Superficial Structures Research Articles

Ultrasound (US) of the fingers: anatomy and pathology.

The development and evolution of high-frequency probes in current ultrasound systems have enabled us to obtain more detailed information about small and superficial structures, such as the fingers, which are frequently injured in a significant portion of the population (traumatic injuries account for 28% of musculoskeletal system injuries) and can result in substantial disability for affected patients. Due to its superior accessibility, resolution, and ability to perform dynamic studies, ultrasound has become the imaging technique of choice for evaluating these conditions. It covers a range of pathologies, including tendinous, ligamentous, and articular injuries, as well as soft tissue tumors and pseudotumors, which will be described in detail in the main body of the article. However, given the complexity and small size of these structures, along with the necessity for early diagnosis to enable surgical treatment and minimize functional impairment, it is essential to be well-versed in the anatomy, examination techniques, and basic pathologies of the fingers to perform a thorough evaluation and achieve an accurate diagnosis. Therefore, the primary objective of this article is to present this content in a practical and straightforward manner, making it useful not only for radiology professionals but also for other specialists, since ultrasound is the most commonly used imaging method outside of radiology.

Ultrasound nail assessment in patients with psoriasic arthritis: is there an association of findings with clinical scores?

BackgroundPsoriatic arthritis can involve several domains. Due to its multifaceted nature and its frequent comorbidities such as depression, obesity, osteoarthritis and fibromyalgia, it is difficult to monitor these patients because the clinical scores involve subjective data. High-resolution ultrasound probes allowed the evaluation of more superficial structures, such as the nails and their synovio-entheseal framework, in close relationship with the enthesis of the distal extensor digitorum tendon. Nail ultrasound studies vary in terms of the parameters and fingers studied and in their findings.ObjectivesTo describe the most significant sonographic nail changes and the most affected fingers in psoriatic arthritis and to verify the association of nail ultrasound findings with clinical scores (nail psoriasis severity index (NAPSI), ankylosing spondylitis disease activity score with C-reactive protein (ASDAS-CRP), minimal disease activity (MDA), disease activity index for psoriatic arthritis (DAPSA)).MethodsThis was a cross-sectional study with 52 patients with psoriatic arthritis at the Hospital de Clínicas do Paraná and 50 controls. A total of 1016 nails were analyzed (517 from patients with psoriatic arthritis and 499 from controls). Ultrasonography of the nails of the 10 fingers was performed to assess the trilaminar appearance, measure the distance from the nail bed, identify synovitis of the distal interphalangeal joints and the presence of a power Doppler signal from the nail matrix/nail bed. The captured images were independently evaluated by a rheumatologist with expertise in musculoskeletal ultrasound. Data analysis was performed using IBM SPSS Statistics v.28.0.0 software, and the association of nail plate changes, nail bed distance and power Doppler signal with the NAPSI, DAPSA, MDA and ASDAS-PCR were calculated. Spearman correlation coefficients were estimated to analyze the correlations between pairs of quantitative variables. Student’s t test and the Mann‒Whitney U test were used to compare quantitative variables, and Fisher’s exact test was used to compare categorical variables between patients and controls. The nonparametric Mann‒Whitney U and Kruskal‒Wallis tests were used to compare groups according to the MDA or DAPSA classification.ResultsThe Doppler signal of the nail matrix and nail bed was more frequently identified in patients (44.2%) than in controls (6%), and the difference in the mean power Doppler signal between the two groups was significant (p < 0.001). Changes in the nail plate were more common in the right thumb (44.2%), left thumb (36.5%) and second finger on the right hand (32.7%). The number of fingers with nail plate changes, enthesitis, paratendinitis, grayscale synovitis and DIP involvement in the distal interphalangeal joints was higher among patients with psoriatic arthritis (p < 0.001). There were found some correlations between US findings and clinical scores: ultrasound nail involvement and the NAPSI score (p = 0.034), the number of fingers and mean change in the nail plate and the ASDAS-CRP (p = 0.030). DAPSA (remission/low activity versus moderate/high activity) was associated to the mean change in the nail plate (p < 0.013). CONCLUSIONS: Nail ultrasound has the potential to assist in the capturing of the actual disease activity status in patients with psoriatic arthritis.

