Percentage Reduction In Volume Research Articles

Long-term outcomes of catheter-directed sclerotherapy for ovarian endometrioma.

Although favorable results have been reported on catheter-directed sclerotherapy (CDS) for ovarian endometrioma, a thorough evaluation of its long-term efficacy is lacking. This study evaluates the long-term efficacy and safety of CDS with 99% ethanol for treatment of ovarian endometrioma. Between January 2020 and February 2022, data from 33 consecutive patients with symptomatic ovarian endometriomas who underwent CDS were retrospectively evaluated. All patients underwent pre-procedural and 6- and 12-month post-procedural ultrasonography. To assess the effect on ovarian reserve, serum anti-Müllerian hormone (AMH) levels were measured before and after the procedure. Procedure-related complications were also assessed. The mean volume of endometriomas decreased from 80.22 ± 66.43 to 0.73 ± 1.10 mL (P < 0.001), and the mean percentage of volume reduction was 98.99% ± 1.53%. No recurrences were observed during the follow-up period. In patients whose serum AMH levels were monitored for 1 year, no significant change in AMH level before and after CDS was observed (3.07 ± 1.81 vs. 2.72 ± 2.02 ng/mL, P = 0.190). One patient complained of moderate abdominal pain after CDS, which was conservatively managed. CDS remained safe and effective in treating ovarian endometrioma at the 1-year follow-up. Ovarian function after CDS was well preserved. CDS is a safe and effective treatment option for patients with ovarian endometrioma without compromising ovarian function.

Silencing siRNA microneedle patches versus silicone sheets in reducing post-surgical scars: a randomized single-blinded intra-individually controlled clinical trial.

A common complication of wounds is exuberant growth of fibrotic scar tissue, which can lead to hypertrophic scars or keloids. There are currently no treatments with good evidence for preventing excessive scar tissue formation. In this study, we explored the use of microneedle patches containing siRNA inhibiting SPARC mRNA in reducing the volume of post-surgical scars. We aim to compare the differences in the volume of post-surgical scars between daily application of siRNA-embedded dissolving microneedle patches and silicone sheets. The primary study outcome measure was the 3D volume of scar elevation.Our hypothesis was that scar formation in the half of the wound treated with siRNA microneedle patches will be lesser, as reflected by a smaller 3D volume, as compared to the half treated with silicone sheets. This was an 8-week, single-blinded intra-individually controlled randomised trial in a tertiary dermatological centre. Patients with two-week-old post-operative wounds were recruited. Each half of the scar was randomly assigned to the microneedle patch or silicone sheet. Three-dimensional (3D) volumes were obtained from the scars via a high-resolution scanner at day 0, 30 and 60. At day 30, scars treated with the microneedle patches had a lower geometric mean volume of 0.79mm3 when compared to scars treated with silicone sheets, with a difference in mean percentage volume reduction of 10.70%.At day 60, scars treated with the microneedle patches had a statistically significant lower volume (8.88mm3) when compared to the side treated with silicone sheets (12.77mm3, p=0.005), with a difference in mean percentage reduction of 9.66%. Additionally, there was also a statistically significant difference between the percentage reduction in scar volume, compared to baseline, on the side treated with microneedle patches (mean=83.78%) compared to the side treated with silicone sheets (mean=74.11%). There was a significantly greater reduction in the volume of post-surgical scars on the side treated with microneedle patches compared to the side treated with silicone sheets. This demonstrates the use of transdermal gene silencing technology for scar inhibition and that siRNA microneedle patches can be an effective and safe modality in the reduction of scar tissue formation. Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12622000558729, https://www.anzctr.org.au.

The Influence of Impedance on the Efficacy of Radiofrequency Ablation for Benign Thyroid Nodules.

