Short Diameter Research Articles

Intrauterine depression of the skull in a neonate.

A 2716-g singleton boy was born at 38 weeks of gestation via a scheduled cesarean section at another hospital. There was no history of instrumentation or birth trauma during delivery. The patient was presented at our hospital at 0 days of age because of a skull depression on the right side (long diameter, 4 cm; short diameter, 3 cm; and depth, 0.5 cm) at birth. On examination, there was no local tenderness, trauma, or neurological deficit, and computed tomography of the head showed no signs of intracranial injuries or fracture (Figs.

DIAGNOSTIC VALUE OF SONOGRAPHY IN MESENTERIC ADENITIS IN PEADATRIC AGE GROUP AND ITS CLINICAL SIGNIFICANCE.

Background: Acute abdominal pain is one of the most common yet challenging complaints in children, often presenting as a diagnostic dilemma. Most patients with abdominal pain have self-limited conditions.The most common medical cause is mesenteric lymphadenitis and the most common surgical problem is appendicitis. Mesenteric adenitis is usually viral in origin and has self limiting course. Our aim was to establish a criteria for diagnosis of mesenteric adenitis in symptomatic patients. Material and Method; Cross sectional study performed on 130 patients and 100 controls group case. Presence of enlarged lymph nodes of 5 -8mm in the shortest dia Results; meter were noted in 80% (n=64) of the patients and in 78% (n=78) of control group. Enlarged abdominal lymph nodes of 8-10mm mm were detected in 40% (n=32) of the patients and 48% (n=48) of controls. Nodes larger than 10 mm were detected in 30% (n=24) of the patients and 11% (n=11) in controls . Differences between the groups were statistically signicant only for lymph nodes of 10 mm and larger in the shortest diameter (P < 0.05). The absolute Conclusion; generalization of enlarged mesenteric nodes should only be taken clinically signicant in a symptomatic patient with nodes greater than 10 mm in short axis diameter favoring more towards mesenteric lymphadenitis

Prediction of hepatic lymph node metastases based on magnetic resonance imaging before and after preoperative chemotherapy in patients with colorectal liver metastases underwent surgical resection

BackgroundPatients with colorectal liver metastases (CRLM) combined with hepatic lymph node (HLN) metastases have a poor prognosis. In this study, we developed and validated a model using clinical and magnetic resonance imaging (MRI) parameters to predict HLN status before surgery.MethodsA total of 104 CRLM patients undergoing hepatic lymphonodectomy with pathologically confirmed HLN status after preoperative chemotherapy were enrolled in this study. The patients were further divided into a training group (n = 52) and a validation group (n = 52). The apparent diffusion coefficient (ADC) values, including ADCmean and ADCmin of the largest HLN before and after treatment, were measured. rADC was calculated referring to the target liver metastases, spleen, and psoas major muscle (rADC-LM, rADC-SP, rADC-m). In addition, ADC change rate (Δ% ADC) was quantitatively calculated. A multivariate logistic regression model for predicting HLN status in CRLM patients was constructed using the training group and further tested in the validation group.ResultsIn the training cohort, post-ADCmean (P = 0.018) and the short diameter of the largest lymph node after treatment (P = 0.001) were independent predictors for metastatic HLN in CRLM patients. The model’s AUC was 0.859 (95% CI, 0.757-0.961) and 0.767 (95% CI 0.634-0.900) in the training and validation cohorts, respectively. Patients with metastatic HLN showed significantly worse overall survival (p = 0.035) and recurrence-free survival (p = 0.015) than patients with negative HLN.ConclusionsThe developed model using MRI parameters could accurately predict HLN metastases in CRLM patients and could be used to preoperatively assess the HLN status and facilitate surgical treatment decisions in patients with CRLM.

Retinitis pigmentosa and nanophthalmos in a patient with attenuated Hunter's syndrome.

To describe a case of retinitis pigmentosa and nanophthalmos in a patient with attenuated Hunter's syndrome. Fundus photography, total field electroretinogram, ultrasound, computerized visual field examination, biochemical examination and genetic testing were obtained. The fundus exam showed diffuse arteriolar attenuation, optic disc with regular contours, and pigment agglomerates like "bone spicules" in the middle periphery. Ultrasound examination revealed scleral thickening and short axial diameter in both eyes. The total field electroretinogram exam showed a subnormal result with greater impairment of the scotopic phase of the exam. Computerized visual field examination demonstrated a diffuse reduction in retinal sensitivity in the periphery. Biochemical examination showed increased urine glycosaminoglycan excretion and iduronate-2-sulphatase activity (IDS) deficiency in leukocytes, confirming the type II mucopolysaccharidosis. Molecular analysis revealed a novel missense mutation (p.A77D) in the IDS gene. The case report is about a patient presented an attenuated form of the syndrome, with no cognitive impairment. Ophthalmologic follow-up is still an important part of multidisciplinary treatment for Hunter's syndrome.

