Transverse Diameter Research Articles

Nutritional and phytochemical composition of the red tamarillo grown in Taiwan

This study aims to examine the physicochemical qualities and components of the peel, pulp, mucilage, seed, and whole fruit of the tamarillo. The average longitudinal diameter, transverse diameter, and weight of tamarillo fruits were 4.64–5.59 cm, 3.48–3.84 cm, and 30.24–39.23 g, respectively. The proportions of peel, pulp, mucilage, and seed in the whole fruit were 5.72%, 64.57%, 22.02%, and 7.69%, respectively. Moreover, tamarillo was rich in ascorbic acid, potassium, chlorogenic acid, and anthocyanins but low in fat and sodium. The peel contained the highest amounts of ascorbic acid and potassium, which were 73 and 923 mg/100 g fresh weight, respectively. Moreover, the peel had the highest total phenols and total carotenoids, and the mucilage had the highest total anthocyanins among the different parts of the tamarillo. Similarly, individual hydroxycinnamoyl derivatives and carotenoids were higher in peel, and anthocyanins were higher in mucilage. The proportion of each component and nutrient was diverse among the different parts of the tamarillo. Overall, tamarillo contains an abundance of nutrients, and some of the components have a positive effect on metabolic syndrome and related diseases. There is value in the tamarillo being further developed into functional foods or supplements.

A new method to predict venous complications in pediatric liver transplantation: Evaluation of splenic parameters by ultrasonography.

Venous complications after pediatric liver transplantation seriously affect the survival rate of patients and grafts. At present, the diagnostic indicators have not been unified. Venous complications may cause portal hypertension, which may lead to splenomegaly and splenic vein dilatation. Therefore, the changes in spleen may be closely related to the venous complications. The purpose of this study was to explore the relationship between ultrasonic splenic parameters and venous complications and to study whether these splenic parameters can be used for the diagnosis of venous complications. We retrospectively included pediatric patients who underwent liver transplantation and collected ultrasonic spleen parameters before, and then 1-3 days, 1-3 weeks, 1-3 months, and 4-12 months after liver transplantation. We observed whether there were portal vein or hepatic vein complications within 1 year after liver transplantation. Among 109 pediatric patients after liver transplantation included in our study, 11 of them suffered from portal vein complications and nine hepatic vein complications. Spleen transverse diameter, spleen longitudinal diameter, spleen portal vein diameter, spleen index, spleen transverse diameter ratio, spleen longitudinal diameter ratio, and spleen index ratio were independent risk factors of venous complications. The accuracy of spleen transverse diameter (AUROC: 0.73), spleen index (AUROC: 0.70), spleen transverse diameter ratio (AUROC: 0.71), and spleen index ratio (AUROC: 0.72) in predicting venous complications were higher than other ones. Ultrasonic examination is a common follow-up method for pediatric patients after liver transplantation and the application of ultrasonic spleen parameters may be helpful to monitor venous complications.

Renal calculus composition analysis using dual-energy CT: a prospective observational study

BackgroundTo analyze preoperatively the composition of renal calculi using dual-energy computed tomography (DECT) and compare it with reference standard biochemical stone analysis.MethodsEighty-one participants who were diagnosed with renal calculi underwent DECT at 80 kVp and 140 kVp. Spectral analysis was performed, and the energy map generated was used to classify the calculus based on available preset data. Average Hounsfield units (HU) were calculated for the two energy levels, and ratio of HU was derived (DE ratio) and calculus was categorized into different stone compositions. Hounsfield units of each calculus was measured at 120 kVp standard dose CT, and Hounsfield density (HU/largest transverse diameter) was derived. Comparison of results of spectral analysis and DE ratio was done and correlated with the biochemical laboratory analysis as reference standard wherever available.ResultsSpectral analysis and CT prediction of stone were performed for all 81 patients. CT prediction of stone based on DE ratio into “uric acid,” “struvite,” “calcium oxalate” and “calcium carbonate apatite” was performed. Assessment of stone composition by biochemical analysis was done for 65 patients who eventually underwent PCNL for stone extraction.Both DE ratio and spectral analysis were able to differentiate calculus into various types based on composition with statistically significant p values. However, spectral analysis proved to be marginally better in renal stone characterization particularly for mixed stones. The DE ratio for uric acid stones was derived as 0.9–1.1, 0.9–2.3 for mixed stones and 1.0–2.4 for calcium stones.ConclusionsSpectral analysis promises a practical approach to predicting calculus composition preoperatively, thereby avoiding unnecessary surgical intervention.

