Protrusion Area Research Articles

Interactions among pelvic organ protrusion, levator ani descent, and hiatal enlargement in women with and without prolapse

Pelvic organ prolapse has 2 components: (1) protrusion of the pelvic organs beyond the hymen; and (2) descent of the levator ani. The Pelvic Organ Prolapse Quantification system measures the first component, however, there remains no standard measurement protocol for the second mechanism. We sought to test the hypotheses that: (1) difference in the protrusion area is greater than the area created by levator descent in prolapse patients compared with controls; and (2) prolapse is more strongly associated with levator hiatus compared to urogenital hiatus. Midsagittal magnetic resonance imaging scans from 30 controls, 30 anterior predominant, and 30 posterior predominant prolapse patients were assessed. Levator area was defined as the area above the levator ani and below the sacrococcygeal inferior pubic point line. Protrusion area was defined as the protruding vaginal walls below the levator area. The levator hiatus and urogenital hiatus were measured. Bivariate analysis and multiple comparisons were performed. Bivariate logistic regression was performed to assess prolapse as a function of levator hiatus, urogenital hiatus, levator area, and protrusion. Pearson correlation coefficients were calculated. The levator area for the anterior (34.0 ± 6.5 cm2) and posterior (35.7 ± 8.0 cm2) prolapse groups were larger during Valsalva compared to controls (20.9 ± 7.8 cm2, P < .0001 for both); similarly, protrusion areas for the anterior (14.3 ± 6.2 cm2) and posterior (14.4±5.7 cm2) prolapse groups were both larger compared to controls (5.0 ± 1.8 cm2, P < .0001 for both). The levator hiatus length for the anterior (7.2 ± 1 cm) and posterior (6.9 ± 1 cm) prolapse groups were longer during Valsalva compared to controls (5.2 ± 1.5 cm, P < .0001 for both); similarly, urogenital hiatus lengths for the anterior (5.7 ± 1 cm) and posterior (6.3 ± 1.1 cm) prolapse groups were both longer than controls (3.8 ± 0.8 cm, P < .0001 for both). The difference in levator area in prolapse patients compared with controls was greater than the difference in protrusion area (14.0 ± 7.2 cm2 vs 9.4 ± 5.9 cm2, P < .0002). The urogenital hiatus was more strongly associated with prolapse than the levator hiatus (odds ratio, 12.9; 95% confidence interval, 4.1-39.2, and odds ratio, 4.3; 95% confidence interval, 2.3-7.5). Levator hiatus and urogenital hiatus are both correlated with levator and protrusion areas, and all were associated with maximum prolapse size (P ≤ .001, for all comparisons). In prolapse, the levator area increases more than the protrusion area and both the urogenital hiatus and levator hiatus are larger. The odds of prolapse for an increase in the urogenital hiatus are 3 times larger than for the levator hiatus, which leads us to reject both the original hypotheses.

Subconjunctival orbital fat prolapse and thyroid associated orbitopathy: a clinical association.

BackgroundThyroid associated orbitopathy (TAO) comprises a spectrum of well-recognized clinical signs including exophthalmos, eyelid retraction, soft tissue swelling, ocular misalignment, keratopathy as well as a number of less common manifestations. Subconjunctival fat prolapse is a rare clinical condition occurring typically spontaneously in elderly patients with a mean age of 65–72 years. We describe subconjunctival prolapse of orbital fat as an uncommon clinical association of TAO.Materials and methodsObservational study of six patients presenting with a subconjunctival protrusion under the lateral canthus in a series of 198 consecutive cases with TAO examined at a tertiary care referral center.ResultsA superotemporally located yellowish, very soft, freely mobile subconjunctival protrusion developed unilaterally in two and bilaterally in four patients with TAO (incidence 3.03%). It was one of the presenting manifestations of TAO in four of ten eyes studied and incited the diagnostic work-up for TAO in two of six patients in this series. Magnetic resonance imaging of the orbit indicated fat density in continuity with intraorbital fat in the area of protrusion. A male to female preponderance of 4:2 and an advanced mean age at onset of TAO is noteworthy for these six patients compared to the pool of 192 patients (64.8 versus 51.8 years, respectively, P=0.003) not bearing this sign.ConclusionSubconjunctival orbital fat prolapse, a clinically impressive age-related ocular lesion, may occasionally predominate amid other clinical manifestations of TAO. It is a nonspecific sign developing most commonly among patients with a relatively advanced age at presentation. Awareness of this association may alert to the diagnosis of thyroid orbitopathy and reassure the patient and physician as to the benign character of the lesion.