Radiofrequency ablation (RFA) uses the heat generated by a high-frequency alternating electric current, and according to Ohm's and Joule's law, the delivered current is inversely proportional to the circuit impedance. The primary objective of this study was to investigate whether tissue impedance during radiofrequency ablation (RFA) for benign thyroid nodules is related to the degree of volume reduction. This observational study included consecutive patients treated with RFA for benign thyroid nodules from February 2020 to August 2023. Technical effectiveness was defined as a volume reduction percentage (VRP) >75% at 6 months after the treatment. Multivariate logistic regression analyses were performed to identify the potential role of clinical factors and changes in tissue impedance on technique effectiveness. Totally 72 patients were included with 73 benign thyroid nodules. Maximal impedance peaks reached <18 times, and mean procedural impedance ≤300 Ω were significantly associated with a volume decrease of >75% at bivariate analysis. These cutoff points were exploratory, as no existing literature suggests these variables are related to the degree of volume reduction. After adjusting for age, volume, and composition, significant associations were found for mean electrical impedance in the multivariate analysis (OR = 4.86 [confidence interval [CI] 1.29-18.26], p = 0.019). The energy adjusted by volume (delivered energy) was not associated with a VRP >75% (p = 0.7746). This study suggests that a mean procedural impedance </= 300 Ω is related to the effectiveness of RFA as measured by VRP. Additional prospective and randomized studies are needed to compare electrical parameters with VRP. 3 Laryngoscope, 2024.

Therapeutic Effectiveness of Leukocyte- and Platelet-rich Fibrin for Diabetic Foot Ulcers: A Retrospective Study.

Diabetic foot ulcer (DFU) is one of the most serious complications of diabetes. Leukocyte- and platelet-rich fibrin (L-PRF) is a second-generation autologous platelet-rich plasma. This study aims to investigate the clinical effects of L-PRF in patients with diabetes in real clinical practice. Patients with DFU who received L-PRF treatment and standard of care (SOC) from 2018 to 2019 in Tongji Hospital were enrolled. The clinical information including patient characteristics, wound evaluation (area, severity, infection, blood supply), SOC of DFU, and images of ulcers was retrospectively extracted and analyzed. L-PRF treatment was performed every 7±2 days until the ulcer exhibited complete epithelialization or an overall percent volume reduction (PVR) greater than 80%. Therapeutic effectiveness, including overall PVR and the overall and weekly healing rates, was evaluated. Totally, 26 patients with DFU were enrolled, and they had an ulcer duration of 47.0 (35.0, 72.3) days. The severity and infection of ulcers varied, as indicated by the Site, Ischemia, Neuropathy, Bacterial Infection, and Depth (SINBAD) scores of 2-6, Wagner grades of 1-4, and the Perfusion, Extent, Depth, Infection and Sensation (PEDIS) scores of 2-4. The initial ulcer volume before L-PRF treatment was 4.94 (1.50, 13.83) cm3, and the final ulcer volume was 0.35 (0.03, 1.76) cm3. The median number of L-PRF doses was 3 (2, 5). A total of 11 patients achieved complete epithelialization after the fifth week of treatment, and 19 patients achieved at least an 80% volume reduction after the seventh week. The overall wound-healing rate was 1.47 (0.63, 3.29) cm3/week, and the healing rate was faster in the first 2 weeks than in the remaining weeks. Concurrent treatment did not change the percentage of complete epithelialization or healing rate. Adding L-PRF to SOC significantly improved wound healing in patients with DFU independent of the ankle brachial index, SINBAD score, or Wagner grade, indicating that this method is appropriate for DFU treatment under different clinical conditions.

Comparison of contraction-type and noncontraction-type lymphatic vessels in lymphaticovenous anastomosis for cancer-related unilateral lower limb lymphedema: a retrospective cohort propensity-score-matched outcome analysis.

Contraction-type lymphatic vessels (LV) are considered suboptimal for lymphaticovenous anastomosis (LVA). However, despite these pathological changes, their functionality and link to outcomes have not been fully elucidated. The aim of this study was to determine the impact on outcomes when contraction-type LVs were used for LVA compared to the noncontraction-type (normal + ectatic) counterpart for treating lower limb lymphedema. Eighty-three patients with gynecologic cancer-related unilateral lower-limb lymphedema who underwent LVA as their primary treatment were enrolled in this study. The study group included 20 patients who used only contraction-type LVs. An additional 63 patients (control group) received noncontraction-type LVs only. Patients with a history of LVA, liposuction, or excisional therapy were excluded. Patient characteristics, intraoperative findings, functional parameters, and pre-LVA and post-LVA volume changes were recorded and matched using propensity scores. The primary endpoint was the volume change at 6/12 months after LVA. After matching, 20 patients were included in each group. All parameters were matched, except that the study group still had a significantly inferior indocyanine green (ICG)-positive ratio, lymph flow-positive ratio, and washout-positive ratios ( P <0.001, P =0.003, and P <0.001, respectively) when compared to the control group after matching. However, at 1-year follow-up, the postoperative percentage volume reduction was comparable between the groups ( P= 0.619). The use of contraction-type LVs for LVA is encouraged when no other LVs are available.