A conformal TOF-DOI Prism-PET prototype scanner for high-resolution quantitative neuroimaging.

Positron emission tomography (PET) has had a transformative impact on oncological and neurological applications. However, still much of PET's potential remains untapped with limitations primarily driven by low spatial resolution, which severely hampers accurate quantitative PET imaging via the partial volume effect (PVE). We present experimental results of a practical and cost-effective ultra-high resolution brain-dedicated PET scanner, using our depth-encoding Prism-PET detectors arranged along a compact and conformal gantry, showing substantial reduction in PVE and accurate radiotracer uptake quantification in small regions. The decagon-shaped prototype scanner has a long diameter of 38.5cm, a short diameter of 29.1 cm, and an axial field-of-view (FOV) of 25.5mm with a single ring of 40 Prism-PET detector modules. Each module comprises a 16 × 16 array of 1.5 × 1.5 × 20-mm3 lutetium yttrium oxyorthosillicate (LYSO) scintillator crystals coupled 4-to-1 to an 8 × 8 array of silicon photomultiplier (SiPM) pixels on one end and to a prismatoid light guide array on the opposite end. The scanner's performance was evaluated by measuring depth-of-interaction (DOI) resolution, energy resolution, timing resolution, spatial resolution, sensitivity, and image quality of ultra-micro Derenzo and three-dimensional (3D) Hoffman brainphantoms. The full width at half maximum (FWHM) DOI, energy, and timing resolutions of the scanner are 2.85 mm, 12.6%, and 271 ps, respectively. Not considering artifacts due to mechanical misalignment of detector blocks, the intrinsic spatial resolution is 0.89-mm FWHM. Point source images reconstructed with 3D filtered back-projection (FBP) show an average spatial resolution of 1.53-mm FWHM across the entire FOV. The peak absolute sensitivity is 1.2% for an energy window of 400-650 keV. The ultra-micro Derenzo phantom study demonstrates the highest reported spatial resolution performance for a human brain PET scanner with perfect reconstruction of 1.00-mm diameter hot-rods. Reconstructed images of customized Hoffman brain phantoms prove that Prism-PET enables accurate radiotracer uptake quantification in small brain regions (2-3 mm). Prism-PET will substantially strengthen the utility of quantitative PET in neurology for early diagnosis of neurodegenerative diseases, and in neuro-oncology for improved management of both primary and metastatic brain tumors.

Construction of a nomogram model for predicting peritoneal metastasis in gastric cancer: focused on cardiophrenic angle lymph node features

BackgroundA different treatment was used when peritoneal metastases (PM) occurred in patients with gastric cancer (GC). Certain cancers' peritoneal metastasis could be predicted by the cardiophrenic angle lymph node (CALN). This study aimed to establish a predictive model for PM of gastric cancer based on the CALN.MethodsOur center retrospectively analyzed all GC patients between January 2017 and October 2019. Pre-surgery computed tomography (CT) scans were performed on all patients. The clinicopathological and CALN features were recorded. PM risk factors were identified via univariate and multivariate logistic regression analyses. The receiver operator characteristic (ROC) curves were generated using these CALN values. Using the calibration plot, the model fit was assessed. A decision curve analysis (DCA) was conducted to assess the clinical utility.Results126 of 483 (26.1%) patients were confirmed as having peritoneal metastasis. These relevant factors were associated with PM: age, sex, T stage, N stage, enlarged retroperitoneal lymph nodes (ERLN), CALN, the long diameter of the largest CALN (LD of LCALN), the short diameter of the largest CALN (SD of LCALN), and the number of CALNs (N of CALNs). The multivariate analysis illustrated that the LD of LCALN (OR = 2.752, p < 0.001) was PM’s independent risk factor in GC patients. The area under the curve (AUC) of the model was 0.907 (95% CI 0.872–0.941), demonstrating good performance in the predictive value of PM. There is excellent calibration evident from the calibration plot, which is close to the diagonal. The DCA was presented for the nomogram.ConclusionCALN could predict gastric cancer peritoneal metastasis. The model in this study provided a powerful predictive tool for determining PM in GC patients and helping clinicians allocate treatment.

