors. Conclusion. Neutrophil-rich HCC is an aggressive primary liver cancer which demonstrates stemness-related features. Programmed cell death ligand 1 expression in tumor cells suggests distinct immunogenic features and potential role of anti-PD-L1 therapies in inoperable disease.

A prediction model of echocardiographic variables to screen for potentially correctable shunts in adult ASD-PAH patients.

Atrial septal defect (ASD) is a prevalent congenital heart condition in adults that leads to pulmonary hypertension (PAH) and right heart failure if left untreated. During a routine follow-up of adult ASD-PAH patients, the suitability of shunt closure depends on the invasive right heart catheterization (RHC).Nevertheless, performing RHC at every follow-up is impractical and may be harmful. The present retrospective cross-sectional study was designed to investigate which echocardiographic variables are related to pulmonary vascular resistance (PVR) in adult ASD-PAH patients and proposed a model using these variables to screen for patients with a correctable shunt. A total of 530 adult ASD-PAH patients with pulmonary arterial systolic pressure (PASP) of ≥60 mmHg measured using transthoracic echocardiogram (TTE) were included in the study. All RHCs were performed within 3 months after TTE. The correctable shunt was defined as PVR ≤3 wood units (WU). Multivariate regressions were performed utilizing echocardiographic variables. A scoring system was constructed based on the predictors of PVR ≤3 WU using multivariate logistic regression analysis. The scoring system was then examined using a receiver operating characteristic (ROC) analysis. In addition, clinical utility of the model was determined based on decision curve analysis and a calibration curve was used to evaluate model conformity. Estimated pulmonary arterial systolic pressure, velocity through the pulmonary valve, tricuspid annulus early diastolic velocity, and maximum defect dimension were identified as independent predictors. The area under the ROC curve of the predictive value in the model was 0.905 [95% confidence interval (CI): 0.878-0.931, sensitivity: 84.3%, specificity: 83.6%]. The net benefit of the model was notable in terms of a wide-range probability threshold in decision curve analysis, indicating that the prediction model had good clinical applicability. The model's calibration curve was close to an ideal diagonal line, showing good predictive accuracy between the actual and predictive probabilities. The study model was demonstrated to be valuable in predicting adult ASD-PAH patients with a correctable shunt, which may help clinicians to make appropriate treatment decision for follow-up patients.

Gysinite-(Ce), PbCe(CO3)2(OH)(H2O), a New Member of the Ancylite Group

Abstract The new mineral gysinite-(Ce), PbCe(CO3)2(OH)(H2O) (IMA2023-035), was found at the Abendröthe Mine, St. Andreasberg, Braunlage, Goslar district, Lower Saxony, Germany, where it occurs in a single vug in association with albite, calcite, and mimetite. It is a secondary oxidation-zone mineral presumably crystallized from hydrothermal solutions. Gysinite-(Ce) occurs in intergrowths of equant pseudo-octahedral crystals, up to about 0.7 mm in maximum dimension. The color is brownish yellow, the streak is pale yellow, and the luster is vitreous to subadamantine. The mineral is brittle with curved, irregular fracture and no cleavage. The Mohs hardness is about 3½. The calculated density is 5.136 g/cm3. The mineral is biaxial (−) with α = 1.750(5), β = 1.825(5), γ = 1.860(5). The 2V is 65.1(4)° with no observable dispersion. The optical orientation is X = c; Y = a; Z = b by analogy with gysinite-(Nd) and there is no pleochroism. Electron probe microanalyses provided the empirical formula (Pb0.930Ce0.434La0.349Nd0.196Pr0.048Gd0.037Sm0.007)Σ2.000(CO3)2(OH)1.074(H2O)0.926. Gysinite-(Ce) is orthorhombic, Pmcn, a = 5.0780(4), b = 8.6689(6), c = 7.3255(6) Å, V = 322.47(4) Å3, and Z = 2. Gysinite-(Ce) is isostructural with gysinite-(La), gysinite-(Nd), and other members of the ancylite group. The crystal structure (R1 = 0.0268 for 396 I &amp;gt; 2σI) is a framework consisting of edge-sharing (PbCe)O8(OH)(H2O) polyhedra and CO3 triangles.