Evaluation of Axillae Skin Thickness by High-Frequency Ultrasound.

High-frequency ultrasound has been utilized in dermatology to visualize superficial cutaneous structures. Axillae are often target of treatments for hair removal, for spot clearing, and for skin conditions such as hyperhidrosis, bromhidrosis, and hidradenitis. Detailed knowledge of armpit thickness can help improve existing therapies and increase their effectiveness. To describe the mean skin thickness of axillae, by further investigating possible correlations with variations in age, sex, and body mass index (BMI). Axillae were divided into 5 quadrants, 1 central and 4 peripherals. Skin has been assessed by ultrasonography, measuring the distance from epidermis surface to dermal depth, in millimeters, for each of the regions. Thirty healthy patients participated, most of them were female (n = 22; 73%), mean age 50 years (26-70 years). Most patients have maximum thickness in the center of axillae (87%). Average skin thickness in the central region was 3.1 ± 0.4 mm. There was significant difference between axillary thickness in central and peripheral regions (p < .05). On the periphery, the mean thickness was smaller (1.8 mm) without significant variation between the squares. There was no significant variation of skin thickness by sex, age, and BMI. This study shows a difference between thickness of axillae in the central region and in its periphery.

Effect of ultrasonic degradation on the physicochemical characteristics, GLP-1 secretion, and antioxidant capacity of Polygonatum cyrtonema polysaccharide

This study aimed to evaluate the influence of ultrasonic degradation on the physicochemical and biological characteristics of Polygonatum cyrtonema polysaccharide (PCP, 8.59 kDa). PCP was subjected to ultrasonic treatment for 8, 16, and 24 h and yielded the degraded fractions PCP-8, PCP-16, and PCP-24 (5.06, 4.13, and 3.69 kDa), respectively. Compared with the intact PCP, PCP-8, PCP-16 and PCP-24 had a reduced particle size (decrements of 28.03 %, 46.15 % and 62.54 %, respectively). Although ultrasonic degradation did not alter the primary structure of PCP, its triple helical and superficial structures were disrupted, with degraded fractions demonstrating reduced thermal stability and apparent viscosities compared with those of the intact PCP. Furthermore, the functional properties of the degraded fractions were different. PCP-16 most favourably affected GLP-1 secretion, while PCP-8 and PCP-24 exhibited the strongest antioxidant and enzyme inhibitory activities, respectively. Hence, controlled ultrasound irradiation is an appealing approach for partially degrading PCP and enhancing its bioactivity as a functional agent.

Quantifying the contribution of lignin to humic acid structures during composting

The transformation behavior of different types of lignin structure was investigated during composing with particular interest of revealing the contribution rate of lignin functional groups as well as their interaction to humic acids (HA). Rice straws, tree branches, and pine needles were selected as composting materials, because they predominantly contain G-S-H, G-S, and G-type lignin. Results showed that microorganisms were the driving force behind the conversion of lignin into HA. During composting, appeared different levels of cleavage, tearing, and fragmentation on the superficial lignin structures. In depth analysis of lignin transformation, lignin primarily consisted of aromatic groups, CO bonds, alkyl groups, hydroxyl groups and linkage between monomeric units (β-O-4, β-5 and β-β) in the early stage of composting. As lignin degraded, the CO bonds were gradually exposed. But due to their unstable nature, the CO bonds were prone to undergo changes with the cleavage of the aromatic rings at positions 2, 5, and 6 during composting. CO bonds could be converted into aromatic rings, alkyl groups, hydroxyl groups, and CO groups in HA. Through multiple linear regression analysis, it could be concluded that the CO bonds in G-type and S-type monomeric units contributed significantly to the aromatic rings, accounting for 30.4 % and 48.4 %, respectively. The main mechanism might be related to the cleavage of CO bonds and subsequent atomic rearrangement after the release of carbon atoms. This in-depth analysis filled the gap in the mechanism of HA formation during composting.