Accuracy of orthodontic movements with 3D printed aligners: A prospective observational pilot study.

Owing to the availability of 3D software, scanners, and printers, clinicians are encouraged to produce in-office aligners. Recently, a new directprinting resin (Tera Harz TC-85DAC) has been introduced. Studies on its mechanical characteristics and biological effects have been published; however, evidence on its efficacy in orthodontic treatment remains scarce. This pilot study aimed to investigate the accuracy of teeth movement achieved with directprinted aligners. Seventeen patients (eight males and nine females) with a mean age of 27.67 ± 8.95 years, presenting with dental rotations < 30° and spaces/crowding < 5 mm, were recruited for this study. The teeth movement was planned starting from a T0 digital dental cast. The 3D direct-printed aligners were produced using Tera Harz TC-85DAC resin. Once the orthodontic treatment was completed, a final digital cast was obtained (T1). The planned teeth positions were then superimposed onto the T0 and T1 digital models. The differences between the programmed movements and the achieved overall torque, tip, rotation, and transverse dimensions were assessed using the paired t test or Wilcoxon's signed rank test. The overall accuracies for torque, tip, and rotation were 67.6%, 64.2%, and 72.0%, respectively. The accuracy of the change in transverse diameter was 99.6%. Within the limits of the present pilot study (difficulties with abnormally shaped teeth and use of attachments), it can be concluded that 3D printed aligners can be successfully printed in-house and utilized for mildly crowded cases, with a comparable accuracy of tooth movement to that of other aligners.

A preliminary study on the normal values of the thoracic Haller index in children.

The Haller index (HI) is widely utilized as a quantitative indicator to assess the extent of the pectus excavatum (PE) deformity, which is the most common chest wall abnormality in children. Both preoperative correction planning and postoperative follow-up need to be based on the standard of normal thoracic growth and development. However, there is currently no established reference range for the HI in children. Consequently, the goal of this study was to conduct a preliminary investigation of normal HI values among children to understand thoracic developmental characteristics. Chest computed tomography images obtained from January 2012 to March 2022 were randomly selected from the imaging system of the Children's Hospital of Chongqing Medical University. We divided the images of children into a total of 19 groups: aged 0-3 months (1 group), 4-12 months (1 group) and 1 year to 17 years (17 groups), with 50 males and 50 females, totaling 100 children in each group. HI was measured in the plane where the lowest point of the anterior thoracic wall was located and statistically analysed using SPSS 26.0 software. A total of 1900 patients were included in the study. Our results showed that HI, transverse diameter and anterior-posterior diameter were positively correlated with age (P < 0.05). Using age as the independent variable and HI as the dependent variable, the best-fit regression equations were HI-male = 2.047 * Age0.054(R2 = 0.276, P<0.0001) and HI-female = 2.045 * Age0.067(R2 = 0.398, P<0.0001). Males had significantly larger thoracic diameters than females, and there was little difference in the HI between the 2 sexes. The HI rapidly increases during the neonatal period, slowly increases during infancy and stops increasing during puberty, with no significant differences between the sexes.

Correlation of age with the size of subcortical nuclei of the brain and its implication in degenerative disease: A magnetic resonance imaging study.