Lymph node stain after radical resection of rectal cancer mainly increased the harvest of mini lymph node: A randomized controlled trial

The lymph node status plays an important role in rectal cancer, which depends on adequate lymph node harvest. Lymph node stain techniques increase the lymph node harvest. The aim of this prospective study is to investigate which subgroups of lymph nodes harvested were increased mostly. From May 2020 to May 2022, 172 stage II-III rectal cancer patients were randomized to methylene blue (MB) stained group or unstained group to retrieve the lymph nodes. Methylene blue solution was injected into the inferior mesenteric artery, we dissected lymph nodes by palpation and sight. The lymph nodes were divided into 3 groups depending on the anatomy (main lymph nodes, superior rectal and perirectal lymph nodes (SPLNs), and pericolic lymph nodes located beyond 10cm proximal to the tumor), and 3 groups depending on the short diameter of the nodes (big: ≥ 5mm, small: 5-2mm, mini: ≤ 2mm). The number of lymph nodes harvested with MB was significantly higher (22.0 (14.8, 32.0) vs 14.5 (11.0, 22.0); p < 0.001) without difference in positive patients or number of positive nodes. The positive rate of the big node was 3.5%, the small node was 1.9%, and the mini node was 0.2%. In the subgroup analysis, the median number of mini lymph nodes in the MB-stained group was significantly more than that of the unstained group (median (IQR): 9.0 (6.0, 14.0) vs 4.0 (2.0,6.0), p < 0.001); and the median number of SPLNs in the MB-stained group were significantly more than that of the unstained group (median (IQR): 15.0 (9.0, 19.0) vs 10.0 (6.0, 13.3), p < 0.001); these differences were existing in both patients with and without neoadjuvant treatments. Intra-arterial injection of MB can significantly increase the number of lymph nodes harvested in rectal cancers, especially those mini lymph nodes. However, methylene blue staining did not significantly increase the number of positive lymph nodes and the proportion of patients with more than 12 lymph nodes, or affect lymph node staging accuracy after radical resection of rectal cancer.

The Chart Diagnostic System Improves the Diagnostic Accuracy of Cervical Lymph Node Metastasis in Oral Squamous Cell Carcinoma

Purpose: To establish a diagnosis method based on imaging findings and histopathological factors associated with cervical lymph node metastasis. Methods: A total of 1587 cervical lymph nodes that were detected using imaging tools in 73 OSCC patients who underwent surgical treatment were enrolled to evaluate the association between imaging findings (long diameter, short diameter, long–short ratio, US findings (hilum and internal echo), contrast effect with enhanced CT, standardized uptake value (SUV) max and SUV average with 18F FDG-Positron Emission Tomography (PET)) and metastatic cervical lymph nodes. In 57 OSCC patients, biopsy specimens were evaluated for histopathologic factors (budding score, lymphatic invasion, vascular invasion, nerve invasion, and YK classification) and the presence of cervical lymph node metastases. Cervical lymph node metastasis was determined based on histopathological examination of the lymph nodes of patients with no metastasis observed 3 years after primary surgery. Results: In total, 22 of the 73 patients had cervical lymph node metastasis pathologically. In the comparison of the presence of metastatic lymph nodes, univariate analysis showed significant differences in cervical lymph node long and short diameter, long/short ratio, internal echo, rim enhancement, SUV max, SUV average, budding score, and vascular invasion. Multivariable analysis showed significant differences in internal echo, rim enhancement, SUV max, and budding score. Conclusions: We propose a chart diagnostic system that combines imaging and histopathological findings to improve the diagnosis of cervical lymph node metastasis.

The usefulness of preoperative CT in colon cancer staging: impact of radiologists' experience.