Contribution of VLF electromagnetic survey to the investigation of Hessdalen lights (Norway)

Hessdalen valley in Norway is known for luminous phenomena suddenly and evenly appearing temporarily. Since several decades, these phenomena are observed by many witnesses, and they are sometimes traced by geophysical devices. The first appearance in modern times was reported in 1981 but systematic observations started during winter of 1984 when the Hessdalen project was launched. Later, Østfold University College led the project and yearly organized one to two field campaigns, with the objective to systematically record and investigate the phenomenon. Till that epoch, detailed tectonics, fault systems and superficial conductive structures remained unknown. Therefore, during the last years, VLF surveys have been performed in Hessdalen valley as part of six geophysical field campaigns which sometimes also included Total Magnetic Field and Self Potential spatial ground measurements. VLF measurements have been carried out on a 20 m average spacing along many traces totaling to100 km length. The entire covered area was about 100 km2.In this paper, we focus on the results of the VLF measurements. Several conductive zones have been found. They are mainly related to mineral deposits (mainly sulfides). The trace at the ground surface of these conductive zones could suggest that they draw an ellipse of 6 by12 km, related to the shape of the gabbro intrusion present in the area and oriented in the SW-NE direction. The results combined with other geophysical data contribute to better understand how the near surface structures (depth less than a few hundred meters) could supply the generation of the so-called Hessdalen lights (‘HL’) and explain why these lights appear inside this valley. The particular geological structure detected in Hessdalen valley may encourage similar campaigns in other areas where similar phenomena are observed.

Microalgal and activated sludge processing for biodegradation of textile dyes

The textile industry contributes substantially to water pollution. To investigate bioremediation of dye-containing wastewater, the decolorization and biotransformation of three textile azo dyes, Red HE8B, Reactive Green 27, and Acid Blue 29, were considered using an integrated remediation approach involving the microalga Chlamydomonas mexicana and activated sludge (ACS). At a 5 mg L−1 dye concentration, using C. mexicana and ACS alone, decolorization percentages of 39%–64% and 52%–54%, respectively, were obtained. In comparison, decolorization percentages of 75%–79% were obtained using a consortium of C. mexicana and ACS. The same trend was observed for the decolorization of dyes at higher concentrations, but the potential for decolorization was low. The toxic azo dyes adversely affect the growth of microalgae and at high concentration 50 mg L−1 the growth rate inhibited to 50–60% as compared to the control. The natural textile wastewater was also treated with the same pattern and got promising results of decolorization (90%). Moreover, the removal of BOD (82%), COD (72%), TN (64%), and TP (63%) was observed with the consortium. The HPLC and GC-MS confirm dye biotransformation, revealing the emergence of new peaks and the generation of multiple metabolites with more superficial structures, such as N-hydroxy-aniline, naphthalene-1-ol, and sodium hydroxy naphthalene. This analysis demonstrates the potential of the C. mexicana and ACS consortium for efficient, eco-friendly bioremediation of textile azo dyes.

The effects of stress ultrasonic rolling on the surface integrity and fatigue properties of TiB2/7050 Al composite

In the present work, a new surface mechanical strengthening (SMS) technique named stress ultrasonic rolling (SUR), which is ultrasonic rolling (UR) assisted with a uniaxial tensile elastic stress field, was reported and successfully conducted on 5 % wt TiB2/7050Al composite. Based on the experimental analysis and numerical simulation, the effects of SUR on surface integrity and fatigue performance of the composite were comprehensively investigated. Compared with ordinary UR, SUR further enhanced the fatigue strength at 106 cycles of the composite by 5 % and prolonged the fatigue life of the composite under the stress level of 532.8 MPa by 1.8 to 3.3 times, which are attributed to the comprehensive effect of excellent surface finish, larger and deeper compressive residual stress (RSc) layer, dispersed TiB2 particles distribution in the surface, and superficial nanocrystalline structures. Besides, the assistance of uniaxial tensile elastic stress field did not increase the amount of surface plastic deformation, which indicates the RSc generated by SUR should have similar mechanical and thermal stability to that produced by ordinary UR treatment.