Aging is a non-modifiable risk factor for neurodegenerative disease. It is well established that the brain undergoes physiological atrophy with age. So, this study was conducted to analyse the correlation between the age of the person and the size of the various subcortical nuclei of the brain and whether these measurements can serve as a useful indicator for physiological atrophy leading to degenerative disease in clinical practice. A total of 600 MRI scans from healthy individuals were examined and the measurements of subcortical nuclei were taken and subsequently analysed. A statistically significant difference between the genders was observed in the sizes of the axial diameters of caudate nucleus, putamen and globus pallidus. Caudate nucleus transverse diameter showed a moderate negative correlation with age in males. Globus pallidus axial diameter with age showed weak positive correlation for males. Globus pallidus transverse diameter showed weak positive correlation with age for both males and females, but it was stronger for males compared to females. These results will help neurologists and neurosurgeons in analysing various early degenerative diseases and treat them accordingly.

Anthropometric and bioimpedansometric predictors of postoperative complications in patients with gastric and cardioesophageal junction cancers

BACKGROUND: Among the most common intra-abdominal complications of surgical treatment of gastric and cardioesophageal junction cancers are acute postoperative pancreatitis and abdominal abscesses.&#x0D; AIM: Identification and study of anthropometric and bioimpedansometric predictors of the complicated course of the postoperative period in patients with gastric and cardioesophageal junction cancers.&#x0D; MATERIAL AND METHODS: 250 patients with gastric and cardioesophageal junction cancers, 123 men and 127 women, were examined. All subjects underwent radical surgical treatment. In the postoperative period, postoperative complications were recorded in 40 patients. All subjects underwent anthropometric and bioimpedance examination. Height and body weight, transverse diameter of the chest, width of the shoulders and pelvis, waist and hip circumference, and body morphotype were determined. Bioimpedansometric examination was carried out before surgery and in the postoperative period using a domestic hardware and software complex with determination of the body component composition and the phase angle value. The phase angle of impedance reflected the metabolic rate in the body. The results were statistically processed using descriptive statistics methods. The Shapiro–Francia, Kolmogorov–Smirnov tests, Student's t-test, Mann–Whitney test, and the logistic regression method were used. Differences were considered statistically significant at p 0.05.&#x0D; RESULTS: Women of the gynecomorphic body type were characterized by a significant decrease in the relative values of active cellular and skeletal muscle mass (p=0.001; p=0.001), and the phase angle value until 12–14 days after surgery (p=0.001). Men of the andromorphic body type were characterized by a significant decrease in the relative values of active cell mass (p=0.001) and the phase angle until 12–14 days after surgery (p=0.001). In women of a gynecomorphic morphotype, the likelihood of postoperative complications was 4 times higher than in women of an andromorphic morphotype (p=0.001). Representatives of the mesomorphic body morphotype of both sexes were characterized by stable bioimpedance measurements during the entire postoperative period.&#x0D; CONCLUSION: Low values of the phase angle in men and women, as well as the classic gynecomorphic body type in women can be used in oncoabdominal surgery as predictors of a high risk postoperative complications developing in patients with gastric and cardioesophageal junction cancers.

CONTRIBUTION OF CT ANGIOS IN THE DIAGNOSIS OF SUBRENAL ABDOMINAL AORTA ANEURYSM AT THE LUXEMBOURG MOTHER-CHILD HOSPITAL CENTER

Objective: Our study aimed to study the value of CT angiography in the diagnosis of subrenal abdominal aortic aneurysm at the Mother-Child University Hospital Center Le Luxembourg Methodology : This was a retrospective, descriptive and analytical study carried out over a period of three years (from January 1, 2019 to December 31, 2021) in the radiology departments of CHME Mère et Enfant Le Luxembourg. It concerned all patients who had an angio-CT scan in the radiology department of the CHU-ME Le Luxembourg in whom a subrenal abdominal aortic aneurysm was diagnosed. Excluded from our study were aneurysms of the thoracic aorta and vessels of the neck as well as the limbs. Results : We retained 22 cases of AAA meeting our inclusion criteria. The male gender was the majority (66.7%) with a sex ratio (M/F) of 1.5. The most represented age group was those over 50 with 66.7%. Hypertension was the most represented risk factor with a rate of 33.3%. Abdominal pain was the most frequent functional sign with 77.77%. More than 66.7% of our patients had an abdominal mass. The majority of our patients had a saccular type of aneurysm (67%). The average anteroposterior diameter of the AAA was 56 mm. The average transverse diameter was 63 mm. The average length of the aneurysm was 77 mm. All our patients had heterogeneous aneurysm contents with mural thrombus. The edge of the aneurysm was irregular with loss of parallelism in all our patients. More than half (55.6%) of our patients had aortic calcifications. Only one of our patients presented with fissure syndrome. 33.3% of our patients had the sign of extension to the renal arteries. The majority of our patients had visceral branch patency with a rate of 88.9%. The biological assessment was dominated by anemia with a rate of 44.4%. The echocardium was pathological in 11.1%. Conclusion: Abdominal aortic aneurysms are becoming more and more common. More than 90% of abdominal aortic aneurysms develop at the expense of the infrarenal aorta. The most common vascular risk factors are hypertension and smoking. Aneurysms are generally asymptomatic, making their clinical diagnosis difficult. CT angiography remains the complementary examination of choice in the diagnosis of thoraco-abdominal arterial lesions.