Ranking the optimal combination of low-impact urban development systems under climate change with the TODIM multi-criteria decision-making method

One of the strategies to manage and reduce the problems caused by floods is to use different Low-Impact Development (LID) systems. Due to the existence of different types of LID systems, it is difficult to choose the best combination of them. The purpose of this research is to rank different LID systems and choose the best combination or arrangement of them under climate change using TODIM multi-criteria decision making method, which has not been done so far, in the northernmost of Tehran city (Iran), which also includes part of Tehran municipality districts 1 and 3 and it is adjacent to Tehran municipality district 6. Previously by the authors, surface runoff in the near future (2030–2047) and far future (2048–2065) under three scenarios of Representative Concentration Pathway (RCP2.6), (RCP4.5), and (RCP8.5) with the Storm Water Management Model (SWMM) was simulated (Dougaheh et al., 2023). Next the LID systems, including Vegetative Swale, bio-retention cell, infiltration trench and permeable pavement, are optimized with Multi-Objective Harris Hawks Optimization (MOHHO) algorithm. Then, using the Pareto Fronts obtained from the optimization algorithm, seven combinations of different LID systems were extracted as final alternatives. Then, the objective functions of the optimization algorithm, including the minimization of the volume of outflow runoff of the basin and the minimization of the cost of construction and maintenance of LID, are determined as problem criteria and weighted by the Entropy-Shannon method. The results show that the volume of urban runoff with the use of LID systems, in all future time periods under RCP2.6, RCP4.5, and RCP8.5 scenarios, will decrease by an average of 54% compared to the baseline time period, and the maximum percentage of volume reduction of the flood is related to the baseline period. In the future research, taking into account the qualitative parameters, the performance of the urban runoff collection system can be evaluated qualitatively in addition to quantitatively.

PP145 The Impacts Of The Corona Virus Disease 2019 Pandemic On Bariatric Surgeries In The Private Healthcare In Brazil

IntroductionThe Corona Virus Disease 2019 (COVID-19) pandemic has impacted the functioning of health systems, imposing the need for adaptations. Elective surgeries also needed to adapt, and research has shown higher mortality in newly infected surgical patients after or during procedures. Thus, was recommended the suspension of elective surgeries during the pandemic. Early studies evaluating the effect of COVID-19 pandemic on bariatric surgery have reported a substantial reduction in procedures performed.MethodsThis retrospective study evaluated the impact of the suspension of bariatric surgeries for a Brazilian Health Maintenance Organization: UNIMED-BH, based on the analysis of data from before and during the pandemic of COVID-19.ResultsThere were 2,641 bariatric procedures conducted in 2019 with a 14.1 percent reduction in volume to 2,314 procedures in 2020. In 2021, there were 2,813 bariatric procedures and 1,700 procedures were observed from January to August 2022. Therefore, it appears that in 2022 the demand for bariatric procedures will be similar to the year 2019, which was before the COVID-19 pandemic.ConclusionsFrom the analysis of the data, a decrease in bariatric surgical volume was evidenced during the year 2020 when compared to 2019. Post-pandemic, monitoring is necessary to assess whether the system was able to meet the demand for bariatric surgical procedures.

Efficacy of uterine artery embolization (UAE) for uterine fibroids according to FIGO classification: a single-center experience.

