Short Axis Length Research Articles

Comparative effectiveness of two abbreviated rectal MRI protocols in assessing tumor response to neoadjuvant chemoradiotherapy in patients with rectal cancer.

The present study aimed to compare the effectiveness of two abbreviated magnetic resonance imaging (MRI) protocols in assessing the response to neoadjuvant chemoradiotherapy (CRT) in patients with rectal cancer. Data from the examinations of 62 patients with rectal cancer who underwent neoadjuvant CRT and standard contrast-enhanced rectal MRI were retrospectively evaluated. Standard contrast-enhanced T2-weighted imaging (T2-WI), post-contrast T1-weighted imaging (T1-WI) and diffusion-weighted imaging (DWI) MRI, as well as two abbreviated protocols derived from these images, namely protocol AB1 (T2-WI and DWI) and protocol AB2 (post-contrast fat-suppressed (FS) T1-WI and DWI), were assessed. Measurements of lesion length and width, lymph node short-axis length, tumor staging, circumferential resection margin (CRM), presence of extramural venous invasion (EMVI), luminal mucin accumulation (MAIN), mucinous response, mesorectal fascia (MRF) involvement, and MRI-based tumor regression grade (mrTRG) were obtained. The reliability and compatibility of the AB1 and AB2 protocols in the evaluation of tumor response were analyzed. The imaging performed according to the AB1 and AB2 protocols revealed significant decreases in lesion length, width and lymph node size after CRT. These protocols also showed reductions in lymph node positivity, CRM, MRF, EMVI.Furthermore, both protocols were found to be reliable in determining lesion length and width. Additionally, compliance was observed between the protocols in determining lymph node size and positivity, CRM involvement, and EMVI after CRT. In conclusion, the use of abbreviated MRI protocols, specifically T2-WI with DWI sequences or post-contrast FS T1-WI with DWI sequences, is effective for evaluating tumor response in patients with rectal cancer following neoadjuvant CRT. The AB protocols examined in this study yielded similar results in terms of lesion length and width, lymph node positivity, CRM involvement, EMVI, MAIN, and MRF involvement.

Challenges in cataract surgery after penetrating keratoplasty managed using femtosecond laser: A series of 3 case reports.

Cataract surgery in patients after penetrating keratoplasty (PKP) is often challenging because of changes in corneal structure induced by PKP and primary corneal disease. Femtosecond laser-assisted cataract surgery offers several advantages over conventional phacoemulsification, and has been widely used in complicated cataract surgery. We report the use of femtosecond laser-assisted cataract surgery in 3 challenging cases after penetrating keratoplasty. Case 1 involved a patient with hard nuclear grade IV° cataract. After surgery, his corrected distance visual acuity (CDVA) improved from 20/400 to 20/25, and the endothelial cell loss (ECL) % was 12.05 % at 3 months postoperatively. The rotation of the toric IOL in Case 1 was 2°. Case 2 involved a patient with severe nuclear cataract and an endothelial cell density of 837 cells/mm2. After surgery, the CDVA improved from 20/100 to 20/40. The ECL% was 4.06% at 1 week postoperatively. Case 3 was a 91-year-old woman with a short axis length of 21.35 mm and an endothelial cell density number of 1238 cells/mm2. After surgery, the CDVA improved from light perception to 20/133, and the ECL% was 26.09% at 1 week postoperatively; ECL% was 2.67% at 1 month post-operation. The corneal grafts were transparent. Femtosecond laser-assisted cataract surgery seems to be an effective, predictable, and safe approach for challenging patients after PKP, and improves visual recovery and optimal refractive outcomes.