Cardiovascular health in women with turner's syndrome: a 3-year single centre audit

Abstract Background Turner’s syndrome (TS) is the most common genetic abnormality affecting females and is characterised by complete or partial absence of the X chromosome. Mortality is predominantly related to cardiovascular disease (1). Risk of life-threatening aortic dissection is 40 per 100,000 (2). Indexed aorta size (ASI) to body surface area (BSA) &amp;gt;20mm/m² is considered abnormal. An ASI of ≥25mm/m² is associated with increased risk of aortic dissection (3). Despite this there is a paucity of data in the literature regarding TS cardiovascular disease and providing evidence-based care can be challenging. Purpose Define cardiovascular disease, with focus upon aortopathy in our TS Cardiovascular Clinic (TCC). Methods Single centre retrospective medical record analysis of 248 women with TS (2021-2024) Results Patient baseline characteristics; mean age 37 years (range 18-75yrs), height 150cm (132-169cm), weight 62kg (37-130kg), BSA 1.55m² (1.19-2.17m²). 65 patients (29%) had bicuspid aortic valve (BAV), 19 (8%) and 5 (3%) had repaired and un-repaired aortic coarctation (CoA) respectively. 30 (13%) had other congenital heart disease, with most common was partial anomalous pulmonary venous connection (12 patients: 5%). 22/248 patients had previous aortic root surgery; 20 elective (mean ASI 29mm/m², range 26-33mm/m², mean age at time of surgery 42 years); 2 presented with aortic dissection (ASI 21mm/m²; pregnant, BAV &amp; 24mm/m²; tri-leaflet aortic valve, TAV). Data was available for 221 unoperated patients (figure 1). The site of maximal dimension was observed at the sinus of Valsalva in 70% compared to 30% at the ascending aorta. 130 patients (59%) had maximal ASI of &amp;lt;20mm/m². Dimensions of 20-23mm/m² and 23-25mm/m² were seen in 64 (29%) and 18 (8%) patients respectively. 7 patients (3%) had a maximal ASI of &amp;gt;25mm/m². 4 patients (2%) had an absolute maximal dimension of 40mm with ASI of 23mm/m² for all four. 9/11 patients with dimension ≥25mm/m² or 40mm had a body mass index (BMI) &amp;gt;25kg/m². Review of medical history for patients at and above threshold for risk of aortic dissection revealed referral to or previous discussion in an Aortic multi-disciplinary meeting (MDT) with a plan for ongoing surveillance. 57 patients (35%) with TAV had significant aortopathy (mean age 46years, range 19-75years) compared with 33 (51%) with BAV (mean age 39yrs, range 22-72 years) (figure 2). Review of patients &amp;gt;55years of age demonstrated a very similar burden of aortopathy in both TAV (14%) and BAV (15%) populations. Conclusions A high burden of cardiovascular disease exists within our TS population. There is a very high prevalence of aortopathy, increasingly with age and both with and without the presence of a bicuspid aortic valve. More published data is needed to help better define those at risk.

Right-sided exercise-induced cardiac remodelling is more pronounced in white than in black elite football players

Abstract Background Most echocardiography studies investigating exercise-induced cardiac remodelling (EICR) in athletes have predominantly focused on left ventricular end-diastolic volume (LVEDV) and wall thickness. Moreover, studies investigating right-sided EICR in individuals with different ethnic backgrounds are scarce, but are needed to assist clinicians in the differentiation between EICR and pathology. Purpose To investigate differences in right-sided EICR between Caucasian (white) and Sub-Saharan (black) male elite football players. Methods We included all male elite football players with echocardiography data from the Evaluation of Lifetime participation in Intensive Top-level sports and Exercise (ELITE) cohort. ELITE collects data from standardised cardiovascular screenings of elite level athletes in the Netherlands, including (but not limited to) standardised resting transthoracic echocardiograms (TTE). Athletes with known cardiovascular disease were excluded. Our primary metrics of interest were right ventricular end-diastolic diameter (RVEDD), maximal dimension of the inferior vena cava (IVC) and right atrial (RA) reservoir, conduit and contractile strain (measured using 2D-Speckle tracking). Secondary metrics of interest included LV ejection fraction (LVEF), LV mass index (LVMi) and left atrial reservoir strain. All metrics of interest were stratified by ethnicity, and indexed for body surface area (BSA) if appropriate. Results A total of 74 elite football players were included (black n = 37; white n = 37), with similar age (18 [2.0] vs 19 [3.0], p = 0.013) and BSA (2 [0.1] vs 2 [0.2] m2, p = 0.268) across ethnicities. There were no differences in indexed LA (35 [10.0] vs 33 [10.0] ml/m2, p = 0.417) and RA volumes (27 [7.4] vs 27 [6.6] ml/m2,p = 0.953). However, black athletes demonstrated smaller max IVC (18 [5.0] vs 25 [5.0] cm, p = &amp;lt;0.001) and RVEDD (40 [2.0] vs 43 [6.0] mm,p = 0.001). Moreover, black athletes demonstrated less RA deformation in the reservoir (31 [8.0] vs 36 [8.0] %, p = 0.003) and contractile phases (9 [4.0] vs 11 [4.0] %, p = 0.017) than white athletes. There were no ethnic-specific differences in RA conduit strain (23 [7.0] vs 25 [6.0] %, p = 0.076). We found no statistically significant differences in LVEF (55 [6.0] vs 55 [6.0] %, p = 0.914), LVMi (92 [15.0] vs 88 [26.8] g/m2, p = 0.236) or LA reservoir strain (32 [7.0] vs 33 [7.0] %, p = 0.157) in black vs white athletes. Conclusion Male elite football players with a Sub-Saharan ethnic background demonstrate less pronounced right-sided EICR than athletes with a Caucasian ethnic background. Our findings emphasize the need for ethnic-specific reference ranges for right-sided EICR to aid in the differentiation between EICR and pathology.