Simple pelvimetry predicts the pelvic manipulation time in robot-assisted low and ultra-low anterior resection for rectal cancer.

This study explored the difficulty factors in robot-assisted low and ultra-low anterior resection, focusing on simple measurements of the pelvic anatomy. This was a retrospective analysis of the clinical data of 61 patients who underwent robot-assisted low and ultra-low anterior resection for rectal cancer between October 2018 and April 2023. The relationship between the operative time in the pelvic phase and clinicopathological data, especially pelvic anatomical parameters measured on X-ray and computed tomography (CT), was evaluated. The operative time in the pelvic phase was defined as the time between mobilization from the sacral promontory and rectal resection. Robot-assisted low and ultra-low anterior resections were performed in 32 and 29 patients, respectively. The median operative time in the pelvic phase was 126 (range, 31-332)min. A multiple linear regression analysis showed that a short distance from the anal verge to the lower edge of the cancer, a narrow area comprising the iliopectineal line, short anteroposterior and transverse pelvic diameters, and a small angle of the pelvic mesorectum were associated with a prolonged operative time in the pelvic phase. Simple pelvic anatomical measurements using abdominal radiography and CT may predict the pelvic manipulation time in robot-assisted surgery for rectal cancer.

INTERMASTOID DISTANCE OF THE HUMAN SKULL: PATTERNS OF INDIVIDUAL VARIABILITY

Sexual dimorphism of the mastoid processes of the temporal bones, namely their linear dimensions, size and shape, and the distance between them, are used in research aimed at determining the gender of the skulls. The distance between the mastoid processes is measured either as intermastoidale distance, or as the intermastoid lateral surface distance, IMLSD. Both indicators aff ect the determination of the sex of skulls better than linear dimensions. At the same time, in previous studies of gender diff erences in the intermastoid distance, the relationships between intermastoid distance and morphometric indicators characterizing the size of the skull were not taken into account. The purpose of the study: to establish the patterns of individual variability of the intermastoid lateral surface distance, namely, its relationship with the variability of the width of the skull base, the distance between asterions and the width of the cerebral cranium (transverse diameter of the skull). The study was conducted on 50 skulls (33 male and 17 female) from the craniological collection of the Department of Human Anatomy of KhNM U.It was established that the intermastoid lateral surface distance in men is signifi cantly greater than in women (M±: 127,4±5,6 and 118,5±3,5, respectively; p&lt;0,05). This is explained by the larger size of the male skull compared to the female one and the peculiarities of the somatotypes of male and female organisms. In men, there are statistical relationships between the intermastoid lateral surface distance, on the one hand, and the width of the skull base (y=0.6x+56.5; r=0.6), the distance between asterions (y=0.5x+67.3; r=0.6), the transverse diameter of the skull (y=0.4x+72.3; r=0.4), on the other hand, are noticeable and statistically signifi cant (p&lt;0.05), while in women they are much smaller (respectively, y=0.3x+87.6; r=0.3; y=0.3x+84.9; r=0.2; p&lt;0.05; and y=0.4x+61.6; r=0.3, p&gt;0.05). The shape of the skull does not aff ect the distance between the mastoid processes, both in men and in women.