Improving the efficiency and environmental safety of emamectin benzoate through a pH-responsive metal–organic framework microencapsulation strategy

Herein, we developed a technique for loading nanopesticides onto Metal-Organic Frameworks (MOFs) to control Spodoptera litura. The average short-axis length of the synthesized carrier emamectin benzoate@PCN-222 @hyaluronic acid (EB@PCN-222 @HA) was ∼40 nm, with an average long-axis length of ∼80 nm. This enabled the manipulation of its size, contact angle, and surface tension on the surface of leaves. Pesticide-loading capacity, determined via thermogravimetric analysis, was measured at ∼16 %. To ensure accurate pesticide release in the alkaline intestine of Spodoptera litura, EB@PCN-222 @HA was engineered to decompose under alkaline conditions. In addition, the carrier delayed the degradation rate of EB, enhancing EB’s stability. Loading Nile red onto PCN-222 @HA revealed potential entry into the insect body through feeding, which was supported by bioassay experiments. Results demonstrated the sustained-release performance of EB@PCN-222 @HA, extending its effective duration. The impact of different carrier concentrations on root length, stem length, fresh weight, and germination rate of pakchoi and tomato were assessed. Promisingly, the carrier exhibited a growth-promoting effect on the fresh weight of both the crops. Furthermore, cytotoxicity experiments confirmed its safety for humans. In cytotoxicity assays, PCN-222 @HA showed minimal toxicity at concentrations up to 100 mg/L, with cell survival rates above 80 %. Notably, the EB@PCN-222 @HA complex demonstrated reduced cytotoxicity compared to EB alone, supporting its safety for human applications. This study presents a safe and effective approach for pest control using controlled-release pesticides with extended effective durations.

Current Preoperative Management of Vulvar Squamous Cell Carcinoma: An Overview.

Vulvar carcinoma is a rare cancer affecting the genital tract, constituting 4% of gynecological tumors. Vulvar squamous cell carcinoma (VSCC) is the most common type. Diagnosis relies on biopsy during vulvoscopy, plus imaging such as ultrasonography (USG), magnetic resonance imaging (MRI) and positron emission tomography (PET). This review aims to lay out a thorough overview as to the current preoperative management of VSCC, both in case of vulvar and lymph node involvement. The data research was conducted using the following databases: MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial.gov, OVID and Cochrane Library from 2010 to 2024. The selection criteria included only original articles. Seventeen studies were assessed for eligibility. A concordance rate of 62.3% for vHSIL and 65.2% for carcinoma at vulvoscopy, with a sensitivity of 98%, specificity of 40%, PPV (Positive Predictive Value) of 37% and NPV (Negative Predictive Value) of 98% in identifying malignant lesions was found. Regarding the reliability of PET for staging and assessing lymph node involvement, a mean SUV (Standardized Uptake Value) for malignant vulvar lesions of 8.4 (range 2.5-14.7) was reported. In the case of MRI, useful for the evaluation of loco-regional infiltration and lymph node involvement, the ratio of the short-to-long-axis diameter and the reader's diagnostic confidence for the presence of lymph node metastasis yielded accuracy of 84.8% and 86.9%, sensitivity of 86.7% and 87.5%, specificity of 81.3% and 86.2%, PPV of 89.7% and 87.5% and NPV of 76.5% and 86.2%, respectively. A long lymph node axis >10 mm and a short diameter >5.8 mm were found to be predictors of malignancy. At USG, instead, the two main characteristics of potentially malignant lymph nodes are cortical thickness and short axis length; the combination of these ultrasound parameters yielded the highest accuracy in distinguishing between negative and positive lymph nodes. Despite the heterogeneity of the included studies and the lack of randomized clinical trials, this review provides a broad overview of the three imaging tools used for the presurgical management of VSCC. Nowadays, although MRI and PET represent the gold standard, ultrasound evaluation is taking on a growing role, as long as it is carried out by expert sonographer. The management of this rare disease should be always performed by a multidisciplinary team in order to precisely stage the tumor and determine the most suitable treatment approach.