To assess the agreement between radiologists in the detection of specific features related to T- and N-stage and evaluate accuracy in colon cancer staging. Patients who underwent contrast-enhanced computed tomography (CECT) before surgery were enrolled and evaluated by three radiologists with different experience. Pathological data were used as the reference standard. Tumor location, presence of tumor bulging, fat stranding, lateroconal fascia invasion, enlarged vessels, axial short diameter of the biggest node, shape, enhancement pattern, intranodal necrosis, and cluster were collected. Reliability analysis was performed with κ statistics and intraclass correlation coefficients (ICCs). Logistic regressions were used to determine independent predictors associated with staging. Seventy five patients were evaluated. The reliability analysis was moderateto substantial for tumor location (κ = 0.853), T staging (κ = 0.531), tumor bulging (κ = 0.478), fat stranding (κ = 0.490), lateroconal fascia invasion (κ = 0.436), enlarged vessels (κ = 0.401), the axial short diameter of the biggest node (ICC = 0.732), shape (κ = 0.484), enhancement pattern (κ = 0.431), intranodal necrosis (κ = 0.606), and cluster (κ = 0.358). For all readers, sensitivity was higher for T3 lesions (60-69%) and specificity was higher for T2 and T4 lesions (84.5-90.0% and 82.4-85.1%). The diagnostic accuracy was acceptable for all lesions and among all readers (50.7-92.1%). The lateroconal fascia invasion and enlarged vessels resulted as independent predictor factors (OR = 3.292 and OR = 2.651) for T staging, while nodes' cluster and dimension as independent predictor factors of N staging [OR = 3.798 and OR = 1.083]. Reader's experience is one of the most important factors associated with the correct classification of colon cancer. Moreover, CECT can help depict radiological features independently associated with the T and N stages.

A Novel Wood Log Measurement Combined Mask R-CNN and Stereo Vision Camera

Wood logs need to be measured for size when passing through customs to verify their quantity and volume. Due to the large number of wood logs needs through customs, a fast and accurate measurement method is required. The traditional log measurement methods are inefficient, have significant errors in determining the long and short diameters of the wood, and are difficult to achieve fast measurements in complex wood stacking environments. We use a Mask R-CNN instance segmentation model to detect the contour of the wood log and employ a binocular stereo camera to measure the log diameter. A rotation search algorithm centered on the wood contour is proposed to find long and short diameters and to optimal log size according to the Chinese standard. The experiments show that the Mask R-CNN we trained obtains 0.796 average precision and 0.943 IOUmask, and the recognition rate of wood log ends reaches 98.2%. The average error of the short diameter of the measurement results is 5.7 mm, the average error of the long diameter is 7.19 mm, and the average error of the diameter of the wood is 5.3 mm.

Diagnostic Usefulness of Diffusion-Weighted MRI for Axillary Lymph Node Evaluation in Patients with Breast Cancer.

This study aimed to determine whether apparent diffusion coefficient (ADC) and morphological features on diffusion-weighted MRI (DW-MRI) can discriminate metastatic axillary lymph nodes (ALNs) from benign in patients with breast cancer. Two radiologists measured ADC, long and short diameters, long-to-short diameter ratio, and cortical thickness and assessed eccentric cortical thickening, loss of fatty hilum, irregular margin, asymmetry in shape or number, and rim sign of ALNs on DW-MRI and categorized them into benign or suspicious ALNs. Pathologic reports were used as a reference standard. Statistical analysis was performed using the Mann-Whitney U test and chi-square test. Overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of DW-MRI were calculated. The ADC of metastatic ALNs was 0.905 × 10-3 mm2/s, and that of benign ALNs was 0.991 × 10-3 mm2/s (p = 0.243). All morphologic features showed significant difference between the two groups. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the final categorization on DW-MRI were 77.1%, 93.3%, 79.4%, 92.5%, and 86.2%, respectively. Our results suggest that morphologic evaluation of ALNs on DWI can discriminate metastatic ALNs from benign. The ADC value of metastatic ALNs was lower than that of benign nodes, but the difference was not statistically significant.

Pleistocene subtribe Terminaliinae (Combretaceae) fossils in the middle-lower Uruguay river basin, South America

The El Palmar Formation is a lithostratigraphic unit deposited by the Uruguay River and has an extensive Upper Pleistocene fossil record. The aims of this study are i. to describe in detail three new silicified wood specimens recovered in the Punta Viracho and Santa Ana fossiliferous localities that have the diagnostic features of the Combretaceae, and ii. to add new data to their significance of palaeoenvironmental and phytogeographical implications. Through the study of wood anatomy, the taxonomic identification of fossil woods is carried out. The mesomorphy and the efficiency of the water conduction system in the fossil woods are calculated. The Nearest Living Relatives (NLRs) method by Mosbrugger (1999) based on assemblage taxa is used to obtain paleoenvironmental data. This work provides three new fossil species related to Terminalia sensu lato (Combretaceae) based on fossil wood specimens. Features such as simple perforation plate, short vessel elements, density and diameter of the vessels suggest a strictly mesomorphic structure; where water conductivity efficiency was the predominant condition of these trees. The nearest living relatives of the fossils currently occur in the Atlantic forest in Brazil but are not present in the study area. We conclude that the present-day Atlantic woodland where these species coexist was more widespread in the Upper Pleistocene, reaching higher latitudes to the south (ca. 32° S).