River delta shoreline reworking and erosion in the Mediterranean and Black Seas: the potential roles of fluvial sediment starvation and other factors

The Mediterranean basin (including the Black Sea) is characterized by a plethora of deltas that have developed in a wave-influenced setting. Many of these deltas are sourced in sediments by river catchments that have been variably dammed. The vulnerability status of a selection of ten deltas subject to different levels of reduction in fluvial sediment supply following damming was analysed by quantifying changes in delta protrusion area and protrusion angle over the last 30 years. The rationale for choosing these two metrics, which do not require tricky calculations of longshore bedload transport volumes and river ‘influence’, is that as sediment supply wanes, increasing relative efficiency of waves leads to longshore redistribution of reworked sediments and progressive ‘flattening’ of the delta protrusion. The results show that eight of the ten deltas (Nile, Rhône, Ebro, Ceyhan, Arno, Ombrone, Moulouya, Medjerda) are in erosion, whereas two (Danube, Po) show stability, but the statistical relationship between change in delta protrusion area and sediment flux reduction is poor, thus suggesting that the role of dams in causing delta shoreline erosion may have been over-estimated. But this poor relationship could also be due to a long temporal lag between dam construction and bedload removal and transport to the coast downstream of dams, and, where the delta protrusion is being eroded, to bedload trapping by shoreline engineering structures and by elongating delta-flank spits. Other potential influential factors in shoreline change include subsidence, sea-level rise, storminess, exceptional river floods, and managed sediment releases downstream of dams. A longer observation period and high-resolution sediment-budget studies will be necessary to determine more definitively to which extent continued trapping of sediment behind dams will impact overall delta stability in the Mediterranean and Black Seas. Mitigation of delta erosion is likely to become costlier under continued sediment starvation and sea-level rise.

Cervical intervertebral disc herniation treatment via radiofrequency combined with low-dose collagenase injection into the disc interior using an anterior cervical approach.

This study aimed to determine the therapeutic effect of radiofrequency combined with low-dose collagenase injected into the disc interior via an anterior cervical approach for cervical intervertebral disc herniation.Forty-three patients (26–62-year old; male/female ratio: 31/12) with cervical intervertebral disc herniation received radiofrequency combined with 60 to 100 U of collagenase, injected via an anterior cervical approach. The degree of nerve function was assessed using the current Japanese Orthopaedic Association (JOA) scoring system at 3 and 12 months postoperation. A visual analogue scale (VAS) was used to evaluate the degree of pain preoperation and 7 days postoperation. The preoperative and 3 month postoperative protrusion areas were measured and compared via magnetic resonance imaging (MRI) and picture archiving and communication systems (PACS).Compared with the preoperative pain scores, the 7-day postoperative pain was significantly reduced (P <0.01). The excellent and good rates of nerve function amelioration were 93.0% and 90.7% at 3 and 12 months postoperation, respectively, which was not significantly different. Twenty-seven cases exhibited a significantly reduced protrusion area (P <0.01) at 3 months postoperation. No serious side effects were noted.To our knowledge, this is the first study to demonstrate that the use of radiofrequency combined with low-dose collagenase injection into the disc interior via an anterior cervical approach is effective and safe for the treatment of cervical intervertebral disc herniation.

Tumor protrusion with intensive blood signals on ultrasonography is a strongly suggestive finding of follicular thyroid carcinoma.