Helmet therapy efficacy and its prediction in Japanese infants with positional plagio- and brachycephaly.

To provide additional information on optimal start times and therapeutic effectiveness based on treatment outcome of Japanese infants with positional plagio- and brachycephaly (PPB) receiving cranial molding helmet therapy (CMHT). In this retrospective cohort study, data from a 3D head scanning system was analyzed from 2173 Japanese infants who completed CMHT. Anterior and posterior symmetry ratio (ASR and PSR) and longitudinal to transverse diagonal ratios (LD/TDR) were calculated based on skull shape at helmet design and at completion of therapy. The outcomes were evaluated using the regression analysis and a predictive model using cranial parameters was developed. The earlier the start of therapy, the greater the therapeutic effect on ASR, PSR, and LD/TDR (ASR, -0.134 percent points (ppt)/day; PSR, -0.086 ppt/day; and LD/TDR, -0.131 ppt/day). In the predictive model, in addition to starting age of the therapy, sex (male), the degree of deformity of the head (DoD) (moderate and severe), quadrant volume, PSR, and head circumference at the start of treatment also had a positive effect on changes in ASR, DoD (moderate and severe), ASR, LD/TDR and transverse diameter for PSR, sex (male), DoD (moderate), quadrant volume, PSR, and head circumference for LD/TDR. The starting age of therapy had a relatively smaller contribution to outcome effects. Applying the cranial parameter obtained at the start of treatment to the predictive model helps to predict the effect of CMHT and whether PPB can be treated with CMHT in infants of older age.

The development of chicken cerebellar cortex and the determination of AgNOR activity of the Purkinje cell nuclei

In this study, the embryonic and post-hatching development of the chicken cerebellar cortex, and the number, size and area of the silver-staining nucleolus-organizer regions (AgNORs) were determined in cerebellar Purkinje cells in layer-hen (Babcock-B380) embryos and chickens. The mean transverse diameter of the Purkinje cells and their nuclei, and the mean area of the Purkinje cell nucleus and AgNOR area increased during the entire experimental period. The mean ratio of the AgNOR area to the Purkinje cell nucleus area reached its highest value at the 15th day of incubation. There was no difference between the mean AgNOR numbers per nucleus. These findings provide reference data for future studies in this and related research topics, for example for establishing AgNOR parameters and we also hope that our data will be supplemented with other techniques such as PCNA and TUNEL in the near future.

Profound Morphometric Analysis of Acetabulum in South Indian Population (Acetabular dimensions)

Aim- Acetabular dimensions plays a challenging role in various arthroplasties and reconstructions. Morphometric study of acetabulum of dry hip bones is a necessity to make proper prosthesis and to ensure good quality of life. Materials &amp; methods - In this 71 dry human hip bones of 35 right and 36 left collected in department of anatomy of Chettinad Hospital and Research Institute, to analyze &amp; measure the diameter, acetabular notch, acetabular circumference, depth and volume of acetabulum. Results – The transverse diameter on right- 49.33 ± 7.36 mm, left 48.57±6.79 mm, depth-right23.28±3.27 mm, left 22.50 ±3.18 mm, vertical diameter- right 48.05±4.40 mm, left 47.66±4.95 mm, acetabular notch- right 22.00±3.28 mm, left 20.56±2.61 mm, outer rim circumference -right 11.90±0.99 cm, left 12.43±0.87 cm, inner rim circumference- right 7.66±0.84 cm, left 8.06±0.72 cm, acetabular circumference- right 15.26±1.38 cm, left 14.60±1.35 cm, capacity- right 27.22±5.43 ml, left-27.22±5.77 ml. Conclusion - All the parameters were statistically analysed and the results suggest that the acetabular dimensions are mostly smaller in South Indian population and hip prosthesis should be made patient specific to increase the success rate of arthroplasties.

