Mean Thickness Research Articles

Progression of PROM1-Associated Retinal Degeneration as Determined by Spectral-Domain Optical Coherence Tomography Over a 24-Month Period

PurposeTo evaluate the progression of atrophy as determined by spectral-domain optical coherence tomography (SD-OCT) in patients with molecularly confirmed PROM1-associated retinal degeneration (RD) over a 24 months period. DesignInternational, multicenter, prospective case series. MethodsA total of 13 eyes (13 patients) affected with PROM1-associated RD were enrolled at five sites and SD-OCT images were obtained at baseline and after 24 months. Loss of mean thickness (MT) and intact area were estimated after semi-automated segmentation for the following individual retinal layers in the central subfield (CS), inner ring and outer ring of the ETDRS grid: retinal pigment epithelium (RPE), outer segments (OS), inner segments (IS), outer nuclear layer (ONL), inner retina (IR), and total retina (TR). ResultsStatistically significant losses of thickness of RPE and TR were detected in the CS and inner ring and of ONL and IS in the outer ring (all p<0,05); a statistically significant decrease of intact area of RPE and IS was observed in the inner ring and of ONL in the outer ring (all p<0,05); the change in MT and the intact area of the other layers showed a trend of decline over an observational period of 24 months. ConclusionsSignificant thickness losses could be detected in outer retinal layers by SD-OCT over a 24 months period in patients with PROM1-associated retinal degeneration. Loss of thickness and/or intact area of such layers may serve as potential endpoints for clinical trials that aim to slow down the disease progression of PROM1-associated retinal degeneration.

Association between Oral Active-Matrix Metalloproteinase-8 Levels and Subretinal Fibrosis among Wet Age-Related Macular Degeneration Patients

Purpose Periodontitis causes low-grade systemic inflammation and has been associated with elevated active-matrix metalloproteinase (aMMP-8) levels, blood-ocular barrier breakdown and a risk of wet age-related macular degeneration. To assess the association between aMMP-8 levels and macular status among patients with wet age-related macular degeneration (AMD). Methods Patients on anti-VEGF treatment for wet AMD were enrolled for oral aMMP-8 rinse test in Mehiläinen Private Hospital, Helsinki, Finland. Macular status was examined from spectral-domain optical coherence tomography (SD-OCT) scans by a medical retina specialist and aMMP-8 levels were analyzed with chairside point-of-care oral rinse (PerioSafe®) test and real-time quantitated by a dentist using the ORALyzer®- reader with a 10 ng/ml cut-off for aMMP-8 activity. Results Elevated aMMP-8 levels were found in 10 out of 32 patients. Age, gender, anti-VEGF (bevacizumab or aflibercept) distribution, cumulative number of anti-VEGF injections and treatment interval were comparable between patients with aMMP-8 levels below and above the point-of-care level. Macular status differed in regard to aMMP-8 activity; among patients with aMMP-8 levels below the point-of-care subretinal fibrosis was found in 6 out of 22 eyes, whereas among patients with aMMP-8 levels above the point-of-care subretinal fibrosis was found in 8 out of 10 eyes (p = 0.005). Respectively, the mean thickness of subretinal fibrosis at fovea was 19.5 ± 44.1 and 92.3 ± 78.3 µm (p = 0.018). No differences were found in the presence and in the area of geographic atrophy, or fluid distribution, whereas thicknesses of serous pigment epithelial detachment (65.5 ± 99.5 and 12.9 ± 27.9 µm, p = 0.038) and neuroretina (204.2 ± 57.8 µm and 143.0 ± 43.7 µm, p = 0.006) were greater in the eyes of patients with physiological aMMP-8 levels compared to those with elevated aMMP-8 levels. Conclusion Elevated aMMP-8 levels may account for subretinal fibrosis formation in wet AMD.

CartiMorph: A framework for automated knee articular cartilage morphometrics

We introduce CartiMorph, a framework for automated knee articular cartilage morphometrics. It takes an image as input and generates quantitative metrics for cartilage subregions, including the percentage of full-thickness cartilage loss (FCL), mean thickness, surface area, and volume. CartiMorph leverages the power of deep learning models for hierarchical image feature representation. Deep learning models were trained and validated for tissue segmentation, template construction, and template-to-image registration. We established methods for surface-normal-based cartilage thickness mapping, FCL estimation, and rule-based cartilage parcellation. Our cartilage thickness map showed less error in thin and peripheral regions. We evaluated the effectiveness of the adopted segmentation model by comparing the quantitative metrics obtained from model segmentation and those from manual segmentation. The root-mean-squared deviation of the FCL measurements was less than 8%, and strong correlations were observed for the mean thickness (Pearson’s correlation coefficient ρ∈[0.82,0.97]), surface area (ρ∈[0.82,0.98]) and volume (ρ∈[0.89,0.98]) measurements. We compared our FCL measurements with those from a previous study and found that our measurements deviated less from the ground truths. We observed superior performance of the proposed rule-based cartilage parcellation method compared with the atlas-based approach. CartiMorph has the potential to promote imaging biomarkers discovery for knee osteoarthritis.