It is difficult to differentiate follicular carcinomas (FC) from follicular adenomas (FA) because ultrasonography and cytology provide very similar findings. FC is histopathologically diagnosed to have capsular and/or vascular invasion. In a few patients, tumor protrusions are observed by preoperative ultrasonography as large forms of capsular invasion of follicular carcinomas. The aim of the study was to clarify the predictive value of tumor protrusions on preoperative ultrasonography for follicular carcinomas. A total of 531 patients (FC: 184 patients, FA: 347 patients) undergoing thyroid surgery were included in this study. A tumor protrusion on ultrasonography was defined as follows: 1) a solid tumor extending beyond a marginal line of capsular zone of the main tumor on B-mode ultrasonography; 2) intensive blood signals observed within the protrusion area on Doppler ultrasonography. The large form of capsular invasion was defined if the protrusion lesion was histopathologically diagnosed to be a capsular invasion of follicular carcinoma. The sensitivity of tumor protrusion was 0.071, specificity 0.994, positive predictive value 0.867, and negative predictive value 0.669 for FC diagnosis. For the large form of capsular invasion in FC the sensitivity of tumor protrusion was 0.813, specificity 0.982, positive predictive value 0.684, and negative predictive value 0.982. A tumor protrusion with intensive blood signals extending from the main tumor on ultrasonography strongly suggests a large form of capsular invasion of follicular carcinoma.

A simple method for controlled reduction duraplasty during cranioplasty

Background. Bone flap re-approximation during cranioplasty can be complicated by underlying pseudomeningocele or meningoencephalocele. A technique for controlled reduction duraplasty to aid bone flap positioning is suggested. Methods. A simple method using bipolar electrocautery in a predetermined radial pattern from the center of defect is described. Localized tissue contraction allows controlled reduction in the surface area and degree of protrusion. This in turn facilitates bone flap positioning. Results. The main advantage of this technique is slow and evenly distributed pressure conferred by controlled tissue contraction using multiple radial coagulation lines. No technical difficulties or complications have occurred with this method during cranioplasty for 11 patients. Conclusion. This simple technique for controlled reduction duraplasty can provide an easy and efficient method for bone flap re-approximation, and add to the existing techniques for a commonly performed procedure.

Incidence and Clinical Significance of Poststent Optical Coherence Tomography Findings: One-Year Follow-Up Study From a Multicenter Registry.

Optical coherence tomography (OCT) was recently introduced to optimize percutaneous coronary intervention. However, the exact incidence and significance of poststent OCT findings are unknown. A total of 900 lesions treated with 1001 stents in 786 patients who had postprocedure OCT imaging were analyzed to evaluate the incidence of poststent OCT findings and to identify the OCT predictors for device-oriented clinical end points, including cardiac death, target vessel-related myocardial infarction, target lesion revascularization, and stent thrombosis. Patients were followed up to 1 year. Stent edge dissection was detected in 28.7% of lesions, and incomplete stent apposition was detected in 39.1% of lesions. The incidences of smooth protrusion, disrupted fibrous tissue protrusion, and irregular protrusion were 92.9%, 61.0%, and 53.8%, respectively. Small minimal stent area, defined as a lesion with minimal stent area <5.0 mm(2) in a drug-eluting stent or <5.6 mm(2) in a bare metal stent, was observed in 40.4% of lesions. One-year device-oriented clinical end points occurred in 33 patients (4.5%). Following adjustment, irregular protrusion and small minimal stent area were independent OCT predictors of 1-year device-oriented clinical end points (P=0.003 and P=0.012, respectively). Abnormal poststent OCT findings were frequent. Irregular protrusion and small minimal stent area were independent predictors of 1-year device-oriented clinical end points, which were primarily driven by target lesion revascularization.

The role of ultrasonography in differential diagnosis of degenerative disk disease of the lumbar spine

Objective: To improve the diagnostics of lumbar degenerative disc disease through the development and implementation of complex of ultrasound criteria into the clinical practice. Methods: There were examined 128 patients aged from 20 to 60 years with degenerative diseases of the lumbar spine, as well as 21 healthy subjects between the ages from 20 and 40 as a comparative group. Results: We in¬vestigated diagnostic capabilities of ultrasonography in patients with degenerative processes in the intervertebral discs (IVD) of different severity. There were defined ultrasound criteria for protru¬sions, IVD herniations, epiduritis, scar-adhesions in the epidural space, and the yellow ligament hypertrophy. The main feature that distinguishes the protrusion from other pathological conditions on the border of IVD and the spinal canal is an absence of the fibrous ring ruptures in the area of protrusions. When rendering ruptures of the disk we diagnosed IVD herniation. To determine the type of herniation using ultrasonography there has been proposed and patented a method of ultrasound diagnostics of the lumbar spine IVD herniation which clearly defined the localization of posterior herniation. There were evaluated and compared the efficiency and informativeness of ultrasonography in different types of IVD protrusions and herniations. Conclusions: An initial stage of the degenerative process in IVD is characterized by increased echo-genicity, heterogeneity in echostructure of the nucleus pulposus, expansion of the boundaries between it and the fibrous ring. Ex¬pressed stages of degenerative disk disease characterize with com¬promising of the integrity of the fibrous ring and the formation of IVD herniations, development of reactive epiduritis and adhesions in epidural space. It was demonstrated a high information content of the ultrasonic method for visualization of localization, direction and size of herniations: sensitivity — 89.2 %; specificity — 66.6 %; accuracy — 87.1 %.