Simplification of selective imaging of dislocation loops: diffraction-selected on-zone STEM

ABSTRACT Contrary to the conventional belief that, in transmission electron microscopy (TEM), selective and sharp imaging of dislocation loops can be realized only by accurate tilting of a specimen from the condition that the symmetrical axis of incident electron beam distribution is parallel to a zone axis of the TEM specimen (on-zone condition), we demonstrate that selective dark-field (DF) imaging of dislocation loops at on-zone condition is possible with a scanning TEM (STEM) mode that uses an objective lens aperture to select a diffraction disk of interest. Diffraction-selected on-zone STEM (DsoZ-STEM) has been applied to selective DF imaging of dislocation loops with a short axis length of <2 nm in a single-crystal aluminum irradiated by argon ions and an electron beam at room temperature. It was found that a Kikuchi line enhances the contrast among the dislocation loops and the matrix of DsoZ-STEM images. DsoZ-STEM obeyed g·b invisibility criterion and showed good agreement with a typical visibility change of a dislocation line and a loop in conventional DF images with a specific pair of ± g. In addition, dislocation loops always showed much higher brightness in the inner side compared to the outer side in DsoZ-STEM images, simplifying the distinction of dislocation loops with apparently the same long-axis direction but different b. Thus, DsoZ-STEM can simplify the selective DF imaging for the determination of the number and the character of dislocation loops.

Association between the Temporomandibular Joint Morphology and Chewing Pattern.

This study aimed to investigate whether the morphology of the temporomandibular joint (TMJ) is associated with chewing patterns while considering skeletal morphology, sex, age, and symptoms of temporomandibular disorder (TMD). A cross-sectional observational study of 102 TMJs of 80 patients (age 16-40 years) was performed using pretreatment records of cone-beam computed tomography imaging of the TMJ, mandibular kinesiographic records of gum chewing, lateral and posteroanterior cephalometric radiographs, patient history, and pretreatment questionnaires. To select appropriate TMJ measurements, linear regression analyses were performed using TMJ measurements as dependent variables and chewing patterns as the independent variable with adjustment for other covariates, including Nasion-B plane (SNB) angle, Frankfort-mandibular plane angle (FMA), amount of lateral mandibular shift, sex, age, and symptoms of TMD. In multiple linear regression models adjusted for other covariates, the length of the horizontal short axis of the condyle and radius of the condyle at 135° from the medial pole were significantly (p < 0.05) associated with the chewing patterns in the frontal plane on the working side. "Non-bilateral grinding" displayed a more rounded shape of the mandibular condyle. Conversely, "bilateral grinding" exhibited a flatter shape in the anteroposterior aspect. These findings suggest that the mandibular condyle morphology might be related to skeletal and masticatory function, including chewing patterns.

SELF-ASSEMBLY AND PHOTOINDUCED DEFORMATION OF MICROSPHERES OF AN AZO MOLECULE CONTAINING A 1,4,3,6-DIANHYDROSORBITOL CORE AND CINNAMATE PERIPHERAL GROUPS

This study investigated the controllable fabrication of anisotropic particles with different sizes and morphologies via self-assembly and photoinduced deformation of azo colloidal microspheres, which were formed from a typical azo molecular material (IAC-4) that contains a 1,4,3,6-dianhydrosorbitol core and the cinnamate peripheral groups. Firstly, azo colloidal microspheres were obtained by self-assembly via gradually adding deionized water into IAC-4 solution of tetrahydrofuran. For precisely controlling the length of short axis of anisotropic particles, IAC-4 colloidal microspheres with different and uniform sizes were obtained by adjusting the IAC-4 concentration, adding rate of water and stirring rate. The size of colloidal microspheres becomes smaller with the increase in IAC-4 concentration, the adding rate of water and the stirring rate. Finally, IAC-4 colloidal microspheres in the solid state, perpendicularly irradiated by the linearly polarized laser beam (λ = 488 nm), were irreversibly and controllably stretched into anisotropic particles with the different morphologies, length of long axis and axial ratio via adjusting the irradiation time and the power of laser beam.