Genotipe-phenotype correlation in alpk3 null variants. an extended analysis

Abstract Introduction ALPK3 null variants (ALPK3nv) in simple heterozygosis represent an established and emerging genetic cause for hypertrophic cardiomyopathy. Some studies have indicated that this genetic substrate would be associated with a disease of late-onset disease and incomplete penetrance. Purpose To perform an extended genotype-phenotype correlation analysis with respect to simple heterozygous ALPK3nv carriers, focusing on age at diagnosis, maximum wall thickness and survival analysis, performed on the largest available released cohort to date. Methods ALPK3 gene was included in an extended NGS panel in 16,780 probands from a reference multicentric genetic laboratory, of whom 6,505 were referred with a HCM phenotype. We collected a composite cohort of ALPK3nv (considering frameshift, nonsense and splice-site predicted frameshift variants), including index and familial cases referred to this laboratory, but also cases reported in the literature. Phenotypic behavior was analyzed, mainly considering age at diagnosis, maximum LV wall thickness, and a composite of events (heart failure and arrhythmia-related endpoints). Results A heterozygous ALPK3 null variant was identified in 110 probands out of 6,505 index cases diagnosed with HCM in our center (1.7% of HCM cases). For genotype-phenotype analysis, in total 189 heterozygous carriers were included, considering relatives and cases from the literature; 21 carriers had biallelic involvement (were homozygous or compound heterozygous for two ALPK3Knv). Among ALPK3nv heterozygous carriers, mean age at diagnosis was 53.4 (±15.2) years; mean left ventricular thickness was 17.7 (±4.9) mm, and morphological profile was mainly apical (42%) and/or concentric (26%). Males tended to be diagnosed at an earlier age than females (median age of diagnosis was 56 vs 71 years, respectively, p &amp;lt;0.01). Five events were observed in this group (four males and one female) all of them related to heart failure, and occur in carriers older than 45 years. The clinical profile was drastically different in cases with biallelic involvement, with a mean age at diagnosis of 22.2±9.3, mean LV wall thickness of 24 mm (±8.6), with LV dysfunction observed in 25%. Nine events were observed in this group, also mostly associated with HF (70%). Conclusions ALPK3 null variants in simple heterozygosis can explain 1.7% of HCM. They were associated with late-onset disease, especially in females, predominance of apical and/or concentric forms, and a phenotype that was not particularly severe, both morphologically and in terms of survival.

FORMULATION AND EVALUATION OF TACROLIMUS LOADED TRANSFERSOMAL SUBLINGUAL FILMS FOR EFFICIENT MANAGEMENT OF ORGAN REJECTION: IN VITRO AND IN VIVO STUDY