The receptor tyrosine kinase Pvr promotes tissue closure by coordinating corpse removal and epidermal zippering.

A leading cause of human birth defects is the incomplete fusion of tissues, often manifested in the palate, heart or neural tube. To investigate the molecular control of tissue fusion, embryonic dorsal closure and pupal thorax closure in Drosophila are useful experimental models. We find that Pvr mutants have defects in dorsal midline closure with incomplete amnioserosa internalization and epidermal zippering, as well as cardia bifida. These defects are relatively mild in comparison to those seen with other signaling mutants, such as in the JNK pathway, and we demonstrate that JNK signaling is not perturbed by altering Pvr receptor tyrosine kinase activity. Rather, modulation of Pvr levels in the ectoderm has an impact on PIP3 membrane accumulation, consistent with a link to PI3K signal transduction. Polarized PI3K activity influences protrusive activity from the epidermal leading edge and the protrusion area changes in accord with Pvr signaling intensity, providing a possible mechanism to explain Pvr mutant phenotypes. Tissue-specific rescue experiments indicate a partial requirement in epithelial tissue, but confirm the essential role of Pvr in hemocytes for embryonic survival. Taken together, we argue that inefficient removal of the internalizing amnioserosa tissue by mutant hemocytes coupled with impaired midline zippering of mutant epithelium creates a situation in some embryos whereby dorsal midline closure is incomplete. Based on these observations, we suggest that efferocytosis (corpse clearance) could contribute to proper tissue closure and thus might underlie some congenital birth defects.

Experimental and Simulation Study of Thermal Protrusion-Induced Head-Disk Contact Instabilities in Hard Disk Drives

Stability of the thermal fly height control slider has profound effects on the read-write performance and reliability of the head-disk interface. As magnetic storage technologies evolve aggressively toward higher areal density in hard disk drives, the fly height around the transducer area on the slider has achieved a read-write physical spacing of \({\sim }2\) nm, and is expected to be even lower to meet the magnetic storage road map in the near future. At such a low spacing, instabilities can occur in terms of slider vibration and prominent lubricant transfer from the disk to the slider, resulting in significant interface change that raises reliability concerns. In this paper, we experimentally investigate the thermal protrusion induced slider instability at contact proximities, and perform numerical simulations to explain the measured dynamics at head-disk contacts. The results suggest that as the slider's thermal protrusion area approaches the disk surface, instabilities mainly come from down-track force excitations. These excitations lead to more significant vibrations in the down-track direction and on the slider's leading edge rather than its trailing edge. The behavior of slider vibration at disk proximity is also dependent on the head-gimbal-assembly design.

Computer-aided image analysis algorithm to enhance in vivo diagnosis of plaque erosion by intravascular optical coherence tomography.

Recent reports show that plaque erosion can be diagnosed in vivo using optical coherence tomography in patients with acute coronary syndrome. However, quantitative optical coherence tomographic image criteria for computer-aided diagnosis of plaque erosion have not been established. A total of 42 patients with acute coronary syndrome caused by plaque erosion were included. Plaque erosion was identified according to the previously established optical coherence tomography criteria. Both optical properties and morphological features of the focal-eroded region as well as erosion-adjacent region were analyzed using a custom-designed computer algorithm. Noneroded fibrous plaques remote from the erosion site within the same vessel were used as controls. Eroded plaques have significantly lower surface intensity (P<0.001), lower region of interest intensity (P<0.001), lower surface normalized SD (P<0.001), lower region of interest normalized SD (P<0.001), higher optical attenuation (P<0.001), larger tissue protrusion area (P<0.001), and greater surface roughness (P<0.001) when compared with control plaques. Erosion-adjacent regions also have lower region of interest normalized SD (P=0.008), higher attenuation (P<0.001), and greater surface roughness (P=0.005). Using a logistic regression model built on the quantitative features, plaque erosion can be accurately classified against intact fibrous plaques. There was low inter- and intraobserver variability associated with the algorithm-assisted quantitative assessment. Plaque erosion has distinctive optical properties and morphological features when compared with noneroded fibrous plaques. Quantitative image analysis may enhance diagnostic accuracy for plaque erosion in vivo.