Research Progress in Imaging-based Diagnosis of Benign and Malignant Enlarged Lymph Nodes in Non-small Cell Lung Cancer

Non-small cell lung cancer (NSCLC) can be detected with enlarged lymph nodes on imaging, but their benignity and malignancy are difficult to determine directly, making it difficult to stage the tumor and design radiotherapy target volumes. The clinical diagnosis of malignant lymph nodes is often based on the short diameter of lymph nodes ≥1 cm or the maximum standard uptake value ≥2.5, but the sensitivity and specificity of these criteria are too low to meet the clinical needs. In recent years, many advances have been made in diagnosing benign and malignant lymph nodes using other imaging parameters, and with the development of radiomics, deep learning and other technologies, models of mining the image information of enlarged lymph node regions further improve the diagnostic accuracy. The purpose of this paper is to review recent advances in imaging-based diagnosis of benign and malignant enlarged lymph nodes in NSCLC for more accurate and noninvasive assessment of lymph node status in clinical practice. .

Semiautomated pelvic lymph node treatment response evaluation for patients with advanced prostate cancer: based on MET-RADS-P guidelines

BackgroundThe evaluation of treatment response according to METastasis Reporting and Data System for Prostate Cancer (MET-RADS-P) criteria is an important but time-consuming task for patients with advanced prostate cancer (APC). A deep learning-based algorithm has the potential to assist with this assessment.ObjectiveTo develop and evaluate a deep learning-based algorithm for semiautomated treatment response assessment of pelvic lymph nodes.MethodsA total of 162 patients who had undergone at least two scans for follow-up assessment after APC metastasis treatment were enrolled. A previously reported deep learning model was used to perform automated segmentation of pelvic lymph nodes. The performance of the deep learning algorithm was evaluated using the Dice similarity coefficient (DSC) and volumetric similarity (VS). The consistency of the short diameter measurement with the radiologist was evaluated using Bland–Altman plotting. Based on the segmentation of lymph nodes, the treatment response was assessed automatically with a rule-based program according to the MET-RADS-P criteria. Kappa statistics were used to assess the accuracy and consistency of the treatment response assessment by the deep learning model and two radiologists [attending radiologist (R1) and fellow radiologist (R2)].ResultsThe mean DSC and VS of the pelvic lymph node segmentation were 0.82 ± 0.09 and 0.88 ± 0.12, respectively. Bland–Altman plotting showed that most of the lymph node measurements were within the upper and lower limits of agreement (LOA). The accuracies of automated segmentation-based assessment were 0.92 (95% CI: 0.85–0.96), 0.91 (95% CI: 0.86–0.95) and 75% (95% CI: 0.46–0.92) for target lesions, nontarget lesions and nonpathological lesions, respectively. The consistency of treatment response assessment based on automated segmentation and manual segmentation was excellent for target lesions [K value: 0.92 (0.86–0.98)], good for nontarget lesions [0.82 (0.74–0.90)] and moderate for nonpathological lesions [0.71 (0.50–0.92)].ConclusionThe deep learning-based semiautomated algorithm showed high accuracy for the treatment response assessment of pelvic lymph nodes and demonstrated comparable performance with radiologists.

High accuracy gender determination using the egg shape index

Since only female chicks are used in layer hens, usually hatched male chicks are killed. It is estimated that around 7 billion chicks per year are killed immediately after hatching. In addition to being unethical, this situation also causes great financial losses. Sex determination in chicks can be done before or after hatching. Of course, determinations made before hatching are more advantageous, but the prediction rate is relatively low. The morphology of an egg is expressed in terms of the Shape Index (SI), which is the ratio of the short diameter to the long diameter. In this study, male and female chicks were predicted by using the shape index of the eggs using the RUSBoost Classifier using Shape Index. Although SI varied according to the egg type, a significant correlation (r = 0.78) was observed between chick sex and SI. Therefore, it was possible to estimate gender by utilizing SI in chickens, even if the accuracy of classification was not as high as in ducks. Besides the SI, mass, short axis, long axis, ovality, volume, eccentricity parameters were obtained and used for the results. With this features, females classified with 80% and males classified 81% correctly. The model predictions were applied to the probability of female chick hatching equation from the previous studies, 71% of the estimations were correctly classified according to this equation.With this work, around 80% of accurate predictions were made. In this case, killing 5.65 billion chicks can be prevented. Likewise, many eggs are not wasted. 1.13 billion USD loss can be prevented.