Improving the quality of computed tomography brain images in the presence of cochlear implant induced metal artefacts through the additional use of tissue mimicking materials alongside metal artefact reduction software

IntroductionMetal artefact reduction software (MAR) can be used to improve Computed Tomography (CT) image quality in the presence of implanted metalwork; however, this software is not effective for superficial metallic structures such as cochlear implants (CI).This study aimed to investigate whether the effectiveness of MAR software could be improved for brain scans with CI present through the use of tissue mimicking materials (TMM) placed exteriorly to the implant. MethodsIn this two-part study, a CI was positioned on the surface of water and anthropomorphic phantoms and imaged using a helical CT brain protocol. Three TMM, Superflab, Sure Thermal heat packs, and Bart's Bolus, were utilised and images were acquired to assess the resulting artefact reduction in terms of CT numbers, noise and artefact index (Aind). Changes in CTDIvol were assessed for the anthropomorphic phantom scans. ResultsIn the water phantom, statistically significant reductions in CT number (p = 0.038) and noise (p = 0.033) were observed for Superflab, whilst the heat packs produced similar significant reductions in CT number (p < 0.001) and noise (p = 0.001) for the anthropomorphic phantom images. Aind values were significantly reduced through the use of Superflab (p = 0.009) and the heat packs (p < 0.001). No significant effects were observed for Bart's Bolus. CTDIvol increases of generally less than 5% were observed for scans with TMM in place. ConclusionThe additional use of TMM alongside MAR software yielded statistically significant reductions in CI induced metal artefacts on both water and anthropomorphic phantom scans with minimal dose increases. Implications for practiceThe extent of metal artefacts in clinical head scans with CI in place could be significantly reduced through combined use of TMM and MAR software, consequently providing greater diagnostic confidence in the images.

Intracerebral Dynamics of Sleep Arousals: A Combined Scalp-Intracranial EEG Study.

As an intrinsic component of sleep architecture, sleep arousals represent an intermediate state between sleep and wakefulness and are important for sleep-wake regulation. They are defined in an all-or-none manner, whereas they actually present a wide range of scalp-electroencephalography (EEG) activity patterns. It is poorly understood how these arousals differ in their mechanisms. Stereo-EEG (SEEG) provides the unique opportunity to record intracranial activities in superficial and deep structures in humans. Using combined polysomnography and SEEG, we quantitatively categorized arousals during nonrapid eye movement sleep into slow wave (SW) and non-SW arousals based on whether they co-occurred with a scalp-EEG SW event. We then investigated their intracranial correlates in up to 26 brain regions from 26 patients (12 females). Across both arousal types, intracranial theta, alpha, sigma, and beta activities increased in up to 25 regions (p < 0.05; d = 0.06-0.63), while gamma and high-frequency (HF) activities decreased in up to 18 regions across the five brain lobes (p < 0.05; d = 0.06-0.44). Intracranial delta power widely increased across five lobes during SW arousals (p < 0.05 in 22 regions; d = 0.10-0.39), while it widely decreased during non-SW arousals (p < 0.05 in 19 regions; d = 0.10-0.30). Despite these main patterns, unique activities were observed locally in some regions such as the hippocampus and middle cingulate cortex, indicating spatial heterogeneity of arousal responses. Our results suggest that non-SW arousals correspond to a higher level of brain activation than SW arousals. The decrease in HF activities could potentially explain the absence of awareness and recollection during arousals.

Fiber-based in vivo imaging: unveiling avenues for exploring mechanisms of synaptic plasticity and neuronal adaptations underlying behavior.

In recent decades, various subfields within neuroscience, spanning molecular, cellular, and systemic dimensions, have significantly advanced our understanding of the elaborate molecular and cellular mechanisms that underpin learning, memory, and adaptive behaviors. There have been notable advancements in imaging techniques, particularly in reaching superficial brain structures. This progress has led to their widespread adoption in numerous laboratories. However, essential physiological and cognitive processes, including sensory integration, emotional modulation of motivated behavior, motor regulation, learning, and memory consolidation, are intricately encoded within deeper brain structures. Hence, visualization techniques such as calcium imaging using miniscopes have gained popularity for studying brain activity in unrestrained animals. Despite its utility, miniscope technology is associated with substantial brain tissue damage caused by gradient refractive index lens implantation. Furthermore, its imaging capabilities are primarily confined to the neuronal somata level, thus constraining a comprehensive exploration of subcellular processes underlying adaptive behaviors. Consequently, the trajectory of neuroscience's future hinges on the development of minimally invasive optical fiber-based endo-microscopes optimized for cellular, subcellular, and molecular imaging within the intricate depths of the brain. In pursuit of this goal, select research groups have invested significant efforts in advancing this technology. In this review, we present a perspective on the potential impact of this innovation on various aspects of neuroscience, enabling the functional exploration of in vivo cellular and subcellular processes that underlie synaptic plasticity and the neuronal adaptations that govern behavior.