This study aims to retrospectively evaluate the outcomes of uterine artery embolization (UAE) for uterine fibroids (UFs), specifically submucosal UFs, according to the International Federation ofGynecologyand Obstetrics (FIGO) classification of UFs. Forty-two patients with symptomatic UFs underwent UAE with Embosphere® between July 2016 and November 2021. MRI was performed before, at 3and 6months after the UAE. At each examination, the volume of UF was measured, and the percentage volume reduction rate (VRR) was calculated. The technical success rate (TSR), symptom improvement rate (SIR), regrowth rate (RR) after 6months, and adverse events (AEs) were examined; VRR was compared between patients with submucosal UFs (FIGO types 0-2, group A), those with submucosal contacts (FIGO type 3, group B), and those without submucosal UFs (FIGO types 4-7, group C). Statistical analysis was performed on the difference in VRR between groups A, B, and C at 3 and 6months after UAE. The relationship with hormone levels before UAE and VRR was evaluated. Thirty-seven of the 42 patients were evaluated. Overall, VRR was 37.0% at 3months and 52.1% at 6months; TSR, SIR, and RR were 100%, 95.2%, and 5.4%, respectively; VRR at 6months was 80.7% for group A (n = 7), 57.8% for group B (n = 13), and 37.1% for group C (n = 17). Significant differences were found between A and C (p < 0.001) and B and C (p = 0.023). Hormone levels before UAE had no effect on VRR. There was no significant AEs other than grade 3 pulmonary embolism in one patient. UAE was effective for submucosal FIGO types 0-3. UAE was especially useful as an option for FIGO type 3 with a low protrusion rate that is difficult to treat with transcervical resection.

Does previous arthroscopic Bankart repair influence coracoid graft osteolysis in Latarjet procedure? A case-control study with computed tomography scan data

Latarjet procedure is commonly performed in treatment of recurrent shoulder instability and also indicated as a salvage procedure for recurrence after failed arthroscopic Bankart repair. While this procedure has shown success, there is an increased awareness of complications in recent studies, especially for graft osteolysis. Most relevant research have focused on pathophysiology, incidence, location or risk factors of graft osteolysis; however, the data is limited to primary Latarjet procedures. This study aims to investigate the effect of previous arthroscopic Bankart repair surgery on corocaid bone graft osteolysis in Latarjet procedure. This retrospective case-control study analyzed data from patients who underwent primary Latarjet procedure or revision Latarjet procedure following failed arthroscopic Bankart repair. Clinical outcome measures included range of motion (ROM), subjective shoulder value (SSV) and Rowe score. Volumetric analysis of each transferred coracoid graft were performed using early postoperative and late postoperative computed tomography (CT) scan data and amount of graft osteolysis was then calculated as percentage of volume reduction of each graft. 32 patients who met the inclusion criteria, with 24 patients in the primary Latarjet group (group I) and 8 patients in revision Latarjet group (group II), were included to study. Mean age of patients was 32.5±7.7 years and mean follow-up duration was 52.1±8.9 months. Both study groups showed significant improvement in SSV compared to baseline (p<0.05). Comparison of postoperative clinical outcome measures showed no significant difference between two study groups in any outcome parameter (p>0.05). No recurrence was observed during follow-up period. There were 6 patients (25%) with positive apprehension sign in group I and 4 patients (50%) in group II (p>0.05). Analysis of radiological data revealed that all patients underwent some degree of graft osteolysis with varying osteolysis ratios between 12% to 98%. Mean osteolysis ratio of the coracoid graft was 67.3±22.6% in group I and 69.4±25.6% in group II, without significant difference between two groups (p>0.05). Findings of this study suggest that both primary and revision Latarjet procedures following failed arthroscopic Bankart repair underwent considerable amount of coracoid graft osteolysis. Previous arthroscopic Bankart repair did not seem to have significant influence on the amount of graft osteolysis and both primary and revision Latarjet procedures showed satisfactory clinical outcomes.

Optimal Performance of Mg-SiC Nanocomposite: Unraveling the Influence of Reinforcement Particle Size on Compaction and Densification in Materials Processed via Mechanical Milling and Cold Iso-Static Pressing

Achieving uniformly distributed reinforcement particles in a dense matrix is crucial for enhancing the mechanical properties of nanocomposites. This study focuses on fabricating Mg-SiC nanocomposites with a high-volume fraction of SiC particles (10 vol.%) using cold isostatic pressing (CIP). The objective is to obtain a fully dense material with a uniform dispersion of nanoparticles. The SiC particle size impact on the compressibility and density distribution of milled Mg-SiC nanocomposites is studied through the elastoplastic Modified Drucker-Prager Cap (MDPC) model and finite element method (FEM) simulations. The findings demonstrate significant variations in the size and dispersion of SiC particles within the Mg matrix. Specifically, the Mg-SiC nanocomposite with 10% submicron-scale SiC content (M10Sµ) exhibits superior compressibility, higher relative density, increased element volume (EVOL), and more consistent density distribution compared to the composite containing 10% nanoscale SiC (M10Sn) following CIP simulation. Under 700 MPa, M10Sµ shows improvements in both computational and experimental results for volume reduction percentage, 2.31% and 2.81%, respectively, and relative density, 4.14% and 3.73%, respectively, compared to M10Sn. The relative density and volume reduction outcomes are in qualitative alignment with experimental findings, emphasizing the significance of particle size in optimizing nanocomposite characteristics.