Design and Control of Polymeric Network Architectures Based on Network Dimension Theory

AbstractA new design policy to synthesize nanogel molecules having desired dimensions under unperturbed state is proposed. Miniemulsion copolymerization of vinyl and divinyl monomers, both conventional free‐radical polymerization and ideal living polymerization, is used to illustrate the method. For the network formation dynamics, the newly proposed model that takes into account the size and structure dependence of cross‐linking/cyclization reactions is employed. The master curve relationship that indicates the maximum average dimensions for randomly cross‐linked networks is used as a guideline and the network dimension is controlled by the magnitude of network maturity index NMI, which is the average number of cycle rank per primary chain. By appropriately sizing the NMI, it is possible to synthesize network polymers with dimensions equal to or greater than the maximum dimensions achievable with a homogeneous, randomly cross‐linked network polymer of the same cycle rank and molecular weight. The current strategy of designing and controlling 3D size is applicable regardless of the reaction mechanism of network formation and will also be applied to the synthesis of macro‐gels.

The polar vessel sign: insights from CT imaging analysis in Asian Indian primary hyperparathyroidism.

Data on the polar vessel sign (enlarged feeding vessel terminating in parathyroid lesions) on four-dimensional computed tomography (4D-CT) is limited. We performed a retrospective analysis to determine the prevalence, predictors, and adjunctive utility of polar vessel sign in pre-operative 4D-CT of patients with primary hyperparathyroidism (PHPT). One radiologist blinded to the patients' details reported the 4D-CT of eighty-four operated patients with histopathology-proven single-gland PHPT. Two protocols were used to obtain arterial-phase images: timed via bolus tracking (n = 41) or fixed at 20 s after contrast injection (n = 43). Seventy-one patients were symptomatic for PHPT, with median serum calcium 12.1 mg/dL. On the arterial phase of 4D-CT, 88.1% of lesions had the polar vessel sign, including 7/9 asymptomatic patients, 6/6 parathyroid carcinomas, and 3/4 ectopic(1:mediastinum, 2:thyro-thymic ligament). Predictors of polar vessel sign were maximum lesion dimension (2.2 vs. 1.4 cm; P = 0.03), solid-cystic CT morphology (47.3% vs. none; P = 0.004), and bolus tracking-timed arterial phase (55.4% vs. none; P = 0.001). Of these, bolus tracking improved the polar vessel's visualization (100% vs. 76.7%; P = 0.001) independent of lesion dimension and solid-cystic morphology. The latter two predicted polar vessel sign in images obtained at a fixed interval (20 s). A significantly lower proportion of bolus tracking-timed scans had lesion percentage arterial enhancement (PAE) < 128.9% (2/41 vs. 9/43; P = 0.04). Even with suboptimal PAE, the polar vessel helped identify 9/11 lesions. The polar vessel sign demonstrated an additive role to PAE during CT reporting. Bolus tracking is valuable in optimizing vessel and tumor arterial enhancement and is easily incorporated into parathyroid 4D-CT protocol.