Intraoperative Videogrammetry and Photogrammetry for Photorealistic Neurosurgical 3-Dimensional Models Generated Using Operative Microscope: Technical Note.

Intraoperative orientation during microsurgery has a prolonged learning curve among neurosurgical residents. Three-dimensional (3D) understanding of anatomy can be facilitated with realistic 3D anatomic models created from photogrammetry, where a series of 2-dimensional images is converted into a 3D model. This study implements an algorithm that can create photorealistic intraoperative 3D models to exemplify important steps of the operation, operative corridors, and surgical perspectives. We implemented photograph-based and video-based scanning algorithms for uptakes using the operating room (OR) microscope, targeted for superficial structures, after surgical exposure, and deep operative corridors, in cranial microsurgery. The algorithm required between 30-45 photographs (superficial scanning), 45-65 photographs (deep scanning), or approximately 1 minute of video recording of the entire operative field to create a 3D model. A multicenter approach in 3 neurosurgical departments was applied to test reproducibility and refine the method. Twenty-five 3D models were created of some of the most common neurosurgical approaches-frontolateral, pterional, retrosigmoid, frontal, and temporal craniotomy. The 3D models present important steps of the surgical approaches and allow rotation, zooming, and panning of the model, enabling visualization from different surgical perspectives. The superficial and medium depth structures were consistently presented through the 3D models, whereas scanning of the deepest structures presented some technical challenges, which were gradually overcome with refinement of the image capturing process. Intraoperative photogrammetry is an accessible method to create 3D educational material to show complex anatomy and demonstrate concepts of intraoperative orientation. Detailed interactive 3D models, displaying stepwise surgical case-based anatomy, can be used to help understand details of the operative corridor. Further development includes refining or automatization of image acquisition intraoperatively and evaluation of other applications of the resulting 3D models in training and surgical planning.

UoloNet: based on multi-tasking enhanced small target medical segmentation model

In recent years, UNET (Ronneberger et al. 2015) and its derivative models have been widely used in medical image segmentation with more superficial structures and excellent segmentation results. Due to the lack of modeling for the overall characteristics of the target, the division tasks of minor marks will produce some discrete noise points, resulting in a decline in model accuracy and application effects. We propose a multi-tasking medical image analysis model UoloNet, a YOLO-based (Redmon et al. 2016; Shafiee et al. 2017) object detection branch is added based on UNET. The shared learning of the two tasks through semantic segmentation and object detection has promoted the model’s mastery of the overall characteristics of the target. In the reasoning stage, merging the two functions of object detection and semantic segmentation can effectively remove discrete noise points in the division and enhance the accuracy of semantic segmentation. In the future, the object detection task will be the problem of excessive convergence of semantic segmentation tasks. The model uses CIOU (Zheng et al. 2020) losses instead of IOU losses in YOLO, which further improves the model’s overall accuracy. The effectiveness of the proposed model is verified both in the MRI dataset SEHPI, which we posted and in the public dataset LITS (Christ 2017).

Feasibility of 177Lu activity quantification using a small portable CZT-based gamma-camera

BackgroundIn image processing for activity quantification, the end goal is to produce a metric that is independent of the measurement geometry. Photon attenuation needs to be accounted for and can be accomplished utilizing spectral information, avoiding the need of additional image acquisitions. The aim of this work is to investigate the feasibility of 177Lu activity quantification with a small CZT-based hand-held gamma-camera, using such an attenuation correction method.MethodsA previously presented dual photopeak method, based on the differential attenuation for two photon energies, is adapted for the three photopeaks at 55 keV, 113 keV, and 208 keV for 177Lu. The measurement model describes the count rates in each energy window as a function of source depth and activity, accounting for distance-dependent system sensitivity, attenuation, and build-up. Parameter values are estimated from characterizing measurements, and the source depth and activity are obtained by minimizing the difference between measured and modelled count rates. The method is applied and evaluated in phantom measurements, in a clinical setting for superficial lesions in two patients, and in a pre-clinical setting for one human tumour xenograft. Evaluation is made for a LEHR and an MEGP collimator.ResultsFor phantom measurements at clinically relevant depths, the average (and standard deviation) in activity errors are 17% ± 9.6% (LEHR) and 2.9% ± 3.6% (MEGP). For patient measurements, deviations from activity estimates from planar images from a full-sized gamma-camera are 0% ± 21% (LEHR) and 16% ± 18% (MEGP). For mouse measurements, average deviations of − 16% (LEHR) and − 6% (MEGP) are obtained when compared to a small-animal SPECT/CT system. The MEGP collimator appears to be better suited for activity quantification, yielding a smaller variability in activity estimates, whereas the LEHR results are more severely affected by septal penetration.ConclusionsActivity quantification for 177Lu using the hand-held camera is found to be feasible. The readily available nature of the hand-held camera may enable more frequent activity quantification in e.g., superficial structures in patients or in the pre-clinical setting.