Morphology and morphometric diversity of pollen grains of 26 Indian species of &lt;i&gt;Dioscorea&lt;/i&gt; L. (Dioscoreaceae)

Pollen morphology of 26 species of Dioscorea collected from different regions of India was examined critically under LM and SEM to explore their unique features. Pollen grains were monad, isopolar, small to medium-sized (11.3–31 µm). Peroblate, oblate, suboblate and oblate spheroidal (P/E=0.41–0.90) pollen shape, mono and bi-sulcate aperture type and psilate, reticulate, rugulose, strito-reticulate, reticulate-rugulose, punctate and striate exine ornamentation were believed to be some of the important characters for differentiation of closely related species in this studied genus. The comprehensive qualitative and quantitative characters of the pollen grains served as reliable features in taxonomical studies. The observed data were analyzed using PCA and hierarchical clustering to obtain a steady relationship and grouping of the observed species. Histograms, pie chart and bar graph were performed to enumerate the distribution of the quantitative data of various attributes (long axis, short equatorial axis, pollen shape and aperture length). Correlation scatter plot along with density graph helped to understand the interrelationship amongst the studied taxa.

Electromagnetic response and optical properties of anisotropic CuSbS2 nanoparticles

We investigate the electromagnetic response of anisotropic (non-spherical) copper antimony disulfide ( C u S b S 2 ) nanoparticles and layers embedded with them using computational methods. To this end, we calculate the scattering and absorption efficiencies of oblate spheroidal C u S b S 2 nanoparticles using the surface integral equation method. We find strong dependence of the response depending on the anisotropy of the spheroids and their orientation with respect to the electric field polarization of incoming radiation. Thin spheroids display a sharp plasmonic resonance in the ultraviolet, which is observed only for the electric field polarization along the short axis. Fano resonances that appear in the near infrared (NIR) blueshift when the short axis length is reduced, and they can be either strongly suppressed or enhanced depending on the relative orientation of the spheroid. We further investigate the optical response of thin layers containing C u S b S 2 spheroids at a low volume fraction using a Monte Carlo method. We find that the response of these layers can be considerably modified by changing the short axis length and the orientation of particles within the layer with respect to polarization. Our results demonstrate the potential of anisotropic dielectric particles for polarization-dependent-response applications such as solar devices and NIR sensors.

Effect of Yijinjing Training on Balance Function and Plantar Pressure of Stroke Patients

<bold>Objective</bold> To observe the effect of Yijinjing training on static balance function and plantar pressure of stroke patient under the condition of eyes opened or closed. <bold>Methods</bold> A total of 48 stroke patients who were treated in the Second Rehabilitation Hospital of Shanghai from January to August 2021, which were randomly divided into the control group and the observation group according to the random number table method, with 24 cases in each groups. The control group received routine rehabilitation therapy, including exercise therapy, occupational therapy, electrotherapy and acupuncture therapy, once a day, five days a week, continuous treatment for four weeks. The observation group received Yijinjing training on the basis of the control group, 30 minutes a time, once a day, five days a week, continuous treatment for four weeks. Before and after treatment, the Berg balance scale (BBS) was used to evaluate balance function; the plantar pressure analysis system was used to evaluate the plantar pressure parameters under the condition of eyes opened or closed, the percentage of plantar pressure of the hemiplegic side and envelope ellipse parameters (long axis length, short axis length and area) were obtained through the analysis of the system; the adverse reactions such as falls, muscle pain, abnormal blood pressure and heart rate of the two groups were recorded. <bold>Results</bold> There was no significant difference in BBS score, percentage of plantar pressure on the hemiplegic side and envelope ellipse parameters of the two groups before treatment,the difference was no statistically significant (<italic>P</italic>&gt;0.05). Compared with before treatment, the BBS score of the two groups after treatment were significantly increased, and the percentage of plantar pressure on the hemiplegic side of the observation group after treatment were significantly increased, while the envelope ellipse parameters of the observation group after treatment were significantly decreased under the condition of eyes open and closed,the difference was statistically significant (<italic>P</italic>&lt;0.05). Compared with the control group, the BBS score and the percentage of plantar pressure on the hemiplegic side under the condition of eyes opened and closed were significantly increased, and the envelope ellipse parameters under the condition of eyes open were significantly lower in the observation group after treatment,the difference was statistically significant (<italic>P</italic>&lt;0.05). There were no adverse events in both groups. <bold>Conclusion</bold> Yijinjing training is helpful to improve the weight-bearing ability of the hemiplegic limb and the stability of center of gravity control of stroke patients, and effectively improve their balance function, which is worthy of clinical application and promotion.