A Case Report of Inflammatory Myofibroblastic Tumor Mimicking Leiomyosarcoma of the Uterus

Abstract Introduction/Objective Inflammatory myofibroblastic tumor (IMT) of the uterus is a rare entity that presents significant diagnostic challenges due to its infrequency and has the potential for being misdiagnosed as a leiomyoma, endometrial stromal tumor, or myxoid leiomyosarcoma, resulting in undertreatment or overtreatment. Methods/Case Report We present a case report of a 50-year-old woman with a history of anemia due to heavy menstruation caused by fibroids, who underwent hysterectomy. The concurrent pelvic wash cytology raised suspicious for myxoid leiomyosarcoma. Results (if a Case Study enter NA) Macroscopic examination revealed both well and poorly circumscribed nodules, ranging upto 4.7 cm in maximum dimension. Cut surfaces exhibited a spectrum of appearances, including tan-pink, whorled and rubbery, as well as soft, hemorrhagic, edematous, and mucinous areas with necrosis. Microscopically, the tumor exhibited myxoid spindle cell proliferation, in the background of lymphoplasmacytic inflammatory infiltrates. She was diagnosed with IMT metastasis to left fallopian tube, ovary, and omentum. Immunohistochemical (IHC) analysis further confirmed the diagnosis, showing strong and diffuse cytoplasmic positivity for ALK (anaplastic lymphoma kinase), caldesmon, and smooth muscle actin. This case underscores the critical importance of accurate diagnosis in guiding appropriate treatment strategies. Moreover, given the morphological overlap with other uterine tumors, the identification of ALK rearrangement emerges as a pivotal diagnostic marker, distinguishing IMT from its mimics such as leiomyoma, leiomyosarcoma and smooth muscle tumor of uncertain malignant potential (STUMP). Enhancing our understanding of the histomorphological features and ALK immunostaining of uterine IMT is essential for optimizing patient management and outcomes. Conclusion IMT in the female genital tract can mimic other more common benign and malignant tumors like leiomyoma, leiomyosarcoma, and endometrial stromal sarcoma. Familiarity with clinical and histologic features and the use of ALK immunostaining can be critical for correct diagnosis.

Stable and unstable fall motions of plate-like ice crystal analogues

Abstract. The orientation of ice crystals affects their microphysical behaviour, growth, and precipitation. Orientation also affects interaction with electromagnetic radiation, and through this it influences remote sensing signals, in situ observations, and optical effects. Fall behaviours of a variety of 3D-printed plate-like ice crystal analogues in a tank of water–glycerine mixture are observed with multi-view cameras and digitally reconstructed to simulate the falling of ice crystals in the atmosphere. Four main falling regimes were observed: stable, zigzag, transitional, and spiralling. Stable motion is characterised by no resolvable fluctuations in velocity or orientation, with the maximum dimension oriented horizontally. The zigzagging regime is characterised by a back-and-forth swing in a constant vertical plane, corresponding to a time series of inclination angle approximated by a rectified sine wave. In the spiralling regime, analogues consistently incline at an angle between 7 and 28°, depending on particle shape. Transitional behaviour exhibits motion in between spiral and zigzag, similar to that of a falling spherical pendulum. The inclination angles that unstable planar ice crystals make with the horizontal plane are found to have a non-zero mode. This observed behaviour does not fit the commonly used Gaussian model of inclination angle. The typical Reynolds number when oscillations start is strongly dependent on shape: solid hexagonal plates begin to oscillate at Re =237, whereas several dendritic shapes remain stable throughout all experiments, even at Re &gt; 1000. These results should be considered within remote sensing applications wherein the orientation characteristics of ice crystals are used to retrieve their properties.

Predictive Factors of Canine Malignant Hepatic Diseases with Multifocal Hepatic Lesions Using Clinicopathology, Ultrasonography, and Hepatobiliary Ultrasound Scores