Regulation of intrinsic axon growth ability at retinal ganglion cell growth cones.

Mammalian central nervous system neurons fail to regenerate after injury or disease, in part due to a progressive loss in intrinsic axon growth ability after birth. Whether lost axon growth ability is due to limited growth resources or to changes in the axonal growth cone is unknown. Static and time-lapse images of purified retinal ganglion cells (RGCs) were analyzed for axon growth rate and growth cone morphology and dynamics without treatment and after manipulating Kruppel-like transcription factor (KLF) expression or applying mechanical tension. Retinal ganglion cells undergo a developmental switch in growth cone dynamics that mirrors the decline in postnatal axon growth rates, with increased filopodial adhesion and decreased lamellar protrusion area in postnatal axonal growth cones. Moreover, expressing growth-suppressive KLF4 or growth-enhancing KLF6 transcription factors elicits similar changes in postnatal growth cones that correlate with axon growth rates. Postnatal RGC axon growth rate is not limited by an inability to achieve axon growth rates similar to embryonic RGCs; indeed, postnatal axons support elongation rates up to 100-fold faster than postnatal axonal growth rates. Rather, the intrinsic capacity for rapid axon growth is due to both growth cone pausing and retraction, as well as to a slightly decreased ability to achieve rapid instantaneous rates of forward progression. Finally, we observed that RGC axon and dendrite growth are regulated independently in vitro. Together, these data support the hypothesis that intrinsic axon growth rate is regulated by an axon-specific growth program that differentially regulates growth cone motility.

Generation and characterization of regulatory dendritic cells derived from murine induced pluripotent stem cells

Regulatory dendritic cells (DCregs) represent a potential therapeutic tool for assessing a variety of immune overreaction conditions; however, current approaches for generating DCregs for therapeutic purposes are limited. We attempted to generate and characterize DCregs from murine induced pluripotent stem (iPS) cells. The iPS cells co-cultured with OP9 cells displayed mesodermally differentiated flat colonies. GM-CSF drove most of the colonies exhibiting a differentiated morphology. Thereafter, cells became morphologically heterologous under the effects of TGF-β and IL-10. Most of the floating cells developed an irregular shape with areas of protrusion. The generated iPS-DCregs demonstrated high CD11b/c and low CD40, CD80, CD86 and MHC-II expressions with a high antigen uptake ability and poor T-cell stimulatory function. Importantly, iPS-DCregs showed immune responsiveness regulation effects both in vitro and in vivo and the ability to generate regulatory T-cells in vitro. Our result illustrates a feasible approach for generating functional DCregs from murine iPS cells.

Finite element analysis of pectus carinatum surgical correction via a minimally invasive approach

Pectus carinatum (PC) is a chest deformity caused by a disproportionate growth of the costal cartilages compared to the bony thoracic skeleton, pulling the sternum towards, which leads to its protrusion. There has been a growing interest on using the ‘reversed Nuss’ technique as a minimally invasive procedure for PC surgical correction. A corrective bar is introduced between the skin and the thoracic cage and positioned on top of the sternum highest protrusion area for continuous pressure. Then, it is fixed to the ribs and kept implanted for about 2–3 years. The purpose of this work was to (a) assess the stresses distribution on the thoracic cage that arise from the procedure, and (b) investigate the impact of different positioning of the corrective bar along the sternum. The higher stresses were generated on the 4th, 5th and 6th ribs backend, supporting the hypothesis of pectus deformities correction-induced scoliosis. The different bar positioning originated different stresses on the ribs' backend. The bar position that led to lower stresses generated on the ribs backend was the one that also led to the smallest sternum displacement. However, this may be preferred, as the risk of induced scoliosis is lowered.