Study on the variation of Bragg propagation period in elliptic bar chain structure

In this paper, the propagation of light along a long chain of two dimensional elliptic bars with infinite period is analyzed. Due to the instability of the shape of the ellipse, the propagation characteristics of light will be changed by changing the ratio of the short half axis length to the long half axis length of the ellipse. The Bragg propagation period is observed by the change of phase constant and attenuation constant with the normalized frequency. The waveguide mode, cut-off mode and leakage mode were explained by analyzing the numerical value and field distribution of the cycle results of a single layer elliptic cylinder with different ratios. The results also indicated that, as the ratio increased, the propagation period of Bragg wave became shorter and special multimodal phenomena emerged. In addition, 20 dielectric bar chain structures are used to visually show the electric field propagation.

Measurement of the banana pseudo-stem phenotypic parameters based on ellipse model

The measurement of banana pseudo-stem phenotypic parameters is a critical way to evaluate the growth status of bananas, and it can provide essential data support for mechanized cultivation operations such as fertilization and pesticide application. Existing studies mainly measure the diameter of banana pseudo-stem as its phenotypic parameter. The banana pseudo-stem cross section was closer to an ellipse other than a standard circle, so the diameter parameter cannot adequately represent the phenotypic characteristics of the banana plant. In this study, an automatic measuring device for banana pseudo-stem phenotypic parameters was developed. The device, which integrates three different types of sensors: a laser ranging sensor, a rotary encoder, and a digital camera, was used to obtain the point cloud and image data of banana pseudo-stem. A K-means point clouds clustering algorithm based on Euclidean distance was proposed. The point cloud of banana pseudo-stem was identified and extracted. A three-dimensional reconstruction algorithm based on the ellipse model was also proposed. The three-dimensional contour of the pseudo-stem was calculated to obtain three types of phenotypic parameters: the long axis length, the short axis length, and the perimeter. Further, a synchronous trigger image acquisition mechanism was used to take pictures of pseudo-stems during measurement. It can be utilized for manual assessment of the growth status of the banana. Field experimental results showed that the three banana phenotypic parameters had a high correlation with the manual measurement results, and R2 is always more significant than 0.95, the total average measurement error and relative error were only 6.16 mm and 4.38%, respectively, both are within the acceptable agronomy range. In general, this method has good universality for plant stem detection, and the stem phenotypic parameters can be obtained by means of a non-contact test, which is of great significance to the mechanized cultivation of the forest and fruit industry. Keywords: multi-sensor fusion, point cloud fitting, phenotypic parameter extraction, banana pseudo-stem, ellipse model DOI: 10.25165/j.ijabe.20221503.6614 Citation: Jiang Y L, Duan J L, Xu X, Ding Y H, Li Y, Yang Z. Measurement of the banana pseudo-stem phenotypic parameters based on ellipse model. Int J Agric & Biol Eng, 2022; 15(3): 195–202.

Isolation and reconstruction of cardiac mitochondria from SBEM images using a deep learning-based method

Mitochondrial morphological defects are a common feature of diseased cardiac myocytes. However, quantitative assessment of mitochondrial morphology is limited by the time-consuming manual segmentation of electron micrograph (EM) images. To advance understanding of the relation between morphological defects and dysfunction, an efficient morphological reconstruction method is desired to enable isolation and reconstruction of mitochondria from EM images. We propose a new method for isolating and reconstructing single mitochondria from serial block-face scanning EM (SBEM) images. CDeep3M, a cloud-based deep learning network for EM images, was used to segment mitochondrial interior volumes and boundaries. Post-processing was performed using both the predicted interior volume and exterior boundary to isolate and reconstruct individual mitochondria. Series of SBEM images from two separate cardiac myocytes were processed. The highest F1-score was 95% using 50 training datasets, greater than that for previously reported automated methods and comparable to manual segmentations. Accuracy of separation of individual mitochondria was 80% on a pixel basis. A total of 2315 mitochondria in the two series of SBEM images were evaluated with a mean volume of 0.78 µm3. The volume distribution was very broad and skewed; the most frequent mitochondria were 0.04–0.06 µm3, but mitochondria larger than 2.0 µm3 accounted for more than 10% of the total number. The average short-axis length was 0.47 µm. Primarily longitudinal mitochondria (0–30 degrees) were dominant (54%). This new automated segmentation and separation method can help quantitate mitochondrial morphology and improve understanding of myocyte structure–function relationships.