Multifocal hepatic lesions in dogs arise from various benign and malignant liver diseases. Diagnosing these lesions is challenging because clinical signs, hematological data, and serum biochemistry are not definitive indicators. Ultrasound is utilized as a diagnostic imaging tool to evaluate liver parenchyma and detect hepatic lesions. This study aims to investigate the predictive factors that differentiate between benign and malignant multifocal hepatic lesions by examining ultrasound characteristics, blood tests, and serum biochemistry. In total, 43 dogs with multifocal hepatic lesions were included in this study. All dogs were classified into benign hepatic diseases (n = 32) and malignant haptic diseases (n = 11). For all dogs, their liver characteristics, lesion characteristics, and hepatobiliary ultrasound score by ultrasound were evaluated and we collected individual clinicopathological data for analysis. The findings of the univariate analysis revealed significant differences in four hematological and blood chemical parameters (hematocrit, white blood cell count, aspartate transaminase (AST), and alkaline phosphatase (ALP)) and six ultrasonographic parameters (liver parenchymal echogenicity, lesion homogeneity, lesion echogenicity, maximum lesion dimension, average lesion dimension, and hepatobiliary ultrasound score). Using multivariate analysis, only two parameters, hepatobiliary ultrasound score and lesion homogeneity, showed significant differences (p-value &lt; 0.001 and p-value = 0.011, respectively). Additionally, these parameters demonstrated high accuracy in predicting malignant multifocal liver lesions, with accuracy rates of 97.67% and 93.02%, respectively. Therefore, the hepatobiliary ultrasound score and lesion homogeneity are considered effective parameters for screening malignant multifocal liver lesions in dogs.

On affine spaces of rectangular matrices with constant rank

Let F be a field, and n≥p≥r>0 be integers. In a recent article, Rubei has determined, when F is the field of real numbers, the greatest possible dimension for an affine subspace of n–by–p matrices with entries in F in which all the elements have rank r. In this note, we generalize her result to an arbitrary field with more than r+1 elements, and we classify the spaces that reach the maximal dimension as a function of the classification of the affine subspaces of invertible matrices of Ms(F) with dimension (s2). The latter is known to be connected to the classification of nonisotropic quadratic forms over F up to congruence.

12345 Staying Ahead of Cowden’s Syndrome in Differentiated Thyroid Cancer

Abstract Disclosure: M.S. Gordon: None. M.B. Gordon: None. Cowden’s syndrome or multiple hamartoma syndrome, is an uncommon autosomal dominant genodermatosis and is a member of the spectrum of disorders involving mutations in the phosphatase and tensin homolog gene (PTEN). It is associated with differentiated thyroid cancer (DTC), ¾ papillary, including follicular variant (FVPTC), 1/4 follicular (FTC), and other malignancies, including breast (most common), colorectal, renal cell, endometrial and skin cancers. We report a case of Cowden’s syndrome in which the patient presented with FVPTC but had no other apparent indication of a genetic abnormality until she was found to have a melanoma and was noted to have macrocephaly. The patient presented at age 26 with a thyroid nodule of 2.7 cm in maximal dimension. FNA was benign. By age 31 the lesion had grown to 3.3 cm and a repeat FNA showed a follicular neoplasm. She underwent left lobectomy and isthmusectomy revealing a 3.0 cm FVPTC with focal Hurthle cell features. There was capsular irregularity, and subsequently she underwent completion thyroidectomy showing a right sided 8mm FVPTC. She then received 30 mCi I 131. There were no apparent pathologic mucocutaneous lesions, intellectual deficits, and no family history of Cowden’s syndrome. At age 39 she was found to have a Stage IA malignant melanoma of the periumbilical skin which was resected. With two malignancies diagnosed at a relatively young age, she was evaluated for genetic syndromes and it was simultaneously noted that she had macrocephaly with head circumference of 66 cm. (&amp;gt;99 percentile). An analysis of 69 genes by Ambry genetics revealed a pathogenic variant in the PTEN gene (c.388 C&amp;gt;T (p.R130*). PTEN R130* results in a premature truncation of the PTEN protein at amino acid 130 of 403 within the phosphatase tensin-type domain resulting in loss of function. Macrocephaly (2% population frequency) is seen in 80% of patients with PTEN mutations. Twenty percent of patients with thyroid carcinoma and macrocephaly have a PTEN mutation and lifetime risk of melanoma in DTC is 25%. BRAF and RAS mutations may cooperate with PTEN loss and explain the increased co-occurrence of malignancies with BRAF and RAS mutations such as melanoma, FTC, and PTC in Cowden’s syndrome. In conclusion, we suggest that head circumference should be measured in all patients with DTC to screen for PTEN abnormalities. Patients with DTC also should have a thorough skin examination. Presentation: 6/2/2024

7090 The Largest Study on Asymptomatic Primary Hyperparathyroidism (APHPT) Conducted at the Tertiary Care Riga East Clinical University Hospital (RECUH)— Three Years of Data