Objective: Patients travailing with end-stage organ failure can benefit from a life-saving treatment protocol called organ transplantation that also rallies eminence of life. Tacrolimus plays an important role in maintaining the healthy status of the organ transplanted, but its widespread clinical application is constrained due to low oral bioavailability which can be the limiting factor for the reduction in life span of transplanted healthy organ. Methods: To overcome the drawbacks of tacrolimus and to maximize its therapeutic efficiency, tacrolimus was formulated as transfersomes using thin film hydration method using soyalecithin and Tween-80, optimized by Central composite designs and characterized for Particle size, deformability index (DI), entrapment efficiency(EE%) and Zeta potential. The selected transfersome formulation was incorporated into sublingual films using Hydroxy Propyl Methyl Cellulose (HPMC) as a film-forming polymer and Polyethylene Glycol (PEG-400) as Plasticizer. The physical characteristics (average weight, pH, uniformity of weight and thickness) of the prepared films were studied, in addition they were evaluated for the in vitro drug release, ex vivo permeation, Differential Scanning Calorimetry (DSC), Attenuated Reflectance Spectroscopy (ATR), Scanning Electronic Microscopy (SEM), stability and in vivo pharmacokinetics in rats to prove the effect of flexibility provided by vesicle formation through sublingual route for enhanced systemic availability of tacrolimus. Results: Designed and optimized transfersomal vesicles showed the vesicle size of 139±2.1 nm with a Deformability Index of 8.53±1.9%, Entrapment Efficiency of 86.66±1.2% and zeta potential of-23.6 mV respectively. Optimized Tacrolimus-loaded transfersomal vesicles (TAC-TFs) showed controlled release with more than 80±3.4% for an extended period of time compared to pure drug Tacrolimus. The average weight of all prepared transfersomal sublingual film (TAC_TF_SL films), batches were found in the range of 55.8±1.45 to 94.2±1.42 mg with mean thickness in the range of 0.23+0.1 to 0.52±0.2 mm indicating uniform cast of respective batches. The surface pH was found to be in the range of 6.9 to 7.0 which was close to saliva pH. Optimized transfersomal sublingual films as well as nanovesicular dispersions found to be followed Zero order diffusion coupled with polymer relaxation. Ex vivo studies revealed the improved permeation of 6.51±0.04µg drug through sublingual mucosa than pure drug of 1.2±0.01 µg, depicting the significant role of soyalecithin and edge activator in the formulations. Transfersomal sublingual films exhibited controlled release with higher plasma concentration of 9.16±2.34 µg/ml at Tmax of 1.29±1.51h in comparison with 7.99±1.23 µg/ml at Tmax of 0.75±1.78h (oral marketed dosage form Pengraf capsules) embarking the higher rate of controlled absorption after sublingual delivery of optimized sublingual films with significant increase in AUC of 129.87±2.40 μg/ml/h when compared to AUC of marketed dosage form of 69.19±1.46 μg/ml/h. In addition, the absolute bioavailability of the drug following sublingual administration was found to be 70.77±2.92% in comparison with that after oral administration 40.60±2.34%. Conclusion: Designed Tacrolimus loaded transfersomal sublingual films can be a promising carrier for delivering tacrolimus through sublingual route by enhancing drug bioavailability efficiently, which can be a boon to organ-transplanted patients.

Spectral-based thickness profiling of the corpus callosum enhances anomaly detection in fetal alcohol spectrum disorders.

Fetal alcohol spectrum disorders (FASD) range from fetal alcohol syndrome (FAS) to non-syndromic forms (NS-FASD). The neuroanatomical consequences of prenatal alcohol exposure are mainly the reduction in brain size, but also focal abnormalities such as those of the corpus callosum (CC). We previously showed a narrowing of the CC for brain size, using manual measurement and its usefulness to improve diagnostic certainty. Our aim was to automate these measurements of the CC and identify more recurrent abnormalities in FAS subjects, independently of brain size reduction. We developed a fast, automated, and normalization-free method based on spectral analysis to generate thicknesses of the CC continuously and at singular points (genu, body, isthmus, and splenium), and its length (LCC). We applied it on midsagittal section of the CC extracted from T1-anatomical brain MRI of 89 subjects with FASD (52 FAS, 37 NS-FASD) and 126 with typically development (6-20 y-o). After adjusting for batch effect, we compared the mean profiles and thicknesses of the singular points across the 3 groups. For each parameter, we established variations with age (growth charts) and brain size in the control group (scaling charts), then identified participants with abnormal measurements (<10th percentile). We confirmed the slimming of the posterior half of the CC in both FASD groups, and of the genu section in the FAS group, compared to the control group. We found a significant group effect for the LCC, genu, median body, isthmus, and splenium thicknesses (p < 0.05). We described a body hump whose morphology did not differ between groups. According to the growth charts, there was an excess of FASD subjects with abnormal LCC and isthmus, and of FAS subjects with abnormal genu and splenium. According to the scaling charts, this excess remained only for LCC, isthmus and splenium, undersized for brain size. We characterized size-independent anomalies of the posterior part of the CC in FASD, with an automated method, confirming and extending our previous study. Our new tool brings the use of a neuroanatomical criterion including CC damage closer to clinical practice. Our results suggest that an FAS signature identified in NS-FASD, could improve diagnosis specificity.

Quantification of joint mobility limitation in adult type 1 diabetes.

Diabetic cheiroarthropathies limit hand mobility due to fibrosis and could be markers of a global profibrotic trajectory. Heterogeneity in definitions and lack of a method to measure it complicate studying associations with organ involvement and treatment outcomes. We measured metacarpophalangeal (MCP) joint extension as a metric and describe magnetic resonance (MR) imaging determinants of MCP restriction. Adults with type 1 diabetes were screened for hand manifestations using a symptom questionnaire, clinical examination, and function [Duruoz hand index (DHI) and grip strength]. Patients were segregated by mean MCP extension (<20°, 20°-40°, 40°-60°, and >60°) for MR imaging (MRI) scanning. Patients in the four groups were compared using ANOVA for clinical features and MRI tissue measurements (tenosynovial, skin, and fascia thickness). We performed multiple linear regression for determinants of MCP extension. Of the 237 patients (90 men), 79 (33.8%) with cheiroarthropathy had MCP extension limitation (39° versus 61°, p < 0.01). Groups with limited MCP extension had higher DHI (1.9 vs. 0.2) but few (7%) had pain. Height, systolic blood pressure, and nephropathy were associated with mean MCP extension. Hand MRI (n = 61) showed flexor tenosynovitis in four patients and median neuritis in one patient. Groups with MCP mobility restriction had the thickest palmar skin; tendon thickness or median nerve area did not differ. Only mean palmar skin thickness was associated with MCP extension angle on multiple linear regression. Joint mobility limitation was quantified by restricted mean MCP extension and had structural correlates on MRI. These can serve as quantitative measures for future associative and interventional studies.