Assessment of hiatus defect size in hiatal hernia patients using computed tomography

Objectives: The aim of this study is to investigate the hiatus defect diameter by measuring on multi-detector computed tomography images in hiatal hernia patients. Methods: The multi-detector computed tomography images of 50 patients and 50 individuals in control group included in this study were investigated. The hiatus surface area (cm²), hiatus antero-posterior and transverse diameters (cm), and the thickness of both diaphragmatic crura (mm) were measured by reformatting contrast-enhanced thoraco-abdomino-pelvic computed tomography images using the region of interest method. Results: In this study, a significant difference was obtained among groups according to hiatus surface area, hiatus antero-posterior, and transverse diameter measurements, and both left and right diaphragmatic crural thickness measurements (P&amp;lt;0.001). In the patient group, the cut-off values were determined by using ROC analysis, and the values above these cut-off values enabled a hernia diagnosis with high sensitivity and specificity. Conclusions: Measuring the hiatus surface area on multi-detector computed tomography images could serve as a supplementary criterion for diagnosing of hiatal hernia.

Thoracic Biometry in Patients with Congenital Diaphragmatic Hernia, a Magnetic Resonance Imaging Study.

This is a retrospective study investigating biometric measurements using magnetic resonance imaging (MRI) examinations in congenital diaphragmatic hernia (CDH). CDH is one of the more common causes of pulmonary hypoplasia, with grave consequences for the fetus. Inclusion criteria were patients diagnosed with CDH as the only observed anomaly, who underwent MRI examination after the second-trimester morphology ultrasound. The patients came from three university hospitals in Bucharest, Romania. In total, 19 patients were included in the study after applying exclusion criteria. Comparing the observed values of the thoracic transverse diameter, the thoracic anterior-posterior diameter, the thoracic circumference, the thoracic area, and the thoracic volume with values from the literature, we observed a predictive alteration of these parameters, with most showing Gaussian distribution. We observed statistical significance for most of our correlations, except between the observed and expected thoracic anterior-posterior diameters and the observed and expected thoracic volume values. This is very helpful when complex studies that can calculate the pulmonary volume cannot be obtained, as in the case of movement artifacts, and allows the clinicians to better assess the severity of the disease. MRI follow-up in CDH cases is a necessity, as it offers the most accurate thoracic biometry.

Study on sex differences and potential clinical value of three-dimensional computerized tomography pelvimetry in rectal cancer patients.

Laparoscopic rectal cancer radical surgery is a complex procedure affected by various factors. However, the existing literature lacks standardized parameters for the pelvic region and soft tissues, which hampers the establishment of consistent conclusions. To comprehensively assess 16 pelvic and 7 soft tissue parameters through computerized tomography (CT)-based three-dimensional (3D) reconstruction, providing a strong theoretical basis to address challenges in laparoscopic rectal cancer radical surgery. We analyzed data from 218 patients who underwent radical laparoscopic surgery for rectal cancer, and utilized CT data for 3D pelvic reconstruction. Specific anatomical points were carefully marked and measured using advanced 3D modeling software. To analyze the pelvic and soft tissue parameters, we employed statistical methods including paired sample t-tests, Wilcoxon rank-sum tests, and correlation analysis. The investigation highlighted significant sex disparities in 14 pelvic bone parameters and 3 soft tissue parameters. Males demonstrated larger measurements in pelvic depth and overall curvature, smaller measurements in pelvic width, a larger mesorectal fat area, and a larger anterior-posterior abdominal diameter. By contrast, females exhibited wider pelvises, shallower depth, smaller overall curvature, and an increased amount of subcutaneous fat tissue. However, there were no significant sex differences observed in certain parameters such as sacral curvature height, superior pubococcygeal diameter, rectal area, visceral fat area, waist circumference, and transverse abdominal diameter. The reconstruction of 3D CT data enabled accurate pelvic measurements, revealing significant sex differences in both pelvic and soft tissue parameters. This study design offer potential in predicting surgical difficulties and creating personalized surgical plans for male rectal cancer patients with a potentially "difficult pelvis", ultimately improving surgical outcomes. Further research and utilization of these parameters could lead to enhanced surgical methods and patient care in laparoscopic rectal cancer radical surgery.

The Size Differences of Breast Cancer and Benign Tumors Measured by Two-Dimensional Ultrasound and Contrast-Enhanced Ultrasound.