Therapeutic response and prognostic factors of 14 dogs undergoing transcatheter arterial embolization for hepatocellular masses: A retrospective study.

Information regarding the therapeutic effect and outcome of transcatheter arterial embolization (TAE) for hepatic masses is limited in veterinary medicine. To analyze the therapeutic response, outcome (overall survival), and their predictors in dogs that underwent TAE for primary hepatocellular masses. We hypothesized that larger pre-TAE tumors would be associated with worse outcomes. Fourteen client-owned dogs. Retrospective study. Medical records between 1 September 2016 and 30 April 2022 were reviewed to identify dogs treated with TAE for hepatic masses diagnosed as hepatocellular origin by cytological or histopathological examination. Computed tomography images were compared before and after TAE. The univariate Cox proportional hazards test was performed to assess the associations between variables and survival. Univariate linear regression analysis was performed to assess the associations between variables and the tumor reduction percentage: ([post-TAE volume - pre-TAE volume]/pre-TAE volume) × 100. The median survival time was 419 days (95% confidence interval, 82-474). History of intra-abdominal hemorrhage (P = .03) and pre-TAE tumor volume/body weight (P = .009) were significantly associated with overall survival. The mean reduction percentage was -51% ± 40%. Pre-TAE tumor volume/body weight ratio (cm3 /kg; P = .02, correlation coefficient = 0.704) was significantly correlated with the volume reduction percentage. History of intra-abdominal hemorrhage and large pre-TAE tumor volume/body weight ratio could be predictive factors for adverse outcomes after TAE. Pre-TAE tumor volume/body weight ratio could be a predictive factor for therapeutic effect.

Factors affecting the reduction rate of odontogenic cysts after decompression based on 3-dimensional volumetric analysis.

This study aimed to investigate the potential factors that could affect the reduction rate of odontogenic cysts following decompression using cone-beam computed tomography (CBCT) for 3-dimensional volumetric analysis. The study sample consisted of CBCT images of 41 individuals who underwent decompression of odontogenic cysts at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, between 2010 and 2022. Preoperative and postoperative CBCT results were collected, and a volumetric analysis was conducted to evaluate the differences in the reduction rate and the percentage of volume reduction of cystic lesions based on different parameters. Correlations between these parameters were analyzed to determine associations. In this study, the average time of decompression for odontogenic cysts was 316 days. Males demonstrated a higher reduction rate than females (P<0.05). The reduction rate was directly proportional to initial cyst volume, with higher reduction rates for cysts with large initial volume than those with small initial volume (P<0.05). Spearman's rank correlation coefficient indicated a weak positive correlation between the initial cyst volume and the duration of decompression. Additionally, a strong positive correlation was observed between the initial volume and the reduction rate. Knowledge of the reduction rate of odontogenic cysts is vital for surgeons to evaluate the duration of decompression before enucleation and to determine a definitive treatment plan. Sex and initial lesion volume had significant effects on the reduction rate.

LBODP095 Radiofrequency Ablation Performed By Endocrinologists Is A Viable Treatment Option For Recurrent Thyroid Cancer In The Outpatient Community Setting In The United States