Induction Immune Checkpoint Inhibitors and Chemotherapy Before Definitive Chemoradiation Therapy for Patients With Bulky Unresectable Stage III Non-Small Cell Lung Cancer

In the era of immunotherapy, the treatment for bulky, locally advanced non-small cell lung cancer (LA-NSCLC) remains challenging. This study explored the feasibility of induction immune checkpoint inhibitors (ICIs) plus chemotherapy before definitive chemoradiation therapy (CRT) for bulky LA-NSCLC. Patients with bulky, unresectable stage III NSCLC (primary tumor ≥5 cm in greatest dimension or metastatic lymph nodes ≥2 cm in shortest diameter) receiving ICIs and chemotherapy before CRT from 2018 to 2022 were identified. Survival outcomes and toxic effects were analyzed. Radiation therapy plans on computed tomography images before and after 2 cycles of induction chemoimmunotherapy were simulated to evaluate dosimetric outcomes. Seventy-five patients were included. One- and 2-year overall-survival (OS) rates were 91.5% (95% CI, 85.2%-98.3%) and 75.1% (95% CI, 64.1%-88.0%), respectively. One- and 2-year progression-free-survival (PFS) rates were 85.8% (95% CI, 78.0%-94.4%) and 64.2% (95% CI, 52.5%-78.6%), respectively. Median OS was not reached (NR). Median PFS was 30.6 months (95% CI, 25.9 months to NR). Grade 2 and ≥3 pneumonitis occurred in 26.7% and 9.3% of patients, respectively. Grade ≥3 pneumonitis was significantly associated with poorer OS (P=.003) and PFS (P=.018). Treatment discontinuation was significantly associated with shorter OS (P=.023) and PFS (P=.047). Patients with consolidation ICIs exhibited numerically better OS than those without consolidation ICIs (2-year OS, 85.8% vs 64.2%; P=.170). The objective response rate was 76.1% for induction treatment and 86.7% for induction treatment plus CRT. The disease control rate after 2 cycles of induction therapy was significantly greater than after 4 (P=.046) or more cycles (P=.025). Simulated radiation plans indicated that all target volumes, mean lung dose, and volume of lung parenchyma receiving ≥5 Gy, ≥20 Gy, and ≥30 Gy significantly decreased after 2 cycles (all P < .005). Two cycles of induction ICIs plus chemotherapy before definitive CRT were feasible for bulky LA-NSCLC, with significant tumor reduction and normal lung protection. Further investigations on CRT combined with induction and consolidation ICIs are warranted.

Delineation of the lacrimal vein: a magnetic resonance imaging study.

To our knowledge, anatomical knowledge about the lacrimal vein (LV) is missed. Therefore, this retrospective study aimed to explore them using magnetic resonance imaging (MRI). Eighty-one patients who underwent contrast-enhanced MRI and three donated bodies to science were enrolled. On the sagittal images, the measured mean right long (LD) and short diameters (SD) of the lacrimal gland (LG) were 17.3 ± 2.4 mm and 13.7 ± 2.1 mm, while the left LD and SD were 17.0 ± 2.6 mm and 13.6 ± 2.6 mm, respectively. Laterality or sex differences were not found in the LD and SD groups. In addition, no specific age range was associated with a significantly longer LD or SD. LVs were identified in 94% of axial images. Their course was classified into as follows: three types: connecting to the superolateral cavernous sinus (CS), to the superior ophthalmic vein (SOV), and the diploic channels of the greater wing of the sphenoid bone (DCGW). The CS type was the most frequently identified, followed by the SOV and DCGW types. In dissected specimens, the LVs consistently coursed between the posterior margin of the LG and the superolateral part of the CS, above the upper margin of the lateral rectus muscle. The LV may consistently emerge from the upper posterior margin of the LG. It commonly pours into the SOV or superolateral part of the CS.