Ultrasound (US) imaging has been observed to underestimate tumor size in clinical practice. This study aims to compare the size measurements of breast cancer and benign tumors using two-dimensional ultrasound (2DUS) and contrast-enhanced ultrasound (CEUS). The study included 42 clinically confirmed breast cancer and 47 benign breast tumors. Two experienced physicians independently measured the maximal longitudinal and transverse diameters of the masses in 2DUS and CEUS. All analyses were performed in R (4.2.2) and GraphPad Prism 6. The maximal longitudinal and transverse diameters of breast cancer measured by CEUS were 26.61 ± 0.21% and 26.24 ± 0.19% larger compared with 2DUS, and benign breast tumors had an 11.74 ± 0.21% and 11.06 ± 0.14% increase in size compared with 2DUS. The area under the curve (AUC) of the receiver operating characteristic curve (ROC) for the difference between 2DUS and CEUS was 0.870 for longitudinal diameters (95% CI: 0.795-0.945, sensitivity 0.842, specificity 0.783, threshold value 0.215), and 0.863 for transverse diameters (95% CI: 0.785-0.942, sensitivity 0.667, specificity 0.936, threshold value 0.203). The size measurements of both breast cancer and benign tumors were larger in CEUS compared with 2DUS, with CEUS measurements of breast cancer being more pronounced than those of benign breast tumors. These findings suggest that CEUS may provide a more precise assessment of tumor size, which is crucial for determining optimal treatment strategies and improving patient outcomes in breast cancer management.

A pilot observation using ultrasonography and vowel articulation to investigate the influence of suspected obstructive sleep apnea on upper airway

Failure to employ suitable measures before administering full anesthesia to patients with obstructive sleep apnea (OSA) who are undergoing surgery may lead to developing complications after surgery. Therefore, it is very important to screen OSA before performing a surgery, which is currently done by subjective questionnaires such as STOP-Bang, Berlin scores. These questionnaires have 10–36% specificity in detecting sleep apnea, along with no information given on anatomy of upper airway, which is important for intubation. To address these challenges, we performed a pilot study to understand the utility of ultrasonography and vowel articulation in screening OSA. Our objective was to investigate the influence of OSA risk factors in vowel articulation through ultrasonography and acoustic features analysis. To accomplish this, we recruited 18 individuals with no risk of OSA and 13 individuals with high risk of OSA and asked them to utter vowels, such as /a/ (as in “Sah”), /e/ (as in “See”). An expert ultra-sonographer measured the parasagittal anterior–posterior (PAP) and transverse diameter of the upper airway. From the recorded vowel sounds, we extracted 106 features, including power, pitch, formant, and Mel frequency cepstral coefficients (MFCC). We analyzed the variation of the PAP diameters and vowel features from "See: /i/" to "Sah /a/" between control and OSA groups by two-way repeated measures ANOVA. We found that, there was a variation of upper airway diameter from “See” to “Sah” was significantly smaller in OSA group than control group (OSA: ∆12.8 ± 5.3 mm vs. control: ∆22.5 ± 3.9 mm OSA, p < 0.01). Moreover, we found several vowel features showed the exact same or opposite trend as PAP diameter variation, which led us to build a machine learning model to estimate PAP diameter from vowel features. We found a correlation coefficient of 0.75 between the estimated and measured PAP diameter after applying four estimation models and combining their output with a random forest model, which showed the feasibility of using acoustic features of vowel sounds to monitor upper airway diameter. Overall, this study has proven the concept that ultrasonography and vowel sounds analysis may be useful as an easily accessible imaging tool of upper airway.

An Evaluation of Variations in the Carpal Tunnel Dimensions of Adult Subjects in a Hospital-Based Population: An Ultrasonographic Cross-Sectional Study.