Abstract Objective To determine if radiofrequency ablation (RFA) performed by endocrinologists for recurrent thyroid cancer in the neck is a treatment option in the outpatient community setting in the USA. Methods A review of 9 patients with 12 recurrent thyroid cancer lesions in the neck who were treated with RFA was conducted (July 2020 to November 2021). Recurrence was defined as biochemical and structural identification of disease. Recurrence was confirmed with ultrasound guided fine needle aspiration (US-FNA) cytology and measurement of thyroglobulin (Tg) washout concentration in cases of papillary thyroid cancer (PTC) and calcitonin washout concentration in medullary thyroid cancer (MTC). Informed consent was obtained. RFA was done in the outpatient setting with standard aseptic techniques, conscious sedation, and local anesthesia. Real time US imaging was used to perform hydro-dissection and a limited "moving shot" technique with a medial to lateral approach. Node volume in mL (length x depth x width×0.525) and tumor markers were recorded before at 6 to 12 weeks and at 6 months (m) after RFA. The volume reduction percentage (VRP) for each nodule was calculated using the following equation: VRP = {[baseline volume in mL - final volume in mL]/baseline volume in mL}×100 A VRP of more than 50% was considered a significant response, and VRP of 100% was considered complete response. Results A total of 9 patients with 12 nodes were included in the study. 7 patients had nodal recurrence of PTC in the neck. RFA was recommended for 1 patient as palliative treatment while on treatment with chemotherapy. 1 patient had recurrent MTC. There were no serious complications. 6 m data was unavailable for 2 patients. 9 of 10 (90%) nodes for which data is available had a volume decrease of at least 50% at 6 m. The only patient without at least a partial response to therapy was on chemotherapy. 4 of the 10 (40%) metastatic nodes of papillary thyroid cancer had a complete response. Mean volume reduction for all lesions at 6 mos was 0.339 mL, P = 0. 012. Median change in Tg level at 6 months was 0.4 IU/ml with a downward trend in 4/5 (80%) of patients with recurrent papillary thyroid cancer who were not receiving chemotherapy. Discussion Complete response may be expected in about 40% of patients after RFA at 6 m, however, this may potentially be improved with extended follow up time or multiple RFA sessions. Patients who are not surgical candidates, refuse surgery, or require palliative treatment may be potential candidates for this procedure. Therefore, RFA appears to be a viable treatment option in selected patients with recurrent thyroid carcinoma. Presentation: No date and time listed

Volumetric change of bony cavity and shrinkage speed after marsupialization for odontogenic keratocyst and unicystic ameloblastoma

The aim of this study was to evaluate the efficacy of marsupialization treatment for odontogenic keratocyst (OKC) and unicystic ameloblastoma (UA) based on the three-dimensional volumetric change over time, and to determine the difference between OKC and UA in terms of the absolute volume reduction (AVR) and absolute shrinkage speed (ASS), and whether they are correlated with the preoperative volume, time after marsupialization (time between marsupialization and second treatment), and patient age. This was a retrospective cohort study with a sample size of 60 patients: 29 with OKC and 31 with UA. Pre- and post-marsupialization cone beam computed tomography images were analysed using Mimics software. The volume reduction and shrinkage speed were analysed and correlated with the preoperative volume, time after marsupialization, and demographic data. Descriptive univariable and multivariable statistics were computed; significance was set at P ≤ 0.05. The mean percentage volume reduction after marsupialization was 67.6 ± 9.6% for OKC and 63.3 ± 20.1% for UA. There was no significant difference in AVR or ASS between the OKC and UA groups. For OKC and UA, the preoperative volume (both P < 0.001) and time after marsupialization (P = 0.024 and P < 0.001, respectively) were associated with AVR. Moreover, for OKC and UA, the preoperative volume and time after marsupialization were also significantly associated with the ASS (all P < 0.001). For both lesions, patient age was not significantly related to AVR or ASS. Marsupialization appears to be a viable option to decrease the volume of OKC and UA. Age was found not to be associated with the volume reduction of either UA or OKC.

Identifying fragile calcifications of the aortic valve in transcatheter aortic valve replacement: iodine concentration of aortic valvular calcification by spectral CT.

To demonstrate the relationship between spectral computed tomography (CT) measured iodine concentration and strength of aortic valvular calcification (AVC) in patients with aortic valve stenosis (AVS). A retrospective study was performed on patients who underwent transcatheter aortic valve replacement (TAVR) for symptomatic AVS and underwent both pre and postprocedural electrocardiogram gated CT scans using a spectral CT system. Preprocedural CT was used to evaluate the volume and iodine concentration (IC) in the AVC. Postprocedural CT data were used to calculate the volume reduction percentage (VRP) of AVC. Multiple linear regression analysis was used to identify the independent variables related to the VRP in AVCs. A total of 94 AVCs were selected from 22 patients. The mean volume and IC of the AVCs before TAVR were 0.37 mL ± 0.15 mL and 7 mg/mL ± 10.5 mg/mL, respectively. After TAVR, a median VRP of all 94 AVCs was 18.5%. Multiple linear regression analysis showed that the IC was independently associated with the VRP (coefficient = 1.64, p < 0.001). When an optimal IC cutoff point was set at 4 mg/mL in the assessment of a fragile AVC which showed the VRP was > 18.5%, the sensitivity was 63%; specificity, 91%; positive predictive value, 88%; and negative predictive value, 71%. When using spectral CT to prepare the TAVR, measuring the IC of the AVC may be useful to assess the probability of AVC deformity after TAVR. • A dual-layer detector-based spectral CT enables quantifying iodine of contrast media in the aortic valve calcification (AVC) on contrast-enhanced CT images. • The AVC including iodine of contrast media on contrast-enhanced CT image may have loose compositions, associated with the deformity of AVC after TAVR. • Measuring the iodine concentration in AVC may have the potential to assess the probability of AVC deformity, which may be associated with the outcome and complications after TAVR.2.