Effect of microaneurysms on the anti-VEGF treatment for diabetic macular edema: A retrospective cross-sectional study.

Although anti-vascular endothelial growth factor (VEGF) treatment is effective for treating diabetic macular edema (DME), the effect of the microaneurysm (MA) status on the therapeutic efficacy of an anti-VEGF treatment remains unclear. Our current study investigated the effects of the number and the presence or absence of leaking MAs on DME and the efficacy of anti-VEGF therapy. A total of 51 eyes of 47 DME patients were administered anti-VEGF treatment. Fluorescence angiography results were used to determine the number of MAs and the presence or absence of leakage, with these findings matched to the optical coherence tomography maps. The correlation between the number of MAs and the retinal thicknesses and the influence of the leaking MAs was examined in order to definitively determine the effect of the anti-VEGF treatment. There was a correlation between the number of MAs and the retinal thickness of the sector in both the 6 mm (correlation coefficients: 0.42) and 3 mm (0.34) sectors (P < .001). There was also a correlation between the number of MAs and the retinal thickness in both the 6 mm (0.31) and 3 mm (0.24) sectors after undergoing the treatment (P < .01). There was a significant difference between the mean thickness of the leaking versus the non-leaking MAs in the 6 mm (388 ± 87 μm) and 3 mm (477 ± 108 μm) sectors before treatment (P < .01). There was also a significant difference for the retinal thickness between the sectors with and without leaking MAs after the treatment (P < .01). The degree of retinal edema before treatment is associated with the number of MAs and the presence of leaking MAs. Anti-VEGF treatment is less effective for focal macular edema with large numbers of MAs, which includes leaking MAs.

Evaluation of the retina, choroid and optic disc vascular structures in individuals with a history of COVID-19

In this study, we aimed to detect changes in posterior segment structures and vascular density caused by COVID-19 using an optical coherence tomography angiography (OCTA) device. The study included 20 eyes of 20 patients no systemic or ocular disease who were followed at the Ophthalmology Clinic of Health Sciences University Antalya Training and Research Hospital. The OCTA images of these individuals taken prior to contracting COVID-19 and six months after recovery were examined. The mean choriocapillaris blood flow was 2.00±0.13mm2 before COVID-19 and 2.08±0.23mm2 after the disease, and the mean subfoveal choroidal thickness was 247.33±7.65μm before the disease and 273.08±4.92μm after the disease, indicating a statistically significant difference (P=0.003, P=0.001, respectively). The mean retinal nerve fiber layer thickness before and after COVID-19 were 119.33±3.88 and 117.50±3.92μm, respectively, representing a statistically significant decrease (P<0.001). This is the first study in the literature to evaluate the post-COVID-19 changes in the vascular structures of the eye compared to the pre-disease values. In this study, we found statistically significant changes in choriocapillaris blood flow, subfoveal chroidal thickness and retinal nerve fiber layer thickness after COVID-19 infection. Further research with a greater sample size is needed to explore the effect of COVID-19 on these parameters.