3D crystal size distributions of pyroxene nanolites from nano X-ray computed tomography: Improved correction of crystal size distributions from CSDCorrections for magma ascent dynamics in conduits

Abstract Groundmass crystals indicate syneruptive magmatic conditions, and thus their crystal size distributions (CSDs) are used to infer magma ascent histories. Three-dimensional (3D) CSDs are most commonly estimated from two-dimensional (2D) observations and plotted against long-axis length, L (hereafter referred to as “L-plot CSDs”). However, L-plot CSDs have two significant problems: the error because of the conversion from 2D to 3D and a lowered sensitivity to changes in the degree of effective undercooling (ΔTeff), which arises because a crystal’s growth rate varies with ΔTeff most strongly along its long dimension. Although these problems can result in false interpretations of magma ascent dynamics, there has been little discussion of the influence of the size criteria on CSDs. In this study, we investigated which 3D size criterion [i.e., long (L), intermediate (I), or short (S) axis length] is optimum for 2D-estimated CSDs of groundmass crystals from two perspectives: (1) conformity with the actual distributions, and (2) the sensitivity of CSD slopes to the magma ascent conditions in the conduit. We observed groundmass pyroxene crystals in pumice clasts from sub-Plinian and Vulcanian eruptive phases during the 2011 eruption of Shinmoedake (andesitic volcano, Japan) by using synchrotron radiation-based X-ray computed nanotomography (SR-XCT) and field-emission scanning electron microscopy (FE-SEM) and rein-vestigated the crystallization kinetics of pyroxene nanolites ranging in width from a few hundred nanometers to 1 µm. The SR-XCT observations provided the detailed 3D shapes and 3D CSDs (CT-CSDs) of these nanolites directly. The FE-SEM observations allowed us to estimate 3D aspect ratios (S:I:L) and CSDs (SEM-CSDs). L-plot SEM-CSDs, acquired using the program CSDCorrections, were used to calculate S-plot SEM-CSDs and I-plot SEM-CSDs. We compared the data from FE-SEM with those from SR-XCT to evaluate the accuracy of 3D aspect ratios and CSDs estimated from 2D data. The L-plot SEM-CSDs from the sub-Plinian pumice sample showed significant inconsistencies with the CTCSD, a result of the difficulty in estimating representative 3D aspect ratios from 2D observations for elongated groundmass crystals. In contrast, the S- and I-plot SEM-CSDs kept the effect of aspect ratio to a minimum and preserved their actual slopes, except for a vertical discrepancy between the CSDs. Moreover, the slopes of S- and I-plot CSDs of the nanolites differed more markedly between the two eruptive styles (by ~20% more) than those of L-plot CSDs. For estimating magma ascent dynamics, we propose that the optimum method for acquiring SEM-CSDs is to measure the cross-sectional widths of crystals and convert the resulting 2D data set into S-plot CSDs. Our new finding that the 3D shapes and CSDs of pyroxene nanolites differ according to eruptive style means that nanolites indicate distinct differences in ascent histories at the shallow conduit: increasing ΔTeff just before sub-Plinian eruptions and decreasing ΔTeff before Vulcanian eruptions. Given the similarity in CSDs of micro-lites, our results suggest that eruptive style was determined in the shallow conduit. Monitoring the condition of the shallow conduit may contribute to predicting the time evolution of eruptive activity.

Specimen number based diagnostic yields of suspicious axillary lymph nodes in core biopsy in breast cancer: clinical implications from a prospective exploratory study.