A custom-made removable appliance for the decompression of odontogenic cysts fabricated using a digital workflow

ObjectivesThis case series aimed to assess the feasibility of a custom-made decompression appliance fabricated using a digital workflow to decompress odontogenic cysts. Additionally, the treated cysts were assessed for volumetric changes. MethodsA three-dimensional (3D) reconstruction software (CoDiagnostiX version 10.4) was used to obtain the master cast STL (Standard Tessellation Language) file by placing a customized virtual implant to create a recess for the tube of the decompression device. The decompression appliance was planned using Dental Wings Open Software (DWOS). Following rapid prototyping, the tube of the appliance was perforated using round burs. In cases where the appliances were designed to replace teeth, denture teeth were added using the conventional workflow. The appliances were delivered on the day of the cystostomy. Following decompression, cyst enucleation was performed. Cyst volume was assessed by manual segmentation of pre- and post-operative cone-beam computed tomography (CBCT) reconstructions using slice-by-slice boundary drawing with a scissors tool in the 3DSlicer 4.10.2 software. Percentage of volume reduction was calculated as follows: volume reduction/pre-operative volume × 100. ResultsSix odontogenic cysts in six patients (5 male, 1 female; age 40 years, range: 15–49 years) with a pre- and post-operative cyst volume of 5597 ± 3983 mm3 and 2330 ± 1860 mm3 respectively (p < 0.05) were treated. Percentage of volume reduction was 58.84 ± 13.22 % following a 6-month-long decompression period. ConclusionsThe digital workflow described in this case series enables the delivery of decompression appliances at the time of cystostomy, thus effectively reducing the volume of odontogenic cysts. The resulting bone formation established a safe zone around the anatomical landmarks; therefore, during enucleation surgery, complications to these landmarks can be avoided.

Steroids Therapy in Patients With Severe COVID-19: Association With Decreasing of Pneumonia Fibrotic Tissue Volume.

BackgroundWe use longitudinal chest CT images to explore the effect of steroids therapy in COVID-19 pneumonia which caused pulmonary lesion progression.Materials and MethodsWe retrospectively enrolled 78 patients with severe to critical COVID-19 pneumonia, among which 25 patients (32.1%) who received steroid therapy. Patients were further divided into two groups with severe and significant-severe illness based on clinical symptoms. Serial longitudinal chest CT scans were performed for each patient. Lung tissue was segmented into the five lung lobes and mapped into the five pulmonary tissue type categories based on Hounsfield unit value. The volume changes of normal tissue and pneumonia fibrotic tissue in the entire lung and each five lung lobes were the primary outcomes. In addition, this study calculated the changing percentage of tissue volume relative to baseline value to directly demonstrate the disease progress.ResultsSteroid therapy was associated with the decrease of pneumonia fibrotic tissue (PFT) volume proportion. For example, after four CT cycles of treatment, the volume reduction percentage of PFT in the entire lung was −59.79[±12.4]% for the steroid-treated patients with severe illness, and its p-value was 0.000 compared to that (−27.54[±85.81]%) in non-steroid-treated ones. However, for the patient with a significant-severe illness, PFT reduction in steroid-treated patients was −41.92[±52.26]%, showing a 0.275 p-value compared to −37.18[±76.49]% in non-steroid-treated ones. The PFT evolution analysis in different lung lobes indicated consistent findings as well.ConclusionSteroid therapy showed a positive effect on the COVID-19 recovery, and its effect was related to the disease severity.

Comparison of transarterial n-BCA and Onyx embolization of brain arteriovenous malformations: A single-center 18-year retrospective analysis.