Imaging Single-Cell Ca2+ Dynamics of Brainstem Neurons and Glia in Freely Behaving Mice.

In vivo brain imaging, using a combination of genetically encoded Ca2+ indicators and gradient refractive index (GRIN) lens, is a transformative technology that has become an increasingly potent research tool over the last decade. It allows direct visualisation of the dynamic cellular activity of deep brain neurons and glia in conscious animals and avoids the effect of anaesthesia on the network. This technique provides a step change in brain imaging where fibre photometry combines the whole ensemble of cellular activity, and multiphoton microscopy is limited to imaging superficial brain structures either under anaesthesia or in head-restrained conditions. We have refined the intravital imaging technique to image deep brain nuclei in the ventral medulla oblongata, one of the most difficult brain structures to image due to the movement of brainstem structures outside the cranial cavity during free behaviour (head and neck movement), whose targeting requires GRIN lens insertion through the cerebellum-a key structure for balance and movement. Our protocol refines the implantation method of GRIN lenses, giving the best possible approach to image deep extracranial brainstem structures in awake rodents with improved cell rejection/acceptance criteria during analysis. We have recently reported this method for imaging the activity of retrotrapezoid nucleus and raphe neurons to outline their chemosensitive characteristics. This revised method paves the way to image challenging brainstem structures to investigate their role in complex behaviours such as breathing, circulation, sleep, digestion, and swallowing, and could be extended to image and study the role of cerebellum in balance, movement, motor learning, and beyond. Key features • We developed a protocol that allows imaging from brainstem neurons and glia in freely behaving rodents. • Our refined method of GRIN lenses implantation and cell sorting approach gives the highest number of cells with the least postoperative complications. • The revised deep brainstem imaging method paves way to understand complex behaviours such as cardiorespiratory regulation, sleep, swallowing, and digestion. • Our protocol can be implemented to image cerebellar structures to understand their role in key functions such as balance, movement, motor learning, and more.

Outstanding performance of core–shell structured chitosan-sodium alginate decorated ZIF-90 beads for the synchronous purification of Pb and Co from industrial effluents

Efficient elimination of heavy metals contaminations can be extensively concerned by utilizing environmental-friendly adsorbents with pursuing high adsorption capacity and reducing the treatment costs of industrial sewage. Herein, the core–shell structured chitosan/sodium alginate polysaccharide polymers loading zeolite imidazolate framework-90 beads (ZIF-90@CS/SA) were successfully synthesized and analyzed to obtain efficient enrichment performances for Pb and Co. The ZIF-90@CS/SA beads were multifariously characterized through the superficial micropore structures, which included both before and after adsorption performance of Pb and Co from the macroscopical experiments. The optimal weight ratio of chitosan/sodium alginate was chosen 1:2 to prepare ZIF-90@CS/SA beads by drop-method, and then adsorption experiments of Pb and Co were also conducted under various water chemistry conditions. The especial adsorption equilibrium time for the elimination of Pb and Co through the ZIF-90@CS/SA beads was 2.5 h and 3.5 h respectively, which was in accordance with pseudo-second order pattern. The maximal adsorption capacity was respectively 1.24 × 10−3 mol/g for Pb and 1.69 × 10−3 mol/g for Co, which considerably improved in comparison with many previously reported adsorbents. The adsorption mechanisms of ZIF-90@CS/SA beads with Pb and Co were dominated by the surface complexation, ion exchange and electrostatic attraction. According to macroscopical experimental studies, the ZIF-90@CS/SA beads have promising applications in the field of sewage treatment with highly efficient enrichment, advantageous regeneration and purfication of numerous heavy metal contaminants.