42 Cognitive and Neuroanatomic Correlates of Olfactory Function in Cognitively Unimpaired and Impaired Older Adults

Objective:Olfactory function declines during normal aging; however, accelerated olfactory decline is observed in neurodegenerative diseases, such as Alzheimer’s disease (AD). Moreover, olfactory deficits in pre-clinical AD are associated with future cognitive decline. Odor identification and memory deficits have been consistently reported in early stage AD indicating its potential sensitivity to AD pathophysiology in olfactory and limbic structures, yet few studies of olfaction have incorporated structural measures in a well-characterized cohort of older adults. In the current study we examined the association between odor identification impairment, cognition, and medial temporal lobe (MTL) sub-regions in cognitively unimpaired and impaired older adults.Participants and Methods:We enrolled 140 participants (age=72.25±6.54, 56% female, years of education=16.30±2.63, 82% Caucasian, 15% Black/AA, 3% Multiracial) from the Penn Alzheimer’s Disease Research Center Clinical Cohort. Participants completed the Sniffin’ Sticks Odor Identification Test (SS-OIT), cognitive testing (NACC UDS2 or UDS3 and additional cognitive tests), and MRI scans (3T Siemens MAGNETOM Prisma MRI scanner). For the SS-OIT, participants were presented with 16 odorants using felt-tipped pen dispensers and asked to identify each odor from four multiple-choice options. Scores range from 0 to 16. Additionally, cognitive domains were created by averaging z-scores from tests within each domain: attention, memory, language, executive function, and visuospatial. This cohort was divided into participants with unimpaired cognition (n=96) and impaired cognition (MCI, dementia; n=44) using established normative data and consensus diagnosis. Linear regressions were performed to examine the association between SS-OIT score, each cognitive domain, and MTL measurements for unimpaired and impaired groups. For all analyses, we controlled for age, race, sex, education, smoking status, and hypertension and additionally for MOCA score and intracranial volume with MTL measurements.Results:In the unimpaired group, SS-OIT significantly associated with language (p&lt;.05). In the impaired group, SS-OIT significantly associated with language and memory (p&lt;.05). In the unimpaired group, SS-OIT significantly associated with right anterior hippocampal volume (p&lt;.05). In the impaired group, significant associations were found between SS-OIT and right anterior hippocampal volume (p&lt;.05) and left hippocampal mean thickness (p&lt;.05). Additionally, SS-OIT significantly associated with left and right entorhinal cortex volume (p&lt;.05) and mean thickness (p&lt;.05).Conclusions:This study reveals that lower odor identification performance is related to lower performance on measures of cognition and atrophy in MTL sub-regions in unimpaired and impaired older adults. Our findings support prior results demonstrating relationships between olfactory function, cognition, and MTL sub-regions. Specifically, olfactory function and episodic memory have been shown to follow similar patterns of decline in the course of AD, potentially reflecting AD pathology in shared regions of the MTL subserving episodic memory and olfactory function. Our findings demonstrate that reductions in both cortical thickness and grey matter volume of MTL regions are linked to olfactory deficits in individuals at risk for Alzheimer’s dementia. Future steps will include the analysis of longitudinal cognitive and imaging indices and the incorporation of fluid biomarker data.

MicroRNA-93 promotes the pathogenesis of glaucoma by inhibiting matrix metalloproteinases as well as up-regulating extracellular matrix and Rho/ROCK signaling pathways

ObjectiveTo investigate the effect and potential molecular mechanism of microRNA-93 (miR-93) on retinal ganglion cells (RGCs) apoptosis as well as retinal damage in acute glaucoma mice. MethodsRGCs apoptosis were induced by oxygen-glucose deprivation and reperfusion (OGD/R). The pro-apoptotic effect of miR-93 was evaluated by transfecting miR-93 mimics or miR-93 inhibitor into OGD/R-induced RGCs. The viability and apoptosis of RGCs were determined by MTT assay and flow cytometry. Mouse model of acute glaucoma were successfully induced via high intraocular pressure (IOP), and then these model animals were randomly divided into vehicle group, miR-93 mimics group or miR-93 inhibitor group (n = 10), using healthy mice as normal control. Histopathologic changes of retinal tissue were evaluated by Hematoxylin and Eosin (H&E) staining method. Moreover, cell counts of retinal ganglion cell layer and mean thickness of different layers were also determined. Quantitative real-time PCR (qPCR) and western blotting analysis were used to detect the mRNA and protein expression levels of extracellular matrix (ECM), matrix metalloproteinases (MMPs) and Rho/ROCK signaling pathway. ResultsmiR-93 mimics significantly decreased or promoted the viability and apoptosis of OGD/R-induced RGCs, respectively. In addition, miR-93 mimics significantly exacerbated the degree of retinal tissue damage in mice with acute glaucoma, which was accompanied by a decrease in the number of ganglion cell layer (GCL) cells and the thickness of different tissue layers. Moreover, miR-93 mimics significantly increased IOP in mice with acute glaucoma. Significantly, miR-93 inhibitors significantly reversed the above changes. In addition, results of Western blot analysis showed that miR-93 mimics increased and decreased the expression of ECM-associated and MMP-associated proteins, respectively, by activating the Rho/ROCK signaling pathway. In contrast, miR-93 significantly decreased and increased the expression of ECM-associated and MMP-associated proteins, and suppressed the expression of Rho/ROCK signaling pathway-related proteins. ConclusionmiR-93 can promote the development of glaucoma by activating Rho/ROCK signaling pathway to mediate the accumulation of ECM-related proteins as well as the down-regulation of MMP-related proteins.