ObjectiveBrain arteriovenous malformations (AVM) are commonly treated with endovascular embolization. Due to the rapid evolution of endovascular technology and lack of consistent practice guidelines regarding AVM embolization, further study of AVM embolization outcomes is warranted.MethodsWe conducted a retrospective review of AVMs embolized at a single center from 2002-2019. Patient demographics, AVM characteristics, intention of embolization, and angiographic and clinical outcome after embolization were recorded. We compared the embolization results of those treated with n-butyl cyanoacrylate (n-BCA) and Onyx.ResultsOver an 18-year period at our institution, 30 (33%) of 92 AVMs were treated with embolization. n-BCA was used in 12 cases and Onyx in 18 cases. Eighty-seven pedicles were embolized over 47 embolization sessions. Fifty percent of AVMs treated with n-BCA underwent more than one embolization session compared to 22% when Onyx was used. The median total percent volume reduction in the n-BCA AVMs was 52% compared to 51% in Onyx AVMs. There were 2 periprocedural complications in the n-BCA cohort and none in the Onyx cohort.ConclusionsIn this small retrospective series, Onyx and n-BCA achieved similar occlusion results, although n-BCA required more sessions and pedicles embolized to do so.

Indocyanine green-guided liposuction for patients presenting with residual nonpitting edema after lymphovenous anastomosis

Lymphovenous anastomoses (LVA) techniques for the treatment of lymphedema are well defined, and results restoring lymph function are reported in the literature. However, unsatisfactory results (poor-responders) are common, leading to persistent nonpitting edema. Blind liposuction eliminates fat and fibrous tissue but may result in inadvertent damage to the lymph vessel system. Indocyanine green imaging of the lymphatic system provides the potential preservation of functioning lymphatics while conducting liposuction to address the excess adipose and fibrous tissue in these patients. Our study reports the results of a prospectively conducted technique in patients with nonpitting edema after failing previous LVA. It consists of indocyanine green-guided liposuction. Twenty poor-responders patients to LVA who presented with persistent nonpitting edema were operated with liposuction. Limb volume measurements, SPECT-CT/lymphoscintigraphy, and ICG lymphography were recorded and complemented with a satisfaction inquiry. The overall percentage of volume reduction was 46.2% after liposuction (p=0.001). None of our patients reported any set back with respect to the improvements they had achieved after LVA nor new infections. Satisfaction showed a mean improvement of 5 points in a 20-point scale. SPECT-CT/lymphoscintigraphy showed further improvements in 17 cases after liposuction, such as dermal back-flow reduction, spots along the lymphatic system, or lymph nodes not described in preoperative reports, without showing significant differences when compared with overall volume reduction (p=0.12). Controlled liposuction with ICG seems to be an effective technique for the reduction of residual non-pitting edema in poor responder patients after LVA. Overall, volume excess reduction after liposuction was 42.6%.

Effectiveness of High-intensity Focused Ultrasound (HIFU) Therapy of Solid and Complex Benign Thyroid Nodules - A Long-term Follow up Two-center Study.

To investigate the effectiveness of high-intensity focused ultrasound (HIFU) of solid and complex benign thyroid nodules. Fifty-eight patients with benign thyroid nodules were treated with HIFU at two centers from 2014-2019. The device, EchoPulse (Teraclion, Malakoff, France), heats the nodes to 80-90 °C. Nodal volumes were measured by ultrasound at regular intervals before and up to 12 months after therapy. In a retrospective long-term two-center study, average volume reductions in relation to baseline volume were statistically analyzed by the Wilcoxon signed-rank test. Side effects were documented. In solid nodules, the average percent volume reductions at the 3, 6, 9, and 12-months follow-up were 49.98%, 46.40%, 65.77%, and 63.88%, respectively. The results were significant with p<0.05 in the Wilcoxon signed-rank test at the 3, 6, and 9-months follow-up. In complex nodules, the average percent volume reduction was 35.2% at 3 months, 36.89% at 6 months, and 63.64% at twelve months follow up. The results were significant with p<0.05 in the Wilcoxon signed-rank test at the 3- and 6-months follow-up. The complication rate was 5.2%. All complications occurred in patients with solid nodules. The study showed that HIFU is an effective treatment method for both solid and complex nodules. The complication rate is relatively high at 5.2%. No long-term complications occurred. The solid nodules responded better to HIFU than complex nodules.