Optimization of nanofountain probe microfabrication enables large-scale nanopatterning

A technological gap in nanomanufacturing has prevented the translation of many nanomaterial discoveries into real-world commercialized products. Bridging this gap requires a paradigm shift in methods for fabricating nanoscale devices in a reliable and repeatable fashion. Here we present the optimized fabrication of a robust and scalable nanoscale delivery platform, the nanofountain probe (NFP), for parallel direct-write of functional materials. Microfabrication of a new generation of NFP was realized with the aim of increasing the uniformity of the device structure. Optimized probe geometry was integrated into the design and fabrication process by modifying the precursor mask dimensions and by using an isotropic selective dry etching of the outer shell that defines the protrusion area. Probes with well-conserved sharp tips and controlled protrusion lengths were obtained. Sealing effectiveness of the channels was optimized. A conformal tetraethyl orthosilicate based oxide layer increased the sealing efficacy while minimizing the required thickness. A compensation scheme based on the residual stresses in each layer was implemented to minimize bending of the cantilever after releasing the device. The device was tested by patterning ferritin catalyst arrays on silicon dioxide with sub-100 nm resolution. The optimized probes increased the control over the parallel patterning resolution which enables manufacturing of ordered arrays of nanomaterials.

Malignant paraganglioma of the parapharyngeal region – clinical case

The authors present the clinical case of a malignant paraganglioma of the parapharyngeal region: diagnosis, surgery and treatment with radiotherapy, MIBG-I131, chemotherapy and octreotid. 63 year old woman was referred to our department with a diagnosis of left parapharyngeal glomic tumour to which she previously refused treatment. She complained of sialorrhea, cough, dysphonia, difficulty in articulating words, vomiting and repeated syncopal episodes during the past year. She presented a history of hypertension, anxiety, and a pacemaker for symptomatic bradicardia. Physical exam revealed paralysis of the left vocal cord; slight atrophy of left hemitongue; an area of protrusion of the soft palate on the left; neck palpation on the left side elicited episodes of cough. Cervical CT scan revealed a 5.8 cm × 3.3 cm × 2.7 cm expansive lesion of the left parapharyngeal region with heterogeneous contrast enhancement. AngioCT showed displacement of internal carotid artery medially and anteriorly. Arteriography revealed a highly vascularized tumour, irrigated by the external carotid artery. Scintigraphy MIGB-I123 demonstrated anomalous uptake on the lesion. Urinary and plasma catecholamines and metanephrines presented normal values. Surgery consisted of a left functional neck dissection (levels I–III) to facilitate the resection of the tumour originating on the left hypoglossal nerve, extending from the carotid bifurcation to the cranial base. Pathology confirmed a paraganglioma with vascular invasion and a metastasis in one of eight ganglia. The patient underwent adjuvant radiotherapy, adjuvant MIBG-I131 and palliative chemotherapy. Ten months after adjuvant radiotherapy the patient presented metastatic disease and local recurrence. MIBG-I131 and palliative chemotherapy were performed with remission, however fourteen months latter presented disseminated disease. We present a case of malignant paraganglioma with significant semiology. Functional neck dissection became determinant in the early diagnosis of malignancy. MIBG-I131 and palliative chemotherapy showed satisfactory immediate results although recurrence occurred. paraganglioma,parapharyngeal, hypoglossal.

Phosphorylation and externalization of galectin-4 is controlled by Src family kinases

Galectin-4 is a cytosolic protein that lacks a signal sequence but is externalized and binds to 3-O-sulfated glycoconjugates extracellularly. The mechanism of subcellular localization and externalization of galectin-4 has not yet been determined. A preliminary experiment using pervanadate (PV) showed that galectin-4 is tyrosine-phosphorylated in cells and suggested that Src kinases are involved. Cell transfection with galectin-4 and active Src plasmids showed that galectin-4 can be tyrosine phosphorylated by members of the Src kinase family. The C-terminal peptide YVQI of galectin-4 was found to play an important role in its tyrosine phosphorylation, and the SH2 domains of Src and SHP2 were found to bind to this peptide. Immunofluorescence analysis showed that galectin-4 and phosphorylated proteins were intensely stained in the area of membrane protrusions of PV-treated or Src-activated cells. Furthermore, MUC1 derived from NUGC-4 cells was observed to bind to galectin-4, and externalization of the bound molecules from the cell to the medium increased in the hyperphosphorylated condition. Study of the transfection of the mutant galectin-4 which lacks the C-terminal peptide revealed that the phosphorylation status is important for externalization of galectin-4. These results suggest that externalization of galectin-4 can be regulated by signaling molecules and that it may function intracellularly as an adaptor protein serving to modulate the trafficking of glycoproteins.