Superior semicircular canal dehiscence: a radiological and clinical study.

to assess radiologically the prevalence of SSCD with its clinical presentations and its relationship with age. a prospective cohort study carried out on 200 consecutive patients (400 temporal bones). Radiological evaluation was performed using High Resolution Computed Tomography (HRCT) with measurement of thickness of bone covering superior semicircular canal (SCC), height and diameter of SSC. Two hundred patients (400 temporal bones) were involved. The mean thickness ± SD, the mean diameter ± SD and the mean height ± SD were 1.38 ± 0.80mm, 0.94 ± 0.26mm and 10.91 ± 2.39mm respectively. The prevalence of SSCD and predehiscence were 1% and 14% respectively. The commonest symptom encountered was autophony (48.3%). When the SSC thickness, diameter and height were compared with the age of patients, statistically significant differences were detected. The highest diameter, lowest height and lowest thickness were found in patients aged from 54 to 72 years. Thickness of bony layer covering SSC was found to be the most validated measurement for differentiation between cases with positive and negative symptoms with the highest sensitivity and specificity. The prevalence of SSCD and predehiscence varied among the studies. Autophony is the commonest symptom usually encountered. The condition is acquired rather than congenital. The thickness of bone covering SCC is the most validated measurement in differentiation between cases with positive and negative symptoms.

CHARACTERISTICS OF THYROID ANATOMY IMAGES ON SONOGRAPHY IN PATIENTS VISITING THE CAN THO UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL IN 2022

Background: Currently, there are no studies providing data on normal thyroid anatomy images on ultrasound to document thyroid imaging for doctors in the country in general and in the Mekong River Delta in particular. Therefore, it is necessary to determine the size of a normal adult human thyroid gland by ultrasound and contribute to providing reference data for the training of clinicians, especially determining the dose of drugs to treat some thyroid diseases related to the size of the gland. Objectives: To determine the thyroid anatomical imaging features in people without thyroid disease on ultrasound. Materials and method: A cross-sectional descriptive study was conducted on 172 patients who visited the Can Tho University of Medicine and Pharmacy Hospital from May 2021 to October 2022. Subjects are selected by the convenient sampling method met the selection and exclusion criteria. Results: The average size of the right lobe (height x width x thickness) was 45.59 x 16.67 x 14.03mm and the left lobe was 43.04 x 16.08 x 12.08mm. The mean thyroid isthmus thickness was 2.62 mm. The mean thyroid volume of the right and left lobes in the study subjects was 5.24ml and 4.31ml, respectively. Conclusions: In general, the size of the right lobe of the thyroid gland is larger than that of the left lobe (p&lt;0.001), and the thickness of the right lobe of the thyroid gland is larger in men than in women (p=0.04). No statistically significant differences were found between thyroid size and factors such as age, sex, ethnicity, and BMI.

Radiological Characteristics of Immunization Adenitis in the Axilla Following the Covid-19 Vaccine

It was aimed to investigate the ultrasonography (US) features of axillary COVID-19 immunization adenitis. Patients with axillary COVID-19 immunization adenitis detected between April 2021 and January 2022 were included. US features of the lymph nodes identified at the patient's initial US were all recorded. Radiological follow-up information and if exists pathology results were investigated. 104 immunization adenitis in the axilla following Covid-19 vaccine were detected. Only 18.3 percent had axillary pain or edema. Biopsy was recommended for 4 patients and follow-up was recommended for the other 100 patients. Core biopsy results were lymphoid tissue with focal micro-abscess formations, reactive lymphoid hyperplasia and plasma cell increase. All of the patients had a history of vaccination in the last 3 months. After immunization, initial US imaging was conducted mean 24-days later. The mean long and short axis were 22-mm and 13-mm, respectively. The mean long-short axes ratio was 2.2. The mean thickness of the cortex was 4.8-mm. The long and short axes of the lymph nodes in the first US and control examinations were compared statistically and they decreased in time. The hilum existed (96%). Elastography revealed soft features. The majority of the immunization adenitis are just enlarged benign-appearing lymph nodes. The majority were found during the extensive immunization campaign and were asymptomatic. Patients and their physicians should be aware of the vaccination and imaging evaluation of specific patient groups considering that these vaccinations will continue to be used for a while in the next years.

Inhibition of retinal ischemia-reperfusion injury in rats by inhalation of low-concentration hydrogen gas.