Prenatal Ultrasound Diagnosis of Klippel-Trenaunay Syndrome.

Klippel-Trenaunay syndrome (KTS) is a very rare vascular malformation syndrome also referred to as a capillary-lymphatic-venous malformation with unknown aetiology. The aim of our paper is to highlight interesting images, regarding a rare case of foetal Klippel-Trenaunay syndrome diagnosed prenatally in our department and confirmed postnatally with a favourable evolution during the gestation and neonatal periods. This case was diagnosed at 26 weeks gestation and characterised through ultrasound by the presence of superficial multiple cystic structures of different sizes spreading over the left leg with hemihypertrophy and reduced mobility. The cystic lesions were spreading to the left buttock and the pelvic area. The right leg and upper limbs had normal appearance with good mobility. There were no signs of hyperdynamic circulation or foetal anaemia, but mild polyhydramnios was associated. The ultrasound findings were confirmed postnatally, the left leg presented multiple cystic lesions and port wine stains, and there was hypertrophy and fixed position, with favourable evolution at 6 months of life, when the size of the lesions began to decrease and the mobility of the leg improved.

Principles of reconstruction. Like with like and flap thinning: two essential tools

The "like with like" and the "flap thinning" are two workhorse principles the surgeon must keep in mind to achieve a functional and cosmetic reconstruction of the hand. These principles are underpinned by a thorough knowledge of anatomy and functional hand units, with a wide range of reconstructive procedures that must be finalized to the necessity of the impaired structures. "Like with like" means that a lost tissue must be replaced with another one that can be compared in appearance and function. In addition, good cosmetic is often associated with good function because the complex attempt to get a proper aesthetic always traduces itself into a better functional reconstruction. "Flap thinning" is essential because soft tissue injuries of the hand represent a more difficult reconstructive challenge than similar injuries elsewhere, and the need for thin tissue to wrap the superficial noble structures of the hand is constant. However, the procedure of thinning a flap can be dangerous and must adhere to the vascular architecture of the flap. This paper aims to review and briefly summarize the current literature in this field.

Three-sensor 2ω method with multi-directional layout: A general methodology for measuring thermal conductivity of solid materials

Anisotropic thermal transport plays a key role in both theoretical study and engineering practice of heat transfer, but accurately measuring anisotropic thermal conductivity remains a significant challenge. To address this issue, we propose the three-sensor 2ω method in this study, which is capable of accurately measuring the isotropic or anisotropic thermal conductivity of solid materials. In this method, several three-sensor groups following the design guidelines are fabricated upon the sample along different characteristic directions, and each group consists of three parallel metal sensors with unequal widths and distances optimally designed based on sensitivity analysis. Among the three sensors, the outer two serve as AC heaters and the middle one as a DC detector. The 2ω voltage signals across the detector in each three-sensor group are measured, and then the data are processed by the proposed Intersection Method to derive thermal conductivities along directions of interest. The application of the detector's 2ω instead of the heater's 3ω voltage signals eliminates errors introduced by the uncertainties of thermal resistance in superficial structures (metal layer, insulation layer, interface, etc.). Meanwhile, by replacing the fitting algorithm with the Intersection Method, the local optimum trap of multivariate fitting is avoided. To verify the accuracy and reliability, four typical monocrystalline semiconductors, i.e., Si, GaN, AlN, and β-Ga2O3, are measured, and the results are consistent with the literature. This method will provide a comprehensive and versatile solution for the thermal conductivity measurements of solid materials.

Evaluation of the knee joint with ultrasound and magnetic resonance imaging.

The knee joint relies on a combination of deep and superficial structures for stability and function. Both ultrasound and high-resolution magnetic resonance imaging are extremely useful in evaluating these structures and associated pathology. This article reviews a combination of critical anatomic structures, joint abnormalities, and pathologic conditions at the knee joint, while highlighting the merits, limitations, and pitfalls of the two imaging modalities. A clear appreciation of each method paired with its relative strengths will aid in expediting diagnosis and appropriate treatment for a wide range of knee joint conditions.