Abstract Disclosure: D. Stūrīte: None. I. Rasa: None. Background: Primary hyperparathyroidism (PHPT) is the third most common endocrine disorder and a leading cause of hypercalcemia in the outpatient setting. The study aimed to assess the characteristics, management and outcomes of pts with APHPT. Methods: A retrospective analysis of data from 168 pts with APHPT, evaluated at RECUH from January 2021 to November 2023 was conducted. Information obtained included medical records, laboratory data, imaging results, surgical protocols, histopathology data. Statistical analysis was performed using IBM SPSS 29.0. Results: From the 168 pts (mean age: 63.7±11.8 years), 86.3% (n=145) were females. Predominantly, 67.3% (n=113) exhibited mild hypercalcemia (2.6-3.0mmol/L), while 22.6% (n=38) had moderate hypercalcemia (3.0-3.49mmol/L), and 4.8% (n=8) -severe hypercalcemia (≥3.5mmol/L). 5.3% (n=9) had normocalcaemic PHPT. The mean preoperative maximal calcium level was 2.9±0.3mmol/L, iPTH level - 247.6±224.9pg/mL, minimal phosphorus - 1.3±6.7mmol/L and 25-OH vitamin D level - 28.3±14.7ng/mL. The mean preoperative eGFR was 90.6±28.2 ml/min/1.73m2, creatinine - 72.5±23.9μmol/L. Parathyroid adenoma sizes ranged from 0.3x0.4cm to 5.3x3.7cm. Calcium levels positively correlated with adenoma cross-sectional area (ρ=0.187, p=0.029) and maximal adenoma dimension (ρ=0.215, p=0.011). Ultrasonography convincingly detected parathyroid adenomas in 63.9% (107/168), SPECT/CT - 68.4% (52/76), 99mTc-sestamibi scintigraphy - 65.6% (61/93), 3D-CT - 70.6% (24/34), contrast-enhanced ultrasonography - 84% (21/25) and MRI in - 40% (2/5) cases. 12.5% (n=21) pts had unlocated parathyroid adenoma. 34.5% (n=58) of pts had osteoporosis, 47.6% (n=80) osteopenia, 12.5% (n=21) had a history of osteoporotic fracture, 17.3% (n=29) had gallstones and 22.0% (n=37) - kidney stones. 80.4% (n=135) of pts had thyroid nodules, 48.2% (n=81) - nontoxic goitre, 24.4% (n=31) - autoimmune thyroiditis, 41.7% (n=70) - hypertension, 10.5% (n=18) - type 2 diabetes. 18.5% (n=31) pts were found to have a diagnosis of malignancy. 61.9% (n=104) of pts underwent parathyroidectomy. Histopathology and radiologic imaging revealed single parathyroid adenoma in 95.2% (n=99), double parathyroid adenomas in 1.9% (n=2), parathyroid hyperplasia in 2.9% (n=3) and parathyroid carcinoma in 1.9% (n=2) pts. The mean maximal postoperative calcium level (n=103) was 2.4±0.1mmol/L, iPTH (n=101) - 63.5±27.7pg/mL, 25-OH vitamin D - 41.5±13.3ng/mL, and the mean minimal phosphorus (n=56) - 1.1±0.2mmol/L. Conclusions: APHPT remains frequently encountered and often showcases bone manifestations. It's crucial to consider the diverse clinical manifestations and associated conditions in patients with APHPT. Presentation: 6/2/2024