Ultrasound (US)-guided core needle biopsy (CNB) is widely applied in the pathological diagnosis of suspicious axillary lymph nodes (ALNs) in breast cancer. However, the number of specimens removed during biopsy is currently based on the preference of the individual radiologist. This study aims to analyze the specimen number based diagnostic yields of US guided CNB of suspicious ALNs in breast cancer. Core biopsy specimens of suspicious lymph nodes were prospectively obtained from breast cancer patients treated at our hospital between November, 2018, and July, 2019. Four specimens were obtained from each patient and labeled 1-4 in the order they were removed. Each specimen underwent pathological evaluation to determine whether metastasis had occurred. The diagnostic yields of the specimens were calculated and differences in diagnostic accuracy according to the number of specimens were evaluated by McNemar's test. A total of 167 patients were enrolled, and 139 (83.2%) cases were identified as metastasis by CNB. The diagnostic yields were: 74.2% (specimen 1), 87.8% (specimens 1-2), 91.2% (specimens 1-3), and 94.6% (specimens 1-4). The increases in diagnostic yield from specimen 1 to 1-2 and from specimens 1-2 to 1-4 were significant; however, no significant differences were detected between specimens 1-3 and the first two, or between specimens 1-4 and the first three in this sample size. The lower diagnostic abilities for the first two specimens were associated with shorter long- and short-axis lengths of lymph nodes on US. Although the second specimen contributed significant diagnostic yield of suspicious axillary lymph nodes in core biopsy in breast cancer, a minimum number cannot be determined by this study. Additional specimens may improve diagnostic yield particularly in patients with small nodes.

Quantitation of Poststress Change in Ventricular Morphology Improves Risk Stratification.

Shape index and eccentricity index are measures of left ventricular morphology. Although both measures can be quantified with any stress imaging modality, they are not routinely evaluated during clinical interpretation. We assessed their independent associations with major adverse cardiovascular events (MACE), including measures of poststress change in shape index and eccentricity index. Methods: Patients undergoing SPECT myocardial perfusion imaging between 2009 and 2014 from the Registry of Fast Myocardial Perfusion Imaging with Next-Generation SPECT (REFINE SPECT) were studied. Shape index (ratio between the maximum left ventricular diameter in short axis and ventricular length) and eccentricity index (calculated from orthogonal diameters in short axis and length) were calculated in end-diastole at stress and rest. Multivariable analysis was performed to assess independent associations with MACE (death, nonfatal myocardial infarction, unstable angina, or late revascularization). Results: In total, 14,016 patients with a mean age of 64.3 ± 12.2 y (8,469 [60.4%] male were included. MACE occurred in 2,120 patients during a median follow-up of 4.3 y (interquartile range, 3.4-5.7). Rest, stress, and poststress change in shape and eccentricity indices were associated with MACE in unadjusted analyses (all P < 0.001). However, in multivariable models, only poststress change in shape index (adjusted hazard ratio, 1.38; P < 0.001) and eccentricity index (adjusted hazard ratio, 0.80; P = 0.033) remained associated with MACE. Conclusion: Two novel measures, poststress change in shape index and eccentricity index, were independently associated with MACE and improved risk estimation. Changes in ventricular morphology have important prognostic utility and should be included in patient risk estimation after SPECT myocardial perfusion imaging.

MRI-detected extramural vascular invasion potentiates the risk for pathological metastasis to the lateral lymph nodes in rectal cancer

Multidisciplinary treatment for locally advanced rectal cancer requires an accurate assessment of the risk of metastasis to the lateral lymph nodes (LNs). We herein aimed to stratify the risk of pathological metastasis to lateral LNs based on the preoperatively detected malignant features. All patients with rectal cancer who underwent surgery from January 2016 to July 2020 were identified. We recorded the TNM factors; perirectal and lateral LN sizes; and MRI findings, including mesorectal fascia involvement, extramural vascular invasion (EMVI), tumor site, and tumor distance from the anal verge. 101 patients underwent rectal resection with lateral lymph node dissection, of whom 16 (15.8%) exhibited pathological metastases to the lateral LNs. Univariate analyses demonstrated that lateral LN metastasis was significantly correlated with mrEMVI positivity (p = 0.0023) and a baseline lateral LN short-axis length of ≥ 5mm (p < 0.0001). These significant associations were confirmed by a multivariate analysis (p = 0.0254 and 0.0027, respectively). The lateral LN metastasis rate was as high as 44% in cases bearing both risk factors, compared to 0% in cases lacking both risk factors. The results elucidated in this study may contribute to risk stratification, which can be used when determining the indications for lateral lymph node dissection.