Anticipatory lip gestures: A validation of the Movement Expansion Model in congenitally blind speakers

In this paper, anticipatory co-articulation of the lip protrusion and constriction gestures is investigated in speakers with visual deprivation. Audio-visual recordings of 11 congenitally blind French speakers producing [V-roundC-roundV+round] sequences were measured with a lip shape tracking system. Lip protrusion and constriction values and their relative timings were analyzed. Results show that despite the reduced magnitude of lip protrusion and constriction area in blind speakers, the timing of the anticipatory gestures can be appropriately modeled by the Movement Expansion Model [from Abry and Lallouache (1995a). Bul. de la Comm. Parlée 3, 85-99; (1995b). Proceedings of ICPHS, pp. 152-155; Noiray et al. (2011). J. Acoust. Soc. Am. 129, 340-349], which predicts lawful anticipatory behavior expanding linearly as the intervocalic consonant interval increases.

Three-dimensional Quantification of Femoral Head Shape in Controls and Patients with Cam-type Femoroacetabular Impingement

An objective measurement technique to quantify 3D femoral head shape was developed and applied to normal subjects and patients with cam-type femoroacetabular impingement (FAI). 3D reconstructions were made from high-resolution CT images of 15 cam and 15 control femurs. Femoral heads were fit to ideal geometries consisting of rotational conchoids and spheres. Geometric similarity between native femoral heads and ideal shapes was quantified. The maximum distance native femoral heads protruded above ideal shapes and the protrusion area were measured. Conchoids provided a significantly better fit to native femoral head geometry than spheres for both groups. Cam-type FAI femurs had significantly greater maximum deviations (4.99 ± 0.39 mm and 4.08 ± 0.37 mm) than controls (2.41 ± 0.31 mm and 1.75 ± 0.30 mm) when fit to spheres or conchoids, respectively. The area of native femoral heads protruding above ideal shapes was significantly larger in controls when a lower threshold of 0.1 mm (for spheres) and 0.01 mm (for conchoids) was used to define a protrusion. The 3D measurement technique described herein could supplement measurements of radiographs in the diagnosis of cam-type FAI. Deviations up to 2.5 mm from ideal shapes can be expected in normal femurs while deviations of 4-5 mm are characteristic of cam-type FAI.

Randomized study to assess the effect of thrombus aspiration on flow area in patients with ST-elevation myocardial infarction: an optical frequency domain imaging study—TROFI trial

Primary percutaneous coronary intervention (PPCI) with thrombectomy (TB) seems to reduce the thrombus burden, resulting in a larger flow area as measured with optical frequency domain imaging (OFDI). In a multi-centre study, 141 patients with ST elevation myocardial infarction <12 h from onset were randomized to either PPCI with TB using an Eliminate catheter (TB: n = 71) or without TB (non-TB: n = 70), having operators blinded for the OFDI results. The primary endpoint was minimum flow area (MinFA) post-procedure assessed by OFDI, defined as: [stent area + incomplete stent apposition (ISA) area] - (intraluminal defect + tissue prolapse area). Sample size was based on the expected difference of 0.72 mm(2) in MinFA. Baseline demographics, pre-procedural quantitative coronary angiography (QCA), and procedural characteristics were well matched between the two groups. On OFDI, the stent area (TB: 7.62 ± 2.23 mm(2), non-TB: 7.05 ± 2.12 mm(2), P = 0.14) and MinFA (TB: 7.08 ± 2.14 mm(2) vs. non-TB: 6.51 ± 1.99 mm(2), Δ0.57 mm(2), P = 0.12) were not different. In addition, the amount of protrusion, intraluminal defect, and ISA area were similar in the both groups. PPCI with TB was associated with a similar flow area as well as stent area to PPCI without TB.