8617 Gender Differences In The Course Of Giant Prolactinomas - Single-Centre Case Series

Abstract Disclosure: M.A. Komisarz-Calik: None. A. Boguslawska: None. K. Ciszek: None. G. Zieliński: None. A. Hubalewska-Dydejczyk: None. A. Gilis-Januszewska: None. Introduction: Giant prolactinomas are the specific subtype of lactotroph PitNET, and are classified, according to their maximum diameter (≥40 mm). They constitute about 3% of prolactinomas. The prevalence is more common in men, however, the differences in the course of the disease between the genders remain unclear. Aim: The purpose of our study was to analyse gender differences in the course of giant prolactinomas. Materials and Methods: We analysed the data of consecutive patients with giant prolactinomas treated in the tertiary clinical center in the years 2022-2023. Results: There were 12 patients with giant prolactinoma (10 men and 2 women).Men and women were of similar age (32 vs 36 years). The maximum dimensions of the pituitary tumour in men were 56x70x67 mm, in women 60x55x55 mm. In all cases, treatment included dopamine agonists (cabergoline in 11 patients (all male patients and one female patient) and bromocriptine in one woman. Combined treatment with temozolomide and pasireotide were implemented in two male patients. In three men (30%) a surgical treatment was performed due to the visual field disturbances and severe headaches. Multiple surgeries were performed in two patients due to recurrence of symptoms and tumour progression (surgery was performed twice, and three times). One male patient received radiotherapy.The most frequent symptoms were associated with insufficiency of the adrenal, thyroid, and gonadal axis (80% vs 50%), visual field deficits (50% vs 50%) and headache (80% vs 0%), respectively in men and women. In men, the most common symptom was hypofunction of the gonadal axis (8 cases - 4 isolated gonadal axis hypofunction and 4 cases - hypofunction of the adrenal, thyroid and gonadal axis). In one woman, hypofunction of the three pituitary axes was present. Serum prolactin was higher in men than in women (6576 - 284232 ulU/ml vs 2000 - 5659 ulU/ml). In total, after treatment, prolactin concentration decreased in 7 cases, 5 men (50%) and 2 women (100%). The decrease in prolactin levels in men was by 80,4-99,9%, while in women it was by 83,9-86,7%. Tumour shrinkage was observed in 7 cases - 6/10 men and 1/2 woman. In men, tumour size was reduced by 27,5-64,4%. Tumour progression was observed in three cases, in 1 case the dimensions were stable. In two cases due to a recent diagnosis, follow-up MRI has not been yet performed. In women, tumour reduction by 99,8% was observed; in second the size of the tumour remained stable. Conclusions: The prevalence of giant prolactinomas is higher in men. The most frequent symptoms in both genders are visual field disturbances. The prevalence of tumour shrinkage is similar in both sexes, however giant prolactinomas require surgery more often in men. Further multicenter projects are needed to study the course of giant prolactinomas and to improve the outcomes of care. Presentation: 6/3/2024

8342 A Rare Case of a Corticotropic and Gonadotropic Pituitary Double Adenoma

Abstract Disclosure: S. Gruber: None. D. Kirschenbaum: None. T. Hortobagyi: None. C. Serra: None. A. Bink: None. F. Beuschlein: None. Z. Erlic: None. Background: Pituitary adenomas account for about 15% of all intracranial neoplasms and typically arise from monoclonal proliferation of anterior pituitary cells. While lactotropic and clinically hormone-inactive adenomas make up by far the largest proportion, somatotropic and corticotropic adenomas have a significantly lower prevalence. This case describes the very rare finding of a corticotropic and gonadotropic double adenoma. Clinical Case: A 63-year-old Caucasian man (BMI 36.7 kg/m2) presented in the obesity clinic. Hypercortisolism was suspected by repeated lack of cortisol suppression in low-dose dexamethasone suppression tests [minimal 87 nmol/l] and disrupted circadian rhythm of cortisol secretion according to salivary cortisol profile. Cortisol levels in a 24-hour sample of urine were normal. ACTH levels were elevated [73 ng/l; n&amp;lt;61 ng/l] leading to suspicion of Morbus Cushing. Concomitant diseases include sleep apnea, arterial hypertension and newly diagnosed type 2 diabetes mellitus. Medical history was notable for deep vein thrombosis and pulmonary embolism. Other stigmata of hypercortisolism were not evident. The rest of endocrine work up confirmed partial secondary hypothyroidism and hypogondotropic hypogonadism. An MRI of the pituitary gland revealed a pituitary macroadenoma with a maximum dimension of 20 mm. The patient underwent an endoscopic transnasal adenomectomy with post-operative corticotropic insufficiency. Contrary to our expectations, the histological examination of the surgical resection revealed a gonadotrophic pituitary adenoma with SF1 and focal FSH expression. The discrepancy between clinical, biochemical and histological findings led to subsequent examinations of the specimen with detection of an small fragment accounting for less than 5% of the total sample with expression of T-Pit and ACTH but neither SF1 nor Pit-1, corresponding to an additional corticotropic adenoma with densely granulated pattern. The tumor cells did not show overlapping expression patterns of transcription factors or hormones, which indicates the coincidence of two distinct adenomas. Three months postoperatively, the patient is biochemically cured. Partial anterior pituitary insufficiency remained. Conclusion: Pituitary double adenomas are found in 0.5-1.5% of all surgical specimens. They are characterized by their origin from different cell lines, which distinguishes them from plurihormonal adenomas, which originate from one single cell line. Here we demonstrate a SF1-T-Pit lineage combination resulting in a neighboring ACTH and FSH-adenoma. In this particular case, the clinically relevant corticotropic adenoma was comparatively tiny, making it easy to miss. This illustrates well the importance of careful correlation of clinical, laboratory and histologic findings as correct diagnosis is crucial for postoperative patient management. Presentation: 6/2/2024