Large distal tear of aortic dissection

BACKGROUND: The traditional treatment for aortic dissections (ADs) is a proximal repair of AD, but the long-term prognosis of residual distal dissection is unsatisfactory. The distal aortic intimal tear of distal aortic segmental enlargement (DASE) is evaluated via its size, with risk assessment, and assessed its risk, which will provide clinicians with diagnosis and treatment direction. METHODS: We analyzed 419 ADs patients who underwent radiographic examination of the aorta between September 1999 and May 2014. We recorded the area of the aortic intimal tear and divided it into two groups (75 patients in DASE group and 344 patients in non-DASE group). Logistics regression analysis or natural logarithm transformation was used to explore the potential risk of remaining distal tears to DASE, while the Logistic multiple regress equations were used to find out the independent risk factors. RESULTS: The postoperative large tear was defined as short diameter ≥5.0 mm. The independent risk factors of DASE are as follows: Short diameter of postoperative tears (odds ratios [ORs], 1.10;95% confidence interval [CI], 1.02–1.19; P &lt; 0.0120); short diameter of the first tear after operation (OR, 1.12; 95% CI, 1.00–1.26; P &lt; 0.0580) and the existence of large tears (OR, 1.13; 95% CI, 1.01–1.26; P &lt; 0.0298). CONCLUSIONS: Our findings suggest that the size of the remaining tears and the existence of large tears are the key risk factors for patients with DASE. Patients with large remaining tears should be supervised regularly and treated timely.

Validation of Ultrasound and Computed Tomography-Based Risk Stratification System and Biopsy Criteria for Cervical Lymph Nodes in Preoperative Patients With Thyroid Cancer.

This study aimed to validate the risk stratification system (RSS) and biopsy criteria for cervical lymph nodes (LNs) proposed by the Korean Society of Thyroid Radiology (KSThR). This retrospective study included a consecutive series of preoperative patients with thyroid cancer who underwent LN biopsy, ultrasound (US), and computed tomography (CT) between December 2006 and June 2015. LNs were categorized as probably benign, indeterminate, or suspicious according to the current US- and CT-based RSS and the size thresholds for cervical LN biopsy as suggested by the KSThR. The diagnostic performance and unnecessary biopsy rates were calculated. A total of 277 LNs (53.1% metastatic) in 228 patients (mean age ± standard deviation, 47.4 years ± 14) were analyzed. In US, the malignancy risks were significantly different among the three categories (all P < 0.001); however, CT-detected probably benign and indeterminate LNs showed similarly low malignancy risks (P = 0.468). The combined US + CT criteria stratified the malignancy risks among the three categories (all P < 0.001) and reduced the proportion of indeterminate LNs (from 20.6% to 14.4%) and the malignancy risk in the indeterminate LNs (from 31.6% to 12.5%) compared with US alone. In all image-based classifications, nodal size did not affect the malignancy risks (short diameter [SD] ≤ 5 mm LNs vs. SD > 5 mm LNs, P ≥ 0.177). The criteria covering only suspicious LNs showed higher specificity and lower unnecessary biopsy rates than the current criteria, while maintaining sensitivity in all imaging modalities. Integrative evaluation of US and CT helps in reducing the proportion of indeterminate LNs and the malignancy risk among them. Nodal size did not affect the malignancy risk of LNs, and the addition of indeterminate LNs to biopsy candidates did not have an advantage in detecting LN metastases in all imaging modalities.

Fault-Tolerant Routing With Load Balancing in LeTQ Networks

With the increasing scale of parallel computer interconnection network, the possibility of processor failure or link failure between processors in the network is also increasing. In the design of supercomputers, not only link overhead and communication delay should be taken into account, but also fault-tolerant performance of networks should be emphasized. Locally exchanged twisted cube ( <inline-formula><tex-math notation="LaTeX">$LeTQ$</tex-math></inline-formula> ) is a newly proposed interconnection network with lower link overhead and shorter diameter. With the increasing scale of supercomputers, fault-tolerant routing is indispensable. In this article, we propose a new load balancing fault-tolerant routing algorithm based on node contraction for <inline-formula><tex-math notation="LaTeX">$LeTQ$</tex-math></inline-formula> networks. The proposed algorithm uses the node shrinkage method to evaluate the priority of nodes. The sending node adaptively adjusts the probability of forwarding packets to the neighbor node according to the priority of the neighbor node and the state of the network. The path can be adapted to the load state of the network. The simulation results show that the fault-tolerant routing algorithm has good performance in throughput and delay.