Background The carpal tunnel is a groove that spans the palm as a 'U.' The ulnar and radial sides of the wrist are made up of the scaphoid tubercle and trapezium while the palmar aspect is made up of carpal bones. Our study aimed to see whether there were differences in carpal tunnel size between men and women. Material and methods The study was conducted on 65 healthy adults, 13 (20%) were males and 52 (80%) were females (both non-pregnant and pregnant). Inclusion criteria were healthy adults and bilaterally symmetrical limbs. Exclusion criteria were chronic disease, diabetes, hypertension, immunological disorders, any visible abnormalities, and a history of upper extremity pain on either side. A high-resolution ultrasound machine with a linear transducer was used to perform an ultrasound scan of the carpal tunnel. The anteroposterior dimension was measured at the midline, or along the axis of the middle finger, and the transverse diameter was measured at the midpoint of the flexor retinaculum. The cross-sectional area of the tunnel was measured at its largest diameter within the carpal tunnel. All the dimensions were measured in centimeters. Results The mean transverse diameter of the right side was 1.824 ± 0.223 cm (p-value 0.002) and of the left side was 1.742 ± 0.197 cm (p-value 0.004). The mean cross-sectionalarea of the carpal tunnel on the right side was 1.417 ± 0.379 cm2 (p-value 0.008) and on the left side was 1.306 ± 0.303 cm2(p-value 0.004), respectively. Age, sex, weight, and BMI were discussed. The carpal tunnels of females were found to be comparatively squarer and smaller than those of males. Conclusion The transverse diameter and cross-sectional area of the carpal tunnel and their correlation with carpal tunnel syndromeare predicted by age, sex, weight, and BMI. Both sexes had the same wrist ratio.

Evaluating growth patterns of abdominal aortic aneurysms among women

ObjectiveThough initially protected from vessel dilation by estrogen, women may experience rapid abdominal aortic aneurysm (AAA) growth post-menopause. The rate of growth has been poorly defined in prior literature. Here, we describe aneurysm growth in a cohort of women found through an AAA screening program. MethodsWomen with AAAs were retrospectively identified. Aortic imaging was reviewed, and measurements of maximum transverse and anterior-posterior diameters were completed. Growth was stratified by the type of aortic pathology (fusiform aneurysm, aortic ectasia, dissection with aneurysmal degeneration, saccular aneurysm) as well as size category (<3 cm, 3.0-3.9 cm, 4.0-4.9 cm, ≥5.0 cm) at diagnosis. ResultsA cohort of 488 women was identified; 286 had multiple scans for review. The mean age of the entire cohort was 75 ± 9.9 years. Stratified by type of pathology, the mean age was 76 ± 8.9 years in patients with a fusiform AAA, 74 ± 9.8 years in ectasia, 65 ± 13.7 years in dissection, and 76 ± 5.6 years in saccular aneurysms. The maximum growth was highest in women with fusiform AAAs, followed by dissection, ectasia, and saccular pathology (9.7 mm, 7.0 mm, 3.0 mm, and 2.2 mm, respectively; P < .001). Comparing mean growth by year, the highest mean growth was in fusiform AAAs (3.6 mm vs 1.75 mm in dissection; P < .001). The Shapiro-Wilk test demonstrated that mean growth per year was non-normally distributed with a right skew. Stratified by aortic diameter at the time of diagnosis, mean growth/year increased with increasing size at diagnosis in fusiform AAAs and dissection (0.91 mm for <3 cm, 2.34 mm for 3.0-3.9 cm, 2.49 mm for 4.0-4.9 mm, and 6.16 mm for ≥5.0 cm in patients with fusiform AAAs vs 0.57 mm, 0.94 mm, 1.87 mm, and 2.66 mm, respectively, for patients with dissection). Smoking history was associated with a higher mean growth/year (2.6 mm vs 3.3 mm; P < .001). Conversely, patients with a family history of AAA had a lower mean growth/year (3.2 mm vs 1.5 mm; P < .001). ConclusionsThe rate of aneurysm growth in women varies based on pathology and aneurysm size, and women experience rapid aneurysm growth at sizes greater than 4.5 cm. Current screening guidelines are inadequate, and our results demonstrate that the rate of growth of fusiform aneurysms in women is faster than in men at a smaller size and may warrant more frequent surveillance than current Society for Vascular Surgery recommendations to prevent risk of increased morbidity.