To investigate the inhibitory effect of hydrogen gas inhalation on retinal ischemia reperfusion (I/R) injury using a rat model. Six-week-old male Sprague-Dawley rats were used. A 27G needle connected by a tube to a saline bottle placed 200cm above the eye was inserted into the anterior eye chamber to create a rat retinal I/R model. In the ischemia-plus-hydrogen-gas group (H2( +) group), the ischemia time was set to 90min, and 1.8% hydrogen was added to the air delivered by the anesthesia mask simultaneously with the start of ischemia. In the non-hydrogen-treatment ischemia group (H2( -) group), I/R injury was created similarly, but only air was inhaled. ERGs were measured; after removal of the eyes, the retina was examined for histological, immunostaining, and molecular biological analyses. The mean thickness of the inner retinal layer in the H2( +) group was 107.2 ± 16.0μm (n = 5), significantly greater than that in the H2( -) group (60.8 ± 6.7μm). Immunostaining for Iba1 in the H2( -) group showed increased numbers of microglia and microglial infiltration into the subretinal space, while there was no increase in microglia in the H2( +) group. B-wave amplitudes in the H2( +) group were significantly higher than in the H2( -) group. In the membrane antibody array, levels of interleukin-6, monocyte chemotactic protein 1, and tumor necrosis factor alpha were significantly lower in the H2( +) group than in the H2( -) group. Inhalation of 1.8% hydrogen gas inhibited the induction of inflammation, morphological/structural changes, and glial cell increase caused by retinal I/R injury.

Normal sonographic spleen dimensions in a healthy population in Saudi Arabia: A cross-sectional prospective study

ObjectiveThis study aimed to determine the normal range of spleen sizes in the adult Saudi Arabian population, and to establish correlations between spleen dimensions, age, height, weight, and body mass index (BMI). Methods and materialsA cross-sectional study was conducted in the Jazan region among 95 participants with no splenic abnormalities or conditions that could affect the spleen. Participants with any abnormal conditions were excluded. Ultrasonography was used to measure the spleen's thickness, width, and length. Spleen size was correlated with different demographic variables such as age, gender, height, weight, and BMI. ResultsNinety-five adult participants aged 18–45 years were included in the study. The mean sonographic longitudinal (length), transverse (width), and thickness dimensions of the spleen were 9.41 ± 1.460 cm, 8.62 ± 1.32 cm, and 4.17 ± 0.89 cm, respectively. The study found no correlation between spleen length and width and age, weight, height, or BMI. However, there was a positive correlation between subjects’ height (r(95) = 0.990, p= .002)and BMI (r(95) = 0.950, p= .005) but negative correlation with weight (r(95) = 0.980, p= .018) with splenic thickness only. ConclusionThese findings identify anatomic spleen size parameters that should be considered as reference data when assessing population differences and are useful for physicians and radiologists.

Cadaveric Assessment of the Butterfly Graft in Rhinoplasty.

The rhinoplasty butterfly graft is used to improve the internal nasal valve (INV), but post-operative visibility remains a concern. Intraoperative techniques have developed to thin the graft with unknown effect on functionality. Improve understanding of how to modify the aesthetics of the butterfly graft without impacting patient outcomes. Determine how graft contouring affects its biomechanical properties. Cadaveric cartilage grafts were used to examine the biomechanics in its native state and with progressive thinning. The force needed to stabilize the INV in an unaltered state and the resistance force provided by native (original), partially thinned, and fully thinned cartilage grafts were recorded. The mean thickness of grafts in their natural state was 1.64 mm, median 1.50 mm (SD 0.64 mm). The fully-thinned mean was 0.84 mm, median 0.8 mm (SD 0.18 mm). The mean force (N) of the native graft was 0.74 N and 0.60 N for fully thin (p = 0.016, 95%). The mean force (N) needed to stabilize the INV was 0.15 N (right) and 0.19 N (left). Butterfly grafts can be thinned by approximately 50% of their original thickness and retain the strength to stabilize the INV. NA Laryngoscope, 134:1638-1641, 2024.

Safety and Efficacy of an Innovative Everolimus-Coated Balloon in a Swine Coronary Artery Model.

Drug-coated balloons have been used as a non-stenting treatment in coronary and peripheral artery disease. Until recently, only sirolimus- and paclitaxel-coated balloons have been investigated in clinical trials. We evaluated the safety and efficacy of an innovative everolimus-coated balloon (ECB) in a swine coronary artery model. thirty-two swine coronary arteries were prepared through dilatation with a non-coated angioplasty balloon in a closed-chest model. During a period of 90 days, the following four groups (four animals per group, two coronary arteries per animal) were compared for safety and efficacy: A, Rontis ECB with 2.5 μg/mm2 of drug per balloon surface; B, Rontis ECB with 7.5 μg/mm2; C, Rontis Europa Ultra bare balloon; and D, Magic Touch, Concept Medical, sirolimus-coated balloon with a drug load of 1.3 μg/mm2. Differences in local biological effects (arterial reaction scores) and surface of intimal area (mm2) were not statistically significant between the treatment groups. Numerically, group A showed the lowest intimal area and intimal mean thickness, while group B showed the lowest stenosis among all groups. ECB was safe and effective in a porcine coronary artery model. The dose of everolimus may play a role in the biocompatibility of the balloon.