Properties of muscle nodules recognized by manual physical therapy practitioners.

[Purpose] The purpose of this study was to describe the properties of muscle nodules (kinkoketsu) recognized by manual physical therapy practitioners. [Participants and Methods] A total of one hundred and thirty-three physical therapists, occupational therapists, judo therapists, and acupuncturists participated in this study. The shape, size, direction, depth, and hardness of muscle nodules, often treated in the buttocks, were investigated through the completion of a questionnaire. [Results] A total of 124 answer sheets were completed; 112 of these described the shape of muscle nodules as ellipsoidal. Of these 112 sheets, 97 effective sheets were analyzed. The results showed that the mean long axis length, short axis length, and thickness of the muscle nodules were 30.9 mm, 16.2 mm, and 9.3 mm, respectively. The most common responses on the long axis direction, depth, and hardness of the muscle nodules were the craniocaudal orientation, the second shallowest layer of 5 divisions, and the eraser level, respectively. [Conclusion] The typical muscle nodule found in the buttocks by manual physical therapy practitioners is roughly the shape of a large almond.

Evaluation of Axillary Lymph Nodes in Breast Cancer Patients with Atopic Dermatitis

This study assessed the diagnostic accuracy of ultrasound in detecting axillary lymph node metastases in women with breast cancer and atopic dermatitis. We retrospectively reviewed the records of 91 breast cancer patients with a history of atopic dermatitis and compared the dimensions of the lymph nodes on ultrasonographic images of women with and without lymph node metastases diagnosed using histology. Using a major-axis length of ≥5 mm, a short-axis length of ≥5 mm and a cortical thickness of ≥2.3 mm as the criteria for diagnosing axillary lymph node metastases, the specificity was 12.7%, 41.3% and 58.7%, respectively. The low specificity of the ultrasound criteria makes ultrasound unsuitable for diagnosing axillary lymph nodes metastases in breast cancer patients with atopic dermatitis.

Superficial Calcification With Rotund Shape Is Associated With Carotid Plaque Rupture: An Optical Coherence Tomography Study.

Background: Plaque rupture is an important etiology for symptomatic carotid stenosis. The role of calcification in the plaque vulnerability has been controversial. We aimed to detect the geometric features of calcifications in carotid plaque and to examine its association with plaque rupture.Methods: Optical coherence tomography assessment of carotid plaque was performed in 88 patients. Calcification shape was evaluated through quantitative measurements of the long and short axis, area size, circumference, calcification arc, and longitudinal length. Calcification location was analyzed through the distance to the lumen. Furthermore, we developed idealized fluid-structure interaction models to investigate the association of calcification shape and plaque stress.Results: A total of 33 ruptured plaques and 30 non-ruptured plaques were recognized. Ruptured plaques had more multiple calcifications and protruded calcifications. The calcifications in the ruptured plaques displayed a remarkably lower long-axis/short-axis (L/S) ratio than in the non-ruptured plaques (p = 0.001). We classified calcification shape into crescentic calcification (L/S > 2.5) and rotund calcification (L/S ≤ 2.5). Rotund-shaped calcifications were more common in ruptured plaques than in non-ruptured plaques (p = 0.02). Superficial calcifications with minimal distance to the lumen ≤ 50 μm accounted for 79.4% of all calcifications in the ruptured plaques, and only 7.7% in the non-ruptured plaques (p < 0.001). Biomechanical analysis showed that the plaque with rotund-shaped calcification developed 7.91-fold higher von Mises stress than the plaque with crescentic calcification.Conclusions: Superficial calcifications and rotund-shaped calcifications are associated with carotid plaque rupture, suggesting that calcification location and shape may play a key role in plaque vulnerability.