Super stable tensegrities and the Colin de Verdière number ν $\nu $

AbstractA super stable tensegrity introduced by Connelly in 1982 is a globally rigid discrete structure made from stiff bars and struts connected by cables with tension. We introduce the super stability number of a multigraph as the maximum dimension that a multigraph can be realized as a super stable tensegrity, and show that it equals the Colin de Verdière number minus one. As a corollary we obtain a combinatorial characterization of multigraphs that can be realized as three‐dimensional super stable tensegrities. We also show that, for any fixed , there is an infinite family of 3‐regular graphs that can be realized as ‐dimensional injective super stable tensegrities.

Conjectural Criteria for the Most Singular Points of the Hilbert Schemes of Points

We provide conjectural necessary and (separately) sufficient conditions for the Hilbert scheme of points of a given length to have the maximum dimension tangent space at a point. The sufficient condition is claimed for 3D and reduces the original problem to a problem in convex geometry. Proving either of the two conjectural statements will in particular resolve a long-standing conjecture by Briançon and Iarrobino back in the ’70s for the case of the powers of the maximal ideal. Furthermore, for specific classes of lengths, we conjecturally classify points satisfying the conjectural sufficient conditions. This in particular (conjecturally) provides many new explicit families of examples of maximum dimension tangent space at a point of the Hilbert schemes of points of lengths strictly between two consecutive tetrahedral numbers ( 3 + k 3 ) .

The ratio-covariety of numerical semigroups having maximal embedding dimension with fixed multiplicity and Frobenius number

In this paper we will show that $\MED(F,m)=\{S\mid S \mbox{ is a numeri-}\\ \mbox{cal semigroup with maximal embedding dimension, Frobenius number $F$ and }\\ \mbox{multiplicity }m\}$ is a ratio-covariety. As a consequence, we present two algorithms: one that computes $\MED(F,m)$ and another one that calculates the elements of $\MED(F,m)$ with a given genus. If $X\subseteq S\backslash (\langle m \rangle \cup \{F+1,\rightarrow\})$ for some $S\in \MED(F,m)$, then there exists the smallest element of $\MED(F,m)$ containing $X$. This element will be denoted by $\MED(F,m)[X]$ and we will say that $X$ one of its $\MED(F,m)$-system of generators. We will prove that every element $S$ of $\MED(F,m)$ has a unique minimal $\MED(F,m)$-system of generators and it will be denoted by $\MED(F,m)\msg(S).$ The cardinality of $\MED(F,m)\msg(S)$, will be called $\MED(F,m)$-$\rank$ of $S.$ We will also see in this work, how all the elements of $\MED(F,m)$ with a fixed $\MED(F,m)$-$\rank$ are.

Molecule Empowerment and Crystal Desensitization: A Multilevel Structure-Property Analysis toward Designing High-Energy Low-Sensitivity Layered Energetic Materials.

Layered energetic materials (LEMs) can effectively balance energy and mechanical sensitivity, making them a current research focus in the field of energetic materials. However, the influence of the layered stacking pattern on impact sensitivity is still unclear, leading to the lack of advanced design strategies for high-energy low-sensitivity LEMs. Herein, we first utilize novel indicators such as maximum plane separation and hydrogen bond dimension to perform high-throughput screening on over 106 candidate structures, resulting in 17 target crystals. A systematic analysis was then conducted on the relationships between the bond dissociation energy (BDE) of the weakest energy-storing bond at the molecular level, the intralayer hydrogen bond energy (HBE), and the sliding energy barrier (SEB) at the crystal level with impact sensitivity. The findings suggest that a material can have low sensitivity only if at least two of the three properties perform well, and the interlayer sliding resistance can be reduced by enhancing the intermolecular hydrogen bond interactions, which reasonably explains the experimental phenomena. More importantly, we developed a prediction model for the impact sensitivity of LEMs with a coefficient of determination of 0.88. Additionally, factors affecting HBE and SEB were identified, and a linear model was established based on molecular-level feature variables. Finally, a new strategy for designing high-energy low-sensitivity LEMs was proposed, namely, empowerment at the molecular scale and desensitization at the crystal scale. This study integrates high-throughput screening, multilevel structure-property relationship analysis, and mathematical model construction, offering new perspectives for the development of novel high-energy and low-sensitivity energetic materials.