Multimodal layer modelling reveals in vivo pathology in amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a rapidly progressing neurodegenerative disease characterized by the loss of motor control. Current understanding of ALS pathology is largely based on post-mortem investigations at advanced disease stages. A systematic in vivo description of the microstructural changes that characterize early stage ALS, and their subsequent development, is so far lacking. Recent advances in ultra-high field (7 T) MRI data modelling allow us to investigate cortical layers in vivo. Given the layer-specific and topographic signature of ALS pathology, we combined submillimetre structural 7 T MRI data (qT1, QSM), functional localizers of body parts (upper limb, lower limb, face) and layer modelling to systematically describe pathology in the primary motor cortex (M1), in 12 living ALS patients with reference to 12 matched controls. Longitudinal sampling was performed for a subset of patients. We calculated multimodal pathology maps for each layer (superficial layer, layer 5a, layer 5b, layer 6) of M1 to identify hot spots of demyelination, iron and calcium accumulation in different cortical fields. We show preserved mean cortical thickness and layer architecture of M1, despite significantly increased iron in layer 6 and significantly increased calcium in layer 5a and superficial layer, in patients compared to controls. The behaviourally first-affected cortical field shows significantly increased iron in L6 compared to other fields, while calcium accumulation is atopographic and significantly increased in the low myelin borders between cortical fields compared to the fields themselves. A subset of patients with longitudinal data shows that the low myelin borders are particularly disrupted and that calcium hot spots, but to a lesser extent iron hot spots, precede demyelination. Finally, we highlight that a very slow progressing patient (Patient P4) shows a distinct pathology profile compared to the other patients. Our data show that layer-specific markers of in vivo pathology can be identified in ALS patients with a single 7 T MRI measurement after first diagnosis, and that such data provide critical insights into the individual disease state. Our data highlight the non-topographic architecture of ALS disease spread and the role of calcium, rather than iron accumulation, in predicting future demyelination. We also highlight a potentially important role of low myelin borders, that are known to connect to multiple areas within the M1 architecture, in disease spread. Finally, the distinct pathology profile of a very-slow progressing patient (Patient P4) highlights a distinction between disease duration and progression. Our findings demonstrate the importance of in vivo histology imaging for the diagnosis and prognosis of neurodegenerative diseases such as ALS.

Ecofriendly alkali metal cations diffusion improves fabrication of mixed-phase titania polymorphs on fixed substrate by chemical vapor deposition (CVD) for photocatalytic degradation of azo dye

Controlling the nanoscale synthesis of semiconductor TiO2 on a fixed substrate has fascinated the curiosity of academics for decades. Synthesis development is required to give an easy-to-control technique and parameters for TiO2 manufacture, leading to advancements in prospective applications such as photocatalysts. This study, mixed-phase TiO2(B)/other titania thin films were synthesized on a fused quartz substrate utilizing a modified Chemical vapor depodition involving alkali-metal ions (Li+, Na+, and K+) solution pre-treatment. It was discovered that different cations promote dramatically varied phases and compositions of thin films. The films had a columnar structure with agglomerated irregular-shaped particles with a mean thickness of 800–2000 nm. Na+ ions can promote TiO2(B) more effectively than K+ ions, however Li+ ions cannot synthesize TiO2(B). The amounts of TiO2(B) in thin films increase with increasing alkali metal (K+ and Na+) concentration. According to experimental and DFT calculations, the hypothesized TiO2(B) production mechanism happened via the meta-stable intermediate alkaline titanate transformation caused by alkali-metal ion diffusion. The mixed phase of TiO2(B) and anatase TiO2 on the fixed substrate (1 × 1 cm2) obtained from Na+ pre-treated procedures showed significant photocatalytic activity for the degradation of methylene blue. K2Ti6O12, Li2TiO3, Rutile TiO2, and Brookite TiO2 phase formations produced by K+ and Li + pretreatment are low activity photocatalysts. Photocatalytic activities were more prevalent in NaOH pre-treated samples (59.1% dye degradation) than in LiOH and KOH pre-treated samples (49.6% and 34.2%, respectively). This revealed that our developed CVD might generate good photocatalytic thin films of mixed-phase TiO2(B)/anatase TiO2 on any substrate, accelerating progress in future applications.